The influence of different methods of verticalization on the level of consciousness in patients in a vegetative state.

2018 ◽  
Author(s):  
Andrey Belkin
Keyword(s):  
Vegetative State ◽  
Level Of Consciousness

Interaction Model of Brain and Consciousness

2018 ◽  
pp. 105-126
Author(s):  
Georg Northoff
Keyword(s):  
Empirical Evidence ◽  
Vegetative State ◽  
Interaction Model ◽  
Necessary Condition ◽  
Additive Interaction ◽  
Fine Grained ◽  
Nancy Cartwright ◽  
Level Of Consciousness ◽  
The Brain

In addition to the spectrum model, I also introduced an interaction model to characterize the brain’s neural activity (chapter 2). Is the interaction model of brain also relevant for consciousness? That is the focus in the present chapter. I here present various lines of empirical evidence focusing on disorders of consciousness like vegetative state, anesthesia, and sleep. Based on empirical evidence, I show that the degree of non-additive interaction between spontaneous and stimulus-induced activity indexes the level of consciousness in a seemingly rather fine-grained way; for that reason, it may be considered a neural correlate of the level of consciousness, i.e., NCC. In contrast, the spontaneous activity and its spatiotemporal structure is rather a necessary condition of possible consciousness, that is, a neural predisposition of consciousness (NPC). The concept of NPC is further enriched by the concept of capacities for which I recruit Nancy Cartwright. I suggest that the brain’s non-additive interaction including the subsequent association of stimulus-induced activity with consciousness is based on the spontaneous activity’s capacity. Since that very same capacity, operating as NPC, can be traced to the spontaneous activity’s spatiotemporal features, I speak of “spatiotemporal capacity”. I conclude that the empirical data suggest a capacity-based approach (rather than law-based approach) to the brain and how it is related to consciousness.

scholarly journals Stimulation of the Angular Gyrus Improves the Level of Consciousness

2019 ◽  
Vol 9 (5) ◽  
pp. 103 ◽  
Author(s):  
Liudmila Legostaeva ◽  
Alexandra Poydasheva ◽  
Elizaveta Iazeva ◽  
Dmitry Sinitsyn ◽  
Dmitry Sergeev ◽  
...  
Keyword(s):  
Repetitive Transcranial Magnetic Stimulation ◽  
Vegetative State ◽  
Minimally Conscious State ◽  
Conscious State ◽  
Angular Gyrus ◽  
New Approach ◽  
Promising Tool ◽  
Level Of Consciousness ◽  
Minimally Conscious ◽  
Left Angular Gyrus

Background: Navigated repetitive transcranial magnetic stimulation (rTMS) is a promising tool for neuromodulation. In previous studies it has been shown that the activity of the default mode network (DMN) areas, particularly of its key region—the angular gyrus—is positively correlated with the level of consciousness. Our study aimed to explore the effect of rTMS of the angular gyrus as a new approach for disorders of consciousness (DOC) treatment; Methods: A 10-session 2-week high-frequency rTMS protocol was delivered over the left angular gyrus in 38 DOC patients with repeated neurobehavioral assessments obtained at baseline and in 2 days after the stimulation course was complete; Results: 20 Hz-rTMS over left angular gyrus improved the coma recovery scale revised (CRS-R) total score in minimally conscious state (MCS) patients. We observed no effects in vegetative state (VS) patients; and Conclusions: The left angular gyrus is likely to be effective target for rTMS in patients with present signs of consciousness.

35. Changes in standard EEG findings parallel improvements in the level of consciousness in patients in a vegetative state

2016 ◽  
Vol 127 (12) ◽  
pp. e331
Author(s):  
C. Boccagni ◽  
S. Bagnato ◽  
A. Sant’Angelo ◽  
C. Prestandrea ◽  
G. Galardi
Keyword(s):  
Vegetative State ◽  
Level Of Consciousness

Assessing level of consciousness and cognitive changes from vegetative state to full recovery

2005 ◽  
Vol 15 (3-4) ◽  
pp. 307-322 ◽  
Author(s):  
Tristan Bekinschtein ◽  
Cecilia Tiberti ◽  
Jorge Niklison ◽  
Mercedes Tamashiro ◽  
Melania Ron ◽  
...  
Keyword(s):  
Vegetative State ◽  
Full Recovery ◽  
Cognitive Changes ◽  
Level Of Consciousness

Spectrum Model of Brain and Consciousness

2018 ◽  
pp. 79-104
Author(s):  
Georg Northoff
Keyword(s):  
Empirical Evidence ◽  
Vegetative State ◽  
Disorders Of Consciousness ◽  
Loss Of Consciousness ◽  
Hybrid Nature ◽  
Level Of Consciousness ◽  
Spectrum Model ◽  
Spatiotemporal Integration

