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https://www.readbyqxmd.com/read/28918680/transcranial-direct-current-stimulation-in-disorders-of-consciousness-a-review
#1
Ye Zhang, Weiqun Song
It is a challenge to evaluate and treat the patients with disorders of consciousness (DOC) in the clinic. Due to the huge costs of prolonged intensive care, the management of these patients raises great financial strain on families and important ethical questions. To date, several studies have attempted to specifically detect pharmacologic or non-pharmacologic effectiveness, until now there were no evidence-based guidelines about the treatment of patients with DOC. Recently, because of ethical and procedural limitations on the use of invasive stimulation techniques, non-invasive brain stimulation, such as the transcranial direct current stimulation (tDCS), has been investigated for improving the level of consciousness in patients with DOC...
September 18, 2017: International Journal of Neuroscience
https://www.readbyqxmd.com/read/28914984/hypercalcemic-disorders-in-children
#2
REVIEW
Victoria J Stokes, Morten F Nielsen, Fadil M Hannan, Rajesh V Thakker
Hypercalcemia is defined as a serum calcium concentration that is greater than 2 standard deviations above the normal mean, which in children may vary with age and sex, reflecting changes in the normal physiology at each developmental stage. Hypercalcemic disorders in children may present with hypotonia, poor feeding, vomiting, constipation, abdominal pain, lethargy, polyuria, dehydration, failure to thrive and seizures. In severe cases renal failure, pancreatitis and reduced consciousness may also occur and older children and adolescents may present with psychiatric symptoms...
September 15, 2017: Journal of Bone and Mineral Research: the Official Journal of the American Society for Bone and Mineral Research
https://www.readbyqxmd.com/read/28913349/brain-computer-interface-for-clinical-purposes-cognitive-assessment-and-rehabilitation
#3
REVIEW
Laura Carelli, Federica Solca, Andrea Faini, Paolo Meriggi, Davide Sangalli, Pietro Cipresso, Giuseppe Riva, Nicola Ticozzi, Andrea Ciammola, Vincenzo Silani, Barbara Poletti
Alongside the best-known applications of brain-computer interface (BCI) technology for restoring communication abilities and controlling external devices, we present the state of the art of BCI use for cognitive assessment and training purposes. We first describe some preliminary attempts to develop verbal-motor free BCI-based tests for evaluating specific or multiple cognitive domains in patients with Amyotrophic Lateral Sclerosis, disorders of consciousness, and other neurological diseases. Then we present the more heterogeneous and advanced field of BCI-based cognitive training, which has its roots in the context of neurofeedback therapy and addresses patients with neurological developmental disorders (autism spectrum disorder and attention-deficit/hyperactivity disorder), stroke patients, and elderly subjects...
2017: BioMed Research International
https://www.readbyqxmd.com/read/28912289/using-best-interests-meetings-for-people-in-a-prolonged-disorder-of-consciousness-to-improve-clinical-and-ethical-management
#4
Derick T Wade
Current management of people with prolonged disorders of consciousness is failing patients, families and society. The causes include a general lack of concern, knowledge and expertise; a legal and professional framework which impedes timely and appropriate decision-making and/or enactment of the decision; and the exclusive focus on the patient, with no legitimate means to consider the broader consequences of healthcare decisions. This article argues that a clinical pathway based on the principles of (a) the English Mental Capacity Act 2005 and (b) using time-limited treatment trials could greatly improve patient management and reduce stress on families...
September 14, 2017: Journal of Medical Ethics
https://www.readbyqxmd.com/read/28904568/pediatric-autoimmune-encephalitis
#5
REVIEW
Massimo Barbagallo, Giovanna Vitaliti, Piero Pavone, Catia Romano, Riccardo Lubrano, Raffaele Falsaperla
Autoimmune (antibody mediated) encephalitis (AE) is emerging as a more common cause of pediatric encephalopathy than previously thought. The autoimmune process may be triggered by an infection, vaccine, or occult neoplasm. In the latter case, onconeural autoantibodies are directed against intracellular neuronal antigens, but a recent heterogeneous group of encephalitic syndromes has been found not to have underlying tumor but is associated with autoantibodies to the neuronal surface or synaptic antigens. Neuropsychiatric symptoms are very common in autoimmune encephalopathy; as a result, affected children may be initially present to psychiatrists...
