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[PMID]:28458343
[Au] Autor:Michinaga S; Koyama Y
[Ad] Endereço:Laboratory of Pharmacology, Faculty of Pharmacy, Osaka Ohtani University.
[Ti] Título:Protection of the Blood-Brain Barrier as a Therapeutic Strategy for Brain Damage.
[So] Source:Biol Pharm Bull;40(5):569-575, 2017.
[Is] ISSN:1347-5215
[Cp] País de publicação:Japan
[La] Idioma:eng
[Ab] Resumo:Severe brain damage by trauma, ischemia, and hemorrhage lead to fatal conditions including sudden death, subsequent complications of the extremities and cognitive dysfunctions. Despite the urgent need for treatments for these complications, currently available therapeutic drugs are limited. Blood-brain barrier (BBB) disruption is a common pathogenic feature in many types of brain damage. The characteristic pathophysiological conditions caused by BBB disruption are brain edema resulting from an excessive increase of brain water content, inflammatory damage caused by infiltrating immune cells, and hemorrhage caused by the breakdown of microvessel structures. Because these pathogenic features induced by BBB disruption cause fatal conditions, their improvement is a desirable strategy. Many studies using experimental animal models have focused on molecules involved in BBB disruption, including vascular endothelial growth factors (VEGFs), matrix metalloproteinases (MMPs) and endothelins (ETs). The inhibition of these factors in several experimental animals was protective against BBB disruption caused by several types of brain damage, and ameliorated brain edema, inflammatory damage, and hemorrhagic transformation. In patients with brain damage, the up-regulation of these factors was observed and was related to brain damage severity. Thus, BBB protection by targeting VEGFs, MMPs, and ETs might be a novel strategy for the treatment of brain damage.
[Mh] Termos MeSH primário: Barreira Hematoencefálica/efeitos dos fármacos
Dano Encefálico Crônico/tratamento farmacológico
[Mh] Termos MeSH secundário: Animais
Barreira Hematoencefálica/fisiopatologia
Dano Encefálico Crônico/fisiopatologia
Lesões Encefálicas/tratamento farmacológico
Lesões Encefálicas/fisiopatologia
Seres Humanos
Proteínas de Junções Íntimas/genética
Proteínas de Junções Íntimas/metabolismo
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Nm] Nome de substância:
0 (Tight Junction Proteins)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180212
[Lr] Data última revisão:
180212
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170502
[St] Status:MEDLINE
[do] DOI:10.1248/bpb.b16-00991


  2 / 12513 MEDLINE  
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[PMID]:28448686
[Au] Autor:Gallentine WB; Shinnar S; Hesdorffer DC; Epstein L; Nordli DR; Lewis DV; Frank LM; Seinfeld S; Shinnar RC; Cornett K; Liu B; Moshé SL; Sun S; FEBSTAT Investigator Team
[Ad] Endereço:Department of Pediatrics (Neurology), Duke Children's Hospital, Durham, North Carolina, U.S.A.
[Ti] Título:Plasma cytokines associated with febrile status epilepticus in children: A potential biomarker for acute hippocampal injury.
[So] Source:Epilepsia;58(6):1102-1111, 2017 06.
