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Disorder of consciousness

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https://www.readbyqxmd.com/read/29050394/cortical-neurons-and-networks-are-dormant-but-fully-responsive-during-isoelectric-brain-state
#1
Tristan Altwegg-Boussac, Adrien E Schramm, Jimena Ballestero, Fanny Grosselin, Mario Chavez, Sarah Lecas, Michel Baulac, Lionel Naccache, Sophie Demeret, Vincent Navarro, Séverine Mahon, Stéphane Charpier
A continuous isoelectric electroencephalogram reflects an interruption of endogenously-generated activity in cortical networks and systematically results in a complete dissolution of conscious processes. This electro-cerebral inactivity occurs during various brain disorders, including hypothermia, drug intoxication, long-lasting anoxia and brain trauma. It can also be induced in a therapeutic context, following the administration of high doses of barbiturate-derived compounds, to interrupt a hyper-refractory status epilepticus...
September 1, 2017: Brain: a Journal of Neurology
https://www.readbyqxmd.com/read/29047318/spontaneous-spinal-epidural-hemorrhage-following-disseminated-intravascular-coagulation-resulting-in-paraplegia-a-case-report
#2
Nazia Dildar, Saeed Bin Ayaz, Muhammad Omer Aamir, Nadeem Ahmad
CONTEXT: Spontaneous spinal epidural hemorrhage (SSEH) mostly presents as low back pain with or without a radiculopathy, and rarely with paraplegia or tetraplegia depending on the site and severity of spinal cord compression. We present here a case who had anemia and developed paraplegia following disseminated intravascular coagulation (DIC) due to a transfusion reaction. FINDINGS: A 65-year-old lady presented with sudden onset chest pain radiating to nape of the neck followed by loss of sensations and power in legs few hours after a blood transfusion...
October 19, 2017: Journal of Spinal Cord Medicine
https://www.readbyqxmd.com/read/29042641/unconscious-avoidance-of-eye-contact-in-autism-spectrum-disorder
#3
Apoorva Rajiv Madipakkam, Marcus Rothkirch, Isabel Dziobek, Philipp Sterzer
Atypical responses to direct gaze are one of the most characteristic hallmarks of autism spectrum disorder (ASD). The cause and mechanism underlying this phenomenon, however, have remained unknown. Here we investigated whether the atypical responses to eye gaze in autism spectrum disorder is dependent on the conscious perception of others' faces. Face stimuli with direct and averted gaze were rendered invisible by interocular suppression and eye movements were recorded from participants with ASD and an age and sex matched control group...
October 17, 2017: Scientific Reports
https://www.readbyqxmd.com/read/29042005/analysis-of-italian-regulations-on-pathways-of-care-for-patients-in-a-vegetative-or-minimally-conscious-state
#4
D Sattin, L De Torres, G Dolce, Francesco Arcuri, Anna Estraneo, V Cardinale, R Piperno, E Zavatta, Rita Formisano, Mariagrazia D'Ippolito, C Vassallo, B Dessi, G Lamberti, E Antoniono, C Lanzillotti, J Navarro, P Bramanti, Silvia Marino, M Zampolini, F Scarponi, R Avesani, L Salvi, S Ferro, L Mazza, P Fogar, S Feller, F De Nigris, A Martinuzzi, M Buffoni, A Pessina, P Corsico, M Leonardi
Different rehabilitation models for persons diagnosed with disorders of consciousness have been proposed in Europe during the last decade. In Italy, the Ministry of Health has defined a national healthcare model, although, to date, there is a lack of information on how this has been implemented at regional level. The INCARICO project collected information on different regional regulations, analysing ethical aspects and mapping care facilities (numbers of beds and medical units) in eleven regional territories...
July 2017: Functional Neurology
https://www.readbyqxmd.com/read/29042001/recovery-from-vegetative-state-of-patients-with-a-severe-brain-injury-a-4-year-real-practice-prospective-cohort-study
#5
Alessio Baricich, A de Sire, E Antoniono, F Gozzerino, G Lamberti, C Cisari, M Invernizzi
Patients who have suffered severe traumatic or nontraumatic brain injuries can show a progressive recovery, transitioning through a range of clinical conditions. They may progress from coma to a vegetative state (VS) and/or a minimally conscious state (MCS). A longer duration of the VS is known to be related to a lower probability of emergence from it; furthermore, the literature seems to lack evidence of late improvements in these patients. This real-practice prospective cohort study was conducted in inpatients in a VS following a severe brain injury, consecutively admitted to a vegetative state unit (VSU)...
