Conscious State Research Articles

Birthing consciousness and the flow experience during physiological childbirth

ProblemIt has been demonstrated that birth without medical intervention conveys significant physical and psychological benefits to the mother and her newborn baby. However, there is a need to include women's subjective experience of physiological birth to understand and promote it. BackgroundThe theoretical concept of “birthing consciousness” hypothesizes that women during natural childbirth sometimes experience a specific altered state of consciousness, which is a positive peak experience that resembles “flow” in many aspects. AimTo investigate the underexplored connection between the physiological mode of childbirth and altered states of consciousness during childbirth. MethodsIsraeli women with childbirth experience were recruited through social media (Facebook groups with a focus on childbirth and motherhood). Participants (n = 766) completed an online survey: the Flow State Scale (FSS) and a demographic questionnaire. FindingsDifferences were found between modes of birth as to flow state, as women who experienced physiological childbirth (i.e., with no epidural anesthesia or instrumental interventions) had a higher flow state during birth. DiscussionThis link empirically confirms the phenomenon of birthing consciousness. All nine dimensions of the mental state of flow apply to childbirth: challenge-skill balance, action-awareness merging, clear goals, unambiguous feedback, concentration on the task, sense of control, loss of self-consciousness, transformation of time, and autotelic experience. ConclusionUnderstanding a women's subjective experience during physiological birth can enhance clinical understanding of physiological birth thus promoting positive physiological birth experiences – which has crucial health benefits. We propose that more studies need to be done to promote experiencing flow during physiological birth.

States of consciousness and interoceptive hypersensibility: A study in patients with insomnia disorder.

This exploratory study aimed to investigate the relationship between interoceptive sensibility and quality of consciousness in individuals with insomnia disorder, in order to understand how the modulation of internal states may contribute to modifying the experience of consciousness during sleep difficulties. A total of 37 patients with insomnia disorder (mean age = 46.05 ± 18.16) and 41 healthy good sleepers (mean age = 50.2 ± 12.99) underwent a psychometric sleep and interoceptive sensibility assessment, using Insomnia Severity Index (ISI), Pittsburgh Sleep Quality Index (PSQI), and Multidimensional Assessment of Interoceptive Awareness (MAIA). Moreover, patients with insomnia disorder also completed a quality of consciousness evaluation, using the Phenomenology of Consciousness Inventory (PCI). Patients with insomnia disorder exhibited heightened interoceptive sensibility, particularly in noticing body sensations (p < 0.0001) and emotional awareness (p = 0.032), along with diminished abilities in attention regulation (p = 0.040), not-worrying (p = 0.001), and trusting (p = 0.002). Furthermore, correlations between interoceptive sensibility and multiple aspects of the consciousness state during the insomnia night were identified. Specifically, higher emotional awareness was linked to a 2.49-fold increase in the likelihood of subjectively experiencing altered consciousness states during insomnia. The study sheds light on the relationship between interoceptive sensibility and the subjective state of consciousness during insomnia, emphasising the importance of exploring and considering interoception as part of the therapeutic process for insomnia disorder. Given the exploratory nature of the study and the increased risk of type-I error from numerous correlations, the results should be interpreted with caution. Further research is needed to validate and confirm their robustness.

Utilizing Involuntary Unfolding Phenomena as Catalyst for Adaptive Responsiveness and Reorganization

ABSTRACT This paper explores the complex area of so-called unfolding processes and unfolding phenomena in hypnotherapy, emphasizing on unfolding movements and unfolding images, identified as complex involuntary phenomena, which emerge spontaneously without suggestions for these phenomena. Unfolding phenomena are examined as foundational elements of the unfolding process. On the one hand, the study unveils the macro-structure of the unfolding process by categorizing it into involuntary unfolding sets, phases, and unfolding subunits, all of which are analogous among patients and across different organizational levels. On the other hand, detailing the micro-structure aids in elucidating the functionality and elements of the unfolding phenomena. These elements encompass unfolding schemas and instruments. They are emphasized for their role in intrapsychic ideodynamics and responsiveness, aiding recurrent induction aligned and being promoted via an intuitive state of consciousness. Unfolding phenomena elucidate resource elicitation, and adaptation, contributing to the phenotypic organization and reorganization. In this context, the mechanisms of responsiveness, characterized by an unfolding process during hypnotherapy with distinct phases, are examined to help therapists and researchers understand how hypnotherapy can induce phenotypic changes, thereby facilitating treatment, personal growth, and the emergence of a new form of consciousness.

