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Disorder of consciousness

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https://www.readbyqxmd.com/read/28431040/prospective-assessment-of-pain-and-comfort-in-chronic-pain-patients-undergoing-interventional-pain-management-procedures
#1
Thomas Simopoulos, Daniel Leffler, Sheila Barnett, Devon Campbell, Shu Jing Lian, Jatinder S Gill
Objective.:  Interventional pain management procedures have an important role in the management of chronic pain. The present study seeks to identify the proportion of patients who experience severe pain during pain procedures either with or without sedation. There is then an attempt to identify any association of high pain levels with factors such as age, gender, ethnicity, preprocedure pain level, procedure type, tobacco use, and baseline pharmaceuticals taken for both pain and/or mood disorder management...
April 18, 2017: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/28424921/evolution-of-psychological-condition-in-caregivers-of-patients-with-disorders-of-consciousness-a-longitudinal-study
#2
Francesco Corallo, Lilla Bonanno, Viviana Lo Buono, Simona De Salvo, Cettina Allone, Rosanna Palmeri, Elena La Gattuta, Carmela Rifici, Antonella Alagna, Antonino Todaro, Placido Bramanti, Silvia Marino
The aim of this study is to evaluate mood disorders and needs in caregivers of disorders of consciousness (DOC) patients during the admission to Neurorehabilitation Unit. A total of 80 caregivers was enrolled and divided in two groups (caregivers of vegetative state-VS patients and caregivers of minimally conscious state-MCS patients). Paired sample t tests were carried out to test differences between baseline observation (T0) and after 6 months (T1). Caregivers of VS patients showed an improvement between T0 and T1 especially, in vitality, mean health, Beck Depression Inventory (BDI-II), Spielberger State-Trait Anxiety Inventory-Y (STAI-Y), Prolonged Grief Disorder (PG 12) and Caregiver Needs Assessment (CNA)...
April 19, 2017: Neurological Sciences
https://www.readbyqxmd.com/read/28424270/significance-of-circadian-rhythms-in-severely-brain-injured-patients-a-clue-to-consciousness
#3
Christine Blume, Julia Lechinger, Nayantara Santhi, Renata Del Giudice, Maria-Teresa Gnjezda, Gerald Pichler, Monika Scarpatetti, Johann Donis, Gabriele Michitsch, Manuel Schabus
OBJECTIVE: To investigate the relationship between the presence of a circadian body temperature rhythm and behaviorally assessed consciousness levels in patients with disorders of consciousness (DOC; i.e., vegetative state/unresponsive wakefulness syndrome or minimally conscious state). METHODS: In a cross-sectional study, we investigated the presence of circadian temperature rhythms across 6 to 7 days using external skin temperature sensors in 18 patients with DOC...
April 19, 2017: Neurology
https://www.readbyqxmd.com/read/28424003/phenotypic-heterogeneity-in-a-congenital-disorder-of-glycosylation-caused-by-mutations-in-stt3a
#4
Arunabha Ghosh, Jill Urquhart, Sarah Daly, Anne Ferguson, Diana Scotcher, Andrew A M Morris, Jill Clayton-Smith
STT3A encodes the catalytic subunit of the oligosaccharyltransferase complex. A congenital disorder of glycosylation caused by mutations in STT3A has only been reported in one family to date, associated with a Type I congenital disorder of glycosylation pattern of transferrin glycoforms. The authors describe a further 5 related individuals with a likely pathogenic variant in STT3A, 2 of whom also had variants in TUSC3. Common phenotypic features in all symptomatic individuals include developmental delay, intellectual disability, with absent speech and seizures...
May 2017: Journal of Child Neurology
https://www.readbyqxmd.com/read/28420294/smart-recognising-the-value-of-existing-practice-and-introducing-recent-developments-leaving-no-stone-unturned-in-the-assessment-and-treatment-of-the-pdoc-patient
#5
H Gill-Thwaites, K E Elliott, R Munday
Over the last 25 years there have been a number of papers highlighting the issues of high rates of misdiagnosis in prolonged disorders of consciousness (PDOC) (Andrews, K., Murphy, L., Munday, R., & Littlewood, C. (1996). Misdiagnosis of the vegetative state: Retrospective study in a rehabilitation unit. BMJ, 313(7048), 13-16; Childs, N. L., Mercer, W. N., & Childs, H. W. (1993). Accuracy of diagnosis of persistent vegetative state. Neurology, 43(8), 1465-1467). Surprisingly, these rates still remain at the same level despite defined criteria for diagnosis (Schnakers, C...
