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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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Addictive disorders are characterized by impulsive behavior that leads to difficulties in preventing certain behaviors despite negative consequences. This symptom predisposes to a vulnerability in developing addictive disorders and is also aggravated by the addiction process itself. As such, understanding the underlying mechanisms of impulsivity is a challenge for understanding the pathophysiology of addiction. One common link between impulsivity and addiction is that both involve actions and decisions that are realized faster than they should be in time. Impulsive traits increase the tendency to choose immediate gratification instead of delayed gratification even when preferred. This observation suggests a relationship between impulsivity and time processing. To better understand this relationship, we reviewed the literature that describes the relationship between time processing and impulsivity in addictive disorders in humans. Despite a lack of literature concerning this question in alcohol, cannabis and gambling disorders, we highlight that addictive behaviors are a good model for understanding the pathophysiology of impulsivity, and could help us to better understand the relationship between time perception and impulsivity.
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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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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.
Erkunden
Eintragsart
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Thema
- Cognition
- Addictive disorders (1)
- Adolescent (1)
- Adult (1)
- Aged (1)
- Aged, 80 and over (1)
- Alzheimer Disease (1)
- Alzheimer's disease (1)
- Behavior, Addictive/*physiopathology (1)
- Brain Diseases (1)
- Child (1)
- Child, Preschool (1)
- Communication (1)
- Consciousness (1)
- Delay Discounting/*physiology (1)
- Dementia (1)
- Documentation (1)
- End-of-life care (1)
- Female (1)
- Humans (4)
- Impulsive Behavior/*physiology (1)
- Impulsivity (1)
- Lucidity (1)
- Male (1)
- Mental Disorders (1)
- Middle Aged (1)
- Mood Disorders (1)
- Neoplasms (1)
- Recovery (1)
- Schizophrenic Psychology (1)
- Substance-Related Disorders/*physiopathology (1)
- Terminally Ill (1)
- Time Perception/*physiology (1)
- Time processing (1)
- Young Adult (1)