While the presence or absence of consciousness plays the central role in the moral/ethical decisions when dealing with patients with disorders of consciousness (DOC), recently it is criticized as not adequate due to number of reasons, among which are the lack of the uniform definition of consciousness and consequently uncertainty of diagnostic criteria for it, as well as irrelevance of some forms of consciousness for determining a patient’s interests and wishes. In her article, Dr. Specker Sullivan reexamined the meaning of (...) consciousness in the DOC taxonomy and proposed to go away from the routinely used clinical definition of consciousness as “wakeful awareness”, and adopt the meaning that is common in the Eastern tradition which is a form of “pure experience” (Specker Sullivan 2018). She further argued that understanding consciousness as a “pure experience” is ethically relevant for DOC patients. This suggestion is original, novel and important since it preserves the importance of the notion of consciousness for the clinical practice while simultaneously offering an additional ethical tool for the moral decisions in medicine. At the same time, without placing such Eastern notion in the Western tradition it is difficult to see how pure experience could be usefully operationalized to make sense in the clinical practice with DOC patients. It is so because pure experience is a subjective phenomenon which is completely inaccessible in noncommunicative DOC patients and also it does not express behaviorally (Monti et al 2010), therefore some objective-like operationalization is needed. This is why the fusion of Eastern and Western traditions is required to gain the full potential of Dr. Specker Sullivan’s suggestion. We propose that such fusion could be achieved on the basis of the Operational Architectonics (OA) theory of brain-mind functioning (Fingelkurts et al. 2010; 2013a) which suits ideally the purpose due its compatibility with both Western and Eastern traditions of consciousness. (shrink)

Dr. Vukov analyzing patients with disorders of consciousness, proposed that medical well-regarded policy recommendations cannot be justified by looking solely to patients’ actual levels of consciousness (minimally conscious state – MCS versus vegetative state – VS), but that they can be justified by looking to patients’ potential for consciousness. One objective way to estimate this potential (actual physical possibility) is to consider a neurophysiologically informed strategy. Ideally such strategy would utilize objective brain activity markers of consciousness/unconsciousness. The Operational Architectonics (OA) (...) theory of brain-mind functioning is an example of such a strategy. Besides being mathematically simple, neurophysiologically accurate, and compatible with the cognitive/phenomenal perspectives on consciousness, application of OA strategy to quantitative EEG analysis of patients in VS and MCS revealed that the absence of consciousness in VS is paralleled by impairment of overall EEG operational architecture. Specifically, neuronal assemblies become smaller, their life span shortened, and they became highly unstable and functionally disconnected (desynchronized). At the same time, fluctuating (minimal) awareness in patients in MCS was paralleled by partial restoration of EEG operational architecture (increased size, life span, and stability of neuronal assemblies, together with an increased number and strength of functional connections among them), approaching the level found in healthy fully conscious participants. Moreover OA strategy to EEG analysis allowed predicting the emergence of consciousness in VS patients after six years following the brain trauma. Therefore, the OA methodology could reliably predict which patients may regain consciousness, and thus determine which patients may have the potential for consciousness. (shrink)

Despite the fact that attention is a core property of all perceptual and cognitive operations, our understanding of its neurophysiological mechanisms is far from complete. There are many theoretical models that try to fill this gap in knowledge, though practically all of them concentrate only on either involuntary (bottom-up) or voluntarily (top-down) aspect of attention. At the same time, both aspects of attention are rather integrated in the living brain. In this chapter we attempt to conceptualise both aspects of attentional (...) state within the theory of Operational Architectonics of brain and mind functioning, which provides a plausible theoretical basis for neurophysiological understanding of how attention is brought to existence in the living brain. (shrink)

The late 19th-century Ignorabimus controversy over the limits of scientific knowledge has often been characterized as proclaiming the end of intellectual progress, and by implication, as plunging Germany into a crisis of pessimism from which Liberalism never recovered. My research supports the opposite interpretation. The initiator of the Ignorabimus controversy, Emil du Bois-Reymond, was a physiologist who worked his whole life against the forces of obscurantism, whether they came from the Catholic and Conservative Right or the scientistic and millenarian Left. (...) Du Bois-Reymond’s doubt that scientists would ever elucidate consciousness must therefore be seen as an endorsement, and not a rejection, of his faith in reason. (shrink)

