Subcortical correlates of consciousness with human single neuron recordings

Reviewer #1 (Public Review):

Summary:

A cortico-centric view is dominant in the study of the neural mechanisms of consciousness. This investigation represents the growing interest in understanding how subcortical regions are involved in conscious perception. To achieve this, the authors engaged in an ambitious and rare procedure in humans of directly recording from neurons in the subthalamic nucleus and thalamus. While participants were in surgery for the placement of deep brain stimulation devices for the treatment of essential tremor and Parkinson's disease, they were awakened and completed a perceptual-threshold tactile detection task. The authors identified individual neurons and analyzed single-unit activity corresponding with the task phases and tactile detection/perception. Among the neurons that were perception-responsive, the authors report changes in firing rate beginning ~150 milliseconds from the onset of the tactile stimulation. Curiously, the majority of the perception-responsive neurons had a higher firing rate for missed/not perceived trials. In summary, this investigation is a valuable addition to the growing literature on the role of subcortical regions in conscious perception.

Strengths:

The authors achieved the challenging task of recording human single-unit activity while participants performed a tactile perception task. The methods and statistics are clearly explained and rigorous, particularly for managing false positives and non-normal distributions. The results offer new detail at the level of individual neurons in the emerging recognition of the role of subcortical regions in conscious perception.

Weaknesses:

"Nonetheless, it remains unknown how the firing rate of subcortical neurons changes when a stimulus is consciously perceived." (lines 76-77) The authors could be more specific about what exactly single-unit recordings offer for interrogating the role of subcortical regions in conscious perception that is unique from alternative neural activity recordings (e.g., local field potential) or recordings that are used as proxies of neural activity (e.g., fMRI).

Related comment for the following excerpts:

"After a random delay ranging from 0.5 to 1 s, a "respond" cue was played, prompting participants to verbally report whether they felt a vibration or not. Therefore, none of the reported analyses are confounded by motor responses." (lines 97-99).

"These results show that subthalamic and thalamic neurons are modulated by stimulus onset, irrespective of whether it was reported or not, even though no immediate motor response was required." (lines 188-190).

"By imposing a delay between the end of the tactile stimulation window and the subjective report, we ensured that neuronal responses reflected stimulus detection and not mere motor responses." (lines 245-247).

It is a valuable feature of the paradigm that the reporting period was initiated hundreds of milliseconds after the stimulus presentation so that the neural responses should not represent "mere motor responses". However, verbal report of having perceived or not perceived a stimulus is a motor response and because the participants anticipate having to make these reports before the onset of the response period, there may be motor preparatory activity from the time of the perceived stimulus that is absent for the not perceived stimulus. The authors show sensitivity to this issue by identifying task-selective neurons and their discussion of the results that refer to the confound of post-perceptual processing. Still, direct treatment of this possible confound would help the rigor of the interpretation of the results.

"When analyzing tactile perception, we ensured that our results were not contaminated with spurious behavior (e.g. fluctuation of attention and arousal due to the surgical procedure)." (lines 118-117).

Confidence in the results would be improved if the authors clarified exactly what behaviors were considered as contaminating the results (e.g., eye closure, saccades, and bodily movements) and how they were determined.

The authors' discussion of the thalamic neurons could be more precise. The authors show that only certain areas of the thalamus were recorded (in or near the ventral lateral nucleus, according to Figure S3C). The ventral lateral nucleus has a unique relationship to tactile and motor systems, so do the authors hypothesize these same perception-selective neurons would be active in the same way for visual, auditory, olfactory, and taste perception? Moreover, the authors minimally interpret the location of the task, sensory, and perception-responsive neurons. Figure S3 suggests these neurons are overlapping. Did the authors expect this overlap and what does it mean for the functional organization of the ventral lateral nucleus and subthalamic nucleus in conscious perception?

"We note that, 6 out of 8 neurons had higher firing rates for missed trials than hit trials, although this proportion was not significant (binomial test: p = 0.145)." (lines 215-216).

It appears that in the three example neurons shown in Figure 4, 2 out of 3 (#001 and #068) show a change in firing rate predominantly for the missed stimulations. Meanwhile, #034 shows a clear hit response (although there is an early missed response - decreased firing rate - around 150 ms that is not statistically significant). This is a counterintuitive finding when compared to previous results from the thalamus (e.g., local field potentials and fMRI) that show the opposite response profile (i.e., missed/not perceived trials display no change or reduced response relative to hit/perceived trials). The discussion of the results should address this, including if these seemingly competing findings can be rectified.

The authors report 8 perception-responsive neurons, but there are only 5 recording sites highlighted (i.e., filled-in squares and circles) in Figures S3C and 4D. Was this an omission or were three neurons removed from the perception-responsive analysis?

Could the authors speak to the timing of the responses reported in Figure 4? The statistically significant intervals suggested both early (~160-200ms) to late responses (~300ms). Some have hypothesized that subcortical regions are early - ahead of cortical activation that may be linked with conscious perception. Do these results say anything about this temporal model for when subcortical regions are active in conscious perception?

