Responses of Patients with Disorders of Consciousness to Habit Stimulation: A Quantitative EEG Study / 神经科学通报·英文版

Whether habit stimulation is effective in DOC patient arousal has not been reported. In this paper, we analyzed the responses of DOC patients to habit stimulation. Nineteen DOC patients with alcohol consumption or smoking habits were recruited and 64-channel EEG signals were acquired both at the resting state and at three stimulation states. Wavelet transformation and nonlinear dynamics were used to extract the features of EEG signals and four brain lobes were selected to investigate the degree of EEG response to habit stimulation. Results showed that the highest degree of EEG response was from the call-name stimulation, followed by habit and music stimulations. Significant differences in EEG wavelet energy and response coefficient were found both between habit and music stimulation, and between habit and call-name stimulation. These findings prove that habit stimulation induces relatively more intense EEG responses in DOC patients than music stimulation, suggesting that it may be a relevant additional method for eliciting patient arousal.

IDH1 mutation and MGMT expression in astrocytoma and the relationship with prognosis after radiotherapy / 中华病理学杂志

<p><b>OBJECTIVE</b>To study the correlation between IDH1 mutation, MGMT expression, clinicopathologic features and post-radiotherapy prognosis in patients with astrocytoma.</p><p><b>METHODS</b>Detection of IDH1 mutation and MGMT expression was carried out in 48 cases of astrocytoma (WHO grade II to III) by EnVision method with immunohistochemical staining. Follow-up data, including treatment response and overall survival time, were analyzed.</p><p><b>RESULTS</b>The rates of IDH1 mutation and MGMT expression in astrocytomas were 62.7% (30/48) and 47.9% (23/48), respectively. There was a negative correlation between IDH1 mutation and MGMT expression (r = -0.641, P < 0.01). The age of patients with IDH1 mutation was younger at disease onset. The IDH1 mutation rate in patients with WHO grade II astrocytoma was higher than that in patients with WHO grade III tumor (P < 0.05). The age at onset was an independent factor affecting the expression of mutant IDH1. After radiotherapy, patients with IDH1 mutation+/MGMT- tumor carried a longer overall survival time than patients with IDH1 mutation-/MGMT+ tumor (P < 0.05).</p><p><b>CONCLUSIONS</b>There is a correlation between IDH1 mutation and MGMT expression in WHO grade II to III astrocytoma. Age at onset is an independent factor affecting the expression of mutant IDH1. Tumors with IDH1+/MGMT- pattern show better response to radiotherapy than tumors with IDH1-/MGMT+ pattern. Detection of IDH1 mutation and MGMT protein expression can provide some guidance in choice of treatment modalities in patients with astrocytoma.</p>

New Strategies of Rehabilitation Therapeutics in Stroke (review) / 中国康复理论与实践

Stroke rehabilitation research has shifted its focus from empiric evidence to biological targets. This article reviewed the plas-ticity of the brain, spinal cord and skeletal muscle, and suggested rehabilitation techniques targeting central nervous system and skeletal mus-cle.

Extradural cortical stimulation for neural network recovery in stroke patients / 中国组织工程研究

BACKGROUND:Extradural cortical stimulation combines the advantages of repetitive transcranial magnetic stimulation, transcranial direct current stimulation, subdural cortical stimulation and deep brain stimulation, which can significantly improve motor and language function after stroke. OBJECTIVE:To review the theoretical research and clinical application of extradural cortical stimulation for stroke recovery. METHODS:An online retrieval of PubMed database and CNKI database between January 1995 and April 2014 was performed for articles on theoretical research and clinical application of extradural cortical stimulation for stroke recovery, with the key words of“cortical stimulation, extradural motor cortex stimulation, extradural cortical implants, extradural cortical stimulation, stroke, rehabilitation”in English and Chinese. RESULTS AND CONCLUSION:Because of implantable cortical stimulation, the advantage of extradural cortical stimulation is its minimal invasiveness, high accuracy and transdural contact with the brain. For lack of effective treatment for the chronic phase of stroke patients with motor and language dysfunction, extradural cortical stimulation may be a new therapeutic method. Motor and language functional improvement must derive from reactivation of plasticity, local enhancement of perilesional areas, enhancement of network function and inter-hemispheric balance function, and amplification of sensory input.

The preliminary study of the sensitivity of clinical consciousness scales to patients with disorders of consciousness / 中华急诊医学杂志

Objective To evaluate the sensitivity of three different clinical consciousness scales to patients with disorders of consciousness.Methods A total of 84 patients in vegetative state (VS) were selected and scored by the consciousness scales including Glasgow Coma Scale (GCS),Coma Recovery Scale-Revised (CRS-R) and Chinese Vegetative State Scale (CVSS) respectively.The patients were followed every 2 weeks for 12 weeks or every 4 weeks for 12-24 weeks.The assessment finished in 6 months or till the time when patients emerged from minimally conscious state ( MCS.The diagnostic sensitivity and the sensitivities of each sub-scale in CRS-R were evaluated when the patients with MCS emerged from VS.The diagnostic consistency with other scales was observed and analyzed by Spearman correlation as well.The Spearman -relate was used to analyze the correlations among the total scores of three scales in the patients on admission (36 patients with acute and 48 patients with chronic phase).Results Of 84 VS patients,there were 47 emerged to MCS.CRS-R was the most sensitive in the diagnosis of MCS (P ＜ 0.05 ) among all scales.The visual subscale is the most sensitive among all the CRS-R subscales ( P ＜0.01 ).Among the 84 patients,the remaining 37 were diagnosed as VS by all three scales.The total scores correlation analysis showed that the score of CRS-R significantly correlate with that of GCS in acute and chronic phase ( P ＜0.01 ) and significantly correlate with that of CVSS only in the acute stage ( P ＜ 0.05 ).Conclusions It is indicated that CRS-R,especially the visual subscale of CRS-R is the more sensitive tool for detecting.MCS during recovery process in the disorders of consciousness.As to the patients with deep unconsciousness and with no significant recovery,the three instruments are in good agreement to determine the degree of disorders of consciousness.It is suggested that CRS-R can be widely used to assess the level of consciousness in various stages.