Results for 'vegetative state (VS)'

28 found
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  1.  86
    The Chief Role of Frontal Operational Module of the Brain Default Mode Network in the Potential Recovery of Consciousness from the Vegetative State: A Preliminary Comparison of Three Case Reports.Andrew A. Fingelkurts, Alexander A. Fingelkurts, Sergio Bagnato, Cristina Boccagni & Giuseppe Galardi - 2016 - The Open Neuroimaging Journal 10:41-51.
    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 (...)
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  2.  21
    Memory During the Presumed Vegetative State: Implications for Patient Quality of Life.Nicola Taylor, Mackenzie Graham, Mark Delargy & Lorina Naci - 2020 - Cambridge Quarterly of Healthcare Ethics 29 (4):501-510.
    A growing number of studies show that a significant proportion of patients, who meet the clinical criteria for the diagnosis of the vegetative state (VS), demonstrate evidence of covert awareness through successful performance of neuroimaging tasks. Despite these important advances, the day-to-day life experiences of any such patient remain unknown. This presents a major challenge for optimizing the patient’s standard of care and quality of life (QoL). We describe a patient who, following emergence from a state of (...)
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  3.  59
    Long-Term (Six Years) Clinical Outcome Discrimination of Patients in the Vegetative State Could be Achieved Based on the Operational Architectonics EEG Analysis: A Pilot Feasibility Study.Andrew A. Fingelkurts, Alexander A. Fingelkurts, Sergio Bagnato, Cristina Boccagni & Giuseppe Galardi - 2016 - The Open Neuroimaging Journal 10:69-79.
    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 (...)
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  4.  37
    Moral dilemmas and conflicts concerning patients in a vegetative state/unresponsive wakefulness syndrome: shared or non-shared decision making? A qualitative study of the professional perspective in two moral case deliberations.Conny A. M. F. H. Span-Sluyter, Jan C. M. Lavrijsen, Evert van Leeuwen & Raymond T. C. M. Koopmans - 2018 - BMC Medical Ethics 19 (1):1-12.
    Patients in a vegetative state/ unresponsive wakefulness syndrome (VS/UWS) pose ethical dilemmas to those involved. Many conflicts occur between professionals and families of these patients. In the Netherlands physicians are supposed to withdraw life sustaining treatment once recovery is not to be expected. Yet these patients have shown to survive sometimes for decades. The role of the families is thought to be important. The aim of this study was to make an inventory of the professional perspective on conflicts (...)
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  5.  71
    How family caregivers' medical and moral assumptions influence decision making for patients in the vegetative state: a qualitative interview study.Katja Kuehlmeyer, Gian Domenico Borasio & Ralf J. Jox - 2012 - Journal of Medical Ethics 38 (6):332-337.
    Background Decisions on limiting life-sustaining treatment for patients in the vegetative state (VS) are emotionally and morally challenging. In Germany, doctors have to discuss, together with the legal surrogate (often a family member), whether the proposed treatment is in accordance with the patient's will. However, it is unknown whether family members of the patient in the VS actually base their decisions on the patient's wishes. Objective To examine the role of advance directives, orally expressed wishes, or the presumed (...)
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  6.  85
    The value of spontaneous EEG oscillations in distinguishing patients in vegetative and minimally conscious states.Andrew And Alexander Fingelkurts, Sergio Bagnato, Cristina Boccagni & Giuseppe Galardi - 2013 - In Eror Basar & et all (eds.), Application of Brain Oscillations in Neuropsychiatric Diseases. Supplements to Clinical Neurophysiology. Elsevier. pp. 81-99.
    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. (...)
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  7. Prognostic Value of Resting-State EEG Structure in Disentangling Vegetative and Minimally Conscious States: A Preliminary Study.Andrew A. Fingelkurts, Alexander A. Fingelkurts, Sergio Bagnato, Cristina Boccagni & Giuseppe Galardi - 2013 - Neurorehabilitation and Neural Repair 27 (4):345-354.
    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 (...)
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  8.  33
    Specific and Nonspecific Thalamocortical Functional Connectivity in Normal and Vegetative States.Shi-Jiang Li Jingsheng Zhou, Xiaolin Liu, Weiqun Song, Yanhui Yang, Zhilian Zhao, Feng Ling, Anthony G. Hudetz - 2011 - Consciousness and Cognition 20 (2):257.
