Breaking News
July 19, 2018 - On-the-Job Stress Relief – Drugs.com MedNews
July 19, 2018 - Compounds found in green tea and wine may block formation of toxic metabolites
July 19, 2018 - Gene regulator associated with protein pileup in exfoliation glaucoma
July 19, 2018 - Trump administration summons immigrant infants
July 19, 2018 - FDA grants approval for first breast cancer drug through ‘Real-Time Oncology Review’
July 19, 2018 - Five tips for men seeking plastic surgery
July 19, 2018 - Researchers discover the reasons why some people get dizzy when hearing certain sounds
July 19, 2018 - Research project investigates snake venom treatment as antibiotic alternative for eye infections
July 19, 2018 - Melanoma could soon be detected using a blood test
July 19, 2018 - Exposure to bright light may have big impact on sleep-related behavior in children
July 19, 2018 - Deleting single gene in gut bacteria affects metabolism, reduces weight gain in mice
July 19, 2018 - New proteomics studies help gain more insights into Alzheimer’s, cancer and listeriosis
July 19, 2018 - Study finds major discrepancies in prescription drug labeling pregnancy information across four countries
July 19, 2018 - Cellectar’s CLR 131 Receives FDA Orphan Drug Designation for Treatment of Ewing’s Sarcoma
July 19, 2018 - Watching the immune system in action reveals what happens when things goes wrong
July 19, 2018 - Increasing blood sugar levels improves memory and performance in older adults
July 19, 2018 - Connection between self-regulation and obesity appears to be different for girls and boys
July 19, 2018 - Researchers develop new, less destructive method for whitening teeth
July 19, 2018 - Revving up innate control of viral infection requires a three-cell ignition
July 19, 2018 - Inaccurate direct-to-consumer raw genetic data can harm patients, new research suggests
July 19, 2018 - Weight loss surgery is effective under the right situations
July 19, 2018 - BioTek awarded patent for autofocus feature on microplate reader
July 19, 2018 - Low-carb diets reduce stiffness of arteries in women and promote weight loss in men
July 19, 2018 - New review examines cannabinoids’ potential for direct treatment of cancer
July 19, 2018 - Allergic responses may help protect the skin against cancer, research suggests
July 19, 2018 - Inappropriate Prescribing of Abx High in Urgent Care Centers
July 19, 2018 - Many at risk for HIV despite lifesaving pill
July 19, 2018 - Tips for doctors and parents on the harms of marijuana use for teens
July 18, 2018 - Researchers detect presence of IgE antibodies after kidney transplantation
July 18, 2018 - New technique allows researchers to create large scale, personalized bone grafts
July 18, 2018 - Smoking May Boost Atrial Fibrillation Risk
July 18, 2018 - Genome editing method targets AIDS virus
July 18, 2018 - These things matter: Medical complications are not inevitable, a physician writes
July 18, 2018 - Cognitive functions often wilt as water departs the body, shows study
July 18, 2018 - Origins of bread found 14,400 years ago in Jordan
July 18, 2018 - Low-dose ketamine found to be as effective as opioids for treating acute pain
July 18, 2018 - Novel bioengineering technique could help repair bone defects
July 18, 2018 - Researchers identify new potential target protein for colon cancer
July 18, 2018 - Air pollution contributes significantly to diabetes globally
July 18, 2018 - Cell membrane’s importance offers new strategy to fight infections
July 18, 2018 - Researchers identify key protein involved in irregular brain cell activity