Angels and Animals: Posthumanism and ‘cosmic consciousness’ in psychedelic ‘expanded’ cinema

Focusing on two ‘expanded’ films - Bruce Conner’s Looking for Mushrooms (1959-65) and Stan Brakhage’s Eye Myth (1967) - this paper stages an encounter between psychedelic ‘expanded’ cinema,&amp;nbsp;the writings of Alan Watts,&amp;nbsp;and the field of posthuman philosophy. Drawing special attention to the materiality of film and its relation to the experience of altered states of consciousness, this paper will critically connect the art and ideas of the Californian counter-culture in the 1960s to a wider network of transnational anti- and posthumanism. Beginning with Watts’ dualism between the ‘angel and animal’ elements of human subjectivity, this paper then considers the inherent tension between the transcendentalism of the psychedelic ‘cosmic consciousness’ and materialist posthumanism centred on ‘embodied and embedded’ experience. Whilst these areas are not usually considered alongside one another, exploring their potential resonances can help to situate Watts’ philosophy within awider genealogy of posthumanist thought, and shed light on the ways in which ‘expanded’ cinema engaged with complicated questions concerning altered experiences. Finally, by highlighting the tensions between materiality and transcendental experience at play in Conner and Brakhage’s films, this paper will demonstrate how film stages a complex intervention into debates around human and posthuman subjectivity. In doing so, this paper offers a radical and alternative perspective on both psychedelic ‘expanded’ cinema, and the intellectual history of transnational anti-humanist philosophy.&amp;nbsp;

Conceptualizing Mindfulness Using Construal Level Theory: A Two-Dimensional Model

Construal Level Theory (CLT) is a well-established, comprehensive framework that provides an account of the relationship between construal level and psychological distance, and the effects they have on cognitive processing and a wide range of phenomena. In this article we present a conceptualization of mindfulness based on the theoretical foundations of CLT. In light of mindfulness definitions and current research, it is difficult to determine whether mindfulness entails low psychological distance and concrete, non-conceptual representations of experience, or high psychological distance and abstract representations. We argue that mindfulness uniquely combines both. The two-dimensional model we present posits that mindfulness is characterized by a simultaneous decreased psychological distance from external sensory experiences and increased psychological distance from internal mental experiences. We highlight the uniqueness of this quality of mindfulness, and demonstrate how the formulation presented here not only aligns well with but also integrates research on mindfulness as a state of consciousness as well as a personality disposition. We further argue that this combination underlies the beneficial effects of mindfulness and delineate how it enables individuals to leverage the advantages and mitigate the drawbacks associated with both high and low levels of construal and psychological distance. The proposed two-dimensional model resolves contradictions in the literature, aiming to deepen our understanding of mindfulness, its benefits, and core mechanisms.

Cognitive Motor Dissociation in Disorders of Consciousness

BackgroundPatients with brain injury who are unresponsive to commands may perform cognitive tasks that are detected on functional magnetic resonance imaging (fMRI) and electroencephalography (EEG). This phenomenon, known as cognitive motor dissociation, has not been systematically studied in a large cohort of persons with disorders of consciousness.MethodsIn this prospective cohort study conducted at six international centers, we collected clinical, behavioral, and task-based fMRI and EEG data from a convenience sample of 353 adults with disorders of consciousness. We assessed the response to commands on task-based fMRI or EEG in participants without an observable response to verbal commands (i.e., those with a behavioral diagnosis of coma, vegetative state, or minimally conscious state–minus) and in participants with an observable response to verbal commands. The presence or absence of an observable response to commands was assessed with the use of the Coma Recovery Scale–Revised (CRS-R).ResultsData from fMRI only or EEG only were available for 65% of the participants, and data from both fMRI and EEG were available for 35%. The median age of the participants was 37.9 years, the median time between brain injury and assessment with the CRS-R was 7.9 months (25% of the participants were assessed with the CRS-R within 28 days after injury), and brain trauma was an etiologic factor in 50%. We detected cognitive motor dissociation in 60 of the 241 participants (25%) without an observable response to commands, of whom 11 had been assessed with the use of fMRI only, 13 with the use of EEG only, and 36 with the use of both techniques. Cognitive motor dissociation was associated with younger age, longer time since injury, and brain trauma as an etiologic factor. In contrast, responses on task-based fMRI or EEG occurred in 43 of 112 participants (38%) with an observable response to verbal commands.ConclusionsApproximately one in four participants without an observable response to commands performed a cognitive task on fMRI or EEG as compared with one in three participants with an observable response to commands. (Funded by the James S. McDonnell Foundation and others.)

