The Neurology of Consciousness: Cognitive Neuroscience and Neuropathology

438 Pages·2008·8.17 MB·English

by  Steven Laureys

The Neurology of Consciousness:
Cognitive Neuroscience and
Neuropathology
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The Neurology of Consciousness:
Cognitive Neuroscience and
Neuropathology
Edited by
Steven Laureys and Giulio Tononi
AMSTERDAM • BOSTON • HEIDELBERG • LONDON • NEW YORK • OXFORD
PARIS • SAN DIEGO • SAN FRANCISCO • SINGAPORE • SYDNEY • TOKYO
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First edition 2009
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Contents
Preface ix
Prologue xi
List of Contributors xiii
Section I: Basics 1
1. Consciousness: An Overview of the Phenomenon and of Its Possible Neural Basis 3
Antonio Damasio and Kaspar Meyer
2. The Neurological Examination of Consciousness 15
Hal Blumenfeld
3. Functional Neuroimaging 31
Steven Laureys, Melanie Boly and Giulio Tononi
4. Consciousness and Neuronal Synchronization 43
Wolf Singer
5. Neural Correlates of Visual Consciousness 53
Geraint Rees
6. The Relationship Between Consciousness and Attention 63
Naotsugu Tsuchiya and Christof Koch
Section II: Waking, Sleep and Anaesthesia 79
7. Intrinsic Brain Activity and Consciousness 81
Marcus E. Raichle and Abraham Z. Snyder
8. Sleep and Dreaming 89
Giulio Tononi
9. Sleepwalking (Somnambulism): Dissociation Between ‘ Body Sleep ’ and ‘ Mind Sleep ’ 108
Claudio L. Bassetti
10. General Anaesthesia and Consciousness 118
Michael T. Alkire
Section III: Coma and Related Conditions 135
11. Coma 137
G. Bryan Young
12. Brain Death 151
James L. Bernat
vii
viii
CONTENTS
13. The Assessment of Conscious Awareness in the Vegetative State 163
Adrian M. Owen, Nicholas D. Schiff and Steven Laureys
14. The Minimally Conscious State: Clinical Features, Pathophysiology
and Therapeutic Implications 173
Joseph T. Giacino and Nicholas D. Schiff
15. Consciousness in the Locked-in Syndrome 191
Olivia Gosseries, Marie-Aurélie Bruno, Audrey Vanhaudenhuyse,
Steven Laureys and Caroline Schnakers
16. Consciousness and Dementia: How the Brain Loses Its Self 204
Pietro Pietrini, Eric Salmon and Paolo Nichelli
17. Brain–Computer Interfaces for Communication in Paralysed
Patients and Implications for Disorders of Consciousness 217
Andrea Kübler
18. Neuroethics and Disorders of Consciousness: A Pragmatic
Approach to Neuropalliative Care 234
Joseph J. Fins
Section IV: Seizures, Splits, Neglects and Assorted Disorders 245
19. Epilepsy and Consciousness 247
Hal Blumenfeld
20. The Left Hemisphere Does Not Miss the Right Hemisphere 261
Michael S. Gazzaniga and Michael B. Miller
21. Visual Consciousness: An Updated Neurological Tour 271
Lionel Naccache
22. The Neurophysiology of Self-awareness Disorders in Conversion Hysteria 282
Patrik Vuilleumier
23. Leaving Body and Life Behind: Out-of-Body and Near-Death Experience 303
Olaf Blanke and Sebastian Dieguez
24. The Hippocampus, Memory, and Consciousness 326
Bradley R. Postle
25. Syndromes of Transient Amnesia 339
Chris Butler and Adam Zeman
26. Consciousness and Aphasia 352
Paolo Nichelli
27. Blindness and Consciousness: New Light from the Dark 360
Pietro Pietrini, Maurice Ptito and Ron Kupers
28. The Neurology of Consciousness: An Overview 375
Giulio Tononi and Steven Laureys
Index 413
Preface
T hinking must never submit itself, neither to a dogma, in engineering led to space observatories such as the
nor to a party, nor to a passion, nor to an interest, nor Hubble Telescope to shed light on where we come
to a preconceived idea, nor to anything whatsoever, from. Rigorous scientific measurements permitted to
except to the facts themselves, because for it to submit trace back the birth of the universe to nearly 14.000
to anything else would be the end of its existence. million years; the age of the earth to more than 4.500
Henri Poincaré (1854–1912; million years; the origin of life on earth to (very)
French mathematician and theoretical physicists) approximately 3.500 million years and the apparition
of the earth’s first simple animals to about 600 mil-
‘ Truth is sought for its own sake. And those who lion years. Natural evolution, as brilliantly revealed
are engaged upon the quest for anything for its own by Charles Darwin (1809–1882), over these many mil-
sake are not interested in other things. Finding the lion years gave rise to nervous systems as complex as
truth is difficult, and the road to it is rough. ’ wrote the human brain, arguably the most complex object in
Ibn al-Haytham (965–1039; Persian polymath), a pio- the universe. And somehow, through the interactions
neer of the scientific method. This book tackles one among its 100 billion neurons, connected by trillions
of the biggest challenges of science; understanding of synapses, emerges our conscious experience of the
the biological basis of human consciousness. It does world and of ourselves.
so through observation and experimentation in neu- Neurology is the study of mankind itself, said
rological patients, formulating hypotheses about the Wilder Penfield (1891–1976; Canadian neurosurgeon).
neural correlates of consciousness and employing an You are your brain. This book offers neurological facts
objective and reproducible methodology. This sci- on consciousness and impaired consciousness. While
entific method, as first proposed by Isaac Newton philosophers have pondered upon the mind–brain
(1643–1727; English polymath), has proven utterly conundrum for millennia, without making much if
successful in replacing dark-age, ‘ magical thinking ’ any progress, scientists have only recently been able to
with an intelligent, rational understanding of nature. explore the connection analytically through measure-
Scientific methodology, however, also requires imagi- ments and perturbations of the brain’s activity. This
nation and creativity. For example, methodologically ability again stems from recent advances in technology
well-described experiments permitted Louis Pasteur and especially from emerging functional neuroimag-
(1822–1895; French chemist and microbiologist) to ing modalities. As demonstrated in the chapters of this
reject the millennia-old Aristotelian (384–322 BC; book, the mapping of conscious perception and cogni-
Greek philosopher) view that living organisms could tion in health (e.g., conscious waking, sleep, dreaming,
spontaneously arise from non-living matter. Pasteur’s sleepwalking and anaesthesia) and in disease (e.g.,
observations and genius gave rise to germ theory of coma, near-death, vegetative state, seizures, split-
medical disease which would lead to the use of anti- brains, neglect, amnesia, dementia, etc.) is providing
septics and antibiotics, saving innumerable lives. exiting new insights into the functional neuroanatomy
The progress of science also largely depends upon of human consciousness. Philosophers might argue
the invention and improvement of technology and that the subjective aspect of the mind will never be
instruments. For example, the big breakthroughs of sufficiently accounted for by the objective methods of
Galileo Galilei (1564–1642; Tuscan astronomer) were reductionistic science. We here prefer a more pragmatic
made possible thanks to eyeglass makers’ improve- approach and see no reason that scientific and techno-
ments in lens-grinding techniques, which permitted logical advances will not ultimately lead to an under-
the construction of his telescopes. Similarly, advances standing of the neural substrate of consciousness.
ix