July 18, 2018 - 3D modeling of drug resistance could lead to more effective cancer treatment
July 18, 2018 - Hunger hormones could be key to new treatments for drug, alcohol addiction
July 18, 2018 - Nitrate-cured meats may contribute to mania, study finds
July 18, 2018 - Why men may recover more quickly from influenza infections than women
July 18, 2018 - Study finds discharge against medical advice as predictor of readmissions in heart attack patients
July 18, 2018 - KemPharm Announces Top Line Results from KP415.E01 Efficacy and Safety Trial in Children With ADHD
July 18, 2018 - Self-control and obesity: Gender matters in children
July 18, 2018 - Bioengineers, diabetes researchers convene to discuss future concepts for precision medicine
July 18, 2018 - New findings support more conservative use of ED neuroimaging for non-index seizures
July 18, 2018 - Practicing yoga benefits pregnant women, study suggests
July 18, 2018 - New strategy may lead to more accurate breast cancer diagnoses
July 18, 2018 - FDA Approves Symtuza (D/C/F/TAF), the First and Only Complete Darunavir-Based Single-Tablet Regimen for the Treatment of HIV-1 Infection
July 18, 2018 - New guide helps hospitals pick right partner to handle hospitalist services
July 18, 2018 - Deep data dive helps predict cerebral palsy
July 18, 2018 - Stricter firearm legislation associated with reduced murder and suicide rates
July 18, 2018 - Physical and sexual abuse in childhood associated with endometriosis risk
July 18, 2018 - Omega 3 supplements do not reduce risk of heart disease, stroke or death
July 18, 2018 - GSA’s new publication provides support for safe use of OTC analgesics by older adults
July 18, 2018 - Researchers receive grant from U.S. Department of Education to study children with HFASD
July 18, 2018 - Early childhood adversity increases sensitivity of the body’s immune response to cocaine
July 18, 2018 - Parental incarceration affects health behaviors of children in adulthood
July 18, 2018 - Researchers find that yellow fever and Asian tiger mosquitoes can carry new virus
July 18, 2018 - Two Regimens Fail to Stop Declines in β-Cell Function
July 18, 2018 - Researchers apply computing power to track the spread of cancer
July 18, 2018 - Olfactory receptors play pathophysiological role in all organs than merely smell perception
July 18, 2018 - Fish consumption associated with lower risk of early death
July 18, 2018 - MR Solutions’ 7T MRI imaging system installed at University of Hawaii
July 18, 2018 - Humorous ads screened around World Cup game achieve higher biometric response than sporty ads
July 18, 2018 - New study demonstrates little effect of hormone therapy on artery thickness
July 18, 2018 - A 3-Pronged Plan to Cut Type 2 Diabetes Risk
July 18, 2018 - New clues to sepsis may speed diagnosis
July 18, 2018 - Stars of Stanford Medicine: Improving cardiovascular health in Africa and beyond
July 18, 2018 - Heart attack risk continues to increase among pregnant women, study finds
July 18, 2018 - Few tips to help avoid sunburns in summer
July 18, 2018 - High-fat diet and systemic inflammation contribute to progression of prostate cancer
July 18, 2018 - Researchers develop 3D map of gene interactions that play key role in heart disease
July 18, 2018 - Conservative management of lung subsolid nodules reduces overtreatment and unnecessary surgery
July 18, 2018 - Report warns of dog illness that can spread to owners
July 18, 2018 - A winning essayist’s tips for keeping track of scientific facts
New stimulation method increases hope for improving disorders of consciousness

