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minimally consciousness state

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https://www.readbyqxmd.com/read/28325926/night-and-day-variations-of-sleep-in-patients-with-disorders-of-consciousness
#1
Malgorzata Wislowska, Renata Del Giudice, Julia Lechinger, Tomasz Wielek, Dominik P J Heib, Alain Pitiot, Gerald Pichler, Gabriele Michitsch, Johann Donis, Manuel Schabus
Brain injuries substantially change the entire landscape of oscillatory dynamics and render detection of typical sleep patterns difficult. Yet, sleep is characterized not only by specific EEG waveforms, but also by its circadian organization. In the present study we investigated whether brain dynamics of patients with disorders of consciousness systematically change between day and night. We recorded ~24 h EEG at the bedside of 18 patients diagnosed to be vigilant but unaware (Unresponsive Wakefulness Syndrome) and 17 patients revealing signs of fluctuating consciousness (Minimally Conscious State)...
March 21, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28325648/role-of-bromocriptine-in-multi-spectral-manifestations-of-traumatic-brain-injury
#2
Sunil Munakomi, Binod Bhattarai, Bijoy Mohan Kumar
PURPOSE: Despite the prevalence and cost of traumatic brain injury related disabilities, there is paucity in the literature on modern approaches to pharmacotherapy. Medications may promote recovery by enhancing some neurological functions without impacting others. Herein we discussed the role of bromocriptine in neurorehabilitation for patients with traumatic brain injury. METHODS: A cohort comprising of 36 selective nonsurgical cases of traumatic brain injury in minimally conscious state were enrolled in the study...
February 21, 2017: Chinese Journal of Traumatology, Zhonghua Chuang Shang za Zhi
https://www.readbyqxmd.com/read/28320187/repeated-transcranial-direct-current-stimulation-in-prolonged-disorders-of-consciousness-a-double-blind-cross-over-study
#3
Anna Estraneo, Angelo Pascarella, Pasquale Moretta, Orsola Masotta, Salvatore Fiorenza, Grazia Chirico, Emanuela Crispino, Vincenzo Loreto, Luigi Trojano
OBJECTIVE: To evaluate effects of 5 sessions of transcranial direct current stimulation (tDCS) over the left dorsolateral prefrontal cortex in patients with prolonged disorders of consciousness (DOC). METHODS: Seven patients in vegetative state (VS) and 6 in minimally conscious state (MCS), at ≥3months after brain injury, were randomized into two groups: group 1 received one week of active tDCS and 1week of sham stimulation, separated by 1 resting week; group 2 received active and sham stimulation in reverse order...
April 15, 2017: Journal of the Neurological Sciences
https://www.readbyqxmd.com/read/28281845/controlled-clinical-trial-of-repeated-prefrontal-tdcs-in-patients-with-chronic-minimally-conscious-state
#4
Aurore Thibaut, Sarah Wannez, Anne-Francoise Donneau, Camille Chatelle, Olivia Gosseries, Marie-Aurélie Bruno, Steven Laureys
OBJECTIVES: To assess the effects of repeated transcranial direct current stimulation (tDCS) sessions on the level of consciousness in chronic patients in minimally conscious state (MCS). METHODS: In this randomized double-blind sham-controlled crossover study, we enrolled 16 patients in chronic MCS. For 5 consecutive days, each patient received active or sham tDCS over the left prefrontal cortex (2 mA during 20 min). Consciousness was assessed with the Coma Recovery Scale-Revised (CRS-R) before the first stimulation (baseline), after each stimulation (day 1-day 5) and 1 week after the end of each session (day 12)...
March 10, 2017: Brain Injury: [BI]
https://www.readbyqxmd.com/read/28278590/evidence-of-altered-pressure-pain-thresholds-in-persons-with-disorders-of-consciousness-as-measured-by-the-nociception-coma-scale-italian-version
#5
Davide Sattin, Caroline Schnakers, Marco Pagani, Francesca Arenare, Guya Devalle, Fabrizio Giunco, GianBattista Guizzetti, Maurizio Lanfranchi, Ambra M Giovannetti, Venusia Covelli, Anna Bersano, Anna Nigri, Ludovico Minati, Davide Rossi Sebastiano, Eugenio Parati, MariaGrazia Bruzzone, Silvana Franceschetti, Matilde Leonardi
Pain assessment in patients with disorders of consciousness (DoC) is a controversial issue for clinicians, who require tools and standardised procedures for testing nociception in non-communicative patients. The aims of the present study were, first, to analyse the psychometric properties of the Italian version of the Nociception Coma Scale and, second, to evaluate pressure pain thresholds in a group of patients with DoC. The authors conducted a multi-centre study on 40 healthy participants and 60 DoC patients enrolled from six hospitals in Italy...
