Editors' note: Disruption of the ascending arousal network in acute traumatic disorders of consciousness

Abstract

In “Disruption of the ascending arousal network in acute traumatic disorders of consciousness,” Snider et al. compared ascending arousal network (AAn) connectivity seen on high-angular-resolution diffusion imaging in patients with traumatic coma to normal controls and found reduced AAn pathway integrity in patients with traumatic coma. Machado commented that consciousness requires some preservation of the AAn pathway and proposed the need to assess the AAn pathway in brain dead patients as a means to assess for awareness. Edlow and Snider responded that it is unknown how much of the AAn pathway must be intact to facilitate consciousness and advised against using AAn connectivity as a means to assess for consciousness. Furthermore, they noted that assessing AAn connectivity may be beneficial for patients with disorders of consciousness, but they do not consider this technique applicable to patients who are brain dead. In “Disruption of the ascending arousal network in acute traumatic disorders of consciousness,” Snider et al. compared ascending arousal network (AAn) connectivity seen on high-angular-resolution diffusion imaging in patients with traumatic coma to normal controls and found reduced AAn pathway integrity in patients with traumatic coma. Machado commented that consciousness requires some preservation of the AAn pathway and proposed the need to assess the AAn pathway in brain dead patients as a means to assess for awareness. Edlow and Snider responded that it is unknown how much of the AAn pathway must be intact to facilitate consciousness and advised against using AAn connectivity as a means to assess for consciousness. Furthermore, they noted that assessing AAn connectivity may be beneficial for patients with disorders of consciousness, but they do not consider this technique applicable to patients who are brain dead.