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https://www.readbyqxmd.com/read/29089921/the-neurological-wake-up-test-a-role-in-neurocritical-care-monitoring-of-traumatic-brain-injury-patients
#1
REVIEW
Niklas Marklund
The most fundamental clinical monitoring tool in traumatic brain injury (TBI) patients is the repeated clinical examination. In the severe TBI patient treated by continuous sedation in a neurocritical care (NCC) unit, sedation interruption is required to enable a clinical evaluation (named the neurological wake-up test; NWT) assessing the level of consciousness, pupillary diameter and reactivity to light, and presence of focal neurological deficits. There is a basic conflict regarding the NWT in the NCC setting; can the clinical information obtained by the NWT justify the risk of inducing a stress response in a severe TBI patient? Furthermore, in the presence of advanced multimodal monitoring and neuroimaging, is the NWT necessary to identify important clinical alterations? In studies of severe TBI patients, the NWT was consistently shown to induce a stress reaction including brief increases in intracranial pressure (ICP) and changes in cerebral perfusion pressure (CPP)...
2017: Frontiers in Neurology
https://www.readbyqxmd.com/read/29088959/traumatic-brain-injury-and-intracranial-hemorrhage-induced-cerebral-vasospasm-a-systematic-review
#2
Fawaz Al-Mufti, Krishna Amuluru, Abhinav Changa, Megan Lander, Neil Patel, Ethan Wajswol, Sarmad Al-Marsoummi, Basim Alzubaidi, I Paul Singh, Rolla Nuoman, Chirag Gandhi
OBJECTIVE Little is known regarding the natural history of posttraumatic vasospasm. The authors review the pathophysiology of posttraumatic vasospasm (PTV), its associated risk factors, the efficacy of the technologies used to detect PTV, and the management/treatment options available today. METHODS The authors performed a systematic review in accordance with the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines using the following databases: PubMed, Google Scholar, and CENTRAL (the Cochrane Central Register of Controlled Trials)...
November 2017: Neurosurgical Focus
https://www.readbyqxmd.com/read/29088949/unraveling-the-complexities-of-invasive-multimodality-neuromonitoring
#3
Saurabh Sinha, Eric Hudgins, James Schuster, Ramani Balu
Acute brain injuries are a major cause of death and disability worldwide. Survivors of life-threatening brain injury often face a lifetime of dependent care, and novel approaches that improve outcome are sorely needed. A delayed cascade of brain damage, termed secondary injury, occurs hours to days and even weeks after the initial insult. This delayed phase of injury provides a crucial window for therapeutic interventions that could limit brain damage and improve outcome. A major barrier in the ability to prevent and treat secondary injury is that physicians are often unable to target therapies to patients' unique cerebral physiological disruptions...
November 2017: Neurosurgical Focus
https://www.readbyqxmd.com/read/29078912/mortality-rates-of-severe-traumatic-brain-injury-patients-impact-of-direct-versus-nondirect-transfers
#4
Kartik Prabhakaran, Patrizio Petrone, Gary Lombardo, Christy Stoller, Anthony Policastro, Corrado P Marini
BACKGROUND: Direct transport of patients with severe traumatic brain injury (sTBI) to trauma centers (TCs) that can provide definitive care results in lower mortality rates. This study investigated the impact of direct versus nondirect transfers on the mortality rates of patients with sTBI. METHODS: Data on patients with TBI admitted between January 1, 2012, and December 31, 2013, to our Level I TC were obtained from the trauma registry. Data included patient age, sex, mechanism, and type of injury, comorbidities, Glasgow Coma Scale, Injury Severity scores, prehospital time, time to request and to transfer, time to initiation of multimodality monitoring and goal-directed therapy protocol, dwell time in the emergency department (EDT), and mortality...
November 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/29064155/assessing-inflammation-in-acute-intracerebral-hemorrhage-with-pk11195-pet-and-dynamic-contrast-enhanced-mri
#5
Kamran A Abid, Oluwaseun A Sobowale, Laura M Parkes, Josephine Naish, Geoff J M Parker, Daniel du Plessis, David Brough, Jack Barrington, Stuart M Allan, Rainer Hinz, Adrian R Parry-Jones
BACKGROUND AND PURPOSE: Studies in animal models suggest that inflammation is a major contributor to secondary injury after intracerebral hemorrhage (ICH). Direct, noninvasive monitoring of inflammation in the human brain after ICH will facilitate early-phase development of anti-inflammatory treatments. We sought to investigate the feasibility of multimodality brain imaging in subacute ICH. METHODS: Acute ICH patients were recruited to undergo multiparametric MRI (including dynamic contrast-enhanced measurement of blood-brain barrier transfer constant (K(trans) ) and PET with [(11) C]-(R)-PK11195)...
