Centralising a loss of consciousness to the central medial thalamus.

Although a role of the thalamus in different arousal and awareness states is well established, there is a surprising lack of knowledge on subregional specificity within this complex, multinucleated structure of the diencephalon. In their recent paper 'Extrasynaptic GABA-A receptors in central medial thalamus mediate anaesthesia in rats', Muheyati et al. evaluated whether GABA receptors expressed in the central medial (CM), paraventricular (PV) or lateral mediodorsal (MD) nuclei of the thalamus contribute to the loss of the righting reflex (LORR) in rats. Deficits in this reflex have previously been interpreted as a surrogate marker of altered levels of consciousness. Using a range of convergent techniques, the authors report the novel finding that delta subunit-expressing GABA receptors in the CM contribute to distinct awareness states. This important discovery implicates a tonic GABA-mediated conductance in the CM that may be relevant for minimally conscious states and other conditions of altered awareness.