101. Concerning the Material Substratum of the Disorders of Consciousness in the Light of Neurosurgical Experience. E. I. Kandel

Institute of Neurology, USSR Academy of Medical Sciences, Moscow

Summary

Neurosurgery should be regarded as a method of investigating the functional organization of the brain, and in particular, the problem of consciousness. Unique opportunities of such investigation arise in operations which frequently involve extirpation or destruction of many cerebral structures, cutting of different brain pathways, electrostimulation of cerebral structures and monitoring of their biopotentials.

Neurosurgical experience indicates that although there apparently is no strictly local "centre of consciousness", the oral areas of the brain stem are most closely related to the "realization" of consciousness. The тащ types of consciousness disorders may be conditionally divided into "quantitative" and "qualitative" ones. It is assumed that the former depends on the level of cerebral metabolism, and the latter on its special features.

Three main cerebral regulating systems which perform the function of consciousness may be distinguished: a) mesencephalic-diencephalic, b) limbic, and c) cortical. These three systems function in close interaction in the realization of consciousness, constituting the highest integrative function of the brain.