Disturbances in higher order consciousness encountered in neuropsychological rehabilitation and assessment DOI Open Access
G. P. Prigatano

Journal of the International Neuropsychological Society, Journal Year: 2024, Volume and Issue: unknown, P. 1 - 10

Published: Dec. 16, 2024

Abstract Objective: The purpose of this invited paper was to summarize my clinical research on disturbances higher order consciousness (i.e., primarily self-awareness but including anosognosia and impaired awareness another person’s cognitive/emotional state) that contributed receiving the Distinguished Career Award from International Neuropsychology Society. Methods: I reviewed early encounters with in then a series studies performed various colleagues over last 45 years better understand nature these disturbances. findings obtained are also discussed within context other researchers’ observations during time frame. Results: Disturbances include classic anosognosia, self-awareness, denial disability, ability. Proposed diagnostic features each outlined model for understanding their complex relationships suggested. Different treatment/rehabilitation approaches summarized. Conclusion: often revealed when exploring person subjective experiences neurological neuropsychological functioning following different brain disorders. These have value lead rehabilitation approaches. investigation should integrating knowledge neurosciences nonbiological understandings how cultural personality may influences associated known or suspected disorder.

Language: Английский

A Landscape of Consciousness: Toward a Taxonomy of Explanations and Implications DOI Creative Commons
Robert Lawrence Kuhn

Progress in Biophysics and Molecular Biology, Journal Year: 2024, Volume and Issue: 190, P. 28 - 169

Published: Jan. 26, 2024

Diverse explanations or theories of consciousness are arrayed on a roughly physicalist-to-nonphysicalist landscape essences and mechanisms. Categories: Materialism Theories (philosophical, neurobiological, electromagnetic field, computational informational, homeostatic affective, embodied enactive, relational, representational, language, phylogenetic evolution); Non-Reductive Physicalism; Quantum Theories; Integrated Information Theory; Panpsychisms; Monisms; Dualisms; Idealisms; Anomalous Altered States Challenge Theories. There many subcategories, especially for Each explanation is self-described by its adherents, critique minimal only clarification, there no attempt to adjudicate among theories. The implications assessed with respect four questions: meaning/purpose/value (if any); AI consciousness; virtual immortality; survival beyond death. A Landscape Consciousness, I suggest, offers perspective.

Language: Английский

Citations

30

Acute biomarkers of consciousness are associated with recovery after severe traumatic brain injury DOI Creative Commons
Yelena G. Bodien, Matteo Fecchio, Natalie Gilmore

et al.

medRxiv (Cold Spring Harbor Laboratory), Journal Year: 2025, Volume and Issue: unknown

Published: March 5, 2025

Abstract Objective Determine whether acute behavioral, electroencephalography (EEG), and functional MRI (fMRI) biomarkers of consciousness are associated with outcome after severe traumatic brain injury (TBI). Methods Patients TBI admitted consecutively to the intensive care unit (ICU) participated in a multimodal battery assessing behavioral level (Coma Recovery Scale-Revised [CRS-R]), cognitive motor dissociation (CMD; task-based EEG fMRI), covert cortical processing (CCP; stimulus-based default mode network connectivity (DMN; resting-state fMRI). The primary was 6-month Disability Rating Scale (DRS) total scores. Results We enrolled 55 patients TBI. Six-month available 45 (45.2±20.7 years old, 70% male), whom 10 died, all due withdrawal life-sustaining treatment (WLST). Behavioral presence command-following ICU were each lower (i.e., better) DRS scores (p=0.003, p=0.011). fMRI did not strengthen this relationship, but higher DMN better recovery on multiple secondary measures. In subsample participants without CRS-R, CMD (EEG:18%; fMRI:33%) CCP (EEG:91%; fMRI:79%) outcome, an unexpected result that may reflect high rate WLST. However, (ρ[95%CI]=-0.41[-0.707, -0.027]; p=0.046) group. Interpretation Standardized assessment improve prediction from Further research is required determine integrating EEG, more predictive than alone.

Language: Английский

Citations

0

Duration of resuscitation, regain of consciousness and histopathological severity of hypoxic-ischemic encephalopathy after cardiac arrest DOI Creative Commons

Christian Endisch,

K. N. Millard,

Sandra Preuß

et al.

