A deep understanding of the molecular neural mechanisms underlying the loss and emergence of consciousness in the brain is of great importance for the prevention and treatment of disorders of consciousness associated with certain brain diseases, as well as for the development of super artificial intelligence. This article summarizes the progress of research into how the brain loses and regains consciousness in response to anesthetics. Based on advances in the biological mechanisms of anaesthesia−induced loss of consciousness and emergence from anesthesia, a new hypothesis for the emergence of consciousness is proposed. This article concludes with a list of key scientific questions that deserve attention in the context of in−depth research on loss and recovery of consciousness and cognitive dysfunction. This article lists several key scientific questions worthy of attention for in−depth research on the loss and recovery of consciousness and cognitive dysfunction: What are the biological principles underlying the molecular, neuronal, and neural network activities that normal conscious activity relies on; How do anesthetics, by acting on their pharmacological molecular targets to inhibit neuronal activity and interfere with or block information transmission, further lead to disorders of consciousness or loss of consciousness; What are the key nuclei, molecules, and their working mechanisms involved in the molecular neural mechanisms of regained consciousness after its loss, beyond the known ubiquitination−mediated degradation of KCC2 in ventral posteromedial thalamic nucleus (VPM) neurons; How does the intervention in specific neural nuclei and circuits through external forces, such as optogenetics, chemogenetics, electrical stimulation, and drugs, significantly alter the state of consciousness in the overall context of the brain; Unlike waking from normal periodic sleep, why does cognitive dysfunction occur after anesthesia or why does cognitive function not fully recover, and what are the molecular neural mechanisms hindering the recovery of cognitive function; Identifying which nuclei, neurons, their activity patterns, neural networks, and arousal systems are unique or shared mechanisms in the processes of anesthesia, sleep, and their recovery; What are the molecular neural mechanisms hindering the recovery of consciousness under states of anesthesia, coma, and vegetative state.

consciousness  /  VPM  /  KCC2  /  anesthesia  /  brain disease  /  super artificial intelligence