THE STATE OF CONSCIOUSNESS IN PATIENTS IN THE VEGETATIVE AND MINIMALLY CONSCIOUS STATES

Autores

  • Edward B Ziff NYU School of Medicine
  • Elisabete Castelon Konkiewitz Universidade Federal da Grande Dourados

Palavras-chave:

disorders of consciousness, vegetative state, minimally conscious state, Global Workspace Theory, functional connectivity, Default Mode Network

Resumo

Brain-injured patients may, with the assistance of life support, continue to perform basic bodily functions, but yet be deficient in wakefulness, awareness, decision making or other overt manifestations of consciousness. Here, we review two neurological states observed in brain injured patients with different degrees of brain impairment, the vegetative state (VS) and the minimally conscious state (MCS), and we discuss how these states are diagnosed through assessing patient behavioral responses during clinical examination. We consider how functional neuroimaging has revealed preserved cognitive capacities in patients that were supposed to be in the VS and has introduced a new diagnosis, cognitive motor dissociation. We review the GW Theory proposal that consciousness arises from functional connectivity (FC) of widely separated brain regions. We discuss how such high FC underlies the Default Mode Network (DMN), a group of neural circuits that are active when an individual is not involved with external tasks and engages in introspective thinking. Finally, we discuss the finding that the level of FC of the DMN is diminished in brain injured patients and the proposal that the level of residual DMN FC in brain injured patients is an index of their consciousness.

Biografia do Autor

Edward B Ziff, NYU School of Medicine

Edward Ziff received a bachelor’s degree in Chemistry from Columbia University in 1963 and a PhD from Princeton University in Biochemistry in 1969. As a postdoctoral student with Nobel Prize winner, Fred Sanger, in Cambridge he conducted early genome sequencing studies. Ed served on the faculties of the Imperial Cancer Research Fund in London and Rockefeller University in New York. In 1982, he joined New York University School of Medicine, where he is Professor of Biochemistry and Molecular Pharmacology and Neural Science and was an Investigator of the Howard Hughes Medical Institute.  Ed researches brain function and neurological disease and was a Visiting Researcher at UFGD in Dourados.

Elisabete Castelon Konkiewitz, Universidade Federal da Grande Dourados

Elisabete Castelon Konkiewitz received a medical degree from UNIFESP in 1993 and a doctorate degree in -Neurology from the German university Technische Universität München, in 2002. She received the title of specialist in Neurology from the Brazilian Academy of Neurology and the title of specialist in Psychiatry from the Brazilian Association of Psychiatry. She has been an associate professor at the Federal University of Grande Dourados (UFGD) since 2008. 

Volume 22, fascículo 1, de 2017, do periódico Ciências & Cognição: www.cienciasecognicao.org/revista

Publicado

2017-06-30

Como Citar

Ziff, E. B., & Castelon Konkiewitz, E. (2017). THE STATE OF CONSCIOUSNESS IN PATIENTS IN THE VEGETATIVE AND MINIMALLY CONSCIOUS STATES. Ciências & Cognição, 22(1). Recuperado de http://www.cienciasecognicao.org/revista/index.php/cec/article/view/1449

Edição

v. 22 n. 1 (2017): Ciências & Cognição

Seção

Revisões de Literatura / Literature Reviews

O(s) autor(es) abaixo assinado(s) transfere(m) à Organização Ciências e Cognição, instituição responsável pela revista Ciências & Cognição (ISSN 1806-5821), todos os direitos de publicação, produção e divulgação, com exclusividade e sem ônus, do material do manuscrito submetido, extensível a versões em outras mídias de comunicação e divulgação (site, redes sociais, vídeos, em meio impresso, digital, áudio/podcast e audiovisual (integral ou parcialmente), buscando, dentro das possibilidades dar a maior visibilidade possível ao material submetido e aprovado, objeto da presente seção de direitos.

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- os procedimentos éticos referentes a um trabalho científico foram atendidos;
- no caso de estudo com humanos, foi conduzido conforme os princípios da Declaração de Helsinki e de suas emendas, com o consentimento informado aprovado por Comitê de Ética devidamente credenciado e com a Resolução 1595/2000, do CFM*;
- a responsabilidade pela informações e pelo conteúdo são do(s) autor(es).