AWARE Update - Peer Review Complete

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This is not a claim, it's a medical fact that the brainstem does not function after cardiac arrest. How can we be sure of this ?? Read the passage below, it tells you what the brainstem does and is responsible for :

brainstem, area at the base of the brain that lies between the deep structures of the cerebral hemispheres and the cervical spinal cord. It is divided into three sections: midbrain (mesencephalon), pons (metencephalon), and medulla oblongata (myelencephalon). The brainstem houses many of the control centres for vital body functions, such as swallowing, breathing, and vasomotor control. All of the cranial nerve nuclei, except those associated with olfaction and vision, are located in the brainstem, providing motor and sensory function to structures of the cranium, including the facial muscles, tongue, pharynx, and larynx, as well as supplying the senses of taste, equilibrium, and hearing. The brainstem also has nuclei important for sympathetic and parasympathetic autonomic functions. All efferent and afferent pathways between the cerebrum and cerebellum course through the brainstem, and many of them decussate, or cross, within this structure. Because of the important neural structures concentrated in this small portion of the nervous system, even very small lesions of the brainstem may have profound effects. Disorders involving the brainstem include trauma, tumours, strokes, infections, and demyelination (multiple sclerosis). Complete loss of brainstem function is regarded by some experts as equivalent to brain death

Have you read that, Master Wu ? Did you read the word SWALLOWING ....is a function of the brainstem

Immediately after a person falls to the floor after cardiac arrest, the doctors can insert a tube down the patients throat AND THE PATIENT DOES NOT
GAG. His swallowing reflex is ABSENT and this is why we can say that the brain stem is not functioning at that time. It doesn't mean that function won't return but it does mean it is temporarily down. Are you going to call bullshit on me ? This is fact

Now, I've spent half an hour rooting around trying to find a paper that might be suitable to show you in a simple manner. They don't and can't do experiments on human brainstems just like that. Animals have been used instead which I don't particularly like but I will continue to search for that kind of experiment.
Yes tim, I know all that. It's what I said to you earlier. We're not talking about swallowing and having tubes put down throats. As I pointed out several times now, generation of motor reflexes is not at argument here.
 
Now, I've spent half an hour rooting around trying to find a paper that might be suitable to show you in a simple manner. They don't and can't do experiments on human brainstems just like that. Animals have been used instead which I don't particularly like but I will continue to search for that kind of experiment.
Correct (as I told you way back in the thread). Animal experiments in this regard are of limited worth to begin with because of the difference in scale and complexity of the human nervous system. At the very least, you would need to be discussing higher primates.
 
Correct (as I told you way back in the thread). Animal experiments in this regard are of limited worth to begin with because of the difference in scale and complexity of the human nervous system. At the very least, you would need to be discussing higher primates.
I don't see why it can't be enough to know that the brainstem function is knocked out by the loss of the gag reflex. If you have no gag your consciousness is gone, it's that simple.
 
I don't see why it can't be enough to know that the brainstem function is knocked out by the loss of the gag reflex. If you have no gag your consciousness is gone, it's that simple.
I thought one of the aims / conclusions of the AWARE study is to show that consciousness continues under such circumstances?
 
No, you misunderstood. It was a serious question. I think there needs to be careful use of words here in order to be clear about what is being discussed.
 
No, you misunderstood. It was a serious question. I think there needs to be careful use of words here in order to be clear about what is being discussed.
Well, we've only been over this 20 000 million times, Typoz. Where were you hiding ? How can patients report conscious experience, lucid cognition with memory formation, when their brain is not functioning ?
 
brainstem, area at the base of the brain that lies between the deep structures of the cerebral hemispheres and the cervical spinal cord. It is divided into three sections: midbrain (mesencephalon), pons (metencephalon), and medulla oblongata (myelencephalon). The brainstem houses many of the control centres for vital body functions, such as swallowing, breathing, and vasomotor control. All of the cranial nerve nuclei, except those associated with olfaction and vision, are located in the brainstem, providing motor and sensory function to structures of the cranium, including the facial muscles, tongue, pharynx, and larynx, as well as supplying the senses of taste, equilibrium, and hearing. The brainstem also has nuclei important for sympathetic and parasympathetic autonomic functions. All efferent and afferent pathways between the cerebrum and cerebellum course through the brainstem, and many of them decussate, or cross, within this structure. Because of the important neural structures concentrated in this small portion of the nervous system, even very small lesions of the brainstem may have profound effects. Disorders involving the brainstem include trauma, tumours, strokes, infections, and demyelination (multiple sclerosis). Complete loss of brainstem function is regarded by some experts as equivalent to brain death

