在2013年6月的《麻醉学》(Anesthesiology)杂志上,马舒尔建议:使用一台监测仪来专门监测大脑内部的通讯能力。这与脑电脉冲研究有点类似,但它们跟踪的是不同的信号。研究显示,在意识清醒的大脑中,感觉区(例如,大脑后部的视觉皮层)与信息加工相关的高级区域(比如位于耳后侧的颞叶)之间存在脑部活动环路。马舒尔等称其为“回返加工”:信号从感觉区进入加工区,然后再返回感觉区。在人失去意识后,这种“回返加工”也随之烟消云散。马舒尔的研究表明,在三种不同类别药物的麻醉下,人的大脑中都呈现了这种模式的存在和缺失。这并不是某一种药物的副作用。这项工作表明,如果麻醉监测器能够监测电信号如何在大脑之中传送,可能会比单纯测定大脑是否产生电波更为有效。
Should such a device be developed, it would be good news not only for those 0.13 percent of patients but also for fans of Enlightenment philosophy. Mashour told me that the synthetic model of consciousness dates back to Immanuel Kant — his "Critique of Pure Reason" might be vindicated by neuroscience. "Kant said there has to be some process that takes individual processing and connects it together into a unified experience," Mashour said. "Over the years, we've teased out the parts of the brain necessary for appreciating vision, color, motion. They're all mediated by different brain areas. But how does the brain put all that together into single perception?" For Kant, this was clear long before EEG monitors and anesthetics. "Without this synthesis," he wrote in 1781, "the manifold would not be united in one consciousness."
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