Inference and Inductive Risk

2021 ◽  
pp. 75-92
Author(s):  
L. Syd M Johnson

Several types of inferences are common in the diagnosis and prognosis of brain injuries. These inferences, although necessary, introduce epistemic uncertainty. This chapter details the various inferences and considers the concept of inductive risk, introduced by Richard Rudner in the 1950s, and the problem of inductive risk: given uncertainty, what is the appropriate epistemic standard of evidence for accepting a scientific (or medical) hypothesis? Two principles of inductive risk are proposed to tackle the problem of inductive risk present in disorders of consciousness (and other medical contexts): the First Principle calls on us to index epistemic risk-taking to the level of ethical risk, thus constraining acceptable epistemic risk-taking. The Second Principle tells us to index ethical risk-taking to the level of epistemic risk, thus constraining ethical risk-taking to a level commensurate with epistemic uncertainty.

Author(s):  
Justin B. Biddle ◽  
Rebecca Kukla

At each stage of inquiry, actions, choices, and judgments carry with them a chance that they will lead to mistakes and false conclusions. One of the most vigorously discussed kinds of epistemic risk is inductive risk—that is, the risk of inferring a false positive or a false negative from statistical evidence. This chapter develops a more fine-grained typology of epistemic risks and argues that many of the epistemic risks that have been classified as inductive risks are actually better seen as examples of a more expansive category, which this paper dubs “phronetic risk.” This more fine-grained typology helps to show that values in science often operate not exclusively at the level of individual psychologies but also at the level of knowledge-generating social institutions.


Brain ◽  
2017 ◽  
Vol 140 (8) ◽  
pp. 2120-2132 ◽  
Author(s):  
Srivas Chennu ◽  
Jitka Annen ◽  
Sarah Wannez ◽  
Aurore Thibaut ◽  
Camille Chatelle ◽  
...  

2019 ◽  
Author(s):  
Bertrand Hermann ◽  
Federico Raimondo ◽  
Lukas Hirsch ◽  
Yu Huang ◽  
Mélanie Denis-Valente ◽  
...  

ABSTRACTSevere brain injuries can lead to long-lasting disorders of consciousness (DoC) such as vegetative state/unresponsive wakefulness syndrome (VS/UWS) or minimally conscious state (MCS). While behavioral assessment remains the gold standard to determine conscious state, EEG has proven to be a promising complementary tool to monitor the effect of new therapeutics. Encouraging results have been obtained with invasive electrical stimulation of the brain, and recent studies identified transcranial direct current stimulation (tDCS) as an effective approach in randomized controlled trials. This non-invasive and inexpensive tool may turn out to be the preferred treatment option. However, its mechanisms of action and physiological effects on brain activity remain unclear and debated. Here, we stimulated 60 DoC patients with the anode placed over left-dorsolateral prefrontal cortex in a prospective open-label study. Clinical behavioral assessment improved in twelve patients (20%) and none deteriorated. This behavioral response after tDCS coincided with an enhancement of putative EEG markers of consciousness: in comparison with non-responders, responders showed increases of power and long-range cortico-cortical functional connectivity in the theta-alpha band, and a larger and more sustained P300 suggesting improved conscious access to auditory novelty. The EEG changes correlated with electric fields strengths in prefrontal cortices, and no correlation was found on the scalp. Taken together, this prospective intervention in a large cohort of DoC patients strengthens the validity of the proposed EEG signatures of consciousness, and is suggestive of a direct causal effect of tDCS on consciousness.


2020 ◽  
Vol 2020 ◽  
pp. 1-7
Author(s):  
Sergio Bagnato ◽  
Giuseppe Galardi ◽  
Francesco Ribaudo ◽  
Cristina Boccagni ◽  
Teresa Valentina Fiorilla ◽  
...  

Little is known about plastic changes occurring in the brains of patients with severe disorders of consciousness (DOCs) caused by acute brain injuries at rest and during rehabilitative treatment. Brain-derived neurotrophic factor (BDNF) is a neurotrophin involved in neurogenesis and synaptic plasticity whose production is powerfully modulated by physical exercise. In this study, we compared serum BDNF levels in 18 patients with unresponsive wakefulness syndrome (UWS) and in a minimally conscious state (MCS) with those in 16 sex- and age-matched healthy controls. In 12 patients, serum BDNF levels before and after verticalization with ErigoPro robot-assisted lower-limb training were compared. Serum BDNF levels were significantly lower in patients (median, 1141 pg/ml; 25th and 75th percentiles, 1016 and 1704 pg/ml) than in controls (median, 2450 pg/ml; 25th and 75th percentiles, 2100 and 2875 pg/ml; p<0.001). BDNF levels measured before and after verticalization with robot-assisted lower-limb training did not change (p=0.5). Moreover, BDNF levels did not differ between patients with UWS and MCS (p=0.2), or between patients with traumatic and nontraumatic brain injuries (p=0.6). BDNF level correlated positively with the time since brain injury (p=0.025). In conclusion, serum BDNF levels are reduced in patients with UWS and MCS and cannot be improved by verticalization associated with passive lower-limb training. Additional studies are needed to better understand the mechanisms underlying BDNF reduction in patients with DOCs and to determine the best rehabilitative strategies to promote restorative plastic changes in these patients.


2017 ◽  
Vol 264 (9) ◽  
pp. 1986-1995 ◽  
Author(s):  
Daniel Golkowski ◽  
Katharina Merz ◽  
Caroline Mlynarcik ◽  
Tobias Kiel ◽  
Barbara Schorr ◽  
...  

2011 ◽  
Vol 6 (2) ◽  
pp. 291-299 ◽  
Author(s):  
Damian Cruse ◽  
Martin M Monti ◽  
Adrian M Owen

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