April 18, 2017: Neuropsychological Rehabilitation
https://www.readbyqxmd.com/read/28419776/the-involuntary-nature-of-binge-drinking-goal-directedness-and-awareness-of-intention
#6
Nuria Doñamayor, Daniela Strelchuk, Kwangyeol Baek, Paula Banca, Valerie Voon
Binge drinking represents a public health issue and is a known risk factor in the development of alcohol use disorders. Previous studies have shown behavioural as well as neuroanatomical alterations associated with binge drinking. Here, we address the question of the automaticity or involuntary nature of the behaviour by assessing goal-directed behaviour and intentionality. In this study, we used a computational two-step task, designed to discern between model-based/goal-directed and model-free/habitual behaviours, and the classic Libet clock task, to study intention awareness, in a sample of 31 severe binge drinkers (BD) and 35 matched healthy volunteers...
April 16, 2017: Addiction Biology
https://www.readbyqxmd.com/read/28418641/classics-in-chemical-neuroscience-ketamine
#7
Marshall W Tyler, Harmony B Yourish, Dawn F Ionescu, Stephen J Haggarty
Ketamine, a molecule of many faces, has contributed immeasurably to numerous realms of clinical practice and scientific inquiry. From anesthesia and analgesia to depression and schizophrenia, it continues to shed light on the molecular underpinnings of pain, consciousness, and the pathophysiology of neuropsychiatric disorders. In particular, research on ketamine's mechanism of action is providing new hope in the search for therapies for treatment-resistant depression and affords insights into disorders of glutamatergic dysfunction...
April 21, 2017: ACS Chemical Neuroscience
https://www.readbyqxmd.com/read/28417610/functional-outcome-of-critical-illness-polyneuropathy-in-patients-affected-by-severe-brain-injury
#8
Domenico Intiso, Filomena DI Rienzo, Andrea Fontana, Maurizio Tolfa, Michelangelo Bartolo, Massimiliano Copetti
BACKGROUND: Critical illness polyneuropathy and myopathy (CIPNM) frequently occur in intensive care unit (ICU) critically ill subjects; about 55-70% of subjects achieve full recovery. CIPNM can occur in ICU subjects with severe acquired brain injury (sABI), but no data have been reported regarding their outcome. AIM: The aim of the present study was to investigate the functional recovery in subjects suffering from both CIPNM and sABI and whether they had poorer outcome than those with sABI only...
April 14, 2017: European Journal of Physical and Rehabilitation Medicine
https://www.readbyqxmd.com/read/28414249/psychological-distress-is-associated-with-altered-cognitive-functioning-in-family-caregivers-of-patients-with-disorders-of-consciousness
#9
P Moretta, O Masotta, E Crispino, G Castronovo, S Ruvolo, C Montalbano, V Loreto, L Trojano, A Estraneo
OBJECTIVES: To analyse the possible presence of reduced cognitive efficiency in family caregivers of patients with prolonged disorders of consciousness (DOC). SUBJECTS: The participants were 27 caregivers of 25 patients with DOC admitted to the severe brain injury units of the ICS Maugeri, Institutes of Telese Terme and Sciacca, Italy. METHODS: We examined cognitive functions such as short- and long-term memory, executive functions and attention by means of standardized tests...
April 17, 2017: Brain Injury: [BI]
https://www.readbyqxmd.com/read/28413709/awareness-apathy-and-depression-in-alzheimer-s-disease-and-mild-cognitive-impairment
#10
COMPARATIVE STUDY
Jean-Pierre Jacus
INTRODUCTION: Results from studies on awareness disorders in Alzheimer's disease (AD) are controversial because the methodologies, the "objects" of awareness, and the patients' pathologic stage all vary. Our study aimed to compare scores and correlates of awareness according to the stage of the disease and the assessment method. METHODS: We compared 20 mild AD patients to 20 mild cognitive impairment (MCI) patients, using the Patient Competency Rating Scale (PCRS; patient vs...
