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Minimally conscious state

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https://www.readbyqxmd.com/read/29428346/improvement-on-the-coma-recovery-scale-revised-during-the-first-four-weeks-of-hospital-stay-predicts-outcome-at-discharge-in-intensive-rehabilitation-after-severe-brain-injury
#1
Emilio Portaccio, Azzurra Morrocchesi, Anna Maria Romoli, Bahia Hakiki, Maria Pia Taglioli, Elena Lippi, Martina Di Renzone, Antonello Grippo, Claudio Macchi
OBJECTIVES: to evaluate the prognostic utility of serial assessment on the Coma Recovery Scale-Revised (CRS-R) during the first 4 weeks of intensive rehabilitation in patients surviving from severe brain injury DESIGN: prospective cohort study PARTICIPANTS: Patients consecutively admitted to the Intensive Rehabilitation Unit at the IRCCS Don Gnocchi Foundation (Florence, Italy). Inclusion criteria were diagnosis of unresponsive wakefulness syndrome (UWS) or minimally conscious state (MCS) due to acquired brain injury, age older than 18 years...
February 8, 2018: Archives of Physical Medicine and Rehabilitation
https://www.readbyqxmd.com/read/29423955/new-and-emerging-techniques-for-endoscopic-treatment-of-zenker-s-diverticulum-a-state-of-the-art-review
#2
REVIEW
Sauid Ishaq, Haleema Sultan, Keith Siau, Toshio Kuwai, C J J Mulder, Helmut Neumann
Zenker's diverticulum (ZD), or pharyngeal pouch, is an anatomical defect characterised by herniation of the posterior pharyngeal wall through Killian's dehiscence, and may result in dysphagia and regurgitation. Multiple therapeutic modalities including surgery, rigid and flexible endoscopy have been developed to manage ZD. Although surgical management with open and endoscopically-assisted techniques have historically been the mainstay of ZD treatment, minimally invasive flexible endoscopic techniques, performed under conscious sedation, are increasingly favoured...
February 9, 2018: Digestive Endoscopy: Official Journal of the Japan Gastroenterological Endoscopy Society
https://www.readbyqxmd.com/read/29417320/bridging-the-gap-towards-awareness-detection-in-disorders-of-consciousness-an-experimental-study-on-the-mirror-neuron-system
#3
Antonino Naro, Rocco Salvatore Calabrò, Antonino Leo, Margherita Russo, Demetrio Milardi, Antonino Cannavò, Alfredo Manuli, Antonio Buda, Carmela Casella, Placido Bramanti, Alberto Cacciola, Alessia Bramanti
Advanced functional neuroimaging approaches dealing with motor imagery have disclosed covert cognitive processes in patients with disorders of consciousness (DoC). However, motor impairment and cognitive-motor dissociation can bias such approaches. Fourteen patients with post-traumatic DoC and ten healthy controls (HC) were provided with three motor tasks related to mirror neuron system (MNS) activation (movement observation, movement execution, and passive motor imagery of a movement) while recording electroencephalographic (EEG) metrics [EEG power and Granger Casualty Index (GCI)] to detect residual signs of conscious awareness...
February 7, 2018: Brain Topography
https://www.readbyqxmd.com/read/29415172/reply-response-to-minimally-conscious-state-or-cortically-mediated-state
#4
Lionel Naccache
No abstract text is available yet for this article.
February 5, 2018: Brain: a Journal of Neurology
https://www.readbyqxmd.com/read/29415149/response-to-minimally-conscious-state-or-cortically-mediated-state
#5
Tim Bayne, Jakob Hohwy, Adrian M Owen
No abstract text is available yet for this article.
February 5, 2018: Brain: a Journal of Neurology
https://www.readbyqxmd.com/read/29390070/no-judge-required-m-by-her-litigation-friend-mrs-b-v-a-hospital-m-withdrawal-of-treatment-need-for-proceedings-2017-ewcop-19
#6
Stephanie M Pywell
The two titles of the judgment on which this commentary is based reflect the fact that its scope was wider than resolving the legal matter at issue between two parties. It records the reasons for Jackson J's decision on a set of facts, it clarifies whether legal proceedings were necessary and the form that they should take, and it explains why the Court of Protection appointed a patient's mother as her litigation friend. The case arose from a request for a declaration that it would be lawful to withdraw clinically assisted nutrition and hydration from a woman with Huntingdon's disease who had been in a minimally conscious state for about one year...
