{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T19:11:22Z","timestamp":1785265882494,"version":"3.55.0"},"reference-count":38,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,6,20]],"date-time":"2025-06-20T00:00:00Z","timestamp":1750377600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Hum. Neurosci."],"abstract":"<jats:p>We report the case of a patient with disease of consciousness who underwent 6 days of antispastic spinal cord stimulation followed by consolidation of a functional connectome as measured by resting state fMRI (rs-fMRI). The test spinal cord stimulation (SCS) system (with electrodes placed epidurally at the C3-C5 level) was used to evaluate its potential to relieve muscle contracture as the primary clinical target. Neurological and rs-fMRI examinations were performed before and after surgical placement of the spinal cord stimulation system. For neurological assessment of spasticity we used the Ashworth scale. To analyze fMRI, we used the extraction of functional connectivity coefficients and the construction of a connectivity matrixes. To construct a normative matrix of functional connectivity, 10 healthy volunteers of appropriate age were recruited as a control group. Analysis of rs-fMRI data showed that after a short course of epidural cervical spinal cord stimulation, the patient\u2019s functional connectivity matrix similarity with the control group increased, which was manifested in the growth of ROI-to-ROI and inter-network functional connectivity coefficients. This finding may indicate the complexity of the neuromodulatory effect of spinal cord stimulation and its consolidating effect on the functional connectome of the brain, including brain regions associated with the function of maintaining arousal and awareness, even when the clinical effect is not perceptibly pronounced. We supposed to conduct the spinal cord therapy for this patient in a permanent way not only to relieve spasticity but also to support consciousness. We assume that functional connectome assessment in such clinical cases may help to give additional arguments in SCS-therapy prescription in patients with disorders of consciousness as well as to understand in the future the pathophysiological mechanism of the effect of this procedure.<\/jats:p>","DOI":"10.3389\/fnhum.2025.1533212","type":"journal-article","created":{"date-parts":[[2025,6,20]],"date-time":"2025-06-20T05:23:23Z","timestamp":1750397003000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Functional connectome integration observed after antispastic epidural cervical spinal cord stimulation in a patient with TBI-induced disorder of consciousness: a case report"],"prefix":"10.3389","volume":"19","author":[{"given":"Larisa Alexeevna","family":"Mayorova","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ekaterina Leonidovna","family":"Bondar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Margarita Leonidovna","family":"Radutnaya","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexey Alexandrovich","family":"Yakovlev","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,6,20]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"13","DOI":"10.1136\/bmj.313.7048.13","article-title":"Misdiagnosis of the vegetative state: Retrospective study in a rehabilitation unit.","volume":"313","author":"Andrews","year":"1996","journal-title":"BMJ"},{"key":"B2","doi-asserted-by":"publisher","first-page":"45","DOI":"10.3389\/conf.fnhum.2014.214.00045","article-title":"Audio-visual crossmodal fMRI connectivity differentiates single patients with disorders of consciousness.","volume":"8","author":"Athena","year":"2014","journal-title":"Front. Hum. Neurosci."},{"key":"B3","doi-asserted-by":"publisher","first-page":"598","DOI":"10.1056\/NEJMoa2400645","article-title":"Cognitive motor dissociation in disorders of consciousness.","volume":"391","author":"Bodien","year":"2024","journal-title":"N. Engl. J. Med."},{"key":"B4","doi-asserted-by":"publisher","first-page":"206","DOI":"10.1093\/ptj\/67.2.206","article-title":"Interrater reliability of a modified Ashworth scale of muscle spasticity.","volume":"67","author":"Bohannon","year":"1987","journal-title":"Phys. Ther."},{"key":"B5","doi-asserted-by":"publisher","first-page":"429","DOI":"10.1136\/jnnp.2007.142349","article-title":"Disrupted intrinsic functional connectivity in the vegetative state.","volume":"80","author":"Cauda","year":"2008","journal-title":"J. Neurol. Neurosurg. Psychiatry"},{"key":"B6","doi-asserted-by":"publisher","first-page":"1465","DOI":"10.1212\/wnl.43.8.1465","article-title":"Accuracy of diagnosis of persistent vegetative state.","volume":"43","author":"Childs","year":"1993","journal-title":"Neurology"},{"key":"B7","doi-asserted-by":"publisher","first-page":"47","DOI":"10.1111\/ner.12368","article-title":"Burst and tonic spinal cord stimulation: Different and common brain mechanisms.","volume":"19","author":"De Ridder","year":"2016","journal-title":"Neuromodulation"},{"key":"B8","doi-asserted-by":"publisher","first-page":"275","DOI":"10.1159\/000348271","article-title":"Neuromodulation of vegetative state through spinal cord stimulation: Where are we now and where are we going?","volume":"91","author":"Della Pepa","year":"2013","journal-title":"Stereotact. Funct. Neurosurg."