Paradoxical lucidity: A potential paradigm shift for the neurobiology and treatment of severe dementias

George A. Mashour; Lori Frank; Alexander Batthyany; Ann Marie Kolanowski; Michael Nahm; Dena Schulman-Green; B. Greyson; Serguei Pakhomov; J. Karlawish; R. C. Shah

doi:10.1016/j.jalz.2019.04.002

Paradoxical lucidity: A potential paradigm shift for the neurobiology and treatment of severe dementias

George A. Mashour, Lori Frank, Alexander Batthyany, Ann Marie Kolanowski, Michael Nahm, Dena Schulman-Green, B. Greyson, Serguei Pakhomov, J. Karlawish, R. C. Shah

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Abstract

Unexpected cognitive lucidity and communication in patients with severe dementias, especially around the time of death, have been observed and reported anecdotally. Here, we review what is known about this phenomenon, related phenomena that provide insight into potential mechanisms, ethical implications, and methodologic considerations for systematic investigation. We conclude that paradoxical lucidity, if systematically confirmed, challenges current assumptions and highlights the possibility of network-level return of cognitive function in cases of severe dementias, which can provide insight into both underlying neurobiology and future therapeutic possibilities.

Original language	English (US)
Pages (from-to)	1107-1114
Number of pages	8
Journal	Alzheimer's and Dementia
Volume	15
Issue number	8
DOIs	https://doi.org/10.1016/j.jalz.2019.04.002
State	Published - Aug 2019

Keywords

Alzheimer's disease
Cognition
Consciousness
Dementia
End-of-life care
Lucidity
Recovery

ASJC Scopus subject areas

Epidemiology
Health Policy
Developmental Neuroscience
Clinical Neurology
Geriatrics and Gerontology
Cellular and Molecular Neuroscience
Psychiatry and Mental health

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10.1016/j.jalz.2019.04.002

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title = "Paradoxical lucidity: A potential paradigm shift for the neurobiology and treatment of severe dementias",

abstract = "Unexpected cognitive lucidity and communication in patients with severe dementias, especially around the time of death, have been observed and reported anecdotally. Here, we review what is known about this phenomenon, related phenomena that provide insight into potential mechanisms, ethical implications, and methodologic considerations for systematic investigation. We conclude that paradoxical lucidity, if systematically confirmed, challenges current assumptions and highlights the possibility of network-level return of cognitive function in cases of severe dementias, which can provide insight into both underlying neurobiology and future therapeutic possibilities.",

keywords = "Alzheimer's disease, Cognition, Consciousness, Dementia, End-of-life care, Lucidity, Recovery",

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year = "2019",

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doi = "10.1016/j.jalz.2019.04.002",

language = "English (US)",

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T2 - A potential paradigm shift for the neurobiology and treatment of severe dementias

AU - Mashour, George A.

AU - Frank, Lori

AU - Batthyany, Alexander

AU - Kolanowski, Ann Marie

AU - Nahm, Michael

AU - Schulman-Green, Dena

AU - Greyson, B.

AU - Pakhomov, Serguei

AU - Karlawish, J.

AU - Shah, R. C.

PY - 2019/8

Y1 - 2019/8

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AB - Unexpected cognitive lucidity and communication in patients with severe dementias, especially around the time of death, have been observed and reported anecdotally. Here, we review what is known about this phenomenon, related phenomena that provide insight into potential mechanisms, ethical implications, and methodologic considerations for systematic investigation. We conclude that paradoxical lucidity, if systematically confirmed, challenges current assumptions and highlights the possibility of network-level return of cognitive function in cases of severe dementias, which can provide insight into both underlying neurobiology and future therapeutic possibilities.

KW - Alzheimer's disease

KW - Cognition

KW - Consciousness

KW - Dementia

KW - End-of-life care

KW - Lucidity

KW - Recovery

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Paradoxical lucidity: A potential paradigm shift for the neurobiology and treatment of severe dementias

Abstract

Keywords

ASJC Scopus subject areas

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