Terminal Lucidity in Patients With Chronic Schizophrenia and Dementia

Nahm, Michael; Greyson, Bruce

doi:10.1097/nmd.0b013e3181c22583

Cited by 46 publications

(58 citation statements)

References 4 publications

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“…Tabela nr. 1 ilustruje tą sytuację, dotyczy ona bowiem liczby przypadków wśród osób cierpiących na zaburzenia psychiczne, które do 2009 r. udało się zidentyfikować w literaturze Nahm i Greyson [8] (tab. 1).…”

Section: Rys Historyczny Związany Z Terminalną Jasnością Umysłuunclassified

“…Dodatkowo, znalazł 14 oświadczeń lekarzy i psychiatrów, którzy byli świadkami TJU [13]. W innym artykule opublikowanym w krótkim odstępie czasu, wraz z Greysonem zaraportowali znajomość 81 przypadków u 51 autorów oraz 3 dodatkowe oświadczenia, ale ogólna liczba tych, w których udało się dojść do raportów lub oryginalnych publikacji, się nie zmieniła, bo dalej wynosiła 49 (20 kobiet i 29 mężczyzn) [8]. Kilka lat później, w 2012 r., liczba przypadków nieznacznie wzrosła do 83 a oświadczenia lekarzy do 18 [1] (tab.…”

Section: Skala Zjawiskaunclassified

“…The authors found his improvement to be extraordinary and the man was released to his brother's home two days before his death. Despite the fact, that improvement was noticed in all of them, certain "mental idiosyncrasies" remained [8]. One of the most interesting eyewitness accounts was presented by Haig.…”

Section: Terminal Luciditymentioning

confidence: 99%

“…Additionally, he found 14 statements of physicians and psychiatrists who witnessed TL [13]. In another article published shortly after, together with Greyson, he reported 81 cases by 51 authors and published 3 additional statements but the overall number of cases where they managed to obtain reports or original publications did not change and still amounted to 49 (20 women and 29 men) [8]. Several years later, in 2012, the number of cases increased slightly to 83 and the number of physicians' statements increased to 18 [1] (table 3).…”

Section: Scale Of the Phenomenonmentioning

confidence: 99%

“…Nahm and Greyson indicated that in the review of literature covering 250 years, among 49 out of 81 cases of TL in persons with mental disorders in which it was possible to find the original publications or reports: 43% of patients experienced TL during the period up to 1 day before death; 41% experienced TL 2-7 days before death; 10% of patients experienced TL 8-30 days before death, and 6% more than 30 days before death (surely this must be the case of the three patients suffering from chronic schizophrenia described by Turetsky and Romanenko [8] (table 2). When describing this TL phenomenon, it was determined that terminal lucidity, in its appearance, is not limited to a single diagnostic category but appears in the final stage of various illnesses such as: Alzheimer's disease and other dementia, schizophrenia, affective disorders, meningitis, stroke and brain tumours.…”

Section: Terminal Luciditymentioning

confidence: 99%

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Review paper. Terminal lucidity

Chiriboga-Oleszczak

2017

Current Problems of Psychiatry

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Terminal lucidity is a term used in the medical literature to determine the improvement of mental functioning shortly before death, even among patients with serious and long-term disorders. In 19 th century, cases of mind clarity recovery shortly before death, were often recognized by doctors and interpreted as a sign of an impending death. In 20 th century, the interest in this phenomenon decreased and then, virtually disappear. In recent years, on the wave of publications concerning near death experiences and related events such as the end of life experiences, papers about the improvement of mental functioning shortly before death, exponentially grew and got a new name, terminal lucidity. In this paper, an overview of the available literature is presented to outline the historical, phenomenological and clinical picture of this phenomenon and its possible implications for medical care and future studies.Keywords: terminal lucidity, lightening up before death, end of life experience, memory. StreszczenieTerminalna jasność umysłu to termin stosowany w literaturze medycznej do określenia poprawy stanu umysłowego na krótko przed śmiercią, nawet u osób z wieloletnimi zaburzeniami w obrębie funkcjonowania poznawczego. W XIX w. przypadki odzyskania wcześniej zmąconego umysłu na krótko przed śmiercią były często rozpoznane przez lekarzy i interpretowane jako znak zbliżającej się śmierci. W XX w. zainteresowanie tym zjawiskiem spadło, aby praktycznie zniknąć. W ostatnich latach, na fali publikacji dotyczących doświadczeń śmierci klinicznej (near death experiences) i pokrewnych jej zjawisk jak doświadczenia końca życia (end of life experiences), liczba prac gwałtownie wzrosła, a poprawa stanu umysłowego na krótko przed śmiercią uzyskała nową nazwę: terminalna jasność umysłu (terminal lucidity). W pracy przedstawiono przegląd dostępnej literatury, aby zarysować obraz historyczny, fenomenologiczny i kliniczny tego zjawiska oraz jego ewentualne implikacje dla opieki medycznej i przyszłych badań.Słowa kluczowe: terminalna jasność umysłu, rozjaśnienie przed śmiercią, doświadczenia końca życia, pamięć IntroductionIn the wake of the growing number of publications concerning near-death experiences and end of life experiences, few publications have appeared which present a somewhat forgotten phenomenon of recovery of full consciousness by ill people several minutes, hours or even days before death; the literature calls this phenomenon terminal lucidity [1]. Apart from the possible importance of this phenomenon for better understanding of mental functioning, including the relationship between the brain and the mind, one should also consider its possible impact on the family of the person which experienced it. It may happen that the patient's close relatives will interpret the "sudden" death of the relative, rightly or wrongly, in categories of negligence or incompetence of the medical staff.

