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Disorder of consciousness

Jitka Annen, Séverine Blandiaux, Nicolas Lejeune, Mohamed A Bahri, Aurore Thibaut, Woosang Cho, Christoph Guger, Camille Chatelle, Steven Laureys
Detection and interpretation of signs of "covert command following" in patients with disorders of consciousness (DOC) remains a challenge for clinicians. In this study, we used a tactile P3-based BCI in 12 patients without behavioral command following, attempting to establish "covert command following." These results were then confronted to cerebral metabolism preservation as measured with glucose PET (FDG-PET). One patient showed "covert command following" (i.e., above-threshold BCI performance) during the active tactile paradigm...
2018: Frontiers in Neuroscience
Eva-Maria Kurz, Guilherme Wood, Silvia Erika Kober, Walter Schippinger, Gerald Pichler, Gernot Müller-Putz, Günther Bauernfeind
BACKGROUND: Recently, fNIRS has been proposed as a promising approach for awareness detection, and a possible method to establish basic communication in patients with disorders of consciousness (DOC). AIM: Using fNIRS, the present study evaluated the applicability of auditory presented mental-arithmetic tasks in this respect. METHODS: We investigated the applicability of active attention to serial subtractions for awareness detection in ten healthy controls (HC, 21-32 y/o), by comparing the measured patterns to patterns induced by self-performance of the same task...
June 14, 2018: Brain and Cognition
Francesco Corallo, Viviana Lo Buono, Marcella Di Cara, Simona De Salvo, Giuliana Vermiglio, Patrizia Pollicino, Placido Bramanti, Silvia Marino, Carmela Rifici
Epilepsy is a neurological disorder characterized by recurrent and unpredictable interruptions of normal brain function, that implies neurobiologic, psychological, and social consequences. Non-convulsive status epilepticus (NCSE) is an electro-clinical state associated to altered level of consciousness. In NCSE could occur the behavioural and emotional disorder, cognitive impairment and psychiatric disorder with a negative impact on quality of life and adaptive social behaviours. Cognitive rehabilitation for epileptic patients may include internal compensation strategies, external memory aids, psychoeducation, verbal and visual memory training, attention exercise and executive functions...
June 13, 2018: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
Aydin Farajidavar
Gastric peristalsis is initiated and coordinated by an underlying bioelectrical activity, termed slow waves. High-resolution (HR) mapping of the slow waves has become a fundamental tool for accurately defining electrophysiological properties in gastroenterology, including dysrhythmias in gastric disorders such as gastroparesis and functional dyspepsia. Currently, HR mapping is achieved via acquisition of slow waves taken directly from the serosa of fasted subjects undergoing invasive abdominal surgery. Recently, a minimally invasive retractable catheter and electrode has been developed for HR mapping that can only be used in short-term studies in subjects undergoing laparoscopy...
August 15, 2018: Brain Research
Xinxin Ma, Wen Su, Haibo Chen
RATIONALE: Reversible splenial lesion syndrome (RESLES) is a reversible condition with an excellent prognosis in most patients. The clinical features include altered states of consciousness, delirium, headache, and seizures, but no callosal disconnection syndromes have been described in RESLES. PATIENT CONCERNS: We presented a 57-year-old patient with alien hand syndrome, autotopagnosia, gait disorders, and left ideomotor apraxia after blood transfusion. The brain magnetic resonance imaging (MRI) showed a few regions with high signal intensity in the genu, body, and splenium of the right corpus callosum on diffusion weighted images...
June 2018: Medicine (Baltimore)
Samira Kashinath Dhamapurkar, Barbara A Wilson, Anita Rose, Gerhard Florschutz, Peter Watson, Agnes Shiel
BACKGROUND & OBJECTIVE: Patients with brain injury are at high risk for infections. Although infection and cognitive deterioration are established for people with dementia, this has not been shown for patients with a prolonged disorder of consciousness (PDOC). This study determines whether regular Wessex Head Injury Matrix (WHIM) assessments can identify early signs of infections in patients with PDOC. METHOD: Retrospective and prospective approaches were used to assess the WHIM scores of patients with a PDOC (N = 21 in the retrospective study and 22 in the prospective study)...
June 12, 2018: Brain Injury: [BI]
Sahib S Khalsa, Ralph Adolphs, Oliver G Cameron, Hugo D Critchley, Paul W Davenport, Justin S Feinstein, Jamie D Feusner, Sarah N Garfinkel, Richard D Lane, Wolf E Mehling, Alicia E Meuret, Charles B Nemeroff, Stephen Oppenheimer, Frederike H Petzschner, Olga Pollatos, Jamie L Rhudy, Lawrence P Schramm, W Kyle Simmons, Murray B Stein, Klaas E Stephan, Omer Van den Bergh, Ilse Van Diest, Andreas von Leupoldt, Martin P Paulus
Interoception refers to the process by which the nervous system senses, interprets, and integrates signals originating from within the body, providing a moment-by-moment mapping of the body's internal landscape across conscious and unconscious levels. Interoceptive signaling has been considered a component process of reflexes, urges, feelings, drives, adaptive responses, and cognitive and emotional experiences, highlighting its contributions to the maintenance of homeostatic functioning, body regulation, and survival...
