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minimally consciousness state

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https://www.readbyqxmd.com/read/28102097/familiar-auditory-sensory-training-in-chronic-traumatic-brain-injury-a-case-study
#1
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
#2
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 non-benzodiazepine 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 (MCS). There is little information on its use in DOC patients with intracranial space occupying lesions. We present a case of a 24year old man in a MCS due to CNS lymphoma who was observed to have increased arousal and improved motor function following administration of zolpidem...
January 13, 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
#3
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
#4
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
#5
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
https://www.readbyqxmd.com/read/28007989/cad-mutations-and-uridine-responsive-epileptic-encephalopathy
#6
Johannes Koch, Johannes A Mayr, Bader Alhaddad, Christian Rauscher, Jörgen Bierau, Reka Kovacs-Nagy, Karlien L M Coene, Ingrid Bader, Monika Holzhacker, Holger Prokisch, Hanka Venselaar, Ron A Wevers, Felix Distelmaier, Tilman Polster, Steffen Leiz, Cornelia Betzler, Tim M Strom, Wolfgang Sperl, Thomas Meitinger, Saskia B Wortmann, Tobias B Haack
Unexplained global developmental delay and epilepsy in childhood pose a major socioeconomic burden. Progress in defining the molecular bases does not often translate into effective treatment. Notable exceptions include certain inborn errors of metabolism amenable to dietary intervention. CAD encodes a multifunctional enzyme involved in de novo pyrimidine biosynthesis. Alternatively, pyrimidines can be recycled from uridine. Exome sequencing in three families identified biallelic CAD mutations in four children with global developmental delay, epileptic encephalopathy, and anaemia with anisopoikilocytosis...
December 21, 2016: Brain: a Journal of Neurology
https://www.readbyqxmd.com/read/28007704/police-officer-in-minimally-conscious-state-should-be-allowed-to-die-says-judge
#7
Clare Dyer
No abstract text is available yet for this article.
December 22, 2016: BMJ: British Medical Journal
https://www.readbyqxmd.com/read/27986800/a-matter-of-life-and-death-controversy-at-the-interface-between-clinical-and-legal-decision-making-in-prolonged-disorders-of-consciousness
#8
Lynne Turner-Stokes
Best interests decision-making and end-of-life care for patients in permanent vegetative or minimally conscious states (VS/MCS) is a complex area of clinical and legal practice, which is poorly understood by most clinicians, lawyers and members of the public. In recent weeks, the Oxford Shrieval lecture by Mr Justice Baker ('A Matter of Life and Death', 11 October 2016) and its subsequent reporting in the public press has sparked debate on the respective roles of clinicians, the Court of Protection and the Mental Capacity Act 2005 in decisions to withhold or withdraw life-sustaining treatments from patients with disorders of consciousness...
December 16, 2016: Journal of Medical Ethics
https://www.readbyqxmd.com/read/27973398/microbiological-quality-of-fresh-nopal-juice
#9
Ana María Hernández-Anguiano, Patricia Landa-Salgado, Carlos Alberto Eslava-Campos, Mateo Vargas-Hernández, Jitendra Patel
The consumption of fresh nopal cactus juice is widely popular among health-conscious consumers in Mexico. The juice is prepared from fresh cladodes that have only been rinsed with tap water and are not subjected to a pasteurization or terminal bacterial reduction process. The aim of this study was to evaluate the microbial quality of commercially available fresh juices (n = 162) made with nopal in Texcoco, State of Mexico, during the summer and spring season. Standard microbiological methods, the PCR technique and the serological method were used for isolation and identification of bacteria...
December 10, 2016: Microorganisms
https://www.readbyqxmd.com/read/27958328/distinct-interactions-between-fronto-parietal-and-default-mode-networks-in-impaired-consciousness
#10
Jinyi Long, Qiuyou Xie, Qing Ma, M A Urbin, Liqing Liu, Ling Weng, Xiaoqi Huang, Ronghao Yu, Yuanqing Li, Ruiwang Huang
Existing evidence suggests that the default-mode network (DMN) and fronto-pariatal network (FPN) play an important role in altered states of consciousness. However, the brain mechanisms underlying impaired consciousness and the specific network interactions involved are not well understood. We studied the topological properties of brain functional networks using resting-state functional MRI data acquired from 18 patients (11 vegetative state/unresponsive wakefulness syndrome, VS/UWS, and 7 minimally conscious state, MCS) and compared these properties with those of healthy controls...
December 13, 2016: Scientific Reports
https://www.readbyqxmd.com/read/27936939/a-study-of-the-internal-construct-and-predictive-validity-of-the-smart-assessment-for-emergence-from-vegetative-state
#11
A Tennant, H Gill-Thwaites
OBJECTIVE: The Sensory Modality Assessment and Rehabilitation Technique (SMART) was developed to assess the levels of awareness, functional, sensory and communicative abilities of adults in vegetative (VS) or minimally-conscious states following severe brain injury. The current study seeks to ascertain if a total score can be derived from the individual assessments contained within SMART and to test the internal construct and predictive validity of that total score. SUBJECTS: Persons in VS were recruited over a 3-year period and current status was determined after a 17-year follow-up...
December 12, 2016: Brain Injury: [BI]
https://www.readbyqxmd.com/read/27930506/change-of-ascending-reticular-activating-system-with-recovery-from-vegetative-state-to-minimally-conscious-state-in-a-stroke-patient
#12
Sung Ho Jang, Chul Hoon Chang, Young Jin Jung, You Sung Seo
RATIONALE: We report on a stroke patient who showed change of the ascending reticular activating system (ARAS) concurrent with recovery from a vegetative state (VS) to a minimally conscious state (MCS), which was demonstrated on diffusion tensor tractography (DTT). PATIENT CONCERNS: A 59-year-old male patient underwent CT-guided stereotactic drainage 3 times for management of intracerebral hemorrhage and intraventricular hemorrhage. DIAGNOSIS: After 4 months from onset, when starting rehabilitation, the patient showed impaired consciousness, with a Glasgow Coma Scale (GCS) score of 6 and a Coma Recovery Scale-Revised score of 2...
December 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27910995/a-diffusion-tensor-magnetic-resonance-imaging-study-of-paediatric-patients-with-severe-non-traumatic-brain-injury
#13
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)...
February 2017: Developmental Medicine and Child Neurology
https://www.readbyqxmd.com/read/27857682/functional-connectivity-substrates-for-tdcs-response-in-minimally-conscious-state-patients
#14
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
#15
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
#16
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
#17
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
#18
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
#19
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
#20
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
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