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traumatic brain injury narcolepsy

Amne Borghol, Michael Aucoin, Ifeanyichukwu Onor, Dana Jamero, Fadi Hawawini
Objective : The authors sought to assess the literature evidence on the efficacy of modafinil use in patients with fatigue or excessive daytime sleepiness (EDS) secondary to traumatic brain injury (TBI). Method of Research : A literature search of Medline and PubMed was performed using the EBSCOhost database. Primary literature, observational studies, meta-analyses, case reports, and systematic reviews were assessed for content regarding modafinil and psychostimulant use in patients with TBI. Of the 23 articles collected, three randomized, controlled studies, three observational studies, one case report, and two systematic reviews gave a description of modafinil use in TBI patients...
April 1, 2018: Innovations in Clinical Neuroscience
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...
December 2017: Disability and Rehabilitation
Mari Viola-Saltzman, Camelia Musleh
Sleep disturbances are frequently identified following traumatic brain injury, affecting 30%-70% of persons, and often occur after mild head injury. Insomnia, fatigue, and sleepiness are the most frequent sleep complaints after traumatic brain injury. Sleep apnea, narcolepsy, periodic limb movement disorder, and parasomnias may also occur after a head injury. In addition, depression, anxiety, and pain are common brain injury comorbidities with significant influence on sleep quality. Two types of traumatic brain injury that may negatively impact sleep are acceleration/deceleration injuries causing generalized brain damage and contact injuries causing focal brain damage...
2016: Neuropsychiatric Disease and Treatment
Thomas Rau, John Ziemniak, David Poulsen
Methamphetamine is a psychostimulant that was initially synthesized in 1920. Since then it has been used to treat attention deficit hyperactive disorder (ADHD), obesity and narcolepsy. However, methamphetamine has also become a major drug of abuse worldwide. Under conditions of abuse, which involve the administration of high repetitive doses, methamphetamine can produce considerable neurotoxic effects. However, recent evidence from our laboratory indicates that low doses of methamphetamine can produce robust neuroprotection when administered within 12h after severe traumatic brain injury (TBI) in rodents...
January 4, 2016: Progress in Neuro-psychopharmacology & Biological Psychiatry
Walid Yassin, Genichi Sugihara, Naoya Oishi, Manabu Kubota, Shiho Ubukata, Toshiya Murai, Keita Ueda
A 17-year-old male with diffuse axonal injury (DAI) was referred to our psychiatric clinic with a diagnosis of depression. However, further investigation indicated that he had narcolepsy without cataplexy secondary to DAI. We assessed regional volume alterations in the patient; MRI analysis showed a significant decrease in the volume of the hypothalamus, left amygdala, and brainstem. Our findings add to further understanding of the structural basis of secondary narcolepsy, and may provide basis for future neuroimaging studies on sleep disturbances in traumatic brain injury (TBI)...
May 2015: Journal of Clinical Sleep Medicine: JCSM: Official Publication of the American Academy of Sleep Medicine
Ping Sheng, Lijun Hou, Xiang Wang, Xiaowen Wang, Chengguang Huang, Mingkun Yu, Xi Han, Yan Dong
BACKGROUND: Modafinil is a novel wake-promoting agent approved by the FDA ameliorating excessive daytime sleepiness (EDS) in three disorders: narcolepsy, shift work sleep disorder and obstructive sleep apnea. Existing trials of modafinil for fatigue and EDS associated with neurological disorders provided inconsistent results. This meta-analysis was aimed to assess drug safety and effects of modafinil on fatigue and EDS associated with neurological disorders. METHODS: A comprehensive literature review was conducted in order to identify published studies assessing the effects of modafinil on fatigue and EDS associated with neurological disorders...
2013: PloS One
Veronica Brito, Chrisoula Politis, Shalinee Chawla
SESSION TYPE: Miscellaneous Case Report Posters IPRESENTED ON: Tuesday, October 23, 2012 at 01:30 PM - 02:30 PMINTRODUCTION: Hypnagogic hallucinations are hallucinatory experiences that accompany the onset of awakening, they can occur in certain states, such as sleep deprivation and conditions such as narcolepsy. Main neural structures responsible for muscle atonia in REM sleep are dorsolateral portions of the pons and brainstem, cholinergic and cholinoceptive REM sleep-on neurons, monoaminergic REM sleep-off neurons...