October 24, 2017: Journal of Neuroimaging: Official Journal of the American Society of Neuroimaging
https://www.readbyqxmd.com/read/29051506/an-integrated-eeg-and-eye-tracking-approach-for-the-study-of-responding-and-initiating-joint-attention-in-autism-spectrum-disorders
#6
Lucia Billeci, Antonio Narzisi, Alessandro Tonacci, Beatrice Sbriscia-Fioretti, Luca Serasini, Francesca Fulceri, Fabio Apicella, Federico Sicca, Sara Calderoni, Filippo Muratori
Autism Spectrum Disorders (ASD) are characterised by impairment in joint attention (JA), which has two components: the response to JA and the initiation of JA. Literature suggests a correlation between JA and neural circuitries, although this link is still largely unexplored in ASD. In this pilot study, we aimed at investigating the neural correlates of responding and initiating JA in high-functioning children with ASD and evaluating the changes in brain function and visual pattern after six months of rehabilitative treatment using an integrated EEG/eye-tracking system...
October 19, 2017: Scientific Reports
https://www.readbyqxmd.com/read/29050469/in-vivo-18-f-ge-179-brain-signal-does-not-show-nmda-specific-modulation-with-drug-challenges-in-rodents-and-nonhuman-primates
#7
Matthias Schoenberger, Frederick A Schroeder, Michael S Placzek, Randall L Carter, Bruce R Rosen, Jacob M Hooker, Christin Y Sander
As one of the major excitatory ion channels in the brain, NMDA receptors have been a leading research target for neuroscientists, physicians, medicinal chemists, and pharmaceutical companies for decades. Molecular imaging of NMDA receptors by means of positron emission tomography (PET) with [(18)F]GE-179 quickly progressed to clinical PET studies, but a thorough understanding of its binding specificity has been missing and has thus limited signal interpretation. Here a preclinical study with [(18)F]GE-179 in rodents and nonhuman primates (NHPs) is presented in an attempt to characterize [(18)F]GE-179 signal specificity...
November 14, 2017: ACS Chemical Neuroscience
https://www.readbyqxmd.com/read/29032126/weekly-follow-up-of-acute-lesions-in-three-early-multiple-sclerosis-patients-using-mr-spectroscopy-and-diffusion
#8
Gabriel Kocevar, Claudio Stamile, Salem Hannoun, Jean-Amédée Roch, Françoise Durand-Dubief, Sandra Vukusic, François Cotton, Dominique Sappey-Marinier
OBJECT: Pathophysiological mechanisms underlying multiple sclerosis (MS) lesion formation, including inflammation, demyelination/remyelination and axonal damage, and their temporal evolution are still not clearly understood. To this end, three acute white matter lesions were monitored using a weekly multimodal magnetic resonance (MR) protocol. MATERIALS AND METHODS: Three untreated patients with early relapsing-remitting MS and one healthy control subject were followed weekly for two months...
October 13, 2017: Journal of Neuroradiology. Journal de Neuroradiologie
https://www.readbyqxmd.com/read/29028696/brain-oxygen-optimization-in-severe-traumatic-brain-injury-phase-ii-a-phase-ii-randomized-trial
#9
RANDOMIZED CONTROLLED TRIAL
David O Okonkwo, Lori A Shutter, Carol Moore, Nancy R Temkin, Ava M Puccio, Christopher J Madden, Norberto Andaluz, Randall M Chesnut, M Ross Bullock, Gerald A Grant, John McGregor, Michael Weaver, Jack Jallo, Peter D LeRoux, Dick Moberg, Jason Barber, Christos Lazaridis, Ramon R Diaz-Arrastia
OBJECTIVES: A relationship between reduced brain tissue oxygenation and poor outcome following severe traumatic brain injury has been reported in observational studies. We designed a Phase II trial to assess whether a neurocritical care management protocol could improve brain tissue oxygenation levels in patients with severe traumatic brain injury and the feasibility of a Phase III efficacy study. DESIGN: Randomized prospective clinical trial. SETTING: Ten ICUs in the United States...
