Unresponsive wakefulness syndrome (UWS, previously known as vegetative state) occurs after patients survive a severe brain injury. Patients suffering from UWS have lost awareness of themselves and of the external environment and do not retain any trace of their subjective experience. Current data demonstrate that neuronal functions subtending consciousness are not completely reset in UWS; however, they are reduced below the threshold required to experience consciousness. The critical factor that determines whether patients will recover consciousness is the distance of their (...) neuronal functions from this threshold level. Recovery of consciousness occurs through functional and/or structural changes in the brain, i.e., through neuronal plasticity. Although some of these changes may occur spontaneously, a growing body of evidence indicates that rehabilitative interventions can improve functional outcome by promoting adaptive functional and structural plasticity in the brain, especially if a comprehensive neurophysiological theory of consciousness is followed. In this review we will focus on the pathophysiological mechanisms involved in UWS and on the plastic changes operating on the recovery of consciousness. (shrink)

Although several studies propose that the integrity of neuronal assemblies may underlie a phenomenon referred to as awareness, none of the known studies have explicitly investigated dynamics and functional interactions among neuronal assemblies as a function of consciousness expression. In order to address this question EEG operational architectonics analysis (Fingelkurts and Fingelkurts, 2001, 2008) was conducted in patients in minimally conscious (MCS) and vegetative states (VS) to study the dynamics of neuronal assemblies and operational synchrony among them as a function (...) of consciousness expression. We found that in minimally conscious patients and especially in vegetative patients neuronal assemblies got smaller, their life-span shortened and they became highly unstable. Furthermore, we demonstrated that the extent/volume and strength of operational synchrony among neuronal assemblies was smallest or even absent in VS patients, intermediate in MCS patients and highest in healthy fully-conscious subjects. All findings were similarly observed in EEG alpha as well as beta1 and beta2 frequency oscillations. The presented results support the basic tenets of Operational Architectonics theory of brain-mind functioning and suggest that EEG operational architectonics analysis may provide an objective and accurate means of assessing signs of (un)consciousness in patients with severe brain injuries. Therefore this methodological approach may complement the existing “gold standard” of behavioral assessment of this population of challenging patients and inform the diagnostic and treatment decision-making processes. (shrink)

It has been argued that complex subjective sense of self is linked to the brain default-mode network (DMN). Recent discovery of heterogeneity between distinct subnets (or operational modules - OMs) of the DMN leads to a reconceptualization of its role for the experiential sense of self. Considering the recent proposition that the frontal DMN OM is responsible for the first-person perspective and the sense of agency, while the posterior DMN OMs are linked to the continuity of ‘I’ experience (including autobiographical (...) memories) through embodiment and localization within bodily space, we have tested in this study the hypothesis that heterogeneity in the operational synchrony strength within the frontal DMN OM among patients who are in a vegetative state (VS) could inform about a stable self-consciousness recovery later in the course of disease (up to six years post-injury). Using EEG operational synchrony analysis we have demonstrated that among the three OMs of the DMN only the frontal OM showed important heterogeneity in VS patients as a function of later stable clinical outcome. We also found that the frontal DMN OM was characterized by the process of active uncoupling (stronger in persistent VS) of operations performed by the involved neuronal assemblies. (shrink)

The value of resting electroencephalogram (EEG) in revealing neural constitutes of consciousness (NCC) was examined. We quantified the dynamic repertoire, duration and oscillatory type of EEG microstates in eyes-closed rest in relation to the degree of expression of clinical self-consciousness. For NCC a model was suggested that contrasted normal, severely disturbed state of consciousness and state without consciousness. Patients with disorders of consciousness were used. Results suggested that the repertoire, duration and oscillatory type of EEG microstates in resting condition quantitatively (...) related to the level of consciousness expression in brain-damaged patients and healthy-conscious subjects. Specifically, results demonstrated that (a) decreased number of EEG microstate types was associated with altered states of consciousness, (b) unawareness was associated with the lack of diversity in EEG alpha-rhythmic microstates, and (c) the probability for the occurrence and duration of delta-, theta- and slow-alpha-rhythmic microstates were associated with unawareness, whereas the probability for the occurrence and duration of fast-alpha-rhythmic microstates were associated with consciousness. In conclusion, resting EEG has a potential value in revealing NCC. This work may have implications for clinical care and medical–legal decisions in patients with disorders of consciousness. (shrink)

