Near-Death Experiences in patients with locked-in syndrome: Not always a blissful journey.
Abstract
Memories of Near-Death Experiences (NDEs) most often are recounted as emotionally positive events. At present, no satisfactory explanatory model exists to fully account for the rich phenomenology of NDEs following a severe acute brain injury. The particular population of patients with locked-in syndrome (LIS) provides a unique opportunity to study NDEs following infratentorial brain lesions. We here retrospectively characterized the content of NDEs in 8 patients with LIS caused by an acute brainstem lesion (i.e., "LIS NDEs") and 23 NDE experiencers after coma with supratentorial lesions (i.e., "cl...
Source: Consciousness and Cognition - March 30, 2015 Category: Neurology Authors: Charland-Verville V, Lugo Z, Jourdan JP, Donneau AF, Laureys S Tags: Conscious Cogn Source Type: research
Critical issues using brain-computer interfaces for augmentative and alternative communication.
This article discusses 4 critical issues that should be addressed as BCIs are translated out of laboratory settings to become fully functional BCI/AAC systems that may be implemented clinically. These issues include (1) identification of primary, secondary, and tertiary system features; (2) integrating BCI/AAC systems in the World Health Organization's International Classification of Functioning, Disability and Health framework; (3) implementing language-based assessment and intervention; and (4) performance measurement. A clinical demonstration project is presented as an example of research beginning to address these crit...
Source: Physica Medica - March 1, 2015 Category: Physics Authors: Hill K, Kovacs T, Shin S Tags: Arch Phys Med Rehabil Source Type: research
Huffman and Linear Scanning Methods with Statistical Language Models.
We present Huffman scanning, a new method for applying statistical language models to binary-switch, static-grid typing AAC interfaces, and compare it to other scanning options under a variety of conditions. We present results for 16 adults without disabilities and one 36-year-old man with locked-in syndrome who presents with complex communication needs and uses AAC scanning devices for writing. Huffman scanning with a statistical language model yielded significant typing speedups for the 16 participants without disabilities versus any of the other methods tested, including two row/column scanning methods. A similar patter...
Source: Augmentative and Alternative Communication - February 12, 2015 Category: Speech Therapy Authors: Roark B, Fried-Oken M, Gibbons C Tags: Augment Altern Commun Source Type: research
Profuse Unilateral Hyperhidrosis Induced by Urinary Retention in a Stroke Patient
Conclusions: This case provides the first description of unilateral hyperhidrosis as a manifestation of urinary retention in a stroke patient. It is important for clinicians to recognize this condition so that appropriate management can be implemented in time to prevent potential detrusor injury and renal impairment caused by bladder overdistension. (Source: The Neurologist)
Source: The Neurologist - February 1, 2015 Category: Neurology Tags: Case Report/Case Series Source Type: research
Brain-Machine Interface (BMI) in paralysis
Publication date: Available online 8 January 2015 Source:Annals of Physical and Rehabilitation Medicine Author(s): U. Chaudhary , N. Birbaumer , M.R. Curado Introduction Brain-machine interfaces (BMIs) use brain activity to control external devices, facilitating paralyzed patients to interact with the environment. In this review, we focus on the current advances of non-invasive BMIs for communication in patients with amyotrophic lateral sclerosis (ALS) and for restoration of motor impairment after severe stroke. BMI for ALS patients BMI represents a promising strategy to establish communication with paralyzed ALS ...
Source: Annals of Physical and Rehabilitation Medicine - January 24, 2015 Category: Rehabilitation Source Type: research
Brain-Machine Interfaces (BMI) in paralysis
Publication date: Available online 8 January 2015 Source:Annals of Physical and Rehabilitation Medicine Author(s): U. Chaudhary , N. Birbaumer , M.R. Curado Introduction Brain-machine interfaces (BMIs) use brain activity to control external devices, facilitating paralyzed patients to interact with the environment. In this review, we focus on the current advances of non-invasive BMIs for communication in patients with amyotrophic lateral sclerosis (ALS) and for restoration of motor impairment after severe stroke. BMI for ALS patients BMI represents a promising strategy to establish communication with paralyzed ALS ...
Source: Annals of Physical and Rehabilitation Medicine - January 9, 2015 Category: Rehabilitation Source Type: research
Stent alone treatment for dissections and dissecting aneurysms involving the basilar artery
Conclusions
Stent alone treatment as a potential and disputable alternative therapeutic option for the treatment of BA dissection and dissecting aneurysms, although technically feasible, was effective in only certain lesions, and this treatment carries substantial risks of complications and a high failure rate. The true effect of this strategy is questionable. A study involving larger populations and a longer follow-up is necessary to evaluate the efficacy of this treatment modality. (Source: Journal of NeuroInterventional Surgery)
Source: Journal of NeuroInterventional Surgery - December 11, 2014 Category: Neurosurgery Authors: Li, C., Li, Y., Jiang, C., Wu, Z., Wang, Y., Yang, X. Tags: Hemorrhagic stroke Source Type: research
Neural repair and rehabilitation: Implant helps patient with incomplete locked-in syndrome
Nature Reviews Neurology 11, 2 (2015).