January 29, 2018: Medical Law Review
https://www.readbyqxmd.com/read/29370729/metaplasticity-a-promising-tool-to-disentangle-chronic-disorders-of-consciousness-differential-diagnosis
#7
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
https://www.readbyqxmd.com/read/29361268/gamma-ventral-capsulotomy-in-intractable-obsessive-compulsive-disorder
#8
Steven A Rasmussen, Georg Norén, Benjamin D Greenberg, Richard Marsland, Nicole C McLaughlin, Paul J Malloy, Stephen P Salloway, David R Strong, Jane L Eisen, Michael A Jenike, Scott L Rauch, Lee Baer, Christer Lindquist
BACKGROUND: Despite the development of effective pharmacologic and cognitive behavioral treatments for obsessive-compulsive disorder (OCD), some patients continue to be treatment-refractory and severely impaired. Fiber tracts connecting orbitofrontal and dorsal anterior cingulate cortex with subcortical nuclei have been the target of neurosurgical lesions as well as deep brain stimulation in these patients. We report on the safety and efficacy of ventral gamma capsulotomy for patients with intractable OCD...
December 15, 2017: Biological Psychiatry
https://www.readbyqxmd.com/read/29338107/how-often-is-the-diagnosis-of-the-permanent-vegetative-state-incorrect-a-review-of-the-evidence
#9
Derick T Wade
BACKGROUND: Some research suggests that 40% of people in the vegetative state are misdiagnosed. This review investigates the frequency, nature and causes of reported misdiagnosis of patients in the vegetative state, focusing on the nature of the error. METHOD: A systematic review of all relevant literature, using references from key papers identified. Data summarised in tables. RESULTS: Five clinical studies of rate of misdiagnosis in practice were identified, encompassing 236 patients in the vegetative state of whom 80 (34%) were reclassified has having some awareness, often minimal...
January 16, 2018: European Journal of Neurology: the Official Journal of the European Federation of Neurological Societies
https://www.readbyqxmd.com/read/29325560/feasibility-and-predictive-performance-of-the-hendrich-fall-risk-model-ii-in-a-rehabilitation-department-a-prospective-study
#10
Isabella Campanini, Stefano Mastrangelo, Annalisa Bargellini, Agnese Bassoli, Gabriele Bosi, Francesco Lombardi, Stefano Tolomelli, Mirco Lusuardi, Andrea Merlo
BACKGROUND: Falls are a common adverse event in both elderly inpatients and patients admitted to rehabilitation units. The Hendrich Fall Risk Model II (HIIFRM) has been already tested in all hospital wards with high fall rates, with the exception of the rehabilitation setting. This study's aim is to address the feasibility and predictive performances of HIIFRM in a hospital rehabilitation department. METHODS: A 6 months prospective study in a Italian rehabilitation department with patients from orthopaedic, pulmonary, and neurological rehabilitation wards...
January 11, 2018: BMC Health Services Research
https://www.readbyqxmd.com/read/29307451/sleep-patterns-associated-with-the-severity-of-impairment-in-a-large-cohort-of-patients-with-chronic-disorders-of-consciousness
#11
Davide Rossi Sebastiano, Elisa Visani, Ferruccio Panzica, Davide Sattin, Anna Bersano, Anna Nigri, Stefania Ferraro, Eugenio Parati, Matilde Leonardi, Silvana Franceschetti
OBJECTIVE: We assessed sleep patterns in 85 patients with chronic disorders of consciousness (DOC) in order to reveal any relationship with the degree of the impairment. METHODS: Nocturnal polysomnography (PSG) was scored in patients classified as being in an unresponsive wakefulness syndrome/vegetative state (UWS/VS; n = 49) or a minimally conscious state (MCS; n = 36) in accordance with the rules of the American Academy of Sleep Medicine. The PSG data in the two diagnostic groups were compared, and the PSG parameters associated with the degree of impairment were analysed...
December 24, 2017: Clinical Neurophysiology: Official Journal of the International Federation of Clinical Neurophysiology
https://www.readbyqxmd.com/read/29278634/pain-intensity-scales-comparison-in-patient-with-abdominal-pain
#12
Zoran Trninić, Manja Spahalić, Gordan Galić, Davorin Kozomara, Valentina Lasić, Danijel Bevanda, Nikica Šutalo
BACKGROUND: The aim of study was to explore efficiency of the pain rating scales on patients experiencing abdominal pain, determine correlation between the scales and their applicability to general population and determine the minimal clinical important difference in mm on the VAS as discriminatory for difference in pain intensity. SUBJECTS AND METHODS: The study was performed at the Emergency Department of the University Clinical Hospital of Mostar on patients with abdominal pain which started less than 24 hours before, excluding patients under 16 years old, uncooperative patients and those with altered state of consciousness...
