P300 Evoked Response Potentials Patterns in Different Complex Concussion Phenotypes

Neurology ◽  
2021 ◽  
Vol 98 (1 Supplement 1) ◽  
pp. S4.2-S5
Author(s):  
Basil Ike ◽  
Landon Watts ◽  
David S. Oakley ◽  
Monica Pita ◽  
Mohammad Mortazavi
Keyword(s):  
Retrospective Study ◽  
Neck Pain ◽  
Mixed Type ◽  
Statistical Significance ◽  
Evoked Response ◽  
Entire Group ◽  
Post Injury ◽  
Neurologic Disorders ◽  
Symptom Scores ◽  
Evoked Response Potentials

ObjectiveDetermine the utility of P300 Evoked Response Potentials (ERP) voltage patterns in predicting phenotypical sequelae of patients with complex concussions or Persistent Post Concussive Symptoms (PPCS).BackgroundERPs have been used to aid in the diagnosis of multiple neurologic disorders. They have also been recently used in the evaluation of concussions.Design/MethodsA retrospective study of 54 patients, 10–71 year (mean age 29.6 yrs), with PPCS were tested between 6 and 12 weeks post-injury using the standard oddball audio P300 ERP protocol with measures extracted including best central parietal P300 ERP. PPCS Phenotyping was completed in each patient using a standardized post-concussive questionnaire and Rivermead method for 5 primary phenotypes and mixed type.ResultsP300 average Voltage for the entire group was 11.6 mV. Overall, these were significantly lower than age-matched non concussed controls whose average voltage was 16.3 mV (p < 0.0001). Average P300 voltages for each phenotype: Cognition- 14.1 mV, Vestibular- 8.6 mV, Headache- 11.1 mV, Mood- 13.6 mV, Neck Pain- 9.6 mV, Visual- 9.8 mV, Mixed- 6.9 mV, Mixed and Vestibular phenotypes demonstrated the lowest average voltage potentials (6.9 mV and 8.6 mV respectively) which coincided with higher average symptom scores (70.5 and 54.5 respectively). Cognition and Mood demonstrated the highest average voltage potentials (14.1 mV and 13.6 nV respectively), which coincided with lower average symptom scores (40.3 and 48.7, respectively). Mood (13.6 mV) was the lowest average symptom score in the group at 40.3 and Mixed (6.9 mV) was highest at 70.5. Comparing phenotypes against one other, mixed vs mood (p = 0.03), cognition vs vestibular (p = 0.02), and cognition vs mixed (p = 0.009) showed statistical significance.ConclusionsP300 ERPs may help identify persistent abnormal complex concussion neurophysiology. ERPs can also potentially exhibit phenotype specific patterns and be a useful tool in helping differentiate more somatic/physiologic vs mood-based phenotypes. This can ultimately lead in the aid in diagnosis, prognosis, subtyping, and targeted phenotype management.

scholarly journals Self-Reported Complaints as Prognostic Markers for Outcome After Mild Traumatic Brain Injury in Elderly: A Machine Learning Approach

2021 ◽  
Vol 12 ◽  
Author(s):  
Mayra Bittencourt ◽  
Sebastián A. Balart-Sánchez ◽  
Natasha M. Maurits ◽  
Joukje van der Naalt
Keyword(s):  
Machine Learning ◽  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Elderly Patients ◽  
Neck Pain ◽  
Functional Outcome ◽  
Mild Traumatic Brain Injury ◽  
Prognostic Markers ◽  
The Elderly ◽  
Post Injury

