{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,19]],"date-time":"2026-06-19T17:57:38Z","timestamp":1781891858373,"version":"3.54.5"},"reference-count":37,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T00:00:00Z","timestamp":1781568000000},"content-version":"vor","delay-in-days":166,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000066","name":"Neuro-aCSis Bonn Neuroscience Clinician Scientist Programme","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000066","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001659","name":"Deutsche Forschungsgemeinschaft","doi-asserted-by":"publisher","award":["493623632"],"award-info":[{"award-number":["493623632"]}],"id":[{"id":"10.13039\/501100001659","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Bonner Forschungsf\u00f6rderung"},{"DOI":"10.13039\/501100021729","name":"Medical Faculty of the University of Bonn","doi-asserted-by":"publisher","award":["2015-6-08"],"award-info":[{"award-number":["2015-6-08"]}],"id":[{"id":"10.13039\/501100021729","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100021729","name":"Medical Faculty of the University of Bonn","doi-asserted-by":"publisher","award":["2022-1A-21"],"award-info":[{"award-number":["2022-1A-21"]}],"id":[{"id":"10.13039\/501100021729","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004937","name":"German Ministry for Research, Technology and Space","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100004937","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,5,5]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Hemispherotomy is a surgical intervention for severe drug-resistant epilepsy that fully disconnects the lesional brain hemisphere from the rest of the nervous system. This creates a rare opportunity to explore whether consciousness can be sustained without external input. The default-mode network, linked to introspective mental activity, is considered a necessary, though not sufficient, condition for consciousness. In this prospective case-control study, resting-state functional MRI data from 26 individuals post-hemispherotomy and 24 healthy controls were analysed. Default-mode network activity was assessed using seed-to-voxel correlations based on the peak activity in the precuneus of controls, delineated by group independent component analysis. In connected hemispheres, typical default-mode network patterns were preserved and did not differ significantly from controls. Isolated hemispheres also showed preserved positive default-mode network connectivity, though negative connectivity was significantly reduced compared to controls. In two patients with both pre- and post-surgical scans, the individual default-mode network remained detectable but was divided between the isolated and connected hemispheres. These findings suggest that default-mode network activity persists in isolated hemispheres, meeting a necessary condition for consciousness. However, the presence of default-mode network activity alone does not confirm conscious awareness, encouraging further investigation into the neural correlates of consciousness in isolated hemispheres.<\/jats:p>","DOI":"10.1093\/braincomms\/fcag211","type":"journal-article","created":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T12:20:11Z","timestamp":1781612411000},"source":"Crossref","is-referenced-by-count":0,"title":["Default-mode network activity is retained in the isolated hemisphere of people after hemispherotomy"],"prefix":"10.1093","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0555-6214","authenticated-orcid":false,"given":"Tobias","family":"Bauer","sequence":"first","affiliation":[{"name":"Department of Neuroradiology, University Hospital Bonn , Bonn 53127 ,","place":["Germany"]},{"name":"Department of Epileptology, University Hospital Bonn , Bonn 53127 ,","place":["Germany"]},{"name":"German Center for Neurodegenerative Diseases (DZNE) , Bonn 53127 ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charlotte","family":"Gauvry","sequence":"additional","affiliation":[{"name":"International Center for Philosophy, University of Bonn , Bonn 53113 ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sebastian","family":"Markett","sequence":"additional","affiliation":[{"name":"Department of Psychology, Humboldt University Berlin , Berlin 10117 ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Kreter-Sch\u00f6nleber","sequence":"additional","affiliation":[{"name":"Department of General Psychiatry, Heidelberg University Hospital , Heidelberg 69120 ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valeri","family":"Borger","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University Hospital Bonn , Bonn 53127 ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hartmut","family":"Vatter","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University