Have you read that, Master Wu ? Did you read the word SWALLOWING ....is a function of the brainstem

Immediately after a person falls to the floor after cardiac arrest, the doctors can insert a tube down the patients throat AND THE PATIENT DOES NOT
GAG. His swallowing reflex is ABSENT and this is why we can say that the brain stem is not functioning at that time. It doesn't mean that function won't return but it does mean it is temporarily down. Are you going to call bullshit on me ? This is fact
Okey, no need to get mad. I just read what you put, I did a quick google search and it turns out you are right. The nucleus of the brain stem seems to have a lot of evidence to be key to developing consciousness, at least on a neurological model. So yes, I agree with you on this. No brain stem does seem to imply no consciousness.

However, that's not the end of the story, or at least, doesn't seem to be to another part of academics. It seems to be quite important to a bunch of people because many persons are declared death due to brain stem lack of function (which would mean again, irreversible lack of consciousness also). Please forgive the long link:

http://books.google.cl/books?id=GZ7mOs3Rpi0C&pg=PA139&lpg=PA139&dq=The demise of 'brain death' in Britain. In Beyond brain death – the case against brain based criteria for human death.&source=bl&ots=6U_Wt8zsKj&sig=CrGPDglAmr_8poOAzfLfG7mEV_8&hl=es-419&sa=X&ei=da9PVOzJAofjsATGqoD4DA&ved=0CDoQ6AEwAw#v=onepage&q=The demise of 'brain death' in Britain. In Beyond brain death – the case against brain based criteria for human death.&f=false

The author puts the following "there is still no convincing theory of consciousness (Pallis 1996), and it is, therefore, not suprising that there is no means of testing for its presence (in some form); still less is there any way of ascertaining the permanent loss of the capacity for its return (under some circumstances), in those who appear deeply comatose. The theory of consciousness upon which the UK version of "brain death" was based (and the curent notion that "brain stem death" is death depends) was proposed some 50 years ago as a result of experiments on cats. Its (scientifically unwarranted) application to comatose man requires acceptance of the hidden assumption that when certain brain stem functions are absent, the whole of the brain stem must be dead, i.e. that all possibly active or recoverable elements of the "arousal system"- the so-called "reticular activating system" (RAS)- within the (anatomically undefined) brain stem have been destroyed. This is because the RAS is not a discrete structure, and how much of it needs to remain active for there to be any possibility of consciousness is not known. As it cannot be directly tested, it is only by implication that it can be said to be permanently out of business (unable to arouse the brain to a state of consciousness for other parts to modulate) when the whole of the brain stem is destroyed. That is not the case in organ donors whose brain stems have been certified dead prior to surgery (Evans and Hill, 1989).
Even if the bedsite tests used had the power to assure us that the whole of the brain stem and all its contained RAS was really and truly dead, there is the difficulty that elements of the critical RAS exist elswhere in the brain (4). To believe that there is never again a possibility of the return of any form of consciousness , therefore, requires acceptance of the additional proposition that, although untested (and currently untestable), all such potential consciousness generators are permanently out of action (destroyed), because some more primitive brain functions are absent. No truly scientific mind would entertain these propositions."

¿
Can it be the case that in some patients with cardiac arrest, only certain portions of the brain stem are out, while others, required for consciousness, may still be functioning, explaining their consciousness during this situations?

I wish you can understand my doubts. I'm by no means an expert in neurology, and so far I think you've done an excelent job in supporting your position. I think we just need to go a bit more deep to see where all this lead us. I hope you understand.

Now, I've spent half an hour rooting around trying to find a paper that might be suitable to show you in a simple manner. They don't and can't do experiments on human brainstems just like that. Animals have been used instead which I don't particularly like but I will continue to search for that kind of experiment.
Thanks, I hope you find them.
 