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Section: Rys Historyczny Związany Z Terminalną Jasnością Umysłuunclassified

Section: Skala Zjawiskaunclassified

Section: Terminal Luciditymentioning

confidence: 99%

Section: Scale Of the Phenomenonmentioning

confidence: 99%

Section: Terminal Luciditymentioning

confidence: 99%

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Review paper. Terminal lucidity

Chiriboga-Oleszczak

2017

Current Problems of Psychiatry

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An update on memory formation and retrieval: An engram‐centric approach

Bostancıklıoğlu

2020

Alzheimer's & Dementia

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Objective We explore here that memory loss observed in the early stage of Alzheimer's disease (AD) is a disorder of memory retrieval, instead of a storage impairment. This engram‐centric explanation aims to enlarge the conceptual frame of memory as an emergent behavior of the brain and to propose a new treatment strategy for memory retrieval in dementia‐AD. Background The conventional memory hypothesis suggests that memory is stored as multiple traces in hippocampal neurons but recent evidence indicates that there are specialized memory engrams responsible for the storage and the retrieval of different memory types. Updated Memory Hypothesis There are specialized memory engram neurons for each memory type and when information will be stored as a memory arrives in the hippocampus through afferent neurons finds its neuron according to the excitability states of engram neurons. The excitability level in engram neurons seems like a code canalizing the interactions between engrams and information. Therefore, to enhance the excitability of memory engram neurons improves memory loss observed in AD. In addition, we suggest that the hippocampus creates an index for information stored in memory engram cells in specialized regions for different types of memory, instead of storing all information; and different anatomic locations of engram cells and their roles in memory retrieval point out that memory could be an emergent behavior of the brain, and the interaction between serotonin fluctuation and engram neurons could be neural underpinnings of terminal lucidity. Major Challenges for the Model The major challenge for this engram‐centric memory retrieval model is the translation from bench to patient, specifically the delivery of optogenetic tools in patients. Engram neurons can be specifically activated by optogenetic tools, but optogenetics is an invasive technique which requires optic fiber implantation into the brain. In addition, light can overheat the tissue and thus induce damage in tissue. Furthermore, light is a foreign object and its direct implantation into the brain may cause neuroinflammation, the main trigger of neurodegenerative diseases. Therefore, to test the engram hypothesis in human, new tools to allow specific engram activation should be discovered.

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Unexpected awakenings in severe dementia from case reports to laboratory

Bostancıklıoğlu¹

2020

Alzheimer's & Dementia

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Objective: Case report notions of unexpected memory retrieval in patients with severe dementia near to death are starting to alter the central "irreversible" paradigm of dementia and locate dementia as a problem of memory retrieval, not consolidation. We suggest that the most likely central tenet of this paradoxical memory retrieval is the fluctuation of neuromodulators projecting from the brain stem to the medial prefrontal cortex and the hippocampus. The neuromodulation-centric explanation of this phenomenon aims to open the "irreversible" paradigm of dementia up for discussion and suggest a plausible treatment strategy by questioning how the devastating process of death fluctuates memory performance in severe dementia. Background: Supporting demented patients, who are mostly unresponsive, without making demands or asking a question and regarding them as valuable human beings unexpectedly improve their memory performance around the time of death. New lucidity hypothesis: Around the time of death, neurological signs (hyper-arousal and-attention) of demented people point out that neurotransmitter discharges are dramatically changed. Relatively resistant neuromodulator circuits to neurodegeneration can maintain optimal levels of arousal and attention for memory processing. In this way, unexpected episodes of lucidity can be triggered. Also, corticotropin-releasing peptides might increase mental clarity by increasing the excitability of the neuromodulator circuits. The science of memory retrieval is more complicated and nuanced than retrieval observations in case reports, but the rapid development of new techniques holds promise for future understanding of lucidity in severe dementia. Major challenge for the model: There is no an animal or human model to test this hypothesis; however, the similarities between neurological signs (instantaneous cognitive fluctuations) of delirium and paradoxical lucidity could provide a unique window to understand neural events of terminal lucidity on a modified animal model of delirium. Likewise, similarities between unexpected consciousness signs of terminal lucidity and lucid dreaming suggest that lucid dreaming episodes might be considered a human model for terminal lucidity research.

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Terminal Lucidity in Patients With Chronic Schizophrenia and Dementia

Cited by 46 publications

References 4 publications

Review paper. Terminal lucidity

Review paper. Terminal lucidity

An update on memory formation and retrieval: An engram‐centric approach

Unexpected awakenings in severe dementia from case reports to laboratory

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