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coma stimulation

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https://www.readbyqxmd.com/read/28323659/stimulus-induced-rhythmic-periodic-or-ictal-discharges-in-coma-incidence-and-interrater-reliability-of-continuous-eeg-after-a-standard-stimulation-protocol-a-prospective-study
#1
Khalid A Alsherbini, Joao Mc-OʼNeil Plancher, David M Ficker, Brandon P Foreman, Opeolu M Adeoye, Jun Ying, Michael D Privitera
PURPOSE: Stimulus-induced rhythmic, periodic, or ictal discharges (SIRPIDs) are often seen during continuous electroencephalographic (cEEG) monitoring in coma. Given their uncertain clinical significance, our prospective study evaluated incidence of SIRPIDs in comatose patients in the neuroscience intensive care unit (NSICU) who underwent a standard stimulation protocol and defined interreader reliability for cEEG. METHODS: Of 146 patients prospectively screened who underwent cEEG during a 6-month period, 53 patients were included and 93 patients were excluded...
March 17, 2017: Journal of Clinical Neurophysiology: Official Publication of the American Electroencephalographic Society
https://www.readbyqxmd.com/read/28281845/controlled-clinical-trial-of-repeated-prefrontal-tdcs-in-patients-with-chronic-minimally-conscious-state
#2
Aurore Thibaut, Sarah Wannez, Anne-Francoise Donneau, Camille Chatelle, Olivia Gosseries, Marie-Aurélie Bruno, Steven Laureys
OBJECTIVES: To assess the effects of repeated transcranial direct current stimulation (tDCS) sessions on the level of consciousness in chronic patients in minimally conscious state (MCS). METHODS: In this randomized double-blind sham-controlled crossover study, we enrolled 16 patients in chronic MCS. For 5 consecutive days, each patient received active or sham tDCS over the left prefrontal cortex (2 mA during 20 min). Consciousness was assessed with the Coma Recovery Scale-Revised (CRS-R) before the first stimulation (baseline), after each stimulation (day 1-day 5) and 1 week after the end of each session (day 12)...
March 10, 2017: Brain Injury: [BI]
https://www.readbyqxmd.com/read/28239544/measures-of-metabolism-and-complexity-in-the-brain-of-patients-with-disorders-of-consciousness
#3
Olivier Bodart, Olivia Gosseries, Sarah Wannez, Aurore Thibaut, Jitka Annen, Melanie Boly, Mario Rosanova, Adenauer G Casali, Silvia Casarotto, Giulio Tononi, Marcello Massimini, Steven Laureys
BACKGROUND: Making an accurate diagnosis in patients with disorders of consciousness remains challenging. (18)F-fluorodeoxyglucose (FDG)-PET has been validated as a diagnostic tool in this population, and allows identifying unresponsive patients with a capacity for consciousness. In parallel, the perturbational complexity index (PCI), a new measure based on the analysis of the electroencephalographic response to transcranial magnetic stimulation, has also been suggested as a tool to distinguish between unconscious and conscious states...
2017: NeuroImage: Clinical
https://www.readbyqxmd.com/read/28222692/hashimoto-s-encephalitis-associated-with-ampar2-antibodies-a-case-report
#4
Mingqin Zhu, Xuefan Yu, Caiyun Liu, Chenchen Duan, Chunxiao Li, Jie Zhu, Ying Zhang
BACKGROUND: Hashimoto's encephalitis (HE) is a rare neurological complication of Hashimoto's thyroiditis (HT), while limbic encephalitis (LE) is an autoimmune inflammatory disorder frequently associated with anti-neuronal antibodies. The glutamate receptor α-amino-3-hydroxy-5-methyl-4-isoxazole-propionic acid receptor (AMPAR) is important for synaptic transmission, memory, and learning. The etiology of HE remains unclear. We present a case of HE with antibodies to AMPAR2 both in the serum and cerebrospinal fluid...
February 21, 2017: BMC Neurology
https://www.readbyqxmd.com/read/28180120/effects-of-a-sensory-stimulation-by-nurses-and-families-on-level-of-cognitive-function-and-basic-cognitive-sensory-recovery-of-comatose-patients-with-severe-traumatic-brain-injury-a-randomized-control-trial
#5
Marzieh Moattari, Fatemeh Alizadeh Shirazi, Nasrin Sharifi, Najaf Zareh
BACKGROUND: Several lines of evidence suggest that early sensory stimulation and regular family visiting programs are potential nursing interventions to improve the outcomes of head injured comatose patients. However, little is known about the impacts of family involvement in providing sensory stimulation. OBJECTIVES: To determine the effects of a sensory stimulation program conducted by nurses and families on the consciousness, level of cognitive function, and basic cognitive sensory recovery of head injury comatose patients...