Objective: The value of spontaneous EEG oscillations in distinguishing patients in vegetative and minimally conscious states was studied. Methods: We quantified dynamic repertoire of EEG oscillations in resting condition with closed eyes in patients in vegetative and minimally conscious states (VS and MCS). The exact composition of EEG oscillations was assessed by the probability-classification analysis of short-term EEG spectral patterns. Results: The probability of delta, theta and slow-alpha oscillations occurrence was smaller for patients in MCS than for VS. Additionally, only (...) patients in MCS demonstrated fast-alpha oscillation occurrence. Depending on the type and composition of EEG oscillations, the probability of their occurrence was either aetiology dependent or independent. The probability of EEG oscillations occurrence differentiated brain injuries with different aetiologies. Conclusions: Spontaneous EEG oscillations have a potential value in distinguishing patients in VS and MCS. Significance: This work may have implications for clinical care, rehabilitative programs and medical–legal decisions in patients with impaired consciousness states following coma due to acute brain injuries. (shrink)

Electroencephalogram (EEG) recordings are increasingly used to evaluate patients with disorders of consciousness (DOC) or assess their prognosis outcome in the short-term perspective. However, there is a lack of information concerning the effectiveness of EEG in classifying long-term (many years) outcome in chronic DOC patients. Here we tested whether EEG operational architectonics parameters (geared towards consciousness phenomenon detection rather than neurophysiological processes) could be useful for distinguishing a very long-term (6 years) clinical outcome of DOC patients whose EEGs were registered (...) within 3 months post-injury. The obtained results suggest that EEG recorded at third month after sustaining brain damage, may contain useful information on the long-term outcome of patients in vegetative state: it could discriminate patients who remain in a persistent vegetative state from patients who reach a minimally conscious state or even recover a full consciousness in a long-term perspective (6 years) post-injury. These findings, if confirmed in further studies, may be pivotal for long-term planning of clinical care, rehabilitative programs, medical-legal decisions concerning the patients, and policy makers. (shrink)

Background: Patients in a vegetative state pose problems in diagnosis, prognosis and treatment. Currently, no prognostic markers predict the chance of recovery, which has serious consequences, especially in end-of-life decision-making. Objective: We aimed to assess an objective measurement of prognosis using advanced electroencephalography (EEG). Methods: EEG data (19 channels) were collected in 14 patients who were diagnosed to be persistently vegetative based on repeated clinical evaluations at 3 months following brain damage. EEG structure parameters (amplitude, duration and variability within quasi-stationary (...) segments, as well as the spatial synchrony between such segments and the strength of this synchrony) were used to predict recovery of consciousness 3 months later. Results: The number and strength of cortical functional connections between EEG segments were higher in patients who recovered consciousness (P < .05 – P < .001) compared with those who did not recover. Linear regression analysis confirms that EEG structure parameters are capable of predicting (P = .0025) recovery of consciousness 6 months post-injury, whereas the same analysis failed to significantly predict patient outcome based on aspects of their clinical history alone (P = .629) or conventional EEG spectrum power (P = .473). Conclusions: The result of this preliminary study demonstrates that structural strategy of EEG analysis is better suited for providing prognosis of consciousness recovery than existing methods of clinical assessment and of conventional EEG. Our results may be a starting point for developing reliable prognosticators in patients who are in vegetative state, with the potential to improve their day-to-day management, quality of life, and access to early interventions. (shrink)

This paper explores taste fragmentalism, a novel approach to matters of taste and faultless disagreement. The view is inspired by Kit Fine’s fragmentalism about time, according to which the temporal dimension can be constituted—in an absolute manner—by states that are pairwise incompatible, provided that they do not obtain together. In the present paper, we will apply this metaphysical framework to taste states. In our proposal, two incompatible taste states (such as the state of rhubarb’s being tasty and the state of (...) rhubarb’s being distasteful) can both constitute reality in an absolute manner, although no agent can have joint access to both states. We will then develop a formalised version of our view by means of an exact truthmaker semantics for taste assertions. Within this framework—we argue—our linguistic and inferential practices concerning cases of faultless disagreement are elegantly vindicated, thus suggesting that taste fragmentalism is worth of further consideration. (shrink)

