EEG-based motor network biomarkers for identifying target patients with stroke for upper limb rehabilitation and its construct validity

<div><p>Rehabilitation is the main therapeutic approach for reducing poststroke functional deficits in the affected upper limb; however, significant between-patient variability in rehabilitation efficacy indicates the need to target patients who are likely to have clinically significant improvement after treatment. Many studies have determined robust predictors of recovery and treatment gains and yielded many great results using linear approachs. Evidence has emerged that the nonlinearity is a crucial aspect to study the inter-areal communication in human brains and abnormality of oscillatory activities in the motor system is linked to the pathological states. In this study, we hypothesized that combinations of linear and nonlinear (cross-frequency) network connectivity parameters are favourable biomarkers for stratifying patients for upper limb rehabilitation with increased accuracy. We identified the biomarkers by using 37 prerehabilitation electroencephalogram (EEG) datasets during a movement task through effective connectivity and logistic regression analyses. The predictive power of these biomarkers was then tested by using 16 independent datasets (i.e. construct validation). In addition, 14 right handed healthy subjects were also enrolled for comparisons. The result shows that the beta plus gamma or theta network features provided the best classification accuracy of 92%. The predictive value and the sensitivity of these biomarkers were 81.3% and 90.9%, respectively. Subcortical lesion, the time poststroke and initial Wolf Motor Function Test (WMFT) score were identified as the most significant clinical variables affecting the classification accuracy of this predictive model. Moreover, 12 of 14 normal controls were classified as having favourable recovery. In conclusion, EEG-based linear and nonlinear motor network biomarkers are robust and can help clinical decision making.</p></div

The sensitivity and the positive predictive value of the neuromarkers.

<p>The sensitivity and the positive predictive value of the neuromarkers.</p

(a)Significant network- and frequency-specific biomarkers of beta plus theta (left) and beta plus gamma (right) rhythms identified by the backward elimination procedure.

<p>The asterisks indicate the 3 common connections in both predictive models.</p

Illustrations of frequency- and connection-specific parameters (a) in 5 core motor cortices and the frequency-specific spectrum dynamics (b) at the five core motor cortices.

<p>Illustrations of frequency- and connection-specific parameters (a) in 5 core motor cortices and the frequency-specific spectrum dynamics (b) at the five core motor cortices.</p

EEG-based motor network biomarkers for identifying target patients with stroke for upper limb rehabilitation and its construct validity - Fig 2

<p>(a) BMS results at the group level under RFX for the patients (left) and the controls (right) both confirmed that Model 1 was the most likely model with exceedance probabilities of 0.87 and 0.97, respectively. (b) Model comparison of nonlinear+linear (Model 1) and all-linear model under FFX (left) and RFX (right).</p

The statistic results of demographic and clinical characteristic.

<p>The statistic results of demographic and clinical characteristic.</p

Demographic and clinical characteristic of the patients.

<p>Demographic and clinical characteristic of the patients.</p

Rémunération des commissaires aux comptes : problème de limites de la mission légale et contentieux pour des travaux externes

<p>Data are shown as mean values and standard deviations. There were no significant differences in baseline levels. IL-10 production in the Terli and Vaso groups increased more significantly than in the LR or Sham groups (P<0.001) but there was no significant difference of serum levels of IL-10 between the Terli and Vaso groups.</p

A Comparison of Vasopressin, Terlipressin, and Lactated Ringers for Resuscitation of Uncontrolled Hemorrhagic Shock in an Animal Model

<div><p>Aim</p><p>The aim of this study is to compare the effect of lactated ringer (LR), vasopressin (Vaso) or terlipressin (Terli) on uncontrolled hemorrhagic shock (UHS) in rats.</p><p>Methods</p><p>48 rats were divided into four treatment groups for UHS study. Vaso group was given bolus vasopressin (0.8 U/kg); the Terli group was given bolus terlipressin (15 mcg/kg); LR group was given LR and the sham group was not given anything. Mean arterial pressure (MAP), serum lactate level, plasma cytokine levels, lung injury and mortality are investigated for these different treatment groups.</p><p>Results</p><p>Compared with LR group, vasopressin and terlipressin-treated groups were associated with higher MAP, lowered mortality rates, less lung injury, lowered serum lactate level, less proinflammatory and more anti-inflammatory cytokine production at certain time points. Comparing between vasopressin and terlipressin treated groups, there is no statistical difference in mortality rates, lung injury, serum lactate level and cytokine level. However, there is a difference in the length of time in maintaining a restored level of MAP (80 to 110 mmHg). The terlipressin treated rats can maintain this restored level of MAP for 45 minutes, but the vasopressin treated rats can only maintain this restored level of MAP for 5 minutes before decreasing gradually to the MAP observed in LR group (40 mmHg).</p><p>Conclusion</p><p>Early optimization of hemodynamics with terlipressin or vasopressin in an animal model of UHS was associated with improved hemodynamics and inflammatory cytokine profile than the LR control. Compared with vasopressin, terlipressin has the advantage of ease of use and sustained effects.</p></div

Comparison of serum lactate levels between different resuscitation strategies groups from 0 to 135 min.

<p>Data are shown as mean values and standard deviations. There were no significant differences in baseline levels. The Terli group had significantly lower serum lactate level than Vaso or LR group at 60 and 90</p