Consciousness in congenitally decorticate children: developmental vegetative state as self-fulfilling prophecy
Abstract
According to traditional neurophysiological theory, consciousness requires neocortical functioning, and children born without cerebral hemispheres necessarily remain indefinitely in a developmental vegetative state. Four children between 5 and 17 years old are reported with congenital brain malformations involving total or near-total absence of cerebral cortex but who, nevertheless, possessed discriminative awareness: for example, distinguishing familiar from unfamiliar people and environments, social interaction, functional vision, orienting, musical preferences, appropriate affective responses, and associative learning. These abilities may reflect 'vertical' plasticity of brainstem and diencephalic structures. The relative rarity of manifest consciousness in congenitally decorticate children could be due largely to an inherent tendency of the label 'developmental vegetative state' to become a self-fulfilling prophecy.
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The same facts of consciousness and volitional behavior in the absence of cortex are observed in congenitally decorticate (hydranencephalic) human beings.
“The same facts are observed in congenitally decorticate (hydranencephalic) human beings.”
From The Hard Problem of Consciousness and the Free Energy Principle (2019) · cites this paper as Shewmon et al., 1999
Each of the four hydranencephalic children assessed by Shewmon and colleagues was conscious.
“the authors found that each of the four children they assessed was conscious.”
From The Hard Problem of Consciousness and the Free Energy Principle (2019) · cites this paper as Shewmon et al., 1999
Removing the cortex of young mammals does not appear to compromise the sensorimotor coherence, basic autonomic processes, or raw affective responses required for a brainstem-level sense of self.
“In corroboration, removing the cortex of young mammals does not appear to compromise the sensorimotor coherence, basic autonomic processes, or raw affective responses required for a brainstem-level sense of self ( Kolb and Tees, 1990 ; Panksepp et al., 1994 ; Shewmon et al., 1999 ; Panksepp, 2005 ; Merker, 2007 ).”
From The brain-body disconnect: A somatic sensory basis for trauma-related disorders (2022) · cites this paper as Shewmon et al., 1999
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TOTAL BRAIN DEATH: A REPLY TO ALAN SHEWMON
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- Authors
- Shewmon, D. A., Holmes, G. L., & Byrne, P. A.
- Affiliations
- Ronald Reagan UCLA Medical Center (US)
- Venue
- Developmental Medicine & Child Neurology
- Publisher
- Wiley
- Published
- 1999-06
- Volume
- 41
- Issue
- 6
- Pages
- 364-374
- ISSN
- 0012-1622 (ISSN-L)
- OpenAlex
- W2166891515
- Cited by
- 215
- References
- 73
- Citations by year
- 2026: 2 · 2025: 2 · 2024: 8 · 2023: 7 · 2022: 11 · 2021: 18 · 2020: 6 · 2019: 13 · 2018: 9 · 2017: 12 · 2016: 14 · 2015: 9 · 2014: 9 · 2013: 11 · 2012: 7
- FWCI
- 1.09
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Developmental Medicine & Child Neurology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Epidemiology › Traumatic Brain Injury Research
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Philosophy and Theoretical Science
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Fetal and Pediatric Neurological Disorders
- Keywords
- consciousness, brain malformations, self-fulfilling prophecy
- MeSH terms
- Brain, Brain Diseases, Child, Consciousness, Female, Humans, Male, Tomography, X-Ray Computed, Persistent Vegetative State
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