Journal international de neuroréadaptation

Background and purpose: Coma is the prolonged period of unconsciousness immediately following traumatic brain injury. Coma is one of the results of brain injuries on the other hand; sensory deprivation is one of the complications, which have a high risk in Intensive Care Unit (ICU) wards for these patients. Cause of nature of illness they are keeping in emphatic environments that it could lead to decreasing sensory inputs and in this condition brain does not have a normal level of brain activity and consequently would lead to sensory deprivation. The study was done to find out the effectiveness of coma stimulation program in traumatic brain injuries.

Design and setting: A randomized control trial study. The study was conducted at Sri Aurbindo Institute of Medical Sciences Indore.

Subjects: The traumatic brain injury patients who admitted at study center and further met the inclusion criteria selected as subjects during specified schedule. A total of 15 traumatic head injury patients who were diagnosed as specified types of traumatic brain injury were purposively selected from the in-door patient department at Sri Aurobindo institute of medical sciences. To all the subjects one session of coma stimulation program with two sessions of conventional physiotherapy were given for 4 weeks.

Outcome measure: Glasgow coma scale.

Results: Statistical analysis results showed significant improvement in level of consciousness in all the cases of traumatic brain injury received coma stimulation program. Frontal contusion injuries showed higher gain followed by temporoparietal contusion and parietal contusion injuries.

Conclusion: The results suggest that coma stimulation program is better treatment in frontal contusion injuries followed by temporoparietal and parietal contusion injuries.

Objective: To review the current status of the contribution of connectionism to the understanding of the participation of the right cerebral hemisphere in metaphor interpretation and semantic processing.

Materials and methods: Literature review and discussion of recent advances in the field. The subject is illustrated with a real case of a right-handed man in whom an ischemic stroke was at the origin of metaphor interpretation impairment.

Results: The interpretation of new, previously unknown, metaphors seems particularly sensitive to lesion of the right cerebral hemisphere. Both hemispheres and different cortical zones are implicated, however, their engagement does not appear to be static and vary according to the requested task. Impairment in working memory can also influence the clinical performance on metaphor interpretation after cerebral damage.

Conclusion: The participation of the right cerebral hemisphere to metaphor processing highlights the necessity to conceive the semantic processing in the form of a system of distributed networks. The clinical consequences of right hemisphere damage are detectable and quantifiable in the acute setting.

Introduction: A non-invasive form of neuromodulation known as transcranial pulse stimulation (TPS) makes use of a neuro-navigated device to deliver brief, recurrent shockwaves. These pulses may cause a wide range of vascular, metabolic, and neurotrophic changes, according to current research. In a clinical pilot study for improving cognition in mild-to-moderate Alzheimer's, this relatively new CE-marked treatment produced its first promising results. Because there is a lack of data from other centers, we examined the safety and pilot real-world short-term TPS results from the first center in Germany. To acquire data about impacts in various stages, patients with gentle as well as moderate-to-extreme Alzheimer's were examined.

Methods: Before and after the first stimulation series, 11 patients were examined for cognitive and emotional function in a retrospective manner. The impact was surveyed utilizing a few neuropsychological tests [Alzheimer's Illness Evaluation Scale (ADAS), including the ADAS mental score (ADAS Pinion) and ADAS emotional scores, Smaller than expected Mental Status Assessment (MMSE), and Montreal Mental Evaluation (MoCA)] remembering for examination between the gatherings of gentle to-extreme patients. Numeric Rating Scales (NRS) were also used to examine subjective improvement in symptom severity, potential effects on depressive symptoms, and side effects.

Results: In only 4% of sessions, side effects occurred that were only brief and of moderate subjective severity. Patients fundamentally worked on in the ADAS and ADAS Pinion, while there was no massive impact in MMSE and MoCA. The self-reported severity of symptoms significantly improved among patients. Also significantly improved were the ADAS subscale measures of depressive symptoms. There was no significant correlation between clinical improvement and baseline symptom severity, according to statistical data analyses.

Conclusion: TPS may be a protected and promising extra treatment for Alzheimer's, in any event, for moderate-to-serious patients. More studies with sham control groups and long-term effects on patients are needed. In addition, in order to comprehend this novel method of neuromodulation, translational research on the mechanisms of action and effects on the physiology of cerebral networks will be required.

Introduction: Obsessive conditions of recuperation after unconsciousness because of a serious cerebrum injury are set apart with changes in primary network of the mind. The purpose of this study was to determine if there was a topological correlation between the degree of functional and cognitive impairment and white matter integrity in coma patients.

Methods: A probabilistic human connectome atlas was used to calculate structural connectomes from fractional anisotropy maps of 40 patients. We utilized an organization based insights way to deal with distinguish potential cerebrum networks related with a better result, evaluated with clinical neurobehavioral scores at the patient's release from the intense neurorehabilitation unit.