October 1, 2012: Chest
Mari Viola-Saltzman, Nathaniel F Watson
Sleep disturbance is common after traumatic brain injury (TBI). Insomnia, fatigue, and sleepiness are the most frequent post-TBI sleep complaints with narcolepsy (with or without cataplexy), sleep apnea (obstructive or central), periodic limb movement disorder, and parasomnias occurring less commonly. In addition, depression, anxiety, and pain are common TBI comorbidities with substantial influence on sleep quality. Diagnosis of sleep disorders after TBI may involve polysomnography, multiple sleep latency testing, or actigraphy...
November 2012: Neurologic Clinics
J L Mathias, P K Alvaro
BACKGROUND: Sleep is often disrupted following a traumatic brain injury (TBI), which may compromise recovery and quality of life. Prevalence rates vary widely, reflecting differences in the criteria and measures that are used to assess sleep, as well as sample differences. This meta-analysis examined the prevalence of general and specific, and formally and informally diagnosed, sleep disturbances following TBI in order to establish the nature and extent of these sequelae and their potential impact on recovery...
August 2012: Sleep Medicine
Marta Marino, Antonio de Belvis, Danila Basso, Maria Avolio, Ferruccio Pelone, Maria Tanzariello, Walter Ricciardi
When an health condition has been identified, the question of whether to continue driving depends not on a medical diagnosis, but on the functional consequences of the illness. The complex nature of physical and mental impairments and their relationship with safe driving make the availability of evidence based tools necessary for health professionals. The review aims at identifying and summarizing scientific findings concerning the relationship between neuropsychological and clinical screening tests and fitness to drive among people with chronic conditions...
January 2013: Accident; Analysis and Prevention
Raffaele Nardone, Jürgen Bergmann, Alexander Kunz, Francesca Caleri, Martin Seidl, Frediano Tezzon, Franz Gerstenbrand, Eugen Trinka, Stefan Golaszewski
Although chronic sleepiness is common after head trauma, the cause remains unclear. Transcranial magnetic stimulation (TMS) represents a useful complementary approach in the study of sleep pathophysiology. We aimed to determine in this study whether post-traumatic sleep-wake disturbances (SWD) are associated with changes in excitability of the cerebral cortex. TMS was performed 3 months after mild to moderate traumatic brain injury (TBI) in 11 patients with subjective excessive daytime sleepiness (EDS; defined by the Epworth Sleepiness Scale ≥10), 12 patients with objective EDS (as defined by mean sleep latency <5 on multiple sleep latency tests), 11 patients with fatigue (defined by daytime tiredness without signs of subjective or objective EDS), 10 patients with post-traumatic hypersomnia "sensu strictu," and 14 control subjects...
July 2011: Journal of Neurotrauma
P R Kaiser, P O Valko, E Werth, J Thomann, J Meier, R Stocker, C L Bassetti, C R Baumann
BACKGROUND: Excessive daytime sleepiness (EDS) and fatigue are common symptoms after traumatic brain injury (TBI), but there is no specific treatment for affected patients. With this pilot study, we aimed at studying the effect of daily modafinil on posttraumatic EDS and fatigue. METHODS: We conducted a prospective, double-blind, randomized, placebo-controlled pilot study in 20 patients with TBI who had fatigue or EDS or both. After baseline examinations (questionnaires including the Epworth Sleepiness Scale to assess EDS and the Fatigue Severity Scale to assess fatigue, actigraphy, polysomnography, maintenance of wakefulness test, and psychomotor vigilance test), 10 patients received 100 to 200 mg modafinil every morning, and 10 patients were treated with placebo...
November 16, 2010: Neurology
Richard J Castriotta, Jayasimha N Murthy
Traumatic brain injury (TBI) is a global problem and causes long-term disability in millions of individuals. This is a major problem for both military- and civilian-related populations. The prevalence of sleep disorders in individuals with TBI is very high, yet mostly unrecognized. Approximately 46% of all chronic TBI patients have sleep disorders, which require nocturnal polysomnography and the Multiple Sleep Latency Test for diagnosis. These disorders include sleep apnoea (23% of all TBI patients), post-traumatic hypersomnia (11%), narcolepsy (6%) and periodic limb movements (7%)...
March 2011: CNS Drugs
Jeremy Peacock, Ruth M Benca
Narcolepsy is a neurologic illness that typically begins in the second and third decades of life. It is chronic in nature and negatively impacts the quality of life of affected patients. The classic presentation is a tetrad of excessive daytime sleepiness, cataplexy, sleep paralysis, and hypnagogic hallucinations. The exact cause remains unknown, but there is significant evidence that hypocretin deficiency plays an integral role. Some primary conditions that result in secondary narcolepsy include traumatic brain injury, congenital disorders, tumours, and strokes...
