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  1 / 2753 MEDLINE  
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[PMID]:29297644
[Au] Autor:Kondratyeva EA; Avdunina IA; Kondratyev AN; Ulitin AU; Ivanova NE; Petrova MV; Luginina EV; Grechko AV
[Ti] Título:Vegetative State: Difficulty in Identifying Consciousness and Predicting Outcome.
[So] Source:Vestn Ross Akad Med Nauk;71(4):273-80, 2016.
[Is] ISSN:0869-6047
[Cp] País de publicação:Russia (Federation)
[La] Idioma:eng
[Ab] Resumo:Article consists of literature review, authors experience of the application of neurovisualization and neurophysiological research methods to predict the recovery of consciousness in patients in vegetative state (VS). According to the literature data PET with FDG has higher sensitivity in the detection of signs of consciousness, then functional MRI (fMRI). The method fMRI allows assessing the functional activity of the brain in a state of rest and in response to stimulation with different modalities ­ visual, auditory, etc (with the application of active and passive paradigm). A higher specificity in the detection of signs of consciousness have the methodology of fMRI with the active paradigm, at the same time, the absence of signs of consciousness according to the fMRI can not be charged as a basis for the conclusion of a poor prognosis in a particular patient. Neurophysiological tests (EEG, TMS, EP, etc) are more readily available and quite effective. Based on the literature analysis, the authors comes to the conclusion that neurovisualization and neurophysiological tests used in the prediction of the outcome of VS reflects the residual functional activity of different brain areas, in a context of diffuse brain damage, and the recovery of consciousness is usually combined with the restoring of the functional activity off the thalamocortical tracts, which activity, indirectly, is evaluated using these methods. In the authors' opinions, the main disadvantage in the interpretation of the is the lack of a common pathophysiological concept of the organization of brain functions in VS patients. The authors offer for the discussion their concept of stable pathological states of the brain, which is based on the works of Russian pathophysiologists.
[Mh] Termos MeSH primário: Estado de Consciência/fisiologia
Neuroimagem/métodos
Estado Vegetativo Persistente
[Mh] Termos MeSH secundário: Encéfalo/diagnóstico por imagem
Encéfalo/fisiopatologia
Seres Humanos
Imagem Multimodal
Estado Vegetativo Persistente/diagnóstico
Estado Vegetativo Persistente/fisiopatologia
Estado Vegetativo Persistente/psicologia
Valor Preditivo dos Testes
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180208
[Lr] Data última revisão:
180208
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180104
[St] Status:MEDLINE
[do] DOI:10.15690/vramn728


  2 / 2753 MEDLINE  
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[PMID]:27773729
[Au] Autor:Naro A; Leo A; Buda A; Manuli A; Bramanti A; Bramanti P; Calabrò RS
[Ad] Endereço:IRCCS Centro Neurolesi "Bonino-Pulejo" Messina, Italy.
[Ti] Título:Do you see me? The role of visual fixation in chronic disorders of consciousness differential diagnosis.
[So] Source:Brain Res;1653:59-66, 2016 12 15.
[Is] ISSN:1872-6240
[Cp] País de publicação:Netherlands
[La] Idioma:eng
[Ab] Resumo: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. To this end, we evaluated the visuomotor integration (VMI) and visual P300 patterns in a chronic Disorder of Consciousness (DOC) sample and a control group of healthy individuals (HC), using an associative stimulation protocol combining transcranial magnetic stimulation (TMS) with visual stimulation through transorbital alternating current stimulation. The Minimally Conscious State (MCS) patients showed preserved patterns of VMI and P300, whereas nearly all the UWS patients showed no significant VMI. Notably, the electrophysiological findings were correlated with the visual domain of the Coma Recovery Scale-Revised. Nonetheless, two fixating UWS individuals had a VMI similar to MCS patients. Our data suggest that some UWS patients showing VF could be aware, but unable to manifest it clearly, probably because of a severe motor output impairment, which is a condition compatible with the Functional Locked-In Syndrome.
