Emotion processing in the minimally conscious state

Bekinschtein, Tristán A.; Niklison, J; Sigman, Lauren; Manes, Facundo; Leiguarda, R; Armony, Jorge L.; Owen, Adrian M.; Carpintiero, Silvina; Olmos, Lisandro

doi:10.1136/jnnp.2003.034876

Cited by 112 publications

(58 citation statements)

References 5 publications

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“…Presentation of the narratives played backward activated the same networks as forward narratives in the healthy controls, but not in the MCS patients. Similarly, Bekinschtein et al (2004) showed amygdala activation induced by stimuli with emotional valence (the voice of the patient's mother compared with an unfamiliar voice) in a MCS case five months after trauma.…”

Section: Own Namementioning

confidence: 86%

Functional connectivity in the default network during resting state is preserved in a vegetative but not in a brain dead patient

Boly¹,

Tshibanda²,

Vanhaudenhuyse³

et al. 2009

Human Brain Mapping

292

216

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The clinical and para-clinical examination of residual self-consciousness in non-communicative severely brain damaged patients (i.e., coma, vegetative state and minimally conscious state) remains exceptionally challenging. Passive presentation of the patient's own name and own face are known to be effective attention-grabbing stimuli when clinically assessing consciousness at the patient's bedside. Event-related potential and functional neuroimaging studies using such self-referential stimuli are currently being used to disentangle the cognitive hierarchy of self-processing. We here review neuropsychological, neuropathological, electrophysiological and neuroimaging studies using the own name and own face paradigm obtained in conscious waking, sleep, pharmacological coma, pathological coma and related disorders of consciousness. Based on these results we discuss what we currently do and do not know about the functional significance of the neural network involved in ''automatic'' and ''conscious'' self-referential processing.

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Section: Own Namementioning

confidence: 86%

Functional connectivity in the default network during resting state is preserved in a vegetative but not in a brain dead patient

Boly¹,

Tshibanda²,

Vanhaudenhuyse³

et al. 2009

Human Brain Mapping

292

216

View full text Add to dashboard Cite

show abstract

“…By contrast, emotionally salient stimuli, such as baby cries and the patient's own name, led to much more widespread temporal activation also recruiting anterior and posterior midline cortices [25,26]. Similarly, in MCS patients, presentation of a story told by their mother lead to more widespread activation [27]. Novel technological developments now permit to assess the directionality of this long-range cortico-cortical connectivity.…”

Section: Tracking the Recovery Of Consciousness Networkmentioning

confidence: 99%

Consciousness supporting networks

Demertzi¹,

Soddu²,

Laureys³

2013

Current Opinion in Neurobiology

163

115

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This article appeared in a journal published by Elsevier. The attached copy is furnished to the author for internal non-commercial research and education use, including for instruction at the authors institution and sharing with colleagues.Other uses, including reproduction and distribution, or selling or licensing copies, or posting to personal, institutional or third party websites are prohibited. Author's personal copy In most cases authors Consciousness supporting networksAthena Demertzi, Andrea Soddu and Steven LaureysFunctional 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 nonreflex 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. What is 'minimally conscious'?At present there is no generally accepted definition of consciousness [1]. As clinicians, we will reduce the complexity of this term and define consciousness operationally, separating two main components: wakefulness and awareness [2]. Wakefulness has been shown to critically depend upon the functional integrity of subcortical arousal systems over 50 years ago [(e.g., see 3)]. The level of wakefulness can be estimated by simple behavioral criteria based on eye opening ranging from absent, over stimulus-induced to spontaneous sustained eye opening.For instance, every night when falling asleep, we experience a decrease of the level of wakefulness up to the point we lose awareness of our environment. Awareness is more difficult to define and more challenging to assess behaviorally [4]. We have recently proposed to reduce the phenomenological complexity of awareness into two further components: external awareness, namely everything we perceive through our senses (what we see, hear, feel, smell and taste), and internal awareness or stimulusindependent thoughts. Interestingly, the switch between the external and internal milieu was found not only to characterize overt...

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“…16 Until now, few studies have investigated the interest of active paradigms in severely brain damaged patients. Most previous ERP 9,17 and functional neuroimaging [18][19][20][21] studies have employed passive paradigms. These studies have shown more widespread and integrated brain activation in MCS as compared to VS patients.…”

mentioning

confidence: 99%