检索结果-南通市图书馆

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 exploration.Given 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 reached.During 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 therapy.However,heterogeneity is profoundly ingrained in study designs,and only rare schemes have been recommended by authoritative institutions.There is still a lack of an effective clinical protocol for managing patients with DOC following ABI.To 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 DOC.We 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

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

disorders of consciousness in China

引用

Neuroscience Bulletin 2018年第4期34卷 605-614页

作者： Jizong Zhao China National Clinical Research Center for Neurological Diseases Beijing Tiantan Hospital Capital Medical University

With the development of modern international medicine, the subject of disorders of consciousness （DOCs） has begun to be raised in China's Mainland. Much progress has been made to date in several specialties related to the management of chronic DOC patients in China. In this article, we briefly review the present status of DOC studies in China, specifically concerning diagnosis, prognosis, therapy, and rehabilitation. The development of DOC- related scientific organizations and activities in China are introduced. Some weaknesses that need improvement are also noted. The current program provides a good foundation for future development.

关键词： China disorders of consciousness Diagno-sis Therapy

来源：

维普期刊数据库

同方期刊数据库评论

在线全文

学校读者我要写书评

暂无评论

Brain Network Studies in Chronic disorders of consciousness:Advances and Perspectives

引用

Neuroscience Bulletin 2018年第4期34卷 592-604页

作者： Ming Song Yujin Zhang Yue Cui Yi Yang Tianzi Jiang National Laboratory of Pattern Recognition Institute ofAutomationThe Chinese Academy of SciencesBeijing 100190China Brainnetome Center Institute of AutomationThe ChineseAcademy of SciencesBeijing 100190China University of Chinese Academy of Sciences Beijing 100190China Department of Neurosurgery PLA Army General HospitalBeijing 100700China CAS Center for Excellence in Brain Science and IntelligenceTechnology Chinese Academy of SciencesBeijing 100190China Key Laboratory for Neuroinformation of the Ministry ofEducation School of Life Science and TechnologyUniversity of Electronic Science and Technology of ChinaChengdu 625014China The Queensland Brain Institute University of QueenslandBrisbaneQLD 4072Australia

Neuroimaging has opened new opportunities to study the neural correlates of consciousness, and provided additional information concerning diagnosis, prognosis, and therapeutic interventions in patients with disorders of consciousness. Here, we aim to review neuroimaging studies in chronic disorders of consciousness from the viewpoint of the brain network, focusing on positron emission tomogra- phy, functional MRI, functional near-infrared spectroscopy, electrophysiology, and diffusion MRI. To accelerate basic research on disorders of consciousness and provide a panoramic view of unconsciousness, we propose that it is urgent to integrate different techniques at various spatiotemporal scales, and to merge fragmented findings into a uniform ＂Brainnetome＂（Brain-net-ome） research framework.

关键词： disorders of consciousness Neuroimaging Brain network Brainnetome

来源：

维普期刊数据库

同方期刊数据库评论

在线全文

学校读者我要写书评

暂无评论

Effect of acoustic stimuli in patients with disorders of consciousness: a quantitative electroencephalography study

引用

Neural Regeneration Research 2018年第11期13卷 1900-1906页

作者： Min Wu Wang-Xiao Bao Jie Zhang Yang-Fan Hu Jian Gao Ben-Yan Luo Department of Neurology&Brain Medical Centre First Affiliated HospitalSchool of MedicineZhejiang University Department of Computer Science Zhejiang University Department of Rehabilitation Hangzhou Hospital of Zhejiang Armed Police Corps

