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G. Bryan Young, MD; Susan E. Pigott, PhD

Arch Neurol. 1999;56:153-157.

Consciousness is an active process with multiple components. The ascending reticular activating system has multiple anatomical and neurochemical components in the rostral brainstem tegmentum, thalamus, and cortex, and is responsible for alertness, a prerequisite for maximal awareness. Awareness also has multiple facets. Sensations, after initial reception in the cortex, are further selected and processed in connected regions. Perception involves the abstraction of selected sensory information, allowing a limited concept of what is happening in the external world and within the body. Attention directs and selects certain information to the exclusion of others. Information is transiently held in working memory to allow for immediate action and decisions. Some forms of memory are accompanied by conscious awareness that is proposed to be necessary for the provision of a sense of continuity in everyday life. Motivation is involved with prioritizing and choosing behavior. The brain also has the capacity for self-awareness, ie, awareness that one has certain cognitive and mental processes. Cognition or thought, traditionally at the "highest level" of cognitive functioning (eg, deductive reasoning), involves the synthesis of the above-listed components.

From the London Health Sciences Centre and University of Western Ontario, London, Ontario.

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