Mind, brain and altered states of consciousness
January 1, 2018 M. Roccella, M. Salerno, L. Parisi et al.
Consciousness is not a simple mental function but the organization of the mind itself, sustained by multiple horizontal levels in structural and functional continuum with emerging phenomena. The distinction between quantitative aspects (surveillance) and qualitative aspects (content of consciousness) rests on surveillance being regulated by brain stem, hypothalamus, and thalamus projection systems, while content depends on cortical activity, especially associative areas. Disturbances like vegetative state, minimally conscious state, coma, and locked-in syndrome suggest alteration of a common underlying system. Neuroimaging evidence in coma, anesthesia, sleep, epilepsy, and somnambulism is advancing understanding, though data heterogeneity prevents certainty about absence of consciousness in individual patients.