Hospital Bonn , Bonn 53127 ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6041-9661","authenticated-orcid":false,"given":"Josemir W","family":"Sander","sequence":"additional","affiliation":[{"name":"Department of Clinical & Experimental Epilepsy, UCL Queen Square Institute of Neurology , London WC1N 3BG ,","place":["UK"]},{"name":"Chalfont Centre for Epilepsy , Chalfont St Peter SL9 0RJ ,","place":["UK"]},{"name":"Department of Neurology, West China Hospital, Sichuan University , Chengdu 610041 ,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Markus","family":"Gabriel","sequence":"additional","affiliation":[{"name":"International Center for Philosophy, University of Bonn , Bonn 53113 ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander","family":"Radbruch","sequence":"additional","affiliation":[{"name":"Department of Neuroradiology, University Hospital Bonn , Bonn 53127 ,","place":["Germany"]},{"name":"German Center for Neurodegenerative Diseases (DZNE) , Bonn 53127 ,","place":["Germany"]},{"name":"Center for Medical Data Usability and Translation, University of Bonn , Bonn 53113 ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rainer","family":"Surges","sequence":"additional","affiliation":[{"name":"Department of Epileptology, University Hospital Bonn , Bonn 53127 ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6180-7671","authenticated-orcid":false,"given":"Theodor","family":"R\u00fcber","sequence":"additional","affiliation":[{"name":"Department of Neuroradiology, University Hospital Bonn , Bonn 53127 ,","place":["Germany"]},{"name":"Department of Epileptology, University Hospital Bonn , Bonn 53127 ,","place":["Germany"]},{"name":"German Center for Neurodegenerative Diseases (DZNE) , Bonn 53127 ,","place":["Germany"]},{"name":"Center for Medical Data Usability and Translation, University of Bonn , Bonn 53113 ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,6,16]]},"reference":[{"issue":"8","key":"2026061913462613000_fcag211-B1","doi-asserted-by":"crossref","first-page":"960","DOI":"10.1007\/s00381-006-0131-6","article-title":"Transsylvian functional hemispherectomy","volume":"22","author":"Binder","year":"2006","journal-title":"Childs Nerv Syst"},{"issue":"2 Suppl 1","key":"2026061913462613000_fcag211-B2","first-page":"ONS19","article-title":"Vertical parasagittal hemispherotomy: Surgical procedures and clinical long-term outcomes in a population of 83 children","volume":"60","author":"Delalande","year":"2007","journal-title":"Neurosurgery"},{"issue":"3","key":"2026061913462613000_fcag211-B3","doi-asserted-by":"crossref","DOI":"10.3171\/FOC\/2008\/25\/9\/E14","article-title":"Hemispherotomy and other disconnective techniques","volume":"25","author":"De Ribaupierre","year":"2008","journal-title":"Neurosurg Focus"},{"issue":"3","key":"2026061913462613000_fcag211-B4","doi-asserted-by":"crossref","first-page":"155","DOI":"10.1016\/S0387-7604(02)00010-4","article-title":"Postoperative development of children after hemispherotomy","volume":"24","author":"Maehara","year":"2002","journal-title":"Brain Dev"},{"issue":"2","key":"2026061913462613000_fcag211-B5","doi-asserted-by":"crossref","first-page":"71","DOI":"10.1017\/S0317167100044668","article-title":"Hemispherectomy for seizures revisited","volume":"10","author":"Rasmussen","year":"1983","journal-title":"Can J Neurol Sci"},{"issue":"8","key":"2026061913462613000_fcag211-B6","doi-asserted-by":"crossref","first-page":"967","DOI":"10.1007\/s00381-006-0134-3","article-title":"Peri-insular hemispherotomy in paediatric epilepsy","volume":"22","author":"Villemure","year":"2006","journal-title":"Childs Nerv Syst"},{"issue":"1","key":"2026061913462613000_fcag211-B7","doi-asserted-by":"crossref","first-page":"6","DOI":"10.1016\/j.tins.2019.11.003","article-title":"Are there islands of awareness?","volume":"43","author":"Bayne","year":"2020","journal-title":"Trends Neurosci"},{"key":"2026061913462613000_fcag211-B8","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1111\/j.1533-6077.2010.00176.x","article-title":"Introspective humility","volume":"20","author":"Bayne","year":"2010","journal-title":"Philosophical Issues"},{"issue":"1\u20132","key":"2026061913462613000_fcag211-B9","doi-asserted-by":"crossref","first-page":"56","DOI":"10.1002\/hbm.460020107","article-title":"Functional and effective connectivity in neuroimaging: A synthesis","volume":"2","author":"Friston","year":"1994","journal-title":"Hum Brain Mapp"},{"issue":"9","key":"2026061913462613000_fcag211-B10","doi-asserted-by":"crossref","first-page":"700","DOI":"10.1038\/nrn2201","article-title":"Spontaneous fluctuations in brain activity observed with functional magnetic resonance