April 2017: Journal of Pediatric Neurosciences
https://www.readbyqxmd.com/read/28902713/long-lasting-repetitive-transcranial-magnetic-stimulation-modulates-electroencephalography-oscillation-in-patients-with-disorders-of-consciousness
#6
Xiaoyu Xia, Yang Liu, Yang Bai, Ziyuan Liu, Yi Yang, Yongkun Guo, Ruxiang Xu, Xiaorong Gao, Xiaoli Li, Jianghong He
Repetitive transcranial magnetic stimulation (rTMS) has been applied for the treatment of patients with disorders of consciousness (DOC). Timely and accurate assessments of its modulation effects are very useful. This study evaluated rTMS modulation effects on electroencephalography (EEG) oscillation in patients with chronic DOC. Eighteen patients with a diagnosis of DOC lasting more than 3 months were recruited. All patients received one session of 10-Hz rTMS at the left dorsolateral prefrontal cortex and then 12 of them received consecutive rTMS treatment everyday for 20 consecutive days...
September 11, 2017: Neuroreport
https://www.readbyqxmd.com/read/28901969/disorders-of-consciousness-after-severe-brain-injury-therapeutic-options
#7
Caroline Schnakers, Martin M Monti
PURPOSE OF REVIEW: Very few options exist for patients who survive severe traumatic brain injury but fail to fully recover and develop a disorder of consciousness (e.g. vegetative state, minimally conscious state). RECENT FINDINGS: Among pharmacological approaches, Amantadine has shown the ability to accelerate functional recovery. Although with very low frequency, Zolpidem has shown the ability to improve the level of consciousness transiently and, possibly, also in a sustained fashion...
September 9, 2017: Current Opinion in Neurology
https://www.readbyqxmd.com/read/28892566/brain-heart-interactions-reveal-consciousness-in-non-communicating-patients
#8
Federico Raimondo, Benjamin Rohaut, Athena Demertzi, Melanie Valente, Denis Engemann, Moti Salti, Diego Fernandez Slezak, Lionel Naccache, Jacobo D Sitt
Objective We here aimed at characterizing heart-brain interactions in patients with disorders of consciousness. We tested how this information impacts data-driven classification between unresponsive and minimally conscious patients. Methods A cohort of 127 patients in vegetative state/unresponsive wakefulness syndrome (VS/UWS, n=70) and minimally conscious state (MCS, n=57) were presented with the 'Local-Global' auditory oddball paradigm, which distinguishes two levels of processing: short-term deviation of local auditory regularities and global long-term rule violations...
September 11, 2017: Annals of Neurology
https://www.readbyqxmd.com/read/28892066/effects-of-vagus-nerve-stimulation-on-extinction-of-conditioned-fear-and-post-traumatic-stress-disorder-symptoms-in-rats
#9
L J Noble, I J Gonzalez, V B Meruva, K A Callahan, B D Belfort, K R Ramanathan, E Meyers, M P Kilgard, R L Rennaker, C K McIntyre
Exposure-based therapies help patients with post-traumatic stress disorder (PTSD) to extinguish conditioned fear of trauma reminders. However, controlled laboratory studies indicate that PTSD patients do not extinguish conditioned fear as well as healthy controls, and exposure therapy has high failure and dropout rates. The present study examined whether vagus nerve stimulation (VNS) augments extinction of conditioned fear and attenuates PTSD-like symptoms in an animal model of PTSD. To model PTSD, rats were subjected to a single prolonged stress (SPS) protocol, which consisted of restraint, forced swim, loss of consciousness, and 1 week of social isolation...
August 22, 2017: Translational Psychiatry
https://www.readbyqxmd.com/read/28890446/my-time-in-medicine
#10
Joseph J Fins
Through this autobiographical reflection on a life in medicine and bioethics, the author discovers that time is a unifying theme in his work. From his early writing on the regulation of house staff work hours and his abandonment of essentialism and the development of clinical pragmatism as a method of moral problem-solving to his scholarship on end-of-life care and disorders of consciousness, time has been a central heuristic in an effort to bridge ethical theory and clinical practice.