July 2017: Functional Neurology
https://www.readbyqxmd.com/read/29035710/blunted-basal-corticosterone-pulsatility-predicts-post-exposure-susceptibility-to-ptsd-phenotype-in-rats
#6
Dor Danan, Michael A Matar, Zeev Kaplan, Joseph Zohar, Hagit Cohen
The basal activity of the hypothalamic-pituitary-adrenal axis is highly dynamic and is characterized by both circadian and ultradian (pulsatile) patterns of hormone secretion. Pulsatility of glucocorticoids has been determined to be critical for optimal transcriptional, neuroendocrine, and behavioral responses. We used an animal model of post-traumatic stress disorder (PTSD) to assess whether stress-induced impairment of behavioral responses is correlated with aberrant secretion of corticosterone. Serial blood samples were collected manually via the jugular vein cannula during the light-(inactive)-phase in conscious male rats at 20-min intervals for a period of 5h before and 6...
October 7, 2017: Psychoneuroendocrinology
https://www.readbyqxmd.com/read/29033868/is-schizophrenia-a-disorder-of-consciousness-experimental-and-phenomenological-support-for-anomalous-unconscious-processing
#7
Anne Giersch, Aaron L Mishara
Decades ago, several authors have proposed that disorders in automatic processing lead to intrusive symptoms or abnormal contents in the consciousness of people with schizophrenia. However, since then, studies have mainly highlighted difficulties in patients' conscious experiencing and processing but rarely explored how unconscious and conscious mechanisms may interact in producing this experience. We report three lines of research, focusing on the processing of spatial frequencies, unpleasant information, and time-event structure that suggest that impairments occur at both the unconscious and conscious level...
2017: Frontiers in Psychology
https://www.readbyqxmd.com/read/29033639/a-survey-focusing-on-lucid-dreaming-metacognition-and-dream-anxiety-in-medical-students
#8
Çağdaş Yokuşoğlu, Mücahit Atasoy, Nurgül Tekeli, Ahmet Ural, Çağla Ulus, Yunus Taylan, Gülser Aydin, Gözde Gültekin, Murat Emül
INTRODUCTION: The aim of this study was to examine the level of lucidity and its relation with metacognitive beliefs and dream anxiety in medical students. METHODS: Nine hundred sixteen medical students were enrolled in the study. The participants were assessed with the Lucidity and Consciousness in Dreams Scale (LuCiD), the Metacognition Questionnaire-30 (MCQ-30), and the Van Dream Anxiety Scale (VDAS). RESULTS: There was no significant difference in mean total lucidity score between females and males, but there were some significant sex differences in subscales of lucidity, and control was significantly higher in male students, while realism, thought, and dissociation were significantly higher in female students...
September 2017: Noro Psikiyatri Arsivi
https://www.readbyqxmd.com/read/29030856/mitochondrial-3-hydroxy-3-methylglutaryl-coa-synthase-deficiency-unique-presenting-laboratory-values-and-a-review-of-biochemical-and-clinical-features
#9
Erin Conboy, Filippo Vairo, Matthew Schultz, Katherine Agre, Ross Ridsdale, David Deyle, Devin Oglesbee, Dimitar Gavrilov, Eric W Klee, Brendan Lanpher
We report an 8-month-old infant with decreased consciousness after a febrile episode and reduced oral intake. He was profoundly acidotic but his lactate was normal. Serum triglycerides were markedly elevated and HDL cholesterol was very low. The urine organic acid analysis during the acute episode revealed a complex pattern of relative hypoketotic dicarboxylic aciduria, suggestive of a potential fatty acid oxidation disorder. MRI showed extensive brain abnormalities concerning for a primary energy deficiency...
October 14, 2017: JIMD Reports
https://www.readbyqxmd.com/read/29024197/multifaceted-brain-networks-reconfiguration-in-disorders-of-consciousness-uncovered-by-co-activation-patterns
#10
Carol Di Perri, Enrico Amico, Lizette Heine, Jitka Annen, Charlotte Martial, Stephen K Larroque, Andrea Soddu, Daniele Marinazzo, Steven Laureys
INTRODUCTION: Given that recent research has shown that functional connectivity is not a static phenomenon, we aim to investigate the dynamic properties of the default mode network's (DMN) connectivity in patients with disorders of consciousness. METHODS: Resting-state fMRI volumes of a convenience sample of 17 patients in unresponsive wakefulness syndrome (UWS) and controls were reduced to a spatiotemporal point process by selecting critical time points in the posterior cingulate cortex (PCC)...