[Mh] Termos MeSH primário: Encéfalo/fisiopatologia
Fixação Ocular/fisiologia
Estado Vegetativo Persistente/diagnóstico
Estado Vegetativo Persistente/fisiopatologia
Percepção Visual/fisiologia
[Mh] Termos MeSH secundário: Adulto
Idoso
Diagnóstico Diferencial
Eletroencefalografia
Potenciais Evocados Visuais
Feminino
Seres Humanos
Masculino
Meia-Idade
Vias Neurais/fisiopatologia
Testes Neuropsicológicos
Estimulação Luminosa
Quadriplegia/diagnóstico
Quadriplegia/fisiopatologia
Estimulação Magnética Transcraniana
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1706
[Cu] Atualização por classe:171205
[Lr] Data última revisão:
171205
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161025
[St] Status:MEDLINE


  3 / 2753 MEDLINE  
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[PMID]:29073185
[Au] Autor:Cretin E; Pazart L; Rousseau MC; Noé A; Decavel P; Chassagne A; Godard-Marceau A; Trimaille H; Mathieu-Nicot F; Beaussant Y; Gabriel D; Daneault S; Aubry R
[Ad] Endereço:Clinical Investigation Center, CIC 1431 Inserm, University Hospital of Besançon, Besançon, France.
[Ti] Título:Exploring the perceptions of physicians, caregivers and families towards artificial nutrition and hydration for people in permanent vegetative state: How can a photo-elicitation method help?
[So] Source:PLoS One;12(10):e0186776, 2017.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:The question of withdrawing artificial nutrition and hydration from people in a permanent vegetative state sparks considerable ethical and legal debate. Therefore, understanding the elements that influence such a decision is crucial. However, exploring perceptions of artificial nutrition and hydration is methodologically challenging for several reasons. First, because of the emotional state of the professionals and family members, who are facing an extremely distressing situation; second, because this question mirrors representations linked to a deep-rooted fear of dying of hunger and thirst; and third, because of taboos surrounding death. We sought to determine the best method to explore such complex situations in depth. This article aims to assess the relevance of the photo-elicitation interview method to analyze the perceptions and attitudes of health professionals and families of people in a permanent vegetative state regarding artificial nutrition and hydration. The photo-elicitation interview method consists in inserting one or more photographs into a research interview. An original set of 60 photos was built using Google Images and participants were asked to choose photos (10 maximum) and talk about them. The situations of 32 patients were explored in 23 dedicated centers for people in permanent vegetative state across France. In total, 138 interviews were conducted with health professionals and family members. We found that the photo-elicitation interview method 1) was well accepted by the participants and allowed them to express their emotions constructively, 2) fostered narration, reflexivity and introspection, 3) offered a sufficient "unusual angle" to allow participants to go beyond stereotypes and habits of thinking, and 4) can be replicated in other research areas. The use of visual methods currently constitutes an expanding area of research and this study stressed that this is of special interest to enhance research among populations facing end-of-life and ethical issues.
[Mh] Termos MeSH primário: Cuidadores
Família
Nutrição Parenteral
Percepção
Estado Vegetativo Persistente
Fotografia
Médicos
[Mh] Termos MeSH secundário: Feminino
Seres Humanos
Masculino
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171110
[Lr] Data última revisão:
171110
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171027
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0186776


  4 / 2753 MEDLINE  
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[PMID]:29050383
[Au] Autor:Edlow BL; Chatelle C; Spencer CA; Chu CJ; Bodien YG; O'Connor KL; Hirschberg RE; Hochberg LR; Giacino JT; Rosenthal ES; Wu O
[Ad] Endereço:Center for Neurotechnology and Neurorecovery, Massachusetts General Hospital, 175 Cambridge Street, Boston, MA, 02114, USA.
[Ti] Título:Early detection of consciousness in patients with acute severe traumatic brain injury.
[So] Source:Brain;140(9):2399-2414, 2017 Sep 01.
