{"title":"意识及其紊乱的历史回顾。","authors":"G Bryan Young, Loretta Norton","doi":"10.1016/B978-0-443-13408-1.00009-9","DOIUrl":null,"url":null,"abstract":"<p><p>Concepts of consciousness and its disorders begin with the realization that both reside in the brain. Then came the realization that consciousness had various components, with two principal aspects, wakefulness and awareness. Awareness has multiple interconnected components, ranging from perception to abstract thought. These require selection of certain stimuli and processing as well as judgment and motivation, colored by emotion, before a consciously directed action is produced. The brain processes information and can influence behavior at levels below conscious awareness. Deeper insights into underlying neuronal functions and the complex interactions of various brain regions that support conscious experience have been made possible by scientific and technologic advancements. Our understanding of regional and global brain functions has been influenced by studies of various diseases and disorders, ranging from \"brain death\" to delirium. We now recognize that we cannot solely rely on behavioral responses to determine the conscious level, as some \"unresponsive-wakeful,\" previously termed \"vegetative,\" patients retain cognitive capacity, revealed by fMRI and electrophysiologic advances. There is still much to learn, especially as to how full awareness and the awareness of awareness arise from the brain and how to best assess and manage patients with various disorders of consciousness.</p>","PeriodicalId":12907,"journal":{"name":"Handbook of clinical neurology","volume":"207 ","pages":"15-28"},"PeriodicalIF":0.0000,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"A historical review of consciousness and its disorders.\",\"authors\":\"G Bryan Young, Loretta Norton\",\"doi\":\"10.1016/B978-0-443-13408-1.00009-9\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p>Concepts of consciousness and its disorders begin with the realization that both reside in the brain. Then came the realization that consciousness had various components, with two principal aspects, wakefulness and awareness. Awareness has multiple interconnected components, ranging from perception to abstract thought. These require selection of certain stimuli and processing as well as judgment and motivation, colored by emotion, before a consciously directed action is produced. The brain processes information and can influence behavior at levels below conscious awareness. Deeper insights into underlying neuronal functions and the complex interactions of various brain regions that support conscious experience have been made possible by scientific and technologic advancements. Our understanding of regional and global brain functions has been influenced by studies of various diseases and disorders, ranging from \\\"brain death\\\" to delirium. We now recognize that we cannot solely rely on behavioral responses to determine the conscious level, as some \\\"unresponsive-wakeful,\\\" previously termed \\\"vegetative,\\\" patients retain cognitive capacity, revealed by fMRI and electrophysiologic advances. There is still much to learn, especially as to how full awareness and the awareness of awareness arise from the brain and how to best assess and manage patients with various disorders of consciousness.</p>\",\"PeriodicalId\":12907,\"journal\":{\"name\":\"Handbook of clinical neurology\",\"volume\":\"207 \",\"pages\":\"15-28\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2025-01-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Handbook of clinical neurology\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1016/B978-0-443-13408-1.00009-9\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"Medicine\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Handbook of clinical neurology","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1016/B978-0-443-13408-1.00009-9","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"Medicine","Score":null,"Total":0}
A historical review of consciousness and its disorders.
Concepts of consciousness and its disorders begin with the realization that both reside in the brain. Then came the realization that consciousness had various components, with two principal aspects, wakefulness and awareness. Awareness has multiple interconnected components, ranging from perception to abstract thought. These require selection of certain stimuli and processing as well as judgment and motivation, colored by emotion, before a consciously directed action is produced. The brain processes information and can influence behavior at levels below conscious awareness. Deeper insights into underlying neuronal functions and the complex interactions of various brain regions that support conscious experience have been made possible by scientific and technologic advancements. Our understanding of regional and global brain functions has been influenced by studies of various diseases and disorders, ranging from "brain death" to delirium. We now recognize that we cannot solely rely on behavioral responses to determine the conscious level, as some "unresponsive-wakeful," previously termed "vegetative," patients retain cognitive capacity, revealed by fMRI and electrophysiologic advances. There is still much to learn, especially as to how full awareness and the awareness of awareness arise from the brain and how to best assess and manage patients with various disorders of consciousness.
期刊介绍：
The Handbook of Clinical Neurology (HCN) was originally conceived and edited by Pierre Vinken and George Bruyn as a prestigious, multivolume reference work that would cover all the disorders encountered by clinicians and researchers engaged in neurology and allied fields. The first series of the Handbook (Volumes 1-44) was published between 1968 and 1982 and was followed by a second series (Volumes 45-78), guided by the same editors, which concluded in 2002. By that time, the Handbook had come to represent one of the largest scientific works ever published. In 2002, Professors Michael J. Aminoff, François Boller, and Dick F. Swaab took on the responsibility of supervising the third (current) series, the first volumes of which published in 2003. They have designed this series to encompass both clinical neurology and also the basic and clinical neurosciences that are its underpinning. Given the enormity and complexity of the accumulating literature, it is almost impossible to keep abreast of developments in the field, thus providing the raison d''être for the series. The series will thus appeal to clinicians and investigators alike, providing to each an added dimension. Now, more than 140 volumes after it began, the Handbook of Clinical Neurology series has an unparalleled reputation for providing the latest information on fundamental research on the operation of the nervous system in health and disease, comprehensive clinical information on neurological and related disorders, and up-to-date treatment protocols.
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