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Abstract(s)
Objetivo: É objetivo principal deste projeto mapear o estado da arte da literatura da default-mode network de modo a formar uma imagem compreensiva e coesa acerca do papel e funcionamento da rede nas patologias neurológicas, no âmbito da consciência humana, especificamente nas doenças de consciência. Introdução: Desde a sua descoberta em 200176 , a default mode network (DMN), uma rede extensa de regiões cerebrais que se ativa quando este se encontra num estado de repouso, tem sido um alvo de estudo no âmbito das neurociências e ciências da mente. Metodologia: A presente revisão Scoping seguiu uma metodologia com base nos critérios delineados pelo Joanna Briggs Institute (ver apêndice IV), tendo começado a pesquisa a 7 de Julho nas seguintes bases de dados para extração de meta dados e de artigos: CINAHL, PubMed, PsycArticles, Scopus, e Web of Science; todas as publicações consideradas para estas bases de dados foram contempladas em espanhol, inglês, francês e português. Critérios de Inclusão: Os critérios de inclusão foram definidos tendo por base a sigla PCC, seguindo as recomendações do protocolo JBI para revisões Scoping, onde P remete para população, C para conceito, e C para contexto. Relativamente à população, o projeto contemplou todos os estudos que como amostra de participantes tinham doentes com doenças de consciência; No que diz respeito ao conceito, foram considerados estudos que abordavam a default-mode network, e no contexto, C, de um estado de consciência patológica (doenças de consciência). Resultados: Um total de 33 artigos foram incluídos nesta revisão Scoping. A análise a esta amostra final aponta para um envolvimento da DMN em patologias DOC no que diz respeito à identificação, modulação e prognóstico do estado de doença, sendo possivelmente uma rede fundamental para considerar no que toca a futuras intervenções de reabilitação para doentes com DOC. Conclusões: A identificação da Default-mode network em patologias do tipo DOC pode ser desafiante, dependendo da etiologia da lesão, contudo tem um impacto profundo para a correta categorização de estado patológico dentro de este espetro, probabilidade de prognóstico e evolução patológica, e através de intervenções direcionadas a agir sobre áreas corticais pertencentes à DMN, via o uso de estimulação eletrofisiológica ou de administração de fármacos, há cada vez mais evidência empírica a suportar a ideia de que a DMN desempenha um papel fundamental nas DOC.
Objective: The current review’s purpose is to map the existing literature regarding the DMN so as to create a cohesive, comprehensive, and clear picture of the state of the art in order to arrive at better understanding of the network’s involvement and role in neurological pathologies, in the context of human consciousness, namely the disorders of consciousness. Introduction: Since its official discovery in 2001 by Raichle and colleagues 76 , the default-mode network, an extensive network of cortical regions that is mostly active in a resting-state of brain activity, has increasingly become the target for a plethora of studies in the mind and brain sciences. Methodology: The present scoping review adopted the Joanna Briggs Institute (see appendix IV) criteria for elaborating and developing scoping reviews. The search for articles for selection and metadata extraction began on the 7th of July, using the following data bases: CINAHL, PubMed, PsycArticles, Scopus, and Web of Science; all of the publications contemplated for the data bases listed above were considered for English, French, Portuguese, and Spanish. Inclusion Criteria: Inclusion criteria were decided upon using the PCC acronym, following JBI’s recommendation for scoping review protocols, where P corresponds to the population, C the concept, and C the context. The current project considered studies whose participant sample included patients with disorders of consciousness, as well as studies that touched upon the default-mode network, in the context of pathological human consciousness (DOC). Results: A final sum of thirty-three articles was reached and were included for the review. The results point to the DMN’s involvement in DOC pathologies with regards to playing a role in identifying the current state of the DOC, modulating it, and developing a prognostic for the evolution of the pathology. It may very well become a fundamental network to consider for future interventions in DOC rehabilitation. Discussion: The act of identifying the Default-mode network in disorders of consciousness may prove challenging depending on the aetiology of the lesion/injury, however, it has a profound impact in correctly categorising the current pathological state within this spectrum and is equally impactful in determining the probability of prognostic and pathological evolution. Also, through the use of guided cortical intra network (intra-DMN) interventions via electrophysiological stimulation, or through the administration of drugs that target this network, it is becoming clearer that there is an increasing body of evidence that implicates the DMN in playing a key role in DOC.
Objective: The current review’s purpose is to map the existing literature regarding the DMN so as to create a cohesive, comprehensive, and clear picture of the state of the art in order to arrive at better understanding of the network’s involvement and role in neurological pathologies, in the context of human consciousness, namely the disorders of consciousness. Introduction: Since its official discovery in 2001 by Raichle and colleagues 76 , the default-mode network, an extensive network of cortical regions that is mostly active in a resting-state of brain activity, has increasingly become the target for a plethora of studies in the mind and brain sciences. Methodology: The present scoping review adopted the Joanna Briggs Institute (see appendix IV) criteria for elaborating and developing scoping reviews. The search for articles for selection and metadata extraction began on the 7th of July, using the following data bases: CINAHL, PubMed, PsycArticles, Scopus, and Web of Science; all of the publications contemplated for the data bases listed above were considered for English, French, Portuguese, and Spanish. Inclusion Criteria: Inclusion criteria were decided upon using the PCC acronym, following JBI’s recommendation for scoping review protocols, where P corresponds to the population, C the concept, and C the context. The current project considered studies whose participant sample included patients with disorders of consciousness, as well as studies that touched upon the default-mode network, in the context of pathological human consciousness (DOC). Results: A final sum of thirty-three articles was reached and were included for the review. The results point to the DMN’s involvement in DOC pathologies with regards to playing a role in identifying the current state of the DOC, modulating it, and developing a prognostic for the evolution of the pathology. It may very well become a fundamental network to consider for future interventions in DOC rehabilitation. Discussion: The act of identifying the Default-mode network in disorders of consciousness may prove challenging depending on the aetiology of the lesion/injury, however, it has a profound impact in correctly categorising the current pathological state within this spectrum and is equally impactful in determining the probability of prognostic and pathological evolution. Also, through the use of guided cortical intra network (intra-DMN) interventions via electrophysiological stimulation, or through the administration of drugs that target this network, it is becoming clearer that there is an increasing body of evidence that implicates the DMN in playing a key role in DOC.
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Keywords
Default-mode network Doenças de consciência Disorders of consciousness