Examining the Frequency of Hypomagnesemia in Multiple Trauma Patients Hospitalized in the Intensive Care Unit

Background: Electrolyte imbalance is one of the influential causes in determining the outcome of traumatic patients. One of the electrolytes that get less attention from healthcare providers is magnesium. Therefore, this study investigated the frequency of hypomagnesemia in trauma patients hospitalized in the intensive care unit. Methods: The descriptive-cross-sectional study was conducted after approval at Zahedan University of Medical Sciences on 118 patients with multiple traumas from 2021 to 2022. Patients were selected by convenience sampling method according to the inclusion criteria. Age, sex, weight, body mass index, level of consciousness, and level of blood serum electrolytes were measured and recorded on the first and fifth days after hospitalization. The data were analyzed and compared using descriptive statistics, chi-square, and independent t-test. Results: Of 118 patients studied, 81 (68.6%) were male, and 38 (31.4%) were female. On the fifth day after hospitalization, the mean serum magnesium level of the patients was 1.4 ± 0.81 mg/dL. 87 patients (73.7%) had normal magnesium serum levels, 27 patients (29.9%) had hypomagnesemia, and 4 patients (3.4%) had severe hypomagnesemia. No statistically significant relationship existed between hypomagnesemia and gender, age group, and comorbidity diseases. The level of other blood serum electrolytes on the fifth day after hospitalization, age, weight, body mass index, and status of consciousness was not statistically significant between the two groups of patients with hypomagnesemia and without hypomagnesemia. Conclusion: Trauma and the subsequent treatment measures lead to decreased magnesium serum levels in intensive care patients. Therefore, the normal serum level of other electrolytes should not be considered a diagnostic indicator for the normality of magnesium serum level. Magnesium should be measured along with other electrolytes to make a timely decision to replace magnesium supplements in a patient with hypomagnesemia.

Chaotic nature of the electroencephalogram during shallow and deep anesthesia: From analysis of the Lyapunov exponent

In conscious states, the electrodynamics of the cortex are reported to work near a critical point or phase transition of chaotic dynamics, known as the edge-of-chaos, representing a boundary between stability and chaos. Transitions away from this boundary disrupt cortical information processing and induce a loss of consciousness. The entropy of the electroencephalogram (EEG) is known to decrease as the level of anesthesia deepens. However, whether the chaotic dynamics of electroencephalographic activity shift from this boundary to the side of stability or the side of chaotic enhancement during anesthesia-induced loss of consciousness remains poorly understood. We investigated the chaotic properties of EEGs at two different depths of clinical anesthesia using the maximum Lyapunov exponent, which is mathematically regarded as a formal measure of chaotic nature, using the Rosenstein algorithm. In 14 adult patients, 12 s of electroencephalographic signals were selected during two depths of clinical anesthesia (sevoflurane concentration 2% as relatively deep anesthesia, sevoflurane concentration 0.6% as relatively shallow anesthesia). Lyapunov exponents, correlation dimensions and approximate entropy were calculated from these electroencephalographic signals. As a result, maximum Lyapunov exponent was generally positive during sevoflurane anesthesia, and both maximum Lyapunov exponents and correlation dimensions were significantly greater during deep anesthesia than during shallow anesthesia despite reductions in approximate entropy. The chaotic nature of the EEG might be increased at clinically deeper inhalational anesthesia, despite the decrease in randomness as reflected in the decreased entropy, suggesting a shift to the side of chaotic enhancement under anesthesia.

