Some neurophysiologic aspects of consciousness

An anatomico-physiologic approach to consciousness is facilitated by recognizing that the various meanings of consciousness have in common a crucial core C variously called subjectivity, awareness, consciousness-as-such, or consciousness per se. A sharp distinction is made between the property C and the contents of consciousness, partial loss of which is typical of cerebro-cortical lesions. The neuronal mechanism producing subjectivity also acts as an attention-action coordinator, hence must have specific connectivity requirements. These requirements are best met by the thalamic intralaminar nuclei (ILN). Whereas large lesions elsewhere leave C undisturbed, quite small bilateral lesions in ILN engender immediate unresponsiveness. This combination of anatomic and neurologic evidence is bolstered by a variety of physiologic evidence leading to the conclusion that further investigations of the ILN, and their interaction with lower centers as well as cerebral cortex, are most apt to yield a better understanding of consciousness.