},{"key":"B9","doi-asserted-by":"publisher","first-page":"35","DOI":"10.1016\/j.cortex.2013.11.005","article-title":"Multiple fMRI system-level baseline connectivity is disrupted in patients with consciousness alterations.","volume":"52","author":"Demertzi","year":"2014","journal-title":"Cortex"},{"key":"B10","doi-asserted-by":"publisher","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":"B11","doi-asserted-by":"publisher","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."},{"key":"B12","doi-asserted-by":"publisher","first-page":"1664","DOI":"10.1038\/nn.4135","article-title":"Functional connectome fingerprinting: Identifying individuals using patterns of brain connectivity.","volume":"18","author":"Finn","year":"2015","journal-title":"Nat. Neurosci."},{"key":"B13","doi-asserted-by":"publisher","first-page":"2020","DOI":"10.1016\/j.apmr.2004.02.033","article-title":"The JFK Coma Recovery Scale-Revised: Measurement characteristics and diagnostic utility.","volume":"85","author":"Giacino","year":"2004","journal-title":"Arch. Phys. Med. Rehabil."},{"key":"B14","doi-asserted-by":"publisher","first-page":"74","DOI":"10.1111\/ner.12969","article-title":"Cortical mapping in conventional and high dose spinal cord stimulation: An exploratory power spectrum and functional connectivity analysis with electroencephalography.","volume":"23","author":"Goudman","year":"2020","journal-title":"Neuromodulation"},{"key":"B15","doi-asserted-by":"publisher","first-page":"145","DOI":"10.1111\/ane.12299","article-title":"Decreased functional connectivity between the mediodorsal thalamus and default mode network in patients with disorders of consciousness.","volume":"131","author":"He","year":"2015","journal-title":"Acta Neurol. Scand."},{"key":"B16","doi-asserted-by":"publisher","first-page":"1545","DOI":"10.1016\/j.clinph.2013.12.095","article-title":"Connectivity biomarkers can differentiate patients with different levels of consciousness.","volume":"125","author":"H\u00f6ller","year":"2014","journal-title":"Clin. Neurophysiol."},{"key":"B17","doi-asserted-by":"publisher","first-page":"1156","DOI":"10.3109\/02699052.2014.920523","article-title":"What kind of consciousness is minimal?","volume":"28","author":"Kotchoubey","year":"2014","journal-title":"Brain Inj."},{"key":"B18","doi-asserted-by":"publisher","first-page":"19","DOI":"10.1007\/978-3-319-39546-3_4","article-title":"Recovery from chronic diseases of consciousness: State of the art in neuromodulation for persistent vegetative state and minimally conscious state.","volume":"124","author":"Mattogno","year":"2017","journal-title":"Acta Neurochir. Suppl."},{"key":"B19","doi-asserted-by":"publisher","first-page":"2266","DOI":"10.3390\/biomedicines11082266","article-title":"Immediate effects of anti-spastic epidural cervical spinal cord stimulation on functional connectivity of the central motor system in patients with stroke- and traumatic brain injury-induced spasticity: A pilot resting-state functional magnetic resonance imaging study.","volume":"11","author":"Mayorova","year":"2023","journal-title":"Biomedicines"},{"key":"B20","doi-asserted-by":"publisher","first-page":"25","DOI":"10.17116\/jnevro20181183225-31","article-title":"The russian version of coma recovery scale-revised - a standardized method for assessment of patients with disorders of consciousness.","volume":"118","author":"Mochalova","year":"2018","journal-title":"Zh Nevrol Psikhiatr Im S S Korsakova"},{"key":"B21","doi-asserted-by":"publisher","first-page":"1399","DOI":"10.1007\/s00234-012-1087-8","article-title":"Spinal cord stimulation modulates cerebral function: An fMRI study.","volume":"54","author":"Moens","year":"2012","journal-title":"Neuroradiology"},{"key":"B22","doi-asserted-by":"publisher","first-page":"1402","DOI":"10.1126\/science.1130197","article-title":"Detecting awareness in the vegetative state.","volume":"313","author":"Owen","year":"2006","journal-title":"Science"},{"key":"B23","doi-asserted-by":"publisher","first-page":"191","DOI":"10.1155\/2000\/421719","article-title":"Stereotaxic display of brain lesions.","volume":"12","author":"Rorden","year":"2000","journal-title":"Behav. Neurol."