Modes and Models in Disorders of Consciousness Science
Modes and Models in Disorders of Consciousness Science
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DOI：
10.4449/aib.v150i2.1372
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发表时间：
2012-06-01
影响因子：
1
通讯作者：
Seth, A. K.
中科院分区：
文献类型：
--
作者：
Boly, M.;Seth, A. K.
非交流性脑损伤患者的临床评估是极其困难的，并且需要意识水平的临床旁诊断标志物。在过去的几年里，神经影像学的进步导致了越来越多的研究调查植物人状态和最低意识状态的患者，这可以分为两个主要的方法。主动神经成像范式搜索对命令的反应，而不需要运动反应。被动神经成像范式研究自发性脑活动和脑对外部刺激的反应，旨在识别意识的神经相关物。其他被动范式避开神经影像学，支持可靠区分健康对照中有意识和无意识状况的行为标记。为了提供准确的诊断标准，似乎需要对大脑如何产生意识进行机械解释。机械和理论方法也可以最终导致统一的被动和主动的范式在一个连贯的诊断方法。在本文中，我们调查目前的被动和主动范式可用于诊断植物人状态和最低意识患者的残留意识。然后，我们回顾了当前意识的主要理论，看看它们如何在这种情况下应用。最后，我们讨论了在这一领域的未来研究的一些途径。
The clinical assessment of non-communicative brain damaged patients is extremely difficult and there is a need for paraclinical diagnostic markers of the level of consciousness. In the last few years, progress within neuroimaging has led to a growing body of studies investigating vegetative state and minimally conscious state patients, which can be classified in two main approaches. Active neuroimaging paradigms search for a response to command without requiring a motor response. Passive neuroimaging paradigms investigate spontaneous brain activity and brain responses to external stimuli and aim at identifying neural correlates of consciousness. Other passive paradigms eschew neuroimaging in favour of behavioural markers which reliably distinguish conscious and unconscious conditions in healthy controls. In order to furnish accurate diagnostic criteria, a mechanistic explanation of how the brain gives rise to consciousness seems desirable. Mechanistic and theoretical approaches could also ultimately lead to a unification of passive and active paradigms in a coherent diagnostic approach. In this paper, we survey current passive and active paradigms available for diagnosis of residual consciousness in vegetative state and minimally conscious patients. We then review the current main theories of consciousness and see how they can apply in this context. Finally, we discuss some avenues for future research in this domain.