Altered states of consciousness in Danish healthy volunteers and recreational users of psilocybin and the possible impact of setting and intention: Danish validation of the five-dimensional altered states of consciousness questionnaire.

Psychedelic substances reliably induce marked altered states of consciousness (ASC), which may be important for lasting effects and clinical outcomes of psychedelic intervention. Several instruments are available to measure the acute psychedelic experience, of which the Five Dimensional Altered States of Consciousness Questionnaire (5D-ASC) is commonly used. The questionnaire can be scored and analyzed as having five dimensions or 11 subscales, but the two have not been evaluated with comparable factor analysis methods. The Danish translation of the 5D-ASC was completed by one sample of healthy volunteers receiving psilocybin in a laboratory setting (N = 47) and one sample of recreative users5D-ASC of psychedelics (N = 550), who reported retrospectively through an online survey based on their most recent experience with psilocybin. We calculated internal consistency measures of Cronbach's alpha and McDonald's omega, conducted a confirmatory factor analysis of the previously suggested factor structures, and tested for possible associations between the 5D-ASC total scores and dose, setting, and intention. For the 11 subscales, we reported omega-sem (composite reliability) using the parameters of the fitted confirmatory factor analyses model. Confirmatory factor analysis showed that the 11 subscales had a good fit to data and showed a better fit compared to the originally proposed five-dimensional solution and good internal consistencies. We further found that the 5D-ASC total scores correlated positively with the dose in the recreative sample. We found no correlations between 5D-ASC total scores and intention or setting. We find the Danish 5D-ASC to be a valid tool for measuring ASC among Danish-speaking individuals.

Psychological Characteristics of Internet Addiction in Students in Problem Life Situations (COVID, War)

The relevance of this research lies in the fact that the number of Internet addicts in the world is constantly growing (the premise of which we consider the possibilities of Internet content that open up to a person in the virtual space), and the situation can turn into a public health problem. The purpose of the article is to carry out a theoretical analysis of the phenomenon of Internet addiction and, based on it, conduct an empirical study of Internet addiction of students, its connection with their personal traits and their satisfaction with life in difficult life situations: during the COVID-19 pandemic (n=88) and war (n=87). The research used the following methods: Internet Addiction Test (K. Young), CIAS, Chen-Internet-Addiction-Scale (S.-H. Cnen), Techniques for diagnosing predisposition to 13 types of addictions (G.V. Lozova), Test T. Leary, Questionnaire “Life Satisfaction Index” (B. Neugarten, R. Havighurst, Sh. Tobin), Oxford Happiness Inventory, OHI. Mathematical processing of research results was carried out using statistical package SPSS 17.0. The analysis of approaches to the understanding of Internet addiction by scientists leads to the conclusion that it is a behavioral deviation that manifests itself in a person’s excessive spending of time in the Internet space due to reluctance to return to real life; this is exactly information addiction. The main symptoms of Internet addiction: the tendency of an individual to choose being on the Internet before any other types of his activity; a change in his/her state of consciousness, a gradual increase in the time spent on the Internet, the lack of an objective assessment of the negative consequences of Internet addiction. As a result of the study, it was found that: Internet addiction can be combined with other types of addiction, Internet addicts are characterized by certain types of attitude towards others and a lack of feeling of satisfaction with life; Respondents who are less dependent on the Internet tend to positively evaluate themselves, be consistent in achieving their goals, fall into other addictions less often, and activate situationally necessary types of attitude towards others.

Dynamic medial parietal and hippocampal deactivations under DMT relate to sympathetic output and altered sense of time, space, and the self.