[Is] ISSN:1460-2156
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:See Schiff (doi:10.1093/awx209) for a scientific commentary on this article. Patients with acute severe traumatic brain injury may recover consciousness before self-expression. Without behavioural evidence of consciousness at the bedside, clinicians may render an inaccurate prognosis, increasing the likelihood of withholding life-sustaining therapies or denying rehabilitative services. Task-based functional magnetic resonance imaging and electroencephalography techniques have revealed covert consciousness in the chronic setting, but these techniques have not been tested in the intensive care unit. We prospectively enrolled 16 patients admitted to the intensive care unit for acute severe traumatic brain injury to test two hypotheses: (i) in patients who lack behavioural evidence of language expression and comprehension, functional magnetic resonance imaging and electroencephalography detect command-following during a motor imagery task (i.e. cognitive motor dissociation) and association cortex responses during language and music stimuli (i.e. higher-order cortex motor dissociation); and (ii) early responses to these paradigms are associated with better 6-month outcomes on the Glasgow Outcome Scale-Extended. Patients underwent functional magnetic resonance imaging on post-injury Day 9.2 ± 5.0 and electroencephalography on Day 9.8 ± 4.6. At the time of imaging, behavioural evaluation with the Coma Recovery Scale-Revised indicated coma (n = 2), vegetative state (n = 3), minimally conscious state without language (n = 3), minimally conscious state with language (n = 4) or post-traumatic confusional state (n = 4). Cognitive motor dissociation was identified in four patients, including three whose behavioural diagnosis suggested a vegetative state. Higher-order cortex motor dissociation was identified in two additional patients. Complete absence of responses to language, music and motor imagery was only observed in coma patients. In patients with behavioural evidence of language function, responses to language and music were more frequently observed than responses to motor imagery (62.5-80% versus 33.3-42.9%). Similarly, in 16 matched healthy subjects, responses to language and music were more frequently observed than responses to motor imagery (87.5-100% versus 68.8-75.0%). Except for one patient who died in the intensive care unit, all patients with cognitive motor dissociation and higher-order cortex motor dissociation recovered beyond a confusional state by 6 months. However, 6-month outcomes were not associated with early functional magnetic resonance imaging and electroencephalography responses for the entire cohort. These observations suggest that functional magnetic resonance imaging and electroencephalography can detect command-following and higher-order cortical function in patients with acute severe traumatic brain injury. Early detection of covert consciousness and cortical responses in the intensive care unit could alter time-sensitive decisions about withholding life-sustaining therapies.
[Mh] Termos MeSH primário: Lesões Encefálicas Traumáticas/complicações
Lesões Encefálicas Traumáticas/fisiopatologia
Estado de Consciência/fisiologia
Diagnóstico Precoce
Estado Vegetativo Persistente/diagnóstico por imagem
Estado Vegetativo Persistente/fisiopatologia
[Mh] Termos MeSH secundário: Adolescente
Adulto
Lesões Encefálicas Traumáticas/diagnóstico por imagem
Estudos de Casos e Controles
Eletroencefalografia
Feminino
Escala de Coma de Glasgow
Escala de Resultado de Glasgow
Seres Humanos
Imaginação/fisiologia
Linguagem
Imagem por Ressonância Magnética
Masculino
Meia-Idade
Música
Estado Vegetativo Persistente/etiologia
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171030
[Lr] Data última revisão:
171030
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:171021
[St] Status:MEDLINE
[do] DOI:10.1093/brain/awx176


  5 / 2753 MEDLINE  
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[PMID]:28728060
[Au] Autor:Ragazzoni A; Cincotta M; Giovannelli F; Cruse D; Young GB; Miniussi C; Rossi S
[Ad] Endereço:Unit of Neurology & Clinical Neurophysiology, Fondazione PAS, Scandicci, Florence, Italy. Electronic address: aldo.ragazzoni@unifi.it.
[Ti] Título:Clinical neurophysiology of prolonged disorders of consciousness: From diagnostic stimulation to therapeutic neuromodulation.
[So] Source:Clin Neurophysiol;128(9):1629-1646, 2017 Sep.
[Is] ISSN:1872-8952
[Cp] País de publicação:Netherlands
[La] Idioma:eng
[Ab] Resumo:The identification of signs of awareness in patients with prolonged disorders of consciousness (DoC) after severe brain injury is a challenging task for clinicians. Differentiating on behavioural examination the vegetative state (VS) from the minimally conscious state (MCS) can lead to a high misdiagnosis rate. Advanced neuroimaging and neurophysiological techniques can supplement clinical evaluation by providing physiological evidence of brain activity. However, an open issue remains whether these empirical results are directly or indirectly associated with covert consciousness and limitations emerge for their diagnostic application at the single-patient level. On the therapeutic side, the efficacy of both non-invasive and invasive brain stimulation/modulation trials is matter of debate. The present review provides an updated analysis of the diagnostic and prognostic impact that the different neurophysiological techniques of stimulation [including short-latency evoked potentials, long-latency event related potentials (ERPs), transcranial magnetic stimulation (TMS), TMS-EEG co-registration] offer in prolonged DoC. The results of the therapeutic stimulation techniques are also evaluated. It is concluded that TMS-EEG emerges as the most promising tool for differentiating VS from MCS whereas ERPs allow neurophysiologists to probe covert cognitive capacities of each patient. Significant behavioural improvements in prolonged DoC with brain stimulation techniques are still anecdotical and further treatment options are awaited.
