Brain Function and Responsiveness in Disorders of Consciousness
This book provides up-to-date information on all aspects of brain function and responsiveness in patients with severe disorders of consciousness. Topics considered include the mechanisms and measures of consciousness; perfusional, metabolic, and fMRI mark
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Martin M. Monti Walter G. Sannita Editors
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Brain Function and Responsiveness in Disorders of Consciousness
Martin M. Monti • Walter G. Sannita Editors
Brain Function and Responsiveness in Disorders of Consciousness
Editors Martin M. Monti Department of Psychology and Neurosurgery University of California Los Angeles Los Angeles, CA USA
Walter G. Sannita Department of Neuroscience Ophthalmology and Genetics University of Genova Genova Italy Department of Psychiatry
State University of New York at Stony Brook Stony Brook, NY USA
ISBN 978-3-319-21424-5 ISBN 978-3-319-21425-2 DOI 10.1007/978-3-319-21425-2
(eBook)
Library of Congress Control Number: 2015957244 Springer Cham Heidelberg New York Dordrecht London © Springer International Publishing Switzerland 2016 This work is subject to copyright. All rights are reserved by the Publisher, whether the whole or part of the material is concerned, specifically the rights of translation, reprinting, reuse of illustrations, recitation, broadcasting, reproduction on microfilms or in any other physical way, and transmission or information storage and retrieval, electronic adaptation, computer software, or by similar or dissimilar methodology now known or hereafter developed. The use of general descriptive names, registered names, trademarks, service marks, etc. in this publication does not imply, even in the absence of a specific statement, that such names are exempt from the relevant protective laws and regulations and therefore free for general use. The publisher, the authors and the editors are safe to assume that the advice and information in this book are believed to be true and accurate at the date of publication. Neither the publisher nor the authors or the editors give a warranty, express or implied, with respect to the material contained herein or for any errors or omissions that may have been made. Printed on acid-free paper Springer International Publishing AG Switzerland is part of Springer Science+Business Media (www.springer.com)
Preface
Over the past 20 years, functional neuroimaging has revealed that even the severely injured brain suffering from a disorder of consciousness can retain several aspects of relatively high-level functions, including sensory and linguistic processing and learning dynamics. In 2006, a provocative report presented the case of a subject in vegetative state who appeared able to voluntarily engage in mental tasks as revealed by her pattern of brain activations. As widely reported as these neuroimaging studies have been, the interpretation of regional brain activations in the vegetative state remains highly debated. These observations nevertheless challenge the current definitions and our understanding of both responsiveness and consciousness after severe brain injury, with an impact in the clinical decision-making process. It is unclear the extent to which regional brain activations can be considered equivalent to behavioral responses in indicating consciousness. The very clinical standards by which patients surviving se
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