Is the spectrum model of brain and its assumption of the hybrid nature of stimulus-induced activity relevant for consciousness? That is the focus in the present chapter. I here present various lines of empirical evidence focusing on disorders of consciousness like vegetative state, anesthesia, and sleep. These findings suggest that the loss of consciousness in vegetative state, anesthesia, and sleep is characterized by the loss of the hybrid nature of stimulus-induced activity which shifts more towards the passive pole. This lets me suppose that the hybrid nature of stimulus-induced activity including its spatiotemporal integration as postulated in the spectrum model is central for the level of consciousness. I therefore conclude that the spectrum model of brain is relevant for consciousness.

scholarly journals Quantitative Rates of Brain Glucose Metabolism Distinguish Minimally Conscious from Vegetative State Patients

2014 ◽  
Vol 35 (1) ◽  
pp. 58-65 ◽  
Author(s):  
Johan Stender ◽  
Ron Kupers ◽  
Anders Rodell ◽  
Aurore Thibaut ◽  
Camille Chatelle ◽  
...  
Keyword(s):  
Glucose Metabolism ◽  
Vegetative State ◽  
Minimally Conscious State ◽  
Conscious State ◽  
Operating Characteristics ◽  
Whole Brain ◽  
Clinical Issue ◽  
Level Of Consciousness ◽  
Minimally Conscious ◽  
Injured Patients

The differentiation of the vegetative or unresponsive wakefulness syndrome (VS/UWS) from the minimally conscious state (MCS) is an important clinical issue. The cerebral metabolic rate of glucose (CMRglc) declines when consciousness is lost, and may reveal the residual cognitive function of these patients. However, no quantitative comparisons of cerebral glucose metabolism in VS/UWS and MCS have yet been reported. We calculated the regional and whole-brain CMRglc of 41 patients in the states of VS/UWS ( n=14), MCS ( n=21) or emergence from MCS (EMCS, n=6), and healthy volunteers ( n=29). Global cortical CMRglc in VS/UWS and MCS averaged 42% and 55% of normal, respectively. Differences between VS/UWS and MCS were most pronounced in the frontoparietal cortex, at 42% and 60% of normal. In brainstem and thalamus, metabolism declined equally in the two conditions. In EMCS, metabolic rates were indistinguishable from those of MCS. Ordinal logistic regression predicted that patients are likely to emerge into MCS at CMRglc above 45% of normal. Receiver-operating characteristics showed that patients in MCS and VS/UWS can be differentiated with 82% accuracy, based on cortical metabolism. Together these results reveal a significant correlation between whole-brain energy metabolism and level of consciousness, suggesting that quantitative values of CMRglc reveal consciousness in severely brain-injured patients.

Deep brain stimulation for the early treatment of the minimally conscious state and vegetative state: experience in 14 patients

2018 ◽  
Vol 128 (4) ◽  
pp. 1189-1198 ◽  
Author(s):  
Darko Chudy ◽  
Vedran Deletis ◽  
Fadi Almahariq ◽  
Petar Marčinković ◽  
Jasenka Škrlin ◽  
...  
Keyword(s):  
Deep Brain Stimulation ◽  
Evoked Potentials ◽  
Brain Stimulation ◽  
Selection Criteria ◽  
Vegetative State ◽  
Minimally Conscious State ◽  
Conscious State ◽  
Level Of Consciousness ◽  
Minimally Conscious ◽  
Deep Brain

OBJECTIVEAn effective treatment of patients in a minimally conscious state (MCS) or vegetative state (VS) caused by hypoxic encephalopathy or traumatic brain injury (TBI) is not yet available. Deep brain stimulation (DBS) of the thalamic reticular nuclei has been attempted as a therapeutic procedure mainly in patients with TBI. The purpose of this study was to investigate the therapeutic use of DBS for patients in VS or MCS.METHODSFourteen of 49 patients in VS or MCS qualified for inclusion in this study and underwent DBS. Of these 14 patients, 4 were in MCS and 10 were in VS. The etiology of VS or MCS was TBI in 4 cases and hypoxic encephalopathy due to cardiac arrest in 10. The selection criteria for DBS, evaluating the status of the cerebral cortex and thalamocortical reticular formation, included: neurological evaluation, electrophysiological evaluation, and the results of positron emission tomography (PET) and MRI examinations. The target for DBS was the centromedian-parafascicular (CM-pf) complex. The duration of follow-up ranged from 38 to 60 months.RESULTSTwo MCS patients regained consciousness and regained their ability to walk, speak fluently, and live independently. One MCS patient reached the level of consciousness, but was still in a wheelchair at the time the article was written. One VS patient (who had suffered a cerebral ischemic lesion) improved to the level of consciousness and currently responds to simple commands. Three VS patients died of respiratory infection, sepsis, or cerebrovascular insult (1 of each). The other 7 patients remained without substantial improvement of consciousness.CONCLUSIONSSpontaneous recovery from MCS/VS to the level of consciousness with no or minimal need for assistance in everyday life is very rare. Therefore, if a patient in VS or MCS fulfills the selection criteria (presence of somatosensory evoked potentials from upper extremities, motor and brainstem auditory evoked potentials, with cerebral glucose metabolism affected not more than the level of hypometabolism, which is judged using PET), DBS could be a treatment option.