[Mh] Termos MeSH primário: Encéfalo/fisiopatologia
Transtornos da Consciência/fisiopatologia
Transtornos da Consciência/terapia
Estimulação Encefálica Profunda/tendências
Eletroencefalografia/tendências
Estimulação Magnética Transcraniana/tendências
[Mh] Termos MeSH secundário: Transtornos da Consciência/diagnóstico
Estimulação Encefálica Profunda/métodos
Eletroencefalografia/métodos
Seres Humanos
Estado Vegetativo Persistente/diagnóstico
Estado Vegetativo Persistente/fisiopatologia
Estado Vegetativo Persistente/terapia
Estimulação Magnética Transcraniana/métodos
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170831
[Lr] Data última revisão:
170831
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170721
[St] Status:MEDLINE


  6 / 2753 MEDLINE  
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[PMID]:28444788
[Au] Autor:Pavlov YG; Gais S; Müller F; Schönauer M; Schäpers B; Born J; Kotchoubey B
[Ad] Endereço:Institute of Medical Psychology and Behavioral Neurobiology, University of Tübingen, Tübingen, Germany.
[Ti] Título:Night sleep in patients with vegetative state.
[So] Source:J Sleep Res;26(5):629-640, 2017 Oct.
[Is] ISSN:1365-2869
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:Polysomnographic recording of night sleep was carried out in 15 patients with the diagnosis vegetative state (syn. unresponsive wakefulness syndrome). Sleep scoring was performed by three raters, and confirmed by means of a spectral power analysis of the electroencephalogram, electrooculogram and electromyogram. All patients but one exhibited at least some signs of sleep. In particular, sleep stage N1 was found in 13 patients, N2 in 14 patients, N3 in nine patients, and rapid eye movement sleep in 10 patients. Three patients exhibited all phenomena characteristic for normal sleep, including spindles and rapid eye movements. However, in all but one patient, sleep patterns were severely disturbed as compared with normative data. All patients had frequent and long periods of wakefulness during the night. In some apparent rapid eye movement sleep episodes, no eye movements were recorded. Sleep spindles were detected in five patients only, and their density was very low. We conclude that the majority of vegetative state patients retain some important circadian changes. Further studies are necessary to disentangle multiple factors potentially affecting sleep pattern of vegetative state patients.
[Mh] Termos MeSH primário: Estado Vegetativo Persistente/fisiopatologia
Sono
[Mh] Termos MeSH secundário: Adulto
Idoso
Ritmo Circadiano
Eletroencefalografia
Eletromiografia
Eletroculografia
Movimentos Oculares
Feminino
Seres Humanos
Masculino
Meia-Idade
Polissonografia
Sono REM
Vigília
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171113
[Lr] Data última revisão:
171113
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170427
[St] Status:MEDLINE
[do] DOI:10.1111/jsr.12524


  7 / 2753 MEDLINE  
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[PMID]:28160751
[Au] Autor:Calabrò RS; Naro A; Manuli A; Leo A; De Luca R; Lo Buono V; Russo M; Bramanti A; Bramanti P
[Ad] Endereço:IRCCS Centro Neurolesi "Bonino-Pulejo", Messina, Italy. Electronic address: salbro77@tiscali.it.
[Ti] Título:Pain perception in patients with chronic disorders of consciousness: What can limbic system tell us?
[So] Source:Clin Neurophysiol;128(3):454-462, 2017 Mar.
[Is] ISSN:1872-8952
[Cp] País de publicação:Netherlands
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: Although it is believed that patients with Unresponsive Wakefulness Syndrome (UWS) do not feel pain, recent neuroimaging and neurophysiologic studies have demonstrated some residual traces of nociceptive processing. METHODS: To confirm this growing evidence, we evaluated 21 patients suffering from chronic disorders of consciousness (DOC) (both UWS, n=11, and Minimally Conscious State - MCS -, n=10), using an Event-Related Potential (ERP) Low-Resolution Brain Electromagnetic Tomography (LORETA) approach, based on nociceptive repeated laser stimulation (RLS). We delivered laser stimuli to the dorsum of both hands and analysed the γ-band LORETA activations and the ERP γ-power magnitude induced by laser stimulation, as well as the heart rate variability (HRV). RESULTS: We found partially preserved cortical activations and ERP γ-power magnitude in all MCS and two UWS individuals. These effects were paralleled by a purposeful behaviour, and a reduced HRV concerning nociceptive stimulation, whereas the two UWS individuals showed no more than reflex behaviours, besides a strong limbic activation. CONCLUSIONS: Some UWS patients may somehow perceive the affective components of nociceptive stimulation. SIGNIFICANCE: The diagnosis of functional locked-in syndrome should be taken into account when dealing with DOC differential diagnosis.
