Neuropsychiatry of consciousness

2020 ◽  
pp. 161-168
Author(s):  
David Linden
Keyword(s):  
Vegetative State ◽  
Persistent Vegetative State ◽  
Mental States ◽  
Unresponsive Wakefulness Syndrome ◽  
Clinical Syndromes ◽  
Clinical Presentations ◽  
Clinical Scenarios ◽  
Ascending Reticular Activating System ◽  
Reticular Activating System ◽  
Neurophysiological Mechanisms

Consciousness requires wakefulness and awareness. Many neuropsychiatric syndromes involve the disturbance of these functions. This chapter provides an overview of the various clinical presentations involving quantitative or qualitative disturbances of consciousness in order to explore the associated pathologies and underlying neurophysiological mechanisms. It lays out a number of clinical syndromes associated with impaired consciousness, such as persistent vegetative state (PVS) or unresponsive wakefulness syndrome (UWS), where the patient’s bodily functions can continue independently and show activity in higher motor areas when prompted under functional magnetic resonance imaging, yet are unable to communicate or follow commands. Focus is then given to altered mental states where conditions, such as neuroleptic malignant syndrome (NMS), may cause patients to experience depersonalization, fugue states, and hallucinations. After exploring the neuroanatomy and neurophysiology of such disorders, with a description of the function and significance of the ascending reticular activating system (ARAS), a number of clinical scenarios are presented.

scholarly journals Recovery of Hypersomnia Concurrent With Recovery of an Injured Ascending Reticular Activating System in a Stroke Patient

Medicine ◽  
2016 ◽  
Vol 95 (2) ◽  
pp. e2484 ◽  
Author(s):  
Sung Ho Jang ◽  
Han Do Lee ◽  
Chul Hoon Chang ◽  
Young Jin Jung
Keyword(s):  
Stroke Patient ◽  
Ascending Reticular Activating System ◽  
Reticular Activating System

Post-traumatic narcolepsy and injury of the ascending reticular activating system

2016 ◽  
Vol 17 ◽  
pp. 124-125 ◽  
Author(s):  
Sung Ho Jang ◽  
Wan Seok Seo ◽  
Hyeok Gyu Kwon
Keyword(s):  
Ascending Reticular Activating System ◽  
Reticular Activating System ◽  
Post Traumatic

scholarly journals The relationship between consciousness and the ascending reticular activating system in patients with traumatic brain injury

2020 ◽  
Author(s):  
Sung Ho Jang ◽  
YOUNGHYEON KWON
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Control Group ◽  
Impaired Consciousness ◽  
Patient Subgroup ◽  
Chronic Stage ◽  
Ascending Reticular Activating System ◽  
Reticular Activating System ◽  
Gcs Score ◽  
The Relationship

Abstract Background: We investigated the relationship between consciousness and the ascending reticular activating system(ARAS) by using diffusion tensor tractography(DTT) in patients with traumatic brain injury(TBI).Methods: Twenty-six patients with TBI and 13 healthy control subjects were recruited for this study. Glasgow Coma Scale(GCS) scores were used for evaluation of subject consciousness state at the chronic stage of TBI(at DTT scanning), According to the GCS score, the patient group was divided into two subgroups: A(14 patients;impaired consciousness:GCS score<15, and B(12 patients;intact consciousness;GCS score=15). Fractional anisotropy(FA) and tract volume(TV) values were assessed in the lower dorsal and upper ARAS.Results: The FA values of the lower dorsal ARAS and the upper ARAS in patient subgroup A were significantly lower than those in patient subgroup B and the control group(p<0.05). However, the FA and TV values for the lower dorsal ARAS and the upper ARAS were not significantly different between patient subgroup B and the control group(p>0.05). The FA value of the lower dorsal ARAS(r=0.473,p<0.05) and the TV of upper ARAS(r=0.484,p<0.05) had moderate positive correlations with the GCS score. The FA value of the upper ARAS had a strong positive correlation with the GCS score of the patient group(r=0.780,p<0.05).Conclusions: We detected a close relationship between consciousness at the chronic stage of TBI and injuries of the lower dorsal and upper ARAS(especially, the upper ARAS) in patients who showed impaired consciousness at the onset of TBI. We believe that our results can be useful during the development of therapeutic strategies for patients with impaired consciousness following TBI.

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