September 2016: Trauma Monthly
https://www.readbyqxmd.com/read/28152637/l-arginine-in-the-treatment-of-valproate-overdose-five-clinical-cases
#6
Verena Schrettl, Norbert Felgenhauer, Christian Rabe, Malkanthi Fernando, Florian Eyer
BACKGROUND: Valproic acid and its metabolites - particularly valproyl-CoA - are inhibitors of the enzyme N-acetylglutamate synthetase. The amino acid l-arginine can stimulate N-acetylglutamate synthetase activity and could be potentially used therapeutically to correct hyperammonemia caused by valproate therapy or overdose. Severely valproic-acid-poisoned patients are usually treated with l-carnitine or hemodialysis in order to decrease hyperammonemia. We herein report of five cases, in which l-arginine was administered...
April 2017: Clinical Toxicology
https://www.readbyqxmd.com/read/28102097/familiar-auditory-sensory-training-in-chronic-traumatic-brain-injury-a-case-study
#7
Emily Galassi Sullivan, Ann Guernon, Brett Blabas, Amy A Herrold, Theresa L-B Pape
PURPOSE: The evaluation and treatment for patients with prolonged periods of seriously impaired consciousness following traumatic brain injury (TBI), such as a vegetative or minimally conscious state, poses considerable challenges, particularly in the chronic phases of recovery. METHOD: This blinded crossover study explored the effects of familiar auditory sensory training (FAST) compared with a sham stimulation in a patient seven years post severe TBI. Baseline data were collected over 4 weeks to account for variability in status with neurobehavioral measures, including the Disorders of Consciousness scale (DOCS), Coma Near Coma scale (CNC), and Consciousness Screening Algorithm...
January 19, 2017: Disability and Rehabilitation
https://www.readbyqxmd.com/read/28087785/thermolytic-degradation-of-synthetic-cannabinoids-chemical-exposures-and-pharmacological-consequences
#8
Brian F Thomas, Timothy W Lefever, Ricardo A Cortes, Alexander L Kovach, Anderson O Cox, Purvi R Patel, Gerald T Pollard, Julie A Marusich, Richard A Kevin, Thomas F Gamage, Jenny L Wiley
Synthetic cannabinoids are manufactured clandestinely with little quality control and are distributed as herbal "Spice" for smoking or as bulk compound for mixing with a solvent and inhalation via electronic vaporizers. Intoxication with synthetic cannabinoids has been associated with seizure, excited delirium, coma, kidney damage, and other disorders. The chemical alterations produced by heating these structurally novel compounds for consumption are largely unknown. Here we show that heating synthetic cannabinoids containing tetramethylcyclopropyl-ring substituents produced thermal degradants with pharmacological activity that varied considerably from their parent compounds...
January 13, 2017: Journal of Pharmacology and Experimental Therapeutics
https://www.readbyqxmd.com/read/28055088/myxedema-psychosis-in-a-patient-with-undiagnosed-hashimoto-thyroiditis
#9
Matthew M Mavroson, Nirav Patel, Eleonora Akker
Myxedema psychosis is uncommon in patients with primary hypothyroidism. Most often, this disease state can be found in patients with Hashimoto thyroiditis or after total thyroidectomy. Chronic hypothyroidism can lead to an insidious onset of psychiatric symptoms in patients, such as dementia, delirium, psychosis, hallucinations, and coma. A 31-year-old man with an unremarkable medical history was brought to the psychiatric emergency department for new-onset aggression, paranoid behavior, and hallucinations for 4 days...
January 1, 2017: Journal of the American Osteopathic Association
https://www.readbyqxmd.com/read/27812319/evaluating-the-effect-of-repetitive-transcranial-magnetic-stimulation-on-disorders-of-consciousness-by-using-tms-eeg
#10
Yang Bai, Xiaoyu Xia, Jiannan Kang, Xiaoxiao Yin, Yi Yang, Jianghong He, Xiaoli Li
Background: The modulation efficacy of Transcranial magnetic stimulation (TMS) on consciousness improvement of patient with disorder of consciousness (DOC) has not been definitely confirmed. Objective: This study proposes TMS-EEG to assess effects of repetitive TMS (rTMS) on brain modulation of DOC. Methods: Twenty sessions of 10 Hz rTMS were applied over the dorsolateral prefrontal cortex for a patient with DOC. Measures of Coma Recovery Scale-Revised (CRS-R) score, TMS-evoked potential (TEP), perturbation complexity index (PCI), and global mean field power (GMFP) were used to evaluate the consciousness level of the patient at three intervals: before the rTMS protocol (T0), immediately after one session rTMS (T1), and immediately after 20 sessions (T2)...