N,N-Dimethyltryptamine (DMT) is a serotonergic psychedelic, known to rapidly induce short-lasting alterations in conscious experience, characterized by a profound and immersive sense of physical transcendence alongside rich and vivid auditory distortions and visual imagery. Multimodal neuroimaging data paired with dynamic analysis techniques offer a valuable approach for identifying unique signatures of brain activity - and linked autonomic physiology - naturally unfolding during the altered state of consciousness induced by DMT. We leveraged simultaneous fMRI and EKG data acquired in 14 healthy volunteers prior to, during, and after intravenous administration of DMT, and, separately, placebo. fMRI data was preprocessed to derive individual dynamic activity matrices, reflecting the similarity of brain activity in time, and community detection algorithms were applied on these matrices to identify brain activity substates; EKG data was used to derive continuous heart rate. We identified a brain substate occurring immediately after DMT injection, characterized by hippocampal and medial parietal deactivations and increased superior temporal lobe activity under DMT. Deactivations in the hippocampus and medial parietal cortex correlated with alterations in the usual sense of time, space and self-referential processes, reflecting a deconstruction of essential features of ordinary consciousness. Superior lobe activations instead correlated with audio/visual hallucinations and experience of "entities", reflecting the emergence of altered sensory experiences under DMT. Finally, increased heart rate under DMT correlated positively with hippocampus/medial parietal deactivation and the experience of "entities", and negatively with altered self-referential processes. These results suggest a chain of influence linking sympathetic regulation to hippocampal and medial parietal deactivations under DMT, which combined, may contribute to positive mental health outcomes related to self-referential processing following psychedelic administration.

Pratimarsh Nasya: The Philosophical Nexus Connecting Pran Vayu and Consciousness in Ayurvedic Healing

In the rich tapestry of Ayurvedic medicine, Pratimarsh Nasya emerges as a profound practice that harmonizes the breath (Pran Vayu) with the mind's consciousness. This ancient therapy not only revitalizes the senses but also bridges the gap between physical and spiritual well-being. Ayurveda, the science of life, intertwines the physical and metaphysical through various practices. Among these, Pratimarsh Nasya stands out for its unique ability to connect the vital life force, Pran Vayu, with the deeper realms of consciousness, offering a holistic approach to healing. This gentle yet potent ritual not only revitalizes the senses but also holds the promise of enhancing the quality of sleep, aligning the body's rhythms with a harmonious balance. By channeling the subtle energies of Pran Vayu and fostering a serene state of consciousness, Pratimarsh Nasya offers a holistic approach to healing that extends its benefits to improving sleep quality and overall well-being. It offers a pathway to enhance mental clarity and spiritual balance by aligning the breath with the mind's essence. Pratimarsh Nasya, a revered practice in Ayurveda, serves as a bridge between the vital force of Pran Vayu and the profound depths of consciousness. By exploring its philosophical and therapeutic dimensions, we gain insights into its transformative impact on holistic health. In the pursuit of optimal health and wellness, Pratimarsh Nasya stands out as a beacon of Ayurvedic wisdom. This practice harmonizes the dynamic energies of Pran Vayu with the contemplative aspects of consciousness, paving the way for improved sleep and profound healing. Delving into its effects reveals how this ancient tradition can be a key player in modern holistic health strategies.

COVID-19 related acute necrotizing encephalopathy and acute myocarditis in an adult female: a novel case report of brain injury and myocarditis

BackgroundAcute necrotizing encephalopathy (ANE) and myocarditis are both acute, life-threatening conditions that can be triggered by COVID-19. We report a case of sequential ANE and myocarditis following a COVID-19 infection.Case presentationA 27-year-old female patient was brought to the emergency department due to episodes of fever for two days and a 9-h altered state of consciousness. Her condition rapidly developed into stuporous and hemodynamic instability within serval hours. Veno-arterial extracorporeal membrane oxygenation (ECMO) was rapidly initiated with other supportive treatments. The following-up MRI showed bilateral, symmetrically distributed lesions in the brainstem, bilateral hippocampal regions, and bilateral basal ganglia, consistent with ANE. The diagnosis was confirmed through the detection of SARS-CoV-2 and the exclusion of other potential causes. After weeks of medical treatment, her condition stabilized, and she was transferred for further rehabilitation treatment.ConclusionsThis case study indicates that COVID-19 may simultaneously and rapidly affect the central nervous system and cardiovascular system, leading to poor outcomes. Accurate diagnosis and timely invasive bridging therapy, when necessary, can be lifesaving. Further exploration of potential mechanisms underlying COVID-19 central nervous system (CNS) and cardiovascular system manifestations will be important.

