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disorders of conscious

Damien Lesenfants, Dina Habbal, Camille Chatelle, Caroline Schnakers, Steven Laureys, Quentin Noirhomme
OBJECTIVE: To propose a new methodology based on single-trial analysis for detecting residual response to command with EMG in patients with disorders of consciousness (DOC), overcoming the issue of trial dependency and decreasing the influence of a patient's fluctuation of vigilance or arousal over time on diagnostic accuracy. METHODS: Forty-five patients with DOC (18 with vegetative/unresponsive wakefulness syndrome [VS/UWS], 22 in a minimally conscious state [MCS], 3 who emerged from MCS [EMCS], and 2 with locked-in syndrome [LIS]) and 20 healthy controls were included in the study...
October 21, 2016: Neurology
Y Kimura, J Maeda, M Yamada, K Takahata, K Yokokawa, Y Ikoma, C Seki, H Ito, M Higuchi, T Suhara
RATIONALE: The beneficial effects of psychostimulant drugs in the treatment of psychiatric disorders occur because they increase the extracellular dopamine concentration by inhibiting re-uptake of extracellular dopamine at dopamine transporters. However, the psychological effects at low dopamine transporter occupancy have not been well demonstrated. OBJECTIVES: The purpose of the study was to evaluate the psychological effects, dopamine transporter occupancy, and dopamine release induced by a single oral administration of a clinical dose of mazindol...
October 20, 2016: Psychopharmacology
Jennifer M Windt, Tore Nielsen, Evan Thompson
Consciousness is often said to disappear in deep, dreamless sleep. We argue that this assumption is oversimplified. Unless dreamless sleep is defined as unconscious from the outset there are good empirical and theoretical reasons for saying that a range of different types of sleep experience, some of which are distinct from dreaming, can occur in all stages of sleep. We introduce a novel taxonomy for describing different kinds of dreamless sleep experiences and suggest research methods for their investigation...
October 17, 2016: Trends in Cognitive Sciences
Zerrin Demirtürk, Evren Şentürk, Abbas Köse, Perihan Ergin Özcan, Lütfi Telci
BACKGROUND: Biotinidase deficiency (BD) is a rare, inherited autosomal recessive disorder that is treatable within childhood. We present a patient with pneumonia and respiratory acidosis who was not diagnosed with any systemic disorders; the patient was finally diagnosed as BD. CASE REPORT: A thirty-year-old woman was admitted to the emergency department with respiratory failure that had persisted for a few days and progressively weakening over the previous six months...
September 2016: Balkan Medical Journal
Chun Yeh, Ching-Heng Ting, Ming-Luen Doong, Chin-Wen Chi, Shou-Dong Lee, Chih-Yen Chen
PURPOSE: Urocortin 3 is a key neuromodulator in the regulation of stress, anxiety, food intake, gut motility, and energy homeostasis, while ghrelin elicits feeding behavior and enhances gastric emptying, adiposity, and positive energy balance. However, the interplays between urocortin 3 and ghrelin on food intake and gastric emptying remain uninvestigated. METHODS: We examined the differential effects of central O-n-octanoylated ghrelin, des-Gln(14)-ghrelin, and urocortin 3 on food intake, as well as on charcoal nonnutrient semiliquid gastric emptying in conscious rats that were chronically implanted with intracerebroventricular (ICV) catheters...
2016: Drug Design, Development and Therapy
Karolina Adamczyk, Beata Średniawa, Katarzyna Mitręga, Stanisław Morawski, Agata Musialik-Łydka, Zbigniew Kalarus
Symptoms such as palpitations, fainting, dizziness and unexplained loss of consciousness are often notified by patients in clinical practice. Cardiological causes of these ailments could be various, inter alia, atriaventricular conduction disorders, supraventricular arrythmias or more life-threatening ventricular arrythmias. Diagnostics of these disorders includes a series of basic non-invasive research and more advanced specialistic methods. Presented case report shows problems of arrythmias diagnostics and imperfections of avaible methods...
September 29, 2016: Polski Merkuriusz Lekarski: Organ Polskiego Towarzystwa Lekarskiego
Chia-Ying Kuo, Hung-Yi Chiou, Jia-Wei Lin, Shin-Han Tsai, Mau-Roung Lin, Yung-Hsiao Chiang, Chien-Min Lin, Shu-Fen Chu, Tsan-Hon Liou, Wen-Ta Chiu
Objective Bicycle riding is increasingly popular in Taiwan, but the number of cyclists injured and cyclists' death rate are both increasing. The aim of this study was to investigate the different characteristics and clinical outcomes of traffic-accident related head injuries to cyclists in urban and rural areas. Methods Records of 812 patients (533 urban and 279 rural) admitted to 27 hospitals in Taipei City and Hualien County as the result of a traumatic head injury while bicycling between 1998 and 2013 were retrieved for study...
