Abstract
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 the neurochemistry of the sleep/wake condition is necessary but not sufficient to understand the circuitry and neurochemistry of consciousness. Disorders of consciousness (DOCs) include coma, vegetative state and minimally conscious state. The study of DOCs and of the electrophysiological changes underlying general anaesthesia-induced loss of consciousness may help in understanding the neuronal correlates of consciousness. In turn, the understanding of the neural bases of consciousness may help in designing interventions aimed at restoring consciousness in DOC patients. Sporadic cases of recovery from a DOC have been reported after the administration of various pharmacological agents (baclofen, zolpidem, amantadine etc.). This review provides an overview of such drugs, which are from various and diverging classes but can be grouped into two main categories: CNS stimulants and CNS depressants.
The available data seem to suggest an awakening effect obtained with CNS depressants rather than stimulants, the latter being more effective at improving functional cognitive and behavioral recovery in patients who have spontaneously regained an appreciable level of consciousness. There is a need for more rigorous systematic trials and further investigation of the above treatments, with particular attention paid to their mechanisms of action and the neurotransmitters involved.
Keywords: Consciousness, vegetative state, coma, minimally conscious state, awakenings, drugs, pharmacology.
Current Pharmaceutical Design
Title:Pharmacological Modulation of the State of Awareness in Patients with Disorders of Consciousness: An Overview
Volume: 20 Issue: 26
Author(s): Elisa Mura, Francesca Pistoia, Marco Sara, Simona Sacco, Antonio Carolei and Stefano Govoni
Affiliation:
Keywords: Consciousness, vegetative state, coma, minimally conscious state, awakenings, drugs, pharmacology.
Abstract: 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 the neurochemistry of the sleep/wake condition is necessary but not sufficient to understand the circuitry and neurochemistry of consciousness. Disorders of consciousness (DOCs) include coma, vegetative state and minimally conscious state. The study of DOCs and of the electrophysiological changes underlying general anaesthesia-induced loss of consciousness may help in understanding the neuronal correlates of consciousness. In turn, the understanding of the neural bases of consciousness may help in designing interventions aimed at restoring consciousness in DOC patients. Sporadic cases of recovery from a DOC have been reported after the administration of various pharmacological agents (baclofen, zolpidem, amantadine etc.). This review provides an overview of such drugs, which are from various and diverging classes but can be grouped into two main categories: CNS stimulants and CNS depressants.
The available data seem to suggest an awakening effect obtained with CNS depressants rather than stimulants, the latter being more effective at improving functional cognitive and behavioral recovery in patients who have spontaneously regained an appreciable level of consciousness. There is a need for more rigorous systematic trials and further investigation of the above treatments, with particular attention paid to their mechanisms of action and the neurotransmitters involved.
Export Options
About this article
Cite this article as:
Mura Elisa, Pistoia Francesca, Sara Marco, Sacco Simona, Carolei Antonio and Govoni Stefano, Pharmacological Modulation of the State of Awareness in Patients with Disorders of Consciousness: An Overview, Current Pharmaceutical Design 2014; 20 (26) . https://dx.doi.org/10.2174/13816128113196660658
DOI https://dx.doi.org/10.2174/13816128113196660658 |
Print ISSN 1381-6128 |
Publisher Name Bentham Science Publisher |
Online ISSN 1873-4286 |
Call for Papers in Thematic Issues
"Tuberculosis Prevention, Diagnosis and Drug Discovery"
The Nobel Prize-winning discoveries of Mycobacterium tuberculosis and streptomycin have enabled an appropriate diagnosis and an effective treatment of tuberculosis (TB). Since then, many newer diagnosis methods and drugs have been saving millions of lives. Despite advances in the past, TB is still a leading cause of infectious disease mortality ...read more
