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coma stimulation

Michele Torrisi, Adriana Piccolo, Rosaria De Luca, Matteo Berenati, Antonella Olivo, Giuseppa Maresca, Antonino Naro, Rocco Salvatore Calabrò
Disorder of consciousness (DOC) can be either an acute and reversible condition or a chronic condition, including vegetative state or minimally conscious state. Herein, we describe a patient who has unexpectedly recovered consciousness after being in a misdiagnosed vegetative state for a long period. A 63-year-old woman was admitted to our rehabilitation center in vegetative state (Coma Recovery Scale-Revised score, 6) and treated with a standard rehabilitation program, including physical therapy and multisensory stimulation, besides psychoactive drugs...
April 2018: Journal of Neuroscience Nursing: Journal of the American Association of Neuroscience Nurses
Sung Ho Jang, Younghyeon Kwon
RATIONALE: A 45-year-old right-handed female patient suffered head trauma after being hit by a truck that ran into a house. PATIENT CONCERNS: The patient lost consciousness for 1 hour and experienced posttraumatic amnesia for 1 month after the accident. DIAGNOSES: She underwent conservative management for a subdural hematoma in the left frontotemporal lobes and intracerebral hematoma in the left frontal lobe. INTERVENTIONS: The patient's Glasgow Coma Scale score was 11...
March 2018: Medicine (Baltimore)
Willard J Costain, Ingrid Rasquinha, Tanya Comas, Melissa Hewitt, Amy Aylsworth, Yanouchka Rouleau, Vincent Marleau, Evelyn C Soo, Joseph S Tauskela
Synthetic cannabinoids are marketed as legal alternatives to Δ9-THC, and are a growing worldwide concern as these drugs are associated with severe adverse effects. Unfortunately, insufficient information regarding the physiological and pharmacological effects of emerging synthetic cannabinoids (ESCs) makes their regulation by government authorities difficult. One strategy used to evade regulation is to distribute isomers of regulated synthetic cannabinoids. This study characterized the pharmacological properties of a panel of ESCs in comparison to Δ9-THC, as well as six JWH-122 isomers relative to its parent compound (JWH-122-4)...
February 2, 2018: European Journal of Pharmacology
Antonino Naro, Alessia Bramanti, Antonino Leo, Placido Bramanti, Rocco Salvatore Calabrò
The extent of cortical reorganization after brain injury in patients with Vegetative State /Unresponsive Wakefulness Syndrome (UWS) and Minimally Conscious State (MCS) depends on the residual capability of modulating synaptic plasticity. Neuroplasticity is largely abnormal in patients with UWS, although the fragments of cortical activity may exist, while patients MCS show a better cortical organization. The aim of this study was to evaluate cortical excitability in patients with disorders of consciousness (DoC) using a transcranial direct current stimulation (TDCS) metaplasticity protocol...
December 17, 2017: International Journal of Neural Systems
Géraldine Martens, Steven Laureys, Aurore Thibaut
Background: Spasticity is a motor disorder frequently encountered after a lesion involving the central nervous system. It is hypothesized to arise from an anarchic reorganization of the pyramidal and parapyramidal fibers and leads to hypertonia and hyperreflexia of the affected muscular groups. While this symptom and its management is well-known in patients suffering from stroke, multiple sclerosis or spinal cord lesion, little is known regarding its appropriate management in patients presenting disorders of consciousness after brain damage...
December 9, 2017: Brain Sciences
Satoru Yumiba, Kazuhiko Komori, Toshichika Iwanishi, Youhei Koida, Masao Kobayashi, Yutaka Ono
A 77-year-old man with castration-resistant prostate cancer (CRPC) received abiraterone acetate in October 2014. He visited our outpatient clinic because of general malaise and anorexia 27 days after starting abiraterone acetate. The lab test showed hepatic dysfunction (aspartate transaminase, AST 440 U/l, alanine transaminase, ALT 420 U/l) and the elevation of liver enzymes continued on the next day even after stopping abiraterone acetate. Three days later, he was hospitalized due to severe elevation of liver enzymes (AST 1,171 U/l, ALT 1,487 U/l) , and the decreased prothrombin activity (60...
November 2017: Hinyokika Kiyo. Acta Urologica Japonica
Ye Zhang, Weiqun Song, Jubao Du, Su Huo, Guixiang Shan, Ran Li
Background: The electrophysiological evidence supporting the therapeutic efficacy of multiple transcranial direct current stimulation (tDCS) sessions on consciousness improvement in patients with prolonged disorders of consciousness (DOCs) has not been firmly established. Objectives: To assess the effects of repeated tDCS in patients with prolonged DOCs by Coma Recovery Scale-Revised (CRS-R) score and event-related potential (ERP). Method: Using a sham-controlled randomized double-blind design, 26 patients were randomly assigned to either a real [five vegetative state (VS) and eight minimally conscious state (MCS) patients] or sham (six VS and seven MCS patients) stimulation group...
