Structural determinants of dynamical state transitions in disorders of consciousness: a whole-brain modeling approach
bioRxiv (Cold Spring Harbor Laboratory) July 1, 2026 Fernando Lehue, Iván Mindlin, Carlos Coronel-Oliveros et al.
Disorders of consciousness are linked to large-scale changes in brain dynamics, but the structural factors behind these changes are unclear. Using a whole-brain computational model constrained by diffusion MRI-derived connectivity, the authors show that a node's integration within the structural connectome, measured by a spectral integration metric, strongly predicts its impact on global brain dynamics. Lesions to highly integrative hubs, especially in posterior medial regions like the precuneus and posterior cingulate cortex, drive the system toward low-complexity dynamical regimes resembling disorders of consciousness. Increasing excitability in these regions restores healthy-like dynamics in silico. Perturbations to weakly integrated regions have limited global effects, explaining why damage to specific hubs disproportionately disrupts conscious brain activity.