[Mh] Termos MeSH primário: Sistema Límbico/fisiologia
Percepção da Dor
Dor/fisiopatologia
Estado Vegetativo Persistente/fisiopatologia
[Mh] Termos MeSH secundário: Adulto
Potenciais Evocados
Feminino
Ritmo Gama
Frequência Cardíaca
Seres Humanos
Potenciais Evocados por Laser
Masculino
Meia-Idade
Nociceptividade
Dor/complicações
Dor/diagnóstico
Estado Vegetativo Persistente/complicações
Estado Vegetativo Persistente/diagnóstico
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1705
[Cu] Atualização por classe:170530
[Lr] Data última revisão:
170530
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170205
[St] Status:MEDLINE


  8 / 2753 MEDLINE  
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[PMID]:28122100
[Au] Autor:Kaplan DM; Gluck O; Kraus M; Slovik Y; Juwad H
[Ad] Endereço:Department of Otorhinolaryngology-Head and Neck Surgery, Soroka University Medical Center and Faculty of Health Sciences, Beer Sheva, Israel. dankap@bgu.ac.il.
[Ti] Título:Acute bacterial meningitis caused by acute otitis media in adults: A series of 12 patients.
[So] Source:Ear Nose Throat J;96(1):20-28, 2017 Jan.
[Is] ISSN:1942-7522
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:We conducted a retrospective chart review to characterize the outcomes of 12 patients-9 men and 3 women, aged 21 to 79 years (mean: 49)-who had been treated at our tertiary care center for acute bacterial meningitis caused by acute otitis media (ABMAO). Fever was the most common presenting sign/symptom, observed in 8 patients, followed by otalgia, neck stiffness, headache, and confusion. An opaque and bulging tympanic membrane was observed in 8 patients. Cultures were positive for Streptococcus pneumoniae in the cerebrospinal fluid, ear, and blood in 7, 5, and 3 patients, respectively. Immediate treatment included tympanocentesis, with aspirates sent for bacteriologic cultures. Seven patients (58.3%) underwent surgery; 5 were operated on early, and 2 underwent surgery at a later stage because of a suspected defect in the mastoid bone. A cortical mastoidectomy was performed in 6 of the 7 surgical patients; the remaining patient underwent a canal-wall-down procedure. Ten patients experienced a full recovery, 1 died, and 1 had a poor neurologic outcome (vegetative state); both of the latter 2 patients were older than 60 years. We conclude that early diagnosis, administration of antibiotics, and myringotomy are crucial for control of ABMAO. A cortical mastoidectomy with ventilation tube insertion can be reserved for patients who do not respond, which is common.
[Mh] Termos MeSH primário: Meningites Bacterianas/etiologia
Otite Média/complicações
Infecções Estreptocócicas/complicações
[Mh] Termos MeSH secundário: Doença Aguda
Adulto
Idoso
Antibacterianos/uso terapêutico
Técnicas de Cultura
Diagnóstico Precoce
Intervenção Médica Precoce
Feminino
Seres Humanos
Masculino
Processo Mastoide/cirurgia
Meningites Bacterianas/terapia
Meia-Idade
Ventilação da Orelha Média/métodos
Otite Média/terapia
Procedimentos Cirúrgicos Otológicos/métodos
Estado Vegetativo Persistente
Estudos Retrospectivos
Infecções Estreptocócicas/terapia
Streptococcus pneumoniae
Timpanocentese
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Anti-Bacterial Agents)
[Em] Mês de entrada:1706
[Cu] Atualização por classe:170614
[Lr] Data última revisão:
170614
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170126
[St] Status:MEDLINE


  9 / 2753 MEDLINE  
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[PMID]:28120050
[Au] Autor:Yamamoto T; Watanabe M; Obuchi T; Kobayashi K; Oshima H; Fukaya C; Yoshino A
[Ad] Endereço:Divisions of Applied System Neuroscience, Department of Neurological Surgery, Nihon University School of Medicine, 30-1 Ohyaguchi Kamimachi, Itabashi-ku, Tokyo, 173-8610, Japan. yamamoto.takamitsu@nihon-u.ac.jp.
