Reconstructing Covert Consciousness: Neural Decoding as a Novel Consciousness Assessment.
Neurology February 25, 2025 David Fischer, Brian L Edlow, Holly J Freeman et al. 9 citations
Some patients with severe brain injury who appear unresponsive can still show covert consciousness by intentionally modulating their brain activity in response to commands, as detected by fMRI or EEG. However, current methods for detecting this covert consciousness have important limitations: they are not sensitive enough, rely on assumptions about brain function that may be incorrect, and fail to capture the full range of conscious experience. Neural decoding, a technique that reconstructs stimuli and concepts from brain activity, offers a promising new approach that could overcome these shortcomings. This article reviews the current state of covert consciousness assessments, their limitations, the science of neural decoding, and how it might be applied to disorders of consciousness, suggesting that neural decoding could improve sensitivity and better address what patients can actually experience.