February 28, 2017: Neuropsychological Rehabilitation
https://www.readbyqxmd.com/read/28268619/an-audiovisual-bci-system-for-assisting-clinical-communication-assessment-in-patients-with-disorders-of-consciousness-a-case-study
#6
Fei Wang, Yanbin He, Jun Qu, Qiuyou Xie, Qing Lin, Xiaoxiao Ni, Yan Chen, Ronghao Yu, Chin-Teng Lin, Yuanqing Li
The JFK Coma Recovery Scale-Revised (JFK CRS-R), a behavioral scale, is often used for clinical assessments of patients with disorders of consciousness (DOC), such as patients in a vegetative state. However, there has been a high rate of clinical misdiagnosis with the JFK CRS-R because patients with severe brain injures cannot provide sufficient behavioral responses. It is particularly difficult to evaluate the communication function in DOC patients using the JFK CRS-R because a higher level of behavioral responses is needed for communication assessments than for many other assessments, such as an auditory startle assessment...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28239544/measures-of-metabolism-and-complexity-in-the-brain-of-patients-with-disorders-of-consciousness
#7
Olivier Bodart, Olivia Gosseries, Sarah Wannez, Aurore Thibaut, Jitka Annen, Melanie Boly, Mario Rosanova, Adenauer G Casali, Silvia Casarotto, Giulio Tononi, Marcello Massimini, Steven Laureys
BACKGROUND: Making an accurate diagnosis in patients with disorders of consciousness remains challenging. (18)F-fluorodeoxyglucose (FDG)-PET has been validated as a diagnostic tool in this population, and allows identifying unresponsive patients with a capacity for consciousness. In parallel, the perturbational complexity index (PCI), a new measure based on the analysis of the electroencephalographic response to transcranial magnetic stimulation, has also been suggested as a tool to distinguish between unconscious and conscious states...
2017: NeuroImage: Clinical
https://www.readbyqxmd.com/read/28226799/an-audiovisual-bci-system-for-assisting-clinical-communication-assessment-in-patients-with-disorders-of-consciousness-a-case-study
#8
Fei Wang, Yanbin He, Jun Qu, Qiuyou Xie, Qing Lin, Xiaoxiao Ni, Yan Chen, Ronghao Yu, Chin-Teng Lin, Yuanqing Li, Fei Wang, Yanbin He, Jun Qu, Qiuyou Xie, Qing Lin, Xiaoxiao Ni, Yan Chen, Ronghao Yu, Chin-Teng Lin, Yuanqing Li, Chin-Teng Lin, Fei Wang, Ronghao Yu, Jun Qu, Yan Chen, Yanbin He, Qiuyou Xie, Yuanqing Li, Xiaoxiao Ni, Qing Lin
The JFK Coma Recovery Scale-Revised (JFK CRS-R), a behavioral scale, is often used for clinical assessments of patients with disorders of consciousness (DOC), such as patients in a vegetative state. However, there has been a high rate of clinical misdiagnosis with the JFK CRS-R because patients with severe brain injures cannot provide sufficient behavioral responses. It is particularly difficult to evaluate the communication function in DOC patients using the JFK CRS-R because a higher level of behavioral responses is needed for communication assessments than for many other assessments, such as an auditory startle assessment...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28222568/severe-disorders-of-consciousness-after-acquired-brain-injury-a-single-centre-long-term-follow-up-study
#9
Alex Lopez-Rolon
OBJECTIVES: To assess long-term clinical outcome, functional independence and health-related quality of life (HRQOL) in acquired brain injury (ABI) patients with a disorder of consciousness at admission to inpatient rehabilitation. METHODS: We selected patients from a cohort of ABI patients from a single centre. In addition to mortality, we measured level of consciousness with the Coma Remission Scale, functional independence with the Barthel Index, as well as generic and condition-specific HRQOL with the EQ5D and the "Quality of Life after Brain Injury" (QOLIBRI) respectively...