2016: Frontiers in Neuroscience
https://www.readbyqxmd.com/read/27793075/does-modafinil-improve-the-level-of-consciousness-for-people-with-a-prolonged-disorder-of-consciousness-a-retrospective-pilot-study
#11
Samira Kashinath Dhamapurkar, Barbara A Wilson, Anita Rose, Peter Watson, Agnes Shiel
BACKGROUND AND AIM: Modafinil is best known as a sleep regulator among healthy individuals, but studies suggest that it reduces excessive daytime sleepiness in patients with brain injury. This retrospective pilot study evaluated the effectiveness of Modafinil for people with a prolonged disorder of consciousness and whether those with a traumatic brain injury did better than those with a non-traumatic brain injury. METHOD: Twenty four prolonged disorder of consciousness patients who were prescribed Modafinil, were assessed at least four times both before and during treatment...
October 28, 2016: Disability and Rehabilitation
https://www.readbyqxmd.com/read/27773729/do-you-see-me-the-role-of-visual-fixation-in-chronic-disorders-of-consciousness-differential-diagnosis
#12
Antonino Naro, Antonino Leo, Antonio Buda, Alfredo Manuli, Alessia Bramanti, Placido Bramanti, Rocco Salvatore Calabrò
Visual fixation (VF) of a target is a possible, although atypical, feature of the Unresponsive Wakefulness Syndrome (UWS). Whether VF may indicate residual awareness in these patients is debatable, since it may simply subtend a series of reflex processes. Objective tools should therefore be used to identify aware VF, which depends on the integrity of visuomotor networks encompassing frontal-parietal-occipital areas. The aim of our study was to detect residual visuomotor network functionality potentially sustaining aware VF...
October 20, 2016: Brain Research
https://www.readbyqxmd.com/read/27738996/the-neural-correlates-of-lexical-processing-in-disorders-of-consciousness
#13
Anna Nigri, Eleonora Catricalà, Stefania Ferraro, Maria Grazia Bruzzone, Ludovico D'Incerti, Davide Sattin, Davide Rossi Sebastiano, Silvana Franceschetti, Giorgio Marotta, Riccardo Benti, Matilde Leonardi, Stefano F Cappa
There is a growing interest in the use of functional imaging to assess brain activity in the absence of behavioural responses in patients with disorders of consciousness (DOC). In the present study, we applied a hierarchical auditory stimulation paradigm to functional magnetic resonance (fMRI) in a group of long-term DOC adult patients. Brain response to pairs of pseudowords, of unrelated words and of semantically related words, i.e. stimuli differing in lexical status (words vs. pseudowords) and semantic relatedness (related vs...
October 13, 2016: Brain Imaging and Behavior
https://www.readbyqxmd.com/read/27695233/evaluation-of-pituitary-function-in-cases-with-the-diagnosis-of-pediatric-mild-traumatic-brain-injury-cross-sectional-study
#14
Hakan Aylanç, Filiz Tütüncüler, Necdet Süt
BACKGROUND: This study was to determine whether pituitary dysfunction occurs after head trauma in children or not and which axis is affected more; to define the association of pituitary dysfunction with the severity of head trauma and duration time after the diagnosis of head trauma. MATERIALS AND METHODS: In this study, 24 children who were diagnosed with head trauma were evaluated regarding pituitary dysfunction. In all cases, after 12 h fasting, serum cortisol, fT3, fT4, thyroid-stimulating hormone, prolactin, insulin-like growth factor-1, serum sodium, urine density, follicle-stimulating hormone, luteinizing hormone, in female cases E2, in male cases, TT levels were determined...
October 2016: Journal of Neurosciences in Rural Practice
https://www.readbyqxmd.com/read/27639840/steroid-responsive-encephalopathy-associated-with-autoimmune-thyroiditis-sreat-characteristics-treatment-and-outcome-in-251-cases-from-the-literature
#15
REVIEW
Charlotte Laurent, Jean Capron, Bluenn Quillerou, Guy Thomas, Sonia Alamowitch, Olivier Fain, Arsène Mekinian
BACKGROUND: Steroid-responsive encephalopathy and associated autoimmune thyroiditis (SREAT) is characterized by encephalopathy and the presence of antithyroid antibodies. We describe the clinical presentation, outcome and treatments for SREAT by a systematic review of the literature. METHODS: MEDLINE via PubMed, Web of Science and the Cochrane Library were searched for articles published until 2015. Inclusion criteria were unexplained encephalopathy with antithyroid antibodies...