2017: Frontiers in Neurology
Mauro Mancuso, Laura Abbruzzese, Stefania Canova, Giulia Landi, Simone Rossi, Emiliano Santarnecchi
Background: The absence of efficient treatments capable to promote central nervous system recovery in patients in vegetative state (VS) due to a severe acquired brain injury highlights the need of exploring alternative neuromodulatory treatments that can lead to neurobehavioral gains. Some encouraging preliminary observations suggest that transcranial direct current stimulation could be effective in disorders of consciousness (DoC) patients, especially when applied on the dorsolateral prefrontal cortex (DLPFC) in patients with minimally conscious state (MCS) but not in those with VS...
2017: Frontiers in Human Neuroscience
Yang Bai, Xiaoyu Xia, Yong Wang, Yongkun Guo, Yi Yang, Jianghong He, Xiaoli Li
A transcranial direct current stimulation (tDCS) protocol (2 min, 2 mA, anodal electrode at the left dorsolateral prefrontal cortex and cathodal electrode at the right supraorbital area) was applied in patients with different degrees of disorders of consciousness (DoC). Although previous research indicates that it could improve patients' coma recovery scale-revised (CRS-R) scores, the brain's electrophysiological responses to tDCS are still unclear. Therefore, the present study was performed to explore the underlying brain responses of patients in a minimally conscious state (MCS) and a Unresponsive Wakefulness Syndrome (UWS) to tDCS modulation...
November 21, 2017: International Journal of Neuroscience
Simona Pichini, Renata Solimini, Paolo Berretta, Roberta Pacifici, Francesco Paolo Busardò
Illicit fentanyl and its analogues are very dangerous synthetic opioids, with high abuse potential and severe adverse effects including coma and death. They are used as adulterants in street heroin, cocaine, and methamphetamine, or as heroin substitutes sold to unaware users with a high risk of overdoses. Fentanyl and its analogues have also been identified in counterfeit medicinal products, such as oxycodone, hydrocodone, and alprazolam tablets, or as components of speedball mixtures together with cocaine or other stimulants...
February 2018: Therapeutic Drug Monitoring
Júlia Rodríguez-Comas, Alba Moreno-Asso, Juan Moreno-Vedia, Mercè Martín, Carlos Castaño, Anna Marzà-Florensa, Xavier Bofill-De Ros, Joan Mir-Coll, Joel Montané, Cristina Fillat, Rosa Gasa, Anna Novials, Joan-Marc Servitja
The pancreatic β-cell transcriptome is highly sensitive to external signals such as glucose oscillations and stress cues. MicroRNAs (miRNAs) have emerged as key factors in gene expression regulation. Here, we aimed to identify miRNAs that are modulated by glucose in mouse pancreatic islets. We identified miR-708 as the most upregulated miRNA in islets cultured at low glucose concentrations, a setting that triggers a strong stress response. miR-708 was also potently upregulated by triggering endoplasmic reticulum (ER) stress with thapsigargin and in islets of ob / ob mice...
December 2017: Diabetes
Xiaoguang Du, Baozhong Dong, Chen Li, Faxue Zhang, Yanwei Ji, Jianbin Zhang, Changjiang Yin
The aim of the study was to investigate dynamic changes in α-melanocyte-stimulating hormone (α-MSH) levels in the serum of patients with craniocerebral trauma. Forty-eight patients with acute craniocerebral injury were selected between January 2015 and October 2016. The patients were divided into three groups: severe (18 cases), moderate (16 cases) and mild (14 cases), according to the Glasgow Coma Scale (GCS) score at the time of admission. At the same time, 10 adults with a similar age distribution to the patients were also selected as a control group...
September 2017: Experimental and Therapeutic Medicine
Xiaoyu Xia, Yang Liu, Yang Bai, Ziyuan Liu, Yi Yang, Yongkun Guo, Ruxiang Xu, Xiaorong Gao, Xiaoli Li, Jianghong He
Repetitive transcranial magnetic stimulation (rTMS) has been applied for the treatment of patients with disorders of consciousness (DOC). Timely and accurate assessments of its modulation effects are very useful. This study evaluated rTMS modulation effects on electroencephalography (EEG) oscillation in patients with chronic DOC. Eighteen patients with a diagnosis of DOC lasting more than 3 months were recruited. All patients received one session of 10-Hz rTMS at the left dorsolateral prefrontal cortex and then 12 of them received consecutive rTMS treatment everyday for 20 consecutive days...