June 2018: Biological Psychiatry: Cognitive Neuroscience and Neuroimaging
Rodrigo Bainy Leal, Mark William Lopes, Douglas Affonso Formolo, Cristiane Ribeiro de Carvalho, Alexandre Ademar Hoeller, Alexandra Latini, Daniel Santos Sousa, Peter Wolf, Rui Daniel Prediger, Zuner Assis Bortolotto, Marcelo Neves Linhares, Kátia Lin, Roger Walz
Fear is a conscious state caused by exposure to real or imagined threats that trigger stress responses that affect the body and brain, particularly limbic structures. A sub-group of patients with mesial temporal lobe epilepsy related to hippocampus sclerosis (MTLE-HS) have seizures with fear, which is called ictal fear (IF), due to epileptic activity within the brain defensive survival circuit structures. Synaptic transmission efficacy can be bi-directionally modified through potentiation (long-term potentiation (LTP)) or depression (long-term depression (LTD)) as well as the phosphorylation state of Ser831 and Ser845 sites at the GluA1 subunit of the glutamate AMPA receptors, which has been characterized as a critical event for this synaptic plasticity...
June 7, 2018: Molecular Psychiatry
Mohamed Adnane Berdai, Smael Labib, Mustapha Harandou
Neurological manifestations of preeclampsia are serious and very variable. We report the case of a woman at 34 weeks gestation with preeclampsia who developed blindness within hours without alteration of consciousness. The imagery was in favor of posterior reversible encephalopathy. The therapeutic management consisted of emergency fetal extraction, the administration of antihypertensive drugs and magnesium sulfate. The outcome was favorable with complete recovery of visual function. This case reflects the heterogeneity of the clinical presentation of preeclampsia, as the only neurological manifestation was cortical blindness, with no associated consciousness disorder...
December 2017: La Tunisie Médicale
Jun Xiao, Qiuyou Xie, Qing Lin, Tianyou Yu, Ronghao Yu, Yuanqing Li
Visual pursuit assessment is extensively applied in the behavioral scale-based clinical examination of patients with disorders of consciousness (DOC). However, this assessment is challenging because it relies on behavioral markers, and these patients severely lack behavioral responses. Brain-computer interfaces (BCIs) may provide a potential solution to detect brain responses to external stimuli without requiring behavioral expressions. A BCI system was designed to simulate visual pursuit detection in the coma recovery scale-revised (CRS-R)...
June 2018: IEEE Transactions on Neural Systems and Rehabilitation Engineering
Motofumi Tosa, Masako Aihara, Junko Murakami
A 78-year-old man had a fever and exhibited disordered consciousness, which led to his transportation to our hospital. On arrival, he exhibited discharge from the ear. Because extended-spectrum beta-lactamase (ESBL)-producing Escherichia coli was detected in the ear discharge and cerebrospinal fluid specimens, it was inferred to be the causal bacteria. Pulsed-field gel electrophoresis indicated the same ESBL-producing E. coli pattern in the patient's ear discharge, external auditory canal granulation, cerebrospinal fluid, and stool, indicating their common molecular epidemiological origin...
June 6, 2018: Internal Medicine
Anselme Alfred Dabilgou, Julie Marie Adeline Kyelem
Vascular arteriovenous malformations (VAM) are aggressive vascular diseases associated with increased haemorrhagic risk in terms of morbidity and mortality. Vascular arteriovenous malformations are usually sporadic. The main symptom of VAM is hemorrhage, in 50% of cases. We here report the case of a 28 year old patient, hospitalized with right sided motor deficit of acute onset associated with consciousness disorder in the Department of Neurology at the Yalgado Ouédraogo University Hospital Center. The patient had a history of chronic headaches treated with self-medication and of right Bravais-Jacksonian seizures...
2018: Pan African Medical Journal
Yonas Raru, Fuad Zeid
Valproic acid (VPA) is widely used for the treatment of epilepsy, migraine, and a variety of psychiatric symptoms, including bipolar disorder, borderline personality disorder, and alcohol withdrawal. Valproate is associated with severe idiosyncratic adverse effects, the most notable being valproate-induced hyperammonemic encephalopathy (VHE). Topiramate is also a broad-spectrum anticonvulsant that is also extensively used for migraine prophylaxis, as a mood stabilizer, and for alcohol dependency. There is increased occurrence of VHE when valproate is used with other medications like phenytoin, phenobarbital, and topiramate...
