@article {4493, title = {Cognitive-Motor Dissociation Following Pediatric Brain Injury: What About the Children?}, journal = {Neurol Clin Pract}, volume = {12}, year = {2022}, month = {2022 Jun}, pages = {248-257}, abstract = {

BACKGROUND AND OBJECTIVES: Following severe brain injury, up to 16\% of adults showing no clinical signs of cognitive function nonetheless have preserved cognitive capacities detectable via neuroimaging and neurophysiology; this has been designated cognitive-motor dissociation (CMD). Pediatric medicine lacks both practice guidelines for identifying covert cognition and epidemiologic data regarding CMD prevalence.

METHODS: We applied a diverse battery of neuroimaging and neurophysiologic tests to evaluate 2 adolescents (aged 15 and 18 years) who had shown no clinical evidence of preserved cognitive function following brain injury at age 9 and 13 years, respectively. Clinical evaluations were consistent with minimally conscious state (minus) and vegetative state, respectively.

RESULTS: Both participants{\textquoteright} EEG, and 1 participant{\textquoteright}s fMRI, provided evidence that they could understand commands and make consistent voluntary decisions to follow them. Both participants{\textquoteright} EEG demonstrated larger-than-expected responses to auditory stimuli and intact semantic processing of words in context.

DISCUSSION: These converging lines of evidence lead us to conclude that both participants had preserved cognitive function dissociated from their motor output. Throughout the 5+ years since injury, communication attempts and therapy had remained uninformed by such objective evidence of their cognitive abilities. Proper diagnosis of CMD is an ethical imperative. Children with covert cognition reflect a vulnerable and isolated population; the methods outlined here provide a first step in identifying such persons to advance efforts to alleviate their condition.

}, issn = {2163-0402}, doi = {10.1212/CPJ.0000000000001169}, author = {Kim, Nayoung and O{\textquoteright}Sullivan, James and Olafson, Emily and Caliendo, Eric and Nowak, Sophie and Voss, Henning U and Lowder, Ryan and Watson, William D and Ivanidze, Jana and Fins, Joseph J and Schiff, Nicholas D and Hill, N Jeremy and Shah, Sudhin A} } @article {4363, title = {Recommendations for Responsible Development and Application of Neurotechnologies.}, journal = {Neuroethics}, volume = {14}, year = {2021}, month = {2021}, pages = {365-386}, abstract = {

Advancements in novel neurotechnologies, such as brain computer interfaces (BCI) and neuromodulatory devices such as deep brain stimulators (DBS), will have profound implications for society and human rights. While these technologies are improving the diagnosis and treatment of mental and neurological diseases, they can also alter individual agency and estrange those using neurotechnologies from their sense of self, challenging basic notions of what it means to be human. As an international coalition of interdisciplinary scholars and practitioners, we examine these challenges and make recommendations to mitigate negative consequences that could arise from the unregulated development or application of novel neurotechnologies. We explore potential ethical challenges in four key areas: identity and agency, privacy, bias, and enhancement. To address them, we propose (1) democratic and inclusive summits to establish globally-coordinated ethical and societal guidelines for neurotechnology development and application, (2) new measures, including "Neurorights," for data privacy, security, and consent to empower neurotechnology users{\textquoteright} control over their data, (3) new methods of identifying and preventing bias, and (4) the adoption of public guidelines for safe and equitable distribution of neurotechnological devices.

}, issn = {1874-5490}, doi = {10.1007/s12152-021-09468-6}, author = {Goering, Sara and Klein, Eran and Specker Sullivan, Laura and Wexler, Anna and Ag{\"u}era Y Arcas, Blaise and Bi, Guoqiang and Carmena, Jose M and Fins, Joseph J and Friesen, Phoebe and Gallant, Jack and Huggins, Jane E and Kellmeyer, Philipp and Marblestone, Adam and Mitchell, Christine and Parens, Erik and Pham, Michelle and Rubel, Alan and Sadato, Norihiro and Teicher, Mina and Wasserman, David and Whittaker, Meredith and Wolpaw, Jonathan and Yuste, Rafael} }