Cognition without behaviour: Cognitive functions in behaviourally non-responsive individuals


Patients, which are completely non-responsive albeit awake (i.e., not in coma), were first described by the famous German neurologist Ernst Kretschmer (1940) who designate this condition “apallic syndrome” meaning that there is no cortical activity altogether. In his description of the syndrome, Kretschmer used such terms as panapraxia (i.e., the complete lack of all functions of action control) and panagnosia (i.e. the complete lack of all cognitive functions). In the 1970ies, the not less famous Scottish neurosurgeon Bryan Jennett proposed a new name “vegetative state” (VS) for the patients of the kind as depicted by Kretschmer. While the term “apallic” (Greek “without cortex”) referred to anatomical and physiological entities, “vegetative” suggests that the patients lack a “subjective world” in form of feelings, thoughts, sensations, etc., while their vital functions such as respiration and circulation remains intact. The latter fact, again, strongly distinguishes this condition from coma.

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