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Okey, no need to get mad. I just read what you put, I did a quick google search and it turns out you are right. The nucleus of the brain stem seems to have a lot of evidence to be key to developing consciousness, at least on a neurological model. So yes, I agree with you on this. No brain stem does seem to imply no consciousness.

However, that's not the end of the story, or at least, doesn't seem to be to another part of academics. It seems to be quite important to a bunch of people because many persons are declared death due to brain stem lack of function (which would mean again, irreversible lack of consciousness also). Please forgive the long link:

http://books.google.cl/books?id=GZ7mOs3Rpi0C&pg=PA139&lpg=PA139&dq=The demise of 'brain death' in Britain. In Beyond brain death – the case against brain based criteria for human death.&source=bl&ots=6U_Wt8zsKj&sig=CrGPDglAmr_8poOAzfLfG7mEV_8&hl=es-419&sa=X&ei=da9PVOzJAofjsATGqoD4DA&ved=0CDoQ6AEwAw#v=onepage&q=The demise of 'brain death' in Britain. In Beyond brain death – the case against brain based criteria for human death.&f=false

The author puts the following "there is still no convincing theory of consciousness (Pallis 1996), and it is, therefore, not suprising that there is no means of testing for its presence (in some form); still less is there any way of ascertaining the permanent loss of the capacity for its return (under some circumstances), in those who appear deeply comatose. The theory of consciousness upon which the UK version of "brain death" was based (and the curent notion that "brain stem death" is death depends) was proposed some 50 years ago as a result of experiments on cats. Its (scientifically unwarranted) application to comatose man requires acceptance of the hidden assumption that when certain brain stem functions are absent, the whole of the brain stem must be dead, i.e. that all possibly active or recoverable elements of the "arousal system"- the so-called "reticular activating system" (RAS)- within the (anatomically undefined) brain stem have been destroyed. This is because the RAS is not a discrete structure, and how much of it needs to remain active for there to be any possibility of consciousness is not known. As it cannot be directly tested, it is only by implication that it can be said to be permanently out of business (unable to arouse the brain to a state of consciousness for other parts to modulate) when the whole of the brain stem is destroyed. That is not the case in organ donors whose brain stems have been certified dead prior to surgery (Evans and Hill, 1989).
Even if the bedsite tests used had the power to assure us that the whole of the brain stem and all its contained RAS was really and truly dead, there is the difficulty that elements of the critical RAS exist elswhere in the brain (4). To believe that there is never again a possibility of the return of any form of consciousness , therefore, requires acceptance of the additional proposition that, although untested (and currently untestable), all such potential consciousness generators are permanently out of action (destroyed), because some more primitive brain functions are absent. No truly scientific mind would entertain these propositions."

¿
Can it be the case that in some patients with cardiac arrest, only certain portions of the brain stem are out, while others, required for consciousness, may still be functioning, explaining their consciousness during this situations?

I wish you can understand my doubts. I'm by no means an expert in neurology, and so far I think you've done an excelent job in supporting your position. I think we just need to go a bit more deep to see where all this lead us. I hope you understand.



Thanks, I hope you find them.
Master Wu said > I wish you can understand my doubts. I'm by no means an expert in neurology, and so far I think you've done an excelent job in supporting your position. I think we just need to go a bit more deep to see where all this lead us. I hope you understand.

Thanks and I do understand. BTW I am not a neurologist, all my opinions are based on what I have been able to learn from reading the literature for many years. I have a good education but I'm not a doctor and have never pretended to be. All the information I hold is in the public domain, anyone can delve into it.


Master Wu said > ¿Can it be the case that in some patients with cardiac arrest, only certain portions of the brain stem are out, while others, required for consciousness, may still be functioning, explaining their consciousness during this situations?

No, this is why I posted the talk from Peter Fenwick. This guy is an expert on these matters.

Consultant Neuropsychiatrist and Neurophysiologist
BA, MB,BChir, DPM, FRCPsych

Bachelor of Arts
Bachelor of Medicine, Bachelor of Surgery
Diploma in Psychological Medicine
Fellow of the Royal College of Psychiatrists


 
I thought one of the aims / conclusions of the AWARE study is to show that consciousness continues under such circumstances?
From what I've read, this studies objective was to find evidence of disembodied consciousness. And as I stated previously, if that's not the objective, then I don't know why this study had such an anticipatory following.
 
