M. -A. Bruno’s research while affiliated with Western University and other places

... Nonetheless, an important warning is that the ostensible nonappearance of consistent circadian rhythms in some of their patients may be a result of a lack of sensitivity of the actigraphy method, rather than the true absence of those rhythms. 86 Moreover, Welek et al, studied day-night variations of EEG activity and sleep, recorded over 24 hours at bedside, and observed higher signal complexity during lighton periods, as compared to night-time only in controls and MCS patients. Furthermore, these day-night changes of brain dynamics appeared to steadily rise from UWS to MCS, to control participants, which reflect their cognitive capabilities or grade of conscious awareness. ...

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PATHOPHYSIOLOGICAL MECHANISM TO EXPLAIN WHY JAHI MCMATH IS IN A NEW STATE OF DISORDER OF CONSCIOUSNESS

... 82 In addition, the occupancy of dynamic connectivity patterns of low complexity, which increases from MCS to UWS, has similar rates in DoC compared to anesthetized volunteers ( Fig. 3C for DoC). 3 Anaesthesia reduces a wide range of brain state properties like corticocortical and thalamocortical connectivity within and between default mode and executive-control networks. [101][102][103][104] There are important commonalities between the observed brain state changes in pathological and pharmacologically altered consciousness (I2), with the important difference that the healthy volunteers undergoing anaesthesia can provide subjective reports after recovery. These studies therefore can serve as a benchmark from which can be extrapolated to the DoC population. ...

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Brain state identification and neuromodulation to promote recovery of consciousness

... La présence de la famille peut également influencer le diagnostic [28]. Or, un diagnostic correct est important pour diverses raisons éthiques et médicales : d'une part, le pronostic du patient dépend non seulement de l'étiologie, mais aussi de ce diagnostic [29] ; d'autre part, il est susceptible d'influencer diverses décisions médicales telles que le traitement antalgique et une éventuelle fin de vie [30,31]. Notons que, bien que la CRS-R soit l'outil le plus sensible pour diagnostiquer les ECA, 32 % des patients considérés comme inconscients comportementalement montrent une activité cérébrale compatible avec un ECM lorsqu'ils sont évalués avec des outils de neuro-imagerie [13]. ...

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Diagnostic, pronostic et traitements des troubles de la conscience

... Facilitated communication is a technique by which a disabled person is physically assisted by another person (i.e., "a facilitator") to communicate using a communication board or computer. We have tested this method and have shown it to be invalid in all patients tested, including PV. 9 Put simply, when we presented words and objects to the patient in the absence of the "facilitator" and then asked him to communicate what had just been presented, we failed to get correct answers. Figure 1. ...

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Uncovering Awareness: Medical and Ethical Challenges in Diagnosing and Treating the Minimally Conscious State

... An individual's inability to communicate pain does not mean that an individual cannot experience pain, thus requiring pain therapy [14]. Pain is a transversal issue that requires study under a zooubiquity scenario in both animal and human patients, since the inability to verbally express pain is not exclusive to animals but also applies to human infants, nonverbal, comatose, and cognitively impaired patients [20][21][22][23]. In veterinary medicine, patients express pain in different ways. ...

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The influence of estrogen on sex-related differences in pain perception using dog as an animal model

... Larger long-term data are available for invasive vagus nerve stimulation in intractable epilepsy, and authors report side effects in 50 % of patients, with surgical complications in 21 % [14]. Our clinical data support that iONS is no more than a symptomatic therapy, as suggested before by other clin- ical [3] and neuroradiological [15] observations. iONS likely induces slow neuroplastic changes within nonspecific pain-control systems [3] , which explains its beneficial effects in various headache types. ...

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Invasive occipital nerve stimulation for refractory chronic cluster headache: what evolution at long-term? Strengths and weaknesses of the method

... These findings confirmed Ledoux study which showed that FOUR score had better prediction than previous scale for classifying and communicating impaired consciousness [10], in emergency department [11, 12], after cardiac arrest [13], and in intensive care units [14]. Compared with the GCS, this new coma scale does not depend on a verbal response and provides greater neurological detail by inclusion of brainstem reflexes and breathing patterns [15, 16]. The present study is one of the first validations of the FOUR score in the ICU outside the institution that developed the FOUR score. ...

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Glasgow coma scale versus full outline of unresponsiveness scale for prediction of outcomes in patients with traumatic brain injury in intensive care unit

... The theory defines the natural afterlife, implying its existence by its association with the NDE-a phenomenon evidenced by numerous accounts recorded across cultures and throughout history as far back as the oral tradition (Holden, Greyson, & James, 2009b;Moody, 2001). The theory assumes that the NDE is indeed a near-death experience, as does the NEC theory, not an after-death experience as some postulate (e.g., Long, 2008;van Lommel, 2010). It occurs in an altered state of consciousness, as do dreams, and is thus dreamlike to some extent. ...

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The Theory of a Natural Eternal Consciousness: The Psychological Basis for a Natural Afterlife

... UWS is characterized by the total lack of signs of consciousness against the background of retained wakefulness, with MCS+ patients being able to follow moving objects with their gaze and perform simple tasks, and MCS-patients being able just to fix their gaze [1]. According to the statistics, in the USA, the number of DOC patients averages 46 per 1 million of the popula tion, in the United Kingdom 14 [2], in Belgium 36 [3], while in Russia, the relevant statistical data are missing. The prevalence of this pathology can be deduced from the data of a questionnaire sur vey of 15 large hospitals in different cities, in which the total number of DOC patients over three years (2009)(2010)(2011)(2012) amounted 747 people with a predominance of patients with the sequelae of traumatic brain injury (42%). ...

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Structural and Metabolic Changes in Skeletal Muscles of Patients with Chronic Disorders of Consciousness—To the Issue of Critical Illness Polyneuromyopathies (a PET/CT Pathomorphological Study)

... The mutual change of the two states also represents a change in the level of consciousness. At present, the gold standard for clinical evaluation of DoC is the Coma Recovery Scale-Revised (CRS-R), [10][11][12] which includes six aspects of auditory, visual, motor, promotor/verbal function, communication, and arousal level. Due to its reliability, it is currently recommended by the mainstream, especially in the identification of VS/ UWS and MCS. 13 In treating patients with DoC, the medical community utilizes a variety of approaches, categorized as noninvasive, invasive, and mechanical therapies. ...

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The Impact of Bispectral Index Monitoring on Outcomes in Spinal Cord Stimulation for Chronic Disorders of Consciousness