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A PET study after treatment with an anxiety-provoking agent, m-chlorophenyl-piperazine, in conscious rhesus monkeys.

UNLABELLED: Several PET studies have been performed on conscious nonhuman primates to examine brain function. However, it is unclear how anxiety or stress during PET measurements influences brain function. In the present study, we examined the effects of a well-known anxiety-provoking agent, m-chlorophenyl-piperazine (mCPP), on regional cerebral blood flow (rCBF) and the regional cerebral metabolic rate of glucose (rCMRglc) using PET on conscious rhesus monkeys. METHODS: Male rhesus monkeys with experience undergoing PET measurements were used. Twenty and 40 min after mCPP injection (0.2, 1.0, or 5.0 mg/kg intramuscularly; n = 5), rCBF and rCMRglc were measured using an intravenous injection of (15)O-H(2)O and (18)F-FDG, respectively. Physiologic parameters, plasma cortisol, and prolactin levels were monitored during PET measurements. RESULTS: Treatment with mCPP significantly increased rCBF in both the cingulate cortex and striatum in a dose-dependent manner, and bell-shaped reductions in rCMRglc were observed for all regions examined. mCPP also significantly increased plasma cortisol and prolactin levels. Physiologic parameters were not affected by mCPP treatment. CONCLUSION: The present study demonstrates that treatment with the anxiety-provoking agent mCPP significantly affects rCBF and rCMRglc in conscious monkeys. Therefore, since the increases in hormone levels demonstrate that mCPP treatment produced anxiety or stress, these results suggest that anxiety or stress influences conscious brain function. Furthermore, the present study suggests that prevention of anxiety or stress is important when measuring conscious brain function in monkeys.

Animals↗

Effect of blood-letting puncture at twelve well-points of hand on consciousness and heart rate in patients with apoplexy.

OBJECTIVE: To observe the effect of blood-letting puncture at Twelve Well-Points of Hand on consciousness and heart rate in patients with early apoplexy. METHOD: Under observation were patients with disturbance of consciousness within 3 days after the apoplectic seizure. The patients were divided into a large injury team, a moderate injury team and a mild injury team. Each team was again randomly divided into a puncture group and a control group, with routine treatment in both groups but blood-letting puncture only in the puncture group. Quantitative changes in consciousness, blood pressure and heart rate of the patients were observed. RESULT: Blood-letting puncture at Twelve Well-Points of Hand can improve the consciousness and raise the systolic pressure in patients of the mild injury team, and accelerate the heart rate in all the patients in the puncture group. CONCLUSION: Blood-letting puncture at Twelve Well-Points of Hand can improve the consciousness of patients with brain injury in small area.

Acupuncture Points↗

[Latent factors generating health behavior and health consciousness].

PURPOSE: The purpose of the present study was to explore structural relationships among health behavior and health consciousness and to delineate latent factors underlying them. METHODS: Data used in this study were obtained from a mail survey conducted by Toshima City Government, Tokyo, in 2002. The subjects were 3,000 community residents, living in the city, ranging in age from 20 to 79 years. The response rate was 54.3%. The data for 1,301 respondents without missing observations were analyzed. A second-order factor model utilizing 23 items of health behavior and health consciousness as observed indicators was developed for the analysis. RESULTS: Covariance structure analysis showed that a model consisting of 23 observed indicators, 9 latent first-order factors, and one second-order factor fitted well and explained the structure of health behavior and health consciousness: the 23 items of health behavior and health consciousness were indicatives of the latent second-order factor named Health-oriented Attitude. The second-order factor score was significantly higher in respondents willing to participate in programs of public health agencies than in those not willing. CONCLUSION: The results imply that reinforcement of the health-oriented attitude may bring about improved health consciousness and practice of health behavior. They also suggest the necessity to reconsider traditional programs of public health agencies because persons with a weak health-oriented attitude are less likely to participate.

Activities of Daily Living↗

[The "bright spot of consciousness"].

