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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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Latent inhibition (LI) is an important model for understanding cognitive deficits in schizophrenia. Disruption of LI is thought to result from an inability to ignore irrelevant stimuli. The study investigated LI in schizophrenic patients by using Pavlovian conditioning of electrodermal responses in a complete within-subject design. Thirty-two schizophrenic patients (16 acute, unmedicated and 16 medicated patients) and 16 healthy control subjects (matched with respect to age and gender) participated in the study. The experiment consisted of two stages: preexposure and conditioning. During preexposure two visual stimuli were presented. one of which served as the to-be-conditioned stimulus (CSp + ) and the other one was the not-to-be-conditioned stimulus (CSp - ) during the following conditioning ( = acquisition). During acquisition, two novel visual stimuli(CSn + and CSn - ) were introduced. A reaction time task was used as the unconditioned stimulus (US). LI was defined as the difference in response differentiation observed between preexposed and non-preexposed sets of CS + and CS - . During preexposure, the schizophrenic patients did not differ in electrodermal responding from the control subjects, neither concerning the extent of orienting nor the course of habituation. The exposure to novel stimuli at the beginning of the acquisition elicited reduced orienting responses in unmedicated patients compared to medicated patients and control subjects. LI was observed in medicated schizophrenic patients and healthy controls, but not in acute unmedicated patients. Furthermore LI was found to be correlated with the duration of illness: it was attenuated in patients who had suffered their first psychotic episode.
Erkunden
Eintragsart
Sprache
- Englisch (2)
Thema
- Schizophrenic Psychology
- Adolescent (2)
- Adult (2)
- Aged (1)
- Aged, 80 and over (1)
- Antipsychotic Agents (1)
- Arousal (1)
- Association Learning (1)
- Attention (1)
- Autonomic Nervous System (1)
- Brain Diseases (1)
- Child, Preschool (1)
- Cognition (1)
- Conditioning, Classical (1)
- Female (2)
- Galvanic Skin Response (1)
- Habituation, Psychophysiologic (1)
- Humans (2)
- Male (2)
- Middle Aged (2)
- Mood Disorders (1)
- Neural Inhibition (1)
- Psychiatric Status Rating Scales (1)
- Reaction Time (1)
- Reference Values (1)
- Schizophrenia (1)
- Terminally Ill (1)
- Young Adult (1)