October 18, 2016: Traffic Injury Prevention
Katherine K M Stavropoulos, Michaela Viktorinova, Adam Naples, Jennifer Foss-Feig, James C McPartland
BACKGROUND: Difficulty with emotion perception is a core feature of autism spectrum disorder (ASD) that is also associated with the broader autism phenotype. OBJECTIVES: The current study explored the neural underpinnings of conscious and non-conscious perceptions of affect in typically developing individuals with varying levels of autistic-like traits, as measured by the Autism Quotient (AQ). We investigated the relationship between autistic traits and face processing efficiency using event-related potentials (ERPs)...
October 18, 2016: Social Neuroscience
Verónica Gómez Toledo, Ileana Gutiérrez Farfán, Antonio Verduzco-Mendoza, Emilio Arch-Tirado
BACKGROUND: Tinnitus is defined as the conscious perception of a sensation of sound that occurs in the absence of an external stimulus. This audiological symptom affects 7% to 19% of the adult population. The aim of this study is to describe the associated comorbidities present in patients with tinnitus usingjoint and conditional probability analysis. PATIENTS: Patients of both genders, diagnosed with unilateral or bilateral tinnitus, aged between 20 and 45 years, and had a full computerised medical record, were selected...
October 13, 2016: Cirugia y Cirujanos
Judith Barasche, Fabiola Stollar, Marcel M Bergmann, Jean-Christoph Caubet
In infants, the causes of acute repetitive vomiting and severely altered-consciousness status include a broad differential diagnosis, that is, primarly sepsis, infectious gastroenteritis, head injury, and intoxication, as well as neurologic, metabolic, and cardiologic condition diseases. In patients developing such symptoms, allergy as an etiological cause is often not considered by primary care physicians. With this case report, we aim to draw the attention of general pediatricians, emergency physicians, and intensivists to the fact that non-immunoglobulin E-mediated food allergic gastrointestinal disorders such as food protein-induced enterocolitis syndrome should be considered in patients with sepsis-like symptoms...
October 6, 2016: Pediatric Emergency Care
Francesca Pistoia, Simona Sacco, Janet Stewart, Marco Sarà, Antonio Carolei
The experience of pain in disorders of consciousness is still debated. Neuroimaging studies, using functional Magnetic Resonance Imaging (fMRI), Positron Emission Tomography (PET), multichannel electroencephalography (EEG) and laser-evoked potentials, suggest that the perception of pain increases with the level of consciousness. Brain activation in response to noxious stimuli has been observed in patients with unresponsive wakefulness syndrome (UWS), which is also referred to as a vegetative state (VS), as well as those in a minimally conscious state (MCS)...
October 8, 2016: Brain Sciences
Anna Nigri, Eleonora Catricalà, Stefania Ferraro, Maria Grazia Bruzzone, Ludovico D'Incerti, Davide Sattin, Davide Rossi Sebastiano, Silvana Franceschetti, Giorgio Marotta, Riccardo Benti, Matilde Leonardi, Stefano F Cappa
There is a growing interest in the use of functional imaging to assess brain activity in the absence of behavioural responses in patients with disorders of consciousness (DOC). In the present study, we applied a hierarchical auditory stimulation paradigm to functional magnetic resonance (fMRI) in a group of long-term DOC adult patients. Brain response to pairs of pseudowords, of unrelated words and of semantically related words, i.e. stimuli differing in lexical status (words vs. pseudowords) and semantic relatedness (related vs...
October 13, 2016: Brain Imaging and Behavior
Mustafa Özçetin, Mehmet Karacı, Ertuğ Toroslu, Nurullah Edebali
Pituitary adenomas usually arise from the anterior lobe of the pituitary gland and are manifested with hormonal disorders or mass effect. Mass effect usually occurs in nonfunctional tumors. Pituitary adenomas may be manifested with visual field defects or rarely in the form of total oculomotor palsy. Visual field defect is most frequently in the form of bitemporal hemianopsia and superior temporal defect. Sudden loss of vision, papilledema and ophthalmoplegia may be observed. Pituitary apoplexy is defined as an acute clinical syndrome characterized with headache, vomiting, loss of vision, ophthalmoplegia and clouding of consciousness...