[Is] ISSN:1528-1167
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: Our aim was to explore the association between plasma cytokines and febrile status epilepticus (FSE) in children, as well as their potential as biomarkers of acute hippocampal injury. METHODS: Analysis was performed on residual samples of children with FSE (n = 33) as part of the Consequences of Prolonged Febrile Seizures in Childhood study (FEBSTAT) and compared to children with fever (n = 17). Magnetic resonance imaging (MRI) was obtained as part of FEBSTAT within 72 h of FSE. Cytokine levels and ratios of antiinflammatory versus proinflammatory cytokines in children with and without hippocampal T2 hyperintensity were assessed as biomarkers of acute hippocampal injury after FSE. RESULTS: Levels of interleukin (IL)-8 and epidermal growth factor (EGF) were significantly elevated after FSE in comparison to controls. IL-1ß levels trended higher and IL-1RA trended lower following FSE, but did not reach statistical significance. Children with FSE were found to have significantly lower ratios of IL-1RA/IL-1ß and IL-1RA/IL-8. Specific levels of any one individual cytokine were not associated with FSE. However, lower ratios of IL-1RA/IL-1ß, IL-1RA/1L-6, and IL-1RA/ IL-8 were all associated with FSE. IL-6 and IL-8 levels were significantly higher and ratios of IL-1RA/IL-6 and IL-1RA/IL-8 were significantly lower in children with T2 hippocampal hyperintensity on MRI after FSE in comparison to those without hippocampal signal abnormalities. Neither individual cytokine levels nor ratios of IL-1RA/IL-1ß or IL-1RA/IL-8 were predictive of MRI changes. However, a lower ratio of IL-1RA/IL-6 was strongly predictive (odds ratio [OR] 21.5, 95% confidence interval [CI] 1.17-393) of hippocampal T2 hyperintensity after FSE. SIGNIFICANCE: Our data support involvement of the IL-1 cytokine system, IL-6, and IL-8 in FSE in children. The identification of the IL-1RA/IL-6 ratio as a potential biomarker of acute hippocampal injury following FSE is the most significant finding. If replicated in another study, the IL-1RA/IL-6 ratio could represent a serologic biomarker that offers rapid identification of patients at risk for ultimately developing mesial temporal lobe epilepsy (MTLE).
[Mh] Termos MeSH primário: Biomarcadores/sangue
Dano Encefálico Crônico/sangue
Citocinas/sangue
Hipocampo/diagnóstico por imagem
Hipocampo/fisiopatologia
Convulsões Febris/sangue
Estado Epiléptico/sangue
[Mh] Termos MeSH secundário: Dano Encefálico Crônico/diagnóstico por imagem
Criança
Pré-Escolar
Epilepsia do Lobo Temporal/sangue
Feminino
Seres Humanos
Lactente
Recém-Nascido
Proteína Antagonista do Receptor de Interleucina 1/sangue
Interleucina-1beta/sangue
Interleucina-6/sangue
Interleucina-8/sangue
Masculino
Fatores de Risco
Convulsões Febris/diagnóstico por imagem
Estado Epiléptico/diagnóstico por imagem
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, N.I.H., EXTRAMURAL
[Nm] Nome de substância:
0 (Biomarkers); 0 (Cytokines); 0 (Interleukin 1 Receptor Antagonist Protein); 0 (Interleukin-1beta); 0 (Interleukin-6); 0 (Interleukin-8)
[Em] Mês de entrada:1707
[Cu] Atualização por classe:180107
[Lr] Data última revisão:
180107
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170428
[St] Status:MEDLINE
[do] DOI:10.1111/epi.13750


  3 / 12513 MEDLINE  
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[PMID]:28651511
[Au] Autor:Forrest A; Butt WW; Namachivayam SP
[Ad] Endereço:Intensive Care Unit, Royal Children's Hospital, Melbourne, VIC, Australia. siva.namachivayam@rch.org.au.
[Ti] Título:Outcomes of children admitted to intensive care after out-of-hospital cardiac arrest in Victoria, Australia.
[So] Source:Crit Care Resusc;19(2):150-158, 2017 Jun.
[Is] ISSN:1441-2772
[Cp] País de publicação:Australia
[La] Idioma:eng
[Ab] Resumo:OBJECTIVES: Paediatric out-of-hospital cardiac arrest (OHCA) is an uncommon event but is associated with high mortality and severe neurological sequelae among survivors. Most studies of paediatric OHCA are population-based, with very few reports on the cohort admitted to the paediatric intensive care unit (PICU). We sought to determine outcomes and predictors of neurologically intact survival in these children admitted to the PICU. DESIGN AND SETTING: Retrospective analysis of data prospectively collected from the PICU and emergency department (ED) databases and cross-checked with medical records and coronial reports for January 2005 to December 2014. Neurological outcome was assessed using the Paediatric Cerebral Performance Category scale. MAIN OUTCOME MEASURE: Survival with a favourable neurological outcome at hospital discharge. RESULTS: In the 10 years, 283 children presented with OHCA. After 16 study exclusions (because of cardiopulmonary resuscitation [CPR] duration < 1 min or age > 16 years), there were 121 children who died in the ED and 146 admitted to the PICU. Among the PICU cohort, hospital survival with favourable neurological outcome was 42% (60 of 143), and at 1 year after arrest it was 41% (59 of 143). The following factors were associated with the primary outcome: bystander CPR (odds ratio [OR], 4.74 [95% CI, 1.49-15.05]); cardiac aetiology (OR, 6.40 [95% CI, 1.65-24.76]); male sex (OR, 0.32 [95% CI, 0.12- 0.84]); and CPR duration: = 20 min v 0-5 min (OR, 0.05 [95% CI, 0.01-0.16]) and 6-20 min v 0-5 min (OR, 0.45 [95% CI, 0.16-1.28]). CONCLUSIONS: Bystander CPR and primary cardiac aetiology had strong associations with survival with a favourable neurological outcome after paediatric OHCA. Maximising CPR education for the community, and targeting people most likely to witness a paediatric OHCA may further improve outcomes.
