scholarly journals Disorders of Consciousness Associated With COVID-19: A Prospective, Multimodal Study of Recovery and Brain Connectivity

Neurology ◽  
2021 ◽  
pp. 10.1212/WNL.0000000000013067
Author(s):  
David Fischer ◽  
Samuel B Snider ◽  
Megan E Barra ◽  
William R Sanders ◽  
Otto Rapalino ◽  
...  
Keyword(s):  
Brain Injury ◽  
Brain Connectivity ◽  
Structural Connectivity ◽  
Disorders Of Consciousness ◽  
Healthy Controls ◽  
Post Discharge ◽  
Prospective Longitudinal Study ◽  
Link Type ◽  
Prospective Longitudinal ◽  
Structural Brain

Background and Objectives:In patients with severe coronavirus disease 2019 (COVID-19), disorders of consciousness (COVID-DoC) have emerged as a serious complication. The prognosis and pathophysiology of COVID-DoC remain unclear, complicating decisions about continuing life-sustaining treatment. We describe the natural history of COVID-DoC and investigate its associated brain connectivity profile.Methods:In a prospective, longitudinal study, we screened consecutive patients with COVID-19 at our institution. We enrolled critically ill adult patients with a DoC unexplained by sedation or structural brain injury, and who were planned to undergo a brain MRI. We performed resting state functional MRI and diffusion MRI to evaluate functional and structural connectivity, as compared to healthy controls and patients with DoC resulting from severe traumatic brain injury (TBI). We assessed the recovery of consciousness (command-following) and functional outcomes (Glasgow Outcome Scale Extended [GOSE] and the Disability Rating Scale [DRS]) at hospital discharge, three months post-discharge, and six months post-discharge. We also explored whether clinical variables were associated with recovery from COVID-DoC.Results:After screening 1,105 patients with COVID-19, we enrolled twelve with COVID-DoC. The median age was 63.5 years [interquartile range 55-76.3]. Excluding one who died shortly after enrollment, all of the remaining eleven patients recovered consciousness, after 0-25 days (median 7 [5-14.5]) following the cessation of continuous intravenous sedation. At discharge, all surviving patients remained dependent – median GOSE 3 [1-3], median DRS 23 [16-30]. However ultimately, except for two patients with severe polyneuropathy, all returned home with normal cognition and minimal disability – at three months, median GOSE 3 [3-3], median DRS 7 [5-13]; at six months, median GOSE 4 [4-5], median DRS 3 [3-5]. Ten patients with COVID-DoC underwent advanced neuroimaging; functional and structural brain connectivity in COVID-DoC was diminished compared to healthy controls, and structural connectivity was comparable to patients with severe TBI.Discussion:Patients who survived invariably recovered consciousness after COVID-DoC. Though disability was common following hospitalization, functional status improved over the ensuing months. While future research is necessary, these prospective findings inform the prognosis and pathophysiology of COVID-DoC.Trial Registration Information:Clinicaltrials.gov, NCT04476589, submitted 7/2020, first enrolled 7/20/2020, https://clinicaltrials.gov/ct2/show/NCT04476589

scholarly journals Functional Connectivity Network Disruption Underlies Domain-Specific Impairments in Attention for Children Born Very Preterm

2020 ◽  
Author(s):  
M D Wheelock ◽  
R E Lean ◽  
S Bora ◽  
T R Melzer ◽  
A T Eggebrecht ◽  
...  
Keyword(s):  
Functional Connectivity ◽  
Network Architecture ◽  
Brain Connectivity ◽  
Network Connectivity ◽  
Attention Problems ◽  
School Age Children ◽  
Prospective Longitudinal Study ◽  
Domain Specific ◽  
Very Preterm ◽  
Prospective Longitudinal

Abstract Attention problems are common in school-age children born very preterm (VPT; < 32 weeks gestational age), but the contribution of aberrant functional brain connectivity to these problems is not known. As part of a prospective longitudinal study, brain functional connectivity (fc) was assessed alongside behavioral measures of selective, sustained, and executive attention in 58 VPT and 65 full-term (FT) born children at corrected-age 12 years. VPT children had poorer sustained, shifting, and divided attention than FT children. Within the VPT group, poorer attention scores were associated with between-network connectivity in ventral attention, visual, and subcortical networks, whereas between-network connectivity in the frontoparietal, cingulo-opercular, dorsal attention, salience and motor networks was associated with attention functioning in FT children. Network-level differences were also evident between VPT and FT children in specific attention domains. Findings contribute to our understanding of fc networks that potentially underlie typical attention development and suggest an alternative network architecture may help support attention in VPT children.

