Division of Perceptual Studies, Department of Psychiatry & Neurobehavioral Sciences, University of Virginia Health System, 210 10th Street NE, Suite 100, Charlottesville, VA 22902-4754, USA.
Arch Gerontol Geriatr. 2012 Jul-Aug;55(1):138-42. doi: 10.1016/j.archger.2011.06.031. Epub 2011 Jul 20.
The unexpected return of mental clarity and memory shortly before death in patients suffering from severe psychiatric and neurologic disorders, which we have called "terminal lucidity", has been reported in the medical literature over the past 250 years, but has received little attention. We review a range of terminal lucidity cases in order to encourage investigation of the mechanisms involved and possible insights into both the neuroscience of memory and cognition at the end of life and treatment of terminal illness. These examples include case reports of patients suffering from brain abscesses, tumors, strokes, meningitis, dementia or Alzheimer's disease, schizophrenia, and affective disorders. Several of these accounts suggest that during terminal lucidity, memory and cognitive abilities may function by neurologic processes different from those of the normal brain. We expect that significant contributions to better understanding the processes involved in memory and cognition processing might be gained through in-depth studies of terminal lucidity. Studying terminal lucidity might also facilitate the development of novel therapies. In addition, increased awareness of unusual end-of-life experiences could help physicians, caregivers, and bereaved family members be prepared for encountering such experiences, and help those individuals cope with them.
在过去的 250 年里,医学文献中已经报道了患有严重精神和神经疾病的患者在死亡前不久出现意外的精神和记忆清晰,我们称之为“终末期清醒”,但这种情况并没有引起太多关注。我们回顾了一系列终末期清醒的病例,以鼓励对所涉及的机制进行调查,并可能深入了解生命末期的记忆和认知的神经科学以及对终末期疾病的治疗。这些例子包括患有脑脓肿、肿瘤、中风、脑膜炎、痴呆或阿尔茨海默病、精神分裂症和情感障碍的患者的病例报告。其中有几个病例表明,在终末期清醒期间,记忆和认知能力可能通过与正常大脑不同的神经过程发挥作用。我们预计,通过对终末期清醒进行深入研究,可能会对更好地理解记忆和认知加工过程做出重大贡献。研究终末期清醒也可能有助于开发新的治疗方法。此外,提高对异常临终体验的认识可以帮助医生、护理人员和失去亲人的家属为遇到此类体验做好准备,并帮助这些人应对这些体验。