October 11, 2017: Human Brain Mapping
https://www.readbyqxmd.com/read/29021484/anti-neutrophil-cytoplasmic-antibody-associated-vasculitis-complicated-by-periaortitis-and-cranial-hypertrophic-pachymeningitis-a-report-of-an-autopsy-case
#11
Hajime Kaga, Atsushi Komatsuda, Masaya Saitoh, Mizuho Nara, Ayumi Omokawa, Masaru Togashi, Shin Okuyama, Hideki Wakui, Naoto Takahashi
Anti-neutrophil cytoplasmic antibody-associated vasculitis (AAV) is a systemic inflammatory disorder categorized as small-vessel vasculitis. We herein report an elderly Japanese man with AAV (granulomatous with polyangiitis affecting the eyes, nose, lungs, and kidneys) who also showed periaortitis at the diagnosis and developed cranial hypertrophic pachymeningitis (HP) during steroid maintenance therapy. His consciousness disturbance caused by HP improved after steroid pulse therapy, but he died of aspiration pneumonia...
October 11, 2017: Internal Medicine
https://www.readbyqxmd.com/read/28991686/period3-gene-in-disorder-of-consciousness-the-role-of-neuroimaging-in-understanding-the-relationship-between-genotype-and-sleep-a-brief-communication
#12
Gloria Bedini, Anna Bersano, Ludovico D'Incerti, Giorgio Marotta, Cristina Rosazza, Davide Rossi Sebastiano, Silvana Franceschetti, Davide Sattin, Matilde Leonardi, Anna Nigri, Stefania Ferraro, Eugenio Agostino Parati
BACKGROUND: Several methodologies including neuroimaging and sleep evaluation are being developed to complement the clinical bedside examinations in patients with disorder of consciousness (DOC). Recently, we demonstrated a possible association between Period3 (Per3) variable number tandem repeat (VNTR) polymorphism and functional impairment of DOC patients, speculating a possible role of this gene in sleep regulation. AIM: To assess whether the degree of structural and metabolic damage of the main brain areas involved in the sleep generation and homeostasis may influence the different outcome of DOC patients carrying the Per3(5/5) genotype in comparison to Per3(4/4) ones...
October 15, 2017: Journal of the Neurological Sciences
https://www.readbyqxmd.com/read/28982805/needs-and-rights-awareness-of-stroke-survivors-and-caregivers-a-cross-sectional-single-centre-questionnaire-survey
#13
Xin Li, Xiaoshuang Xia, Peilu Wang, Shuting Zhang, Ming Liu, Lin Wang
OBJECTIVES: The needs and rights awareness of stroke survivors have not been reported in China. This study investigated the needs and rights awareness of stroke survivors and caregivers in Tianjin, China. SETTING: A survey launched by the World Stroke Organization was conducted in Tianjin, China. The questionnaire included demands for psychological support, treatment and care, social support and information. Stroke survivors and their caregivers were interviewed face to face for the questionnaire...
October 5, 2017: BMJ Open
https://www.readbyqxmd.com/read/28980847/mirror-efficiency-in-the-assessment-of-visual-pursuit-in-patients-in-minimally-conscious-state
#14
Sarah Wannez, Audrey Vanhaudenhuyse, Steven Laureys, Serge Brédart
OBJECTIVE: Visual pursuit should be tested with a mirror in patients with disorders of consciousness. This stimulus was indeed more efficient than a person or an object, and the auto-referential aspect was supposed to be the key feature. The present study tested the hypothesis that the mirror was more efficient because of its self-aspect. METHODS: The mirror was compared (1) to the patient's picture and to the picture of a famous face, in 22 patients in minimally conscious state and (2) to the patient's picture and a fake mirror, which had dynamical and bright aspects of the mirror, without reflecting the face, in 26 other patients in minimally conscious state...
October 5, 2017: Brain Injury: [BI]
https://www.readbyqxmd.com/read/28979520/status-epilepticus-and-anti-nmda-receptor-encephalitis-after-resection-of-an-ovarian-teratoma
#15
Amritpal S Jandu, Peter M Odor, Steven D Vidgeon
Anti-N-methyl-D-aspartate receptor encephalitis is a recently recognised autoimmune, paraneoplastic syndrome that typically presents with psychiatric disturbance, reduced conscious level and seizures. The disorder has been previously associated with ovarian teratomas. We present the case of a 35-year-old female, with a previous surgical history for resection of an ovarian teratoma, who later developed status epilepticus and anti-N-methyl-D-aspartate receptor encephalitis requiring intensive care management...
