Detecting awareness after severe brain injury

被引:133
作者
Fernandez-Espejo, Davinia [1 ]
Owen, Adrian M. [1 ]
机构
[1] Univ Western Ontario, Dept Psychol, Brain & Mind Inst, Ctr Nat Sci, London, ON N6A 5B7, Canada
基金
加拿大健康研究院; 加拿大自然科学与工程研究理事会;
关键词
PERSISTENT VEGETATIVE STATE; MINIMALLY CONSCIOUS STATE; LOCKED-IN SYNDROME; BEDSIDE DETECTION; MOTOR IMAGERY; COGNITIVE FUNCTION; MENTAL NAVIGATION; MEDICAL ASPECTS; DISORDERS; COMMUNICATION;
D O I
10.1038/nrn3608
中图分类号
Q189 [神经科学];
学科分类号
071006 ;
摘要
Recent developments in functional neuroimaging have provided a number of new tools for assessing patients who clinically appear to be in a vegetative state. These techniques have been able to reveal awareness and even allow rudimentary communication in some patients who remain entirely behaviourally non-responsive. The implications of these results extend well beyond the immediate clinical and scientific findings to influencing legal proceedings, raising new ethical questions about the withdrawal of nutrition and hydration and providing new options for patients and families in that decision-making process. The findings have also motivated significant public discourse about the role of neuroscience research in society.
引用
收藏
页码:801 / 809
页数:9
相关论文
共 70 条
[21]   Shades of gray: New insights into the vegetative state [J].
Fins, Joseph J. ;
Schiff, Nicholas D. .
HASTINGS CENTER REPORT, 2006, 36 (06) :8-8
[22]   The ethics of measuring and modulating consciousness: the imperative of minding time [J].
Fins, Joseph J. .
COMA SCIENCE: CLINICAL AND ETHICAL IMPLICATIONS, 2009, 177 :371-382
[23]   Mental navigation along memorized routes activates the hippocampus, precuneus, and insula [J].
Ghaem, O ;
Mellet, E ;
Crivello, F ;
Tzourio, N ;
Mazoyer, B ;
Berthoz, A ;
Denis, M .
NEUROREPORT, 1997, 8 (03) :739-744
[24]   Behavioral assessment in patients with disorders of consciousness: gold standard or fool's gold? [J].
Giacino, Joseph T. ;
Schnakers, Caroline ;
Rodriguez-Moreno, Diana ;
Kalmar, Kathy ;
Schiff, Nicholas ;
Hirsch, Joy .
COMA SCIENCE: CLINICAL AND ETHICAL IMPLICATIONS, 2009, 177 :33-48
[25]   The JFK Coma Recovery Scale-Revised: Measurement characteristics and diagnostic utility [J].
Giacino, JT ;
Kalmar, K ;
Whyte, J .
ARCHIVES OF PHYSICAL MEDICINE AND REHABILITATION, 2004, 85 (12) :2020-2029
[26]   The minimally conscious state - Definition and diagnostic criteria [J].
Giacino, JT ;
Ashwal, S ;
Childs, N ;
Cranford, R ;
Jennett, B ;
Katz, DI ;
Kelly, JP ;
Rosenberg, JH ;
Whyte, J ;
Zafonte, RD ;
Zasler, ND .
NEUROLOGY, 2002, 58 (03) :349-353
[27]   Reanalysis of "Bedside detection of awareness in the vegetative state: a cohort study" [J].
Goldfine, Andrew M. ;
Bardin, Jonathan C. ;
Noirhomme, Quentin ;
Fins, Joseph J. ;
Schiff, Nicholas D. ;
Victor, Jonathan D. .
LANCET, 2013, 381 (9863) :289-291
[28]   A Wireless Brain-Machine Interface for Real-Time Speech Synthesis [J].
Guenther, Frank H. ;
Brumberg, Jonathan S. ;
Wright, E. Joseph ;
Nieto-Castanon, Alfonso ;
Tourville, Jason A. ;
Panko, Mikhail ;
Law, Robert ;
Siebert, Steven A. ;
Bartels, Jess L. ;
Andreasen, Dinal S. ;
Ehirim, Princewill ;
Mao, Hui ;
Kennedy, Philip R. .
PLOS ONE, 2009, 4 (12)
[29]   Assessing residual reasoning ability in overtly non-communicative patients using fMRI [J].
Hampshire, Adam ;
Parkin, Beth L. ;
Cusack, Rhodri ;
Espejo, Davinia Fernandez ;
Allanson, Judith ;
Kamau, Evelyn ;
Pickard, John D. ;
Owen, Adrian M. .
NEUROIMAGE-CLINICAL, 2013, 2 :174-183
[30]   Reach and grasp by people with tetraplegia using a neurally controlled robotic arm [J].
Hochberg, Leigh R. ;
Bacher, Daniel ;
Jarosiewicz, Beata ;
Masse, Nicolas Y. ;
Simeral, John D. ;
Vogel, Joern ;
Haddadin, Sami ;
Liu, Jie ;
Cash, Sydney S. ;
van der Smagt, Patrick ;
Donoghue, John P. .
NATURE, 2012, 485 (7398) :372-U121