imaging","volume":"8","author":"Fox","year":"2007","journal-title":"Nat Rev Neurosci"},{"issue":"3","key":"2026061913462613000_fcag211-B11","doi-asserted-by":"crossref","first-page":"1125","DOI":"10.1152\/jn.00338.2011","article-title":"The organization of the human cerebral cortex estimated by intrinsic functional connectivity","volume":"106","author":"Yeo","year":"2011","journal-title":"J Neurophysiol"},{"issue":"44","key":"2026061913462613000_fcag211-B12","doi-asserted-by":"crossref","first-page":"12574","DOI":"10.1073\/pnas.1608282113","article-title":"Situating the default-mode network along a principal gradient of macroscale cortical organization","volume":"113","author":"Margulies","year":"2016","journal-title":"Proc Natl Acad Sci U S A"},{"issue":"2","key":"2026061913462613000_fcag211-B13","doi-asserted-by":"crossref","first-page":"1137","DOI":"10.1016\/j.neuroimage.2011.10.035","article-title":"The serendipitous discovery of the brain\u2019s default network","volume":"62","author":"Buckner","year":"2012","journal-title":"Neuroimage"},{"key":"2026061913462613000_fcag211-B14","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1196\/annals.1440.011","article-title":"The brain\u2019s default network: Anatomy, function, and relevance to disease","volume":"1124","author":"Buckner","year":"2008","journal-title":"Ann N Y Acad Sci"},{"issue":"2","key":"2026061913462613000_fcag211-B15","doi-asserted-by":"crossref","first-page":"676","DOI":"10.1073\/pnas.98.2.676","article-title":"A default mode of brain function","volume":"98","author":"Raichle","year":"2001","journal-title":"Proc Natl Acad Sci U S A"},{"issue":"3","key":"2026061913462613000_fcag211-B16","doi-asserted-by":"crossref","first-page":"335","DOI":"10.1002\/ana.23635","article-title":"A role for the default mode network in the bases of disorders of consciousness","volume":"72","author":"Fern\u00e1ndez-Espejo","year":"2012","journal-title":"Ann Neurol"},{"issue":"5","key":"2026061913462613000_fcag211-B17","doi-asserted-by":"crossref","first-page":"841","DOI":"10.1002\/ana.24634","article-title":"Multimodal study of default-mode network integrity in disorders of consciousness","volume":"79","author":"Rosazza","year":"2016","journal-title":"Ann Neurol"},{"issue":"Pt 9","key":"2026061913462613000_fcag211-B18","doi-asserted-by":"crossref","first-page":"2619","DOI":"10.1093\/brain\/awv169","article-title":"Intrinsic functional connectivity differentiates minimally conscious from unresponsive patients","volume":"138","author":"Demertzi","year":"2015","journal-title":"Brain"},{"issue":"8","key":"2026061913462613000_fcag211-B19","doi-asserted-by":"crossref","first-page":"830","DOI":"10.1016\/S1474-4422(16)00111-3","article-title":"Neural correlates of consciousness in patients who have emerged from a minimally conscious state: A cross-sectional multimodal imaging study","volume":"15","author":"Di Perri","year":"2016","journal-title":"Lancet Neurol"},{"key":"2026061913462613000_fcag211-B20","volume-title":"Hamburg-Wechsler-intelligenztest F\u00fcr erwachsene-revision (HAWIE-R)","author":"Tewes","year":"1991"},{"key":"2026061913462613000_fcag211-B21","volume-title":"HAWIK-III Hamburg-Wechsler-Intelligenztest F\u00fcr Kinder","author":"Tewes","year":"2000"},{"issue":"1","key":"2026061913462613000_fcag211-B22","doi-asserted-by":"crossref","first-page":"160044","DOI":"10.1038\/sdata.2016.44","article-title":"The brain imaging data structure, a format for organizing and describing outputs of neuroimaging experiments","volume":"3","author":"Gorgolewski","year":"2016","journal-title":"Sci Data"},{"issue":"1","key":"2026061913462613000_fcag211-B23","doi-asserted-by":"crossref","first-page":"111","DOI":"10.1038\/s41592-018-0235-4","article-title":"fMRIPrep: A robust preprocessing pipeline for functional MRI","volume":"16","author":"Esteban","year":"2019","journal-title":"Nat Methods"},{"issue":"Supplement 1","key":"2026061913462613000_fcag211-B24","doi-asserted-by":"crossref","first-page":"S102","DOI":"10.1016\/S1053-8119(09)70884-5","article-title":"Unbiased nonlinear average age-appropriate brain templates from birth to adulthood","volume":"47","author":"Fonov","year":"2009","journal-title":"NeuroImage"},{"key":"2026061913462613000_fcag211-B25","doi-asserted-by":"crossref","unstructured":"Varoquaux G, Sadaghiani S, Pinel P, Kleinschmidt A, Poline JB, Thirion B. A group model for stable multi-subject ICA on fMRI datasets. Neuroimage. 