2018: Respiratory Medicine Case Reports
Mohammed Rupawala, Hamid Dehghani, Samuel J E Lucas, Peter Tino, Damian Cruse
Qualitative clinical assessments of the recovery of awareness after severe brain injury require an assessor to differentiate purposeful behavior from spontaneous behavior. As many such behaviors are minimal and inconsistent, behavioral assessments are susceptible to diagnostic errors. Advanced neuroimaging tools can bypass behavioral responsiveness and reveal evidence of covert awareness and cognition within the brains of some patients, thus providing a means for more accurate diagnoses, more accurate prognoses, and, in some instances, facilitated communication...
2018: Frontiers in Neurology
Zachary D Threlkeld, Yelena G Bodien, Eric S Rosenthal, Joseph T Giacino, Alfonso Nieto-Castanon, Ona Wu, Susan Whitfield-Gabrieli, Brian L Edlow
Integrity of the default mode network (DMN) is believed to be essential for human consciousness. However, the effects of acute severe traumatic brain injury (TBI) on DMN functional connectivity are poorly understood. Furthermore, the temporal dynamics of DMN reemergence during recovery of consciousness have not been studied longitudinally in patients with acute severe TBI. We performed resting-state functional magnetic resonance imaging (rs-fMRI) to measure DMN connectivity in 17 patients admitted to the intensive care unit (ICU) with acute severe TBI and in 16 healthy control subjects...
May 12, 2018: Cortex; a Journal Devoted to the Study of the Nervous System and Behavior
Hanna B Cygan, Artur Marchewka, Ilona Kotlewska, Anna Nowicka
Previous studies indicate that autobiographical memory is impaired in individuals with autism spectrum disorder (ASD). Successful recollection of information referring to one's own person requires the intact ability to re-activate representation of the past self. In the current fMRI study we investigated process of conscious reflection on the present self, the past self, and a close-other in the ASD and typically developing groups. Significant inter-group differences were found in the Past-Self condition. In individuals with ASD, reflection on the past self was associated with additional engagement of the posterior cingulate and posterior temporal structures...
June 5, 2018: Journal of Autism and Developmental Disorders
Boris Kotchoubey, Yuri G Pavlov
A systematic search revealed 68 empirical studies of neurophysiological [EEG, event-related brain potential (ERP), fMRI, PET] variables as potential outcome predictors in patients with Disorders of Consciousness (diagnoses Unresponsive Wakefulness Syndrome [UWS] and Minimally Conscious State [MCS]). Data of 47 publications could be presented in a quantitative manner and systematically reviewed. Insufficient power and the lack of an appropriate description of patient selection each characterized about a half of all publications...
2018: Frontiers in Neurology
Ben J A Palanca, Hannah R Maybrier, Angela M Mickle, Nuri B Farber, R Edward Hogan, Emma R Trammel, J Wylie Spencer, Donald D Bohnenkamp, Troy S Wildes, ShiNung Ching, Eric Lenze, Mathias Basner, Max B Kelz, Michael S Avidan
Electroconvulsive therapy (ECT) employs the elective induction of generalizes seizures as a potent treatment for severe psychiatric illness. As such, ECT provides an opportunity to rigorously study the recovery of consciousness, reconstitution of cognition, and electroencephalographic (EEG) activity following seizures. Fifteen patients with major depressive disorder refractory to pharmacologic therapy will be enrolled (, NCT02761330). Adequate seizure duration will be confirmed following right unilateral ECT under etomidate anesthesia...
2018: Frontiers in Psychiatry
Jiahui Pan, Qiuyou Xie, Haiyun Huang, Yanbin He, Yuping Sun, Ronghao Yu, Yuanqing Li
For patients with disorders of consciousness (DOC), such as vegetative state (VS) and minimally conscious state (MCS), detecting and assessing the residual cognitive functions of the brain remain challenging. Emotion-related cognitive functions are difficult to detect in patients with DOC using motor response-based clinical assessment scales such as the Coma Recovery Scale-Revised (CRS-R) because DOC patients have motor impairments and are unable to provide sufficient motor responses for emotion-related communication...
2018: Frontiers in Human Neuroscience
Josep Dinarès-Ferran, Rupert Ortner, Christoph Guger, Jordi Solé-Casals
EEG-based Brain-Computer Interfaces (BCIs) are becoming a new tool for neurorehabilitation. BCIs are used to help stroke patients to improve the functional capability of the impaired limbs, and to communicate and assess the level of consciousness in Disorder of Consciousness (DoC) patients. BCIs based on a motor imagery paradigm typically require a training period to adapt the system to each user's brain, and the BCI then creates and uses a classifier created with the acquired EEG. The quality of this classifier relies on amount of data used for training...
2018: Frontiers in Neuroscience
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