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https://www.readbyqxmd.com/read/27910995/a-diffusion-tensor-magnetic-resonance-imaging-study-of-paediatric-patients-with-severe-non-traumatic-brain-injury
#1
Erika Molteni, Maria A Rocca, Sandra Strazzer, Elisabetta Pagani, Katia Colombo, Filippo Arrigoni, Giacomo Boffa, Massimiliano Copetti, Valentina Pastore, Massimo Filippi
AIM: In this observational study using 3T magnetic resonance imaging (MRI) and diffusion tensor, we investigated the differential effects of pathology, stage of disease, state of consciousness, and aetiology on the modifications of supra- and infra-tentorial white matter tracts and their correlations with clinical scales in paediatric patients with severe non-traumatic brain injury. METHOD: Diffusion tensor magnetic resonance imaging (DT-MRI) was obtained from seven children with unresponsive wakefulness syndrome (UWS; five males, two females; age at event 5y; standard deviation [SD] 2y 1mo), six children in a minimally conscious state (MCS; three males, three females; age at event 5y 10mo; SD 5y), and 10 healthy children as controls(two males, eight females; age at study 10y 10mo; SD 2y 10mo)...
December 2, 2016: Developmental Medicine and Child Neurology
https://www.readbyqxmd.com/read/27857682/functional-connectivity-substrates-for-tdcs-response-in-minimally-conscious-state-patients
#2
Carlo Cavaliere, Marco Aiello, Carol Di Perri, Enrico Amico, Charlotte Martial, Aurore Thibaut, Steven Laureys, Andrea Soddu
Transcranial direct current stimulation (tDCS) is a non-invasive technique recently employed in disorders of consciousness, and determining a transitory recovery of signs of consciousness in almost half of minimally conscious state (MCS) patients. Although the rising evidences about its possible role in the treatment of many neurological and psychiatric conditions exist, no evidences exist about brain functional connectivity substrates underlying tDCS response. We retrospectively evaluated resting state functional Magnetic Resonance Imaging (fMRI) of 16 sub-acute and chronic MCS patients (6 tDCS responders) who successively received a single left dorsolateral prefrontal cortex (DLPFC) tDCS in a double-blind randomized cross-over trial...
2016: Frontiers in Cellular Neuroscience
https://www.readbyqxmd.com/read/27829654/minimally-conscious-state-evolution-of-concept-diagnosis-and-treatment
#3
Ricardo Hodelín-Tablada
The study of consciousness disorders is a scientific challenge, and clinical differentiation among the various sorts of alterations in consciousness is difficult. Persistent vegetative state was defined in 1972, but years later cases appeared in which diagnosed patients showed signs of cognitive activity, and therefore could not be considered vegetative. Minimally conscious state was defined in 2002. This article discusses minimally conscious state based on a literature review and the author's clinical experience...
October 2016: MEDICC Review
https://www.readbyqxmd.com/read/27812319/evaluating-the-effect-of-repetitive-transcranial-magnetic-stimulation-on-disorders-of-consciousness-by-using-tms-eeg
#4
Yang Bai, Xiaoyu Xia, Jiannan Kang, Xiaoxiao Yin, Yi Yang, Jianghong He, Xiaoli Li
Background: The modulation efficacy of Transcranial magnetic stimulation (TMS) on consciousness improvement of patient with disorder of consciousness (DOC) has not been definitely confirmed. Objective: This study proposes TMS-EEG to assess effects of repetitive TMS (rTMS) on brain modulation of DOC. Methods: Twenty sessions of 10 Hz rTMS were applied over the dorsolateral prefrontal cortex for a patient with DOC. Measures of Coma Recovery Scale-Revised (CRS-R) score, TMS-evoked potential (TEP), perturbation complexity index (PCI), and global mean field power (GMFP) were used to evaluate the consciousness level of the patient at three intervals: before the rTMS protocol (T0), immediately after one session rTMS (T1), and immediately after 20 sessions (T2)...