December 2016: Autoimmunity Reviews
https://www.readbyqxmd.com/read/27631398/myxedema-coma-secondary-to-central-hypothyroidism-a-rare-but-real-cause-of-altered-mental-status-in-pediatrics
#16
Michael D Thompson, Rohan K Henry
BACKGROUND: Myxedema coma (MC), a medical emergency defined as severe hypothyroidism leading to altered mental status, is more common in older women with hypothyroidism. METHODS/RESULTS: A 7-year-old Caucasian male with chromosome 1q deletion presented with altered mental status preceded by milestone regression. His presenting labs results were: thyroid-stimulating hormone (TSH) 0.501 μIU/ml and free thyroxine (T4) <0.5 ng/dl. His morning cortisol level was 8...
September 16, 2016: Hormone Research in Pædiatrics
https://www.readbyqxmd.com/read/27598995/granzyme-a-contributes-to-inflammatory-arthritis-through-stimulation-of-osteoclastogenesis
#17
Llipsy Santiago, Cheikh Menaa, Maykel Arias, Praxedis Martin, Paula Jaime-Sánchez, Sunil Metkar, Laura Comas, Nadina Erill, Victor Gonzalez-Rumayor, Erica Esser, Eva Ma Galvez, Sri Raja, Markus M Simon, Stuart M Sprague, Cem Gabay, Luis Martinez-Lostao, Julian Pardo, Christopher J Froelich
OBJECTIVE: Granzyme A (GzmA) is elevated in the plasma and synovium in RA patients suggesting the involvement of the protease in its pathogenesis. GzmA contributes to sepsis by regulating pro-inflammatory cytokine production. We evaluated the contribution of GzmA to the pathogenesis of RA in vivo and the possibility that GzmA via TNF-α stimulates osteoclastogenesis. METHODOLOGY: Inflammatory arthritis induced by type II collagen was evaluated in wild type, GzmA deficient and perforin deficient mice...
September 6, 2016: Arthritis & Rheumatology
https://www.readbyqxmd.com/read/27585057/helping-persons-in-a-minimally-conscious-state-develop-responding-and-stimulation-control-through-a-microswitch-aided-program
#18
Giulio E Lancioni, Nirbhay Singh, Mark F O'Reilly, Jeff Sigafoos, Fiora D'Amico, Francesca Buonocunto, Jorge Navarro, Crocifissa Lanzilotti, Pietro Fiore, Marisa Megna, Sabino Damiani, Riccardo Marvulli
BACKGROUND: Post-coma persons in a minimally conscious state (MCS) and with extensive motor impairment cannot independently access and control environmental stimulation. AIM: Assessing the effects of a microswitch-aided program aimed at helping MCS persons develop responding and stimulation control and conducting a social validation/evaluation of the program. DESIGN: A single-subject ABAB design was used for each participant to determine the impact of the program on his or her responding...
September 1, 2016: European Journal of Physical and Rehabilitation Medicine
https://www.readbyqxmd.com/read/27581664/presentations-to-an-urban-emergency-department-in-switzerland-due-to-acute-%C3%AE-hydroxybutyrate-toxicity
#19
Evangelia Liakoni, Fabio Walther, Christian H Nickel, Matthias E Liechti
BACKGROUND: γ-Hydroxybutyrate (GHB) is a drug of abuse with dose-dependent sedative effects. Systematic data on the acute toxicity of GHB from emergency department (ED) presentations over a long period of time are currently missing from the literature. The present study described the clinical features of GHB toxicity. METHODS: Retrospective case series of GHB intoxications seen in an urban ED. RESULTS: From January 2002 to September 2015, 78 GHB-related intoxication cases were recorded (71 % male patients)...
August 31, 2016: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/27494756/neurobehavioural-assessment-and-diagnosis-in-disorders-of-consciousness-a-preliminary-study-of-the-sensory-tool-to-assess-responsiveness-star
#20
Verity Stokes, Sarah Gunn, Katie Schouwenaars, Derar Badwan
The Sensory Tool to Assess Responsiveness (STAR) is an interdisciplinary neurobehavioural diagnostic tool for individuals with prolonged disorders of consciousness. It utilises current diagnostic criteria and is intended to improve upon the high misdiagnosis rate in this population. This study assesses the inter-rater reliability of the STAR and its diagnostic validity in comparison with the Coma Recovery Scale-Revised (CRS-R) and the Wessex Head Injury Matrix (WHIM). Participants were patients with severe acquired brain injury resulting in a disorder of consciousness, who were admitted to the Royal Leamington Spa Rehabilitation Hospital between 1999 and 2009...
August 5, 2016: Neuropsychological Rehabilitation
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