Resuscitation Plus, Journal Year: 2025, Volume and Issue: unknown, P. 100945 - 100945

Published: March 1, 2025

To study the histopathologically quantified severity of hypoxic-ischemic encephalopathy (HIE) in deceased cardiac arrest unbiased by death causes and correlated with demographic parameters. We conducted a retrospective, single-centre including patients postmortem brain autopsies. Using selective eosinophilic neuronal (SEND), histopathological HIE was cerebral neocortex, hippocampus, basal ganglia, cerebellum, brainstem, included 319 median time return from to spontaneous circulation (tROSC) 10 min, whom 62(19.4%) had regain consciousness (RoC) before death. The tROSC significantly SEND all regions (p < 0.05, Spearman's rho = 0.14 0.29). ganglia RoC -0.25 -0.11). In 9 tROSCs less than 1 brainstem 30%, 8(88.9%) neocortical 30%. Among 69 greater 20 47.8-82.6% showed 30% across regions. found more likely shorter tROSCs. A min mostly associated Prolonged resuscitations did not exclude relevant proportion patients. Future studies are warranted investigate impact modifiable clinical parameters on HIE.

Language: Английский

Citations

0

Shared subcortical arousal systems across sensory modalities during transient modulation of attention DOI Creative Commons
Aya Khalaf, Erick Gómez Tagle López, Jian Li

et al.

NeuroImage, Journal Year: 2025, Volume and Issue: unknown, P. 121224 - 121224

Published: April 1, 2025

Language: Английский

Citations

0

Restoring consciousness with pharmacologic therapy: Mechanisms, targets, and future directions DOI Creative Commons
Megan E. Barra, Ken Solt, Xin Yu

et al.

Neurotherapeutics, Journal Year: 2024, Volume and Issue: 21(4), P. e00374 - e00374

Published: July 1, 2024

Language: Английский

Citations

2

Mesoscale Brain Mapping: Bridging Scales and Modalities in Neuroimaging – A Symposium Review DOI Creative Commons

Joshua K Marchant,

Natalie Ferris,

Diana Grass

et al.

Neuroinformatics, Journal Year: 2024, Volume and Issue: 22(4), P. 679 - 706

Published: Sept. 23, 2024

Abstract Advances in the spatiotemporal resolution and field-of-view of neuroimaging tools are driving mesoscale studies for translational neuroscience. On October 10, 2023, Center Mesoscale Mapping (CMM) at Massachusetts General Hospital (MGH) Athinoula A. Martinos Biomedical Imaging Institute Technology (MIT) Health Sciences based Neuroimaging Training Program (NTP) hosted a symposium exploring state-of-the-art this rapidly growing area research. “Mesoscale Brain Mapping: Bridging Scales Modalities Neuroimaging” brought together researchers who use broad range imaging techniques to study brain structure function convergence microscopic macroscopic scales. The day-long event centered on areas which CMM has established expertise, including development emerging technologies their application clinical needs basic neuroscience questions. in-person welcomed more than 150 attendees, 57 faculty members, 61 postdoctoral fellows, 35 students, four industry professionals, represented institutions local, regional, international levels. also served training goals both NTP. content, organization, format were planned collaboratively by trainees. Many presented or participated panel discussion, thus contributing dissemination they have developed under auspices findings obtained using those technologies. NTP trainees benefited from included helped organize and/or posters gave “flash” oral presentations. In addition gaining experience presenting work, had opportunities throughout day engage one-on-one discussions with visiting scientists other faculty, potentially opening door future collaborations. presentations provided deep exploration many technological advances enabling progress structural functional imaging. Finally, students worked closely develop report summarizing content putting it broader context current state field share scientific community. We note that references cited here include conference abstracts corresponding poster

Language: Английский

Citations

2

Covert Consciousness in the ICU DOI
Brian L. Edlow,

David K. Menon

Critical Care Medicine, Journal Year: 2024, Volume and Issue: 52(9), P. 1414 - 1426

Published: Aug. 15, 2024

OBJECTIVES: For critically ill patients with acute severe brain injuries, consciousness may reemerge before behavioral responsiveness. The phenomenon of covert (i.e., cognitive motor dissociation) be detected by advanced neurotechnologies such as task-based functional MRI (fMRI) and electroencephalography (EEG) in who appear unresponsive on the bedside examination. In this narrative review, we summarize state-of-the-science ICU detection consciousness. Further, consider prognostic therapeutic implications diagnosing ICU, well its potential to inform discussions about continuation life-sustaining therapy for injuries. DATA SOURCES: We reviewed salient medical literature regarding STUDY SELECTION: included clinical studies investigating diagnostic performance characteristics utility fMRI EEG. focus guidelines, professional society scientific statements, neuroethical analyses pertaining implementation detect EXTRACTION AND SYNTHESIS: extracted study results, guideline recommendations, statement recommendations diagnostic, prognostic, relevance care CONCLUSIONS: Emerging evidence indicates that is present approximately 15–20% Covert traumatic nontraumatic including whose examination suggests a comatose state. presence predict pace extent long-term recovery. Professional guidelines now recommend assessment using However, criteria patient selection investigations are uncertain global access limited.