Auditory stimuli are proposed as beneficial neurorehabilitation methods in patients with disorders of consciousness. However, precise and accurate quantitative indices to estimate their potential effect remain scarce. Fourteen patients were recruited from the Neuro-Rehabilitation Unit of Hangzhou Hospital of Zhejiang Armed Police Corps of China. Altogether, there were seven cases of unresponsive wakefulness syndrome（five males and two females, aged 45.7 ± 16.8 years） and seven cases of minimally conscious state（six males and one female, aged 42.3 ± 20.8 years）. Simultaneously, fourteen healthy controls（10 males and 4 females, aged 51.7 ± 9.7 years） also participated in this case-control experiment. Brain response to music, subjects＇ own name, and noise was monitored by quantitative electroencephalography（QEEG） in the resting state and with acoustic stimulation. Predictive QEEG values in various brain regions were investigated. Our results show that cerebral activation was high in subjects stimulated by their own name, especially in the temporal lobe in patients with disorders of consciousness, and the frontal lobe in the control group. Further, during resting and stimulation, QEEG index（δ ＋ θ/α ＋ β ratio） negatively correlated with the Coma Recovery Scale-Revised score in traumatic disorders of consciousness patients. Hence, we speculate that a subject＇s own name might be an effective awakening therapy for patients with disorders of consciousness. Moreover, QEEG index in specific stimulation states may be used as a prognostic indicator for disorders of consciousness patients（sensitivity, 75%; specificity, 50%）.

关键词： nerve regeneration auditory stimulation disorders of consciousness frontal lobe neuroplasticity quantitative electroencephalography Coma Recovery Scale-Revised awakening music subjects own name white noise neural regeneration

来源：

维普期刊数据库

同方期刊数据库评论

在线全文

学校读者我要写书评

暂无评论

Risk factors for brain injury in patients with exertional heatstroke:A 5-year experience

引用

Chinese Journal of Traumatology 2024年第2期27卷 91-96页

作者： Li Zhong Ming Wu Zhe-Ying Liu Yan Liu Zhi-Feng Liu Department of Traditional Chinese Medicine The First Affiliated HospitalGuizhou University of Chinese MedicineGuiyang550001China Department of Infection and Critical Care Medicine The Second People's Hospital of Shenzhen&First Affiliated Hospital of Shenzhen UniversityHealth Science CenterShenzhenGuangdong province518035China Department of Medical Critical Care Medicine General Hospital of Southem Theatre Command of PLA.Guangzhou510010China Guangdong Branch Center National Clinical Research Center for Geriatric Diseases(Chinese PLA General Hospital)Guangzhou510010China

Purpose:Minimal data exist on brain injury in patients with exertional heatstroke(EHS)in developing country.In this study,we explored the risk factors for brain injury induced by EHS 90-day after onset.Methods:A retrospective cohort study of patients with EHS was conducted in the intensive care unit of the General Hospital of Southern Theater Command of PLA in China from April 2014 to June 2019.Patients were divided into non-brain injury(fully recovered)and brain injury groups(comprising deceased patients or those with neurological sequelae).The brain injury group was further subdivided into a death group and a sequela group for detailed analysis.General information,neurological performance and information on important organ injuries in the acute stage were recorded and analysed.Multivariable logistic regression was used to identify risk factors for brain injury after EHS and mortality risk factors for brain injury,and Kaplan-Meier survival curve was used to evaluate the effect of the neurological dysfunction on survival.Results:Out of the 147 EHS patients,117 were enrolled,of which 96(82.1%)recovered,13(11.1%)died,and 8(6.8%)experienced neurological sequelae.Statistically significant differences were found between non-brain injury and brain injury groups in age,hypotension,duration of consciousness disorders,time to drop core body temperature below 38.5℃,lymphocyte counts,platelet counts,procalcitonin,alanine aminotransferase,aspartate aminotransferase,creatinine,cystatin C,coagulation parameters,international normalized ratio,acute physiology and chronic health evaluation II scores,sequential organ failure assessment(SOFA)scores,and Glasgow coma scale scores(all p<0.05).Multivariate logistic regression showed that age(OR=1.090,95%CI:1.02-1.17,p=0.008),time to drop core temperature(OR=8.223,95%CI:2.30-29.40,p=0.001),and SOFA scores(OR=1.676,95%CI:1.29-2.18,p<0.001)are independent risk factors for brain injury induced by EHS.The Kaplan-Meier curves suggest significantly prolonged survival(p<0.001)in patients with

