意识作为一种多维现象:对意识障碍评估的启示。

IF 3.1 Q1 PSYCHOLOGY, BIOLOGICAL
Jasmine Walter
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引用次数: 11

摘要

意识障碍(DoCs)是一个重大的临床和伦理挑战,因为它们允许患者在故意行为和沟通高度有限或不存在的情况下产生复杂形式的意识体验。迫切需要基于大脑的评估,能够准确、准确地描述DoC患者个体的意识状态。人们一直在努力开发意识的神经测量方法。然而,这些措施很难验证,这不仅是因为我们在许多DoC患者中缺乏关于意识的基本事实,还因为关于意识存在一个开放的本体论问题。有一种越来越多、得到充分支持的观点认为,意识是一种多维现象,不能用层次分明、易于有序的意识层次的理论结构来完全描述。意识的多维视角挑战了基于水平的神经测量在DoC评估中的效用。为了研究这些措施是如何将意识映射为一种多维现象的,本文将调查一系列研究,这些研究已经在除DoC之外的州应用,并且对意识体验有更多的了解。这一比较证据表明,意识水平的测量对意识的某些维度比其他维度更敏感,不能被认为提供了意识状态的直接层次特征。例如,大脑复杂性水平的提高与以高度的感官丰富性和最小的注意力限制为特征的意识状态有关,但对于目标导向的行为和外部反应来说是次优的。总的来说,这种比较分析表明,目前将这些指标作为评估意识作为一种多维现象的工具存在局限性,这些神经特征与现象学之间的关系需要更仔细的研究。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Consciousness as a multidimensional phenomenon: implications for the assessment of disorders of consciousness.

Consciousness as a multidimensional phenomenon: implications for the assessment of disorders of consciousness.

Disorders of consciousness (DoCs) pose a significant clinical and ethical challenge because they allow for complex forms of conscious experience in patients where intentional behaviour and communication are highly limited or non-existent. There is a pressing need for brain-based assessments that can precisely and accurately characterize the conscious state of individual DoC patients. There has been an ongoing research effort to develop neural measures of consciousness. However, these measures are challenging to validate not only due to our lack of ground truth about consciousness in many DoC patients but also because there is an open ontological question about consciousness. There is a growing, well-supported view that consciousness is a multidimensional phenomenon that cannot be fully described in terms of the theoretical construct of hierarchical, easily ordered conscious levels. The multidimensional view of consciousness challenges the utility of levels-based neural measures in the context of DoC assessment. To examine how these measures may map onto consciousness as a multidimensional phenomenon, this article will investigate a range of studies where they have been applied in states other than DoC and where more is known about conscious experience. This comparative evidence suggests that measures of conscious level are more sensitive to some dimensions of consciousness than others and cannot be assumed to provide a straightforward hierarchical characterization of conscious states. Elevated levels of brain complexity, for example, are associated with conscious states characterized by a high degree of sensory richness and minimal attentional constraints, but are suboptimal for goal-directed behaviour and external responsiveness. Overall, this comparative analysis indicates that there are currently limitations to the use of these measures as tools to evaluate consciousness as a multidimensional phenomenon and that the relationship between these neural signatures and phenomenology requires closer scrutiny.

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来源期刊
Neuroscience of Consciousness
Neuroscience of Consciousness Psychology-Clinical Psychology
CiteScore
6.90
自引率
2.40%
发文量
16
审稿时长
19 weeks
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