Symposium “Consciousness-meters” for assessing levels of consciousness: from research, to clinics and ethics: Intrinsic fMRI functional architecture differentiates single patients after severe brain injury

Summary of symposium
Behaviorally unresponsive patients provide a unique opportunity to investigate what makes
us awake and aware, or otherwise, conscious. Typically, clinicians tell whether a patient is
(minimally) conscious or not by asking them to perform simple motor tasks or by evaluating
non-reflex behaviors. Patients, though, can fluctuate in vigilance, may suffer from cognitive
and/or sensory impairments, from small or easily exhausted motor activity and pain. In that
case, they may not respond to given commands and their consciousness level can be
underestimated.
Alternatively, motor-independent technologies can aid the differentiation between patient
groups. To date, studies using electrophysiology and functional neuroimaging during resting
conditions elucidate the neural substrates essential to host residual consciousness. Such
methodologies have moved from group-level to the single-patient level detection of
preserved awareness and now suggest distinctive thresholds and patterns characteristic of
one’s level of consciousness.
The present symposium aims to: a) bring together state of the art research advances in
motor-independent assessment of consciousness levels, b) show how these methods can be
implemented in clinics to detect residual awareness, and c) to stress that the ethical
significance of detecting consciousness and restoring functional communication adds an
important normative component to methodological considerations of both false positive and
false negative findings.