Cognition & Emotion Vol X; Issue Y
A recent publication discusses the different stages of the so-called post-traumatic amnesic period, including brain death,coma, vegetative state and minimaly conscious state. Brain function in coma, vegetative state, and related disorders. Laureys S, Owen AM, Schiff ND. Lancet Neurol. 2004 Sep;3(9):537-46 Abstract We review the nosological criteria and functional neuroanatomical basis for brain death, coma, […]
A recent publication discusses the different stages of the so-called post-traumatic amnesic period, including brain death,coma, vegetative state and minimaly conscious state.
Brain function in coma, vegetative state, and related disorders.
Laureys S, Owen AM, Schiff ND.
Lancet Neurol. 2004 Sep;3(9):537-46
Abstract
We review the nosological criteria and functional neuroanatomical basis for brain death, coma, vegetative state, minimally conscious state, and the locked-in state. Functional neuroimaging is providing new insights into cerebral activity in patients with severe brain damage. Measurements of cerebral metabolism and brain activations in response to sensory stimuli with PET, fMRI, and electrophysiological methods can provide information on the presence, degree, and location of any residual brain function. However, use of these techniques in people with severe brain damage is methodologically complex and needs careful quantitative analysis and interpretation. In addition, ethical frameworks to guide research in these patients must be further developed. At present, clinical examinations identify nosological distinctions needed for accurate diagnosis and prognosis. Neuroimaging techniques remain important tools for clinical research that will extend our understanding of the underlying mechanisms of these disorders.
_/_/_/_/_/ COMMENT
This work is some of the most important presently done on conscious states. The distinction between conscious and unconscious states have come a far way from the mere division between conscious and unconscious states. Today, unconscious states following e.g. brain injury or OD’ing are said to be part of a post-traumatic amnesic period. We can now distinguish between brain death, coma, vegetative state, minimally conscious state, conscious state and locked-in syndrome. This has tremendous impact not only on our theories about consciousness, but also on the lives of those affected by such injuries. The most prominent example is the case of Terri Schiavo. The scientific study of different states of awareness are probably still in their infancy, one of the potent methods for settling cases of whether a patient is conscious or not being neuroimaging techniques such as fMRI, PET, SPECT, MEG and EEG.
Links on these different disorders, or “steps” of consciousness:
_/_/_/ RELEVANT ARTICLES ON SCI-CON:ORG
Baars — Unconscious states cast light on consciousness
Overgaard — Automaticity, unconsciousness and speech production
Franklin — Web Workshop – The IDA model
_/_/_/ BRAIN DEATH
Wikipedia — Brain death
Brain Injury and Brain Death Resources
TransWeb — What is brain death?
Critical Care Nurse — Determining brain death
_/_/_/ COMA
Coma Recovery Association, Inc.
NINDS Coma and Persistent Vegetative State Information Page
Wikipedia — coma
_/_/_/ VEGETATIVE STATE
Wikipedia — Persistent vegetative state
Healthlink – Coma and vegetative state
Gustafson – Persistent vegetative state
The permanent vegetative state; ethical crux, medical function?
_/_/_/ MINIMALLY CONSCIOUS STATE
Kurzweil.net — Minimally conscious states
Giacino et al. (2002) The minimally conscious state: definition and diagnostic criteria (see comments)
_/_/_/ LOCKED-IN SYNDROME
NINDS Locked-In Syndrome Information Page
SfN — Unlocking Locked-In Syndrome
Healthlink – Locked-in syndrome
_/_/_/ COMA SCALES (examples)
_/_/_/ MISC LINKS
Terri Schindler-Schiavo Foundation
Wikipedia — Terri Schiavo
Baars, Rams�y & Laureys (2003) Brain, conscious experience and the observing self. Trends in Neuroscience (pdf)
>>> see also (at sci-con.org):
Clark – Is there an observing self?
and reply:
Baars – The evidence is overwhelming for an observing self in the brain.
