{"title":"Neural mechanism of conscious perception for potential clinical applications","authors":"Yong Wang, Shouyang Yu, Yueqing Dong, Yuanyuan Dang, Hulin Zhao, Mingsha Zhang, Xiaoli Li","doi":"10.1002/ctm2.70387","DOIUrl":null,"url":null,"abstract":"<p>The generation of consciousness has remained one of the most enduring scientific quests in human history. When a visual stimulus enters the eye, how does the brain transform it into the subjective experience of “I see”? Traditional theories posited the cerebral cortex as the epicenter of conscious perception, relegating the thalamus to a mere relay station for sensory signals. However, a groundbreaking study recently published in Science has overturned this paradigm, identifying the mediodorsal thalamic nuclei (MDm) and intralaminar nuclei (ILN) as the true “gatekeepers” of conscious perception.<span><sup>1</sup></span> Through dynamic connectivity with the prefrontal cortex, these nuclei determine which sensory information gains access to the conscious perception. What groundbreaking clinical implications might this discovery yield?</p><p>Conscious perception, is one of the most complex issues in the field of cognitive science, meaning subjects convert external stimuli into subjective experiences through neural activity. Conscious perception involves the awareness and understanding of one's environment, internal stimuli, and cognitive processes. As a key capability for human cognition, it enables individuals to be aware of events, emotions, thoughts, and bodily states. From the perspective of neuroscience, conscious perception is a process that involves several brain regions, particularly the thalamus and the prefrontal cortex.<span><sup>2, 3</sup></span> These regions synthesize information from sensory systems, such as vision, hearing, and touch, to construct a clear conscious experience.</p><p>Conscious perception is impaired in various medical conditions (see Figure 1). Neurodegenerative diseases, including Alzheimer's and Parkinson's, are linked to progressive deterioration in awareness and perception. Individuals with Alzheimer's disease often exhibit a decline in consciousness and self-awareness,<span><sup>4</sup></span> whereas those with Parkinson's may endure visual perception problems due to the loss of dopamine-producing cells in the retina.<span><sup>5</sup></span> Other conditions that affect conscious perception include epilepsy, which can cause sensory disturbances; and sleep disorders, which can lead to perceptual changes due to sleep deprivation or disrupted circadian rhythms (Figure 1).</p><p>This paradigm shift, from cortical-centric to thalamocortical network models of consciousness, calls for multidisciplinary collaboration. By integrating sEEG-guided neuromodulation, computational modeling of mesocircuit dynamics, and machine learning-based biomarker discovery, clinicians can develop precision therapies that bridge molecular mechanisms with systems-level network reorganization. These advances not only redefine our approach to DoC but also offer novel pathways for treating perceptual-cognitive deficits across neurological and psychiatric disorders.</p>","PeriodicalId":10189,"journal":{"name":"Clinical and Translational Medicine","volume":"15 9","pages":""},"PeriodicalIF":6.8000,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ctm2.70387","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Clinical and Translational Medicine","FirstCategoryId":"3","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1002/ctm2.70387","RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"MEDICINE, RESEARCH & EXPERIMENTAL","Score":null,"Total":0}
引用次数: 0
Abstract
The generation of consciousness has remained one of the most enduring scientific quests in human history. When a visual stimulus enters the eye, how does the brain transform it into the subjective experience of “I see”? Traditional theories posited the cerebral cortex as the epicenter of conscious perception, relegating the thalamus to a mere relay station for sensory signals. However, a groundbreaking study recently published in Science has overturned this paradigm, identifying the mediodorsal thalamic nuclei (MDm) and intralaminar nuclei (ILN) as the true “gatekeepers” of conscious perception.1 Through dynamic connectivity with the prefrontal cortex, these nuclei determine which sensory information gains access to the conscious perception. What groundbreaking clinical implications might this discovery yield?
Conscious perception, is one of the most complex issues in the field of cognitive science, meaning subjects convert external stimuli into subjective experiences through neural activity. Conscious perception involves the awareness and understanding of one's environment, internal stimuli, and cognitive processes. As a key capability for human cognition, it enables individuals to be aware of events, emotions, thoughts, and bodily states. From the perspective of neuroscience, conscious perception is a process that involves several brain regions, particularly the thalamus and the prefrontal cortex.2, 3 These regions synthesize information from sensory systems, such as vision, hearing, and touch, to construct a clear conscious experience.
Conscious perception is impaired in various medical conditions (see Figure 1). Neurodegenerative diseases, including Alzheimer's and Parkinson's, are linked to progressive deterioration in awareness and perception. Individuals with Alzheimer's disease often exhibit a decline in consciousness and self-awareness,4 whereas those with Parkinson's may endure visual perception problems due to the loss of dopamine-producing cells in the retina.5 Other conditions that affect conscious perception include epilepsy, which can cause sensory disturbances; and sleep disorders, which can lead to perceptual changes due to sleep deprivation or disrupted circadian rhythms (Figure 1).
This paradigm shift, from cortical-centric to thalamocortical network models of consciousness, calls for multidisciplinary collaboration. By integrating sEEG-guided neuromodulation, computational modeling of mesocircuit dynamics, and machine learning-based biomarker discovery, clinicians can develop precision therapies that bridge molecular mechanisms with systems-level network reorganization. These advances not only redefine our approach to DoC but also offer novel pathways for treating perceptual-cognitive deficits across neurological and psychiatric disorders.
期刊介绍:
Clinical and Translational Medicine (CTM) is an international, peer-reviewed, open-access journal dedicated to accelerating the translation of preclinical research into clinical applications and fostering communication between basic and clinical scientists. It highlights the clinical potential and application of various fields including biotechnologies, biomaterials, bioengineering, biomarkers, molecular medicine, omics science, bioinformatics, immunology, molecular imaging, drug discovery, regulation, and health policy. With a focus on the bench-to-bedside approach, CTM prioritizes studies and clinical observations that generate hypotheses relevant to patients and diseases, guiding investigations in cellular and molecular medicine. The journal encourages submissions from clinicians, researchers, policymakers, and industry professionals.