Intellectual Outcome from Preschool Traumatic Brain Injury: A 5-Year Prospective, Longitudinal Study

PEDIATRICS ◽  
2009 ◽  
Vol 124 (6) ◽  
pp. e1064-e1071 ◽  
Author(s):  
V. Anderson ◽  
C. Catroppa ◽  
S. Morse ◽  
F. Haritou ◽  
J. V. Rosenfeld
Keyword(s):  
Traumatic Brain Injury ◽  
Longitudinal Study ◽  
Brain Injury ◽  
Prospective Longitudinal Study ◽  
Intellectual Outcome ◽  
Prospective Longitudinal

Structural Brain Development and Depression Onset During Adolescence: A Prospective Longitudinal Study

2014 ◽  
Vol 171 (5) ◽  
pp. 564-571 ◽  
Author(s):  
Sarah Whittle ◽  
Renee Lichter ◽  
Meg Dennison ◽  
Nandita Vijayakumar ◽  
Orli Schwartz ◽  
...  
Keyword(s):  
Longitudinal Study ◽  
Brain Development ◽  
Prospective Longitudinal Study ◽  
Prospective Longitudinal ◽  
Structural Brain

scholarly journals The Diagnostic and Prognostic Value of Neurofilament Heavy Chain Levels in Immune-Mediated Optic Neuropathies

2012 ◽  
Vol 2012 ◽  
pp. 1-5 ◽  
Author(s):  
Axel Petzold ◽  
Gordon T. Plant
Keyword(s):  
Optic Neuritis ◽  
Heavy Chain ◽  
Prognostic Value ◽  
Visual Outcome ◽  
High Serum ◽  
Healthy Controls ◽  
Prospective Longitudinal Study ◽  
Immune Mediated ◽  
Prospective Longitudinal ◽  
Diagnostic And Prognostic Value

Background. Loss of visual function differs between immune-mediated optic neuropathies and is related to axonal loss in the optic nerve. This study investigated the diagnostic and prognostic value of a biomarker for neurodegeneration, the neurofilament heavy chain (NfH) in three immune-mediated optic neuropathies.Methods. A prospective, longitudinal study including patients with optic neuritis due to multiple sclerosis (MSON,n=20), chronic relapsing inflammatory optic neuritis (CRION,n=19), neuromyelitis optica (NMO,n=9), and healthy controls (n=28). Serum NfH-SMI35 levels were quantified by ELISA.Findings. Serum NfH-SMI35 levels were highest in patients with NMO (mean0.79±1.51 ng/mL) compared to patients with CRION (0.13±0.16 ng/mL,P=0.007), MSON (0.09±0.09,P=0.008), and healthy controls (0.01±0.02 ng/mL,P=0.001). High serum NfH-SMI35 levels were related to poor visual outcome.Conclusions. Blood NfH-SMI35 levels are of moderate diagnostic and more important prognostic value in immune-mediated optic neuropathies. We speculate that longitudinal blood NfH levels may help to identify particular disabling events in relapsing conditions.

scholarly journals Pituitary deficiency and precocious puberty after childhood severe traumatic brain injury: a long-term follow-up prospective study

2019 ◽  
Vol 180 (5) ◽  
pp. 281-290 ◽  
Author(s):  
Yamina Dassa ◽  
Hélène Crosnier ◽  
Mathilde Chevignard ◽  
Magali Viaud ◽  
Claire Personnier ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Precocious Puberty ◽  
Central Precocious Puberty ◽  
Height Velocity ◽  
Prospective Longitudinal Study ◽  
Pituitary Dysfunction ◽  
Severe Tbi ◽  
Prospective Longitudinal

