Background: Spasticity following a stroke occurs in about 30% of patients. The mechanisms underlying this disorder, however, are not well understood. Method: This review aims to define spasticity, describe hypotheses explaining its development after a stroke, give an overview of related neuroimaging studies as well as a description of the most common scales used to quantify the degree of spasticity and finally explore which treatments are currently being used to treat this disorder.
Patient To examine neural responses to aurally-presented sentences, a sparse imaging technique was used to minimize interference from scanner noise. The patient was played a single sentence (or noise-equivalent) in the 7.4s silent period before a single 1.6s scan with stimulus timing jittered relative to scan onset. There were 118 spoken sentences trials, 59 signal correlated noise trials, and an additional 60 silent trials for the purpose of monitoring data quality. The signal correlated noise stimuli had the same duration, spectral (...) profile and amplitude envelope as the original speech, but were entirely unintelligible (S1). The experiment was divided into three sessions of 79 trials with events pseudo-randomly ordered within each scanning session. The sentences were presented using a MRI compatible auditory stimulusdelivery system (Resonance Technology, Northridge, CA), with insert earplugs to further attenuate scanner noise. DMDX software running on a Windows XP PC was used to present the stimulus items. (shrink)
This joint article reflects the authors’ personal views regarding noteworthy advances in the neuroscience of consciousness in the last ten years, and suggests what we feel may be promising future directions. It is based on a small conference at the Samoset Resort in Rockport, Maine, USA, in July of 2012, organized by the Mind Science Foundation of San Antonio, Texas. Here, we summarize recent advances in our understanding of subjectivity in humans and other animals, including empirical, applied, technical and conceptual (...) insights. These include the evidence for the importance of fronto-parietal connectivity and of feedback processes, both of which enable information to travel across distant cortical areas effectively, as well as numerous dissociations between consciousness and cognitive functions, such as attention, in humans. In addition, we describe the development of mental imagery paradigms, which made it possible to identify covert awareness in non-responsive subjects. Non-human animal consciousness research has also witnessed substantial advances on the specific role of cortical areas and higher order thalamus for consciousness, thanks to important technological advances. In addition, much progress has been made in the understanding of non-vertebrate cognition relevant to possible conscious states. Finally, major advances have been made in theories of consciousness, and also in their comparison with the available evidence. Along with reviewing these findings, each author suggests future avenues for research in their field of investigation. (shrink)
In order to better understand the functional contribution of resting state activity to conscious cognition, we aimed to review increases and decreases in fMRI functional connectivity under physiological (sleep), pharmacological (anesthesia) and pathological altered states of consciousness, such as brain death, coma, vegetative state/unresponsive wakefulness syndrome, and minimally conscious state. The reviewed RSNs were the DMN, left and right executive control, salience, sensorimotor, auditory and visual networks. We highlight some methodological issues concerning resting state analyses in severely injured brains mainly (...) in terms of hypothesis-driven seed-based correlation analysis and data-driven independent components analysis approaches. Finally, we attempt to contextualize our discussion within theoretical frameworks of conscious processes. We think that this “lesion” approach allows us to better determine the necessary conditions under which normal conscious cognition takes place. At the clinical level, we acknowledge the technical merits of the resting state paradigm. Indeed, fast and easy acquisitions are preferable to activation paradigms in clinical populations. Finally, we emphasize the need to validate the diagnostic and prognostic value of fMRI resting state measurements in non-communicating brain damaged patients. (shrink)
Niedenthal et al. discuss the importance of eye gaze in embodied simulation and, more globally, in the processing of emotional visual stimulation (such as facial expression). In this commentary, we illustrate the relationship between oriented eye movements, consciousness, and emotion by using the case of severely brain-injured patients recovering from coma (i.e., vegetative and minimally conscious patients).
