scholarly journals Automated pupillometry to detect command following in neurological patients: a proof-of-concept study

PeerJ ◽  
2019 ◽  
Vol 7 ◽  
pp. e6929 ◽  
Author(s):  
Alexandra Vassilieva ◽  
Markus Harboe Olsen ◽  
Costanza Peinkhofer ◽  
Gitte Moos Knudsen ◽  
Daniel Kondziella
Keyword(s):  
Brain Injury ◽  
Healthy Volunteers ◽  
Neurological Disorders ◽  
Mental Arithmetic ◽  
Proof Of Concept ◽  
Icu Patients ◽  
Wide Range ◽  
Level Of Consciousness ◽  
Neurological Patients ◽  
Command Following

Background Levels of consciousness in patients with acute and chronic brain injury are notoriously underestimated. Paradigms based on electroencephalography (EEG) and functional magnetic resonance imaging (fMRI) may detect covert consciousness in clinically unresponsive patients but are subject to logistical challenges and the need for advanced statistical analysis. Methods To assess the feasibility of automated pupillometry for the detection of command following, we enrolled 20 healthy volunteers and 48 patients with a wide range of neurological disorders, including seven patients in the intensive care unit (ICU), who were asked to engage in mental arithmetic. Results Fourteen of 20 (70%) healthy volunteers and 17 of 43 (39.5%) neurological patients, including 1 in the ICU, fulfilled prespecified criteria for command following by showing pupillary dilations during ≥4 of five arithmetic tasks. None of the five sedated and unconscious ICU patients passed this threshold. Conclusions Automated pupillometry combined with mental arithmetic appears to be a promising paradigm for the detection of covert consciousness in people with brain injury. We plan to build on this study by focusing on non-communicating ICU patients in whom the level of consciousness is unknown. If some of these patients show reproducible pupillary dilation during mental arithmetic, this would suggest that the present paradigm can reveal covert consciousness in unresponsive patients in whom standard investigations have failed to detect signs of consciousness.

scholarly journals Automated pupillometry to detect command following in neurological patients: A proof-of-concept study

2019 ◽  
Author(s):  
Alexandra Vassilieva ◽  
Markus Harboe Olsen ◽  
Costanza Peinkhofer ◽  
Gitte Moos Knudsen ◽  
Daniel Kondziella
Keyword(s):  
Brain Injury ◽  
Healthy Volunteers ◽  
Neurological Disorders ◽  
Mental Arithmetic ◽  
Proof Of Concept ◽  
Icu Patients ◽  
Wide Range ◽  
Level Of Consciousness ◽  
Neurological Patients ◽  
Command Following

AbstractBackgroundLevels of consciousness in patients with acute and chronic brain injury are notoriously underestimated. Paradigms based on electroencephalography (EEG) and functional magnetic resonance imaging (fMRI) may detect covert consciousness in unresponsive patients but are subject to logistical challenges and the need for advanced statistical analysis.MethodsTo assess the feasibility of automated pupillometry for the detection of command following, we enrolled 20 healthy volunteers and 48 patients with a wide range of neurological disorders, including 7 patients in the intensive care unit (ICU), who were asked to engage in mental arithmetic.ResultsFourteen of 20 (70%) healthy volunteers and 17 of 43 (39.5%) neurological patients, including 1 in the ICU, fulfilled prespecified criteria for command following by showing pupillary dilations during ≥4 of 5 arithmetic tasks. None of the 5 sedated and unconscious ICU patients passed this threshold.ConclusionsAutomated pupillometry combined with mental arithmetic appears to be a promising paradigm for the detection of covert consciousness in people with brain injury. We plan to build on this study by focusing on non-communicating ICU patients in whom the level of consciousness is unknown. If some of these patients show reproducible pupillary dilation during mental arithmetic, this would suggest that the present paradigm can reveal conscious awareness in unresponsive patients in whom standard investigations have failed to detect signs of covert consciousness.