I.P. Pavlov considered consciousness as an area of optimum excitability moving over the human cerebral cortex depending on the character of performed mental activity. Contemporary methods of computer analysis of electrical activity and brain thermal production have allowed to turn this metaphor into experimentally observed reality. It is shown that preservation of connections of cortical gnostic zones with verbal structures of the left hemisphere is the obligatory condition for consciousness functioning. These data reinforce the determination of consciousness as operation with knowledge, which by means of words, mathematic symbols and art images can be transmitted to other people. Communicative origin of consciousness creates possibility of mental dialogue with oneself, i.e. leads to the appearance of self-consciousness of the personality.

Animals↗

[Consciousness and reflex].

In the paper an analogy is drawn between functions of consciousness and scheme of reflex. Consciousness includes afferent part perception of external world, central one--thinking, and efferent one--decision about action and motor command presentation. The basis of higher psychic functions is the junction of reflexes in complicated complexes, singling out in their composition key structures realizing synthesis of qualitatively different information. The centers of integration at realization of afferent functions of consciousness are situated in posterior, and at efferent ones--in anterior brain areas. In the process of thinking predominantly afferent and efferent stages may also be singled out with corresponding localization of foci of interaction. Communicative function of consciousness is provided mainly by centers of the left hemisphere. Breakage between afferent and efferent functions of consciousness may be the basis of some forms of psychic pathology as depression.

Afferent Pathways↗

[The reorganization of the electrical activity of the human brain during the depression of consciousness (comatose states)].

To study the problem of consciousness an original structural-functional approach has been applied with the use of possibilities of spectral-coherent EEG analysis in evaluation of human brain functional state together with the specificity of the cerebral coma having local focal belonging. It is revealed that the most informative signs for characteristics of consciousness state are peculiarities of reconstruction of intercentral relations of the electrical brain processes: decrease of mean levels of the EEG coherence at progressive development of coma; staged approach to relative norm at regressive course of comatose state and recovery of consciousness; their stability on the low level at prolonged coma; increase in low or high (above optimum) frequencies band at neighbouring with coma states of consciousness. It may be considered that one of the necessary conditions of normal state of consciousness is preservation of the optimum level of correlation of electrical brain activity alongside with frequency-regional specificity of the EEG coherence spectrum. Any deviation from the optimum is unfavourable condition for normal course of cerebral reactions because of the disturbance of intercentral connections mosaic necessary for their realization.

Brain↗

[An autopsied case of type II citrullinemia--transient effectiveness with either citrate or benzoate to the consciousness disturbance].

A 44-year-old man suffered from repeated impairment of consciousness associated with flapping tremor, myoclonus and generalized convulsions, and died in coma 6 months after admission. He had had a psychosomatically underdeveloped childhood, with a propensity for legumes without a family history of the same or a record of consanguinity. On admission, he had disturbed consciousness and emaciation without other physical abnormalities. The EEG revealed diffuse slow waves with occasional appearance of triphasic waves. A high level of serum citrulline (534.7 nmol/ml) was recognized and the assay of urea cycle enzymes in the liver demonstrated decreased argininosuccinate synthetase (ASS) activity (0.062 U/g liver, 7.4% of that in normal liver), although no kinetic abnormality was found. Accordingly he was diagnosed as having type II citrullinemia. In addition, this case could be classified as cluster type of localization of the ASS in the liver by immunohistochemical study. There were characteristic findings concerning his clinical picture and laboratory data, such as a significant correlation between the grade of disturbed consciousness and arterial blood gas pH (r = 0.61, p less than 0.01). However, the blood ammonia level did not always correlate with the severity of disturbed consciousness. Oral treatment with sodium citrate and sodium benzoate was very effective, though transiently, for disturbed consciousness in this case. Pathological findings of the autopsied liver were fatty change and fibrosis. Neuropathologically, characteristic findings were brain edema with cerebellar tonsilar herniation, laminar necrosis with spongy formation in cerebral cortex, and Alzheimer type II glia. The relationship between citrullinemia and other hepatic encephalopathy was also discussed.