Thanks and I do understand. BTW I am not a neurologist, all my opinions are based on what I have been able to learn from reading the literature for many years. I have a good education but I'm not a doctor and have never pretended to be. All the information I hold is in the public domain, anyone can delve into it.
Haha, I see. I thought you were a neurologist or a doctor of some kind, but I guess it's because you are well informed in this subjects.

No, this is why I posted the talk from Peter Fenwick. This guy is an expert on these matters.

Consultant Neuropsychiatrist and Neurophysiologist
BA, MB,BChir, DPM, FRCPsych

Bachelor of Arts
Bachelor of Medicine, Bachelor of Surgery
Diploma in Psychological Medicine
Fellow of the Royal College of Psychiatrists
Okey, lets go by parts. Fenwick is an expert indeed. But the book I quoted seems to have been written also by a bunch of experts from different areas (anesthiologists, neurologists, philosophers, physchologists). The book seems to imply that bedtests of the brain stem don't imply it's fully non-functional because it's possible to get the same results with only a partially non-functional brain stem. The RAS seems to be the key here. ¿How does Fenwick or anyone refutes the claims in the book? I see two ways: either prove that bedtests by themselves show full brain-stem lack of function, or prove that brain-stem lack of function occurs in cardiac arrest by other means.
 
Who cares if the brain stem is fully functional at the time of NDE? I'm no neuroscientist, but the last I heard that part of the brain controls autonomic functions and shit. I think consciousness is supposed to reside somewhere in the neocortex/frontal area. When we're having an experience, corresponding associations are registered on EEGs, so obviously as far as neuroscience is concerned a flat EEG equals loss of consciousness and no experience. Is this in dispute?

Edit: Never mind. I don't care. This has already been covered anyway. Please don't reply to this, especially if it's regarding deep brain probes or something.
 
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No, you misunderstood. It was a serious question. I think there needs to be careful use of words here in order to be clear about what is being discussed.
Well, we've only been over this 20 000 million times, Typoz. Where were you hiding ? How can patients report conscious experience, lucid cognition with memory formation, when their brain is not functioning ?
Well what have you got to say for yourself, Typoz? Are you finished playing games now?
 
From what I've read, this studies objective was to find evidence of disembodied consciousness.
AWAreness during REsuscitation, not, disembodied consciousness...

AWARE II is being set up... Similar thing again, but it looks like they may finally have realized that fixed, hidden and secret visual targets are - at least initially - a step too far...

http://public.ukcrn.org.uk/Search/StudyDetail.aspx?StudyID=17129

"We propose a two year multicenter observational study of 900-1500 patients experiencing cardiac arrests. Cardiac arrest is defined as the cessation of heartbeat and respiration [the heart stops pumping blood causing sudden collapse and absence of breathing]. These patients need cardiopulmonary resuscitation [CPR] which is delivered as chest compressions from a rescuer or mechanical device with artificial breathing. These measures can avert death and allow potential for survival. A number of recent studies have indicated that 10% of cardiac arrest survivors report memories and thought processes from their period of resuscitation. A small proportion of survivors have also described the ability to “see” and “hear” details of their cardiac arrest. The significance and mechanisms that lead to these experiences are not fully understood – we do not know if they matter or why they happen. It is possible that patients who are able to recount these experiences may have better patient outcomes in terms of reduced brain damage, improved functional ability and better psychological adjustment to the event. We think that these patients may have had better blood flow to the brain during cardiac arrest, leading to consciousness and activity of the mind. Our target population is patients experiencing cardiac arrest in hospital [in the emergency department or hospital wards] or out of hospital [in whom resuscitation efforts are ongoing at ED arrival]. Emergency Department or Research staff will be alerted to cardiac arrest and will attend with portable brain oxygen monitoring devices and a tablet which will display visual images upwards above the patient as resuscitation is taking place. Measurements obtained during cardiac arrest will be used to compare data from all cardiac arrest patients independent of outcome [whether they live or die]. Survivors will then be followed up and with their consent will have in-depth, audio recorded interviews."
 
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