Abstract
Dr. Machado's comments on our article1 raise important neuroscientific and clinical issues pertaining to patients with disorders of consciousness. From a neuroscientific perspective, the relationship between mesopontine connectivity and consciousness remains unclear. Specifically, it is unknown which and how many mesopontine connections are needed to support consciousness.2 In patients with severe brain injuries, partial preservation of these connections may be insufficient to generate arousal (i.e., the comatose state) or may be sufficient for arousal but not awareness (i.e., the vegetative state).3 Until the field of ascending arousal network (AAn) connectivity mapping has matured, we caution against using AAn structural connectivity phenotypes to make inferences about the presence or absence of consciousness.
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