nature | Understanding the brain basis of consciousness remains one of the
outstanding challenges in modern science. While rigorous definitions are
still mainly lacking, consciousness can be defined rather broadly as
that which “vanishes every night when we fall into dreamless sleep” and
returns the next morning when we wake up1.
Equally, when we are conscious, our conscious experiences are populated
by a variety of perceptions, thoughts, and feelings that collectively
form an integrated conscious scene. These observations lead to an
intuitive distinction between conscious level (how conscious one is) and
conscious content (what one is conscious of, when one is conscious).
The large majority of recent neuroscientific research into consciousness
has treated these dimensions separately2,3,4,5.
Investigations of conscious level typically contrast global changes in
brain activity among different states including wakeful awareness,
various sleep stages, and different forms of anaesthesia. Many of these
studies attempt to isolate neural changes that accompany alterations of
conscious level independently of changes in general physiological
arousal. Studies of conscious content have focused primarily on
uncovering differences in brain activity between closely matched
conscious and unconscious perception, while conscious level is
maintained constant6.
Recently, following early suggestions that increased conscious level may be related to an increased range of conscious contents3,7, there has been growing interest in characterising how conscious level and conscious content may relate2,5.
One empirical approach to this question is to apply emerging measures
of conscious level to experimental manipulations that primarily affect
conscious content. Here, we capitalise on the profound effects on
conscious phenomenology elicited by psychedelic compounds, specifically
LSD, psilocybin, and subanesthetic doses of ketamine. These drugs
normally have profound and widespread effects on conscious experiences
of self and world. More specifically, they appear to “broaden” the scope
of conscious contents, vivifying imagination8 and positively modulating the flexibility of cognition9,10.
At the same time, the states they induce are not accompanied by a
global loss of consciousness or the marked changes in physiological
arousal as seen in sleep or anaesthesia. These observations raise the
question of whether theoretically-grounded measures of conscious level
would be changed in the psychedelic state.
Empirical measures of
conscious level have reached a new benchmark with the development of the
perturbational complexity index, PCI11.
The PCI quantifies the diversity across channels and observations of
the EEG response to a transcranial magnetic stimulation (TMS) pulse and
has been shown to robustly index levels of consciousness6, ranging from anaesthesia induced by various substances11,12, sleep stages11 and graded disorders of consciousness such as (emergence from) the minimally conscious state11,13. Notably, all these comparisons resulted in lower PCI values compared to a baseline state of wakeful awareness. Fist tap Big Don.
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