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Assessment and Communication for People with Disorders of Consciousness

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Published on: August 1, 2017

Attentional and confusional States.

M-Marsel Mesulam

Continuum (Minneapolis, Minn.)

|July 20, 2012

Summary

Attention involves prioritizing cognitive and neural resources for relevant events. Disruptions to attention regulation, via brain lesions, can lead to acute confusional state syndrome.

Area of Science:

Neuroscience
Cognitive Psychology

Background:

Attention is the selective allocation of cognitive and neural resources.
Attention is regulated by both bottom-up (ascending reticular activating system) and top-down (association and limbic cortices) influences.

Purpose of the Study:

To explain the neurobiological underpinnings of attention.
To elucidate the mechanisms by which attentional disruptions lead to confusional states.

Main Methods:

Review of neurobiological and cognitive mechanisms of attention.
Analysis of lesion studies impacting attentional networks.

Main Results:

Attention is modulated by ascending reticular activating system and corticolimbic pathways.

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Focal or multifocal brain lesions disrupting these pathways can impair attention.

Conclusions:

Disruption of the attentional matrix, through various lesion types, results in acute confusional state syndrome.