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What happens in the brain when conscious awareness of the surrounding world fades? We manipulated consciousness in two experiments in a group of healthy males and measured brain activity with positron emission tomography. Measurements were made during wakefulness, escalating and constant levels of two anesthetic agents (experiment 1, n = 39), and during sleep-deprived wakefulness and non-rapid eye movement sleep (experiment 2, n = 37). In experiment 1, the subjects were randomized to receive either propofol or dexmedetomidine until unresponsiveness. In both experiments, forced awakenings were applied to achieve rapid recovery from an unresponsive to a responsive state, followed by immediate and detailed interviews of subjective experiences during the preceding unresponsive condition. Unresponsiveness rarely denoted unconsciousness, as the majority of the subjects had internally generated experiences. Unresponsive anesthetic states and verified sleep stages, where a subsequent report of mental content included no signs of awareness of the surrounding world, indicated a disconnected state. Functional brain imaging comparing responsive and connected versus unresponsive and disconnected states of consciousness during constant anesthetic exposure revealed that activity of the thalamus, cingulate cortices, and angular gyri are fundamental for human consciousness. These brain structures were affected independent from the pharmacologic agent, drug concentration, and direction of change in the state of consciousness. Analogous findings were obtained when consciousness was regulated by physiological sleep. State-specific findings were distinct and separable from the overall effects of the interventions, which included widespread depression of brain activity across cortical areas. These findings identify a central core brain network critical for human consciousness. SIGNIFICANCE STATEMENT Trying to understand the biological basis of human consciousness is currently one of the greatest challenges of neuroscience. While the loss and return of consciousness regulated by anesthetic drugs and physiological sleep are used as model systems in experimental studies on consciousness, previous research results have been confounded by drug effects, by confusing behavioral "unresponsiveness" and internally generated consciousness, and by comparing brain activity levels across states that differ in several other respects than only consciousness. Here, we present carefully designed studies that overcome many previous confounders and for the first time reveal the neural mechanisms underlying human consciousness and its disconnection from behavioral responsiveness, both during anesthesia and during normal sleep, and in the same study subjects., (Copyright © 2021 Scheinin et al.)

Anesthetic-induced changes in the neural activity of the brain have been recently utilized as a research model to investigate the neural mechanisms of phenomenal consciousness. However, the anesthesiologic definition of consciousness as "responsiveness to the environment" seems to sidestep the possibility that an unresponsive individual may have subjective experiences. The aim of the present study was to analyze subjective reports in sessions where sedation and the loss of responsiveness were induced by dexmedetomidine, propofol, sevoflurane or xenon in a nonsurgical experimental setting. After regaining responsiveness, participants recalled subjective experiences in almost 60% of sessions. During dexmedetomidine sessions, subjective experiences were associated with shallower "depth of sedation" as measured by an electroencephalography-derived anesthesia depth monitor. Results confirm that subjective experiences may occur during clinically defined unresponsiveness, and that studies aiming to investigate phenomenal consciousness under sedative and anesthetic effects should control the subjective state of unresponsive participants with post-recovery interviews., (Copyright © 2011 Elsevier Inc. All rights reserved.)

Despite the complexity and methodological difficulties in defining the concept of consciousness, it is a central concept in epileptology, and should thus be tractable for scientific analysis. In the present article, a two-dimensional model consisting of concepts related to the level and the contents of consciousness will be presented. This model has been found to be well suited for the description of seizure-induced alterations of consciousness, and is supported both by findings from neuroimaging and electrophysiological studies as well as from phenomenological studies. Further, we will review both traditional introspective methods as well as methods that have recently been developed or utilized in epilepsy research, summarize the main findings concerning first person experiences during epileptic seizures acquired with some of these methods, and discuss their strengths and weaknesses.

Establishing the neural mechanisms responsible for the altered global states of consciousness during anesthesia and dissociating these from other drug-related effects remains a challenge in consciousness research. We investigated differences in brain activity between connectedness and disconnectedness by administering various anesthetics at concentrations designed to render 50% of the subjects unresponsive. One hundred and sixty healthy male subjects were randomized to receive either propofol (1.7 μg/ml; n = 40), dexmedetomidine (1.5 ng/ml; n = 40), sevoflurane (0.9% end-tidal; n = 40), S-ketamine (0.75 μg/ml; n = 20), or saline placebo (n = 20) for 60 min using target-controlled infusions or vaporizer with end-tidal monitoring. Disconnectedness was defined as unresponsiveness to verbal commands probed at 2.5-min intervals and unawareness of external events in a postanesthesia interview. High-resolution positron emission tomography (PET) was used to quantify regional cerebral metabolic rates of glucose (CMRglu) utilization. Contrasting scans where the subjects were classified as connected and responsive versus disconnected and unresponsive revealed that for all anesthetics, except S-ketamine, the level of thalamic activity differed between these states. A conjunction analysis across the propofol, dexmedetomidine and sevoflurane groups confirmed the thalamus as the primary structure where reduced metabolic activity was related to disconnectedness. Widespread cortical metabolic suppression was observed when these subjects, classified as either connected or disconnected, were compared with the placebo group, suggesting that these findings may represent necessary but alone insufficient mechanisms for the change in the state of consciousness.SIGNIFICANCE STATEMENT Experimental anesthesia is commonly used in the search for measures of brain function which could distinguish between global states of consciousness. However, most previous studies have not been designed to separate effects related to consciousness from other effects related to drug exposure. We employed a novel study design to disentangle these effects by exposing subjects to predefined EC50 doses of four commonly used anesthetics or saline placebo. We demonstrate that state-related effects are remarkably limited compared with the widespread cortical effects related to drug exposure. In particular, decreased thalamic activity was associated with disconnectedness with all used anesthetics except for S-ketamine.

