Recovery of Consciousness after Brain Injury: An Integrative Research Paradigm for the Cognitive Neuroscience of Consciousness

Abstract

This chapter reviews the evolving understanding of recovery of consciousness following severe brain injuries. Important questions guiding current research are considered including the need to develop new diagnostic tools based on neuroimaging methods that can guide longitudinal assessments of brain function. Novel assessments of cognitive function in the absence of behavior and slowly evolving plastic changes in brain structure that may arise after injury are reviewed. Emphasis is placed on the importance of developing more precise and testable models at the “circuit level” that are predictive of patterns of recovery and response to treatments. It is argued that recovery of consciousness in the human brain is likely to depend on interactions between dynamic circuit-level mechanisms that support reestablishment of goal-directed behaviors and cellular repair mechanisms. Further suggestions for the development of a cognitive neuroscience of the recovery of consciousness based on quantitative assessment of evolving changes in behavior and brain function are outlined.