    Recent theoretical advances describing consciousness from information and integration have highlighted the unique role of the thalamocortical system in leading to integrated information and thus, consciousness. Here, we examined the differential distributions of specific and nonspecific thalamocortical functional connections using resting-state fMRI in a group of healthy subjects and vegetative-state patients. We found that both thalamic systems were widely distributed, but they exhibited different patterns. Nonspecific connections were preferentially associated with brain regions involved in higher-order cognitive processing, (...)
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  9. EEG oscillatory states as neuro-phenomenology of consciousness as revealed from patients in vegetative and minimally conscious states.Alexander A. Fingelkurts, Andrew A. Fingelkurts, Sergio Bagnato, Cristina Boccagni & Giuseppe Galardi - 2012 - Consciousness and Cognition 21 (1):149-169.
    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 (...)
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  10. Toward operational architectonics of consciousness: basic evidence from patients with severe cerebral injuries.Andrew A. Fingelkurts, Alexander A. Fingelkurts, Sergio Bagnato, Cristina Boccagni & Giuseppe Galardi - 2012 - Cognitive Processing 13 (2):111-131.
    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 (...)
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  11.  72
    When Does Consciousness Matter? Lessons from the Minimally Conscious State.Joseph Vukov - 2018 - American Journal of Bioethics Neuroscience 9 (1):5-15.
    Patients in a minimally conscious state (MCS) fall into a different diagnostic category than patients in the more familiar vegetative states (VS). Not only are MCS patients conscious in some sense, they have a higher chance for recovery than VS patients. Because of these differences, we ostensibly have reason to provide MCS patients with care that goes beyond what we provide to patients with some VS patients. But how to justify this differential treatment? I argue we can’t justify (...)
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  12.  76
    Attitudes of Lay People to Withdrawal of Treatment in Brain Damaged Patients.Jacob Gipson, Guy Kahane & Julian Savulescu - 2013 - Neuroethics 7 (1):1-9.
    BackgroundWhether patients in the vegetative state (VS), minimally conscious state (MCS) or the clinically related locked-in syndrome (LIS) should be kept alive is a matter of intense controversy. This study aimed to examine the moral attitudes of lay people to these questions, and the values and other factors that underlie these attitudes.MethodOne hundred ninety-nine US residents completed a survey using the online platform Mechanical Turk, comprising demographic questions, agreement with treatment withdrawal from each of the conditions, agreement (...)
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  13.  75
    Long-lasting coma.Sergio Bagnato, Cristina Boccagni, A. Sant'Angelo, Alexander A. Fingelkurts, Andrew A. Fingelkurts, C. Gagliardo & G. Galardi - 2014 - Functional Neurology 29 (3):201-205.
    In this report, we describe the case of a patient who has remained in a comatose state for more than one year after a traumatic and hypoxic brain injury. This state, which we refer to as long-lasting coma (LLC), may be a disorder of consciousness with significantly different features from those of conventional coma, the vegetative state, or brain death. On the basis of clinical, neurophysiological and neuroimaging data, we hypothesize that a multilevel involvement of the (...)
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  14.  14
    Behavioral vs. Neural Methods in the Treatment of Acutely Comatose Patients.Hyungrae Noh - 2022 - Ramon Llull Journal of Applied Ethics 1 (13):245-258.
    Behaviorally assessing residual consciousness of acutely comatose patients involves a high rate of false-negatives. That is, long-term behavioral assessment shows that 41% of vegetative state patients in fact have residual consciousness. Nonetheless, surrogates need to remove ventilation before the acute-phase passes away if they want to induce medico-legal death due to pragmatic factors, such as financial costs. So, surrogate decision-making regarding behaviorally nonresponsive acutely comatose patients involves a moral dilemma: should we ignore the chance that patients have residual (...)
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  15.  69
    Actual physical potentiality for consciousness.Andrew And Alexander Fingelkurts - 2018 - American Journal of Bioethics Neuroscience 9 (1):24-25.
    Dr. Vukov analyzing patients with disorders of consciousness, proposed that medical well-regarded policy recommendations cannot be justified by looking solely to patients’ actual levels of consciousness (minimally conscious state – MCS versus vegetative state – VS), but that they can be justified by looking to patients’ potential for consciousness. One objective way to estimate this potential (actual physical possibility) is to consider a neurophysiologically informed strategy. Ideally such strategy would utilize objective brain activity markers of consciousness/unconsciousness. The (...)
