Disorders of consciousness

Understanding consciousness is one of the major unsolved problems in medical science.

Recent studies have underscored that recovery of consciousness after severe brain injury remains poorly understood. Many of these investigations are very much in the public eye in part because of their relationship to controversies about end-of-life decisions in permanently unconscious patients and the relationship to one of the major philosophical, sociological, political, and religious questions of humankind.

This program focuses on our current understanding of the clinical, neuroanatomical and functional underpinnings of human consciousness by emphasizing a lesional approach offered via the study of coma and related states. The challenges are surprisingly difficult with a degree of diagnostic uncertainty that may range at the bedside in some patients from unconscious to fully aware, even for patients with no evidence of behavioral responsiveness. As measurements improve, behaviorally defined states from vegetative state (wakeful unawareness), minimally conscious state (at least some evidence of awareness), and up to patients in locked-in syndrome (full consciousness with virtually no motor control) will reveal subcategories of patients whose level of consciousness we cannot at present with confidence identify.

The organizers Steven Laureys (Liège), Adrian Owen (Cambridge) and Nicholas Schiff (New York) are leaders in the field. They have here brought together an outstanding group of neuroscientists and clinical investigators engaged in the study of coma and consciousness and mechanisms underlying large-scale cortical integration, state-of-the-art neuroimaging studies of sleep, anesthesia and patients with disorders of consciousness, and experts in the fields of the neurology of consciousness and ethics who addressed the larger context in which the emerging neuroscience will be received and integrated.

Chair : Steven Laureys MD PhD, Coma Science Group, University and University Hospital of Liège www.comascience.org

• Basic knowledge on consciousness and disorders of consciousness encountered after acute severe brain damage - Steven Laureys, LIEGE
• The problem of unreportable awareness - Adam Zeman (Peninsula Medical School, UK)
• Clinical scales to Assess consciousness – Joseph Giacino (Harvard Boston USA, USA)
• Coma and Brain death – James Bernat (Dartmouth- Hitchcock Medical Center, Lebanon, NH, USA)
• Vegetative and Minimally conscious state - Steven Laureys, LIEGE
• Locked-in syndrome – Steven Laureys, LIEGE with Patient Association for Locked-in www.alis-asso.fr
• Electroencephalography and evoked potentials – Steven Laureys, LIEGE, Nicholas D. Schiff (Cornell University, NY, USA)
• PET studies – Steven Laureys, LIEGE
• fMRI - LIEGE
• Brain computer interfaces – Steven Laureys, LIEGE – Adrian M. Owen (Ontario, Canada)
• Transcranial magnetic stimulation connectivity studies – Marcello Massimini (University of Milano, Italy)
• Improving consciousness using deep brain stimulation - Nicholas D. Schiff (Cornell University, NY, USA)
• Neuroethics - Joseph J. Fins (Cornell University, NY, USA)

In production. Authors and topics subject to change.

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