Reviewer #2 (Public Review):

The authors have studied subpopulations of individual neurons recorded in the thalamus and subthalamic nucleus (STN) of awake humans performing a simple cognitive task. They have carefully designed their task structure to eliminate motor components that could confound their analyses in these subcortical structures, given that the data was recorded in patients with Parkinson's Disease (PD) and diagnosed with an Essential Tremor (ET). The recorded data represents a promising addition to the field. The analyses that the authors have applied can serve as a strong starting point for exploring the kinds of complex signals that can emerge within a single neuron's activity. Pereira et. al conclude that their results from single neurons indicate that task-related activity occurs, purportedly separate from previously identified sensory signals. These conclusions are a promising and novel perspective for how the field thinks about the emergence of decisions and sensory perception across the entire brain as a unit.

Despite the strength of the data that was obtained and the relevant nature of the conclusions that were drawn, there are certain limitations that must be taken into consideration:

(1) The authors make several claims that their findings are direct representations of consciousness identifiable in subcortical structures. The current context for consciousness does not sufficiently define how the consciousness is related to the perceptual task.

(2) The current work would benefit greatly from a description and clarification of what all the neurons that have been recorded are doing. The authors' criteria for selecting subpopulations with task-relevant activity are appropriate, but understanding the heterogeneity in a population of single neurons is important for broader considerations that are being studied within the field.

(3) The authors have omitted a proper set of controls for comparison against the active trials, for example, where a response was not necessary. Please explain why this choice was made and what implications are necessary to consider.

Reviewer #3 (Public Review):

Summary:

This important study relies on a rare dataset: intracranial recordings within the thalamus and the subthalamic nucleus in awake humans, while they were performing a tactile detection task. This procedure allowed the authors to identify a small but significant proportion of individual neurons, in both structures, whose activity correlated with the task (e.g. their firing rate changed following the audio cue signalling the start of a trial) and/or with the stimulus presentation (change in firing rate around 200 ms following tactile stimulation) and/or with participant's reported subjective perception of the stimulus (difference between hits and misses around 200 ms following tactile stimulation). Whereas most studies interested in the neural underpinnings of conscious perception focus on cortical areas, these results suggest that subcortical structures might also play a role in conscious perception, notably tactile detection.

Strengths:

There are two strongly valuable aspects in this study that make the evidence convincing and even compelling. First, these types of data are exceptional, the authors could have access to subcortical recordings in awake and behaving humans during surgery. Additionally, the methods are solid. The behavioral study meets the best standards of the domain, with a careful calibration of the stimulation levels (staircase) to maintain them around the detection threshold, and an additional selection of time intervals where the behavior was stable. The authors also checked that stimulus intensity was the same on average for hits and misses within these selected periods, which warrants that the effects of detection that are observed here are not confounded by stimulus intensity. The neural data analysis is also very sound and well-conducted. The statistical approach complies with current best practices, although I found that, in some instances, it was not entirely clear which type of permutations had been performed, and I would advocate for more clarity in these instances. Globally the figures are nice, clear, and well presented. I appreciated the fact that the precise anatomical location of the neurons was directly shown in each figure.

Weaknesses:

Some clarification is needed for interpreting Figure 3, top rows: in my understanding the black curve is already the result of a subtraction between stimulus present trials and catch trials, to remove potential drifts; if so, it does not make sense to compare it with the firing rate recorded for catch trials.

I also think that the article could benefit from a more thorough presentation of the data and that this could help refine the interpretation which seems to be a bit incomplete in the current version. There are 8 stimulus-responsive neurons and 8 perception-selective neurons, with only one showing both effects, resulting in a total of 15 individual neurons being in either category or 13 neurons if we exclude those in which the behavior is not good enough for the hit versus miss analysis (Figure S4A). In my opinion, it should be feasible to show the data for all of them (either in a main figure, or at least in supplementary), but in the present version, we get to see the data for only 3 neurons for each analysis. This very small selection includes the only neuron that shows both effects (neuron #001; which is also cue selective), but this is not highlighted in the text. It would be interesting to see both the stimulus-response data and the hit versus miss data for all 13 neurons as it could help develop the interpretation of exactly how these neurons might be involved in stimulus processing and conscious perception. This should give rise to distinct interpretations for the three possible categories. Neurons that are stimulus-responsive but not perception-selective should show the same response for both hits and misses and hence carry out indifferently conscious and unconscious responses. The fact that some neurons show the opposite pattern is particularly intriguing and might give rise to a very specific interpretation: if the neuron really doesn't tend to respond to the stimulus when hits and misses are put together, it might be a neuron that does not directly respond to the stimulus, but whose spontaneous fluctuations across trials affect how the stimulus is perceived when they occur in a specific time window after the stimulus. Finally, neuron #001 responds with what looks like a real burst of evoked activity to stimulation and also shows a difference between hits and misses, but intriguingly, the response is strongest for misses. In the discussion, the interesting interpretation in terms of a specific gating of information by subcortical structures seems to apply well to this last example, but not necessarily to the other categories.