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Multimodal brain monitor

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https://www.readbyqxmd.com/read/29262436/multimodality-monitoring-toward-improved-outcomes
#1
Richard Gandee, Chad Miller
Multimodality monitoring provides insights into the critically ill brain-injured patient through the assessment of biochemical, physiological, and electrical data that provides insight into a patient's condition and what strategies may be available to limit further damage and improve the odds for recovery. Modalities utilized include evaluation of intracranial pressure along with cerebral perfusion pressure to determine adequate blood flow; continuous electroencephalography to protect the patient from seizures and to identify early functional manifestations of ischemia and toxicity; transcranial Doppler evaluation for bedside review of circulatory adequacy; tissue oxygen monitoring to establish that brain tissue is receiving adequate oxygen from blood flow; and microdialysis to evaluate the metabolic function of the tissue in areas of concern...
December 2017: Seminars in Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/29234304/hypothesis-on-the-role-of-cryptochromes-in-inflammation-and-subarachnoid-hemorrhage-outcome
#2
Adriano Barreto Nogueira, Ariel Barreto Nogueira, José Carlos Esteves Veiga, Manoel Jacobsen Teixeira
We have recently found that the temperature variability (TV) in the day-night cycle may predict the mean intracranial pressure in the following 24 h (ICP24) in subarachnoid hemorrhage (SAH) patients under multimodality monitoring, sedation, and hypothermia (<35°C). Specifically, we found that ICP24 = 6 (4 - TV) mmHg. TV is the ratio between the coefficient of variation of temperature during the nocturnal and the preceding diurnal periods. This result suggests that the circadian clock reflects brain plasticity mechanisms and its malfunctioning leads to deterioration of the neurologic status...
2017: Frontiers in Neurology
https://www.readbyqxmd.com/read/29210401/hybrid-magneto-plasmonic-liposomes-for-multimodal-image-guided-and-brain-targeted-hiv-treatment
#3
Asahi Tomitaka, Hamed Arami, Zaohua Huang, Andrea Raymond, Elizette Rodriguez, Yong Cai, Marcelo Febo, Yasushi Takemura, Madhavan Nair
Image-guided drug delivery is an emerging strategy in the field of nanomedicine. The addition of image guidance to a traditional drug delivery system is expected to achieve highly efficient treatment by tracking the drug carriers in the body and monitoring their effective accumulation in the targeted tissues. In this study, we developed multifunctional magneto-plasmonic liposomes (MPLs), a hybrid system combining liposomes and magneto-plasmonic nanoparticles for a triple-modality image-guided drug delivery...
December 6, 2017: Nanoscale
https://www.readbyqxmd.com/read/29209266/current-opportunities-for-clinical-monitoring-of-axonal-pathology-in-traumatic-brain-injury
#4
REVIEW
Parmenion P Tsitsopoulos, Sami Abu Hamdeh, Niklas Marklund
Traumatic brain injury (TBI) is a multidimensional and highly complex disease commonly resulting in widespread injury to axons, due to rapid inertial acceleration/deceleration forces transmitted to the brain during impact. Axonal injury leads to brain network dysfunction, significantly contributing to cognitive and functional impairments frequently observed in TBI survivors. Diffuse axonal injury (DAI) is a clinical entity suggested by impaired level of consciousness and coma on clinical examination and characterized by widespread injury to the hemispheric white matter tracts, the corpus callosum and the brain stem...
2017: Frontiers in Neurology
https://www.readbyqxmd.com/read/29165917/a-novel-multisite-confocal-system-for-rapid-ca-2-imaging-from-submicron-structures-in-brain-slices
#5
Luiza Filipis, Karima Ait Ouares, Philippe Moreau, Dimitrii Tanese, Valeria Zampini, Andrea Latini, Chun Bleau, Charlie Bleau, Jeremy Graham, Marco Canepari
In brain slices, resolving fast Ca(2+) fluorescence signals from submicron structures is typically achieved using two-photon or confocal scanning microscopy, an approach that limits the number of scanned points. The novel multiplexing confocal system presented here overcomes this limitation. This system is based on a fast spinning disk, a multimode diode laser and a novel high-resolution CMOS camera. The spinning disk, running at 20,000 rpm, has custom-designed spiral pattern that maximises light collection while rejecting out-of-focus fluorescence to resolve signals from small neuronal compartments...
November 22, 2017: Journal of Biophotonics
https://www.readbyqxmd.com/read/29089921/the-neurological-wake-up-test-a-role-in-neurocritical-care-monitoring-of-traumatic-brain-injury-patients
#6
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
#7
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
#8
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
#9
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
#10
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
#11
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
#12
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
#13
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
#14
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
#15
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
#16
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
#17
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
#18
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
#19
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
#20
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
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