September 2016: Türk Pediatri Arşivi
Chiara Zucchella, Massimo Di Santis, Biagio Ciccone, Massimiliano Pelella, Marina Scappaticci, Giovanna Badalassi, Susanna Lavezzi, Michelangelo Bartolo
INTRODUCTION: Preliminary evidences showed that telemedicine may allow a reduction of costs and an enhancement of patients' satisfaction and quality of life (QoL), with the same effectiveness of conventional methods of healthcare delivery. Literature is quite absent in relation to the use of telemedicine for patients with disorders of consciousness (DoC) whose management is delegated almost entirely to the family. In order to promote an alternative setting to manage persons affected by DoC, also supporting their families, a pilot project was designed to test the feasibility of home-care assistance based on a system of telemonitoring...
October 12, 2016: Journal of Telemedicine and Telecare
Paola Ferri, Monica Silvestri, Cecilia Artoni, Rosaria Di Lorenzo
BACKGROUND: Workplace violence (WPV) against health professionals is a global problem with an increasing incidence. The aims of this study were as follows: 1) to examine the frequency and characteristics of WPV in different settings and professionals of a general hospital and 2) to identify the clinical and organizational factors related to this phenomenon. METHODS: The study was cross-sectional. In a 1-month period, we administered the "Violent Incident Form" to 745 professionals (physicians, head nurses, nurses, nursing assistants), who worked in 15 wards of a general hospital in northern Italy...
2016: Psychology Research and Behavior Management
Jung Ju Choi, Hong Soon Kim, Kyung Cheon Lee, Youseok Shin, Youn Yi Jo
BACKGROUND: Citrullinemia type II is an autosomal recessive urea cycle disorder and a subtype of citrin deficiency. However, the management of recurrent hyperammonemia with neurologic symptoms in patients with citrullinemia type II is quite different from the management of other types of urea cycle disorders. In pats with citrullinemia type II, regional anesthesia might be a good choice for the early detection of hyperammonemic symptoms and addressing psychic stress. CASE PRESENTATION: A 48-year-old male with adult onset citrullinemia type II was scheduled for urethral scrotal fistula repair...
October 11, 2016: BMC Anesthesiology
Juliette Brown
Here, the author revisits the discussion on the impact of dementia on experiences of self and identity over time that formed part of the workshop session on Mental Disorder and Selfhood at Kings College London, September 1, 2015. Dementia is described as being synonymous with loss, but this, in the author's view, is due to conscious and unconscious focus on the later stages of the illness that undermine all our abilities to think about and use the intervening years. Those years can deliver remarkable insights into the capacity to navigate fragmented identities...
October 10, 2016: Journal of Evaluation in Clinical Practice
R J Brown
Dissociation has been cited as a possible psychologic mechanism underpinning functional neurologic disorders (FND) since the 19th century. Since that time, changes in psychiatric classification have created confusion about what the term dissociation actually means. The available evidence suggests that it now refers to at least two qualitatively distinct types of phenomena: detachment (an altered state of consciousness characterized by a sense of separation from the self or world) and compartmentalization (a reversible loss of voluntary control over apparently intact processes and functions), as well as their underlying mechanisms...
2017: Handbook of Clinical Neurology
M Hallett
Functional neurologic disorders are largely genuine and represent conversion disorders, where the dysfunction is unconscious, but there are some that are factitious, where the abnormality is feigned and conscious. Malingering, which can have the same manifestations, is similarly feigned, but not considered a genuine disease. There are no good methods for differentiating these three entities at the present time. Physiologic studies of functional weakness and sensory loss reveal normal functioning of primary motor and sensory cortex, but abnormalities of premotor cortex and association cortices...
2017: Handbook of Clinical Neurology
M Reuber, G H Rawlings
Psychogenic nonepileptic seizures (PNES) superficially resemble epileptic seizures or syncope and most patients with PNES are initially misdiagnosed as having one of the latter two types of transient loss of consciousness. However, evidence suggests that the subjective seizure experience of PNES and its main differential diagnoses are as different as the causes of these three disorders. In spite of this, and regardless of the fact that PNES are considered a mental disorder in the current nosologies, research has only given limited attention to the subjective symptomatology of PNES...
2017: Handbook of Clinical Neurology
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