Self-awareness is a pivotal component of the conscious experience. It is correlated with a paralimbic net-work of medial prefrontal/anterior cingulate and medial parietal/posterior cingulate cortical “hubs” and associated regions.Electromagnetic and transmitter manipulation have demonstrated that the network is not an epiphenomenon but instrumental in the generation of self-awareness. Thus, transcranial magnetic stimulation(TMS) targeting the hubs impedes different aspects of self-awareness with a latency of 160 ms. The network is linked by ∼40 Hz oscillations and regulated by dopamine.The oscillations are generated by rhythmic GABA-ergic inhibitory activity in interneurons with an extraordinarily high metabolic rate. The hubs are richly endowed with interneurons and therefore highly vulnerable to disturbed energy supply. Consequently, deficient paralimbic activity and self-awareness characteristic features of many disorders with impaired oxygen homeostasis. Such disorders may, therefore, be treated unconventionally by targeting interneuron function.
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