doi:10.1038/nrneurol.2014.230
Author: Ian Fyfe
A brain–computer interface (BCI) that uses an implanted electrode array has enabled a patient with incomplete locked-in syndrome to communicate effectively. Results in the new study also demonstrate the importance of on-screen keyboard design in such interfaces.Existing BCIs designed to facilitate communication for people (Source: Nature Reviews Neurology)
Source: Nature Reviews Neurology - November 25, 2014 Category: Neurology Authors: Ian Fyfe Tags: Research Highlight Source Type: research
Intrathecal Baclofen: Effects on Spasticity, Pain, and Consciousness in Disorders of Consciousness and Locked-in Syndrome
Abstract
Disorders of consciousness (DOCs) include coma, vegetative state (VS), and minimally conscious state (MCS). Coma is characterized by impaired wakefulness and consciousness, while VS and MCS are defined by lacking or discontinuous consciousness despite recovered wakefulness. Conversely, locked-in syndrome (LIS) is characterized by quadriplegia and lower cranial nerve paralysis with preserved consciousness. Intrathecal baclofen (ITB) is a useful treatment to improve spasticity both in patients with DOCs and LIS. Moreover, it supports the recovery of consciousness in some patients with VS or MCS. ...
Source: Current Pain and Headache Reports - November 22, 2014 Category: Neurology Source Type: research
Technology-based assessment in patients with disorders of consciousness.
Abstract
Introduction. A number of studies highlight the difficulty in forming a diagnosis for patients with disorders of consciousness when this is established merely on behavioral assessments. Background. Positron emission tomography (PET), functional magnetic resonance imaging (fMRI), diffusion tensor imaging (DTI), and electroencephalography combined with transcranial magnetic stimulation (TMS-EEG) techniques are promoting the clinical characterization of this challenging population. With such technology-based "objective" tools, patients are also differentially able to follow simple commands and in som...
Source: Annali dell'Istituto Superiore di Sanita - October 12, 2014 Category: Global & Universal Authors: Di Perri C, Heine L, Amico E, Soddu A, Laureys S, Demertzi A Tags: Ann Ist Super Sanita Source Type: research
Ethics briefing
Assisted dyingNicklinson Supreme Court judgement In June 2014 the Supreme Court ruled on the joint appeals of the late Tony Nicklinson, Paul Lamb and a person identified only as Martin, on the status of UK law on assisted dying.1 As previously reported here,2 3 Tony Nicklinson had a catastrophic stroke in 2005, which left him with locked-in syndrome. Unable to end his life himself, he had for many years sought a declaration that it would be lawful for someone to assist him to do so. He died in 2012 from pneumonia, a week after an unsuccessful appeal to the High Court. His widow pursued his appeal to the Court of Appeal wit...
Source: Journal of Medical Ethics - August 13, 2014 Category: Medical Ethics Authors: Brannan, S., Campbell, R., Davies, M., English, V., Mussell, R., Sheather, J. C. Tags: Ethics briefing Source Type: research
[Comment] Functional brain imaging: gatecrashing the clinical party?
In The Lancet, Johan Stender and colleagues report the use of two functional brain imaging techniques to improve diagnosis and prognostic accuracy in 126 patients with severe brain injury (81 in a minimally conscious state, 41 with unresponsive wakefulness syndrome [vegetative state], and four with locked-in syndrome). The investigators used standardised clinical assessments (Coma Recovery Scale–Revised [CSR-R]), cerebral 18F-fluorodeoxyglucose (FDG) PET, and functional MRI (fMRI) during mental imagery tasks. (Source: LANCET)
Source: LANCET - August 9, 2014 Category: Journals (General) Authors: Jamie Sleigh, Catherine E Warnaby Tags: Comment Source Type: research
Utilizing a Language Model to Improve Online Dynamic Data Collection in P300 Spellers
P300 spellers provide a means of communication for individuals with severe physical limitations, especially those with locked-in syndrome, such as amyotrophic lateral sclerosis. However, P300 speller use is still limited by relatively low communication rates due to the multiple data measurements that are required to improve the signal-to-noise ratio of event-related potentials for increased accuracy. Therefore, the amount of data collection has competing effects on accuracy and spelling speed. Adaptively varying the amount of data collection prior to character selection has been shown to improve spelling accuracy and speed...
Source: IEE Transactions on Neural Systems and Rehabilitation Engineering - July 1, 2014 Category: Neuroscience Source Type: research
Locked in, but not out?
The most devastating aspect of amyotrophic lateral sclerosis (ALS) may not be the loss of mobility or spontaneous respiration but the inability to communicate. For people with ALS who elect mechanical ventilation, the inexorable disease progression can lead to an incomplete locked-in syndrome (LIS)1,2 and then to a total LIS where neither eye movements nor any other efferent capacity remains. The moment that occurs, consciousness undoubtedly persists, but for an unknown period of time. In some cases, years later, family members maintain that their loved one is communicating by changing pupil size or pulse rate, or just a l...
Source: Neurology - May 26, 2014 Category: Neurology Authors: Hochberg, L. R., Cudkowicz, M. E. Tags: EDITORIALS Source Type: research
[In Context] News in brief
18F-fluorodeoxyglucose (FDG) PET could help in assessment of patients with disorders of consciousness and in prediction of recovery (Lancet 2014; published online April 16. http://dx.doi.org/10.1016/S0140-6736(14)60042-8). In a clinical validation study, 18F-FDG PET and functional MRI during mental activation tasks were compared against reference diagnosis with the Coma Recovery Scale–Revised (CRS–R) in 41 patients with unresponsive wakefulness syndrome (ie, in a vegetative state), four patients with locked-in syndrome, and 81 patients in a minimally conscious state. (Source: Lancet Neurology)
Source: Lancet Neurology - May 19, 2014 Category: Neurology Authors: The Lancet Neurology Tags: In Context Source Type: research