[Ti] Título:Spinal Cord Stimulation for Vegetative State and Minimally Conscious State: Changes in Consciousness Level and Motor Function.
[So] Source:Acta Neurochir Suppl;124:37-42, 2017.
[Is] ISSN:0065-1419
[Cp] País de publicação:Austria
[La] Idioma:eng
[Ab] Resumo:Twenty-one vegetative state (VS) patients and 10 minimally conscious state (MCS) patients were treated by spinal cord stimulation (SCS) following an electrophysiological evaluation 3 months or more after the onset of brain injury.A flexible four-contact cylindrical electrode was inserted into the epidural space of the cervical vertebrae, and placed at cervical levels C2-C4. Five-hertz stimulation was applied for 5 min every 30 min during the daytime at an intensity that produced muscle twitches of the upper extremities.Both the fifth wave in the auditory brainstem response (ABR) and N20 in the somatosensory evoked potential (SEP) were detected in 8 of the 21 VS patients and 9 of the 10 MCS patients. Of the 3 VS patients and 7 MCS patients who recovered following SCS therapy, all showed a preserved fifth wave in the ABR and N20 in the SEP, and all had received SCS therapy within 9 months after the onset of brain injury. Although the 3 patients who recovered from VS remained in a bedridden state, all 7 patients who recovered from MCS were able to emerge from the bedridden state within 12 months after the start of SCS.Five-hertz cervical SCS caused increased cerebral blood flow (CBF) and induced muscle twitches of the upper extremities, and MCS patients showed a remarkable recovery of consciousness and motor function in the upper extremities compared with the lower extremities. This SCS method could be a new neuromodulation and neurorehabilitation technique, and MCS patients may be good candidates for SCS therapy.
[Mh] Termos MeSH primário: Encéfalo/irrigação sanguínea
Circulação Cerebrovascular
Estado Vegetativo Persistente/reabilitação
Estimulação da Medula Espinal
[Mh] Termos MeSH secundário: Adolescente
Adulto
Idoso
Potenciais Evocados Auditivos do Tronco Encefálico/fisiologia
Potenciais Somatossensoriais Evocados/fisiologia
Feminino
Seres Humanos
Masculino
Meia-Idade
Músculo Esquelético/inervação
Estado Vegetativo Persistente/fisiopatologia
Tomografia Computadorizada de Emissão de Fóton Único
Resultado do Tratamento
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171102
[Lr] Data última revisão:
171102
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170126
[St] Status:MEDLINE
[do] DOI:10.1007/978-3-319-39546-3_6


  10 / 2753 MEDLINE  
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[PMID]:28120048
[Au] Autor:Mattogno PP; Barbagallo G; Iacopino G; Pappalardo G; LA Rocca G; Signorelli F; Zhong J; Visocchi M
[Ad] Endereço:Neurosurgery, Catholic University Medical School, Rome, Italy. pierpaolo.mattogno@gmail.com.
[Ti] Título:Recovery from Chronic Diseases of Consciousness: State of the Art in Neuromodulation for Persistent Vegetative State and Minimally Conscious State.
[So] Source:Acta Neurochir Suppl;124:19-25, 2017.
[Is] ISSN:0065-1419
[Cp] País de publicação:Austria
[La] Idioma:eng
[Ab] Resumo:Chronic diseases of consciousness (CDC) can still be considered a challenging frontier for modern medicine, probably because of their not completely understood physiopathological mechanisms. Following encouraging evidence on cerebral hemodynamics, some authors have hypothesized a role for neuromodulation in the treatment of CDC patients. In the past 40 years, spinal cord stimulation (SCS) and deep brain stimulation (DBS) have been used experimentally for the treatment of patients in a severe altered state of consciousness, with some interesting but not conclusive results. The present review summarizes the data currently available in the literature on this particular and debated topic. On these grounds, further clinical studies are needed to better understand the altered dynamics of neuronal network circuits in CDC patients as a step towards novel therapeutic strategies.
[Mh] Termos MeSH primário: Estimulação Encefálica Profunda
Estado Vegetativo Persistente/reabilitação
Estimulação da Medula Espinal
[Mh] Termos MeSH secundário: Seres Humanos
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171102
[Lr] Data última revisão:
171102
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170126
[St] Status:MEDLINE
[do] DOI:10.1007/978-3-319-39546-3_4



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