Why families ask: is my loved one still there?

0:40about a paper today that's trying to tackle one of the hardest questions in neuroscience about comas and how AI is helping us better understand the state of deep prolonged unconsciousness. This was a paper published in Nature Neuroscience by friend of the pod Daniel Toker at all on March 26th, and as always, we are going to learn about the science from the ground up because this is from first principles.

1:24Every year tens of thousands of people fall into comas, and it's either from traumatic brain injury or a stroke, cardiac arrest, drug overdoses, and whenever this happens, some patients recover and some patients don't. We don't really know why some recover and why some don't. The other thing is for families that are sitting in that intensive care unit, there's a question that haunts them every time, which is is my loved one still there? And this question is one of the hardest problems in all of neuroscience, Right? What is consciousness? It's not just philosophically hard, which that's above my pay grade and we're not going to get into, but even like mechanistically and

2:05clinically, this is a very hard problem. Right? What is consciousness even physically speaking? Obviously, it has something to do with the brain. The human brain has 86 billion neurons. It's a muscle of fat and neural tissue and it's quite incredible that that like sack of fat and tissue is where we get this profound phenomenon of consciousness, right? Our ability to perceive, to feel, to think and to have this subjective experience of ourselves and the world around us. And it's all just from like this sack of like blood and fat

2:46in our skull, right? And one can ask, so it's somewhere in the brain, but what are the specific circuits that generate consciousness? And if a part of that circuit breaks, how does it affect consciousness? And then can I actually figure out how to repair it? Right? Now, doctors can observe that a patient is conscious or unconscious, right? Cuz they're not responsive and they can classify the depth of unconsciousness on behavioral scales. But all we can do really is like wait for them to wake up. There are some new therapies right now that we're going to get into that are maybe getting at

3:26trying to wake them up. But at the end of the day, we still don't have a way to peer inside the machinery of awareness and start asking like what is the thing that is broken and how do we fix it? Okay, or how do we replace it? There there's still this delta between sort of uh what we have as a scientific understanding currently and the actual mechanism that generates that it's kind of a little bit of a >> Yeah. dark cave. >> Yeah, very much a black box in that sense, right? And that's why I really like this new paper. It's a new study that I think represents a genuine step change in that field. Okay, so it's a team that was led by Daniel Toker at

4:06UCLA, who is, as you said, a friend of