Drug induced arousal from the permanent vegetative state

Clauss, R.P.; Nel, Wally

doi:10.3233/nre-2006-21104

Cited by 100 publications

(62 citation statements)

References 31 publications

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“…Finally, a similar return from abnormally high global brain metabolism to a normal balance of activation and inhibition could be evoked in rare cases of zolpidemevoked (a GABAergic agent) clinical improvement in VS patients. 26 Looking at these data as a whole (summarized in FIG. 1), the complex relationships between global brain metabolism and awareness could be linked to Tononi's theory of information integration.…”

Section: Pet Studies Of Brain Metabolism In Altered States Of Consciomentioning

confidence: 99%

Intrinsic Brain Activity in Altered States of Consciousness

Boly¹,

Phillips²,

Tshibanda

et al. 2008

Annals of the New York Academy of Sciences

317

123

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Spontaneous brain activity has recently received increasing interest in the neuroimaging community. However, the value of resting-state studies to a better understanding of brain-behavior relationships has been challenged. That altered states of consciousness are a privileged way to study the relationships between spontaneous brain activity and behavior is proposed, and common resting-state brain activity features observed in various states of altered consciousness are reviewed. Early positron emission tomography studies showed that states of extremely low or high brain activity are often associated with unconsciousness. However, this relationship is not absolute, and the precise link between global brain metabolism and awareness remains yet difficult to assert. In contrast, voxel-based analyses identified a systematic impairment of associative frontoparieto-cingulate areas in altered states of consciousness, such as sleep, anesthesia, coma, vegetative state, epileptic loss of consciousness, and somnambulism. In parallel, recent functional magnetic resonance imaging studies have identified structured patterns of slow neuronal oscillations in the resting human brain. Similar coherent blood oxygen level-dependent (BOLD) systemwide patterns can also be found, in particular in the default-mode network, in several states of unconsciousness, such as coma, anesthesia, and slow-wave sleep. The latter results suggest that slow coherent spontaneous BOLD fluctuations cannot be exclusively a reflection of conscious mental activity, but may reflect default brain connectivity shaping brain areas of most likely interactions in a way that transcends levels of consciousness, and whose functional significance remains largely in the dark.

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Section: Pet Studies Of Brain Metabolism In Altered States Of Consciomentioning

confidence: 99%

Intrinsic Brain Activity in Altered States of Consciousness

Boly¹,

Phillips²,

Tshibanda

et al. 2008

Annals of the New York Academy of Sciences

317

123

View full text Add to dashboard Cite

show abstract

“…5 Though the study did not examine the effects of amantadine on chronic consciousness disorders, case reports and preliminary trials have described marked (if transient) improvements in visual tracking and command-following in a small number of patients administered zolpidem, even years after their initial brain injuries. 3,4 As such reports continue to emerge, patients with acute and sub-acute disorders of consciousness are increasingly likely to become candidates for rehabilitative rather than supportive care.…”

Section: Brief Reportsmentioning

confidence: 99%

“…In the last 10 years, isolated reports have described patients being aroused from minimally conscious and persistent vegetative states with the hypnotic drug zolpidem. 3,4 More recently, a multi-center,…”

mentioning

confidence: 99%

Holistic Rehabilitation Care of a Minimally Conscious Patient

Stevenson¹,

Roth²

2015

AMSRJ

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“…The "workhorse" agents used in rehabilitation of individuals with disturbances in consciousness have his-torically centered on dopamine agonists, [76][77][78][79][80][81][82][83] and more recently on the GABA agonists zolpidem and baclofen. [84][85][86][87][88][89][90][91]…”

Section: Pharmacologic Interventionsmentioning

confidence: 99%

Neurorehabilitation in Disorders of Consciousness

2013

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Survivors of severe acquired brain injury often experience prolonged disturbance in consciousness following emergence from coma. Most individuals pass through the vegetative or minimally conscious states en route to eventual recovery of consciousness, although either condition may be permanent. Rehabilitation clinicians charged with the care of these patients face numerous challenges as there are many open questions concerning diagnostic and prognostic accuracy, the natural history of recovery, and the most effective approaches to prevent medical complications and facilitate functional recovery. The last 5 years have been witness to a marked increase in well-designed empirical investigations concerning the rehabilitation of patients with disorders of consciousness. In this article, the authors review recent evidence concerning key factors that influence the course of recovery, present a model of care designed to mitigate medical complications, describe a systematic approach to assessment, and review the effectiveness of treatment interventions utilized in the rehabilitation setting.

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Drug induced arousal from the permanent vegetative state

Cited by 100 publications

References 31 publications

Intrinsic Brain Activity in Altered States of Consciousness

Intrinsic Brain Activity in Altered States of Consciousness

Holistic Rehabilitation Care of a Minimally Conscious Patient

Neurorehabilitation in Disorders of Consciousness

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