Self-reported complaints are common after mild traumatic brain injury (mTBI). Particularly in the elderly with mTBI, the pre-injury status might play a relevant role in the recovery process. In most mTBI studies, however, pre-injury complaints are neither analyzed nor are the elderly included. Here, we aimed to identify which individual pre- and post-injury complaints are potential prognostic markers for incomplete recovery (IR) in elderly patients who sustained an mTBI. Since patients report many complaints across several domains that are strongly related, we used an interpretable machine learning (ML) approach to robustly deal with correlated predictors and boost classification performance. Pre- and post-injury levels of 20 individual complaints, as self-reported in the acute phase, were analyzed. We used data from two independent studies separately: UPFRONT study was used for training and validation and ReCONNECT study for independent testing. Functional outcome was assessed with the Glasgow Outcome Scale Extended (GOSE). We dichotomized functional outcome into complete recovery (CR; GOSE = 8) and IR (GOSE ≤ 7). In total 148 elderly with mTBI (median age: 67 years, interquartile range [IQR]: 9 years; UPFRONT: N = 115; ReCONNECT: N = 33) were included in this study. IR was observed in 74 (50%) patients. The classification model (IR vs. CR) achieved a good performance (the area under the receiver operating characteristic curve [ROC-AUC] = 0.80; 95% CI: 0.74–0.86) based on a subset of only 8 out of 40 pre- and post-injury complaints. We identified increased neck pain (p = 0.001) from pre- to post-injury as the strongest predictor of IR, followed by increased irritability (p = 0.011) and increased forgetfulness (p = 0.035) from pre- to post-injury. Our findings indicate that a subset of pre- and post-injury physical, emotional, and cognitive complaints has predictive value for determining long-term functional outcomes in elderly patients with mTBI. Particularly, post-injury neck pain, irritability, and forgetfulness scores were associated with IR and should be assessed early. The application of an ML approach holds promise for application in self-reported questionnaires to predict outcomes after mTBI.

P–515 Clinical outcome of mosaic-blastocyst transfer versus euploid-blastocyst transfer in single frozen blastocyst transfer cycles

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
W Y Yap ◽  
M W Lim ◽  
C S S Lee
Keyword(s):  
Retrospective Study ◽  
Clinical Outcome ◽  
Statistical Significance ◽  
Implantation Rate ◽  
Clinical Pregnancy ◽  
Blastocyst Transfer ◽  
Miscarriage Rate ◽  
Similar Clinical Outcome ◽  
Group A ◽  
Transfer Group

Abstract Study question What is the clinical outcome of transferring a mosaic blastocyst versus a euploid blastocyst in single frozen blastocyst transfer (sFBT) cycles? Summary answer Single mosaic blastocyst transfer has similar clinical outcome to single euploid blastocyst transfer. What is known already Embryonic mosaicism occurs when there are two or more distinct cell lines found in preimplantation embryos derived from IVF. Data from recent studies show that mosaic blastocysts have the potential to implant and can result in healthy live births. As a result, patients now have the option of transferring mosaic blastocyst when they do not have any euploid blastocyst available for transfer. However, the clinical outcome of transferring mosaic blastocyst has not been definitively reported. Thus, a retrospective study was conducted to compare the clinical outcome of mosaic sFBT and euploid sFBT. Study design, size, duration A total of 602 patients underwent frozen blastocyst transfer in Alpha IVF from January to October 2019 and had their blastocysts screened for aneuploidy. These patients were divided into 2 groups: 26 patients with mosaic blastocysts transferred (Group A, age ranged 19–44), and 576 patients with euploid blastocysts transferred (Group B, age ranged 21–44). The mean age of patients from Group A and B were 34.0 and 32.8 respectively (p &gt; 0.05). Participants/materials, setting, methods All samples had their DNA libraries constructed for sequencing using Next Generation Sequencing according to manufacturer’s specification (IonTorrent, USA). All blastocysts were frozen for subsequent sFBT cycle (Cryotech, Japan). All thawed blastocysts for sFBT survived with morphologically intact inner cell mass and trophectoderm cells. The importance of antenatal confirmation of the fetal chromosome status was emphasized in patients from Group A. The clinical outcomes of both groups were analysed and compared. Main results and the role of chance No significant differences were seen in the clinical pregnancy and implantation rate of Group A and B (65.4% vs 63.0%; p &gt; 0.05). The miscarriage rate of Group A and B were 23.5% and 14.0% respectively. Albeit the higher miscarriage rate in Group A, there was no statistical significance between these two groups (p &gt; 0.05). Group A was further divided into two subgroups, Subgroup A1: low risk mosaic blastocyst transfer; Subgroup A2: high risk mosaic blastocyst transfer. In the comparison of Group A subgroups, the clinical pregnancy and implantation of Group A1 is higher than Group A2 (76.9% vs 44.4%). In addition, the miscarriage rate of Group A1 and A2 were 23.1% and 0.0% respectively. Interestingly, there was no statistical significance in clinical pregnancy rate, implantation rate and miscarriage rate between these two subgroups. Limitations, reasons for caution This is a retrospective study and the sample size was comparatively smaller in the mosaic blastocyst transfer group than the euploid blastocyst transfer group. Further studies with a larger sample size should be carried out to ascertain the clinical outcome. Wider implications of the findings: Single mosaic blastocyst transfer has similar clinical outcome to single euploid blastocyst transfer. Thus, mosaic blastocyst can be considered for transfer when no euploid blastocyst are available. Nevertheless, stringent antenatal surveillance for chromosomal abnormalities to confirm the chromosomal status of the fetus must be followed. Trial registration number Not applicable