2017: Perspectives in Biology and Medicine
https://www.readbyqxmd.com/read/28890113/relationship-between-swallowing-function-and-breathing-phonation
#11
Satoshi Yamaguchi, Mariko Ishida, Kanako Hidaka, Shinya Gomi, Sachiyo Takayama, Kazuki Sato, Yuma Yoshioka, Nozomu Wakayama, Kuwon Sekine, Shoji Matsune, Toshiaki Otsuka, Kimihiro Okubo
OBJECTIVE: Clarification of the association between the swallowing function and respiratory and phonatory functions. METHODS: The subjects were 30 patients with a chief complaint of swallowing disorder with clear consciousness capable of retaining a sitting position. Patients with organic and functional diseases of the larynx were excluded. Twenty-two and eight patients were male and female, respectively, and the mean age was 77.0±14.6years old. The chest expansion score was measured as an index of the respiratory function, and the maximum phonation time (MPT) was measured as an index of the phonatory function...
September 7, 2017: Auris, Nasus, Larynx
https://www.readbyqxmd.com/read/28878299/a-study-on-clinicoradiological-characteristics-and-pregnancy-outcomes-of-reversible-posterior-leukoencephalopathy-syndrome-in-preeclampsia-or-eclampsia
#12
Xiaobo Fang, Yanling Liang, Dunjin Chen, Fang He, Jia Chen, Fami Huang
Reversible posterior leukoencephalopathy syndrome (RPLS) is a critical maternal complication in preeclampsia or eclampsia during pregnancy. However, studies regarding the clinicoradiological and outcome differences between RPLS and non-RPLS pregnancies are scarce. We aimed to explore the incidence of RPLS, and summarize the clinicoradiological characteristics and pregnancy outcomes. We consecutively collected a total of 100 patients who were diagnosed with preeclampsia or eclampsia, and examined via magnetic resonance imaging (MRI) among 21 872 women between 2013 and 2016...
September 7, 2017: Hypertension Research: Official Journal of the Japanese Society of Hypertension
https://www.readbyqxmd.com/read/28872596/survey-of-veterinarians-using-a-novel-physical-compression-squeeze-procedure-in-the-management-of-neonatal-maladjustment-syndrome-in-foals
#13
Monica Aleman, Kalie M Weich, John E Madigan
Horses are a precocious species that must accomplish several milestones that are critical to survival in the immediate post-birth period for their survival. One essential milestone is the successful transition from the intrauterine unconsciousness to an extrauterine state of consciousness or awareness. This transition involves a complex withdrawal of consciousness inhibitors and an increase in neuroactivating factors that support awareness. This process involves neuroactive hormones as well as inputs related to factors such as cold, visual, olfactory, and auditory stimuli...
September 5, 2017: Animals: An Open Access Journal From MDPI
https://www.readbyqxmd.com/read/28871712/some-quantitative-eeg-features-in-default-mode-resting-state-network-under-general-anaesthesia
#14
Peter Jombík, Michal Drobny, Beata Saniova, Martin Fischer, Petra Kaderjaková, Marianna Lajčiaková, Erika Bakosova, Eva Drobna, Petr Bob, Vladimír Nosáľ
OBJECTIVES: The default mode resting state network (DMRSN) constitutes a circuit which is active in conditions when the subject is at rest. We tested the hypothesis that its function will be altered during unconsciousness. METHODS: Changes in the mean squared coherences in five conventional frequency bands (delta to gamma) in DMRSN during general anaesthesia (GA) were investigated in 39 patients. They were compared with the normal EEG of 86 alert subjects, severely abnormal EEG of 112 patients with dementia and/or encephalopathy, and the mathematical model of brain death...
August 5, 2017: Neuro Endocrinology Letters
https://www.readbyqxmd.com/read/28870587/the-value-of-midbrain-morphology-in-predicting-prognosis-in-chronic-disorders-of-consciousness-a-preliminary-ultrasound-study
#15
Antonino Chillura, Antonino Naro, Katia Micchia, Alessia Bramanti, Placido Bramanti, Rocco Salvatore Calabrò
Transcranial sonography (TCS) of the brainstem is currently used to support the clinical diagnosis of movement disorders. The aim of the study was to assess the usefulness of midbrain TCS in assessing outcome in patients with Chronic Disorders of Consciousness (DOC). Eleven patients with Minimally Conscious State (MCS) and Unresponsive Wakefulness Syndrome (UWS) were included in the study. We measured the area and echogenicity of the midbrain by encoding and digitally analyzing the corresponding images from the orbitomeatal plane, the morphology of brain parenchyma from the thalamic and cella media plane, and the intracranial circulation...
