Frontiers in Systems Neuroscience
August 14, 2019
Vincent Bonhomme, Cécile Staquet, Javier Montupil et al.
109 citations
General anesthesia reversibly alters consciousness without globally shutting down the brain. Depending on the agent and dose, it can produce a complete absence of subjective experience (unconsciousness), a conscious experience without environmental perception (disconnected consciousness, like during dreaming), or oriented consciousness with environmental awareness (connected consciousness). Each state may be followed by explicit or implicit memories. Progress in brain function exploration has improved understanding of neural correlates of consciousness and their alterations during anesthesia, including changes in functional and effective brain connectivity, consciousness network topology, and spatio-temporal dynamics.
BJA Open
September 26, 2023
Javier Montupil, Paolo Cardone, Cécile Staquet et al.
32 citations
The source of consciousness is widely thought to be within the brain, and anesthesiologists have their own operational definition based on observations during anesthesia. The full functional correlates of consciousness remain unclear, but several theories have gained varying support from experiments, including those using anesthesia to reversibly alter aspects of consciousness. Understanding these mechanisms could improve patient management by enabling monitoring devices that detect different states during anesthesia: unconsciousness, internal awareness with or without conscious perception of the environment (connected or disconnected consciousness). Unresponsiveness does not guarantee absence of connectedness or consciousness. This narrative review presents current knowledge from a system-level perspective, highlighting anesthesia's contribution to theories of consciousness and proposing future research directions.
iScience
January 17, 2025
Paolo Cardone, Arthur Bonhomme, Vincent Bonhomme et al.
9 citations
In a small double-blind, placebo-controlled, cross-over trial with three adults who had prolonged disorders of consciousness after a coma, an intravenous sub-anesthetic dose of the atypical psychedelic ketamine increased brain complexity as measured by Lempel-Ziv complexity, but did not change the explainable consciousness indicator. Patients showed reduced spastic paresis and spent more time with their eyes open, yet their diagnosis of consciousness did not improve. No adverse effects occurred. The findings suggest a potential therapeutic role for ketamine in disorders of consciousness and support a link between brain complexity and conscious states.
Frontiers in Neuroscience
February 13, 2024
Benedetta Cecconi, Javier Montupil, Sepehr Mortaheb et al.
6 citations
Disconnected consciousness, where subjective experience persists but is cut off from the external world, often occurs during sleep or sedation but is difficult to study because unresponsive people may still be conscious and amnesia can erase memories of events. This research uses a serial awakening paradigm during mild propofol sedation: participants hear sounds and are interviewed while still sedated to determine whether they are connected or disconnected from the environment, bypassing the need for behavioral responses and amnesia. Functional MRI data reveal neural activity patterns during these states, testing whether sensory disconnection arises at the thalamus or from disrupted information flow to higher brain regions. Slow-wave activity's role is also explored via high-frequency BOLD oscillations. Findings could improve anesthesia monitoring and assessment of patients with reduced consciousness.