Effects of Orthokeratology Lens On Axial Length Elongation in Myopia With Anisometropia Children

2021 ◽  
Author(s):  
Ziyang Chen ◽  
Kai-Ming Chen ◽  
Ying Shi ◽  
Zhao-Da Ye ◽  
Sheng Chen ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Axial Length ◽  
Statistical Significance ◽  
Spherical Equivalent ◽  
Significant Difference ◽  
The Mean ◽  
The Difference ◽  
Better Than ◽  
Group 1

Abstract AimTo investigate the effect of orthokeratology (OK) lens on axial length (AL) elongation in myopia with anisometropia children.MethodsThirty-seven unilateral myopia (group 1) and fifty-nine bilateral myopia with anisometropia children were involved in this 1-year retrospective study. And bilateral myopia with anisometropia children were divided into group 2A (diopter of the lower SER eye under − 2.00D) and group 2B(diopter of the lower SER eye is equal or greater than − 2.00D). The change in AL were observed.The datas were analysed using SPSS 21.0.Results(1) In group 1, the mean baseline AL of the H eyes and L eye were 24.70 ± 0.89 mm and 23.55 ± 0.69 mm, respectively. In group 2A, the mean baseline AL of the H eyes and L eyes were 24.61 ± 0.84 mm and 24.00 ± 0.70 mm respectively. In group 2B, the mean baseline AL of the H eyes and L eyes were 25.28 ± 0.72 mm and 24.70 ± 0.74 mm. After 1 year, the change in AL of the L eyes was faster than the H eyes in group 1 and group 2A (all P<0.001).While the AL of the H eyes and L eyes had the same increased rate in group 2B. (2) The effect of controlling AL elongation of H eyes is consistent in three groups (P = 0.559).The effect of controlling AL elongation of L eyes in group 2B was better than that in group 1 and group 2A (P < 0.001). And the difference between group 1 and group 2A has no statistical significance. (3) The AL difference in H eyes and L eyes decreased from baseline 1.16 ± 0.55mm to 0.88 ± 0.68mm after 1 year in group 1.And in group 2A, the AL difference in H eyes and L eyes decreased from baseline 0.61 ± 0.34mm to 0.48 ± 0.28mm. There was statistically significant difference (all P<0.001). In group 2B, the baseline AL difference in H eyes and L eyes has no significant difference from that after 1 year (P = 0.069).ConclusionsMonocular OK lens is effective on suppression AL growth of the myopic eyes and reduce anisometropia value in unilateral myopic children. Binocular OK lenses only reduce anisometropia with the diopter of the low eye under − 2.00D. Binocular OK lenses cannot reduce anisometropia with the diopter of the low eye equal or greater than − 2.00D. Whether OK lens can reduce refractive anisometropia value is related to the spherical equivalent refractive of low refractive eye in bilateral myopia with anisometropia children after 1-year follow-up.

Features and prognosis of cytomegalovirus-associated biliary atresia: a retrospective study

2020 ◽  
Author(s):  
Zhe Wang ◽  
Xi-Si Guan ◽  
Yue Wu ◽  
Qiu-Ming He ◽  
Le Li ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Biliary Atresia ◽  
Statistical Significance ◽  
Underlying Mechanism ◽  
Gamma Glutamyl Transferase ◽  
Cmv Infection ◽  
Short Term ◽  
Term Outcome ◽  
Dna Test ◽  
Glutamyl Transferase