February 10, 2017: NeuroRehabilitation
https://www.readbyqxmd.com/read/28178070/prolonged-changes-in-amyloid-%C3%AE-metabolism-after-a-severe-traumatic-brain-injury
#10
Sergio Bagnato, Maria Andriolo, Cristina Boccagni, Giuseppe Galardi
Traumatic brain injury (TBI) is a major risk factor for Alzheimer's disease. Recent studies suggest that amyloid-beta (Aβ) deposit can be detected several years after TBI. However, it is unknown whether post-TBI Aβ deposits arise from short-term changes in Aβ metabolism or reflect a long-term sequela. To answer this question, we evaluated the cerebrospinal levels of Aβ several months after a severe TBI. The participants of this study were eight consecutive patients who developed a disorder of consciousness after a TBI, including seven in a minimally conscious state and one with unresponsive wakefulness syndrome (mean age: 35...
February 7, 2017: Neuroreport
https://www.readbyqxmd.com/read/28160751/pain-perception-in-patients-with-chronic-disorders-of-consciousness-what-can-limbic-system-tell-us
#11
Rocco Salvatore Calabrò, Antonino Naro, Alfredo Manuli, Antonino Leo, Rosaria De Luca, Viviana Lo Buono, Margherita Russo, Alessia Bramanti, Placido Bramanti
OBJECTIVE: Although it is believed that patients with Unresponsive Wakefulness Syndrome (UWS) do not feel pain, recent neuroimaging and neurophysiologic studies have demonstrated some residual traces of nociceptive processing. METHODS: To confirm this growing evidence, we evaluated 21 patients suffering from chronic disorders of consciousness (DOC) (both UWS, n=11, and Minimally Conscious State - MCS -, n=10), using an Event-Related Potential (ERP) Low-Resolution Brain Electromagnetic Tomography (LORETA) approach, based on nociceptive repeated laser stimulation (RLS)...
December 29, 2016: Clinical Neurophysiology: Official Journal of the International Federation of Clinical Neurophysiology
https://www.readbyqxmd.com/read/28147246/spinal-cord-stimulation-modulates-frontal-delta-and-gamma-in-patients-of-minimally-consciousness-state
#12
Yang Bai, Xiaoyu Xia, Xiaoli Li, Yong Wang, Yi Yang, Yangfeng Liu, Zhenhu Liang, Jianghong He
Spinal cord stimulation (SCS) has been suggested as a therapeutic technique for treating patients with disorder of consciousness (DOC). Although studies have reported its benefits for patients, the underlying pathophysiological mechanisms remain unclear. The aim of this study was to measure the effects of SCS on the EEG of patients in a minimally conscious state (MCS), which would allow us to explore the possible workings underpinning of the approach. Resting state EEG was recorded before and immediately after SCS, using various frequencies (5Hz, 20Hz, 50Hz, 70Hz and 100Hz), for 11 patients in MCS...
January 29, 2017: Neuroscience
https://www.readbyqxmd.com/read/28120050/spinal-cord-stimulation-for-vegetative-state-and-minimally-conscious-state-changes-in-consciousness-level-and-motor-function
#13
Takamitsu Yamamoto, Mitsuru Watanabe, Toshiki Obuchi, Kazutaka Kobayashi, Hideki Oshima, Chikashi Fukaya, Atsuo Yoshino
Twenty-one vegetative state (VS) patients and 10 minimally conscious state (MCS) patients were treated by spinal cord stimulation (SCS) following an electrophysiological evaluation 3 months or more after the onset of brain injury.A flexible four-contact cylindrical electrode was inserted into the epidural space of the cervical vertebrae, and placed at cervical levels C2-C4. Five-hertz stimulation was applied for 5 min every 30 min during the daytime at an intensity that produced muscle twitches of the upper extremities...
2017: Acta Neurochirurgica. Supplement
https://www.readbyqxmd.com/read/28120048/recovery-from-chronic-diseases-of-consciousness-state-of-the-art-in-neuromodulation-for-persistent-vegetative-state-and-minimally-conscious-state
#14
Pier Paolo Mattogno, Giuseppe Barbagallo, Gerardo Iacopino, Gaetano Pappalardo, Giuseppe LA Rocca, Francesco Signorelli, Jun Zhong, Massimiliano Visocchi
Chronic diseases of consciousness (CDC) can still be considered a challenging frontier for modern medicine, probably because of their not completely understood physiopathological mechanisms. Following encouraging evidence on cerebral hemodynamics, some authors have hypothesized a role for neuromodulation in the treatment of CDC patients. In the past 40 years, spinal cord stimulation (SCS) and deep brain stimulation (DBS) have been used experimentally for the treatment of patients in a severe altered state of consciousness, with some interesting but not conclusive results...