Altered Mental Status at the Extreme: Behavioral Evaluation of Disorders of Consciousness.

Disorders of consciousness represent altered mental status at its most severe, comprising a continuum between coma, the vegetative state/unresponsive wakefulness syndrome, the minimally conscious state, and emergence from the minimally conscious state. Patients often transition between these levels throughout their recovery, and determining a patient's current level can be challenging, particularly in the acute care setting. Although healthcare providers have classically relied on a bedside neurological exam or the Glasgow Coma Scale to aid with assessment of consciousness, studies have identified multiple limitations of doing so. Neurobehavioral assessment measures, such as the Coma Recovery Scale-Revised, have been developed to address these shortcomings. Each behavioral metric has strengths as well as weaknesses when applied in the acute care setting. In this review, we appraise common assessment approaches, outline alternative measures for fine-tuning these assessments in the acute care setting, and highlight strategies for implementing these practices in an interdisciplinary manner.

Does Consciousness Have Dimensions?

Whether consciousness is unidimensional with states defined along a single scale or it consists of multiple fundamental dimensions has been debated. Clinical assessment of consciousness distinguishes the content of consciousness (awareness) and the level of consciousness (wakefulness or arousal), which conflates firstperson phenomenal properties with third-person observable properties. The state of consciousness is more appropriately defined in terms of subjective level and content which are interdependent. On this account, the state of consciousness is exclusively defined by the experienced mental content, i.e.awareness, whereas behaviour and cognition are overt expressions of the state. Wakefulness and arousal are predisposing factors for specific forms of conscious experience. Nevertheless, a unidimensional representation of consciousness fails to account for the variety of qualitatively different experiences in both normal and altered states of consciousness. To overcome this problem, cognitive and abstract multidimensional models of consciousness have been proposed, but such dimensions are interdependent and lack axiomatic support. A novel multidimensional characterization of consciousness based on the brain's macroscale functional geometry provides an alternative, empirically grounded model whose dimensions are defined by neurofunctional rather than behavioural attributes. The state of consciousness is then represented as a point in this functional multidimensional space.

Exploration of resting-state brain functional connectivity as preclinical markers for arousal prediction in prolonged disorders of consciousness: A pilot study based on functional near-infrared spectroscopy.

There is no diagnostic assessment procedure with moderate or strong evidence of use, and evidence for current means of treating prolonged disorders of consciousness (pDOC) is sparse. This may be related to the fact that the mechanisms of pDOC have not been studied deeply enough and are not clear enough. Therefore, the aim of this study was to explore the mechanism of pDOC using functional near-infrared spectroscopy (fNIRS) to provide a basis for the treatment of pDOC, as well as to explore preclinical markers for determining the arousal of pDOC patients. Five minutes resting-state data were collected from 10 pDOC patients and 13healthy adults using fNIRS. Based on the concentrations of oxyhemoglobin (HbO) and deoxyhemoglobin (HbR) in the time series, the resting-state cortical brain functional connectivity strengths of the two groups were calculated, and the functional connectivity strengths of homologous and heterologous brain networks were compared at the sensorimotor network (SEN), dorsal attention network (DAN), ventral attention network (VAN), default mode network (DMN), frontoparietal network (FPN), and visual network (VIS) levels. Univariate binary logistic regression analyses were performed on brain networks with statistically significant differences to identify brain networks associated with arousal in pDOC patients. The receiver operating characteristic (ROC) curves were further analyzed to determine the cut-off value of the relevant brain networks to provide clinical biomarkers for the prediction of arousal in pDOC patients. The results showed that the functional connectivity strengths of oxyhemoglobin (HbO)-based SEN∼SEN, VIS∼VIS, DAN∼DAN, DMN∼DMN, SEN∼VIS, SEN∼FPN, SEN∼DAN, SEN∼DMN, VIS∼FPN, VIS∼DAN, VIS∼DMN, HbR-based SEN∼SEN, and SEN∼DAN were significantly reduced in the pDOC group and were factors that could reflect the participants' state of consciousness. The cut-off value of resting-state functional connectivity strength calculated by ROC curve analysis can be used as a potential preclinical marker for predicting the arousal state of subjects. Resting-state functional connectivity strength of cortical networks is significantly reduced in pDOC patients. The cut-off values of resting-state functional connectivity strength are potential preclinical markers for predicting arousal in pDOC patients.

