• George A Mashour.
• Associate Professor of Anesthesiology, Faculty of Neuroscience Graduate Program, University of Michigan Medical School, 1500 East Medical Center Drive, 1H247 University Hospital/SPC-5048, Ann Arbor, MI 48109-5048, USA. Electronic address: gmashour@med.umich.edu.
• Neurosci Biobehav Rev. 2013 Dec 1;37(10 Pt 2):2751-9.

Abstract"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.Copyright © 2013 Elsevier Ltd. All rights reserved.

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