[Mh] Termos MeSH primário: Dano Encefálico Crônico/mortalidade
Dano Encefálico Crônico/prevenção & controle
Unidades de Terapia Intensiva Neonatal
Unidades de Terapia Intensiva Pediátrica
Parada Cardíaca Extra-Hospitalar/mortalidade
Parada Cardíaca Extra-Hospitalar/terapia
[Mh] Termos MeSH secundário: Adolescente
Reanimação Cardiopulmonar
Criança
Pré-Escolar
Estudos de Coortes
Comorbidade
Serviços Médicos de Emergência
Feminino
Seguimentos
Mortalidade Hospitalar
Seres Humanos
Lactente
Recém-Nascido
Masculino
Exame Neurológico
Parada Cardíaca Extra-Hospitalar/etiologia
Ressuscitação
Estudos Retrospectivos
Análise de Sobrevida
Vitória
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170901
[Lr] Data última revisão:
170901
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170628
[St] Status:MEDLINE


  4 / 12513 MEDLINE  
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[PMID]:28526647
[Au] Autor:Fotakopoulos G; Tsianaka E; Fountas K; Makris D; Spyrou M; Hernesniemi J
[Ad] Endereço:Department of Neurosurgery, University Hospital of Thessaly, University Hospital of Larissa, Larissa, Thessaly, Greece. Electronic address: gfotakop@yahoo.gr.
[Ti] Título:Clipping Versus Coiling in Anterior Circulation Ruptured Intracranial Aneurysms: A Meta-Analysis.
[So] Source:World Neurosurg;104:482-488, 2017 Aug.
[Is] ISSN:1878-8769
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: To evaluate open surgical versus endovascular repair of anterior circulation ruptured intracranial aneurysms based on operative mortality, permanent neurologic deficit, late mortality, and need for reintervention. METHODS: This meta-analysis included articles published since December 6, 2016, that compared outcomes of the 2 methods. Extracted data were organized in a standard table format, including first author, country, covered study period, publication year, number of patients and patients at follow-up, operative mortality rate (with 30 days from treatment), permanent neurologic deficit (appearing after surgery), late mortality (after 1 month), and reintervention (surgery or coiling) for both groups of patients. Follow-up was at least 1 year. RESULTS: There were 8 articles that matched our study criteria. The study population was 628 patients; 374 were treated with surgical clipping, and 254 were treated with endovascular coiling. Pooled results showed no statistically significant difference between the 2 groups in terms of operative mortality, permanent neurologic deficit, late mortality, and need for reintervention. CONCLUSIONS: Selection of the appropriate procedure must be made on the basis of the special characteristics of each case.
[Mh] Termos MeSH primário: Aneurisma Roto/cirurgia
Embolização Terapêutica
Aneurisma Intracraniano/cirurgia
Instrumentos Cirúrgicos
[Mh] Termos MeSH secundário: Aneurisma Roto/diagnóstico
Aneurisma Roto/mortalidade
Dano Encefálico Crônico/etiologia
Dano Encefálico Crônico/mortalidade
Ensaios Clínicos como Assunto
Intervalos de Confiança
Mortalidade Hospitalar
Seres Humanos
Aneurisma Intracraniano/diagnóstico
Aneurisma Intracraniano/mortalidade
Exame Neurológico
Razão de Chances
Complicações Pós-Operatórias/etiologia
Complicações Pós-Operatórias/mortalidade
Prognóstico
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE; META-ANALYSIS; REVIEW
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170928
[Lr] Data última revisão:
170928
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170521
[St] Status:MEDLINE


  5 / 12513 MEDLINE  
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[PMID]:28502817
[Au] Autor:Mullally WJ
[Ad] Endereço:Department of Neurology, Brigham and Women's Faulkner Hospital, Boston, Mass. Electronic address: wmullally@bwh.harvard.edu.
