Current Pharmaceutical Design - Volume 20, Issue 26, 2014

The neurobiological approach to consciousness moves from the assumption that all phenomenal experiences are based on neuronal activity in the brain. Consciousness has two main components: wakefulness and awareness. While it may be relatively easy to determine the neuronal correlates of wakefulness, it is not the same for awareness, of which the neural correlates are poorly understood. Knowledge of the circuitry and t Read More

Oxygen based neurotransmitters in the synapses of the brain are proposed to play an important role in the generation of consciousness. They include the amino acids glutamate and GABA which use Krebs cycle precursors for their synthesis, and the monoamines dopamine, noradrenalin, adrenalin and serotonin, which are derived from tyrosine and tryptophan. During ischemia after an acute brain injury, a GABA surge oft Read More

Cases of recovery from vegetative and minimally conscious state after the administration of various pharmacological agents have been recently reported. These agents include CNS depressants (zolpidem, baclofen, lamotrigine) and CNS stimulants (tricyclic antidepressants, selective serotonin reuptake inhibitors, dopaminergic agents, methylphenidate). The action of CNS depressants as awakening agents sounds paradoxical, as Read More

Survivors of severe brain injuries may end up in a state of ‘wakeful unresponsiveness’ or in a minimally conscious state. Pharmacological treatments of patients with disorders of consciousness aim to improve arousal levels and recovery of consciousness. We here provide a systematic overview of the therapeutic effects of amantadine, apomorphine and zolpidem in patients recovering from coma. Evidence from clinical Read More

Objective. To study the Zolpidem arousing effect in persistent vegetative state (PVS) patients combining clinical evaluation, autonomic assessment by heart rate variability (HRV), and EEG records. Methods. We studied a group of 8 PVS patients and other 8 healthy control subjects, matched by age and gender. The patients and controls received drug or placebo in two experimental sessions, separated by 10-14 days. The first 30 Read More

General anesthesia-induced pharmacological protection of the central nervous system following injury has been under intense investigations during the past four decades. Indeed, if general anesthetics could provide therapeutic benefit in the event of hypoxia, ischemia or any other kinds of brain lesions, that would be of tremendous clinical importance. The potential for anesthesia-related brain protection, however, has been serio Read More

Philosophers have been trying to solve the mind-body problem for hundreds of years. Consciousness is the core of this problem: How do subjective conscious sensations, perceptions, feelings, and thoughts arise out of objective physical brain activities? How is this subjective conscious world in causal interaction with the objective sensory and motor mechanisms of the brain and the body? Although we witness the seamless inter Read More

In this paper, we review the contribution of our research group to the study of human consciousness by quantitative electroencephalographic (EEG) techniques. We posit that EEG techniques can be extremely useful for a direct measurement of brain electrophysiological activity related to human consciousness for their unsurpassable high temporal resolution (milliseconds). This activity can be expressed in terms of event-related p Read More

Twenty-nine patients with Unresponsive Wakefulness Syndrome (UWS), 26 patients in Minimally Conscious State (MCS), and 21 healthy control individuals matched in age and social environment (patients’ relatives) were presented with 80 short sentences half of which were factually correct, and the other half factually incorrect. The diagnosis was made on the basis of repeated neurological examinations as well as the standa Read More

The last years have witnessed a significant increase in our understanding of brain functions in survivors of severe brain injuries with disorders of consciousness (DOC). Despite there is currently no effective standardized treatment for DOC patients, in the past decade many potential pharmacological as well as non-pharmacological therapies have been proposed. A promising and increasingly growing field of non-phar Read More

The design of neurorehabilitation therapy to treat subjects with altered consciousness provides opportunities and challenges to professionals involved with the care for these severely ill patients. While there is an increased interest in determining methods to restore consciousness in these patients, the process is complex and challenging, due in part to the diverse aetiology of these states of consciousness, and also to the in Read More

Recovery from traumatic brain injury (TBI) is variable despite similarities in the severity or mechanism of injury. The study of genetic polymorphisms offers an avenue for explaining individual differences in recovery and outcome following TBI. The current paper reviews the role that genetic polymorphisms may play in influencing recovery and quality of life following TBI. Investigating the role of polymorphisms on recovery fro Read More

The pathophysiology of degenerative, infectious, inflammatory and traumatic diseases of the central nervous system includes a significant immune component. As to the latter, damage to the cerebral vasculature and neural cell bodies, caused by traumatic brain injury (TBI) activates innate immunity with concomitant infiltration of immunocytes into the damaged nervous system. This leads to proinflammatory cytokine and p Read More

The growing diffusion of life support procedures, including cardiopulmonary resuscitation (CPR) and advanced cardiac life support (ACLS), allows physicians to keep a person alive almost indefinitely when the person's heart has stopped beating autonomously or spontaneous breathing is precluded. However, in some cases patients are brought back to life but remain in a vegetative state (VS) or in a minimally conscious st Read More