Adult↗

[Consciousness and the brain].

I.P. Pavlov wrote: "First of all it is important to comprehend psychologically and then translate into physiological language". On the examples of comparison of the evoked potentials with a theory of signal identification (A.M. Ivanitskiĭ) and need-informational theory of emotions (P.V. Simonov) with the "general low of human emotions" (D. Price, J. Barrell) is demonstrated the efficiency of the simultaneous study of the higher brain functions by neurophysiological and psychological methods. Recent experimental data are underlied by the natural-scientific bases of consciousness. From the author's point of view consciousness is knowledge, which by means of words, mathematical symbols and artistic images may be shared with other individuals, with other generations in a form of cultural monuments. Recent studies by O. Grindel' have shown that preservation of connections between the gnostic cortical areas with the verbal brain structures is a necessary condition of consciousness functioning. The subconsciousness is well automatized and because of that no longer conscious skills, well learned social norms controlling behaviour and experienced as "the voice of heart", "the call of duty" etc. Super-Ego by Freud belongs to the subconscious sphere of the psychic. The superconsciousness (creative intuition) is an initial stage of a creative venture, uncontrolled by consciousness and will: initial closing of new temporary connections (whether they conform to the reality or not is defined only later). Actual controversy between determinism and freedom of choice may be removed by the complementation principle. The man is not free (determined) from the point of view of an external observer, who considers the determination of the man by genetic factors and educational conditions.(ABSTRACT TRUNCATED AT 250 WORDS)

Brain↗

[The age-related factor in the pathology of consciousness in craniocerebral trauma].

In children (n = 103), elderly and old persons (n = 42), abnormal consciousness was comparatively studied in the acute period of brain injury. The revealed clinical features were compared with the previously described syndromes of consciousness disorders in young and middle-aged patients. The authors consider it appropriate to identify quantitative (deafening, sopor, coma) and qualitative (obscure consciousness, confusion, and mixed types differing in the ratio of productive to deficiency symptoms). Depressed consciousness was found to be prevalent in children, obscure consciousness was most typical in adults, confusion was common in elderly and old patients. The low presentation of productive disorders and their low association mainly with brain injury in patients who are on the different poles of ontogenesis are explained in the context of the teaching of cerebral functional asymmetry.

Acute Disease↗

[40-Hz auditory steady state response (40-Hz SSR) in patients with intracranial lesions--with reference to consciousness level and sites of lesions].

OBJECTIVE: The issue of whether the 40-Hz SSR could become a useful neurophysiological monitoring tool in the patients with intracranial lesions was investigated. SUBJECTS AND METHODS: 40-Hz SSR was recorded in 50 normal persons and 63 patients with intracranial lesions, and correlation among differences in consciousness level, lesion site and 40-Hz SSR was determined. RESULTS: (1) Consciousness level and lesion site were both statistically significantly correlated with the pattern of wave forms at a single variable (alpha < 0.0001). (2) Using the multivariate's analysis, an equation to predict the level of consciousness from the SSR waveform and the site of lesion was made. The coefficient of determination between the calculated value and the actual value was 0.822. (3) In the group with intracranial lesions, the P1-N1 amplitude was confirmed to have significantly decreased (alpha < 0.0001) despite a apparently alert level. DISCUSSION AND CONCLUSION: This study revealed that the pattern of 40-Hz SSR waveforms varies with changes in consciousness and lesion site. Moreover, the amplitude of individual waves of SSR waveform is distinctly reduced prior to change the waveform pattern in the alert group. These findings mean that subtle changes of intracranial status could be detected by the continuous monitoring of 40-Hz SSR even at earlier stage of second insult. Consequently, the 40-Hz SSR is a probable objective means of monitoring the consciousness level.

Adult↗

Brain and conscious experience.

