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

Pharmaceutical Care and Health Systems

Research output: Contribution to journal › Article › peer-review

58 Scopus citations

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

Bibliographical note

Funding Information:
The authors thank Basil A. Eldadah, MD, PhD, as well as his team members from the National Institute on Aging for catalyzing and supporting discussions related to lucidity in dementia.

Publisher Copyright:
© 2019 The Authors

Keywords

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

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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",

author = "Mashour, \{George A.\} and Lori Frank and Alexander Batthyany and Kolanowski, \{Ann Marie\} and Michael Nahm and Dena Schulman-Green and B. Greyson and Serguei Pakhomov and J. Karlawish and Shah, \{R. C.\}",

note = "Funding Information: The authors thank Basil A. Eldadah, MD, PhD, as well as his team members from the National Institute on Aging for catalyzing and supporting discussions related to lucidity in dementia. Publisher Copyright: {\textcopyright} 2019 The Authors",

year = "2019",

month = aug,

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

language = "English (US)",

volume = "15",

pages = "1107--1114",

journal = "Alzheimer's and Dementia",

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TY - JOUR

T1 - Paradoxical lucidity

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.

N1 - Funding Information: The authors thank Basil A. Eldadah, MD, PhD, as well as his team members from the National Institute on Aging for catalyzing and supporting discussions related to lucidity in dementia. Publisher Copyright: © 2019 The Authors

PY - 2019/8

Y1 - 2019/8

N2 - 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.

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

UR - https://www.scopus.com/pages/publications/85070499590

UR - https://www.scopus.com/pages/publications/85070499590#tab=citedBy

U2 - 10.1016/j.jalz.2019.04.002

DO - 10.1016/j.jalz.2019.04.002

M3 - Article

C2 - 31229433

AN - SCOPUS:85070499590

SN - 1552-5260

VL - 15

SP - 1107

EP - 1114

JO - Alzheimer's and Dementia

JF - Alzheimer's and Dementia

IS - 8

ER -

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

Abstract

Bibliographical note

Keywords

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