[Ti] Título:Concussion.
[So] Source:Am J Med;130(8):885-892, 2017 Aug.
[Is] ISSN:1555-7162
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Concussion has been recognized as a clinical entity for more than 1000 years. Throughout the 20th century it was studied extensively in boxers, but it did not pique the interest of the general population because it is the accepted goal of the boxer to inflict such an injury on their opponent. In 2002, however, the possibility that repetitive concussions could result in chronic brain damage and a progressive neurologic disorder was raised by a postmortem evaluation of a retired player in the most popular sports institution in the United States, the National Football League. Since that time concussion has been a frequent topic of conversation in homes, schools, and on television and has become a major focus of sports programs in communities and schools at all levels. Now all 50 states, the District of Columbia, and the National Collegiate Athletic Association have enacted laws and rules to protect the athlete.
[Mh] Termos MeSH primário: Traumatismos em Atletas/complicações
Concussão Encefálica/complicações
Dano Encefálico Crônico/etiologia
[Mh] Termos MeSH secundário: Traumatismos em Atletas/etiologia
Concussão Encefálica/diagnóstico
Concussão Encefálica/etiologia
Concussão Encefálica/fisiopatologia
Dano Encefálico Crônico/diagnóstico
Seres Humanos
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170901
[Lr] Data última revisão:
170901
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170516
[St] Status:MEDLINE


  6 / 12513 MEDLINE  
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[PMID]:28378439
[Au] Autor:Baca CB; Barry F; Vickrey BG; Caplan R; Berg AT
[Ad] Endereço:Department of Neurology, University of Colorado Anschutz School of Medicine, Aurora, Colorado, U.S.A.
[Ti] Título:Social outcomes of young adults with childhood-onset epilepsy: A case-sibling-control study.
[So] Source:Epilepsia;58(5):781-791, 2017 May.
[Is] ISSN:1528-1167
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: We aimed to compare long-term social outcomes in young adults with childhood-onset epilepsy (cases) with neurologically normal sibling controls. METHODS: Long-term social outcomes were assessed at the 15-year follow-up of the Connecticut Study of Epilepsy, a community-based prospective cohort study of children with newly diagnosed epilepsy. Young adults with childhood-onset epilepsy with complicated (abnormal neurologic exam findings, abnormal brain imaging with lesion referable to epilepsy, intellectual disability (ID; IQ < 60) or informative history of neurologic insults to which the occurrence of epilepsy might be attributed), and uncomplicated epilepsy presentations were compared to healthy sibling controls. Age, gender, and matched-pair adjusted generalized linear models stratified by complicated epilepsy and 5-year seizure-free status estimated adjusted odds ratios (aORs) and 95% confidence intervals [CIs] for each outcome. RESULTS: The 15-year follow-up included 361 individuals with epilepsy (59% of initial cases; N = 291 uncomplicated and N = 70 complicated epilepsy; mean age 22 years [standard deviation, SD 3.5]; mean epilepsy onset 6.2 years [SD 3.9]) and 173 controls. Social outcomes for cases with uncomplicated epilepsy with ≥5 years terminal remission were comparable to controls; cases with uncomplicated epilepsy <5 years seizure-free were more likely to be less productive (school/employment < 20 h/week) (aOR 3.63, 95% CI 1.83-7.20) and not to have a driver's license (aOR 6.25, 95% CI 2.85-13.72). Complicated cases with epilepsy <5 years seizure-free had worse outcomes across multiple domains; including not graduating high school (aOR 24.97, 95% CI 7.49-83.30), being un- or underemployed (<20 h/week) (aOR 11.06, 95% CI 4.44-27.57), being less productively engaged (aOR 15.71, 95% CI 6.88-35.88), and not living independently (aOR 10.24, 95% CI 3.98-26.36). Complicated cases without ID (N = 36) had worse outcomes with respect to productive engagement (aOR 6.02; 95% CI 2.48-14.58) compared to controls. Cases with complicated epilepsy were less likely to be driving compared to controls, irrespective of remission status or ID. SIGNIFICANCE: In individuals with uncomplicated childhood-onset epilepsy presentations and 5-year terminal remission, young adult social outcomes are comparable to those of sibling controls. Complicated epilepsy, notable for intellectual disability, and seizure remission status are important prognostic indicators for long-term young adult social outcomes in childhood-onset epilepsy.
