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Neuroscientists typically assume that human mental functions are generated by the brain and that its structural elements, including the different cell layers and tissues that form the neocortex, play specific roles in this complex process. Different functional units are thought to complement one another to create an integrated self-awareness or episodic memory. Still, findings that pertain to brain dysplasia and brain lesions indicate that in some individuals there is a considerable discrepancy between the cerebral structures and cognitive functioning. This seems to question the seemingly well-defined role of these brain structures. This article provides a review of such remarkable cases. It contains overviews of noteworthy aspects of hydrocephalus, hemihydranencephaly, hemispherectomy, and certain abilities of “savants.” We add considerations on memory processing, comment on the assumed role of neural plasticity in these contexts, and highlight the importance of taking such anomalies into account when formulating encompassing models of brain functioning.
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Biologie und Naturphilosophie werden gegenwärtig von frischen Denkströmungen belebt, z. B. in der Formulierung der neodarwinistischen Evolutionstheorie, neuer Konzepte und Inter-pretationen der Quantenphysik oder panpsychistischer Ansätze. Es lohnt sich daher, das Werk des bedeutenden Biologen und Philosophen Hans Driesch (1867-1941) aus heutiger Sicht neu zu betrachten. Driesch setzte vor rund 100 Jahren mit seinem ganzheitlichen Lebensverständ-nis entscheidende Impulse, die heute wieder aktuell sind. Seine Pionierleistungen würdigend werden hier verschiedene Aspekte seines Lebens, seiner empirischen Forschungen und philo-sophischen Leitideen beleuchtet. Die Autoren Krall und Nahm sind Biologen, Waldrich ver-fügt über eine breite geisteswissenschaftliche Ausbildung. Zahlreiche Publikationen der Auto-ren zu naturphilosophischen Themen.
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The unexpected return of mental clarity and memory shortly before death in patients suffering from severe psychiatric and neurologic disorders, which we have called "terminal lucidity", has been reported in the medical literature over the past 250 years, but has received little attention. We review a range of terminal lucidity cases in order to encourage investigation of the mechanisms involved and possible insights into both the neuroscience of memory and cognition at the end of life and treatment of terminal illness. These examples include case reports of patients suffering from brain abscesses, tumors, strokes, meningitis, dementia or Alzheimer's disease, schizophrenia, and affective disorders. Several of these accounts suggest that during terminal lucidity, memory and cognitive abilities may function by neurologic processes different from those of the normal brain. We expect that significant contributions to better understanding the processes involved in memory and cognition processing might be gained through in-depth studies of terminal lucidity. Studying terminal lucidity might also facilitate the development of novel therapies. In addition, increased awareness of unusual end-of-life experiences could help physicians, caregivers, and bereaved family members be prepared for encountering such experiences, and help those individuals cope with them.
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In an earlier study, Rupert Sheldrake, Pam Smart, and Michael Nahm reviewed accounts of end-of-life experiences (ELEs) involving non-human animals. They showed animal ELEs to be similar to human ELEs, suggesting common underlying processes. Here, we consider apparent after-death communications (ADCs) from non-human animals and compare them to accounts of ADCs from humans. We collected 442 accounts of animal ADCs from our own appeals and from reports in the literature. We found a close resemblance between ADCs from animals and from humans in the types of experience—dream visitations, a sense of presence, visual, auditory, tactile, and olfactory apparitions, and psychokinetic effects. As with human ADCs, the great majority of animal ADCs were reported to have occurred in the first hours or days after death, with a dramatic falling off over time. Moreover, our data show that people grieve their pets in much the same fashion as they grieve their human loved ones, suggesting that human bereavement studies would do well to take into account the animal data to which we draw attention. Doing so may help clarify issues regarding the fundamental nature of the experiences—determining whether they are best regarded as internal hallucinations, as living-agent-psi-mediated subjective or objective phenomena, or as actual contacts with the deceased—which in turn carries implications not only for academic studies of bereavement but for clinical practice with the bereaved.
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The sporadic occurrence of unusually enhanced mental clarity before death has been documented over time and cultures, and reported in patients with and without neurodegenerative diseases, psychiatric disorders, and other neurocognitive deficits, as well as those with nonterminal and terminal conditions. Using a purposive sampling method via existing professional networks, clinical presentations of terminal lucidity in pediatric populations, as witnessed by pediatric oncologists and medical personnel, were solicited. We document clinical presentations suggestive of terminal lucidity in children, which were compiled by their attending physician at two large tertiary pediatric hospitals. Unanticipated and unexplained changes in mental clarity, verbal communication, and/or physical capability in the days and hours before the death of the pediatric patients were observed. Each patient's medical condition should not have allowed for such changes. The phenomenon known as terminal lucidity provides a conceptual framework for these deviations, although more systematic documentation and clinical research is required before definitive conclusions can be drawn.
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Unexpected cognitive lucidity and communication in patients with severe dementias, especially around the time of death, have been observed and reported anecdotally. Here, we review what is known about this phenomenon, related phenomena that provide insight into potential mechanisms, ethical implications, and methodologic considerations for systematic investigation. We conclude that paradoxical lucidity, if systematically confirmed, challenges current assumptions and highlights the possibility of network-level return of cognitive function in cases of severe dementias, which can provide insight into both underlying neurobiology and future therapeutic possibilities.
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Team
- Nahm (75)
Eintragsart
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Thema
- Adolescent (1)
- Adult (2)
- Aged (1)
- Aged, 80 and over (1)
- Alzheimer Disease (1)
- Alzheimer's disease (1)
- Anthroposophy (1)
- Brain Diseases (1)
- Child (1)
- Child, Preschool (1)
- Cognition (3)
- Communication (1)
- Consciousness (1)
- Dementia (1)
- Documentation (1)
- End-of-life care (1)
- Female (2)
- Hospitals (1)
- Humans (4)
- Lucidity (1)
- Male (2)
- Mental Disorders (1)
- Middle Aged (2)
- Mood Disorders (1)
- Neoplasms (1)
- Nurses (1)
- Perception (1)
- Physicians (1)
- Recovery (1)
- Retrospective Studies (1)
- Schizophrenic Psychology (1)
- Surveys and Questionnaires (1)
- Switzerland (1)
- Terminal Care (1)
- Terminally Ill (1)
- Young Adult (1)