Das Buch enthält die Einführung in die Lektüre sowie den Textkommentar zu den der Analyse der Grundsätze der Modalität gewidmeten "Postulaten des empirischen Denkens überhaupt". Untersucht wird Kants gesamte Theorie der Modalbegriffe (Möglichkeit - Unmöglichkeit, Dasein - Nichtsein, Notwendigkeit - Zufälligkeit) seit Mitte der 1750er Jahre bis zur Kritik der reinen Vernunft. Die Postulate sind nach Kant nicht objektiv, sondern subjektiv-synthetisch: Der Gegenstand der Erfahrung, welcher zunächst anhand der objektiv-synthetischen Funktionen der Quantität, Qualität und Relation bestimmt wird, lässt sich nun (...) in seinem Verhältnis zum setzenden Subjekt betrachten. Die Postulate thematisieren jedoch nicht - hier liegt die konstitutive Charakteristik dieser synthetischen Urteile a priori - das Subjekt selbst, sondern das Objekt als solches und die Objektivität überhaupt. Wie diese Untersuchung zeigt, antwortet Kant erst hier - nicht in den viel diskutierten Deduktionskapiteln oder in den anderen Grundsatzkapiteln - auf die Frage "Was ist ein Objekt?" und bezieht zugleich Stellung gegenüber anderen philosophischen Theorien der Objektivität des 18. Jahrhunderts: Rationalismus, Empirismus, Idealismus, Skeptizismus. (shrink)

The notion of subject matter is a key concern of contemporary philosophy of language and logic. A central task for a theory of subject matter is to characterise the notion of sentential subject matter, that is, to assign to each sentence of a given language a subject matter that may count as its subject matter. In this paper, we elaborate upon David Lewis’ account of subject matter. Lewis’ proposal is simple and elegant but lacks a satisfactory characterisation of sentential subject (...) matter. Drawing on linguistic literature on focus and on the question under discussion, we offer a neo-Lewisian account of subject matter, which retains all the virtues of Lewis’ but also includes an attractive characterisation of sentential subject matter. (shrink)

Dans la mythologie grecque, Prométhée - le 'prévoyant' - déroba le feu aux dieux et le transmit aux hommes. Zeus, courroucé par ce transfert technologique, condamna Prométhée à un châtiment itéré à l'identique, à l'infini, algorithmique. Le problème que pose l'ancien mythe est celui des limites de la connaissance. En termes modernes, jusqu'à quel point pouvons-nous transformer la nature sans une connaissance des conséquences de nos actions sur elle? Cette question nous pousse à analyser les limites des sciences : à (...) une techno-science devenue toujours plus invasive, la science répond en se donnant à elle-même des limites"--Page 4 of cover. (shrink)

Sceptical Paths gathers a variety of innovative studies that inquire into the presence and function of sceptical elements, strategies, and approaches in various traditions throughout Ancient, Medieval, Modern, and contemporary philosophy. Special at.

Introduction: in search of a Jewish renaissance -- Jewish philosophy: humanist roots of a contradiction in terms -- The prophetic-poetic dimension of philosophy: the ars poetica and Immanuel of Rome -- Leone Ebreo's concept of Jewish philosophy -- Conceptions of history: Azariah de Rossi -- Scientific thought and the exegetical mind, with an essay on the life and works of Rabbi Judah Loew -- Mathematical and biblical exegesis: Jewish sources of Athanasius Kircher's musical theory -- Creating geographical and political utopias: (...) the ten lost tribes and the east -- Ceremonial law: history of a philosophical-political concept -- The city and the ghetto: Simone Luzzatto and the development of Jewish political thought -- Body of conversion and immortality of the soul: Sara Copio Sullam, the 'Beautiful Jewess'. (shrink)

v. 1. Apologia di Socrate, Critone, Eutifrone, Ione, Carmide, Lachete, Liside, Ippia maggiore, Ippia minore, Protagora, Giorgia, Menone, Fedone, Eutidemo.--v. 2. Cratilo, Simposio, Fedro, Teeteto, Parmenide, Sofista, Filebo.