By Martin M. Monti, Walter G. Sannita
This booklet offers up to date details on all features of mind functionality and responsiveness in sufferers with serious issues of attention. issues thought of contain the mechanisms and measures of cognizance; perfusional, metabolic, and fMRI markers of responsiveness; responsiveness to ache; the position of brain–computer interface suggestions; electrophysiology; cortical excitability; autonomic responsiveness; the average historical past of vegetative and minimally wide awake states; and prediction of final result. mind neuroimaging has documented residual responsiveness within the vegetative nation. The clinical influence of this seminal facts has generated a schism among neuroscience and the scientific standards defining recognition and responsiveness. Our present figuring out of human recognition needs to be reconsidered additionally in view of the emotional effect at the public and the far-reaching implications for analysis, diagnosis, scientific therapy, human expenditures, scientific and person accountability, logistics, healthcare, ethics, and so on. it really is was hoping that this publication can help to bridge the distance among neuroscience and medical regimen.
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Additional resources for Brain Function and Responsiveness in Disorders of Consciousness
1 Summary of the behavioral features for coma, VS/UWS, MCS−, MCS+, and emergence from MCS Level of consciousness Coma Vegetative state/unresponsive wakefulness syndrome Minimally conscious state Behavioral features No arousal/eye opening Impaired spontaneous breathing/brainstem reflexes No oriented or purposeful behaviors No groans, vocalizations, or verbalizations No language comprehension/response to command Arousal/spontaneous or stimulus-induced eye opening Preserved spontaneous breathing/brainstem reflexes No oriented or purposeful behaviors Groans and/or vocalizations but no verbalizations No language comprehension/response to command Fluctuation of vigilance (MCS−/+) Preserved spontaneous breathing/brainstem reflexes MCS−: object localization-reaching-manipulation and/or sustained visual fixation and/or visual pursuit and/or automatic motor behavior and/or localization to pain MCS+: command following and/or object recognition and/or intelligible verbalization and/or intentional communication Emergence: functional communication and/or functional object use on at least two consecutive assessments Consciousness recovery consists of regaining fluctuating but reproducible nonreflexive-oriented and/or voluntary behaviors.
Lancet Neurol 3:537–546. 1016/S1474-4422(04)00852-X 65. Monti MM, Laureys S, Owen AM (2010) The vegetative state. BMJ 341:c3765. c3765 66. Fernández-Espejo D, Bekinschtein T, Monti MM et al (2011) Diffusion weighted imaging distinguishes the vegetative state from the minimally conscious state. Neuroimage 54:103– 112. 035 24 D. Bor 67. Schiff ND, Giacino JT, Kalmar K et al (2007) Behavioural improvements with thalamic stimulation after severe traumatic brain injury. Nature 448:600–603. 1038/nature06818 68.
PLoS Biol 7, e61 78. Aaronson S (2014) Why i am not an integrated information theorist (or, The unconscious expander). In: Shtetl Optim. Blog Scott Aaronson. p=1799 79. Barrett AB, Seth AK (2011) Practical measures of integrated information for time-series data. PLoS Comput Biol 7:e1001052. 1001052 80. Monti MM, Vanhaudenhuyse A, Coleman MR et al (2010) Willful modulation of brain activity in disorders of consciousness. N Engl J Med 362:579–589. 1056/NEJMoa0905370, NEJMoa0905370 [pii] 81. Owen AM, Coleman MR, Boly M et al (2006) Detecting awareness in the vegetative state.