Quantitative EEG analysis in minimally conscious state patients during postural changes

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Role of acupuncture in the management of severe acquired brain injuries (sABIs)

Acupuncture therapy has been used to treat several disorders in Asian countries and its use is increasing in Western countries as well. Current literature assessed the safety and efficacy of acupuncture in the acute management and rehabilitation of patients with neurologic disorders. In this paper, the role of acupuncture in the treatment of acute severe acquired brain injuries is described, acting on neuroinflammation, intracranial oedema, oxidative stress, and neuronal regeneration. Moreover, beneficial effects of acupuncture on subacute phase and chronic outcomes have been reported in controlling the imbalance of IGF-1 hormone and in decreasing spasticity, pain, and the incidence of neurovegetative crisis. Moreover, acupuncture may have a positive action on the arousal recovery. Further work is needed to understand the effects of specific acupoints on the brain. Allegedly concurrent neurophysiological measurements (e.g., EEG) may help in studying acupuncture-related changes in central nervous system activity and determining its potential as an add-on rehabilitative treatment for patients with consciousness disorders

A systematised review of assisted standing for persons in a prolonged disorder of consciousness

Background: Persons in disorders of consciousness after brain injury pose a highly complex philosophical and scientific issue. With medical advances, more people now survive previously fatal brain injuries but can be left in prolonged disorders of consciousness. The mechanisms for regaining consciousness after brain injury are still poorly understood. Treatment to remediate consciousness is an important rehabilitative issue. Passive standing using equipment such as a tilt table is a therapeutic method used with the intention to aid the recovery of consciousness. This is a commonly used treatment method but, it is not known if it is effective. Research objective: The intention of this systematised review is to analyse the evidence for passive standing’s effect on consciousness for those in a prolonged disorder of consciousness. Methods: This review followed a PRISMA-P protocol for comprehensive reporting. The use of this ensured structured searching, selection and presentation of articles. The search was completed independently by two separate researchers. The search strategy was created to retrieve all possible causes of disorders of consciousness, combined with all conceivable passive standing devices and assessments of consciousness. Papers were identified through primary database searching (in Medline, CINAHL, AMED, PEDro and The Cochrane Library) and post-citation searching (via Scopus). A search for relevant grey literature was performed in profession-specific magazines, theses, conference proceedings and clinical trial registries. Inclusion criteria were any papers that evaluated passive standing on adults who were in defined disorders of consciousness. Exclusion criteria included active stand studies, paediatric studies and animal studies, as these are inappropriate to answer the research question. A consensus was reached through discussion between the two separate researchers. Results: Ten papers were appropriate for inclusion through adherence to the inclusion and exclusion criteria. Data collection from the papers was completed using the Cochrane data collection form (2014). For all articles assessment of study quality and bias was completed using the Cochrane risk of bias tool (2014), additionally, the Downs and Black tool (1998) was used to assess the quality of observational studies. The majority of studies reviewed were of low to medium quality. The results of these did not provide conclusive recommendations as to the effectiveness of supportive standing. This systematised review has created recommendations for future research to assess if standing is a therapeutically effective treatment of consciousness

Quantitative EEG Analysis in Minimally Conscious State Patients During Postural Changes

Mobilization and postural changes of patients with cognitive impairment are standard clinical practices useful for both psychic and physical rehabilitation process. During this process, several physiological signals, such as Electroencephalogram (EEG), Electrocardiogram (ECG), Photopletysmography (PPG), Respiration activity (RESP), Electrodermal activity (EDA), are monitored and processed. In this paper we investigated how quantitative EEG (qEEG) changes with postural modifications in minimally conscious state patients. This study is quite novel and no similar experimental data can be found in the current literature, therefore, although results are very encouraging, a quantitative analysis of the cortical area activated in such postural changes still needs to be deeply investigated. More specifically, this paper shows EEG power spectra and brain symmetry index modifications during a verticalization procedure, from 0 to 60 degrees, of three patients in Minimally Consciousness State (MCS) with focused region of impairment. Experimental results show a significant increase of the power in beta band (12-30 Hz), commonly associated to human alertness process, thus suggesting that mobilization and postural changes can have beneficial effects in MCS patients