Asking questions that matter - Question prompt lists as tools for improving the consent process for neurotechnology clinical trials.

Implantable neurotechnology devices such as Brain Computer Interfaces (BCIs) and Deep Brain Stimulators (DBS) are an increasing part of treating or exploring potential treatments for neurological and psychiatric disorders. While only a few devices are approved, many promising prospects for future devices are under investigation. The decision to participate in a clinical trial can be challenging, given a variety of risks to be taken into consideration. During the consent process, prospective participants might lack the language to consider those risks, feel unprepared, or simply not know what questions to ask. One tool to help empower participants to play a more active role during the consent process is a Question Prompt List (QPL). QPLs are communication tools that can prompt participants and patients to articulate potential concerns. They offer a structured list of disease, treatment, or research intervention-specific questions that research participants can use as support for question asking. While QPLs have been studied as tools for improving the consent process during cancer treatment, in this paper, we suggest they would be helpful in neurotechnology research, and offer an example of a QPL as a template for an informed consent tool in neurotechnology device trials.

A contactless positioning system for monitoring discontinuities in three dimensions with geological and geotechnical applications.

In this paper, a contactless positioning system is presented which has been designed to monitor the kinematic behavior of mechanical discontinuities in three dimensions. The positioning system comprises a neodymium magnet, fixed on one side of a discontinuity, and a magnetoresistive sensing array, fixed on the opposing side. Each of the anisotropic magnetoresistive sensors in the sensing array records the magnetic field along three orthogonal directions. The positioning system intrinsically generates compact data packages which are transmitted effectively using a range of standard wireless telecommunication technologies. These data are then modeled using a global least squares fitting procedure in which the adjustable parameters are represented by the position and orientation of the neodymium magnet. The instrumental resolution of the positioning system can be tuned depending on the strength of the magnetic field generated by the neodymium magnet and the distance between the neodymium magnet and the magnetoresistive sensing array. For a typical installation, the displacement resolution is shown to be circa 10 µm while the rotation resolution is circa 0.1°. The first permanently deployed positioning system was established in June 2016 to monitor the behavior of an N-S trending fault located at the contact between the eastern Alps and the Vienna Basin. The robust design of the positioning system is demonstrated by the fact that no interruptions in the broadcasted data streams have occurred since its installation. It has a range of potential applications in many areas of basic and applied research including geology, geotechnical engineering, and structural health monitoring.

Hiperglicinemia no cetósica neonatal: presentación de caso / Non-ketotic neonatal hyperglycinemia: case report

La hiperglicinemia no cetósica es un error innato del metabolismo del aminoácido glicina. Es una entidad rara que se manifiesta de manera clásica en el período neonatal con convulsiones intratables y apneas que requieren asistencia ventilatoria prolongada. Se presenta el caso de un lactante de 2 meses de edad con deterioro neurológico desde el tercer día de vida y convulsiones. Se describen los hallazgos en imágenes por resonancia magnética y espectroscopia por resonancia magnética.

Resonancia magnética cerebral funcional en la evaluación prequirúrgica de malformaciones vasculare / Functional magnetic resonance imaging in the presurgical evaluation of brain vascular malformations

Objetivo: Describir la experiencia en la evaluación prequirúrgica de pacientes con malformaciones vasculares con resonancia magnética cerebral funcional (RMf ). Método: Se evaluaron ocho pacientes con malformaciones vasculares cerebrales (siete malformaciones arteriovenosas [MAV ] y una malformación cavernosa) remitidos para mapeo prequirúrgico de la corteza elocuente con RMf. Se usó una técnica dependiente de la concentración de oxígeno (BOLD) para localizar estas zonas en relación con la malformación vascular cerebral, aplicando diferentes paradigmas. Resultados: Se encontró una MAV en el lóbulo mesotemporal derecho, con representación de la memoria visuoespacial en el hipocampo y parahipocampo contralesionales; una MAV temporal posterior izquierda con activación contralateral exclusiva del área de Wernicke; una MAV parietal izquierda sin afectación de la corteza sensoriomotora; una malformación cavernosa en la circunvolución angular izquierda con dominancia hemisférica del lenguaje en ese lado; una MAV talámica derecha sin daño en la corteza elocuente; una MAV periventricular izquierda con patrón de equidominancia del lenguaje; una MAV pequeña occipital izquierda con activación normal en la corteza visual primaria y disminución en la activación de la corteza de asociación visual del lado izquierdo donde se encuentra la lesión, y una MAV temporooccipital con dominancia hemisférica izquierda y desacople neurovascular. Conclusión: La RMf puede delinear anatómicamente la relación entre la lesión y la corteza elocuente y brindar información que facilita la planeación quirúrgica, incluida la estimación del riesgo de la intervención.

Objective: To describe our experience in presurgical evaluation of intracranial vascular malformations by means of functional magnetic resonance (fMRI). Method: To evaluate eight patients with cerebral vascular malformations (seven arterio-venous malformation [AVM ] and one cavernous malformation) to send to the eloquent cortex with RMf pre-surgical mapping is assessed. Used a technique that is dependent on the level of oxygen (BOLD) to locate these areas in the cerebral vascularmalformation, by applying different paradigms. Results: We found one AVMat the right temporal lobe with activation of the parahipocampal gyrus at the contralateral side using a memory paradigm; another patient with an AVM at the right mesotemporal lobe showed activation of visual and spatial memoryof the contralateral hippocampus and parahippocampus. One patient withan AVM at the left parietal lobe without compromise of sensorial and motorcortex; a cavernous malformation at the left angular gyrus with hemisphericlanguage dominance in that side; one right talamic AVM , one periventricularAVM bilateral language dominance; one left occipital AVM with decreasedactivation in visual association cortex; one temporoccipital AVM with leftlanguage dominance and neurovascular uncoupling. Conclusion: fMRI candelineate anatomically the relationship between the lesion and eloquent cortex, providing useful information for presurgical planning and allowing risk estimation of intervention.