2016: Frontiers in Neuroscience
https://www.readbyqxmd.com/read/27810793/testing-the-significance-of-connectivity-networks-comparison-of-different-assessing-procedures
#5
Jlenia Toppi, Donatella Mattia, Monica Risetti, Rita Formisano, Fabio Babiloni, Laura Astolfi
: Despite the well-established use of partial directed coherence (PDC) to estimate interactions between brain signals, the assessment of its statistical significance still remains controversial. Commonly used approaches are based on the generation of empirical distributions of the null case, implying a considerable computational time, which may become a serious limitation in practical applications. Recently, rigorous asymptotic distributions for PDC were proposed. The aim of this work is to compare the performances of the asymptotic statistics with those of an empirical approach, in terms of both accuracy and computational time...
December 2016: IEEE Transactions on Bio-medical Engineering
https://www.readbyqxmd.com/read/27794486/changes-in-standard-eeg-parallel-consciousness-improvement-in-patients-with-unresponsive-wakefulness-syndrome
#6
Sergio Bagnato, Cristina Boccagni, Caterina Prestandrea, Alexander A Fingelkurts, Andrew A Fingelkurts, Giuseppe Galardi
OBJECTIVE: To identify changes in the standard electroencephalograms (EEGs) of patients with unresponsive wakefulness syndrome (UWS) who did or did not recover consciousness 6 months after admission to a rehabilitation department. DESIGN: Prospective cohort study. SETTING: Unit for Severe Acquired Brain Injuries. PARTICIPANTS: Twenty-eight consecutive patients with UWS. INTERVENTIONS: Not applicable...
October 26, 2016: Archives of Physical Medicine and Rehabilitation
https://www.readbyqxmd.com/read/27793075/does-modafinil-improve-the-level-of-consciousness-for-people-with-a-prolonged-disorder-of-consciousness-a-retrospective-pilot-study
#7
Samira Kashinath Dhamapurkar, Barbara A Wilson, Anita Rose, Peter Watson, Agnes Shiel
BACKGROUND AND AIM: Modafinil is best known as a sleep regulator among healthy individuals, but studies suggest that it reduces excessive daytime sleepiness in patients with brain injury. This retrospective pilot study evaluated the effectiveness of Modafinil for people with a prolonged disorder of consciousness and whether those with a traumatic brain injury did better than those with a non-traumatic brain injury. METHOD: Twenty four prolonged disorder of consciousness patients who were prescribed Modafinil, were assessed at least four times both before and during treatment...
October 28, 2016: Disability and Rehabilitation
https://www.readbyqxmd.com/read/27788615/the-impact-of-prolonged-disorders-of-consciousness-on-the-occupational-life-of-family-members
#8
Karen Elliott, Andrew McVicar
The impact of vegetative state (VS) and minimally conscious states (MCSs) on an individual is devastating. VS and MCSs may be transitional towards recovery, but may become permanent. Although devastating for the individual the nature of these conditions also has a profound effect on the family. This study examined the impact on the family member and the changes in the individuals' occupation. Six participants (spouses, partners or parents) were recruited to the study. Mixed methods were adopted to meet the requirements of the research and participants...
October 27, 2016: Neuropsychological Rehabilitation
https://www.readbyqxmd.com/read/27780215/return-to-work-a-cut-off-of-fim-gain-with-montebello-rehabilitation-factor-score-in-order-to-identify-predictive-factors-in-subjects-with-acquired-brain-injury
#9
Marco Franceschini, Maria Pia Massimiani, Stefano Paravati, Maurizio Agosti
Return to work (RTW) for people with acquired brain injury (ABI) represents a main objective of rehabilitation: this work presents a strong correlation between personal well-being and quality of life. The aim of this study is to investigate the prognostic factors that can predict RTW after ABI (traumatic or non- traumatic aetiology) in patients without disorders of consciousness (e.g. coma, vegetative or minimally conscious state) at the beginning of their admission to rehabilitation. At the end of a 6-month follow-up after discharge, data were successfully collected in 69 patients...