Breathwork-induced psychedelic experiences modulate neural dynamics.

Breathwork is an understudied school of practices involving intentional respiratory modulation to induce an altered state of consciousness (ASC). We simultaneously investigate the phenomenological and neural dynamics of breathwork by combining Temporal Experience Tracing, a quantitative methodology that preserves the temporal dynamics of subjective experience, with low-density portable EEG devices. Fourteen novice participants completed a course of up to 28 breathwork sessions-of 20, 40, or 60min-in 28days, yielding a neurophenomenological dataset of 301 breathwork sessions. Using hypothesis-driven and data-driven approaches, we found that "psychedelic-like" subjective experiences were associated with increased neural Lempel-Ziv complexity during breathwork. Exploratory analyses showed that the aperiodic exponent of the power spectral density-but not oscillatory alpha power-yielded similar neurophenomenological associations. Non-linear neural features, like complexity and the aperiodic exponent, neurally map both a multidimensional data-driven composite of positive experiences, and hypothesis-driven aspects of psychedelic-like experience states such as high bliss.

Pattern Theory of Selflessness: How Meditation May Transform the Self-Pattern

For many centuries, scholars and philosophers from wisdom traditions in different cultures have reported and discussed non-self states of consciousness. These states can be both short-term (state, transitory) and long-term (trait, lasting) conditions. However, in psychology, the importance of a healthy self is usually emphasized, and some theorists have dismissed the idea of “selfless” modes of functioning. This disagreement hinders further empirical progress in the study of self and the way it might be affected by meditation. This paper addresses this issue by providing an interdisciplinary conceptual discussion, grounded in the pattern theory of self (PTS). According to PTS, what we call “self” is a complex pattern of dynamically related constituent processes, which include embodied, experiential (prereflective), affective, psychological/cognitive, reflective, narrative, intersubjective, ecological, and normative processes. We propose that Buddhist and secular meditative practices induce a reorganization of the self-pattern, allowing individuals to experience a “selfless” state, both temporarily and persistently. We then put forward a heuristic model, the pattern theory of selflessness (PTSL), possibly experienced through meditation practices. The proposed PTSL model consists of six transformations that contribute to self-pattern reorganization in a nonlinear and iterative manner: consolidating and integrating the self-pattern; cultivating concentration and present-moment awareness; cultivating mindful awareness; self-deconstruction (non-self) states; self-flexibility; and self-liberation as a trait. This conceptual analysis and integrative view contributes to the growing field of consciousness and contemplative research by advancing the contemporary understanding of non-self experience and its relation to Buddhist and secular meditation. The proposed model serves as a basis for interdisciplinary efforts to guide empirical research in this area.

Comparative analysis of the consistency of anesthesia depth between anesthesia index and Narcotrend index in monitoring pediatric tonsillectomy/adenoidectomy surgery

