Brain Function in the Vegetative State

Laureys, Steven; Antoine, Sylvie; Boly, Mélanie; Elincx, Sandra; Faymonville, Marie-Élisabeth; Berré, Jacques; Sadzot, Bernard; Ferring, Martine; Tiège, Xavier De; Bogaert, Patrick Van; Hansen, Isabelle; Damas, Pierre; Mavroudakis, Nicolas; Lambermont, Bernard; Fiore, Guy Del; Aerts, Joël; Degueldre, Christian; Phillips, Christophe; Franck, George; Vincent, Jean‐Louis; Lamy, Maurice; Luxen, André; Moonen, Gustave; Goldman, Serge; Maquet, Pierre

doi:10.1007/978-0-306-48526-8_21

Cited by 70 publications

(59 citation statements)

References 37 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Studying VS/UWS patients has shown that awareness seems an emergent property of collective critical cortico-thalamo-cortical network dynamics, involving the frontoparietal global workspace [35]. At the moment, it remains controversial whether consciousness should be considered as a binary all-or-none phenomenon or continuous [36].…”

Section: Discussionmentioning

confidence: 99%

Consciousness supporting networks

Demertzi¹,

Soddu²,

Laureys³

2013

Current Opinion in Neurobiology

Self Cite

174

115

View full text Add to dashboard Cite

This article appeared in a journal published by Elsevier. The attached copy is furnished to the author for internal non-commercial research and education use, including for instruction at the authors institution and sharing with colleagues.Other uses, including reproduction and distribution, or selling or licensing copies, or posting to personal, institutional or third party websites are prohibited. Author's personal copy In most cases authors Consciousness supporting networksAthena Demertzi, Andrea Soddu and Steven LaureysFunctional neuroimaging shows that patients with disorders of consciousness exhibit disrupted system-level functional connectivity. Unresponsive/''vegetative state'' patients preserve wakefulness networks of brainstem and basal forebrain but the cerebral networks accounting for external perceptual awareness and internal self-related mentation are disrupted. Specifically, the 'external awareness' network encompassing lateral fronto-temporo-parietal cortices bilaterally, and the 'internal awareness' network including midline anterior cingulate/mesiofrontal and posterior cingulate/ precuneal cortices, are functionally disconnected. By contrast, patients in minimally conscious state 'minus', who show nonreflex behaviors, are characterized by right-lateralized recovery of the external awareness network. Similarly, patients who evolve to minimally conscious state 'plus' and respond to commands recover the dominant left-lateralized language network. Now, the use of active experimental paradigms targeting at detecting motor-independent signs of awareness or even establishing communication with these patients, challenge these two clinical boundaries. Such advances are naturally accompanied by legitimate neuroscientific and ethical queries demanding our attention on the medical implementations of this new knowledge. What is 'minimally conscious'?At present there is no generally accepted definition of consciousness [1]. As clinicians, we will reduce the complexity of this term and define consciousness operationally, separating two main components: wakefulness and awareness [2]. Wakefulness has been shown to critically depend upon the functional integrity of subcortical arousal systems over 50 years ago [(e.g., see 3)]. The level of wakefulness can be estimated by simple behavioral criteria based on eye opening ranging from absent, over stimulus-induced to spontaneous sustained eye opening.For instance, every night when falling asleep, we experience a decrease of the level of wakefulness up to the point we lose awareness of our environment. Awareness is more difficult to define and more challenging to assess behaviorally [4]. We have recently proposed to reduce the phenomenological complexity of awareness into two further components: external awareness, namely everything we perceive through our senses (what we see, hear, feel, smell and taste), and internal awareness or stimulusindependent thoughts. Interestingly, the switch between the external and internal milieu was found not only to characterize overt...

show abstract

Section: Discussionmentioning

confidence: 99%

Consciousness supporting networks

Demertzi¹,

Soddu²,

Laureys³

2013

Current Opinion in Neurobiology

Self Cite

174

115

View full text Add to dashboard Cite

show abstract

“…Studies of comatose or vegetative patients indicate that a global loss of consciousness is usually caused by lesions that impair multiple sectors of the thalamocortical system, or at least their ability to work together as a system. [22][23][24]. By contrast, selective lesions of individual thalamocortical areas impair different submodalities of conscious experience, such as the perception of color or of faces [25].…”

Section: Consciousness Is Generated By a Distributed Thalamocortical mentioning

confidence: 99%

The Information Integration Theory of Consciousness

Tononi¹

2007

The Blackwell Companion to Consciousness

452

620

View full text Add to dashboard Cite

Background: Consciousness poses two main problems. The first is understanding the conditions that determine to what extent a system has conscious experience. For instance, why is our consciousness generated by certain parts of our brain, such as the thalamocortical system, and not by other parts, such as the cerebellum? And why are we conscious during wakefulness and much less so during dreamless sleep? The second problem is understanding the conditions that determine what kind of consciousness a system has. For example, why do specific parts of the brain contribute specific qualities to our conscious experience, such as vision and audition?

show abstract

“…For example, conscious perception of a stimulus is associated with a synchronous activation of higher associative cortices, particularly parietal, prefrontal, and anterior cingulate areas, whereas unconscious perception is associated only with a local activation (Dehaene et al, 2006). Consistent with these ideas, clinical work has shown that patients in a pervasive vegetative state (awake but unconscious) show only localised, modality-specific responses to stimuli, whereas patients in a minimally conscious state show coherent responses across multiple sensory and associative systems (Laureys et al, 2002). This is very important work as, in those cases, the difference between being unconscious and conscious can sometimes mean the difference between life and death (Caplan, McCartney, & Sisti, 2006).…”

Section: Splitting Consciousness In Social Cognition 29mentioning

confidence: 89%

Splitting consciousness: Unconscious, conscious, and metaconscious processes in social cognition

Winkielman¹,

Schooler²

2011

European Review of Social Psychology

View full text Add to dashboard Cite

This paper explores the interplay between unconscious, conscious, and metaconscious processes in social cognition. We distinguish among mental states that are (i) genuinely unaware, (ii) aware, but lack meta-awareness, and (iii) meta-aware-internally articulated as states of the perceiver. We review key studies from our own and related research programmes to highlight this theoretical framework, and to illustrate access, translational, and temporary dissociations between levels of awareness. The discussed phenomena include unconscious affect, mind-wandering, verbal overshadowing, theory-based biases in reporting of experiences, and many others. We also show how our framework can offer new perspectives on some classic social psychology findings and inspire discovery of new findings. However, we also highlight challenges inherent in establishing whether a phenomenon is genuinely unconscious or experientially conscious but lacking in meta-awareness.

show abstract

Brain Function in the Vegetative State

Cited by 70 publications

References 37 publications

Consciousness supporting networks

Consciousness supporting networks

The Information Integration Theory of Consciousness

Splitting consciousness: Unconscious, conscious, and metaconscious processes in social cognition

Contact Info

Product

Resources

About