Anaesthetic-induced unresponsiveness and non-rapid eye movement (NREM) sleep share common neural pathways and neurophysiological features. We hypothesised that these states bear resemblance also at the experiential level. We compared, in a within-subject design, the prevalence and content of experiences in reports obtained after anaesthetic-induced unresponsiveness and NREM sleep. Healthy males (N =39) received dexmedetomidine (n =20) or propofol (n =19) in stepwise doses to induce unresponsiveness. Those rousable were interviewed and left unstimulated, and the procedure was repeated. Finally, the anaesthetic dose was increased 50%, and the participants were interviewed after recovery. The same participants (N =37) were also later interviewed after NREM sleep awakenings. Most subjects were rousable, with no difference between anaesthetic agents (P =0.480). Lower drug plasma concentrations were associated with being rousable for both dexmedetomidine (P =0.007) and propofol (P =0.002) but not with recall of experiences in either drug group (dexmedetomidine: P =0.543; propofol: P =0.460). Of the 76 and 73 interviews performed after anaesthetic-induced unresponsiveness and NREM sleep, 69.7% and 64.4% included experiences, respectively. Recall did not differ between anaesthetic-induced unresponsiveness and NREM sleep (P =0.581), or between dexmedetomidine and propofol in any of the three awakening rounds (P >0.05). Disconnected dream-like experiences (62.3% vs 51.1%; P =0.418) and memory incorporation of the research setting (88.7% vs 78.7%; P =0.204) were equally often present in anaesthesia and sleep interviews, respectively, whereas awareness, signifying connected consciousness, was rarely reported in either state. Anaesthetic-induced unresponsiveness and NREM sleep are characterised by disconnected conscious experiences with corresponding recall frequencies and content. Clinical trial registration. This study was part of a larger study registered at ClinicalTrials.gov (NCT01889004). [ABSTRACT FROM AUTHOR]

The Dream Catcher test defines the criteria for a genuine discovery of the neural constituents of phenomenal consciousness. Passing the test implies that some patterns of purely brain-based data directly correspond to the subjective features of phenomenal experience, which would help to bridge the explanatory gap between consciousness and brain. Here, we conducted the Dream Catcher test for the first time in a step-wise and simplified form, capturing its core idea. The Dream Catcher experiment involved a Data Team, which measured participants' brain activity during sleep and collected dream reports, and a blinded Analysis Team, which was challenged to predict, based solely on brain measurements, whether or not a participant had a dream experience. Using a serial-awakening paradigm, the Data Team prepared 54 1-min polysomnograms of non-rapid eye movement sleep—27 of dreamful sleep and 27 of dreamless sleep (three of each condition from each of the nine participants)—redacting from them all associated participant and dream information. The Analysis Team attempted to classify each recording as either dreamless or dreamful using an unsupervised machine learning classifier, based on hypothesis-driven, extracted features of electroencephalography (EEG) spectral power and electrode location. The procedure was repeated over five iterations with a gradual removal of blindness. At no level of blindness did the Analysis Team perform significantly better than chance, suggesting that EEG spectral power could not be utilized to detect signatures specific to phenomenal consciousness in these data. This study marks the first step towards realizing the Dream Catcher test in practice. [ABSTRACT FROM AUTHOR]