Objectives Childhood traumatic brain injury (TBI) is a public health issue. Our objectives were to determine the prevalence of permanent pituitary hormone deficiency and to detect the emergence of other pituitary dysfunctions or central precocious puberty several years after severe TBI. Design Follow-up at least 5 years post severe TBI of a prospective longitudinal study. Patients Overall, 66/87 children, who had endocrine evaluation 1 year post severe TBI, were included (24 with pituitary dysfunction 1 year post TBI). Main outcome measures In all children, the pituitary hormones basal levels were assessed at least 5 years post TBI. Growth hormone (GH) stimulation tests were performed 3–4 years post TBI in children with GH deficiency (GHD) 1 year post TBI and in all children with low height velocity (<−1 DS) or low IGF-1 (<−2 DS). Central precocious puberty (CPP) was confirmed by GnRH stimulation test. Results Overall, 61/66 children were followed up 7 (5–10) years post TBI (median; (range)); 17/61 children had GHD 1 year post TBI, and GHD was confirmed in 5/17 patients. For one boy, with normal pituitary function 1 year post TBI, GHD was diagnosed 6.5 years post TBI. 4/61 patients developed CPP, 5.7 (2.4–6.1) years post-TBI. Having a pituitary dysfunction 1 year post TBI was significantly associated with pituitary dysfunction or CPP more than 5 years post TBI. Conclusion Severe TBI in childhood can lead to permanent pituitary dysfunction; GHD and CPP may appear after many years. We recommend systematic hormonal assessment in children 1 year after severe TBI and a prolonged monitoring of growth and pubertal maturation. Recommendations should be elaborated for the families and treating physicians.

scholarly journals Connectivity-Informed Adaptive Regularization for Generalized Outcomes

2018 ◽  
Author(s):  
Damian Brzyski ◽  
Marta Karas ◽  
Beau Ances ◽  
Mario Dzemidzic ◽  
Joaquin Goni ◽  
...  
Keyword(s):  
Linear Regression ◽  
Brain Connectivity ◽  
Association Studies ◽  
Structural Connectivity ◽  
Laplacian Matrix ◽  
External Information ◽  
Penalty Term ◽  
Generalized Linear Regression ◽  
The Brain ◽  
Structural Brain

AbstractOne of the challenging problems in the brain imaging research is a principled incorporation of information from different imaging modalities in association studies. Frequently, data from each modality is analyzed separately using, for instance, dimensionality reduction techniques, which result in a loss of mutual information. We propose a novel regularization method, griPEER (generalized ridgified Partially Empirical Eigenvectors for Regression) to estimate the association between the brain structure features and a scalar outcome within the generalized linear regression framework. griPEER provides a principled approach to use external information from the structural brain connectivity to improve the regression coefficient estimation. Our proposal incorporates a penalty term, derived from the structural connectivity Laplacian matrix, in the penalized generalized linear regression. We address both theoretical and computational issues and show that our method is robust to the incomplete information about the structural brain connectivity. We also provide a significance testing procedure for performing inference on the estimated coefficients in this model. griPEER is evaluated in extensive simulation studies and it is applied in classification of the HIV+ and HIV- individuals.

scholarly journals Association between high mobility group box 1 protein and juvenile idiopathic arthritis: a prospective longitudinal study

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Dan Xu ◽  
Yu Zhang ◽  
Zhi-Yong Zhang ◽  
Xue-Mei Tang
Keyword(s):  
Juvenile Idiopathic Arthritis ◽  
Longitudinal Study ◽  
High Mobility ◽  
Healthy Controls ◽  
C Reactive Protein ◽  
Prospective Longitudinal Study ◽  
Reactive Protein ◽  
Systemic Jia ◽  
Duration Of Disease ◽  
Prospective Longitudinal

Abstract Objective To analyze the levels of high mobility group box 1 (HMGB1) protein on different courses of juvenile idiopathic arthritis (JIA). Methods In our prospective longitudinal study, children with JIA were included with their blood samples collected at the first visit, 1-month, 3-month, and 6-month follow-up, respectively. Samples were also collected from healthy controls and children with reactive arthritis at the first visit. Levels of HMGB1 were determined using enzyme-linked immunosorbent assays. Clinical disease characteristics and routine laboratory findings were analyzed as well. Results A total of 64 children were enrolled, of whom 31 (48.4%) were female. The median age at the first visit for participants with JIA was 9.25 years (range, 1.42–15.42) and the median duration of disease was 2.38 months (range, 1.53–49.31). Serum HMGB1 levels at the first visit were significantly elevated in children with systemic JIA compared with other groups, and so were in enthesitis-related arthritis versus healthy controls. Significant correlations were established at the first visit between HMGB1 levels and duration of disease, C-reactive protein, percentage of neutrophils, and ferritin. Data from all samples revealed that serum HMGB1 levels in JIA were significantly associated with erythrocyte sedimentation rates, C-reactive protein, percentage of neutrophils, and disease activity scores. Conclusions Serum HMGB1 may be associated with clinical disease activity of JIA and specifically increased at the first visit in children with systemic JIA, suggesting its function as a sensitive inflammatory marker. Further large-scale studies are warranted to explore its spectrum in JIA.

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