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Clinical Decision on Disorders of Consciousness After acquired brain injury:Stepping Forward

Neuroscience Bulletin 2023年第1期39卷 138-162页

作者： Rui-Zhe Zheng Zeng-Xin Qi Zhe Wang Ze-Yu Xu Xue-Hai Wu Ying Mao Department of Neurosurgery Huashan HospitalShanghai Medical CollegeFudan UniversityShanghai200040China National Center for Neurological Disorders Shanghai200040China Shanghai Key Laboratory of brain Function and Restoration and Neural Regeneration Shanghai200040China Neurosurgical Institute of Fudan University Shanghai200040China Shanghai Clinical Medical Center of Neurosurgery Shanghai200040China State Key Laboratory of Medical Neurobiology MOE Frontiers Center for Brain ScienceSchool of Basic Medical Sciences and Institutes of Brain ScienceFudan UniversityShanghai200032China

Major advances have been made over the past few decades in identifying and managing disorders of consciousness(DOC)in patients with acquired brain injury(ABI),bringing the transformation from a conceptualized definition to a complex clinical scenario worthy of scientific *** the continuously-evolving framework of precision medicine that integrates valuable behavioral assessment tools,sophisticated neuroimaging,and electrophysiological techniques,a considerably higher diagnostic accuracy rate of DOC may now be *** the treatment of patients with DOC,a variety of intervention methods are available,including amantadine and transcranial direct current stimulation,which have both provided class II evidence,zolpidem,which is also of high quality,and non-invasive stimulation,which appears to be more encouraging than pharmacological ***,heterogeneity is profoundly ingrained in study designs,and only rare schemes have been recommended by authoritative *** is still a lack of an effective clinical protocol for managing patients with DOC following *** advance future clinical studies on DOC,we present a comprehensive review of the progress in clinical identification and management as well as some challenges in the pathophysiology of *** propose a preliminary clinical decision protocol,which could serve as an ideal reference tool for many medical institutions.

关键词： Clinical decision Disorders of consciousness acquired brain injury Identification Management

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Correlation between Glasgow Coma Scale with central venous pressure and near-infrared spectroscopy in patients with acquired brain injury in the intensive care unit of Adam Malik Hospital Medan

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Emergency and Critical Care Medicine 2023年第1期3卷 12-17页

作者： Galdy Wafie Akhyar H.Nasution Bastian Lubis Department of Anesthesiology and Intensive Therapy Faculty of Medicine Universitas Sumatera Utara Adam Malik Hospital Medan Medan Indonesia

Background:acquired brain injury(ABI)is caused by trauma or nontrauma to the brain after *** intracranial pressure in patients with traumatic or nontraumatic brain injury affects the cerebral perfusion *** traumatic brain injury,there is an increase in air content in the brain and an increase in volume of blood flow to the brain,which can cause increased intracranial pressure,herniation of brain tissue,impaired cerebral perfusion,and brain *** patients with traumatic brain injury die from uncontrolled increases in intracranial ***-infrared spectroscopy(NIRS)and central venous pressure(CVP)monitoring are also associated with cerebral *** study aimed to determine the relationship between the Glasgow Coma Scale(GCS)scores and CVP and NIRS values in patients with ***:This prospective analytical study used a cross-sectional design to compareGCS scores with CVP and NIRS values in patients with traumatic and nontraumatic brain injury in the intensive care unit(ICU)of Haji Adam Malik Hospital ***,CVP,and NIRS descriptive data in patients with brain injury were presented in terms of mean and standard deviation if the data were normally distributed,or median(interquartile range)values if the data were not normally *** relationship between GCS scores and CVP and NIRS values was assessed using the Pearson correlation test if the data were normally distributed,or the Spearman test if the data were not normally ***:In this study,the mean GCS score and CVP values were 7.04±2.69 and 5.63±25.82 mmHg,*** right tissue oxygen saturation(StO2)was 55.61%±18.72%,and the left StO2 was 57.57%±17.48%with normally distributed *** was no correlation between GCS scores and CVP values(P=0.829),and no correlation between moderate GCS scores and right and left StO2(P=0.343;P=0.121);however,there was a significantly strong positive correlation between severe GCS scores and right and lef

关键词： acquired brain injury Central venous pressure Glasgow Coma Scale Near-infrared spectroscopy

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Voxel-based statistical analysis of cerebral glucose metabolism in patients with permanent vegetative state after acquired brain injury

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Chinese Medical Journal 2010年第20期123卷 2853-2857页

作者： Yong Wook Kim Hyoung Seop Kim Young-Sil An Sang Hee Im Department and Research Institute of Rehabilitation Medicine Yonsei University College of MedicineSeoulRepublic of Korea Department of Physical Medicine and Rehabilitation National Health Insurance Corporation Ilsan Hospital Gyonggi-doRepublic of Korea) Young-Sil An(Department of Nuclear MedicineAjou University School of MedicineSuwonRepublic of Korea Department of Nuclear Medicine Ajou University School of Medicine Suwon Republic of Korea Department of Rehabilitation Medicine Jeju National University School of MedicineJejuRepublic of Korea