Drug Repurposing in Neurological Disorders: Implications for Neurotherapy in Traumatic Brain Injury

2020 ◽  
pp. 107385842096107
Author(s):  
Zaynab Shakkour ◽  
Karl John Habashy ◽  
Moussa Berro ◽  
Samira Takkoush ◽  
Samar Abdelhady ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Drug Administration ◽  
Neurological Disorders ◽  
De Novo ◽  
Food And Drug Administration ◽  
Drug Repurposing ◽  
Adverse Outcomes ◽  
Minimal Risk ◽  
Wide Range

Traumatic brain injury (TBI) remains a significant leading cause of death and disability among adults and children globally. To date, there are no Food and Drug Administration–approved drugs that can substantially attenuate the sequelae of TBI. The innumerable challenges faced by the conventional de novo discovery of new pharmacological agents led to the emergence of alternative paradigm, which is drug repurposing. Repurposing of existing drugs with well-characterized mechanisms of action and human safety profiles is believed to be a promising strategy for novel drug use. Compared to the conventional discovery pathways, drug repurposing is less costly, relatively rapid, and poses minimal risk of the adverse outcomes to study on participants. In recent years, drug repurposing has covered a wide range of neurodegenerative diseases and neurological disorders including brain injury. This review highlights the advances in drug repurposing and presents some of the promising candidate drugs for potential TBI treatment along with their possible mechanisms of neuroprotection. Edaravone, glyburide, ceftriaxone, levetiracetam, and progesterone have been selected due to their potential role as putative TBI neurotherapeutic agents. These drugs are Food and Drug Administration–approved for purposes other than brain injuries; however, preclinical and clinical studies have shown their efficacy in ameliorating the various detrimental outcomes of TBI.

scholarly journals Physical Therapy Exercises for Sleep Disorders in a Rehabilitation Setting for Neurological Patients: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 11 (9) ◽  
pp. 1176
Author(s):  
Marco Tramontano ◽  
Sara De De Angelis ◽  
Giovanni Galeoto ◽  
Maria Carmela Cucinotta ◽  
Danilo Lisi ◽  
...  
Keyword(s):  
Systematic Review ◽  
Physical Therapy ◽  
Sleep Disorders ◽  
Neurological Disorders ◽  
Human Life ◽  
Meta Analysis ◽  
Well Being ◽  
Wide Range ◽  
Neurological Patients ◽  
Present Systematic Review

Background: Sleep occupies one-third of human life and is essential for health and for emotional, physical, and cognitive well-being. Poor or insufficient sleep is associated with a wide range of dysfunctions that involve different body systems, such as the endocrine, metabolic, and immune systems, thus compromising the higher cortical functions, cognitive performance, mood, and post-physical activity recovery. The present systematic review and meta-analysis aimed to explore the effectiveness of physical therapy exercises on sleep disorders in patients with neurological disorders. Our systematic review identified 10 articles that investigated the effects of physical therapy on sleep disorders in patients with neurological disorders, 6 of which were included in the meta-analysis. Results suggest that physical therapy exercises are a safe and useful strategy for managing sleep disorders in neurorehabilitation.

P.576 Automated pupillometry to detect command following in neurological patients: A proof-of-concept study

2019 ◽  
Vol 29 ◽  
pp. S402-S403
Author(s):  
C. Peinkhofer ◽  
A. Vassilieva ◽  
M.H. Olsen ◽  
G.M. Knudsen ◽  
D. Kondziella
Keyword(s):  
Proof Of Concept ◽  
Concept Study ◽  
Neurological Patients ◽  
Command Following

COGNITIVE IMPAIRMENT IN PATIENTS WITH CORONAVIRUS INFECTION

2021 ◽  
Vol 2 (1) ◽  
pp. 5-8
Author(s):  
Gulnoza Urinova ◽  
◽  
Nargiza Nasirtdinova ◽  
Janna Nazarova
Keyword(s):  
Cognitive Impairment ◽  
Neurological Disorders ◽  
Sinus Thrombosis ◽  
The Novel ◽  
Altered Level ◽  
Wide Range ◽  
Level Of Consciousness ◽  
Coronavirus Infection ◽  
Novel Coronavirus ◽  
The Brain

Thisarticle discusses cognitive impairment in patients with coronavirus infection and explains that observations have been made on this topic. The novel coronavirus infection COVID-19 caused by the SARS-CoV-2 coronavirus poses a global health threat. Neurological disordersfound in patients with coronavirus infection have a wide range of clinical neurological signs: headache, dizziness, altered level of consciousness, acute cerebrovascular accident (ACVE), venous sinus thrombosis the brain [12].Keywords:coronavirus infection, cognitive impairment, neurological disorders, headache, dizziness, muscle weakness, encephalopathy, encephalitis

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