},{"key":"B24","doi-asserted-by":"publisher","first-page":"946","DOI":"10.1097\/ALN.0b013e318249d0a7","article-title":"Unresponsiveness \u2260 unconsciousness.","volume":"116","author":"Sanders","year":"2012","journal-title":"Anesthesiology"},{"key":"B25","doi-asserted-by":"publisher","first-page":"e2219666120","DOI":"10.1073\/pnas.2219666120","article-title":"Whole-brain, gray, and white matter time-locked functional signal changes with simple tasks and model-free analysis.","volume":"120","author":"Schilling","year":"2023","journal-title":"Proc. Natl. Acad. Sci. U. S. A."},{"key":"B26","doi-asserted-by":"publisher","first-page":"35","DOI":"10.1186\/1471-2377-9-35","article-title":"Diagnostic accuracy of the vegetative and minimally conscious state: Clinical consensus versus standardized neurobehavioral assessment.","volume":"9","author":"Schnakers","year":"2009","journal-title":"BMC Neurol."},{"key":"B27","doi-asserted-by":"publisher","first-page":"1795","DOI":"10.1016\/j.apmr.2010.07.218","article-title":"Assessment scales for disorders of consciousness: Evidence-based recommendations for clinical practice and research.","volume":"91","author":"Seel","year":"2010","journal-title":"Arch. Phys. Med. Rehabil."},{"key":"B28","doi-asserted-by":"publisher","first-page":"2036","DOI":"10.1212\/WNL.0000000000002196","article-title":"Disruption of posteromedial large-scale neural communication predicts recovery from coma.","volume":"85","author":"Silva","year":"2015","journal-title":"Neurology"},{"key":"B29","doi-asserted-by":"publisher","first-page":"2929","DOI":"10.1002\/hbm.24050","article-title":"Degrees of functional connectome abnormality in disorders of consciousness.","volume":"39","author":"Sinitsyn","year":"2018","journal-title":"Hum. Brain Mapp."},{"key":"B30","doi-asserted-by":"publisher","first-page":"85.e9","DOI":"10.1016\/j.jamda.2014.10.014","article-title":"The vegetative state: Prevalence, misdiagnosis, and treatment limitations.","volume":"16","author":"van Erp","year":"2015","journal-title":"J. Am. Med. Dir. Assoc."},{"key":"B31","doi-asserted-by":"publisher","first-page":"180","DOI":"10.1111\/j.1540-8159.1987.tb05947.x","article-title":"Spinal cord stimulation and motor disorders","volume":"10","author":"Waltz","year":"1987","journal-title":"Pacing Clin. Electrophysiol"},{"key":"B32","doi-asserted-by":"publisher","first-page":"244","DOI":"10.1159\/000102207","article-title":"Multi-lead spinal cord stimulation for control of motor disorders.","volume":"44","author":"Waltz","year":"1981","journal-title":"Appl. Neurophysiol."},{"key":"B33","doi-asserted-by":"publisher","first-page":"662","DOI":"10.1080\/00207454.2019.1702543","article-title":"Spinal cord stimulation modulates complexity of neural activities in patients with disorders of consciousness.","volume":"130","author":"Wang","year":"2020","journal-title":"Int. J. Neurosci."},{"key":"B34","doi-asserted-by":"publisher","first-page":"12932","DOI":"10.1523\/JNEUROSCI.0415-15.2015","article-title":"Intrinsic functional connectivity patterns predict consciousness level and recovery outcome in acquired brain injury.","volume":"35","author":"Wu","year":"2015","journal-title":"J. Neurosci."},{"key":"B35","doi-asserted-by":"publisher","first-page":"615","DOI":"10.1007\/s12264-018-0244-4","article-title":"Current status of neuromodulatory therapies for disorders of consciousness.","volume":"34","author":"Xia","year":"2018","journal-title":"Neurosci. Bull."},{"key":"B36","doi-asserted-by":"publisher","first-page":"347","DOI":"10.1111\/ner.12903","article-title":"Cervical spinal cord stimulation for the vegetative state: A preliminary result of 12 cases.","volume":"22","author":"Xu","year":"2019","journal-title":"Neuromodulation"},{"key":"B37","doi-asserted-by":"publisher","first-page":"1249","DOI":"10.1111\/cns.13870","article-title":"Long-term functional prognosis and related factors of spinal cord stimulation in patients with disorders of consciousness.","volume":"28","author":"Yang","year":"2022","journal-title":"CNS Neurosci. Ther."},{"key":"B38","doi-asserted-by":"publisher","first-page":"168","DOI":"10.1016\/j.jns.2015.06.044","article-title":"Thalamocortical sensorimotor circuit damage associated with disorders of consciousness for diffuse axonal injury patients.","volume":"356","author":"Yao","year":"2015","journal-title":"J. Neurol. Sci."}],"container-title":["Frontiers in Human Neuroscience"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fnhum.2025.1533212\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,6,20]],"date-time":"2025-06-20T05:23:24Z","timestamp":1750397004000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fnhum.2025.1533212\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,6,20]]},"references-count":38,"alternative-id":["10.3389\/fnhum.2025.1533212"],"URL":"https:\/\/doi.org\/10.3389\/fnhum.2025.1533212","relation":{},"ISSN":["1662-5161"],"issn-type":[{"value":"1662-5161","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,6,20]]},"article-number":"1533212"}}