[Mh] Termos MeSH primário: Epilepsia/diagnóstico
Epilepsia/psicologia
Irmãos/psicologia
[Mh] Termos MeSH secundário: Atividades Cotidianas/classificação
Atividades Cotidianas/psicologia
Idade de Início
Encéfalo/patologia
Dano Encefálico Crônico/diagnóstico
Dano Encefálico Crônico/psicologia
Estudos de Casos e Controles
Criança
Estudos de Coortes
Connecticut
Avaliação da Deficiência
Epilepsia/complicações
Epilepsia/etiologia
Feminino
Seguimentos
Seres Humanos
Deficiência Intelectual/diagnóstico
Deficiência Intelectual/psicologia
Imagem por Ressonância Magnética
Masculino
Exame Neurológico
Avaliação de Resultados (Cuidados de Saúde)
Prognóstico
Estudos Prospectivos
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1706
[Cu] Atualização por classe:170630
[Lr] Data última revisão:
170630
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170406
[St] Status:MEDLINE
[do] DOI:10.1111/epi.13726


  7 / 12513 MEDLINE  
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[PMID]:28159618
[Au] Autor:Belfi AM; Evans E; Heskje J; Bruss J; Tranel D
[Ad] Endereço:Interdisciplinary Graduate Program in Neuroscience, University of Iowa Carver College of Medicine, 356 MRC, Iowa City, IA, USA; Department of Neurology, University of Iowa Carver College of Medicine, 2155 RCP, Iowa City, IA, USA. Electronic address: amy.belfi@nyu.edu.
[Ti] Título:Musical anhedonia after focal brain damage.
[So] Source:Neuropsychologia;97:29-37, 2017 Mar.
[Is] ISSN:1873-3514
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:People listen to music because it is pleasurable. However, there are individual differences in the reward value of music. At the extreme low end of this continuum, individuals who derive no pleasure from music are said to have 'musical anhedonia.' Cases of acquired musical anhedonia following focal brain damage are rare, with only a handful having been reported in the scientific literature. Here, we surveyed a large sample of patients with focal brain damage to identify the frequency, specificity, and neural correlates of acquired musical anhedonia. Participants completed the Musical anhedonia Questionnaire and the Barcelona Music Reward Questionnaire (Mas-Herrero et al., 2013) to assess changes in musical enjoyment and reward following brain injury. Neuroanatomical data were analyzed with a proportional MAP-3 method to create voxelwise lesion proportion difference maps. No clear or consistent neuroanatomical correlates of musical anhedonia were identified. One patient with damage to the right-hemisphere putamen and internal capsule displayed specific and severe acquired musical anhedonia. These findings indicate that acquired musical anhedonia is very uncommon, a result which is consistent with the fact that only a small number of such cases have been reported in the literature. This rarity could have positive implications for the therapeutic potentialities of music in patients with severe neurological disorders.
[Mh] Termos MeSH primário: Anedonia/fisiologia
Dano Encefálico Crônico/fisiopatologia
Música/psicologia
Sistema de Registros
[Mh] Termos MeSH secundário: Idoso
Feminino
Seres Humanos
Masculino
Meia-Idade
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1706
[Cu] Atualização por classe:170605
[Lr] Data última revisão:
170605
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170205
[St] Status:MEDLINE


  8 / 12513 MEDLINE  
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[PMID]:28143915
[Au] Autor:Fogtmann EP; Plomgaard AM; Greisen G; Gluud C
[Ad] Endereço:Department of Neonatology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark empifo@gmail.com.
[Ti] Título:Prognostic Accuracy of Electroencephalograms in Preterm Infants: A Systematic Review.