In general, dreams are a novel but realistic simulation of waking social life, with a mixture of characters, motivations, scenarios, and positive and negative emotions. We propose that the sharing of dreams has an empathic effect on the dreamer and on significant others who hear and engage with the telling of the dream. Study 1 tests three correlations that are predicted by the theory of dream sharing and empathy: that trait empathy will be correlated with frequency of telling dreams to others, with frequency of listening to others' dreams, and with trait attitude toward dreams (ATD) (for which higher scores indicate positive attitude). 160 participants completed online the Toronto Empathy Questionnaire and the Mannheim Dream Questionnaire. Pearson partial correlations were conducted, with age and sex partialled out. Trait empathy was found to be significantly associated with the frequency of listening to the dreams of others, frequency of telling one's own dreams to others, and attitude toward dreams. Study 2 tests the effects of discussing dreams on state empathy, using an adapted version of the Shen (2010) state empathy scale, for 27 pairs of dream sharers and discussers. Dream discussion followed the stages of the Ullman (1996) dream appreciation technique. State empathy of the dream discusser toward the dream sharer was found to increase significantly as a result of the dream discussion, with a medium effect size, whereas the dream sharer had a small decrease in empathy toward the discusser. A proposed mechanism for these associations and effects is taken from the robust findings in the literature that engagement with literary fiction can induce empathy toward others. We suggest that the dream acts as a piece of fiction that can be explored by the dreamer together with other people, and can thus induce empathy about the life circumstances of the dreamer. We discuss the speculation that the story-like characteristics of adult human dreams may have been selected for in human evolution, including in sexual selection, as part of the selection for emotional intelligence, empathy, and social bonding. [ABSTRACT FROM AUTHOR]

Despite the complexity and methodological difficulties in defining the concept of consciousness, it is a central concept in epileptology, and should thus be tractable for scientific analysis. In the present article, a two-dimensional model consisting of concepts related to the level and the contents of consciousness will be presented. This model has been found to be well suited for the description of seizure-induced alterations of consciousness, and is supported both by findings from neuroimaging and electrophysiological studies as well as from phenomenological studies. Further, we will review both traditional introspective methods as well as methods that have recently been developed or utilized in epilepsy research, summarize the main findings concerning first person experiences during epileptic seizures acquired with some of these methods, and discuss their strengths and weaknesses. [ABSTRACT FROM AUTHOR]

The recently proposed threat simulation theory (TST) states that dreaming about threatening events has a biological function. In the past few years, the TST has led to several dream content analysis studies that empirically test the theory. The predictions of the TST have been investigated mainly with a new content analysis system, the Dream Threat Scale (DTS), a method developed for identifying and classifying threatening events in dreams. In this article we review the studies that have tested the TST with the DTS. We summarize and reevaluate the results based on the dreams of Finnish and Swedish university students, traumatized and nontraumatized Kurdish, Palestinian, and Finnish children, and special dream samples, namely recurrent dreams and nightmares collected from Canadian participants. We sum up other recent research that has relevance for the TST and discuss the extent to which empirical evidence supports or conflicts with the TST. New evidence and new direct tests of the predictions of the TST yield strong support for the theory, and the TST's strengths seem to outweigh its weaknesses. [ABSTRACT FROM AUTHOR]

Abstract: Epilepsy research suffers from a deficiency of systematic studies concerning the phenomenology of the contents of consciousness during seizures, partially because of the lack of suitable research methods. The Phenomenology of Consciousness Inventory (PCI), a standardized, valid, and reliable questionnaire, was used here to study which dimensions of the contents of consciousness are distorted during partial epileptic seizures compared with baseline. Further, the similarity of the altered pattern of subjective experiences across recurring seizures was also explored. Our results indicate that patients with epilepsy report alterations on most dimensions of the contents of consciousness in conjunction with seizures, but individual seizure experiences remain similar from one seizure to another. The PCI was found suitable for the assessment of subjective experiences during epileptic seizures and could be a valuable tool in providing new information about phenomenal consciousness in epilepsy in both the research and clinical settings. [Copyright &y& Elsevier]

• Experiences recalled after responsive and unresponsive sedation were assessed. • Equipotent doses of dexmedetomidine, propofol, sevoflurane, and S-ketamine were used. • 46.9% of arousable participants reported disconnected experiences after sedation. • Responsiveness did not affect the prevalence or content of reported experiences. • Unresponsiveness during anesthetic administration does not denote unconsciousness. To understand how anesthetics with different molecular mechanisms affect consciousness, we explored subjective experiences recalled after responsive and unresponsive sedation induced with equisedative doses of dexmedetomidine, propofol, sevoflurane, and S-ketamine in healthy male participants (N = 140). The anesthetics were administered in experimental setting using target-controlled infusion or vapouriser for one hour. Interviews conducted after anesthetic administration revealed that 46.9% (n = 46) of arousable participants (n = 98) reported experiences, most frequently dreaming or memory incorporation of the setting. Participants receiving dexmedetomidine reported experiences most often while S-ketamine induced the most multimodal experiences. Responsiveness at the end of anesthetic administration did not affect the prevalence or content of reported experiences. These results demonstrate that subjective experiences during responsive and unresponsive sedation are common and anesthetic agents with different molecular mechanisms of action may have different effects on the prevalence and complexity of the experiences, albeit in the present sample the differences between drugs were minute. [ABSTRACT FROM AUTHOR]