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  16.  54
    Dualism Revisited: Body vs. Mind vs. Soul.Rebekah Richert & Paul Harris - 2008 - Journal of Cognition and Culture 8 (1-2):99-115.
    A large, diverse sample of adults was interviewed about their conception of the ontological and functional properties of the mind as compared to the soul. The existence of the mind was generally tied to the human lifecycle of conception, birth, growth and death, and was primarily associated with cognitive as opposed to spiritual functions. In contrast, the existence of the soul was less systematically tied to the lifecycle and frequently associated with spiritual as opposed to cognitive functions. Participants were also (...)
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  17.  22
    Into the Grey Zone: A Neuroscientist Explores the Border Between Life and Death by Adrian Owen.Edward F. Kelly - 2018 - Journal of Scientific Exploration 32 (2).
    Dramatic modern advances in emergency and resuscitation medicine, starting perhaps with the development of effective mechanical ventilators in the mid-20th century, have created a large class of persons who in earlier times would almost certainly have died, but who can now go on existing, suspended at least temporarily in a state somewhere between death and the conscious life they formerly pursued. A very wide range of brain injuries lead first to coma, in which the patient shows no sign of (...)
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  18. The Ethical Pain: Detection and Management of Pain and Suffering in Disorders of Consciousness.Michele Farisco - 2011 - Neuroethics 6 (2):265-276.
    The intriguing issue of pain and suffering in patients with disorders of consciousness (DOCs), particularly in Unresponsive Wakefulness Syndrome/Vegetative State (UWS/VS) and Minimally Conscious State (MCS), is assessed from a theoretical point of view, through an overview of recent neuroscientific literature, in order to sketch an ethical analysis. In conclusion, from a legal and ethical point of view, formal guidelines and a situationist ethics are proposed in order to best manage the critical scientific uncertainty about pain and (...)
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  19.  65
    Clinicians' Attitudes toward Patients with Disorders of Consciousness: A Survey.Michele Farisco, Enrico Alleva, Flavia Chiarotti, Simone Macri & Carlo Petrini - 2013 - Neuroethics 7 (1):93-104.
    Notwithstanding fundamental methodological advancements, scientific information about disorders of consciousness (DOCs)—e.g. Vegetative State/Unresponsive Wakefulness Syndrome (VS/UWS) and Minimally Conscious State (MCS)—is incomplete. The possibility to discriminate between different levels of consciousness in DOC states entails treatment strategies and ethical concerns. Here we attempted to investigate Italian clinicians’ and basic scientists’ opinions regarding some issues emerging from the care and the research on patients with DOCs. From our survey emerged that Italian physicians working with patients with DOCs give (...)
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  20.  79
    Comment on Laureys et al. Self-consciousness in non-communicative patients☆.Jonathan Cole - 2007 - Consciousness and Cognition 16 (3):742-745.
    Until comparatively recently, say the middle of the last century, spinal cord injury was fatal as pressure sores and other infections took their toll. Those with severe brain injuries, unable to move or even communicate, fared even worse; without movement or feeding such patients were nursed until nature took its course. Over the last few decades medical and nursing advances have enabled some of these vegetative patients to survive for considerable time, provoking, at times, ethical and legal dilemmas. Though (...)
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  21. Clinical/Scientific Notes.J. Bradley White - unknown
    The blink response to visual threat is a standard bedside method for testing visual processing. In response to a sudden gesture directed toward the eyes, a person with a normal blink response will promptly contract both orbicularis oculi muscles to close the eyelids momentarily. There is no consensus as to whether blinking to visual threat (BVT) is purely reflex1 or a cognitively mediated behavior that heralds consciousness; i.e., is incompatible with the diagnosis of the vegetative state (VS).2,3 Some (...)
     
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  22. Pain Perception in Disorders of Consciousness: Neuroscience, Clinical Care, and Ethics in Dialogue. [REVIEW]A. Demertzi, E. Racine, M.-A. Bruno, D. Ledoux, O. Gosseries, A. Vanhaudenhuyse, M. Thonnard, A. Soddu, G. Moonen & S. Laureys - 2012 - Neuroethics 6 (1):37-50.
