Hostname: page-component-cd9895bd7-lnqnp Total loading time: 0 Render date: 2024-12-26T18:32:37.987Z Has data issue: false hasContentIssue false

The challenge of disentangling reportability and phenomenal consciousness in post-comatose states

Published online by Cambridge University Press:  27 March 2008

Audrey Vanhaudenhuyse
Affiliation:
Coma Science Group, Cyclotron Research Center, University of Liège, Sart Tilman B30, 4000 Liège, Belgium
Marie-Aurélie Bruno
Affiliation:
Coma Science Group, Cyclotron Research Center, University of Liège, Sart Tilman B30, 4000 Liège, Belgium
Serge Brédart
Affiliation:
Department of Cognitive Science, University of Liège, Sart Tilman B32, 4000 Liège, Belgium
Alain Plenevaux
Affiliation:
Department of Cognitive Sciences, Cyclotron Research Center, University of Liège, Sart Tilman B30, 4000 Liège, Belgium. avanhaudenhuyse@student.ulg.ac.bewww.comascience.orgmarieaureliebruno@[email protected]://www.fapse.ulg.ac.be/Lab/Cog/[email protected]://www.ulg.ac.be/crc/[email protected]
Steven Laureys
Affiliation:
Coma Science Group, Cyclotron Research Center, University of Liège, Sart Tilman B30, 4000 Liège, Belgium

Abstract

Determining whether or not noncommunicative patients are phenomenally conscious is a major clinical and ethical challenge. Clinical assessment is usually limited to the observation of these patients' motor responses. Recent neuroimaging technology and brain computer interfaces help clinicians to assess whether patients are conscious or not, and to avoid diagnostic errors.

Type
Open Peer Commentary
Copyright
Copyright © Cambridge University Press 2008

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

American Congress of Rehabilitation Medicine (1995) Recommendations for use of uniform nomenclature pertinent to patients with severe alterations of consciousness. Archives of Physical Medicine and Rehabilitation 76:205209.CrossRefGoogle Scholar
Andrews, K., Murphy, L., Munday, R. & Littlewood, C. (1996) Misdiagnosis of the vegetative state: Retrospective study in a rehabilitation unit. British Medical Journal 313(7048):1316.CrossRefGoogle Scholar
Bauer, G., Gerstenbrand, F. & Rumpl, E. (1979) Varieties of the locked-in syndrome. Journal of Neurology 221(2):7791.CrossRefGoogle ScholarPubMed
Birbaumer, N., Ghanayim, N., Hinterberger, T., Iversen, I., Kotchoubey, B., Kubler, A., Perelmouter, J., Taub, E. & Flor, H. (1999) A spelling device for the paralysed. Nature 398(6725):297–98.CrossRefGoogle ScholarPubMed
Boly, M., Coleman, M. R., Davis, M. H., Hampshire, A., Bor, D., Moonen, G., Maquet, P. A., Pickard, J. D., Laureys, S. & Owen, A. M. (2007) When thoughts become action: An fMRI paradigm to study volitional brain activity in non-communicative brain injured patients. Neuroimage 36(3):979–92.CrossRefGoogle ScholarPubMed
Childs, N. L., Mercer, W. N. & Childs, H. W. (1993) Accuracy of diagnosis of persistent vegetative state. Neurology 43(8):1465–67.CrossRefGoogle ScholarPubMed
Giacino, J. T., Ashwal, S., Childs, N., Cranford, R., Jennett, B., Katz, D. I., Kelly, J. P., Rosenberg, J. H., Whyte, J., Zafonte, R. D. & Zasler, N. D. (2002) The minimally conscious state: Definition and diagnostic criteria. Neurology 58(3):349–53.CrossRefGoogle ScholarPubMed
Giacino, J. T., Hirsch, J., Schiff, N. & Laureys, S. (2006) Functional neuroimaging applications for assessment and rehabilitation planning in patients with disorders of consciousness. Archives of Physical Medicine and Rehabilitation 87(12, Suppl. 2):S6776.CrossRefGoogle ScholarPubMed
Hinterberger, T., Birbaumer, N. & Flor, H. (2005) Assessment of cognitive function and communication ability in a completely locked-in patient. Neurology 64:1307.CrossRefGoogle Scholar
Hochberg, L. R., Serruya, M. D., Friehs, G. M., Mukand, J. A., Saleh, M., Caplan, A. H., Branner, A., Chen, D., Penn, R. D. & Donoghue, J. P. (2006) Neuronal ensemble control of prosthetic devices by a human with tetraplegia. Nature 442(7099):164–71.CrossRefGoogle ScholarPubMed
Kubler, A. & Neumann, N. (2005) Brain-computer interfaces – the key for the conscious brain locked into a paralyzed body. Progress in Brain Research 150:513–25.CrossRefGoogle ScholarPubMed
Laureys, S., Pellas, F., Van Eeckhout, P., Ghorbel, S., Schnakers, C., Perrin, F., Berré, J., Faymonville, M. E., Pantke, K. H., Damas, F., Lamy, M., Moonen, G. & Goldman, S. (2005) The locked-in syndrome: What is it like to be conscious but paralyzed and voiceless? Progress in Brain Research 150:495511.CrossRefGoogle ScholarPubMed
Owen, A. M., Coleman, M. R., Boly, M., Davis, M. H., Laureys, S. & Pickard, J. D. (2006) Detecting awareness in the vegetative state. Science 313(5792):1402.CrossRefGoogle ScholarPubMed
Owen, A. M., Coleman, M. R., Boly, M., Davis, M. H., Laureys, S., Jolles, D. & Pickard, J. (2007) Response to comments on “Detecting awareness in the vegetative state.” Science 315(5816):1221c.CrossRefGoogle Scholar
Tavalaro, J. & Tayson, R. (1997) Look up for yes. Kodansha America.Google Scholar
The Multi-Society Task Force on PVS (1994) Medical aspects of the persistent vegetative state (1). New England Journal of Medicine 330(21):1499–508.CrossRefGoogle Scholar
Wilhelm, B., Jordan, M. & Birbaumer, N. (2006) Communication in locked-in syndrome: Effects of imagery on salivary pH. Neurology 67(3):534–35.CrossRefGoogle ScholarPubMed