September 11, 2017: Neuroreport
Li Zhang, Jinyun Tan, Xiaoping Jiang, Weiwei Qian, Ting Yang, Xijun Sun, Zhaohui Chen, Qiwen Zhu
BACKGROUND: CCL2 was up-regulated in neurons and involved in microglia activation and neurological decline in mice suffering from hepatic encephalopathy (HE). However, no data exist concerning the effect of neuron-derived CCL2 on microglia activation in vitro. METHODS: The rats were pretreated with CCL2 receptor inhibitors (INCB or C021, 1 mg/kg/day i.p.) for 3 days prior to thioacetamide (TAA) administration (300 mg/kg/day i.p.) for inducing HE model. At 8 h following the last injection (and every 4 h after), the grade of encephalopathy was assessed...
September 4, 2017: Biological Research
Antonino Naro, Placido Bramanti, Alessia Bramanti, Rocco Salvatore Calabrò
The deterioration of sensory-motor integration within the pain matrix in patients with chronic Disorders of Consciousness (DoC) is one of the principal mechanisms responsible for non-conscious pain perception. The present study aimed to assess whether the variability in the inter-peak interval (IPI) between the N2 and P2 components of laser evoked potentials (LEP) could represent an objective marker of the behavioral responsiveness to nociceptive stimulation, as measured by the Nociception Coma Scale-Revised (NCS-R), and regardless of the sensory part of pain processing...
October 2017: Consciousness and Cognition
Birger Johnsen, Kristoffer B Nøhr, Christophe H V Duez, Mads Q Ebbesen
EEG reactivity (EEG-R) is regarded as an important parameter in coma prognosis but knowledge is sparse on the nature of EEG changes due to different kinds of stimulation and their prognostic significance. EEG-R was quantified in a study of 39 comatose neurosurgical patients. Six 30-second standardized visual, auditory, and painful stimulations were applied. EEG-R in the delta, theta, alpha, and beta band was normalized in z-scores as the power of a stimulation epoch relative to average power of 6 resting epochs...
November 2017: Clinical EEG and Neuroscience: Official Journal of the EEG and Clinical Neuroscience Society (ENCS)
Joel Montane, Sara de Pablo, Carlos Castaño, Júlia Rodríguez-Comas, Lisa Cadavez, Mercè Obach, Montse Visa, Gema Alcarraz-Vizán, Melchor Sanchez-Martinez, Alfons Nonell-Canals, Marcelina Parrizas, Joan-Marc Servitja, Anna Novials
Human islet amyloid polypeptide (hIAPP) aggregation is associated with β-cell dysfunction and death in type 2 diabetes (T2D). we aimed to determine whether in vivo treatment with chemical chaperone 4-phenylbutyrate (PBA) ameliorates hIAPP-induced β-cell dysfunction and islet amyloid formation. Oral administration of PBA in hIAPP transgenic (hIAPP Tg) mice expressing hIAPP in pancreatic β cells counteracted impaired glucose homeostasis and restored glucose-stimulated insulin secretion. Moreover, PBA treatment almost completely prevented the transcriptomic alterations observed in hIAPP Tg islets, including the induction of genes related to inflammation...
December 2017: FASEB Journal: Official Publication of the Federation of American Societies for Experimental Biology
Xiang Wu, Chao Zhang, Junfeng Feng, Qing Mao, Guoyi Gao, Jiyao Jiang
BACKGROUND: Traumatic brain injury (TBI) has become the most common cause of death and disability in persons between 15 and 30 years of age, and about 10-15% of patients affected by TBI will end up in a coma. Coma caused by TBI presents a significant challenge to neuroscientists. Right median nerve electrical stimulation has been reported as a simple, inexpensive, non-invasive technique to speed recovery and improve outcomes for traumatic comatose patients. METHODS/DESIGN: This multicentre, prospective, randomised (1:1) controlled trial aims to demonstrate the efficacy and safety of electrical right median nerve stimulation (RMNS) in both accelerating emergence from coma and promoting long-term outcomes...
July 10, 2017: Trials
H J Stemmler, R Pihusch
Stupor and coma are clinical states in which patients have impaired responsiveness or are unresponsive to external stimulation and are either difficult to arouse or are unarousable. The term stupor refer to states between alertness and coma. An alteration in arousal represents an acute life-threatening emergency, requiring prompt intervention for preservation of life and brain function.
September 2017: Der Internist
F Salmani, E Mohammadi, M Rezvani, A Kazemnezhad
BACKGROUND: Despite the well-defined effects of sensory stimulation, the knowledge of the pure effects of affective stimulation is scarce. OBJECTIVE: To evaluate the effects of family-centered affective stimulation on the level of consciousness among comatose patients with brain injuries. DESIGN: This study was designed as a three-group double-blinded Randomized Controlled Trial. METHODS: Ninety consecutive patients with traumatic brain injuries and a Glasgow Coma Scale score of 5-8 were selected...
June 4, 2017: International Journal of Nursing Studies
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