scholarly journals Nociceptive Response Is a Possible Marker of Evolution in the Level of Consciousness in Unresponsive Wakefulness Syndrome Patients

2021 ◽  
Vol 15 ◽  
Author(s):  
Maria Daniela Cortese ◽  
Francesco Arcuri ◽  
Idan E. Nemirovsky ◽  
Lucia Francesca Lucca ◽  
Paolo Tonin ◽  
...  
Keyword(s):  
Vegetative State ◽  
Behavioral Responses ◽  
Minimally Conscious State ◽  
Conscious State ◽  
Behavioral Changes ◽  
Nociceptive Response ◽  
Unresponsive Wakefulness Syndrome ◽  
Careful Evaluation ◽  
Level Of Consciousness ◽  
Minimally Conscious

The Nociception Coma Scale (NCS) and its revised version (NCS-R) were used to evaluate behavioral responses to pain in non-communicative patients. We hypothesized that if patients demonstrate changes to their NCS(-R) scores over time, their evolving behavioral abilities could indicate a forthcoming diagnostic improvement with the Coma Recovery Scale-Revised (CRS-R). Forty-three Vegetative State/Unresponsive Wakefulness Syndrome (VS/UWS) patients were enrolled in the study. The patients were assessed weekly using the CRS-R and NCS(-R) for four consecutive weeks. The first assessment was within 10 days after hospitalization. The assessments were performed between 09:30 and 11:30 AM in a room with constant levels of humidity, light and temperature, as well as an absence of transient noise. Noxious stimuli were administered using a Newton-meter, with pressure applied to the fingernail bed for a maximum of 5 s unless interrupted by a behavioral response from subjects. Seventeen patients demonstrated improvements in their level of consciousness, 13 of whom showed significant behavioral changes through the NCS(-R) before being diagnosed with a Minimally Conscious State (MCS) according to the CRS-R. The behavioral changes observed using the NCS(-R) corresponded to a high probability of observing an improvement from VS/UWS to MCS. To characterize the increased likelihood of this transition, our results present threshold scores of ≥5 for the NCS (accuracy 86%, sensitivity 87%, and specificity 86%) and ≥3 for the NCS-R (accuracy 77%, sensitivity 89%, and specificity 73%). In conclusion, a careful evaluation of responses to nociceptive stimuli in DOC patients could constitute an effective procedure in assessing their evolving conscious state.

Oncogenesis and the Lucké Virus

1968 ◽  
Vol 26 ◽  
pp. 200-201
Author(s):  
A. E. Vatter ◽  
J. Zambernard
Keyword(s):  
Rna Viruses ◽  
Vegetative State ◽  
Temperature Sensitive ◽  
Structural Level ◽  
Oncogenic Viruses ◽  
Dna Viruses ◽  
Leopard Frogs ◽  
Renal Adenocarcinoma ◽  
Induced Tumors ◽  
Northern Leopard Frogs

Oncogenic viruses, like viruses in general, can be divided into two classes, those that contain deoxyribonucleic acid (DNA) and those that contain ribonucleic acid (RNA). The RNA viruses have been recovered readily from the tumors which they cause whereas, the DNA-virus induced tumors have not yielded the virus. Since DNA viruses cannot be recovered, the bulk of present day investigations have been concerned with RNA viruses.The Lucké renal adenocarcinoma is a spontaneous tumor which occurs in northern leopard frogs (Rana pipiens) and has received increased attention in recent years because of its probable viral etiology. This hypothesis was first advanced by Lucké after he observed intranuclear inclusions in some of the tumor cells. Tumors with inclusions were examined at the fine structural level by Fawcett who showed that they contained immature and mature virus˗like particles.The use of this system in the study of oncogenic tumors offers several unique features, the virus has been shown to contain DNA and it can be recovered from the tumor, also, it is temperature sensitive. This latter feature is of importance because the virus can be transformed from a latent to a vegetative state by lowering or elevating the environmental temperature.

Confronting the grey zone after severe brain injury

2019 ◽  
Vol 3 (6) ◽  
pp. 707-711 ◽  
Author(s):  
Andrew Peterson ◽  
Adrian M. Owen
Keyword(s):  
Brain Injury ◽  
Ethical Issues ◽  
Vegetative State ◽  
Clinical Care ◽  
Grey Zone ◽  
Severe Brain Injury ◽  
New Methods ◽  
Legal Decision Making ◽  
Technological Developments ◽  
The Brain

In recent years, rapid technological developments in the field of neuroimaging have provided several new methods for revealing thoughts, actions and intentions based solely on the pattern of activity that is observed in the brain. In specialized centres, these methods are now being employed routinely to assess residual cognition, detect consciousness and even communicate with some behaviorally non-responsive patients who clinically appear to be comatose or in a vegetative state. In this article, we consider some of the ethical issues raised by these developments and the profound implications they have for clinical care, diagnosis, prognosis and medical-legal decision-making after severe brain injury.

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