November 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/29027094/multimodal-functional-neuroimaging-by-simultaneous-bold-fmri-and-fiber-optic-calcium-recordings-and-optogenetic-control
#10
REVIEW
Franziska Albers, Lydia Wachsmuth, Timo Mauritz van Alst, Cornelius Faber
Recent developments of optogenetic tools and fluorescence-based calcium recording techniques enable the manipulation and monitoring of neural circuits on a cellular level. Non-invasive imaging of brain networks, however, requires the application of methods such as blood oxygen level-dependent (BOLD) functional magnetic resonance imaging (fMRI), which is commonly used for functional neuroimaging. While BOLD fMRI provides brain-wide non-invasive reading of the hemodynamic response, it is only an indirect measure of neural activity...
October 12, 2017: Molecular Imaging and Biology: MIB: the Official Publication of the Academy of Molecular Imaging
https://www.readbyqxmd.com/read/28978655/change-in-multimodal-mri-markers-predicts-dementia-risk-in-cerebral-small-vessel-disease
#11
Eva A Zeestraten, Andrew J Lawrence, Christian Lambert, Philip Benjamin, Rebecca L Brookes, Andrew D Mackinnon, Robin G Morris, Thomas R Barrick, Hugh S Markus
OBJECTIVE: To determine whether MRI markers, including diffusion tensor imaging (DTI), can predict cognitive decline and dementia in patients with cerebral small vessel disease (SVD). METHODS: In the prospective St George's Cognition and Neuroimaging in Stroke study, multimodal MRI was performed annually for 3 years and cognitive assessments annually for 5 years in a cohort of 99 patients with SVD, defined as symptomatic lacunar stroke and confluent white matter hyperintensities (WMH)...
October 31, 2017: Neurology
https://www.readbyqxmd.com/read/28962804/practical-approach-to-posttraumatic-intracranial-hypertension-according-to-pathophysiologic-reasoning
#12
REVIEW
Daniel Agustín Godoy, Walter Videtta, Mario Di Napoli
Intracranial hypertension is one of leading causes of mortality after acute brain injury. Its causes and origins are multiple. The approach should be based on the underlying pathophysiology. There are different therapeutic modalities to control increased intracranial pressure (ICP), but all share the objective of normalizing basic physiologic variables. ICP control should be combined with adequate cerebral perfusion pressure. The classic approach to ICP control is unidirectional and sequential escalation of therapy...
November 2017: Neurologic Clinics
https://www.readbyqxmd.com/read/28951892/webcmd-a-cross-platform-interface-for-the-bcmd-modelling-framework
#13
Joshua Russell-Buckland, Matthew Caldwell, Ilias Tachtsidis
Multimodal monitoring of the brain generates a great quantity of data, providing the potential for great insight into both healthy and injured cerebral dynamics. In particular, near-infrared spectroscopy can be used to measure various physiological variables of interest, such as haemoglobin oxygenation and the redox state of cytochrome-c-oxidase, alongside systemic signals, such as blood pressure. Interpreting these measurements is a complex endeavour, and much work has been done to develop mathematical models that can help to provide understanding of the underlying processes that contribute to the overall dynamics...
2017: Wellcome Open Research
https://www.readbyqxmd.com/read/28938277/multimodality-neuromonitoring-in-adult-traumatic-brain-injury-a-narrative-review
#14
Martin Smith
Neuromonitoring plays an important role in the management of traumatic brain injury. Simultaneous assessment of cerebral hemodynamics, oxygenation, and metabolism allows an individualized approach to patient management in which therapeutic interventions intended to prevent or minimize secondary brain injury are guided by monitored changes in physiologic variables rather than generic thresholds. This narrative review describes various neuromonitoring techniques that can be used to guide the management of patients with traumatic brain injury and examines the latest evidence and expert consensus guidelines for neuromonitoring...
September 22, 2017: Anesthesiology
https://www.readbyqxmd.com/read/28928632/neurophysiology-of-the-celiac-brain-disentangling-gut-brain-connections
#15
REVIEW
Manuela Pennisi, Alessia Bramanti, Mariagiovanna Cantone, Giovanni Pennisi, Rita Bella, Giuseppe Lanza
Celiac disease (CD) can be considered a complex multi-organ disorder with highly variable extra-intestinal, including neurological, involvement. Cerebellar ataxia, peripheral neuropathy, seizures, headache, cognitive impairment, and neuropsychiatric diseases are complications frequently reported. These manifestations may be present at the onset of the typical disease or become clinically evident during its course. However, CD subjects with subclinical neurological involvement have also been described, as well as patients with clear central and/or peripheral nervous system and intestinal histopathological disease features in the absence of typical CD manifestations...