April 2017: Brain and Behavior
https://www.readbyqxmd.com/read/28407743/new-drugs-new-toxicities-severe-side-effects-of-modern-targeted-and-immunotherapy-of-cancer-and-their-management
#11
REVIEW
Frank Kroschinsky, Friedrich Stölzel, Simone von Bonin, Gernot Beutel, Matthias Kochanek, Michael Kiehl, Peter Schellongowski
Pharmacological and cellular treatment of cancer is changing dramatically with benefits for patient outcome and comfort, but also with new toxicity profiles. The majority of adverse events can be classified as mild or moderate, but severe and life-threatening complications requiring ICU admission also occur. This review will focus on pathophysiology, symptoms, and management of these events based on the available literature.While standard antineoplastic therapy is associated with immunosuppression and infections, some of the recent approaches induce overwhelming inflammation and autoimmunity...
April 14, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28406662/explicit-and-implicit-reinforcement-learning-across-the-psychosis-spectrum
#12
Deanna M Barch, Cameron S Carter, James M Gold, Sheri L Johnson, Ann M Kring, Angus W MacDonald, Diego A Pizzagalli, J Daniel Ragland, Steven M Silverstein, Milton E Strauss
Motivational and hedonic impairments are core features of a variety of types of psychopathology. An important aspect of motivational function is reinforcement learning (RL), including implicit (i.e., outside of conscious awareness) and explicit (i.e., including explicit representations about potential reward associations) learning, as well as both positive reinforcement (learning about actions that lead to reward) and punishment (learning to avoid actions that lead to loss). Here we present data from paradigms designed to assess both positive and negative components of both implicit and explicit RL, examine performance on each of these tasks among individuals with schizophrenia, schizoaffective disorder, and bipolar disorder with psychosis, and examine their relative relationships to specific symptom domains transdiagnostically...
April 13, 2017: Journal of Abnormal Psychology
https://www.readbyqxmd.com/read/28399715/prevalence-of-coma-recovery-scale-revised-signs-of-consciousness-in-patients-in-minimally-conscious-state
#13
Sarah Wannez, Olivia Gosseries, Deborah Azzolini, Charlotte Martial, Helena Cassol, Charlène Aubinet, Jitka Annen, Géraldine Martens, Olivier Bodart, Lizette Heine, Vanessa Charland-Verville, Aurore Thibaut, Camille Chatelle, Audrey Vanhaudenhuyse, Athena Demertzi, Caroline Schnakers, Anne-Françoise Donneau, Steven Laureys
Different behavioural signs of consciousness can distinguish patients with an unresponsive wakefulness syndrome from patients in minimally conscious state (MCS). The Coma Recovery Scale-Revised (CRS-R) is the most sensitive scale to differentiate the different altered states of consciousness and eleven items detect the MCS. The aim of this study is to document the prevalence of these items. We analysed behavioural assessments of 282 patients diagnosed in MCS based on the CRS-R. Results showed that some items are particularly frequent among patients in MCS, namely fixation, visual pursuit, and reproducible movement to command, which were observed in more than 50% of patients...
April 11, 2017: Neuropsychological Rehabilitation
https://www.readbyqxmd.com/read/28393761/enhancing-clinical-communication-assessments-using-an-audiovisual-bci-for-patients-with-disorders-of-consciousness
#14
Fei Wang, Yanbin He, Jun Qu, Qiuyou Xie, Qing Lin, Xiaoxiao Ni, Yan Chen, Steven Laureys, Ronghao Yu, Yuanqing Li
OBJECTIVE: The JFK Coma Recovery Scale-Revised (JFK CRS-R), a behavioral observation scale, is widely used in the clinical diagnosis/assessment of patients with disorders of consciousness (DOC). However, the JFK CRS-R is associated with a high rate of misdiagnosis (approximately 40%) because DOC patients cannot provide sufficient behavioral responses. A brain-computer interface (BCI) that detects command/intention-specific changes in electroencephalography (EEG) signals without the need for behavioral expression may provide an alternative method...
April 10, 2017: Journal of Neural Engineering
https://www.readbyqxmd.com/read/28393011/motivated-attention-and-family-risk-for-depression-neuronal-generator-patterns-at-scalp-elicited-by-lateralized-aversive-pictures-reveal-blunted-emotional-responsivity
#15
Jürgen Kayser, Craig E Tenke, Karen S Abraham, Daniel M Alschuler, Jorge E Alvarenga, Jamie Skipper, Virginia Warner, Gerard E Bruder, Myrna M Weissman
Behavioral and electrophysiologic evidence suggests that major depression (MDD) involves right parietotemporal dysfunction, a region activated by arousing affective stimuli. Building on prior event-related potential (ERP) findings (Kayser et al. 2016 NeuroImage 142:337-350), this study examined whether these abnormalities also characterize individuals at clinical high risk for MDD. We systematically explored the impact of family risk status and personal history of depression and anxiety on three distinct stages of emotional processing comprising the late positive potential (LPP)...
