Cognitive unbinding: A neuroscientific paradigm of general anesthesia and related states of unconsciousness

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“Cognitive unbinding” refers to the impaired synthesis of specialized cognitive activities in the brain and has been proposed as a mechanistic paradigm of unconsciousness. This article draws on recent neuroscientific data to revisit the tenets and predictions of cognitive unbinding, using general anesthesia as a representative state of unconsciousness. Current evidence from neuroimaging and neurophysiology supports the proposition that cognitive unbinding is a parsimonious explanation for the direct mechanism (or “proximate cause”) of anesthetic-induced unconsciousness across multiple drug classes. The relevance of cognitive unbinding to sleep, disorders of consciousness, and psychological processes is also explored. It is concluded that cognitive unbinding is a viable neuroscientific framework for unconscious processes across the fields of anesthesiology, sleep neurobiology, neurology and psychoanalysis.HighlightsCognitive unbinding is the disrupted synthesis of specialized neural activity.Current evidence suggests that diverse anesthetics cause cognitive unbinding.Other unconscious states are also consistent with cognitive unbinding.Cognitive unbinding may be a general theory of unconsciousness.

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