关键词： Exertional heatstroke Brain injury Sequela Risk factors disorders of consciousness

来源：

维普期刊数据库

同方期刊数据库评论

在线全文

学校读者我要写书评

暂无评论

Neuromodulatory therapies for patients with prolonged disorders of consciousness

引用

Chinese Medical Journal 2021年第7期134卷 765-776页

作者： Yue-Hao Wu Jie Yu Li-Rong Hong Ben-Yan Luo Department of Neurology First Affiliated HospitalSchool of MedicineZhejiang UniversityHangzhouZhejiang 310003China Department of Neurology First People’s Hospital of Yuhang DistrictHangzhouZhejiang 310003China Department of Rehabilitation Hangzhou Hospital of Zhejiang Armed Police CorpsHangzhouZhejiang 310051China.

Background:Reviving patients with prolonged disorders of consciousness(DOCs)has always been focused and challenging in medical research.Owing to the limited effectiveness of available medicine,recent research has increasingly turned towards neuromodulatory therapies,involving the stimulation of neural circuits.We summarised the progression of research regarding neuromodulatory therapies in the field of DOCs,compared the differences among different studies,in an attempt to explore optimal stimulation patterns and parameters,and analyzed the major limitations of the relevant studies to facilitate future research.Methods:We performed a search in the PubMed database,using the concepts of DOCs and neuromodulation.Inclusion criteria were:articles in English,published after 2002,and reporting clinical trials of neuromodulatory therapies in human patients with DOCs.Results:Overall,187 published articles met the search criteria,and 60 articles met the inclusion criteria.There are differences among these studies regarding the clinical efficacies of neurostimulation techniques for patients with DOCs,and large-sample studies are still lacking.Conclusions:Neuromodulatory techniques were used as trial therapies for DOCs wherein their curative effects were controversial.The difficulties in detecting residual consciousness,the confounding effect between the natural course of the disease and therapeutic effect,and the heterogeneity across patients are the major limitations.Large-sample,well-designed studies,and innovations for both treatment and assessment are anticipated in future research.

关键词： disorders of consciousness Neuromodulation Therapy

来源：

维普期刊数据库

同方期刊数据库评论

在线全文

学校读者我要写书评

暂无评论

Recovery from prolonged disorders of consciousness:A dual-center prospective cohort study in China

引用

World Journal of Clinical Cases 2020年第12期8卷 2520-2529页

作者： Wei-Guan Chen Ran Li Ye Zhang Jian-Hui Hao Ju-Bao Du Ai-Song Guo Wei-Qun Song Department of Rehabilitation Medicine Xuan Wu HospitalCapital Medical UniversityBeijing 100053China Department of Rehabilitation Medicine Affiliated Hospital of Nantong UniversityNantong 226001Jiangsu ProvinceChina

