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

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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

Bibliographical note

Publisher Copyright:
© 2019 The Authors

Keywords

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

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AU - Nahm, Michael

AU - Schulman-Green, Dena

AU - Greyson, B.

AU - Pakhomov, Serguei

AU - Karlawish, J.

AU - Shah, R. C.

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

Abstract

Bibliographical note

Keywords

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