September 15, 2017: Journal of the Neurological Sciences
https://www.readbyqxmd.com/read/28867408/associations-between-a-history-of-traumatic-brain-injuries-and-conduct-disorder-during-youth-in-a-population-sample-of-canadian-adults
#16
Gabriela Ilie, Christine M Wickens, Evelyn R Vingilis, Robert E Mann, Hayley Hamilton, Maggie Toplak, Edward M Adlaf, Nathan Kolla, Anca R Ialomiteanu, Mark van der Mass, Mark Asbridge, Jürgen Rehm, Michael D Cusimano
This study describes the association between history of traumatic brain injury (TBI) and childhood symptoms of conduct disorder (CD). Data were based on telephone interviews with 6048 respondents derived from the 2011-2013 cycles of a representative cross-sectional survey of adults aged 18+ years in Ontario, Canada. TBI was defined as loss of consciousness for at least 5min or overnight hospitalization due to injury symptoms. Symptoms of CD before 15 years of age were assessed using five items based on the DSM-IV...
August 12, 2017: Psychiatry Research
https://www.readbyqxmd.com/read/28866718/hypersomnia-and-cognitive-impairment-in-a-patient-with-bipolar-disorder-a-case-report
#17
Katarzyna Szaulińska, Anna Antosik-Wójcińska, Ewa Paszkowska, Łukasz Święcicki, Marek Jarema, Adam Wichniak
OBJECTIVES: Obstructive sleep apnea (OSA) is a common clinical problem that can have serious health consequences and complicate the course of mental disorders. It is estimated that the prevalence of sleep apnea in patients with bipolar disorder can be 21-47.5%. Some symptoms of OSA are the same as the symptoms of depression: daytime drowsiness, cognitive dysfunction, decreased drive, apathy, depressed mood, anhedonia. METHODS: We present a case of a patient whose depressive symptoms persisted despite repeated changes of pharmacological treatment and were exacerbated by severe sleep disorder...
June 18, 2017: Psychiatria Polska
https://www.readbyqxmd.com/read/28865377/assessing-pain-in-patients-with-chronic-disorders-of-consciousness-are-we-heading-in-the-right-direction
#18
Antonino Naro, Placido Bramanti, Alessia Bramanti, Rocco Salvatore Calabrò
The deterioration of sensory-motor integration within the pain matrix in patients with chronic Disorders of Consciousness (DoC) is one of the principal mechanisms responsible for non-conscious pain perception. The present study aimed to assess whether the variability in the inter-peak interval (IPI) between the N2 and P2 components of laser evoked potentials (LEP) could represent an objective marker of the behavioral responsiveness to nociceptive stimulation, as measured by the Nociception Coma Scale-Revised (NCS-R), and regardless of the sensory part of pain processing...
August 30, 2017: Consciousness and Cognition
https://www.readbyqxmd.com/read/28860853/disability-from-posttraumatic-headache-is-compounded-by-coexisting-posttraumatic-stress-disorder
#19
Louise S Roper, Peter Nightingale, Zhangjie Su, James L Mitchell, Antonio Belli, Alexandra J Sinclair
BACKGROUND: Posttraumatic headache (PTH) occurs in up to 82% of patients with traumatic brain injury (TBI). Posttraumatic stress disorder (PTSD) occurs in 39% of those with PTH. This study evaluates whether PTSD affects PTH disability. METHODS: Eighty-six patients with TBI were prospectively evaluated in a secondary care trauma center. Headache disability was assessed using the Headache Impact Test version 6 and signs indicative of PTSD using the PTSD Check List Civilian version...
2017: Journal of Pain Research
https://www.readbyqxmd.com/read/28844345/the-effect-of-atomoxetine-a-selective-norepinephrine-reuptake-inhibitor-on-respiratory-arrest-and-cardiorespiratory-function-in-the-dba-1-mouse-model-of-sudep
#20
Haiting Zhao, Joseph F Cotten, Xiaoyan Long, Hua-Jun Feng
Sudden unexpected death in epilepsy (SUDEP) is a significant public health burden. The mechanisms of SUDEP are elusive, although cardiorespiratory dysfunction is a likely contributor. Clinical and animal studies indicate that seizure-induced respiratory arrest (S-IRA) is the primary event leading to death in many SUDEP cases. Our prior studies demonstrated that intraperitoneal (IP) injection of atomoxetine, a norepinephrine reuptake inhibitor (NRI) widely used to treat attention deficit hyperactivity disorder, suppresses S-IRA in DBA/1 mice...
August 22, 2017: Epilepsy Research
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