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Importance, limits and caveats of the use of "disorders of consciousness" to theorize consciousness.

作者信息

Hermann Bertrand, Sangaré Aude, Munoz-Musat Esteban, Salah Amina Ben, Perez Pauline, Valente Mélanie, Faugeras Frédéric, Axelrod Vadim, Demeret Sophie, Marois Clémence, Pyatigorskaya Nadya, Habert Marie-Odile, Kas Aurélie, Sitt Jacobo D, Rohaut Benjamin, Naccache Lionel

机构信息

Brain institute-ICM, Inserm U1127, CNRS UMR 7225, Sorbonne Université, Paris 75013, France.

Department of Neurology, AP-HP, Hôpital Henri-Mondor-Albert Chenevier, Université Paris Est Creteil, Créteil 94 000, France.

出版信息

Neurosci Conscious. 2022 Feb 16;2021(2):niab048. doi: 10.1093/nc/niab048. eCollection 2021.


DOI:10.1093/nc/niab048
PMID:35369675
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8966966/
Abstract

The clinical and fundamental exploration of patients suffering from disorders of consciousness (DoC) is commonly used by researchers both to test some of their key theoretical predictions and to serve as a unique source of empirical knowledge about possible dissociations between consciousness and cognitive and/or neural processes. For instance, the existence of states of vigilance free of any self-reportable subjective experience [e.g. "vegetative state (VS)" and "complex partial epileptic seizure"] originated from DoC and acted as a cornerstone for all theories by dissociating two concepts that were commonly equated and confused: vigilance and conscious state. In the present article, we first expose briefly the major achievements in the exploration and understanding of DoC. We then propose a synthetic taxonomy of DoC, and we finally highlight some current limits, caveats and questions that have to be addressed when using DoC to theorize consciousness. In particular, we show (i) that a purely behavioral approach of DoC is insufficient to characterize the conscious state of patients; (ii) that the comparison between patients in a minimally conscious state (MCS) and patients in a VS [also coined as unresponsive wakefulness syndrome (UWS)] does not correspond to a pure and minimal contrast between unconscious and conscious states and (iii) we emphasize, in the light of original resting-state positron emission tomography data, that behavioral MCS captures an important but misnamed clinical condition that rather corresponds to a cortically mediated state and that MCS does not necessarily imply the preservation of a conscious state.

摘要
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f22e/8966966/b278b3f37f5a/niab048f4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f22e/8966966/3761eed3ec38/niab048f1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f22e/8966966/71a7b130b9b8/niab048f2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f22e/8966966/ca256e282014/niab048f3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f22e/8966966/b278b3f37f5a/niab048f4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f22e/8966966/3761eed3ec38/niab048f1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f22e/8966966/71a7b130b9b8/niab048f2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f22e/8966966/ca256e282014/niab048f3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f22e/8966966/b278b3f37f5a/niab048f4.jpg

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Importance, limits and caveats of the use of "disorders of consciousness" to theorize consciousness.

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[2]
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[3]
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[5]
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[6]
Pupil dilation response elicited by violations of auditory regularities is a promising but challenging approach to probe consciousness at the bedside.

Sci Rep. 2023-11-21

[7]
Conscious processing of global and local auditory irregularities causes differentiated heartbeat-evoked responses.

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[8]
Probing Intrinsic Neural Timescales in EEG with an Information-Theory Inspired Approach: Permutation Entropy Time Delay Estimation (PE-TD).

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[9]
Brain-heart interactions in the neurobiology of consciousness.

Curr Res Neurobiol. 2022-8-6

本文引用的文献

[1]
Conscious processing of narrative stimuli synchronizes heart rate between individuals.

Cell Rep. 2021-9-14

[2]
A Systematic Review of Sleep in Patients with Disorders of Consciousness: From Diagnosis to Prognosis.

Brain Sci. 2021-8-16

[3]
Preservation of Brain Activity in Unresponsive Patients Identifies MCS Star.

Ann Neurol. 2021-7

[4]
Multimodal FDG-PET and EEG assessment improves diagnosis and prognostication of disorders of consciousness.

Neuroimage Clin. 2021

[5]
Pearls & Oy-sters: Eyes-Open Coma.

Neurology. 2021-5-4

[6]
Unmasking Covert Language Processing in the Intensive Care Unit with Electroencephalography.

Ann Neurol. 2021-4

[7]
Auditory Event-Related "Global Effect" Predicts Recovery of Overt Consciousness.

Front Neurol. 2021-1-8

[8]
Development of a brain-computer interface for patients in the critical care setting.

PLoS One. 2021

[9]
Covert Speech Comprehension Predicts Recovery From Acute Unresponsive States.

Ann Neurol. 2021-4

[10]
Recovery from disorders of consciousness: mechanisms, prognosis and emerging therapies.

Nat Rev Neurol. 2021-3

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