Current Pharmaceutical challenges in the treatment and diagnosis of neurological dysfunctions
Neurological dysfunctions (MND, ALS, MS, PD, AD, HD, ALS, Autism, OCD etc..) present significant challenges in both diagnosis and treatment, often necessitating innovative approaches and therapeutic interventions. This thematic issue aims to explore the current pharmaceutical landscape surrounding neurological disorders, shedding light on the challenges faced by researchers, clinicians, and ...read more
Emerging and re-emerging diseases
Faced with a possible endemic situation of COVID-19, the world has experienced two important phenomena, the emergence of new infectious diseases and/or the resurgence of previously eradicated infectious diseases. Furthermore, the geographic distribution of such diseases has also undergone changes. This context, in turn, may have a strong relationship with ...read more
Melanoma and Non-Melanoma Skin Cancer Treatment: Standard of Care and Recent Advances
In this thematic issue, we aim to provide a standard of care of the diagnosis and treatment of melanoma and non-melanoma skin cancer. The editor will invite authors from different countries who will write review articles of melanoma and non-melanoma skin cancers. The Diagnosis, Staging, Surgical Treatment, Non-Surgical Treatment all ...read more
- Author Guidelines
- Graphical Abstracts
- Fabricating and Stating False Information
- Research Misconduct
- Post Publication Discussions and Corrections
- Publishing Ethics and Rectitude
- Increase Visibility of Your Article
- Archiving Policies
- Peer Review Workflow
- Order Your Article Before Print
- Promote Your Article
- Manuscript Transfer Facility
- Editorial Policies
- Allegations from Whistleblowers
- Announcements
Related Articles
-
Dynamics of Nicotinic Acetylcholine Receptors and Receptor-Associated Proteins at the Vertebrate Neuromuscular Junction
Current Alzheimer Research Copper Status Abnormalities and How to Measure Them in Neurodegenerative Disorders
Recent Patents on CNS Drug Discovery (Discontinued) New Strategies in the Development of Antidepressants: Towards the Modulation of Neuroplasticity Pathways
Current Pharmaceutical Design Cannabinoids for the Treatment of Schizophrenia: An Overview
Current Topics in Medicinal Chemistry The Genetics of Small-Vessel Disease
Current Medicinal Chemistry Targeting Opioid and Neurokinin-1 Receptors to Treat Alcoholism
Current Medicinal Chemistry Augmentation Strategies to Improve Treatment of Major Depression
Central Nervous System Agents in Medicinal Chemistry Nerve Growth Factor: Structure, Function and Therapeutic Implications for Alzheimers Disease
Current Drug Targets - CNS & Neurological Disorders The Bioanalytical Molecular Pharmacology of the N-methyl-<sub>D</sub>-Aspartate (NMDA) Receptor Nexus and the Oxygen-Responsive Transcription Factor HIF-1α : Putative Mechanisms and Regulatory Pathways Unravel the Intimate Hypoxia Connection
Current Molecular Pharmacology Inflammation and Mood Disorders: Proinflammatory Cytokines and the Pathogenesis of Depression
Anti-Inflammatory & Anti-Allergy Agents in Medicinal Chemistry Tachykinins and the Cardiovascular System
Current Drug Targets The Emerging Role of TRP Channels in Mechanisms of Temperature and Pain Sensation
Current Neuropharmacology Effect of Polyphenolic Compounds from Solanum torvum on Plasma Lipid Peroxidation, Superoxide anion and Cytochrome P450 2E1 in Human Liver Microsomes
Medicinal Chemistry Uncovering CNS Pathways Involved in State Dependent Control of Lower Airway Function
Current Respiratory Medicine Reviews Is the Cytoskeleton an Intracellular Receptor for Adrenomedullin and PAMP?
Current Protein & Peptide Science Food Addiction Spectrum: A Theoretical Model from Normality to Eating and Overeating Disorders
Current Medicinal Chemistry Self-Regulatory Control and Habit Learning in the Development of Eating Disorders
Current Psychiatry Reviews Brain Perfusion In Sepsis
Current Vascular Pharmacology Recent Advances in the Synthesis and Development of Curcumin, its Combinations and Formulations and Curcumin-like Compounds as Anti-infective Agents
Current Medicinal Chemistry Neural Basis of Anhedonia and Amotivation in Patients with Schizophrenia: The Role of Reward System
Current Neuropharmacology