There is increasing recognition that a significant amount of brain processing is done under the level of consciousness. This has implications — both practical and ethical — about where intervention might be possible, and how we assess levels of consciousness.

Future Horizons:

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5-yearhorizon

Diagnosis of consciousness improves

Brain-state diagnostics improve, and machine learning overcomes individual patient variability to assist in prognosis and guide rehabilitation. Specific tests reliably detect early onset of diseases that disrupt consciousness. Better computational models improve our understanding of the systems biology that contributes to conscious states.

10-yearhorizon

Guidelines for consciousness assessment agreed

An agreed set of international guidelines (effectively a standard scale) standardises assessment of human consciousness. Improved imaging, combined with AI pattern recognition, leads to more reliable prediction of which patients are aware, which will respond to stimulation and which will require implants to communicate from their vegetative state. Neuroscientific tools give a rudimentary ability to decode the content of dreams in sleeping humans, as well as other contents of conscious experience.

25-yearhorizon

Consciousness evaluation evolves

Scientifically validated assessment of presence and quality of human consciousness is established, opening up the possibility of significant progress on theories of consciousness. Brain-machine interfaces open up seamless communication with apparently unconscious people, even restoring natural consciousness in some cases. Precision neuropsychiatry uses a suite of new interventions — technological and chemical tools — to steer consciousness away from dangerous or unwanted states.

Different kinds of consciousness are at play at different stages of human development, from foetus through to early childhood and beyond. On top of that, injury or disease can compromise human consciousness in a variety of ways, such as that seen in vegetative-state patients and people suffering from dementia. There is progress towards creating tests for consciousness.⁸

Understanding the difference between all these various types of human consciousness will be a vital part of the effort to treat injury and disease, and to understand various aspects of human-rights issues associated with consciousness. Research efforts are aiming to do this, with some success in the application of diagnostic tools that can differentiate between a vegetative state and a minimally conscious state, for instance.⁹ Functional MRI and EEG can be used to demonstrate performance of cognitive tasks in some comatose patients who do not follow verbal commands.¹⁰ Intervention in coma patients, aiming at recovery, is becoming a realistic, if long-term, prospect.¹¹,¹²There is hope that better understanding will help detect and assess early memory loss in ageing and in Alzheimer’s disease, and guide treatment and care.¹³At the other end of life the need to assess consciousness “in the cradle” in the prenatal and infant stages is becoming an issue with medical, educational , legal and ethical implications.¹⁴

Neurosurgical research demonstrates that specific neuronal activity underlies the emergence of concepts, memories and intentions in human consciousness, and further exploration here, with emerging brain-recording and stimulation tools, partnered with AI-based analysis, could help decode conscious and preconscious states.¹⁵,¹⁶ Interaction with sleeping humans can also help to explore the space between the conscious and unconscious brain.¹⁷

Such work could also help with fundamental science, such as developing theoretical understanding of consciousness by identifying areas of interest for probing the neural correlates of consciousness, and contribute to quantification and classification of consciousness in humans.

Human consciousness - Anticipation Scores

The Anticipation Potential of a research field is determined by the capacity for impactful action in the present, considering possible future transformative breakthroughs in a field over a 25-year outlook. A field with a high Anticipation Potential, therefore, combines the potential range of future transformative possibilities engendered by a research area with a wide field of opportunities for action in the present. We asked researchers in the field to anticipate:

The uncertainty related to future science breakthroughs in the field
The transformative effect anticipated breakthroughs may have on research and society
The scope for action in the present in relation to anticipated breakthroughs.

This chart represents a summary of their responses to each of these elements, which when combined, provide the Anticipation Potential for the topic. See methodology for more information.