February 2010: Indian Journal of Medical Research
Richard J Castriotta, Strahil Atanasov, Mark C Wilde, Brent E Masel, Jenny M Lai, Samuel T Kuna
STUDY OBJECTIVES: Determine whether treatment of sleep disorders identified in brain injured adults would result in resolution of those sleep disorders and improvement of symptoms and daytime function. METHODS: Prospective evaluation of unselected traumatic brain injury patients with nocturnal polysomnography (NPSG), multiple sleep latency test (MSLT), Epworth Sleepiness Scale (ESS), and neuropsychological testing including Psychomotor Vigilance Test (PVT), Profile of Mood States (POMS), and Functional Outcome of Sleep Questionnaire (FOSQ) before and after treatment with continuous positive airway pressure (CPAP) for obstructive sleep apnea (OSA), modafinil (200 mg) for narcolepsy and posttraumatic hypersomnia (PTH), or pramipexole (0...
April 15, 2009: Journal of Clinical Sleep Medicine: JCSM: Official Publication of the American Academy of Sleep Medicine
Christian R Baumann, Claudio L Bassetti, Philipp O Valko, Johannes Haybaeck, Morten Keller, Erika Clark, Reto Stocker, Markus Tolnay, Thomas E Scammell
Chronic, daytime sleepiness is a major, disabling symptom for many patients with traumatic brain injury (TBI), but thus far, its etiology is not well understood. Extensive loss of the hypothalamic neurons that produce the wake-promoting neuropeptide hypocretin (orexin) causes the severe sleepiness of narcolepsy, and partial loss of these cells may contribute to the sleepiness of Parkinson disease and other disorders. We have found that the number of hypocretin neurons is significantly reduced in patients with severe TBI...
October 2009: Annals of Neurology
S D Robertson, H J G Matthies, A Galli
Amphetamine (AMPH) and its derivatives are regularly used in the treatment of a wide array of disorders such as attention-deficit hyperactivity disorder (ADHD), obesity, traumatic brain injury, and narcolepsy (Prog Neurobiol 75:406-433, 2005; J Am Med Assoc 105:2051-2054, 1935; J Am Acad Child Adolesc Psychiatry 41:514-521, 2002; Neuron 43:261-269, 2004; Annu Rev Pharmacol Toxicol 47:681-698, 2007; Drugs Aging 21:67-79, 2004). Despite the important medicinal role for AMPH, it is more widely known for its psychostimulant and addictive properties as a drug of abuse...
April 2009: Molecular Neurobiology
Rolf Fronczek, Christian Rainer Baumann, Gert Jan Lammers, Claudio Lino Bassetti, Sebastiaan Overeem
The hypothalamic hypocretin (orexin) system plays a crucial role in the regulation of sleep and wakefulness. The strongest evidence for this is the fact that the primary sleep disorder narcolepsy is caused by disrupted hypocretin signaling in humans as well as various animal models. There is a growing interest in the role of hypocretin defects not only in the pathophysiology of other sleep disorders, but also in neurological diseases with associated sleep symptomatology. In this paper we first review the current methods to measure the integrity of the hypocretin system in human patients...
February 2009: Sleep Medicine Reviews
Raminder Kumar
Modafinil is a wake-promoting agent that is pharmacologically different from other stimulants. It has been investigated in healthy volunteers, and in individuals with clinical disorders associated with excessive sleepiness, fatigue, impaired cognition and other symptoms. This review examines the use of modafinil in clinical practice based on the results of randomized, double-blind, placebo-controlled clinical trials available in the English language in the MEDLINE database. In sleep-deprived individuals, modafinil improves mood, fatigue, sleepiness and cognition to a similar extent as caffeine but has a longer duration of action...
2008: Drugs
M J Makley, J B English, D A Drubach, A J Kreuz, P A Celnik, P M Tarwater
UNLABELLED: Traumatic brain injury (TBI) is a leading cause of disability in young people in the United States. Disorders of arousal and attention are common in closed head injury (CHI). Daytime drowsiness impairs participation in rehabilitation, whereas nighttime wakefulness leads to falls and behavioral disturbances. Sleep disturbances in TBI reported in the literature have included excessive daytime somnolence, sleep phase cycle disturbance, narcolepsy, and sleep apnea. Although well known to the clinician treating these patients, the extent and prevalence of disrupted sleep in patients in an acute inpatient rehabilitation unit has not been described...
July 2008: Neurorehabilitation and Neural Repair
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