Are biomarkers of consciousness ready for clinical practice?
Novel biomarkers of consciousness often have limited clinical utility.
There is still no simple test or brain scan that can definitively determine whether someone is conscious. Although research is making steady progress, translating advances into clinical practice remains a long and uncertain process. And one that should be approached with great care.
Michele Farisco is a researcher at the Centre for Research Ethics & Bioethics
Even state-of-the-art measures of consciousness like EEG complexity (brain wave patterns), connectivity patterns (how different parts of the brain communicate with each other) and spectral signatures (how different frequencies of brain activity are distributed) are statistical indicators. Another way of measuring consciousness could be using virtual reality (VR) to help doctors and researchers look for more meaningful signs of consciousness in a controlled way in hospital settings.
But virtual reality does not solve the problem. False positives and false negatives remain serious risks. As a result, physicians struggle to make informed decisions about treatment. Families and caregivers suffer not knowing for sure.
A recent publication in Neuroscience & Biobehavioral Reviews describes a multidisciplinary, multiperspective approach to better connecting research and clinical practice: combining expertise from many fields, including medicine, neuroscience, technology, and ethics, and listening to patients and caregivers.
The research community is under strong pressures to publish-or-perish. According to the authors, researchers, clinicians, hospitals, funders, and even academic journals all share ethical responsibility for how biomarkers of consciousness are developed and used. They affect life-and-death decisions, treatment choices, communication with families, and judgements about whether a person is conscious.
“Biomarkers of consciousness must be developed slowly, collaboratively, transparently, and ethically, with clinicians and families at the centre, and should not be driven by academic competition or technological hype. Not every measure of consciousness should become a clinical biomarker. Only those that truly meet ethical, scientific, and practical standards should,” says Michele Farisco, researcher at the Uppsala University Centre for Research Ethics & Bioethics and one of the authors.
The paper outlines a series of recommendations that biomarkers of consciousness should meet. They must be understandable (not a mysterious black-box number), be accurate and clinically meaningful (not just statistically interesting), add something that is truly novel (not just duplicate cheaper or existing methods), be reliable and reproducible across hospitals, machines and patient groups, be useable in real clinical settings (not only in labs), be affordable enough to be realistically adopted by healthcare systems.
“We want to make a case for re-centring clinicians, families and caregivers in the process of translating research to clinical practice to make sure that the prognostic and diagnostic tools developed for disorders of consciousness improve quality of life, respect ethical complexity, support caregivers, and avoid technological hype,” Michele Farisco concludes.
By Anna Holm Bodin
Farisco M, Evers K, et al. Advancing the science of consciousness: From ethics to clinical care, Neuroscience & Biobehavioral Reviews, Volume 180, 2026, 106497, DOI: 10.1016/j.neubiorev.2025.106497.
About the paper
Advancing the science of consciousness: From ethics to clinical care is a “live-paper” and includes links to the brain research infrastructure EBRAINS, giving the possibility to execute relevant computational models and to reproduce the figures presented. In this way researchers can access some “live” functionalities, including tools for simulating real cases and test the functionalities of the models that the paper presents.