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Paradoxical lucidity: A potential paradigm shift for the neurobiology and treatment of severe dementias
Author(s) -
Mashour George A.,
Frank Lori,
Batthyany Alexander,
Kolanowski Ann Marie,
Nahm Michael,
SchulmanGreen Dena,
Greyson Bruce,
Pakhomov Serguei,
Karlawish Jason,
Shah Raj C.
Publication year - 2019
Publication title -
alzheimer's and dementia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 6.713
H-Index - 118
eISSN - 1552-5279
pISSN - 1552-5260
DOI - 10.1016/j.jalz.2019.04.002
Subject(s) - neuroscience , cognition , psychology , phenomenon , paradigm shift , cognitive science , philosophy , epistemology
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.