There is a deep belief that we can attain not only a neuroscience of consciousness but a neuroscience of human consciousness. It is as if something terribly new and complex happens as the brain enlarges to its human form. Whatever this is, it triggers our capacity for self-reflection, for ennui, and for lingering moments, I would like to propose a simple, three-step suggestion. First, we should focus on what we mean when we talk about conscious experience. It is merely the awareness we have of our capacities as a species, but not the capacities themselves--only the awareness or feelings we have about them. The brain is clearly not a general purpose computing device but is a collection of circuits devoted to quite specific capacities. This is true for all brains, but what is wonderful about the human brain is that we have untold numbers of these capacities. We have more than the chimp, which has more than the monkey, which has more than the cat, which runs circles around the rat. Because we have so many specialized systems and because they can frequently do things they were not designed to do, it appears our brains have a single, general computing device. But we do not. Thus, step 1 requires that we recognize we are a collection of adaptations and, furthermore, we recognize the distinction between a species' capacities and its feelings about those capacities. Now consider step 2. Can there be any doubt that a rat at the moment of copulation is as sensorially fulfilled as a human? Of course it is. Do you think a cat does not enjoy a good piece of cod? Of course it does. Or, a monkey does not enjoy a spectacular swing? Again, it has to be true. Each species is aware of its special capacities. So, what is human consciousness? It is the very same awareness, save for the fact that we can be aware of so much more, so many wonderful things. A circuit--perhaps a single system or one duplicated over and over again--is associated with each brain capacity. The more systems a brain possesses, the greater the awareness of capacities. Think of the variations in capacity within our own species; they are not unlike the vast differences between species. Years of split-brain research have informed us that the left hemisphere has many more mental capacities than the right one. The left is capable of logical feats that the right hemisphere cannot manage. Although the right has capacities such as facial recognition systems, it is a distant second with problem-solving skills. In short, the right hemisphere's level of awareness is limited. It knows precious little about a lot of things, but the limits to human capacity are everywhere in the population. No one need be offended to realize that just as someone with normal intelligence can understand Ohm's law, others, like yours truly, are clueless about Kepler's laws. I am ignorant about them and will remain so. I am unable to be aware about what they mean for the universe. The circuits that enable me to understand these things are not present in my brain. By emphasizing specialized circuits that arise from natural selection, we see that the brain is not a unified neural net that supports a general problem-solving device. With this being understood, we can concentrate on the possibility that smaller, more manageable circuits produce awareness of a species' capacities. Holding fast to the notion of a unified neural net means we can understand human conscious experience only by figuring out the interactions of billions of neurons. That task is hopeless. My scheme is not. Hence step 3. The very same split-brain research that exposed shocking differences between the two hemispheres also showed that the human left hemisphere has the interpreter. The left brain interpreter's job is to interpret our behavior and our responses, whether cognitive or emotional, to environmental challenges. It constantly establishes a running narrative of our actions, emotions, thoughts, and dreams. It is the glue that keeps our

Animals↗

Brief loss of consciousness in bilateral carotid occlusive disease.

Loss of consciousness is rare in the absence of transient or persistent insult to the diencephalon or mesencephalon. We found three patients with severe atherosclerotic stenosis or occlusion of both internal carotid arteries who experienced brief loss of consciousness. Common characteristics were the absence of clinical or electroencephalographic seizure activities, significant cardiovascular disease, or a history suggestive of vasovagal syncope. Angiographically, the patients had widely patent vertebrobasilar circulation and collaterals from vertebrobasilar to carotid circulation. Episodic loss of consciousness disappeared after carotid endarterectomy. We concluded that bilateral hemispheric ischemia caused brief loss of consciousness, but selective focal ischemia in the subcortical structures superimposed on widespread bihemispheric ischemia may have been responsible. Since loss of consciousness is rare in carotid occlusive diseases, systemic and vertebrobasilar causes must be carefully ruled out in each instance.

