Neuroscience
From tomorrow's Times, a feature article about the different states of unconsciousness and the different etiologies that may cause them to occur:
Inside the Injured Brain, Many Kinds of Awareness
The New York Times
By BENEDICT CAREY
Published: April 5, 2005
Read the article (free registration required)
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Here is the abstract of one of the research studies reported in the article:
Whyte J, Katz D, Long D, DiPasquale MC, Polansky M, Kalmar K, Giacino J, Childs N, Mercer W, Novak P, Maurer P, Eifert B. Predictors of outcome in prolonged posttraumatic disorders of consciousness and assessment of medication effects: A multicenter study. Archives of Physical Medicine and Rehabilitation. 2005 Mar; 86(3): 453-462.
Moss Rehabilitation Research Institute/Albert Einstein Healthcare Network, Philadelphia, PA, USA.
OBJECTIVES: To develop predictive models of recovery from the vegetative state (VS) and minimally conscious state (MCS) after traumatic brain injury (TBI) and to gather preliminary evidence on the impact of various psychotropic medications on the recovery process to support future randomized controlled trials. Design Longitudinal observational cohort design, in which demographic information, injury and acute care history, neuroimaging data, and an initial Disability Rating Scale (DRS) score were collected at the time of study enrollment. Weekly follow-up data, consisting of DRS score, current psychoactive medications, and medical complications, were gathered until discharge from inpatient rehabilitation. SETTING: Seven acute inpatient rehabilitation facilities in the United States and Europe with specialized programs for treating patients in the VS and MCS. PARTICIPANTS: People with TBI (N=124) who were in the VS or MCS 4 to 16 weeks after injury. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: DRS score at 16 weeks after injury and time until commands were first followed (among those participants demonstrating no command following at study enrollment). Results DRS score at enrollment, time between injury and enrollment, and rate of DRS change during the first 2 weeks of poststudy observation were all highly predictive of both outcomes. No variables related to injury characteristics or lesions on neuroimaging were significant predictors. Of the psychoactive medications, amantadine hydrochloride was associated with greater recovery and dantrolene sodium was associated with less recovery, in terms of the DRS score at 16 weeks but not the time until commands were followed. More detailed analysis of the timing of functional improvement, with respect to the initiation of amantadine provided suggestive, but not definitive, evidence of the drug's causal role. CONCLUSIONS: These findings show the feasibility of improving outcome prediction from the VS and MCS using readily available clinical variables and provide suggestive evidence for the effects of amantadine and dantrolene, but these results require confirmation through randomized controlled trials.
PMID: 15759228 [PubMed - in process]
- Neuropsychology Abstract Of The Day: Traumatic Brain Injury (tbi)
Bayley MT, Tate R, Douglas JM, Turkstra LS, Ponsford J, Stergiou-Kita M, Kua A, & Bragge P. (2014). INCOG Guidelines for Cognitive Rehabilitation Following Traumatic Brain Injury: Methods and Overview. Journal of Head Trauma Rehabilitation, 29(4), 290-306....
- Neuropsychology Abstract Of The Day: Tbi Clinical Trials
Today's recommended reading addresses proposed efficacy measures for use in clinical trials related to traumatic brain injury (TBI): Bagiella E, Novack TA, Ansel B, Diaz-Arrastia R, Dikmen S, Hart T, & Temkin N. Measuring Outcome in Traumatic Brain...
- Neuropsychology Abstract Of The Day: Stroke Rehab Outcome Assessment
Salter KL, Teasell RW, Foley NC, & Jutai JW. Outcome assessment in randomized controlled trials of stroke rehabilitation. American Journal of Physical Medicine and Rehabilitation. 2007 Dec ;86(12): 1007-1012. Department of Physical Medicine and Rehabilitation,...
- Deep Brain Stimulation
A curious case report discussed in today's New York Times: Man Regains Speech After Brain Stimulation By BENEDICT CAREY Published: August 1, 2007 A 38-year-old man who spent more than five years in a mute, barely conscious state as a result of a...
- Rehabilitation Trends: Decreased Length Of Stay And Mortality
Usually, the weekly online issue of the Journal of the American Medical Association includes the full text of one of its articles available on a free-access basis. Today's new issue has as its "free access" choice a report on trends in rehabilitation...