BACKGROUND Recent innovations in intensive care have improved the prognosis of patients with severe brain injuries and brought more patients with disorders of consciousness(DoC).Data are lacking regarding the long-term outcomes of those patients in China.It is necessary to study the long-term outcomes of patients with prolonged DoC in light of many factors likely to influence crucial decisions about their care and their life.AIM To present the preliminary results of a DoC cohort.METHODS This was a two-center prospective cohort study of inpatients with vegetative state(VS)/unresponsive wakefulness syndrome(UWS).The study outcomes were the recovery from VS/UWS to minimally conscious state(MCS)and the long-term status of patients with prolonged DoC considered in VS/UWS or MCS for up to 6 years.The patients were evaluated using the Glasgow coma scale,coma recovery scale-revised,and Glasgow outcome scale.The endpoint of follow-up was recovery of full consciousness or death.The changes in the primary clinical outcome improvement in clinical diagnosis were evaluated at 12 mo compared with baseline.RESULTS The study population included 93 patients(62 VS/UWS and 31 MCS).The postinjury interval range was 28-634 d.Median follow-up was 20 mo(interquartile range,12-37 mo).At the endpoint,33 transitioned to an emergence from MCS or full consciousness,eight had a locked-in syndrome,and there were 35 patients remaining in a VS/UWS and 11 in an MCS.Seven(including one locked-in syndrome)patients(7.5%)died within 12 mo of injury.Compared with the unresponsive group(n=52)at 12 mo,the responsive group(n=41)had a higher proportion of males(87.8%vs 63.5%,P=0.008),shorter time from injury(median,40.0 d vs 65.5 d,P=0.006),higher frequency of vascular etiology(68.3%vs 38.5%,P=0.007),higher Glasgow coma scale score at admission(median,9 vs 6,P<0.001),higher coma recovery scale-revised score at admission(median,9 vs 2.5,P<0.001),at 1 mo(median,14 vs 5,P<0.001),and at 3 mo(median,20 vs 6,P<0.001),lower frequency of VS/UWS(36.6%vs 90.0%,P<0.

关键词： Brain injury disorders of consciousness Behavioral assessment Coma recovery scale-revised Prospective cohort study Neurorehabilitation

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Deep Convolutional Neural Network for Detection of disorders of consciousness

Deep Convolutional Neural Network for Detection of Disorders...

引用

第三十九届中国控制会议

作者： Zifan Xu Jiang Wang Ruofan Wang Zhen Zhang Shuangming Yang School of Electrical and Information Engineering Tianjin University School of Automation and Electrical Engineering Tianjin University of Technology and Education

The diagnosis of consciousness has always been a major challenge in clinical diagnosis. Resent researches prove that machine learning has a powerful ability to distinguish between minimally conscious state（MCS） and unresponsive wakefulness syndrome（UWS）. What’s more, convolutional neural network has made great progress in electroencephalography（EEG） analysis of other disorders. As a result, an improved 1 D-convolutional neural network structure has been proposed for outcome prediction, using resting-state EEG signals from patients with disorders of consciousness. The model is established by training690 EEG segments from 34 of MCS and 35 of UWS diagnosed by Coma Recovery Scale – Revised. The experimental results show that the accuracy, positive predictive value, specificity and sensitivity of the improved model in our research are 88.84%, 85.59%, 86.79% and 91.22%, respectively. It shows that our improved model has better performance than the model without Batch Normalization layer, as well as the model with deep graph convolutional neural network. The improved 1 D-convolutional neural network model in this study can be used as an auxiliary medical method for clinical diagnosis and detection of consciousness disorders. More profoundly, it could drive the development of robust expert systems in other neurological diseases.

关键词： disorders of consciousness Convolutional neural network Deep learning Electroencephalogram（EEG）

来源： cnki会议评论

在线全文

cnki会议

学校读者我要写书评

暂无评论

Connecting the P300 to the diagnosis and prognosis of unconscious patients

引用

Neural Regeneration Research 2015年第3期10卷 473-480页

作者： Ran Li Wei-qun Song Ju-bao Du Su Huo Gui-xiang Shan Department of Rehabilitation Medicine Xuanwu HospitalCapital Medical University

The residual consciousness of unconscious patients can be detected by studying the P300, a wave among event-related potentials. Previous studies have applied tones, the subject＇s name and other names as stimuli. However, the results were not satisfactory. In this study, we changed the constituent order of subjects＇ two-character names to create derived names. The subject＇s derived names, together with tones and their own names, were used as auditory stimuli in event-related potential experiments. Healthy controls and unconscious patients were included in this study and made to listen to these auditory stimuli. In the two paradigms, a sine tone followed by the subject＇s own name and the subject＇s derived name followed by the subject＇s own name were used as standard and deviant stimuli, respectively. The results showed that all healthy controls had the P300 using both paradigms, and that the P300 in the second paradigm had a longer latency and two peaks. All minimally conscious state patients had the P300 in the first paradigm and the majority of them had the P300 in the second paradigm. Most vegetative state patients had no P300. Patients who showed the P300 in the two paradigms had more residual consciousness, and patients with the two-peak P300 had a higher probability of awakening within a short time. Our experimental findings suggest that the P300 event-related potential could reflect the conscious state of unconscious patients.