2016: PloS One
https://www.readbyqxmd.com/read/27773729/do-you-see-me-the-role-of-visual-fixation-in-chronic-disorders-of-consciousness-differential-diagnosis
#10
Antonino Naro, Antonino Leo, Antonio Buda, Alfredo Manuli, Alessia Bramanti, Placido Bramanti, Rocco Salvatore Calabrò
Visual fixation (VF) of a target is a possible, although atypical, feature of the Unresponsive Wakefulness Syndrome (UWS). Whether VF may indicate residual awareness in these patients is debatable, since it may simply subtend a series of reflex processes. Objective tools should therefore be used to identify aware VF, which depends on the integrity of visuomotor networks encompassing frontal-parietal-occipital areas. The aim of our study was to detect residual visuomotor network functionality potentially sustaining aware VF...
October 20, 2016: Brain Research
https://www.readbyqxmd.com/read/27770069/electromyographic-decoding-of-response-to-command-in-disorders-of-consciousness
#11
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...
November 15, 2016: Neurology
https://www.readbyqxmd.com/read/27748687/update-on-pharmacotherapy-for-stroke-and-traumatic-brain-injury-recovery-during-rehabilitation
#12
Joachim Liepert
PURPOSE OF REVIEW: This article evaluates whether specific drugs are able to facilitate motor recovery after stroke or improve the level of consciousness, cognitive, or behavioral symptoms after traumatic brain injury. RECENT FINDINGS: After stroke, serotonin reuptake inhibitors can enhance restitution of motor functions in depressed as well as in nondepressed patients. Erythropoietin and progesterone administered within hours after moderate to severe traumatic brain injury failed to improve the outcome...
December 2016: Current Opinion in Neurology
https://www.readbyqxmd.com/read/27740600/disorders-of-consciousness-painless-or-painful-conditions-evidence-from-neuroimaging-studies
#13
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
https://www.readbyqxmd.com/read/27739612/structural-and-functional-connectivity-of-the-precuneus-and-thalamus-to-the-default-mode-network
#14
Samantha I Cunningham, Dardo Tomasi, Nora D Volkow
Neuroimaging studies have identified functional interactions between the thalamus, precuneus, and default mode network (DMN) in studies of consciousness. However, less is known about the structural connectivity of the precuneus and thalamus to regions within the DMN. We used diffusion tensor imaging (DTI) to parcellate the precuneus and thalamus based on their probabilistic white matter connectivity to each other and DMN regions of interest (ROIs) in 37 healthy subjects from the Human Connectome Database. We further assessed resting-state functional connectivity (RSFC) among the precuneus, thalamus, and DMN ROIs...
October 14, 2016: Human Brain Mapping
https://www.readbyqxmd.com/read/27738996/the-neural-correlates-of-lexical-processing-in-disorders-of-consciousness
#15
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
https://www.readbyqxmd.com/read/27717082/stratification-of-unresponsive-patients-by-an-independently-validated-index-of-brain-complexity
#16
Silvia Casarotto, Angela Comanducci, Mario Rosanova, Simone Sarasso, Matteo Fecchio, Martino Napolitani, Andrea Pigorini, Adenauer G Casali, Pietro D Trimarchi, Melanie Boly, Olivia Gosseries, Olivier Bodart, Francesco Curto, Cristina Landi, Maurizio Mariotti, Guya Devalle, Steven Laureys, Giulio Tononi, Marcello Massimini
OBJECTIVE: Validating objective, brain-based indices of consciousness in behaviorally unresponsive patients represents a challenge due to the impossibility of obtaining independent evidence through subjective reports. Here we address this problem by first validating a promising metric of consciousness-the Perturbational Complexity Index (PCI)-in a benchmark population who could confirm the presence or absence of consciousness through subjective reports, and then applying the same index to patients with disorders of consciousness (DOCs)...
