"Eyes wide open, brain wide shut: (un)consciousness in the vegetative state"
Speaker Dr. Mélanie BOLY (Coma Science Group, Liège/Lüttich)
Date 10 February 2010, 17:30
Location
Hörsaal der Alten Nervenklinik, Ebene 3,
Charité Campus Mitte (Lecture hall, Clinic for Neurology, Level 3)
Internal address on Campus: Bonhoefferweg 3
Organized by Matthias Endres, Jens Steinbrink, Christoph Ploner
Abstract:
Patients in a vegetative state (VS) and minimally conscious state (MCS) continue to pose problems in terms of their diagnosis, prognosis and treatment. Consciousness is a subjective first-person experience which study has remained the field of philosophy for the past millennia. That time has finally changed and empirical evidence from functional neuroimaging is offering a genuine glimpse on the solution to the infamous mind-body conundrum. New technological and scientific advances offer the neurological community unique ways to improve our understanding and management of severely brain damaged patients. Good medical management starts by making a correct diagnosis. There is an irreducible limitation in knowing for certain whether any other being is conscious. Vegetative patients can move extensively and clinical studies have shown how difficult it is to differentiate reflex or ‘automatic’ from voluntary or ‘willed’ movements. This results in an underestimation of behavioral signs of consciousness and hence a misdiagnosis, estimated to occur in about one third to nearly half of chronically vegetative patients. PET and fMRI studies permitted to reject the ancient view that vegetative patients are neocortically dead or a-pallic. A succession of neuroimaging data has shown cerebral activation in isolated and disconnected islands of “lower level” cortices or “pallium” in response to auditory, visual, somatosensory and noxious stimuli. Functional neuroimaging studies have also provided scientific evidence that residual brain function in VS is very different from the brain’s integrative capacity in MCS.