2010;51(1):288\u2013299.","DOI":"10.1016\/j.neuroimage.2010.02.010"},{"issue":"1","key":"2026061913462613000_fcag211-B26","doi-asserted-by":"crossref","first-page":"83","DOI":"10.1016\/j.neuroimage.2008.03.061","article-title":"Threshold-free cluster enhancement: Addressing problems of smoothing, threshold dependence and localisation in cluster inference","volume":"44","author":"Smith","year":"2009","journal-title":"NeuroImage"},{"issue":"8","key":"2026061913462613000_fcag211-B27","doi-asserted-by":"crossref","first-page":"3508","DOI":"10.1093\/cercor\/bhw157","article-title":"The human brainnetome atlas: A new brain atlas based on connectional architecture","volume":"26","author":"Fan","year":"2016","journal-title":"Cereb Cortex"},{"issue":"1","key":"2026061913462613000_fcag211-B28","doi-asserted-by":"crossref","first-page":"1010","DOI":"10.1038\/s41598-020-57504-x","article-title":"Pyramidal tract and alternate motor fibers complementarily mediate motor compensation in patients after hemispherotomy","volume":"10","author":"Gaubatz","year":"2020","journal-title":"Sci Rep"},{"key":"2026061913462613000_fcag211-B29","doi-asserted-by":"crossref","DOI":"10.3389\/fnhum.2020.00262","article-title":"Contralesional white matter alterations in patients after hemispherotomy","volume":"14","author":"Gaubatz","year":"2020","journal-title":"Front Hum Neurosci"},{"issue":"9","key":"2026061913462613000_fcag211-B30","doi-asserted-by":"crossref","first-page":"1796","DOI":"10.1002\/acn3.51427","article-title":"Functional redundancy of the premotor network in hemispherotomy patients","volume":"8","author":"Prillwitz","year":"2021","journal-title":"Ann Clin Transl Neurol"},{"issue":"5","key":"2026061913462613000_fcag211-B31","doi-asserted-by":"crossref","first-page":"873","DOI":"10.1097\/ALN.0000000000001275","article-title":"Resting-state network-specific breakdown of functional connectivity during ketamine alteration of consciousness in volunteers","volume":"125","author":"Bonhomme","year":"2016","journal-title":"Anesthesiology"},{"issue":"5","key":"2026061913462613000_fcag211-B32","doi-asserted-by":"crossref","first-page":"1038","DOI":"10.1097\/ALN.0b013e3181f697f5","article-title":"Breakdown of within- and between-network resting state functional magnetic resonance imaging connectivity during propofol-induced loss of consciousness","volume":"113","author":"Boveroux","year":"2010","journal-title":"Anesthesiology"},{"issue":"4","key":"2026061913462613000_fcag211-B33","doi-asserted-by":"crossref","first-page":"537","DOI":"10.1002\/epi4.12433","article-title":"Complete hemispherotomy leads to lateralized functional organization and lower level of consciousness in the isolated hemisphere","volume":"5","author":"Blauwblomme","year":"2020","journal-title":"Epilepsia Open"},{"issue":"1","key":"2026061913462613000_fcag211-B34","doi-asserted-by":"crossref","first-page":"107","DOI":"10.3233\/JAD-180847","article-title":"Resting state abnormalities of the default mode network in mild cognitive impairment: A systematic review and meta-analysis","volume":"70","author":"Eyler","year":"2019","journal-title":"J Alzheimers Dis"},{"issue":"1","key":"2026061913462613000_fcag211-B35","doi-asserted-by":"crossref","first-page":"25","DOI":"10.1089\/brain.2016.0438","article-title":"The default mode network in healthy individuals: A systematic review and meta-analysis","volume":"7","author":"Mak","year":"2017","journal-title":"Brain Connect"},{"issue":"7","key":"2026061913462613000_fcag211-B36","doi-asserted-by":"crossref","first-page":"450","DOI":"10.1038\/nrn.2016.44","article-title":"Integrated information theory: From consciousness to its physical substrate","volume":"17","author":"Tononi","year":"2016","journal-title":"Nat Rev Neurosci"},{"issue":"198","key":"2026061913462613000_fcag211-B37","doi-asserted-by":"crossref","first-page":"198ra105","DOI":"10.1126\/scitranslmed.3006294","article-title":"A theoretically based index of consciousness independent of sensory processing and behavior","volume":"5","author":"Casali","year":"2013","journal-title":"Sci Transl Med"}],"container-title":["Brain Communications"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/braincomms\/advance-article-pdf\/doi\/10.1093\/braincomms\/fcag211\/68537074\/fcag211.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/braincomms\/article-pdf\/8\/3\/fcag211\/68537074\/fcag211.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/braincomms\/article-pdf\/8\/3\/fcag211\/68537074\/fcag211.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,19]],"date-time":"2026-06-19T17:46:37Z","timestamp":1781891197000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/braincomms\/article\/doi\/10.1093\/braincomms\/fcag211\/8709206"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026]]},"references-count":37,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2026,5,5]]}},"URL":"https:\/\/doi.org\/10.1093\/braincomms\/fcag211","relation":{},"ISSN":["2632-1297"],"issn-type":[{"value":"2632-1297","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2026]]},"published":{"date-parts":[[2026]]},"article-number":"fcag211"}}