September 22, 2016: Annals of Neurology
https://www.readbyqxmd.com/read/27662495/acupuncture-increases-the-excitability-of-the-cortico-spinal-system-in-patients-with-chronic-disorders-of-consciousness-following-traumatic-brain-injury
#17
Jun Matsumoto-Miyazaki, Yoshitaka Asano, Shingo Yonezawa, Yuichi Nomura, Yuka Ikegame, Tatsuki Aki, Shunsuke Takenaka, Jun Shinoda
OBJECTIVE: To evaluate the immediate effect of acupuncture on cortico spinal tract (CST) activity in patients with chronic disorders of consciousness (DOC) after traumatic brain injury (TBI) by measuring motor-evoked potential (MEP) using transcranial magnetic stimulation (TMS). DESIGN: Changes in several variables in the acupuncture session were compared with those in the control session without acupuncture in the same patients. SETTING: Chubu Medical Center for Prolonged Traumatic Brain Dysfunction, Gifu, Japan...
November 2016: Journal of Alternative and Complementary Medicine: Research on Paradigm, Practice, and Policy
https://www.readbyqxmd.com/read/27644000/non-invasive-fecal-microbiota-transplantation-for-recurrent-clostridium-difficile-infection-in-a-patient-presenting-with-hypertensive-disorder-post-interventionem
#18
F Goeser, S Schlabe, C E Ruiner, L Kramer, C P Strassburg, U Spengler
Fecal microbiota transplantation has gathered much attention due to its high efficacy in resolving recurrent Clostridium difficile infection. Until today, it is recognized as a safe procedure without any severe side effects. Patients with impaired conscious states suffering from recurrent episodes of aspiration are at increased risk by endoscopic interventions needed during standard approaches for fecal microbiota transplantation application.Here, we illustrate the case of a tetraplegic patient undergoing fecal microbiota transplantation due to his fifth recurrent episode of Clostridium difficile infection using a self-advancing nasal jejunal feeding tube as effective minimal-invasive option of fecal microbiota transplantation application...
October 2016: Zeitschrift Für Gastroenterologie
https://www.readbyqxmd.com/read/27622575/disentangling-disorders-of-consciousness-insights-from-diffusion-tensor-imaging-and-machine-learning
#19
Zhong S Zheng, Nicco Reggente, Evan Lutkenhoff, Adrian M Owen, Martin M Monti
Previous studies have suggested that disorders of consciousness (DOC) after severe brain injury may result from disconnections of the thalamo-cortical system. However, thalamo-cortical connectivity differences between vegetative state (VS), minimally conscious state minus (MCS-, i.e., low-level behavior such as visual pursuit), and minimally conscious state plus (MCS+, i.e., high-level behavior such as language processing) remain unclear. Probabilistic tractography in a sample of 25 DOC patients was employed to assess whether structural connectivity in various thalamo-cortical circuits could differentiate between VS, MCS-, and MCS+ patients...
September 13, 2016: Human Brain Mapping
https://www.readbyqxmd.com/read/27595064/a-hierarchy-of-event-related-potential-markers-of-auditory-processing-in-disorders-of-consciousness
#20
Steve Beukema, Laura E Gonzalez-Lara, Paola Finoia, Evelyn Kamau, Judith Allanson, Srivas Chennu, Raechelle M Gibson, John D Pickard, Adrian M Owen, Damian Cruse
Functional neuroimaging of covert perceptual and cognitive processes can inform the diagnoses and prognoses of patients with disorders of consciousness, such as the vegetative and minimally conscious states (VS;MCS). Here we report an event-related potential (ERP) paradigm for detecting a hierarchy of auditory processes in a group of healthy individuals and patients with disorders of consciousness. Simple cortical responses to sounds were observed in all 16 patients; 7/16 (44%) patients exhibited markers of the differential processing of speech and noise; and 1 patient produced evidence of the semantic processing of speech (i...
2016: NeuroImage: Clinical
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