[So] Source:Pediatrics;139(2), 2017 Feb.
[Is] ISSN:1098-4275
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:CONTEXT: Brain injury is common in preterm infants, and predictors of neurodevelopmental outcome are relevant. OBJECTIVE: To assess the prognostic test accuracy of the background activity of the EEG recorded as amplitude-integrated EEG (aEEG) or conventional EEG early in life in preterm infants for predicting neurodevelopmental outcome. DATA SOURCES: The Cochrane Library, PubMed, Embase, and the Cumulative Index to Nursing and Allied Health Literature. STUDY SELECTION: We included observational studies that had obtained an aEEG or EEG within 7 days of life in preterm infants and reported neurodevelopmental outcomes 1 to 10 years later. DATA EXTRACTION: Two reviewers independently performed data extraction with regard to participants, prognostic testing, and outcomes. RESULTS: Thirteen observational studies with a total of 1181 infants were included. A meta-analysis was performed based on 3 studies (267 infants). Any aEEG background abnormality was a predictor of abnormal outcome. For prediction of a developmental quotient <70 points, cerebral palsy, or death, the pooled sensitivity was 0.83 (95% confidence interval, 0.69-0.92) and specificity 0.83 (95% confidence interval, 0.77-0.87). LIMITATIONS: All studies were at high risk of bias. Heterogeneity was evident among the studies with regard to the investigated aEEG and EEG variables, neurodevelopmental outcomes, and cutoff values. CONCLUSIONS: aEEG or EEG recorded within the first 7 days of life in preterm infants may have potential as a predictor for later neurodevelopmental outcome. We need high-quality studies to confirm these findings. Meanwhile, the prognostic value of aEEG and EEG should be used only as a scientific tool.
[Mh] Termos MeSH primário: Dano Encefálico Crônico/diagnóstico
Paralisia Cerebral/diagnóstico
Deficiências do Desenvolvimento/diagnóstico
Eletroencefalografia
Doenças do Prematuro/diagnóstico
Processamento de Sinais Assistido por Computador
[Mh] Termos MeSH secundário: Dano Encefálico Crônico/fisiopatologia
Morte Encefálica
Paralisia Cerebral/fisiopatologia
Deficiências do Desenvolvimento/fisiopatologia
Feminino
Seres Humanos
Recém-Nascido
Doenças do Prematuro/fisiopatologia
Estudos Longitudinais
Masculino
Estudos Observacionais como Assunto
Prognóstico
Ensaios Clínicos Controlados Aleatórios como Assunto
Sensibilidade e Especificidade
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1706
[Cu] Atualização por classe:170627
[Lr] Data última revisão:
170627
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170202
[St] Status:MEDLINE


  9 / 12513 MEDLINE  
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[PMID]:28103638
[Au] Autor:Magee WL; Clark I; Tamplin J; Bradt J
[Ad] Endereço:Boyer College of Music and Dance, Temple University, 2001 North 13th Street, Philadelphia, USA, PA 19122.
[Ti] Título:Music interventions for acquired brain injury.
[So] Source:Cochrane Database Syst Rev;1:CD006787, 2017 01 20.
