Consciousness supporting networks

被引：132
作者：
Demertzi, Athena [1 ]
Soddu, Andrea
Laureys, Steven
机构：
[1] Univ Liege, Cyclotron Res Ctr, Coma Sci Grp, B-4000 Liege, Belgium
来源：
CURRENT OPINION IN NEUROBIOLOGY | 2013年 / 23卷 / 02期
关键词：
VEGETATIVE STATE; UNRESPONSIVE WAKEFULNESS; BRAIN ACTIVITY; DISORDERS; AWARENESS; CONNECTIVITY; MODULATION; RECOVERY; COMA; NAME;
D O I：
10.1016/j.conb.2012.12.003
中图分类号：
Q189 [神经科学];
学科分类号：
071006 ;
摘要：
Functional neuroimaging shows that patients with disorders of consciousness exhibit disrupted system-level functional connectivity. Unresponsive/"vegetative state" patients preserve wakefulness networks of brainstem and basal forebrain but the cerebral networks accounting for external perceptual awareness and internal self-related mentation are disrupted. Specifically, the 'external awareness' network encompassing lateral fronto-temporo-parietal cortices bilaterally, and the 'internal awareness' network including midline anterior cingulate/mesiofrontal and posterior cingulate/precuneal cortices, are functionally disconnected. By contrast, patients in minimally conscious state 'minus', who show non-reflex behaviors, are characterized by right-lateralized recovery of the external awareness network. Similarly, patients who evolve to minimally conscious state 'plus' and respond to commands recover the dominant left-lateralized language network. Now, the use of active experimental paradigms targeting at detecting motor-independent signs of awareness or even establishing communication with these patients, challenge these two clinical boundaries. Such advances are naturally accompanied by legitimate neuroscientific and ethical queries demanding our attention on the medical implementations of this new knowledge.
引用
收藏
页码：239 / 244
页数：6
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