Transcranial Direct Current Stimulation for a Patient with Locked-in Syndrome

Locked-in syndrome (LIS) was first introduced by Plum and Posner. It refers to the combination of quadriplegia and anarthria brought about by disruption of the corticospinal and corticobulbar pathways of the brain stem, respectively [1]. Patients with LIS are alert and aware of their environment but cannot speak or move their limbs. They retain the capacity to use vertical eye movements and blinking to communicate. LIS occurs following disruption of the motor tracts in the ventral brain stem and at least 60% of the cases are caused by stroke [2].Early and intensive rehabilitation reportedly improves the functional outcome and reduces the mortality following LIS [3].
Source: BRAIN STIMULATION: Basic, Translational, and Clinical Research in Neuromodulation - Category: Neurology Authors: Source Type: research

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This study demonstrates that body part-specific somatosensory imagery differentially activates somatosensory cortex in a topographically specific manner; evidence which was surprisingly still lacking in the literature. It also offers proof of concept for a novel somatosensory imagery-based fMRI-BCI control strategy, with particularly high potential for visually and motor-impaired patients. The strategy could also be transferred to lower MRI field strengths and to mobile functional near-infrared spectroscopy. Finally, given that communication BCIs provide the BCI user with a form of feedback based on their brain signals and...
Source: Frontiers in Human Neuroscience - Category: Neuroscience Source Type: research
The unidentified patient, from Maryland, suffered a rare but devastating brain-stem stroke which paralysed her from head-to-toe. She was diagnosed with locked-in syndrome.
Source: the Mail online | Health - Category: Consumer Health News Source Type: news
ConclusionOur patient developed locked-in syndrome after use of cocaine. Given the prevalence of its use in the United States, cocaine use should be included among the potential causes of locked-in syndrome.
Source: Journal of Medical Case Reports - Category: General Medicine Source Type: research
In 2017, Darren Leith had a stroke that left him in a locked-in state. This recent story on Leith reminded me that many patients seek to hasten their death not because of their (non-fixable) medical condition but because of their (potentially fixable) social condition. While Leith has not sought to end his life, his depression comes not so much from the locked-in condition as much as from the fact that he is 100 miles away from his family in a neuro-rehabilitation center.  The last time Leith’s daughter visited him, he spelled out five words by using his eyes to point to letters on a board - "take me home you two." 
Source: blog.bioethics.net - Category: Medical Ethics Authors: Tags: Health Care syndicated Source Type: blogs
Background&significance: Locked-in syndrome is a very serious condition with desperate quality of life due to profound paralysis, and there is no effective treatment other than rehabilitation. Repetitive transcranial magnetic stimulation (rTMS) seems to be benefit in motor recovery of stroke patients. We explored the benefit and feasibility of rTMS in locked-in syndrome.
Source: BRAIN STIMULATION: Basic, Translational, and Clinical Research in Neuromodulation - Category: Neurology Authors: Source Type: research
A TEENAGE girl hopes to be home for Christmas after making a rare recovery from "locked-in syndrome" caused by a brain haemorrhage. Miranda Meldrum, was left imprisoned in a paralysed body when she had a stroke in April last year.
Source: Daily Express - Health - Category: Consumer Health News Source Type: news
Talking, conversing, exchanging words: for more than 10 million people, this seemingly simple act cannot be imagined without assistive technologies, such as voice generating devices, touch screens or text-to-speech apps. What does the digital future bring for them? How could innovations turn around the translation industry or the medical administration process? Here’s a glimpse into the future of voice and speaking. Speaking, identity, voice stereotypes Give me the key! – This simple sentence carries much more information when it’s pronounced. A weary Philippino mother could instruct her little child as s...
Source: The Medical Futurist - Category: Information Technology Authors: Tags: Cyborgization Future of Medicine Medical Professionals Patients apps assistive technology Health Healthcare Innovation speaking speech speech generating voice voice generating device Source Type: blogs
Conclusion: Studies indicate a positive trend of effect of exercise for physical recovery of people with LIS after stroke including the improvement of muscle strength, tone, walking ability, and activity in daily living. Mixed physical exercises were used. The effects were not significant. No adverse event has been reported. The quality of the existing evidence is relatively low since the papers were either case series or case studies. Further studies are needed on exercise types and dosages for better prescriptions for people with LIS after stroke. This may help to extend their lives with better control of the complicatio...
Source: Cerebrovascular Diseases Extra - Category: Neurology Source Type: research
I was mightily impressed by the 1997 book Le Scaphandre et le Papillon and the feature film based on that book, The Diving Bell and the Butterfly. Jean-Dominique Bauby was paralyzed after a stroke with locked-in syndrome. Yet, he was abl...
Source: blog.bioethics.net - Category: Medical Ethics Authors: Tags: Health Care syndicated Source Type: blogs
AbstractThe locked-in syndrome (LIS) is a state of profound paralysis with preserved awareness of self and environment who typically results from a brain stem stroke. Although patients in LIS have great difficulty communicating, their consciousness, cognition, and language usually remain intact. Medical decision-making by LIS patients is compromised, not by cognitive impairment, but by severe communication impairment. Former systems of communication that permitted LIS patients to make only “yes” or “no” responses to questions was sufficient to validate their consent for simple medical decisions but ...
Source: Neuroethics - Category: Medical Ethics Source Type: research
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