2017: Frontiers in Neuroscience
https://www.readbyqxmd.com/read/28840162/simultaneous-functional-near-infrared-spectroscopy-and-electroencephalography-for-monitoring-of-human-brain-activity-and-oxygenation-a-review
#16
REVIEW
Antonio M Chiarelli, Filippo Zappasodi, Francesco Di Pompeo, Arcangelo Merla
Multimodal monitoring has become particularly common in the study of human brain function. In this context, combined, synchronous measurements of functional near-infrared spectroscopy (fNIRS) and electroencephalography (EEG) are getting increased interest. Because of the absence of electro-optical interference, it is quite simple to integrate these two noninvasive recording procedures of brain activity. fNIRS and EEG are both scalp-located procedures. fNIRS estimates brain hemodynamic fluctuations relying on spectroscopic measurements, whereas EEG captures the macroscopic temporal dynamics of brain electrical activity through passive voltages evaluations...
October 2017: Neurophotonics
https://www.readbyqxmd.com/read/28805756/-an-experience-of-neurophysiological-monitoring-in-neurosurgery
#17
A G Vasyatkina, E A Levin, K Yu Orlov, V V Kobozev
AIM: To evaluate the efficacy of neuromonitoring methods in prevention of postoperative neurological complications and estimation of predictive power of intraoperative changes in monitored characteristics. MATERIAL AND METHODS: Retrospective study examined 240 patients, operated in the years 2014-2015 using intraoperative neurophysiological monitoring. One hundred and seventy-three patients suffered from hemispheric lesions and 67 had lesions located in or near the brainstem...
2017: Zhurnal Nevrologii i Psikhiatrii Imeni S.S. Korsakova
https://www.readbyqxmd.com/read/28761162/hearables-multimodal-physiological-in-ear-sensing
#18
Valentin Goverdovsky, Wilhelm von Rosenberg, Takashi Nakamura, David Looney, David J Sharp, Christos Papavassiliou, Mary J Morrell, Danilo P Mandic
Future health systems require the means to assess and track the neural and physiological function of a user over long periods of time, and in the community. Human body responses are manifested through multiple, interacting modalities - the mechanical, electrical and chemical; yet, current physiological monitors (e.g. actigraphy, heart rate) largely lack in cross-modal ability, are inconvenient and/or stigmatizing. We address these challenges through an inconspicuous earpiece, which benefits from the relatively stable position of the ear canal with respect to vital organs...
July 31, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28754993/neurometabolic-and-electrophysiological-changes-during-cortical-spreading-depolarization-multimodal-approach-based-on-a-lactate-glucose-dual-microbiosensor-arrays
#19
Cátia F Lourenço, Ana Ledo, Greg A Gerhardt, João Laranjinha, Rui M Barbosa
Spreading depolarization (SD) is a slow propagating wave of strong depolarization of neural cells, implicated in several neuropathological conditions. The breakdown of brain homeostasis promotes significant hemodynamic and metabolic alterations, which impacts on neuronal function. In this work we aimed to develop an innovative multimodal approach, encompassing metabolic, electric and hemodynamic measurements, tailored but not limited to study SD. This was based on a novel dual-biosensor based on microelectrode arrays designed to simultaneously monitor lactate and glucose fluctuations and ongoing neuronal activity with high spatial and temporal resolution...
July 28, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28730399/optical-coherence-tomography-angiography-findings-in-susac-s-syndrome-a-case-report
#20
Rodolfo Mastropasqua, Lisa Toto, Alfonso Senatore, Alessandro D'Uffizi, Piergiorgio Neri, Cesare Mariotti, Marica Tina Maccarone, Luca Di Antonio
PURPOSE: To report clinical features of Susac's syndrome (SS) using optical coherence tomography angiography (OCTA). METHODS: Case report. RESULTS: A 25-year-old Caucasian female with a history of non-pulsatile migraine, tinnitus, and verbal apraxia complaining of peripheral scotoma in left eye due to branch retinal arteriole occlusion (BRAO) was diagnosed as having SS after audiometric test, brain magnetic resonance imaging, and multimodal retinal imaging...
July 20, 2017: International Ophthalmology
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