December 2017: Psychiatria Danubina
https://www.readbyqxmd.com/read/29274102/effect-of-age-on-narcotrend-index-monitoring-during-sevoflurane-anesthesia-in-children-below-2%C3%A2-years-of-age
#13
Nils Dennhardt, Stefanie Arndt, Christiane Beck, Dietmar Boethig, Sebastian Heiderich, Barbara Schultz, Frank Weber, Robert Sümpelmann
BACKGROUND: In older children, different electroencephalogram-based algorithms for measuring depth of anesthesia displayed a similar performance as in adults, but in infants they have not displayed the same reliability so far. According to the individual developmental state, the Narcotrend distinguishes "differentiated" electroencephalograms, which can be classified using the full Narcotrend Index scale, from "undifferentiated" electroencephalograms, which are classified using a scale with fewer stages...
December 23, 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/29232836/spasticity-management-in-disorders-of-consciousness
#14
REVIEW
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
https://www.readbyqxmd.com/read/29209270/transcranial-direct-current-stimulation-in-patients-with-prolonged-disorders-of-consciousness-combined-behavioral-and-event-related-potential-evidence
#15
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
https://www.readbyqxmd.com/read/29206895/minimally-conscious-state-or-cortically-mediated-state
#16
Lionel Naccache
Durable impairments of consciousness are currently classified in three main neurological categories: comatose state, vegetative state (also recently coined unresponsive wakefulness syndrome) and minimally conscious state. While the introduction of minimally conscious state, in 2002, was a major progress to help clinicians recognize complex non-reflexive behaviours in the absence of functional communication, it raises several problems. The most important issue related to minimally conscious state lies in its criteria: while behavioural definition of minimally conscious state lacks any direct evidence of patient's conscious content or conscious state, it includes the adjective 'conscious'...
December 1, 2017: Brain: a Journal of Neurology
https://www.readbyqxmd.com/read/29182381/a-validation-of-the-polish-version-of-the-coma-recovery-scale-revised-crsr
#17
Marek Binder, Urszula Górska, Anna Wójcik-Krzemień, Krzysztof Gociewicz
PRIMARY OBJECTIVE: The aim of this study was to determine the validity of the Polish version of the Coma Recovery Scale-Revised (CRS-R). METHODS AND DESIGN: Two trained raters, A and B, administered CRS-R on a group of 20 patients with severe brain injury (median age ± SD, 38.0 ± 14.39 years). Both rater A and rater B completed their assessment on day 1, and rater A repeated their assessment on day 2. Inter-rater and test-retest reliability were evaluated with an intra-class correlation coefficient and Spearman rank correlation...
November 28, 2017: Brain Injury: [BI]
https://www.readbyqxmd.com/read/29168167/interdependent-feedback-regulation-of-breathing-by-the-carotid-bodies-and-the-retrotrapezoid-nucleus
#18
Patrice G Guyenet, Douglas A Bayliss, Ruth L Stornetta, Roy Kanbar, Yingtang Shi, Benjamin B Holloway, George M P R Souza, Tyler M Basting, Stephen B G Abbott, Ian C Wenker
The retrotrapezoid nucleus, RTN, regulates breathing in a CO2 and state-dependent manner. RTN neurons are glutamatergic and innervate principally the respiratory pattern generator; they regulate multiple aspects of breathing, including active expiration, and maintain breathing automaticity during non-REM sleep. RTN neurons encode arterial PCO2 /pH via cell-autonomous and paracrine mechanisms, and via input from other CO2 -responsive neurons. In short, RTN neurons are a pivotal structure for breathing automaticity and arterial PCO2 homeostasis...
November 22, 2017: Journal of Physiology
https://www.readbyqxmd.com/read/29164571/assessment-of-mismatch-negativity-and-p300-response-in-patients-with-disorders-of-consciousness
#19
X-Y Wang, H-Y Wu, H-T Lu, T-T Huang, H Zhang, T Zhang
OBJECTIVE: To evaluate changes in mismatch negativity (MMN) and P300 response in vegetative state (VS) and minimally conscious state (MCS) patients before and after treatment, and their value for prediction of prognosis. PATIENTS AND METHODS: Event-related potentials (ERPs), performed on 11 patients classified as VS (n = 6) or MCS (n = 5), and five healthy participants (i.e., control group). We performed a six months telephone follow-up to monitor changes in consciousness recovery...
November 2017: European Review for Medical and Pharmacological Sciences
https://www.readbyqxmd.com/read/29163104/transcranial-random-noise-stimulation-does-not-improve-behavioral-and-neurophysiological-measures-in-patients-with-subacute-vegetative-unresponsive-wakefulness-state-vs-uws
#20
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
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