New stimulation method increases hope for improving disorders of consciousness

image_pdfDownload PDFimage_print

To diagnose patients with severe brain injuries reliably, their state of consciousness has to be evaluated several times with suitable tools. A new stimulation method increases the hope that disorders of consciousness can be improved according to Prof Steven Laureys who spoke at the Congress of the European Academy of Neurology in Lisbon.

An increasing number of individuals survive the coma that follows severe brain injury and open their eyes. However, it is extremely difficult to determine their level of consciousness. Prof Steven Laureys, neurologist and head of the Coma Science Group at Liège University Hospital, emphasized the following point while speaking at the 4th Congress of the European Academy of Neurology (EAN) in Lisbon: “Assessing disorders of consciousness after a brain injury correctly is a huge challenge for neurologists. Our decisions are often a matter of life and death, so it is essential that they be scientifically reliable.”

Quick assessment with the SECONDs scale

Disorders of consciousness due to brain injuries are highly complex syndromes. A reliable behavioral assessment depends on a measurement method that must be repeatable and standardized. The Glasgow Coma Scale has become established for coma patients but does not reflect all states of consciousness. Prof Laureys: “We need simple scales that are applicable to every assessed patient and that can help with treatment decisions.”

The Coma Recovery Scale-Revised (CRS-R) is currently the gold standard neurobehavioral tool to assess a patient’s state of consciousness, i.e. whether he or she presents an unresponsive wakefulness syndrome (formerly known as vegetative state) or is in a minimally conscious state. This comprehensive series of tests determines, among other things, whether patients can respond to prompts or pain stimuli, can display attentiveness, a startle reflex or can produce verbalizations. Prof Laureys: “This assessment process takes a great deal of time, however, and cannot always be carried out. We therefore developed the SECONDs scale and tested it in a study involving patients with severe brain injuries. It concentrates on the five most frequent criteria with which it is possible to determine with 99 percent accuracy whether a patient is conscious.” The SECONDs scale is a useful instrument especially when time is limited.

Conscious states fluctuate – multiple examinations are needed

It is likewise important to assess patients multiple times because their state of consciousness may fluctuate. Prof Laureys: “As part of a study, we examined patients with severe brain injuries four times a day applying the CRS scores. It turned out that their conscious state can vary greatly over the course of the day. This finding supports the recommendation to test patients multiple times within a short time period to establish a reliable diagnosis.” Future studies with a larger number of patients should focus on better characterizing these fluctuations.

High-tech examination of conscious states

With the MRI, nearly all large European hospitals have a very good, albeit expensive, high-tech instrument available to them for examining conscious states. The imaging diagnosis procedure is also being constantly refined. Prof Laureys: “We were able to show in a study that diffusion tensor imaging helps to eliminate uncertainties in the diagnosis of conscious states.” Diffusion tensor imaging is an imaging method that uses MRI to record the motion and also directional dependence of the diffusion of water molecules in bodily tissue or in the brain and depicts them in a spatially resolved manner. Prof Laureys: “We face the challenge, however, of having the high-tech methods and the new scientific findings become part of clinical practice everywhere in Europe.”

tDCS can improve a state of consciousness

Prof Laureys is convinced that patients suffering from disorders of consciousness due to injuries or neurological diseases will benefit from new therapeutic options in the future. For instance, a new treatment method has proved promising in a controlled clinical study. Steven Laureys: “Transcranial direct current stimulation is an important non-invasive instrument for all of neurology and neuropsychiatry.” The expert went on to elaborate: “We showed that a twenty-minute treatment with tDCS applied over the prefrontal cortex can transiently improve the level of consciousness in patients with brain injuries. More interestingly, repeating the stimulation for 5 days induces longer behavioral changes, lasting up to a week after the end of the treatment. But we must not stir up false hope in the patients’ families that tDCS is a new miracle cure. On the other hand, it is also a historical error to believe that nothing can be done for these patients.”

More research needed

One out of three Europeans is affected by a brain disease or injury in the course of his or her lifetime. Skull-brain traumas are the most frequent cause of death for people under 45 and the main reason for severe disabilities among young adults in particular. Prof Laureys: “We are talking here about one million patients in Europe who end up in the hospital because of brain injuries. Of that total, 75,000 die. It is therefore vital that we devote attention to research in this area.” Compared to the major neurological diseases, research on brain-damage and coma is quite a small field. The limited size of this field is detrimental to the efforts of the medical technology sector. Their will to invest a lot of money in advances for new treatment methods is limited. Moreover, research has suffered a number of setbacks in recent years according to Prof Laureys: “Processes that people believed they understood in an animal model turned out to be inapplicable to human beings after all. The industry is therefore only minimally active in this research area right now.”

Tagged with:

About author

Related Articles