Abstract Purpose To investigate the relationship between cytomegalovirus (CMV) infection and biliary atresia (BA) onset, development and short-term prognosis after Kasai operation. Methods A retrospective study was conducted. BA Patients with obstructive jaundice and tested for CMV infection were included and grouped by CMV-IgM and CMV-DNA test results, between-group differences of preoperative blood tests and short-term prognosis indicators were investigated for the statistical significance. Results the CMV infection rate was higher in BA patients compared with non-BA jaundiced patients. Higher preoperative gamma-glutamyl transferase (GGT) level and lymphocyte percentage (Lym%) were significantly corelated with the CMV infection in BA patients. CMV(+) BA Patients had similar short-term outcome comparing with CMV(-) patients. IgM(+)DNA(+) group had highest GGT, total bilirubin (TBiL) and direct bilirubin (DBiL) level. IgM(-)DNA(+) group had the lowest GGT and the highest alkaline phosphatase (ALP) level. IgM(+)DNA(-) group had the highest bodyweight and lymphocyte percentage. The IgM (+)DNA (-) group had more patient achieved complete jaundice clearance than other groups. Conclusion CMV infection may associate to BA development and progression. Perioperative antivirus treatments may be necessary for improving outcome. Better elucidation of the underlying mechanism will require further investigation.

scholarly journals Association between Thyroiditis and Multifocality in Papillary Thyroid Carcinoma

2020 ◽  
Author(s):  
Rogério Aparecido Dedivitis ◽  
Leandro Luongo de Matos ◽  
Felipe Guilherme Silva Souza ◽  
Jose Luis Bogado Ortiz
Keyword(s):  
Retrospective Study ◽  
Papillary Thyroid Carcinoma ◽  
Thyroid Carcinoma ◽  
Total Thyroidectomy ◽  
Direct Relationship ◽  
Statistical Significance ◽  
Hashimoto Thyroiditis ◽  
Papillary Thyroid ◽  
Multifocal Lesions ◽  
The Relationship

Abstract Introduction Hashimoto thyroiditis (HT) shares many characteristics with papillary thyroid carcinoma (PTC), and some studies show that, when associated, PTC is diagnosed mostly with smaller lesions and multifocal pattern. Objective To evaluate the relationship between HT and PTC. Methods A retrospective study of 155 patients who underwent total thyroidectomy from 2009 to 2015. Demographical, clinical and ultrasonographical data, as well as anatomopathological findings were evaluated. Results There were signs of thyroidits in 35 patients, and 114 patients had a unifocal disease. There was no statistical significance between the variables studied and thyroiditis. However, when compared with the occurrence of unifocal or multifocal lesions, there was statistical significance regarding age (p = 0.038) and mass (p = 0.031). There was no direct relationship between thyroiditis and multifocality (p = 0.325) nor between thyroiditis and cervical extension of the disease (p = 0.300 e p = 0.434). Conclusion There was no relationship between thyroiditis and multifocality in cases of PTC.

scholarly journals Minor Head Injury Symptoms and Recovery From Whiplash Injury: A 1-Year Prospective Study

2019 ◽  
Vol 8 ◽  
pp. 117957271984563
Author(s):  
Helge Kasch ◽  
Luana Leonora Jensen
Keyword(s):  
Head Injury ◽  
Neck Pain ◽  
Prospective Study ◽  
Work Disability ◽  
Characteristic Curve ◽  
University Hospital ◽  
Predictive Test ◽  
Post Injury ◽  
Direct Head ◽  
Global Pain

Aim: To examine concussion-related disability in neck injuries, the Rivermead Head Injury Follow-Up Questionnaire (RHFUQ) was applied. Furthermore, we wanted to investigate symptoms found in post-concussion syndrome (PCS) and global pain, neck pain intensities obtained from acute whiplash patients within 1 week and at 6 months after injury in a prospective study on 1-year work disability. Methods: A total of 143 consecutive acute whiplash-injured patients were admitted to the study from the Emergency Unit (Aarhus University Hospital). Patients with direct head trauma or reported retro- or anterograde amnesia were excluded from the study. Average neck pain and global pain intensity were measured on a Visual Analogue Scale (VAS 0-10). The RHFUQ (10 items, score from 0 to 4, total score from 0 to 40) was fulfilled after 1 week and 6 months. Patients underwent neurological examination within 1 week after injury. Recovery (return to work) was assessed 1 year post-injury. Results: In total, 97% completed the study, and 9% (12/138) did not recover. Non-recovered patients reported more neck pain and global pain after 1 week ( P < .003) and 6 months ( P < .008) and higher PCS symptom score after 1 week ( P < .001) and 6 months ( P < .002). Using the RHFUQ total score as a predictive test, a receiver-operating characteristic curve (ROC) area of 0.77 (0.61-0.92) and a cut-off at 10 points revealed a sensitivity of 75% and a specificity of 67.2%. At 1 week, 8 of 10 items reached higher scores among non-recovered and 10 of 10 items after 6 months post-injury. Conclusions: RHFUQ is useful in acute whiplash patients for predicting 1-year work disability. PCS-related symptoms along with neck pain and global pain are more burdensome in the non-recovered group. This emphasizes that post-concussion symptoms are not a sign of brain injury alone, but are found in other types of mishaps like whiplash injuries.