Language: Английский

Citations

1

Subcortical Hubs of Brain Networks Sustaining Human Consciousness DOI Creative Commons

Morgan K. Cambareri,

Andreas Horn, Laura D. Lewis

et al.

bioRxiv (Cold Spring Harbor Laboratory), Journal Year: 2024, Volume and Issue: unknown

Published: Oct. 5, 2024

Abstract Neuromodulation of subcortical network hubs by pharmacologic, electrical, or ultrasonic stimulation is a promising therapeutic strategy for patients with disorders consciousness (DoC). However, optimal targets are not well established. Here, we leveraged 7 Tesla resting-state functional MRI (rs-fMRI) data from 168 healthy subjects the Human Connectome Project to map connectivity six canonical cortical networks that modulate higher-order cognition and function: default mode, executive control, salience, dorsal attention, visual, somatomotor networks. Based on spatiotemporally overlapped generated Nadam-Accelerated SCAlable Robust (NASCAR) tensor decomposition method, our goal was identify functionally connected multiple We found ventral tegmental area (VTA) in midbrain central lateral (CL) parafascicular (Pf) nuclei thalamus – regions have historically been targeted neuromodulatory therapies restore widely Further, identified hub pontomesencephalic tegmentum reticular extrareticular arousal encompassed well-established “hot spot” coma-causing brainstem lesions. Multiple within thalamic intralaminar were both DMN SN, emphasizing importance these integrative subcortico-cortical signaling. Additional observed caudate head, putamen, amygdala, hippocampus, bed nucleus stria terminalis, classically associated modulation cognition, behavior, sensorimotor function. Collectively, results suggest tegmentum, thalamus, basal ganglia, medial temporal lobe function human brain. Our findings strengthen evidence targeting area, DoC. release all maps support ongoing efforts at neuromodulation consciousness.

Language: Английский

Citations

1

Synthetic data in generalizable, learning-based neuroimaging DOI Creative Commons
Karthik Gopinath, Andrew Hoopes, Daniel C. Alexander

et al.

Imaging Neuroscience, Journal Year: 2024, Volume and Issue: 2, P. 1 - 22

Published: Jan. 1, 2024

Synthetic data have emerged as an attractive option for developing machine-learning methods in human neuroimaging, particularly magnetic resonance imaging (MRI)-a modality where image contrast depends enormously on acquisition hardware and parameters. This retrospective paper reviews a family of recently proposed methods, based synthetic data, generalizable machine learning brain MRI analysis. Central to this framework is the concept domain randomization, which involves training neural networks vastly diverse array synthetically generated images with random properties. technique has enabled robust, adaptable models that are capable handling contrasts, resolutions, pathologies, while working out-of-the-box, without retraining. We successfully applied method tasks such whole-brain segmentation (SynthSeg), skull-stripping (SynthStrip), registration (SynthMorph, EasyReg), super-resolution, MR transfer (SynthSR). Beyond these applications, discusses other possible use cases future work our methodology. Neural trained enable analysis clinical MRI, including large datasets, greatly alleviating (and sometimes eliminating) need substantial labeled offer enormous potential robust tools address various research goals.

Language: Английский

Citations

1

Shared subcortical arousal systems across sensory modalities during transient modulation of attention DOI Creative Commons
Aya Khalaf, Erick Gómez Tagle López, Jian Li

et al.

bioRxiv (Cold Spring Harbor Laboratory), Journal Year: 2024, Volume and Issue: unknown

Published: Sept. 16, 2024

Abstract Subcortical arousal systems are known to play a key role in controlling sustained changes attention and conscious awareness. Recent studies indicate that these have major influence on short-term dynamic modulation of visual attention, but their across sensory modalities is not fully understood. In this study, we investigated shared subcortical during transient using block event-related fMRI paradigms. We analyzed massive publicly available datasets collected while 1,561 participants performed visual, auditory, tactile, taste perception tasks. Our analyses revealed circuit exhibiting early increases activity midbrain reticular formation central thalamus perceptual modalities, as well less consistent pons, hypothalamus, basal forebrain, ganglia. Identifying networks critical for understanding mechanisms normal consciousness may help facilitate targeting therapeutic neuromodulation.

Language: Английский

Citations

0