关键词： nerve regeneration brain injury cognitive neuroscience event-related potential P300 electrophysiology nutritional state minimally conscious state consciousness disorders of consciousness unconsciousness evaluation prognosis NSFC grants neural regeneration

来源：

维普期刊数据库

同方期刊数据库评论

在线全文

学校读者我要写书评

暂无评论

Cognitive Neurobiology of consciousness and Memory during Anesthesia Awareness—Scientific Possibilities and Clinical Implications

引用

Neuroscience & Medicine 2022年第3期13卷 126-134页

作者： Berenika Maciejewicz College of Medicine University of Science Arts and Technology Montserrat BWI Department of Biomedical Engineering Einstein Medical Institute Florida USA

The condition of pharmacologically induced unconsciousness that renders a patient unresponsive to uncomfortable surgical stimuli is known as general anesthesia. When it is used for surgery, a fairly rare but traumatizing state known as anesthesia awareness might develop. What is the probability that a patient can be awake, conscious, and able to hear the surroundings and experience excruciating pain but be immobilized to communicate it during surgery? According to estimates, there are 1 to 2 cases for every 1000 patients who experience this phenomenon and retain various sensory information after general anesthesia was applied. Even with seemingly effective anesthetic care, emerging consciousness states during anesthesia are reported and often come with various degrees of memory loss mechanisms. Some researchers and the experiments covered in this paper suggest anesthesia is merely a memory loss or poorly understood neurological form of amnesia induced during the event itself and not a loss of consciousness per se during the traumatic event, as suggested by studies described in this article. In some instances, the agony may be unbearable, with long-term neuropsychiatric effects such as post-traumatic stress disorder. Although the neurobiological phenomenon of consciousness regained during anesthesia is still poorly understood, these continuously reported events carry significant medical and legal ramifications. The numerous contributing elements that may increase the risk of intraoperative raised levels of consciousness are gathered, analyzed, and discussed in this research study. Preventive methods for both preinduction and intraoperative usage, as well as corrective actions to take after such occurrences, are also discussed.

关键词： Neuroscience of consciousness Memory during Anesthesia Anesthesia Awareness disorders of consciousness

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

欢迎您,

建议与咨询留下您的常用邮箱和电话号码，以便我们向您反馈解决方案和替代方法

时间限定

文献类型

馆藏选择

核心期刊

语言

文献类型

帮助

文字说明：

检索规则说明：

检索范例：

分类表

所选分类

限定检索结果

文献类型

馆藏范围

日期分布

学科分类号

主题

机构

作者

语言

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

请选择保存的检索档案：

请选择收藏分类：

通借通还

欢迎您,

建议与咨询 留下您的常用邮箱和电话号码，以便我们向您反馈解决方案和替代方法

时间限定

文献类型

馆藏选择

核心期刊

语言

文献类型

帮助

文字说明：

检索规则说明：

检索范例：

分类表

所选分类

限定检索结果

文献类型

馆藏范围

日期分布

学科分类号

主题

机构

作者

语言

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

请选择保存的检索档案： 新增检索档案 确定 取消

请选择收藏分类： 新增自定义分类 确定 取消

通借通还

建议与咨询留下您的常用邮箱和电话号码，以便我们向您反馈解决方案和替代方法

请选择保存的检索档案：

请选择收藏分类：