Center for Translational Cognitive Neuroscience, VA Boston Healthcare System, 150 S. Huntington Ave., Jamaica Plain, Boston, MA, 02130, USA.
Department of Neurology, Boston University Chobanian & Avedisian School of Medicine, Boston, MA, USA.
Curr Neurol Neurosci Rep. 2023 Jul;23(7):345-352. doi: 10.1007/s11910-023-01276-0. Epub 2023 Jun 12.
In this review, we summarize the current understanding of consciousness including its neuroanatomic basis. We discuss major theories of consciousness, physical exam-based and electroencephalographic metrics used to stratify levels of consciousness, and tools used to shed light on the neural correlates of the conscious experience. Lastly, we review an expanded category of 'disorders of consciousness,' which includes disorders that impact either the level or experience of consciousness.
Recent studies have revealed many of the requisite EEG, ERP, and fMRI signals to predict aspects of the conscious experience. Neurological disorders that disrupt the reticular activating system can affect the level of consciousness, whereas cortical disorders from seizures and migraines to strokes and dementia may disrupt phenomenal consciousness. The recently introduced memory theory of consciousness provides a new explanation of phenomenal consciousness that may explain better than prior theories both experimental studies and the neurologist's clinical experience. Although the complete neurobiological basis of consciousness remains a mystery, recent advances have improved our understanding of the physiology underlying level of consciousness and phenomenal consciousness.
在这篇综述中,我们总结了意识的现有理解,包括其神经解剖基础。我们讨论了意识的主要理论、用于分层意识水平的基于体格检查和脑电图的指标,以及用于揭示意识体验的神经相关性的工具。最后,我们回顾了一个扩展的“意识障碍”类别,其中包括影响意识水平或意识体验的障碍。
最近的研究揭示了许多必要的脑电图、事件相关电位和功能磁共振成像信号,以预测意识体验的各个方面。破坏网状激活系统的神经障碍会影响意识水平,而癫痫发作、偏头痛、中风和痴呆等皮质障碍可能会破坏现象意识。最近提出的记忆意识理论为现象意识提供了一个新的解释,可能比以前的理论更好地解释实验研究和神经科医生的临床经验。尽管意识的完整神经生物学基础仍然是一个谜,但最近的进展提高了我们对意识水平和现象意识基础生理学的理解。