Journal Article

DZNE-2026-00662

http://join2-wiki.gsi.de/foswiki/pub/Main/Artwork/join2_logo100x88.png Default-mode network activity is retained in the isolated hemisphere of people after hemispherotomy.

Bauer, T. (First author)DZNE* ; Gauvry, C. ; Markett, S. ; Kreter-Schönleber, T. ; Borger, V. ; Vatter, H. ; Sander, J. W. ; Gabriel, M. ; Radbruch, A.DZNE* ; Surges, R. ; Rüber, T. (Last author)DZNE*

2026
Oxford University Press [Oxford]

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Please use a persistent id in citations: doi:10.1093/braincomms/fcag211

Abstract: 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.

Keyword(s): consciousness ; epilepsy surgery ; functional MRI

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Contributing Institute(s):

1. Clinical Neuroimaging (AG Radbruch)
2. MR Physics (AG Stöcker)

Research Program(s):

1. 353 - Clinical and Health Care Research (POF4-353) (POF4-353)
2. 354 - Disease Prevention and Healthy Aging (POF4-354) (POF4-354)

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