[Is] ISSN:1469-493X
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Acquired brain injury (ABI) can result in impairments in motor function, language, cognition, and sensory processing, and in emotional disturbances, which can severely reduce a survivor's quality of life. Music interventions have been used in rehabilitation to stimulate brain functions involved in movement, cognition, speech, emotions, and sensory perceptions. An update of the systematic review published in 2010 was needed to gauge the efficacy of music interventions in rehabilitation for people with ABI. OBJECTIVES: To assess the effects of music interventions for functional outcomes in people with ABI. We expanded the criteria of our existing review to: 1) examine the efficacy of music interventions in addressing recovery in people with ABI including gait, upper extremity function, communication, mood and emotions, cognitive functioning, social skills, pain, behavioural outcomes, activities of daily living, and adverse events; 2) compare the efficacy of music interventions and standard care with a) standard care alone, b) standard care and placebo treatments, or c) standard care and other therapies; 3) compare the efficacy of different types of music interventions (music therapy delivered by trained music therapists versus music interventions delivered by other professionals). SEARCH METHODS: We searched the Cochrane Stroke Group Trials Register (January 2016), the Cochrane Central Register of Controlled Trials (CENTRAL) (2015, Issue 6), MEDLINE (1946 to June 2015), Embase (1980 to June 2015), CINAHL (1982 to June 2015), PsycINFO (1806 to June 2015), LILACS (1982 to January 2016), and AMED (1985 to June 2015). We handsearched music therapy journals and conference proceedings, searched dissertation and specialist music databases, trials and research registers, reference lists, and contacted relevant experts and music therapy associations to identify unpublished research. We imposed no language restriction. We performed the original search in 2009. SELECTION CRITERIA: We included all randomised controlled trials and controlled clinical trials that compared music interventions and standard care with standard care alone or combined with other therapies. We examined studies that included people older than 16 years of age who had ABI of a non-degenerative nature and were participating in treatment programmes offered in hospital, outpatient, or community settings. We included studies in any language, published and unpublished. DATA COLLECTION AND ANALYSIS: Two review authors independently extracted data and assessed the risk of bias of the included studies. We contacted trial researchers to obtain missing data or for additional information when necessary. Where possible, we presented results for continuous outcomes in meta-analyses using mean differences (MDs) and standardised mean differences (SMDs). We used post-test scores. In cases of significant baseline difference, we used change scores. We conducted a sensitivity analysis to assess the impact of the randomisation method. MAIN RESULTS: We identified 22 new studies for this update. The evidence for this update is based on 29 trials involving 775 participants. A music intervention known as rhythmic auditory stimulation may be beneficial for improving the following gait parameters after stroke. We found a reported increase in gait velocity of 11.34 metres per minute (95% confidence interval (CI) 8.40 to 14.28; 9 trials; 268 participants; P < 0.00001; moderate-quality evidence). Stride length of the affected side may also benefit, with a reported average of 0.12 metres more (95% CI 0.04 to 0.20; 5 trials; 129 participants; P = 0.003; moderate-quality evidence). We found a reported average improvement for general gait of 7.67 units on the Dynamic Gait Index (95% CI 5.67 to 9.67; 2 trials; 48 participants; P < 0.00001). There may also be an improvement in gait cadence, with a reported average increase of 10.77 steps per minute (95% CI 4.36 to 17.18; 7 trials; 223 participants; P = 0.001; low-quality evidence).Music interventions may be beneficial for improving the timing of upper extremity function after stroke as scored by a reduction of 1.08 seconds on the Wolf Motor Function Test (95% CI -1.69 to -0.47; 2 trials; 122 participants; very low-quality evidence).Music interventions may be beneficial for communication outcomes in people with aphasia following stroke. Overall, communication improved by 0.75 standard deviations in the intervention group, a moderate effect (95% CI 0.11 to 1.39; 3 trials; 67 participants; P = 0.02; very low-quality evidence). Naming was reported as improving by 9.79 units on the Aachen Aphasia Test (95% CI 1.37 to 18.21; 2 trials; 35 participants; P = 0.02). Music interventions may have a beneficial effect on speech repetition, reported as an average increase of 8.90 score on the Aachen Aphasia Test (95% CI 3.25 to 14.55; 2 trials; 35 participants; P = 0.002).There may be an improvement in quality of life following stroke using rhythmic auditory stimulation, reported at 0.89 standard deviations improvement on the Stroke Specific Quality of Life Scale, which is considered to be a large effect (95% CI 0.32 to 1.46; 2 trials; 53 participants; P = 0.002; low-quality evidence). We found no strong evidence for effects on memory and attention. Data were insufficient to examine the effect of music interventions on other outcomes.The majority of studies included in this review update presented a high risk of bias, therefore the quality of the evidence is low. AUTHORS' CONCLUSIONS: Music interventions may be beneficial for gait, the timing of upper extremity function, communication outcomes, and quality of life after stroke. These results are encouraging, but more high-quality randomised controlled trials are needed on all outcomes before recommendations can be made for clinical practice.