Results: We distinguished a subnetwork whose strength of availability corresponded with a better result as estimated with the Handicap Rating Scale (network based measurements: t >3.5, P =.010). The thalamic nuclei, putamen, precentral and postcentral gyri, and medial parietal regions were all part of the subnetwork, which predominated in the left hemisphere. The score and the subnetwork's mean fractional anisotropy value had a Spearman correlation of=0.60 (P.0001). The Coma Recovery Scale Revised score was correlated with a smaller overlapping subnetwork that mostly consisted of left hemisphere connectivity between the thalamic nuclei and the pre- and post-central gyri (network-based statistics: t >3.5, P =.033; P.0001, Spearman's=0.58).

Conclusion: The current discoveries propose a significant job of primary network between the thalamus, putamen and somatomotor cortex in the recuperation from trance like state as assessed with neurobehavioral scores. These structures are a part of the motor circuit, which is responsible for creating and modifying voluntary movement, as well as the forebrain circuit, which is thought to be responsible for maintaining consciousness. As social evaluation of cognizance relies intensely upon the indications of intentional engine conduct, further work will explain whether the distinguished subnetwork mirrors the primary design fundamental the recuperation of awareness or rather the capacity to convey its substance.

A brain or sensory system disorder, confusion, or injury will affect one in three Canadians at some point in their lives. These conditions range the presence cycle. Emotional health issues frequently cause psychological problems in young Canadians during their prime of life that begin before the age of 18. In adult life, wounds to the sensory system, such as blackout, are common and can result in profound impairment. According to the Assessment Board of the CIHR Foundation of Neurosciences, Psychological wellness, and Enslavement, the overall cost of neurological and emotional well-being issues to the Canadian economy is estimated to be at computer aided design every year. Age-related dementia has outperformed other conditions as the biggest financial burden on the Canadian medical services framework at the moment.

This autonomic deregulation is still poorly understood, and there are few treatment options. By means of glancing through writing concerning youth frontal cortex injury, we expected to see whether understanding autonomic liberation following youth mind injury as a model can help us with better sorting out the autonomic liberation in RTT. After the articles were separated, a topical analysis revealed that Acknowledgment of Autonomic Deregulation, Potential Instruments and Evaluation of Autonomic Deregulation, and Treatment of Autonomic Deregulation were the three primary topics. We argue that physical issues involving the thalamus and hypothalamus in patients with RTT should be investigated, and drug-induced secondary effects that can impair autonomic function, such as dystonia and diaphoresis, should be considered. Our combination of data on autonomic deregulation in children with brain injuries has led to more information and a better understanding of its foundations, which has led to the development of RTT treatment protocols for children.

Background and purpose: Because neuroimaging is rarely readily available, long-term monitoring of intracranial pressure (ICP) in neurological/ neurosurgical patients during ventilator weaning and early neurorehabilitation currently relies on clinical observation. Pupilometry and multimodal neurosonography are evaluated for follow-up monitoring in this prospective study.

Methods: During weaning and early neurorehabilitation, sonographic neuromonitoring was used to noninvasively examine the ICP of patients. It made it possible to measure the width of the third ventricle, the possibility of a midline shift, the flow velocities of the middle cerebral artery, and the diameters of the bilateral optic nerve sheaths. The size and reactivity of the pupils were measured with quantitative pupillometry. As controls, we used data from clinical follow-up, ICP measurements from a spinal tap, and other neuroimaging results.

Results: During a mean observation period of 21 days, 17 patients-11 with intracranial hemorrhage, four with encephalopathies, and two with ischemic stroke-were examined for ICP changes using neurosonography and pupillometry. 354 out of 980 analyses, or 36.1%, produced pathological findings. Pathological values without a clear clinical correlate were found during follow-up in 15 of 17 patients (88.2%). Neurosonography was used to identify clinically relevant changes in ICP in two patients (11.8%). The absence of clinical improvement was highly predicted by abnormal pupillometry results.

Conclusion: Pupilometry can only detect rapid ICP changes in acute neurointensive care, whereas multimodal neurosonography may be a noninvasive method for long-term ICP assessment. With a large number of pathological but nonsignificant findings, the study also demonstrates typical pitfalls in neuromonitoring. The effect of detected subtle changes in ICP on neurological outcome should be confirmed by additional controlled studies.

Introduction: A well-planned rehabilitation program is just as important as the size and location of the tear, the surgical method, and the fixation methods for patients undergoing rotator cuff repair to complete tendon healing and achieve the best possible shoulder functional outcome (RCR). It is still up for debate which stages of rehabilitation should take precedence.

Purpose: The purpose of this meta-objective analysis is to contrast the outcomes of conventional rehabilitation with post-operative aggressive treatment. Methods: We searched PubMed, Ovid MEDLINE, CINAHL, the Cochrane Library, and CEPS databases. In the end, six publications that met our selection criteria were included.

Results: Although the intensive postoperative rehabilitation approach has a higher risk of the rotator cuff tendon failing to repair or rupturing once more, it achieves greater improvements in ROM and shoulder function than the conventional protocol.

Conclusion: There is a need for additional research on the factors that influence the risk of tendon unhealing or re-tearing, despite the fact that RCR patients benefit from the rigorous postoperative rehabilitation regimen. When developing a post-operative program for RCR patients, it is necessary to take these aspects into consideration.