Aged↗

Acetylcholine and hallucinations: disease-related compared to drug-induced alterations in human consciousness.

Newly proposed criteria for Lewy body dementia include alterations in consciousness. Lewy body dementia is also associated with a disturbance in cholinergic transmission; neocortical cholinergic deficits in this disorder are more extensive than in Alzheimer's disease and are correlated with symptoms commonly associated with delirium, such as visual hallucinations. The traditional view that derangements of the basal forebrain cholinergic system in Alzheimer's disease relate specifically to memory impairment is assessed in terms of a more general role for cortical acetylcholine in consciousness. This extends the concept that cortical acetylcholine enhances neuronal signal to noise ratio. It is suggested that muscarinic receptor activation in the cortex is involved in confining the contents of the discrete self-reported conscious "stream." In the absence of cortical acetylcholine, currently irrelevant intrinsic and sensory information, which is constantly processed in parallel at the subconscious level, enters conscious awareness. This is consistent with the ability of anti-muscarinic drugs administered medically, recreationally, or ritualistically to induce visual hallucinations and other perceptual disturbances. The hypothesis is explored through comparisons between muscarinic and nicotinic receptor psychopharmacology and between the pathology of the basal forebrain as opposed to pedunculopontine cholinergic systems in different diseases of the human brain affecting consciousness and cognition. The paradoxical effects of muscarinic receptor blockade to induce hallucinations and of REM sleep-associated cholinergic activation of the thalamus to induce dreaming may be related to the differential distribution and activity of muscarinic receptor subtypes or to the differing responses of intrinsic GABA neurons in cortex and thalamus.

Acetylcholine↗

Comparison of acid/base status in conscious and anaesthetized rats during acute hypothermia.

Acute hypothermia was surface-induced in unrestrained conscious rats at two different levels, moderate (30 degrees C TB) and severe (20 degrees C TB). Data reflecting the acid/base status were determined. The values obtained for moderate hypothermia were compared with the acid/base pattern observed during hypothermia induced by two different anaesthetics, sodium pentobarbital and urethane, at room temperature. Conscious, hypothermic animals developed an apparent respiratory alkalosis, with an increase in pHa (from 7.476 to 7.546 in moderate hypothermia and from 7.484 to 7.563 in severe hypothermia) correlated with a decrease in arterial bicarbonate levels (from 22.9 to 16.8 mmol l-1 and from 20.7 to 14.9 mmol l-1 respectively). Lactate increased slightly in conscious, severely hypothermic rats (1.02 mmol l-1). This acid/base pattern was clearly different from that seen in sodium pentobarbital (mild respiratory acidosis) and urethane-induced hypothermia (metabolic acidosis). These results suggest that conscious rats follow a pattern closer to that underlying the relative alkalinity shown by many poikilotherms than to that underlying the constant pH shown in hibernating mammals. This latter pattern, nevertheless, approaches that observed during moderate pentobarbital hypothermia and the acid/base pattern during shallow hypothermia in birds. Anaesthesia may interfere with the development of the processes that lead to the acid/base pattern observed in conscious animals.

Acid-Base Equilibrium↗

Immediate prediction of recovery of consciousness after cardiac arrest.

OBJECTIVE: Short-latency somatosensory evoked potential (SSEP) monitoring has been reported to be useful in predicting neurological outcome in patients with cardiac arrest and hypoxic-ischemic encephalopathy. To obtain the immediate data of SSEP and evaluate the relationship between the presence of cortical activity and the recovery of consciousness, SSEP was recorded immediately after return of spontaneous circulation. DESIGN AND SETTING: Prospective observational study in an intensive care unit of a university general hospital. PATIENTS: The study included 30 patients resuscitated from out-of-hospital cardiac arrest. INTERVENTIONS: Basic and advanced cardiac life support, and intensive care. MEASUREMENTS AND RESULTS: SSEP were recorded between 40 and 170 min (median 65) after spontaneous circulation returned. In the initial study all 30 patients showed the Erb's point potential and the N11-13 component, while only 12 (40%) showed cortical activity. Patients were assessed neurologically for recovery of consciousness until 1 month after cardiac arrest. Of 12 these patients 8 recovered consciousness within 10 days, while all patients without cortical activity died without opening their eyes. CONCLUSION: Even immediately following resuscitation, absence of cortical activity in SSEP indicates unlikelihood of recovering consciousness, while the preservation of such activity suggests that consciousness is improved. The result promises further accumulation of patients to validate the predictive ability of SSEP in managing postresuscitated patients.