Husserl characterizes sleep with the idea of “the relaxation of the will.” One finds a similar approach in the work of Maine de Biran, who explains sleep as “the suspension of the will.” More recently, Brian O’Shaughnessy and Matthew Soteriou have argued that mental actions constitute wakeful consciousness. In clinical practice, patients with disorders of consciousness who show “purposeful” behavior are classified as “minimally conscious,” while those in an “unresponsive wakeful state” merely behave reflexively. To what extent and how are (...) these proposals justified? This question pushes both the first- and the third-personal approaches to their limits: in an unconscious state, like a coma, one cannot reflect upon oneself; likewise, one cannot infer from physiological data whether someone is phenomenally conscious. This work offers a critical review of these proposals regarding the constitutive role for agency in phenomenal consciousness. It then presents revised versions of O’Shaughnessy’s and Soteriou’s Arguments from Synthesis and from Self-Consciousness. The argument is that everything of which one is phenomenally conscious is either a potential reason for a possible agentive power exertion, or just that power exertion itself. The “self” referred to in “self”-consciousness is either the agent or a “non-agent,” carrying out functions for the agent. Agency is therefore constitutive of phenomenal consciousness. The resulting view helps to solve the Combination Problem for panpsychism, by suggesting that agency is what raises sub-personal micro-consciousness to the personal level. The view may also justify the notion of a “Minimally Conscious State” in clinical practice. (shrink)

In this brief overview paper, we analyse information flow in the brain. Although Shannon’s information concept, in its pure algebraic form, has made a number of valuable contributions to neuroscience, information dynamics within the brain is not fully captured by its classical description. These additional dynamics consist of self-organisation, interplay of stability/instability, timing of sequential processing, coordination of multiple sequential streams, circular causality between bottom-up and top-down operations, and information creation. Importantly, all of these processes are dynamic, hierarchically nested and (...) correspond to continuous brain state change, even if the external environment remains constant. This is where metastable coordination comes into play. In a metastable regime of brain functioning, as a result of the simultaneous co-existence of tendencies for independence and cooperation, information is continuously created, preserved for some time and then dissipated through the formation of dynamical and nested spatio-temporal coalitions among simple neuronal assemblies and larger coupled conglomerates of them—so-called delocalised operational modules. (shrink)

The value of resting electroencephalogram (EEG) in revealing neural constitutes of consciousness (NCC) was examined. We quantified the dynamic repertoire, duration and oscillatory type of EEG microstates in eyes-closed rest in relation to the degree of expression of clinical self-consciousness. For NCC a model was suggested that contrasted normal, severely disturbed state of consciousness and state without consciousness. Patients with disorders of consciousness were used. Results suggested that the repertoire, duration and oscillatory type of EEG microstates in resting condition quantitatively (...) related to the level of consciousness expression in brain-damaged patients and healthy-conscious subjects. Specifically, results demonstrated that (a) decreased number of EEG microstate types was associated with altered states of consciousness, (b) unawareness was associated with the lack of diversity in EEG alpha-rhythmic microstates, and (c) the probability for the occurrence and duration of delta-, theta- and slow-alpha-rhythmic microstates were associated with unawareness, whereas the probability for the occurrence and duration of fast-alpha-rhythmic microstates were associated with consciousness. In conclusion, resting EEG has a potential value in revealing NCC. This work may have implications for clinical care and medical–legal decisions in patients with disorders of consciousness. (shrink)

In this report, we describe the case of a patient who has remained in a comatose state for more than one year after a traumatic and hypoxic brain injury. This state, which we refer to as long-lasting coma (LLC), may be a disorder of consciousness with significantly different features from those of conventional coma, the vegetative state, or brain death. On the basis of clinical, neurophysiological and neuroimaging data, we hypothesize that a multilevel involvement of the ascending reticular activating system (...) is required in LLC. This description may be useful for the identification of other patients suffering from this severe disorder of consciousness, which raises important ethical issues. (shrink)

Modelling and simulations have gained a leading position in contemporary attempts to describe, explain, and quantitatively predict the human brain's operations. Computer models are highly sophisticated tools developed to achieve an integrated knowledge of the brain with the aim of overcoming the actual fragmentation resulting from different neuroscientific approaches. In this paper we investigate plausibility of simulation technologies for emulation of consciousness and the potential clinical impact of large-scale brain simulation on the assessment and care of disorders of consciousness, e.g. (...) Coma, Vegetative State/Unresponsive Wakefulness Syndrome, Minimally Conscious State.Notwithstanding their technical limitations, we suggest that simulation technologies may offer new solutions to old practical problems, particularly in clinical contexts. We take DOCs as an illustrative case, arguing that the simulation of neural correlates of consciousness is potentially useful for improving treatments of patients with DOCs. (shrink)

Adequate assessment of (un)consciousness is not only of theoretical interest but also has a practical and ethical importance, especially when it comes to disorders of consciousness (DOC). Accurately determining the presence or absence of consciousness in patients with DOC allows informed decisions to be made about long-term care support, referral for rehabilitation, pain management and withdrawal of life support. We believe that a theoretical account of what conscious experience is and how it emerges within the brain will advance the search (...) for appropriate neuromarkers of the presence or absence of consciousness in non-communicative brain-damaged patients. (shrink)