2017: NeuroImage: Clinical
https://www.readbyqxmd.com/read/28392830/psychometric-properties-of-the-eating-disorder-examination-questionnaire-in-japanese-adolescents
#16
Tomoyo Mitsui, Toshiyuki Yoshida, Gen Komaki
BACKGROUND: Although the Eating Disorder Examination Questionnaire version 6.0 (EDE-Q) is one of the most widely used questionnaires for eating disorders in Western countries, no research has addressed the psychometric properties of the EDE-Q in a Japanese sample. METHODS: We explored the factor structure of the EDE-Q and examined the internal consistency of the derived scales for Japanese participants (Study I), the convergent validity with other eating disorder-related psychological measures (Study II) and the distinction between the derived two body image-related factors with psychological measures (StudyIII)...
2017: BioPsychoSocial Medicine
https://www.readbyqxmd.com/read/28390511/disorders-of-consciousness
#17
REVIEW
Blessen C Eapen, Jason Georgekutty, Bruno Subbarao, Sheital Bavishi, David X Cifu
Disorder of consciousness (DOC) is a state of prolonged altered consciousness, which can be categorized into coma, vegetative state, or minimally conscious state based on neurobehavioral function. The pathophysiology of DOC is poorly understood but recent advances in neuroimaging and advanced electrophysiological techniques may provide an improved understanding for the neural network involved with consciousness. The primary aim of DOC rehabilitation programs is to promote arousal while preventing secondary medical complications while providing education and training to families...
May 2017: Physical Medicine and Rehabilitation Clinics of North America
https://www.readbyqxmd.com/read/28389257/physiotherapy-and-speech-and-language-therapy-intervention-for-chronic-cough
#18
REVIEW
Surinder S Birring, Sarah Floyd, Charles C Reilly, Peter Siu Pan Cho
There are few effective pharmacological therapies available to treat refractory chronic cough. Functional MRI studies of the brain have recently shown that patients with chronic cough have dysfunctional inhibitory control of cough. Self-management therapies delivered by physiotherapists or speech therapists are effective at suppressing cough. They enable patients to consciously suppress the urge to cough. The intervention consists of education, laryngeal hygiene, cough suppression and distraction measures and behaviour modification...
April 4, 2017: Pulmonary Pharmacology & Therapeutics
https://www.readbyqxmd.com/read/28385104/prolonged-cerebrospinal-fluid-neurofilament-light-chain-increase-in-patients-with-post-traumatic-disorders-of-consciousness
#19
Sergio Bagnato, Luigi M E Grimaldi, Giorgio Di Raimondo, Antonino Sant'Angelo, Cristina Boccagni, Vittorio Virgilio, Maria Andriolo
The mechanisms involved in secondary brain injury after the acute phase of severe traumatic brain injury (TBI) are largely unknown. Ongoing axonal degeneration, consequent to the initial trauma, may lead to secondary brain injury. To test this hypothesis, we evaluated the cerebrospinal fluid (CSF) level of neurofilament light chain (NF-L), a proposed marker of axonal degeneration, in ten patients who developed a severe disorder of consciousness after a TBI, including seven in a minimally conscious state and three with unresponsive wakefulness syndrome (time since brain injury 309 ± 169 days)...
April 7, 2017: Journal of Neurotrauma
https://www.readbyqxmd.com/read/28385064/the-assessment-of-language-and-the-emergence-from-disorders-of-consciousness
#20
Amy Pundole, Sarah Crawford
In order to demonstrate emergence from a disorder of consciousness (DoC) an individual is currently required to demonstrate functional object use of two objects, or functional communication defined as accurately answering six yes/no questions on two consecutive occasions (Giacino et al., 2002 ). In practice, experienced speech and language therapists (SLTs) working with this group often focus on facilitating object use or employ other language tasks, since achieving a 100% accurate yes/no response can be difficult for patients following an extensive brain injury due to language and/or cognitive impairments...
April 6, 2017: Neuropsychological Rehabilitation
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