Across the consciousness continuum-from unresponsive wakefulness to sleep

Advances in the development of new paradigms as well as in neuroimaging techniques nowadays enable us to make inferences about the level of consciousness patients with disorders of consciousness (DOC) retain. They, moreover, allow to predict their probable development. Today, we know that certain br...

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Published inFrontiers in human neuroscience Vol. 9; p. 105
Main Authors Blume, Christine, Del Giudice, Renata, Wislowska, Malgorzata, Lechinger, Julia, Schabus, Manuel
Format Journal Article
LanguageEnglish
Published Switzerland Frontiers Research Foundation 10.03.2015
Frontiers Media S.A
Subjects
Behavior
Brain mapping
Circadian rhythms
Cognition
Coma
Consciousness
disorders of consciousness
EEG
Electroencephalography (EEG)
Event-related potentials
Eye movements
Functional magnetic resonance imaging
Neuroimaging
Neuroscience
Positron emission tomography
resting state
Sleep
Sleep and wakefulness
Traumatic brain injury
Austria
electroencephalography (EEG)
sleep
resting state
circadian rhythms
disorders of consciousness (DOC)
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Summary:Advances in the development of new paradigms as well as in neuroimaging techniques nowadays enable us to make inferences about the level of consciousness patients with disorders of consciousness (DOC) retain. They, moreover, allow to predict their probable development. Today, we know that certain brain responses (e.g., event-related potentials or oscillatory changes) to stimulation, circadian rhythmicity, the presence or absence of sleep patterns as well as measures of resting state brain activity can serve the diagnostic and prognostic evaluation process. Still, the paradigms we are using nowadays do not allow to disentangle VS/UWS and minimally conscious state (MCS) patients with the desired reliability and validity. Furthermore, even rather well-established methods have, unfortunately, not found their way into clinical routine yet. We here review current literature as well as recent findings from our group and discuss how neuroimaging methods (fMRI, PET) and particularly electroencephalography (EEG) can be used to investigate cognition in DOC or even to assess the degree of residual awareness. We, moreover, propose that circadian rhythmicity and sleep in brain-injured patients are promising fields of research in this context.
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This article was submitted to the journal Frontiers in human Neuroscience.
Edited by: Marta Olivetti, Sapienza University of Rome, Italy
These authors have contributed equally to this work.
Reviewed by: Srivas Chennu, University of Cambridge, UK; Andrew A. Fingelkurts, BM-Science - Brain & Mind Technologies Research Centre, Finland; Rita Formisano, Santa Lucia Foundation, Italy; Caroline Schnakers, University of California, Los Angeles, USA
ISSN:1662-5161
1662-5161
DOI:10.3389/fnhum.2015.00105