2017: Acta Neurochirurgica. Supplement
https://www.readbyqxmd.com/read/28113255/testing-the-significance-of-connectivity-networks-comparison-of-different-assessing-procedures
#15
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...
October 26, 2016: IEEE Transactions on Bio-medical Engineering
https://www.readbyqxmd.com/read/28102097/familiar-auditory-sensory-training-in-chronic-traumatic-brain-injury-a-case-study
#16
Emily Galassi Sullivan, Ann Guernon, Brett Blabas, Amy A Herrold, Theresa L-B Pape
PURPOSE: The evaluation and treatment for patients with prolonged periods of seriously impaired consciousness following traumatic brain injury (TBI), such as a vegetative or minimally conscious state, poses considerable challenges, particularly in the chronic phases of recovery. METHOD: This blinded crossover study explored the effects of familiar auditory sensory training (FAST) compared with a sham stimulation in a patient seven years post severe TBI. Baseline data were collected over 4 weeks to account for variability in status with neurobehavioral measures, including the Disorders of Consciousness scale (DOCS), Coma Near Coma scale (CNC), and Consciousness Screening Algorithm...
January 19, 2017: Disability and Rehabilitation
https://www.readbyqxmd.com/read/28093373/improved-arousal-and-motor-function-using-zolpidem-in-a-patient-with-space-occupying-intracranial-lesions-a-case-report
#17
Martin Nicholas Bomalaski, Sean Robinson Smith
Patients with disorders of consciousness (DOC) have profound functional limitations with few treatment options for improving arousal and quality of life. Zolpidem is a nonbenzodiazepine hypnotic used to treat insomnia that has also been observed to paradoxically improve arousal in those with DOC, such as the vegetative or minimally conscious states. Little information exists on its use in patients with DOC who have intracranial space-occupying lesions. We present a case of a 24-year-old man in a minimally conscious states due to central nervous system lymphoma who was observed to have increased arousal and improved motor function after the administration of zolpidem...
January 16, 2017: PM & R: the Journal of Injury, Function, and Rehabilitation
https://www.readbyqxmd.com/read/28059800/twist-and-turn-into-chronic-disorders-of%C3%A2-consciousness-potential-role-of%C3%A2-the%C3%A2-auditory-stapedial-reflex
#18
Antonino Naro, Rocco Bruno, Antonino Leo, Margherita Russo, Carlo Salviera, Alessia Bramanti, Placido Bramanti, Rocco Salvatore Calabrò
BACKGROUND: Patients suffering from chronic disorders of consciousness (DOC), including minimally conscious state (MCS) and unresponsive wakefulness syndrome (UWS), typically show an awareness impairment paralleled by a significant reflex hyper-excitability, which depend on the cortical deafferentation following brain-damage-induced thalamocortical system deterioration. Nonetheless, recent studies have shown a residual preservation of cortico-subcortical pathways that may sustain residual fragments of awareness in some DOC patients...
January 3, 2017: Restorative Neurology and Neuroscience
https://www.readbyqxmd.com/read/28041983/basic-discriminative-and-semantic-processing-in-patients-in-the-vegetative-and-minimally-conscious-state
#19
Helena Erlbeck, Ruben G L Real, Boris Kotchoubey, Donatella Mattia, Jakob Bargak, Andrea Kübler
Patients who survive injuries to the brain following accidents or diseases often acquire a disorder of consciousness (DOC). Assessment of the state of consciousness in these patients is difficult since they are usually incapable of reproducible motor movements. The application of event-related potentials (ERP) recorded via EEG constitutes one promising approach to complement the assessment of cognitive functions in DOC patients. For these assessments, a hierarchical approach was suggested which means that paradigms aiming at higher order ERPs are only presented if early responses were found...
December 30, 2016: International Journal of Psychophysiology
https://www.readbyqxmd.com/read/28009244/neuroethics-and-disorders-of-consciousness-discerning-brain-states-in-clinical-practice-and-research
#20
Joseph J Fins
Decisions about end-of-life care and participation in clinical research for patients with disorders of consciousness begin with diagnostic discernment. Accurately distinguishing between brain states clarifies clinicians' ethical obligations and responsibilities. Central to this effort is the obligation to provide neuropalliative care for patients in the minimally conscious state who can perceive pain and to restore functional communication through neuroprosthetics, drugs, and rehabilitation to patients with intact but underactivated neural networks...
December 1, 2016: AMA Journal of Ethics
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