Coma↗

Cardiovascular responses to centrally administered serotonin in conscious normotensive and spontaneously hypertensive rats.

Serotonin (5-HT, 1-10 micrograms), injected into the lateral ventricle of the urethanized, and conscious normotensive and spontaneously hypertensive rats produced a dose-dependent increase in blood pressure. In conscious rats, there was mainly a decrease in heart rate while variable changes in heart rate were elicited by intraventricular (i.c.v.) administration of 5-HT in anesthetized animals. These pressor responses and bradycardia caused by 5-HT in conscious rats were reduced by pretreatment with i.c.v. methysergide (25 micrograms). Microinjection of 5-HT (2.5-5 micrograms) directly into the medial hypothalamus and the anterior hypothalamus/preoptic area of conscious normotensive rats caused a pressor response accompanied by variable changes in heart rate. The present results indicate that urethane can affect the HR response to 5-HT injected i.c.v. without having a marked influence on the pressor response. These findings, which show that 5-HT produced a rise in BP independent of the anesthetized or conscious state and of normotension or hypertension, further confirm the idea that 5-HT plays a pressor role in the central regulation of the cardiovascular system.

Animals↗

Mexiletine's antifibrillatory actions are limited by the occurrence of convulsions in conscious animals.

The antiarrhythmic actions of the racemate and enantiomers of mexiletine were studied in conscious and anaesthetised rats. Racemate or enantiomers, at 20 mg/kg i.v., had little effect on ischaemia-induced ventricular fibrillation in conscious or anaesthetised rats. In conscious rats 20 mg/kg caused convulsions in 78-89% of rats when the plasma concentration of racemate was 20 +/- 2 microM. In anaesthetized animals a higher dose (40 mg/kg) of racemate could be given; this completely prevented ischaemia-induced fibrillation when the plasma concentration was 26 +/- 2 microM. Racemate and enantiomers accumulated in the heart and brain of conscious animals to give tissue: plasma ratios of 7.5 and 23, respectively. With electrical stimulation, both racemate and enantiomers dose dependently (4-32 mg/kg) increased threshold currents for induction of ventricular fibrillation, increased refractory period and minimally changed the ECG; findings expected with a Class Ib antiarrhythmic. The above studies failed to show major differences between racemate or enantiomers except for consistently lower (20-30%) plasma concentrations of R(-) at all dose levels. In conclusion, mexiletine prevented ischaemia-induced ventricular fibrillation in anaesthetised animals but only when given at doses producing convulsions in conscious animals.

Animals↗

EEG and EMG responses to emotion-evoking stimuli processed without conscious awareness.

Dichotic stimulus pairs were constructed with one word that was emotionally neutral and another that evoked either negative or positive feelings. Temporal and spectral overlap between the members of each pair was so great that the two words fused into a single auditory percept. Subjects were consciously aware of hearing only one word from most pairs; sometimes the emotion-evoking word was heard consciously, other times the neutral word was heard consciously. Subjects were instructed to let their thoughts wander in response to the word they heard, during which time EEG alpha activity over left and right frontal regions, and muscle activity (EMG) in the corrugator ("frowning") and zygomatic ("smiling") regions were recorded. Both EEG and EMG provided evidence of emotion-specific responses to stimuli that were processed without conscious awareness. Moreover both suggested relatively greater right hemisphere activity with unconscious rather than conscious processing.

Adolescent↗