    Pain, suffering and positive emotions in patients in vegetative state/unresponsive wakefulness syndrome (VS/UWS) and minimally conscious states (MCS) pose clinical and ethical challenges. Clinically, we evaluate behavioural responses after painful stimulation and also emotionally-contingent behaviours (e.g., smiling). Using stimuli with emotional valence, neuroimaging and electrophysiology technologies can detect subclinical remnants of preserved capacities for pain which might influence decisions about treatment limitation. To date, no data exist as to how healthcare providers think about end-of-life options (e.g., withdrawal of (...)
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  23.  66
    Do we need a theory-based assessment of consciousness in the field of disorders of consciousness?Alexander A. Fingelkurts & Andrew A. Fingelkurts - 2014 - Frontiers in Human Neuroscience 8:402.
    Adequate assessment of (un)consciousness is not only of theoretical interest but also has a practical and ethical importance, especially when it comes to disorders of consciousness (DOC). Accurately determining the presence or absence of consciousness in patients with DOC allows informed decisions to be made about long-term care support, referral for rehabilitation, pain management and withdrawal of life support. We believe that a theoretical account of what conscious experience is and how it emerges within the brain will advance the search (...)
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  24.  55
    Establishing consciousness in non-communicative patients: A modern-day version of the Turing test.John F. Stins - 2009 - Consciousness and Cognition 18 (1):187-192.
    In a recent study of a patient in a persistent vegetative state, [Owen, A. M., Coleman, M. R., Boly, M., Davis, M. H., Laureys, S., & Pickard, J. D. . Detecting awareness in the vegetative state. Science, 313, 1402] claimed that they had demonstrated the presence of consciousness in this patient. This bold conclusion was based on the isomorphy between brain activity in this patient and a set of conscious control subjects, obtained in various imagery tasks. (...)
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  25.  96
    Pain Perception in Disorders of Consciousness: Neuroscience, Clinical Care, and Ethics in Dialogue.Athina Demertzi, Eric Racine, Marie-Aurélie Bruno, Didier Ledoux, Olivia Gosseries, Audrey Vanhaudenhuyse, Marie Thonnard, Andrea Soddu, Gustave Moonen & Steven Laureys - 2013 - Neuroethics 6 (1):37-50.
    Pain, suffering and positive emotions in patients in vegetative state/unresponsive wakefulness syndrome (VS/uws) and minimally conscious states (MCS) pose clinical and ethical challenges. Clinically, we evaluate behavioural responses after painful stimulation and also emotionally-contingent behaviours (e.g., smiling). Using stimuli with emotional valence, neuroimaging and electrophysiology technologies can detect subclinical remnants of preserved capacities for pain which might influence decisions about treatment limitation. To date, no data exist as to how healthcare providers think about end-of-life options (e.g., withdrawal of (...)
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  26.  45
    Severe Brain Injury: Recognizing the Limits of Treatment and Exploring the Frontiers of Research.William J. Winslade - 2007 - Cambridge Quarterly of Healthcare Ethics 16 (2):161-168.
    Persons who experience severe brain injury often suffer significant disorders of consciousness. Anoxic injuries from cardiac arrest or strokes and traumatic injuries from falls, vehicular crashes, or assaults can result in several conditions in which patients lose or have diminished consciousness for an extended period of time. Two such conditions that create considerable public confusion and controversy are the vegetative state and the minimally conscious state. Although these conditions have generated significant medical and academic research, the general (...)
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  27.  38
    Long-term transformations in the Sundarbans wetlands forests of Bengal.John F. Richards & Elizabeth P. Flint - 1990 - Agriculture and Human Values 7 (2):17-33.
    The landscape of the Sundarbans today is a product of two countervailing forces: conversion of wetland forests to cropland vs. sequestration of the forests in reserves to be managed for long-term sustained yield of wood products. For two centures, land-hungry peasants strove to transform the native tidal forest vegetation into an agroecosystem dominated by paddy rice and fish culture. During the colonial period, their reclamation efforts were encouraged by landlords and speculators, who were themselves encouraged by increasingly favorable state (...)
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  28.  25
    Environmental Education—Ponderings From Down Under.Gene C. Sager - 2001 - Global Bioethics 14 (1):105-111.
    This article describes and reflects upon Australia's extensive, federally-mandated, environmental education program. This program is based on a National Conservation Strategy which went into effect in 1989. But the program has massive support on the state and local levels as well. In addition to traditional classroom study of the environment and environmental issues, Audtralian Students do composting, re-vegetation of local canyons, and other hands-on activities. In many areas of the students' deatiledreports become the data base for the government's environmental (...)
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