November 2016: J Intensive Care Soc
https://www.readbyqxmd.com/read/28968032/-epidemiological-clinical-and-pathogenic-features-of-stroke-in-elderly-and-senile-age
#16
E S Ostapchuk, V S Myakotnykh
A comparative investigation of the epidemiological, clinical and pathogenetic indices of cerebral stroke in 1 153 representatives of different age was conducted. The predominance in the incidence of strokes among women of elderly and senile age largely is due to higher life expectancy of women compared to men. A significant number of intracerebral blood effusions in elderly and senile can arise secondarily, after the ischemic focus formation by the type of «red softening». This, to a certain extent, can be explained by the high frequency of somatic complications of stroke, disorders of consciousness and high mortality among persons older than 60 years compared to younger...
2017: Advances in Gerontology, Uspekhi Gerontologii
https://www.readbyqxmd.com/read/28967533/disruption-of-conscious-access-in-schizophrenia
#17
REVIEW
Lucie Berkovitch, Stanislas Dehaene, Raphaël Gaillard
Schizophrenia is a severe and complex psychiatric disorder resulting in delusions, hallucinations, and cognitive impairments. Across a variety of paradigms, an elevated threshold for conscious perception has been repeatedly observed in persons with schizophrenia. Remarkably, even subtle measures of subliminal processing appear to be preserved. We argue here that the dissociation between impaired conscious access and intact unconscious processing may be due to a specific disruption of top-down attentional amplification...
November 2017: Trends in Cognitive Sciences
https://www.readbyqxmd.com/read/28967351/acute-lsd-effects-on-response-inhibition-neural-networks
#18
A Schmidt, F Müller, C Lenz, P C Dolder, Y Schmid, D Zanchi, U E Lang, M E Liechti, S Borgwardt
BACKGROUND: Recent evidence shows that the serotonin 2A receptor (5-hydroxytryptamine2A receptor, 5-HT2AR) is critically involved in the formation of visual hallucinations and cognitive impairments in lysergic acid diethylamide (LSD)-induced states and neuropsychiatric diseases. However, the interaction between 5-HT2AR activation, cognitive impairments and visual hallucinations is still poorly understood. This study explored the effect of 5-HT2AR activation on response inhibition neural networks in healthy subjects by using LSD and further tested whether brain activation during response inhibition under LSD exposure was related to LSD-induced visual hallucinations...
October 2, 2017: Psychological Medicine
https://www.readbyqxmd.com/read/28966051/deep-brain-stimulation-for-disorders-of-consciousness-systematic-review-of-cases-and-ethics
#19
REVIEW
Jonathan Vanhoecke, Marwan Hariz
BACKGROUND: A treatment for patients suffering from prolonged severely altered consciousness is not available. The success of Deep Brain Stimulation (DBS) in diseases such as Parkinson's, dystonia and essential tremor provided a renewed impetus for its application in Disorders of Consciousness (DoC). OBJECTIVE: To evaluate the rationale for DBS in patients with DoC, through systematic review of literature containing clinical data and ethical considerations. METHODS: Articles from PubMed, Embase, Medline and Web of Science were systematically reviewed...
August 24, 2017: Brain Stimulation
https://www.readbyqxmd.com/read/28956479/psychogenic-non-epileptic-seizures-in-children-and-adolescents-part-ii-explanations-to-families-treatment-and-group-outcomes
#20
Kasia Kozlowska, Catherine Chudleigh, Catherine Cruz, Melissa Lim, Georgia McClure, Blanche Savage, Ubaid Shah, Averil Cook, Stephen Scher, Pascal Carrive, Deepak Gill
Psychogenic non-epileptic seizures (PNES) - time-limited disturbances of consciousness and motor-sensory control, not accompanied by ictal activity on electroencephalogram (EEG) - are best conceptualized as atypical neurophysiological responses to emotional distress, physiological stressors and danger. Patients and families find the diagnosis of PNES difficult to understand; the transition from neurology (where the diagnosis is made) to mental health services (to which patients are referred for treatment) can be a bumpy one...
September 1, 2017: Clinical Child Psychology and Psychiatry
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