Background Permanent vegetative state is defined as the impaired level of consciousness longer than 12 months after traumatic causes and 3 months after non-traumatic causes of brain injury. Although many studies assessed the cerebral metabolism in patients with acute and persistent vegetative state after brain injury, few studies investigated the cerebral metabolism in patients with permanent vegetative state. In this study, we performed the voxel-based analysis of cerebral glucose metabolism and investigated the relationship between regional cerebral glucose metabolism and the severity of impaired consciousness in patients with permanent vegetative state after acquired brain *** We compared the regional cerebral glucose metabolism as demonstrated by F-18 fluorodeoxyglucose positron emission tomography from 12 patients with permanent vegetative state after acquired brain injury with those from 12 control subjects. Additionally, covariance analysis was performed to identify regions where decreased changes in regional cerebral glucose metabolism significantly correlated with a decrease of level of consciousness measured by JFK-coma recovery scare. Statistical analysis was performed using statistical parametric *** Compared with controls, patients with permanent vegetative state demonstrated decreased cerebral glucose metabolism in the left precuneus, both posterior cingulate cortices, the left superior parietal lobule （Pcorrected 〈0.001）, and increased cerebral glucose metabolism in the both cerebellum and the right supramarginal cortices （Pcorrected 〈0.001）. In the covariance analysis, a decrease in the level of consciousness was significantly correlated with decreased cerebral glucose metabolism in the both posterior cingulate cortices （Puncorrected 〈0.005）.Conclusion Our findings suggest that the posteromedial parietal cortex, which are part of neural network for consciousness, may be relevant structure for pathophysiological mechanism in pat

关键词： cerebral glucose metabolism permanent vegetative state acquired brain injury

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Mindfulness and Aerobic Exercise as an Intervention for Cognitive Dysfunction Following an acquired brain injury: A Pilot Study

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Open Journal of Therapy and Rehabilitation 2019年第1期7卷 12-24页

作者： Lovisa Hellgren Anna Lundqvist Bjorn Borsbo Richard Levi Kersti Samuelsson Department of Rehabilitation Medicine Region Jonkoping CountyJonkopingSweden Department of Medical and Health Sciences Linkoping UniversityLinköpingSweden Department of Rehabilitation Medicine Linkoping UniversityLinkopingSweden

Background: Cognitive impairments as sequelae of brain injury are common and can negatively affect activities of everyday life, participation and quality of life. Thus, finding ways to reduce cognitive impairments and ameliorate their negative impact on everyday life is an important focus of research. Aim: The aim of this pilot study was to analyse the effects of a combination of guided mindfulness and aerobic exercise on cognitive ability and mental fatigue in patients with acquired brain injury (ABI). Design: Pilot study, with a before-after design. Setting: Outpatient. Population: Twenty-one patients suffering from ABI, former patients of three rehabilitation medicine departments. Methods: The intervention comprised a structured combination of guided mindfulness program and outdoor walking, three times/week for 12 weeks. The outcome measures included assessment of information processing speed, working memory, oxygen uptake and self-reported mental fatigue. Results: The main results showed improvements in cognitive abilities related to information processing speed, perceived mental fatigue and physical capacity. Conclusions: A combination of mindfulness and physical activity can increase information processing speed and ameliorate mental fatigue. Further studies are needed to confirm our findings. Clinical Rehabilitation Impact: The combination of guided mindfulness and physical activity shows promise as a treatment modality in rehabilitation of impaired information processing speed and mental fatigue following ABI.

关键词： Rehabilitation acquired brain injury Mental Fatigue Cognition

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The Characteristics of Perceived Difficulties in Everyday Technology Use among Individuals with acquired brain injury Compared to That among Controls

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Journal of Behavioral and brain Science 2020年第10期10卷 410-419页

作者： Osamu Nakata Rumi Tanemura Toru Nagao Kazue Noda Jiro Sagara Department of Rehabilitation Naragakuen University Nara Japan Graduate School of Health Sciences Kobe University Hyogo Japan Graduate School of Arts and Design Kobe Design University Kobe Japan

Objectives: People with acquired brain injury (ABI) have various difficulties when using everyday technology (ET) in their daily life. The aim of this study was to reveal the characteristics of perceived difficulties of people with ABI when using ET through a comparison with the control group. Method: We recruited participants in the Kansai area and Okayama prefecture between 2010 and 2015. A total of 24 participants (18 males and 6 females;aged 20 to 62 years;mean age: 42.6 ± 13.3 years) with ABI and 26 healthy controls were interviewed about their perceived difficulties using ET via the Everyday Technology Use Questionnaire revised Japanese version (ETUQ-Japan). Results: Compared to the controls, the mean number of ETs used by people with ABI was significantly lower. When various difficulties arose, they were unable to independently manage ET, requiring the assistance of caregivers. Conclusion: It is necessary for the medical staff, involved in the home life of patients with ABI to consider the patient’s perceived difficulties when using ET.

关键词： acquired brain injury Cognitive Impairment Everyday Technology

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