Neuroscience
Unconsciousness
From tomorrow's Times, a feature article about the different states of unconsciousness and the different etiologies that may cause them to occur:
Inside the Injured Brain, Many Kinds of Awareness
The New York Times
By BENEDICT CAREY
Published: April 5, 2005
Read the article (free registration required)
Here is the abstract of one of the research studies reported in the article:
Whyte J, Katz D, Long D, DiPasquale MC, Polansky M, Kalmar K, Giacino J, Childs N, Mercer W, Novak P, Maurer P, Eifert B. Predictors of outcome in prolonged posttraumatic disorders of consciousness and assessment of medication effects: A multicenter study. Archives of Physical Medicine and Rehabilitation. 2005 Mar; 86(3): 453-462.
Moss Rehabilitation Research Institute/Albert Einstein Healthcare Network, Philadelphia, PA, USA.
OBJECTIVES: To develop predictive models of recovery from the vegetative state (VS) and minimally conscious state (MCS) after traumatic brain injury (TBI) and to gather preliminary evidence on the impact of various psychotropic medications on the recovery process to support future randomized controlled trials. Design Longitudinal observational cohort design, in which demographic information, injury and acute care history, neuroimaging data, and an initial Disability Rating Scale (DRS) score were collected at the time of study enrollment. Weekly follow-up data, consisting of DRS score, current psychoactive medications, and medical complications, were gathered until discharge from inpatient rehabilitation. SETTING: Seven acute inpatient rehabilitation facilities in the United States and Europe with specialized programs for treating patients in the VS and MCS. PARTICIPANTS: People with TBI (N=124) who were in the VS or MCS 4 to 16 weeks after injury. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: DRS score at 16 weeks after injury and time until commands were first followed (among those participants demonstrating no command following at study enrollment). Results DRS score at enrollment, time between injury and enrollment, and rate of DRS change during the first 2 weeks of poststudy observation were all highly predictive of both outcomes. No variables related to injury characteristics or lesions on neuroimaging were significant predictors. Of the psychoactive medications, amantadine hydrochloride was associated with greater recovery and dantrolene sodium was associated with less recovery, in terms of the DRS score at 16 weeks but not the time until commands were followed. More detailed analysis of the timing of functional improvement, with respect to the initiation of amantadine provided suggestive, but not definitive, evidence of the drug's causal role. CONCLUSIONS: These findings show the feasibility of improving outcome prediction from the VS and MCS using readily available clinical variables and provide suggestive evidence for the effects of amantadine and dantrolene, but these results require confirmation through randomized controlled trials.
PMID: 15759228 [PubMed - in process]
- Neuropsychology Abstract Of The Day: Traumatic Brain Injury (tbi)
Bayley MT, Tate R, Douglas JM, Turkstra LS, Ponsford J, Stergiou-Kita M, Kua A, & Bragge P. (2014). INCOG Guidelines for Cognitive Rehabilitation Following Traumatic Brain Injury: Methods and Overview. Journal of Head Trauma Rehabilitation, 29(4), 290-306....
- Neuropsychology Abstract Of The Day: Tbi Clinical Trials
Today's recommended reading addresses proposed efficacy measures for use in clinical trials related to traumatic brain injury (TBI): Bagiella E, Novack TA, Ansel B, Diaz-Arrastia R, Dikmen S, Hart T, & Temkin N. Measuring Outcome in Traumatic Brain...
- Neuropsychology Abstract Of The Day: Stroke Rehab Outcome Assessment
Salter KL, Teasell RW, Foley NC, & Jutai JW. Outcome assessment in randomized controlled trials of stroke rehabilitation. American Journal of Physical Medicine and Rehabilitation. 2007 Dec ;86(12): 1007-1012. Department of Physical Medicine and Rehabilitation,...
- Deep Brain Stimulation
A curious case report discussed in today's New York Times: Man Regains Speech After Brain Stimulation By BENEDICT CAREY Published: August 1, 2007 A 38-year-old man who spent more than five years in a mute, barely conscious state as a result of a...
- Rehabilitation Trends: Decreased Length Of Stay And Mortality
Usually, the weekly online issue of the Journal of the American Medical Association includes the full text of one of its articles available on a free-access basis. Today's new issue has as its "free access" choice a report on trends in rehabilitation...