scholarly journals A-22 Gender Effects and Self-Reported Symptomatology at Baseline

2020 ◽  
Vol 35 (5) ◽  
pp. 618-618
Author(s):  
K Horne ◽  
M Gilmore ◽  
R Bennett ◽  
L Lashley
Keyword(s):  
Sports Medicine ◽  
Statistical Significance ◽  
Somatic Symptoms ◽  
South Florida ◽  
T Test ◽  
Gender Effects ◽  
Post Injury ◽  
Return To Learn ◽  
Concussion History ◽  
The Relationship

ABSTRACT Objective To examine potential effects of gender on self-reported symptomatology in athletes who did not report a prior concussion history at baseline using ImPACT. Method Participants were selected from an archival de-identified sports medicine ImPACT database. The sample (N = 28,616) consisted of primarily male (58.2%) student athletes in South Florida with a mean age of 15.36 years (SD = 1.332). An exploratory factor analysis performed by Kontos and colleagues (2012) was utilized to categorize ImPACT self-reported symptomatology into four symptom groups: Affective, Sleep, Cognitive, and Vestibular Somatic. An independent samples t-test was conducted to determine the relationship between gender and self-reported symptoms at baseline. Statistical significance was set at p &lt; 0.01. Results The independent samples t-test determined significant differences (p &lt; .001) between gender and self-reported symptomatology regarding cognitive (d = 0.14), affective (d = 0.30), sleep (d = 0.13), and vestibular somatic symptoms (d = 0.17). Descriptive statistics revealed females on average reported more symptoms than males at baseline. Conclusions Findings indicate females are more likely to endorse sleep, emotion, and somatic symptoms in comparison to males at baseline. The results suggest that gender may be a mediating factor in regards to self-reported symptomatology, and should be accounted for when comparing baseline assessments to post-injury. Additionally, these results suggest self-reported symptomatology may be an accurate representation of athlete’s baseline functioning and are not solely related to post injury complications. Going forward, one’s self-reported symptomatology at baseline should be highly considered when clearing athletes for both return to learn and play.

scholarly journals Diagnostic Application of Fractal Dimension Analysis of Bone Invasion in Oral Malignancy—A Preliminary Retrospective Study

2020 ◽  
Vol 56 (01) ◽  
pp. 42-45
Author(s):  
Archana M. ◽  
Sadaksharam Jayachandran
Keyword(s):  
Fractal Dimension ◽  
Retrospective Study ◽  
Alveolar Bone ◽  
Bone Structure ◽  
Statistical Significance ◽  
Digital Radiographs ◽  
Box Counting ◽  
Set Inclusion ◽  
Oral Malignancy ◽  
Imagej Software

Abstract Introduction Fractal dimension (FD) analysis gives a numerical measure of the degree of boundary irregularity or surface roughness of an object and is based on quantitative analysis of features in an image. It quantifies the trabecular pattern of bone by analyzing the trabecular bone and bone marrow detecting the early changes in alveolar bone mineral content. The aim of this study is to assess the alveolar bone density by FD analysis in digital orthopantomograms (OPGs) showing bony erosion. Materials and Methods The OPGs of 10 patients from the archives of Department of Oral Medicine and Radiology were included in this retrospective study. The radiographs were selected based on set inclusion and exclusion criteria. FD analysis through box counting (using ImageJ software) was applied to the digital radiographs to establish a noninvasive evaluation of bone structure. The FD values obtained were recorded. Results The FD values were recorded and the data were analyzed. FD values showed statistical significance with p < 0.05. Conclusion With the number of samples analyzed and the results obtained, it can be concluded that FD analysis is an innovative method which can be used for early diagnosis of bony invasion in oral cancer. It can serve as a guide to dental surgeons in identifying the extent of bony invasion and can help in determining the margins of surgical resection of oral malignancy. This will prove to be a useful tool in surgical planning of oral malignancy.

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