Objective: To analyze the consistency of the anesthesia index (AI) and Narcotrend index (NI) in monitoring the depth of anesthesia in pediatric tonsil/adenoidectomy. Methods: A total of 129 children who underwent elective tonsil/adenoidectomy at Xijing Hospital Affiliated to Air Force Medical University from July 2022 to October 2023 were prospectively enrolled. Both AI monitoring by ConView monitor and NI monitoring by Narcotrend monitor were conducted for children after they were admitted to the operating room, while Propofol-remifentanil combined with total intravenous anesthesia was used during the operation and the anesthetic dose was adjusted to maintain the NI value at 40-60. In addition, the AI and NI values were recorded at following time points: quiet eyes closing (T1), the beginning of induction (T2), loss of consciousness (T3), tracheal intubation (T4), the beginning of surgery (T5), during tonsil excision (T6), adenoidectomy (T7), the end of surgery (T8), consciousness recovery (T9) and tracheal extubation (T10). Bland-Altman consistency analysis was used to evaluate the consistency of the results of the two types of anesthesia depth monitoring, AI value and NI value. Receiver operator characteristic (ROC) curve and area under curve (AUC) were used to analyze the predictive efficacy of AI and NI values for the state of consciousness of children. The intraoperative awareness was followed up at 24 hours, 1 week and 1 month after surgery. Results: In 129 cases, there were 78 boys and 51 girls, with an average age of (7.2±3.2) years and an operation time of (72.8±14.0) min. No AI data were missing, but 13 NI data were missing, with a missing rate of 10.1% (13/129). At time points T1-T10, the AI values were 67.5±19.2 and the NI values were 67.2±19.2. Bland-Altman consistency analysis showed that the difference in value between AI and NI was 0.3 (95%CI:-0.1-0.6, P=0.120), with an out-of-consistency range of 4.0% (51/1 290). Before anesthesia induction, AI and NI values were maintained at a high level; with the beginning of anesthesia induction and the disappearance of the children's consciousness, both AI and NI values gradually decreased; after discontinuing the infusion of anesthetics, the values of AI and NI gradually increased, and the change trend of AI and NI in each stage of the perioperative period was consistent, and there was no significant difference between the two groups at each time point (all P>0.05). ROC curve analysis showed that the cut-off value for predicting the state of consciousness using AI was 72.5, with an AUC of 0.73 (95%CI: 0.70-0.75), and the cut-off value of NI was 79.5 and the AUC was 0.74 (95%CI: 0.72-0.77). There was no significant difference in AUC between the two indices (P=0.310). None of the children had intraoperative awareness. Conclusion: Both AI and NI can be used to monitor the depth of anesthesia in pediatric tonsil/adenoidectomy with high accuracy.

Natural course and predictors of consciousness recovery in children with prolonged disorder of consciousness

Prolonged disorder of consciousness (DoC) is a rising challenge. Pediatric data on diagnosis and prognosis of prolonged DoC were too limited and heterogeneous, making it difficult to define the natural course and evaluate the prognosis. The present study explored the emergence from the Minimally Conscious State (eMCS) incidence at different months postinjury drawing the natural course, and detected the predictors of the incidence in children with prolonged DoC. A hospital-based prospective cohort study was conducted. Kaplan–Meier curves, as well as univariate and multivariate COX regression analysis, were performed. The study enrolled 383 pediatric DoC individuals, including 220 males (57.4%), with an average age of 3.9 (1.9–7.3) years. The median duration between onset and rehabilitation is 30.0 (21.0–46.0) days. At enrollment, the ratio of vegetative state/unresponsive wakefulness syndrome (VS/WUS) to MCS is 78.9%–21.1%. Traumatic brain injury and infection are the major etiologies (36.8% and 37.1%, respectively), followed by hypoxia cerebral injury (12.3%). For children with prolonged DoC, the cumulative incidence of eMCS at months 3, 6, 12, and 24 was 0.510, 0.652, 0.731, 0.784 VS 0.290, 0.418, 0.539, 0.603 in the traumatic VS non-traumatic subgroup, respectively. For children in a persistent vegetative state (PVS), the cumulative incidence of emergence at months in 3, 6, 12, 24, 36 and 48 was testified as 0.439, 0.591, 0.683, 0.724, 0.743 and 0.743 in the traumatic subgroup, and 0.204, 0.349, 0.469, 0.534, 0.589 and 0.620 in the non-traumatic subgroup. Participants who exhibit any of the following four demographical and/or clinical characteristics—namely, older than 4 years at onset, accepted rehabilitation within 28 days of onset, remained MCS at enrollment, or with etiology of traumatic brain injuries—had a significantly positive outcome of consciousness recovery (eMCS). Moreover, both prolongation of the central somatosensory conductive time (CCT) (level 2) and absence of N20 (level 3) independently predict a negative outcome. In children with prolonged DoC, we found that 12 months postinjury was critical to eMCS, and a preferred timepoint to define chronic vegetative state (VS). The characteristics including age, etiology, time before rehabilitation, consciousness state, and SEP results were useful predictors of conscious recovery.Trial registration Registered 06/11/2018, the registration number is chiCTR1800019330 (chictr.org.cn). Registered prospectively.