Electrical stimulation of a small brain area reversibly disrupts consciousness

Koubeissi, Mohamad Z.; Bartolomei, Fabricē; Beltagy, Abdelrahman; Picard, Fabienne

doi:10.1016/j.yebeh.2014.05.027

Cited by 167 publications

(148 citation statements)

References 14 publications

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“…The strongest signal was found in the claustrum, and nearly all neurons exhibited high k opioid receptor signals. Interestingly, Koubeissi et al (2014) reported the case of a 54-year-old patient with intractable epilepsy. Fifteen intraparenchymal electrodes were implanted in her brain to assess the origin of her seizures.…”

Section: H a Role For The Claustrum?mentioning

confidence: 99%

“…Stimulation of neighboring contacts that were within 2.7 mm did not elicit such phenomena. Koubeissi et al (2014) speculate that the claustrum "could be a key component of the network supporting 'conscious awareness' during wakefulness." The authors suggest that the claustrum might constitute a common gate to the external and internal awareness networks, perhaps being a component of the neural correlates of consciousness mediating increased synchronization between various cortical regions.…”

Section: H a Role For The Claustrum?mentioning

confidence: 99%

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Psychedelics

2016

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Section: H a Role For The Claustrum?mentioning

confidence: 99%

Section: H a Role For The Claustrum?mentioning

confidence: 99%

Psychedelics

2016

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“…16 Only in recent years has the scientific community gained a strong interest in the function of the claustrum, mainly with respect to its role in sensory integration and consciousness. [17][18][19][20][21] METHODS Patients and investigations. In a retrospective multicenter study ( -Dec 2013, information including demographic data, clinical features, diagnostic findings, therapeutic interventions, and clinical outcomes of patients fulfilling the following inclusion criteria were acquired: (1) previously healthy adults (.16 years of age) with refractory SE (failed IV treatment with antiepileptic drugs, requiring general anesthesia) 22 ; (2) onset of seizures 0-21 days after a febrile illness; and (3) lacking evidence of infectious agents in CSF.…”

mentioning

confidence: 99%

“…Recent advances in neuroanatomy and physiology indicate this subcortical region as a highly relevant hub center in neural synchronization of several (and distant) cortical areas, and, as a consequence, a structure involved in integration of conscious perception. [17][18][19][20][21] Considering these physiologic properties of the claustrum, this structure could also be a key region in promoting the propagation and synchronization of abnormal epileptic activity from several cortical regions. To this point, 2 properties of claustral neurons are relevant.…”

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confidence: 99%

Claustrum damage and refractory status epilepticus following febrile illness

et al. 2015

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Objective: To characterize the clinical, EEG, and brain imaging findings in an adult case series of patients with de novo refractory status epilepticus (SE) occurring after a febrile illness.Methods: A retrospective study (2010)(2011)(2012)(2013) was undertaken with the following inclusion criteria: (1) previously healthy adults with refractory SE; (2) seizure onset 0-21 days after a febrile illness; (3) lacking evidence of infectious agents in CSF; (4) no history of seizures (febrile or afebrile) or previous or concomitant neurologic disorder.Results: Among 155 refractory SE cases observed in the study period, 6 patients (17-35 years old) fulfilled the inclusion criteria. Confusion and stupor were the most common symptoms at disease onset, followed after a few days by acute repeated seizures that were uncountable in all but one. Seizures consisted of focal motor/myoclonic phenomena with subsequent generalization. Antiepileptic drugs failed in every patient to control seizures, with all participants requiring intensive care unit admission. Barbiturate coma with burst-suppression pattern was applied in 4 out of 6 patients for 5-14 days. One participant died in the acute phase. In each patient, we observed a reversible bilateral claustrum MRI hyperintensity on T2-weighted sequences, without restricted diffusion, time-related with SE. All patients had negative multiple neural antibodies testing. Four out of 5 surviving patients developed chronic epilepsy.Conclusions: This is a hypothesis-generating study of a preliminary nature supporting the role of the claustrum in postfebrile de novo SE; future prospective studies are needed to delineate the specificity of this condition, its pathogenesis, and the etiology. Neurology ® 2015;85:1224-1232 GLOSSARY ADC 5 apparent diffusion coefficient; AED 5 antiepileptic drug; FIRES 5 febrile infection-related epilepsy syndrome; ICU 5 intensive care unit; IVIg 5 IV immunoglobulin; NORSE 5 new-onset refractory status epilepticus; PEX 5 plasma exchange; SE 5 status epilepticus.In the last 2 decades, several authors described a series of syndromes characterized by the development of a difficult to treat status epilepticus (SE) in previously healthy children after a febrile illness.1-7 The condition is characterized by a refractory SE and followed by drug-resistant epilepsy, with often severe neuropsychiatric sequelae or death. These entities have been identified by different acronyms, but febrile infection-related epilepsy syndrome (FIRES) is the one that best underscores the main features of the disorder.8 Cases with a similar clinical picture have been described also in adults and in these case series the most frequently used definition is new-onset refractory SE (NORSE).9-13 Recently, it was pointed out that different terms probably have been used to describe the same condition.14,15 However, there is no consensus among investigators. Adult cases are more heterogeneous, some with clear similarities with FIRES cases (with only the age at onset as the main difference), other...

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“…A specific anatomical question that arises is whether brain regions implicated in consciousness (89) (e.g. claustrum (90,91), the thalamus, hypothalamus and amygdala (92), or the posterior cerebral cortex (89)) have myelinated axons with sufficient diameter to allow light transmission.…”

Section: Discussionmentioning

confidence: 99%