[Mh] Termos MeSH primário: Dano Encefálico Crônico/reabilitação
Lesões Encefálicas/reabilitação
Transtornos Neurológicos da Marcha/reabilitação
Musicoterapia/métodos
[Mh] Termos MeSH secundário: Estimulação Acústica/métodos
Adulto
Afasia/reabilitação
Lesões Encefálicas/complicações
Feminino
Transtornos Neurológicos da Marcha/etiologia
Seres Humanos
Masculino
Ensaios Clínicos Controlados Aleatórios como Assunto
Acidente Vascular Cerebral/complicações
Teste de Caminhada
[Pt] Tipo de publicação:JOURNAL ARTICLE; META-ANALYSIS; RESEARCH SUPPORT, NON-U.S. GOV'T; REVIEW
[Em] Mês de entrada:1704
[Cu] Atualização por classe:170922
[Lr] Data última revisão:
170922
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170120
[St] Status:MEDLINE
[do] DOI:10.1002/14651858.CD006787.pub3


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[PMID]:28053037
[Au] Autor:Zhao Y; Song L; Ding J; Lin N; Wang Q; Du X; Sun R; Han Z
[Ad] Endereço:State Key Laboratory of Cognitive Neuroscience and Learning and International Data Group/McGovern Institute for Brain Research, Beijing Normal University, Beijing 100875, China.
[Ti] Título:Left Anterior Temporal Lobe and Bilateral Anterior Cingulate Cortex Are Semantic Hub Regions: Evidence from Behavior-Nodal Degree Mapping in Brain-Damaged Patients.
[So] Source:J Neurosci;37(1):141-151, 2017 Jan 04.
[Is] ISSN:1529-2401
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:The organizational principles of semantic memory in the human brain are still controversial. Although studies have shown that the semantic system contains hub regions that bind information from different sensorimotoric modalities to form concepts, it is unknown whether there are hub regions other than the anterior temporal lobe (ATL). Meanwhile, previous studies have rarely used network measurements to explore the hubs or correlated network indexes with semantic performance, although the most direct supportive evidence of hubs should come from the network perspective. To fill this gap, we correlated the brain-network index with semantic performance in 86 brain-damaged patients. We especially selected the nodal degree measure that reflects how well a node is connected in the network. The measure was calculated as the total number of connections of a given node with other nodes in the resting-state functional MRI network. Semantic ability was measured using the performance of both general and modality-specific (object form, color, motion, sound, manipulation, and function) semantic tasks. We found that the left ATL and the bilateral anterior cingulate cortex could be semantic hubs because the reduced nodal degree values of these regions could effectively predict the deficits in both general and modality-specific semantic performance. Moreover, the effects remained when the analyses were performed only in the patients who did not have lesions in these regions. The two hub regions might support semantic representations and executive control processes, respectively. These data provide empirical evidence for the distributed-plus-hub theory of semantic memory from the network perspective. SIGNIFICANCE STATEMENT: Although the distributed-plus-hub organization of semantic memory has been proposed for several years, it remains unclear which hubs other than the anterior temporal lobe are included in the semantic system. Here, we identified such hubs from an innovative network perspective. The voxelwise nodal degree values were correlated with the performance of general and modality-specific semantic tasks in 86 patients with brain damage. We observed that the left anterior temporal lobe and bilateral anterior cingulate cortex could be semantic hubs because their decreased nodal degree values were significantly correlated with the severity of the deficit in semantic performance. The two hub regions might contribute to semantic representational and control processes, respectively. These findings offer new evidence for the distributed-plus-hub theory.
[Mh] Termos MeSH primário: Dano Encefálico Crônico/diagnóstico por imagem
Dano Encefálico Crônico/psicologia
Giro do Cíngulo/lesões
Giro do Cíngulo/fisiologia
Semântica
Lobo Temporal/lesões
Lobo Temporal/fisiologia
[Mh] Termos MeSH secundário: Adulto
Idoso
Mapeamento Encefálico
Função Executiva
Feminino
Giro do Cíngulo/diagnóstico por imagem
Voluntários Saudáveis
Seres Humanos
Imagem por Ressonância Magnética
Masculino
Meia-Idade
Rede Nervosa/diagnóstico por imagem
Desempenho Psicomotor
Lobo Temporal/diagnóstico por imagem
Comportamento Verbal
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1707
[Cu] Atualização por classe:170724
[Lr] Data última revisão:
170724
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170106
[St] Status:MEDLINE
[do] DOI:10.1523/JNEUROSCI.1946-16.2016



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