Recovery of consciousness after severe brain injury: the role of arousal regulation mechanisms and some speculation on the heart-brain interface.

Recovery of consciousness after severe brain injury involves reconstitution of brain arousal mechanisms and cerebral integrative function. This review discusses several aspects of neuroanatomy and neuropathology relevant to the process of recovery. Particular emphasis is placed on the role of the anterior forebrain and circuit mechanisms linking the frontal lobe, striatum, and central thalamus. The article concludes with some observations on the heart-brain interface and future research directions in the context of recovery from severe brain injury.