Brain damage can cause massive changes in consciousness levels. From a clinical and ethical point of view it is desirable to assess the level of residual consciousness in unresponsive patients. However, no direct measure of consciousness exists, so we run into the philosophical problem of other minds. Neurologists often make implicit use of a Turing test-like procedure in an attempt to gain access to damaged minds, by monitoring and interpreting neurobehavioral responses. New brain imaging techniques are now being developed that (...) permit communication with unresponsive patients, using their brain signals as carriers of messages relating to their mental states. (shrink)
The application of neuroimaging technology to the study of the injured brain has transformed how neuroscientists understand disorders of consciousness, such as the vegetative and minimally conscious states, and deepened our understanding of mechanisms of recovery. This scientific progress, and its potential clinical translation, provides an opportunity for ethical reflection. It was against this scientific backdrop that we convened a conference of leading investigators in neuroimaging, disorders of consciousness and neuroethics. Our goal was to develop an ethical frame to move (...) these investigative techniques into mature clinical tools. This paper presents the recommendations and analysis of a Working Meeting on Ethics, Neuroimaging and Limited States of Consciousness held at Stanford University during June 2007. It represents an interdisciplinary approach to the challenges posed by the emerging use of neuroimaging technologies to describe and characterize disorders of consciousness. (shrink)
Neuronal aggregates involved in conscious awareness are not evenly distributed throughout the CNS but comprise key components referred to as the neural network correlates of consciousness (NNCC). A critical node in this network is the posterior cingulate, precuneal, and retrosplenial cortices. The cytological and neurochemical composition of this region is reviewed in relation to the Brodmann map. This region has the highest level of cortical glucose metabolism and cytochrome c oxidase activity. Monkey studies suggest that the anterior thalamic projection likely (...) drives retrosplenial and posterior cingulate cortex metabolism and that the midbrain projection to the anteroventral thalamic nucleus is a key coupling site between the brainstem system for arousal and cortical systems for cognitive processing and awareness. The pivotal role of the posterior cingulate, precuneal, and retrosplenial cortices in consciousness is demonstrated with posterior cingulate epilepsy cases, midcingulate lesions that de-afferent this region and are associated with unilateral sensory neglect, observations from stroke and vegetative state patients, alterations in blood ﬂow during sleep, and the actions of general anesthetics. Since this region is critically involved in self reﬂection, it is not surprising that it is similarly a site for the NNCC. Interestingly, information processing during complex cognitive tasks and during aversive sensations such as pain induces efforts to terminate self reﬂection and result in decreased processing in posterior cingulate and precuneal cortices. (shrink)
In cognitive neuroscience, dissociating the brain networks that ing—has thus become one of the best empirical situations subtend conscious and nonconscious memories constitutes a through which to study the mechanisms of implicit learning, very complex issue, both conceptually and methodologically.
Soltis' paper contains little data on the underlying neural substrate of the discussed signal function of early infant crying – probably because there is amazingly little known about it. We here discuss the interest of functional neuroimaging as an objective measurement of brain activity in (1) early infants during crying and (2) parents hearing their offspring cry.
Conscious perception, like the sight of a coffee cup, seems to involve the brain identifying a stimulus. But conscious input activates more brain regions than are needed to identify coffee cups and faces. It spreads beyond sensory cortex to frontoparietal association areas, which do not serve stimulus identiﬁcation as such. What is the role of those regions? Parietal cortex support the ‘ﬁrst person perspective’ on the visual world, unconsciously framing the visual object stream. Some prefrontal areas select and interpret conscious (...) events for executive control. Such functions can be viewed as properties of the subject, rather than the object, of experience – the ‘observing self’ that appears to be needed to maintain the conscious state. (shrink)
Using positron emission tomography (PET) and regional cerebral blood ﬂow (rCBF) measurements, we investigated the cerebral correlates of consciousness in a sequence learning task through a novel application of the Process Dissociation Procedure, a behavioral paradigm that makes it possible to separately assess conscious and unconscious contributions to performance. Results show that the metabolic response in the anterior cingulate / mesial prefrontal cortex (ACC / MPFC) is exclusively and speciﬁcally correlated with the explicit component of performance during recollection of a (...) learned sequence. This suggests a signiﬁcant role for the ACC / MPFC in the explicit processing of sequential material. 2003 Elsevier Science B.V. All rights reserved. (shrink)
Pierre Maquet1,2,6, Steven Laureys1,2, Philippe Peigneux1,2,3, Sonia Fuchs1, Christophe Petiau1, Christophe Phillips1,6, Joel Aerts1, Guy Del Fiore1, Christian Degueldre1, Thierry Meulemans3, André Luxen1, Georges Franck1,2, Martial Van Der Linden3, Carlyle Smith4 and Axel Cleeremans5.