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Coma, vegetative state and minimally conscious state

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Coma, vegetative state and minimally conscious state

Intrinsic functional connectivity differentiates minimally conscious from unresponsive patients
Demertzi,* A., Antonopoulos,* G., Heine. L., Voss. H.U., Crone, J.S., de Los Angeles, C. Bahri, M.A., Di Perri, C., Vanhaudenhuyse, A., Charland-Verville, V., Kronbichler, M., Trinka, E., Phillips, C., Gomez, F., Tshibanda, L. Soddu, A., Schiff, N.D., Whitfield-Gabrieli,* S, Laureys,* S
Brain (2015: 138(9): 2619-2631)

Cerebral functional connectivity periodically (de)synchronizes with anatomical constraints.
Liégeois R, Ziegler E, Phillips C, Geurts P, Gómez F, Bahri MA, Yeo BT, Soddu A, Vanhaudenhuyse A, Laureys S, Sepulchre R
Brain Struct Funct. 2015 Jul 22

Cerebral response to subject’s own name showed high prognostic value in traumatic vegetative state
Fuyan Wang, Haibo Di, Xiaohua Hu, Shan Jing, Aurore Thibaut, Carol Di Perri, Wangshan Huang, Yunzhi Nie, Caroline Schnakers and Steven Laureys 
BMC Medicine 2015, 13:83 doi:10.1186/s12916-015-0330-7

On the cerebral origin of EEG responses to TMS: insights from severe cortical lesions.
Gosseries O, Sarasso S, Casarotto S, Boly M, Schnakers C, Napolitani M, Bruno MA, Ledoux D, Tshibanda JF, Massimini M, Laureys S, Rosanova M. 
Brain Stimul. 2015 Jan-Feb;8(1):142-9. doi: 10.1016/j.brs.2014.10.008.

Detection of visual pursuit in patients in minimally conscious state: a matter of stimuli and visual plane?
Thonnard M, Wannez S, Keen S, Brédart S, Bruno MA, Gosseries O, Demertzi A, Thibaut A, Chatelle C, Charland-Verville V, Heine L, Habbal D, Laureys S, Vanhaudenhuyse A. 
Brain Inj. 2014;28(9):1164-70. doi: 10.3109/02699052.2014.920521.

Amantadine, apomorphine and zolpidem in the treatment of disorders of consciousness.
Gosseries O, Charland-Verville V, Thonnard M, Bodart O, Laureys S, Demertzi A. 
Curr Pharm Des. 2014;20(26):4167-84.

Detection of response to command using voluntary control of breathing in disorders of consciousness
Charland-Verville V, Lesenfants D, Sela L, Noirhomme Q, Ziegler E, Chatelle C, Plotkin A, Sobel N, Laureys S. 
Front Hum Neurosci. Dec 23, 2014

Changes in cerebral metabolism in patients with a minimally conscious state responding to zolpidem.
Chatelle C, Thibaut A, Gosseries O, Bruno MA, Demertzi A, Bernard C, Hustinx R, Tshibanda L, Bahri MA, Laureys S.
Front Hum Neurosci. 
2014 Dec 2;8:917. doi: 10.3389/fnhum.2014.00917. eCollection 2014.

Recent advances in disorders of consciousness: focus on the diagnosis.
Gosseries O, Zasler ND, Laureys S.
Brain Inj. 2014;28(9):1139-40. doi: 10.3109/02699052.2014.932554

Current knowledge on severe acquired brain injury with disorders of consciousness.
Gosseries O, Laureys S.
Brain Inj. 2014;28(9):1141-50. doi: 10.3109/02699052.2014.920522.

Detecting awareness in patients with disorders of consciousness using a hybrid brain-computer interface.
Pan J, Xie Q, He Y, Wang F, Di H, Laureys S, Yu R, Li Y.
J Neural Eng. 2014 Oct;11(5):056007. doi: 10.1088/1741-2560/11/5/056007. Epub 2014 Aug 1.

Quantitative rates of brain glucose metabolism distinguish minimally conscious from vegetative state patients 
Stender J, Kupers R, Rodell A, Thibaut A, Chatelle C, Bruno MA, Gejl M, Bernard C, Hustinx R, Laureys S, Gjedde A. 
Journal of Cerebral Blood Flow and Metabolism 2014 Oct 8

The Glasgow Coma Scale: time for critical reappraisal? 
Laureys S, Bodart O, Gosseries O. 
The Lancet Neurology, Volume 13, Issue 8, August 2014 Pages 755 - 757,

Measuring Consciousness in Severely Damaged Brains 
Gosseries O, Di H, Laureys S, Boly M. 
Annual Review of Neuroscience Vol. 37: 457-478, July 2014

Impact of Aphasia on Consciousness Assessment: A Cross-Sectional Study. 
Schnakers C, Bessou H, Rubi-Fessen I, Hartmann A, Fink GR, Meister I, Giacino JT, Laureys S, Majerus S. 
Neurorehabil Neural Repair. 2014 Apr 16.

Volitional electromyographic responses in disorders of consciousness
Habbal D, Gosseries O, Noirhomme Q, Renaux J, Lesenfants D, Bekinschtein TA, Majerus S, Laureys S, Schnakers C.
Brain Injury (2014) 28(9):1171-9. doi: 10.3109/02699052.2014.920519.

The vegetative state/unresponsive wakefulness syndrome: a systematic review of prevalence studies 
Van Erp WS, Lavrijsen JC, van de Laar FA, Vos PE, Laureys S, Koopmans RT .
Eur J Neurol (2014) Jul 21. doi: 10.1111/ene.12483.

 

Ultimo aggiornamento Domenica 31 Gennaio 2016 09:57
 

DECODER

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DECODER è un progetto europeo di collaborazione che sfrutta la Brain-Computer-Interfaces (BCI) per la rilevazione della coscienza in pazienti non responsivi. Il team DECODER sta sviluppando diversi sistemi che consentiranno di valutare lo stato di coscienza nei pazienti non responsivi utilizzando diversi paradigmi di stimolazione dei canali sensoriali (uditivi, visivi, tattili), senso-motori e mentali.

Il progetto è iniziato nel febbraio 2010. Il team DECODER ha presentato lo scorso 11 e 12 aprile a Parigi, durante il primo INTERNATIONAL DECODER WORKSHOP, i primi risultati promettenti al pubblico scientifico e non-scientifico.

Call: FP7-ICT-2009-4

Project no.: 247919

Budget: 2.799.921,00 €

Durata del progetto: February 2010 - February 2013

Coordinato da: University of Würzburg, Germany

Partners: Fondazione Santa Lucia, Italy; Technische Universität Graz, Austria; Medical Research Council, UK; Universiteit Maastricht, The Netherlands; Université de Liège, Belgium; Eberhard Karls Universität Tübingen, Germany; Association du Locked-In Syndrom (ALIS), France; Guger Technologies OG, Austria.

Contatto: Prof. Dr. Andrea Kübler (Coordinatore)

DECODER sfrutta le soluzioni ssBCI (Single-Switch Brain Computer Interface) per migliorare le capacità dei pazienti che sono poco o per nulla in grado di interagire con l'ambiente.

Attraverso l'implementazione delle Brain Computer Interface (BCI) per i pazienti non responsivi sarà possibile accedere alle moderne tecnologie dell'informazione e della comunicazione, come internet, elettrodomestici, personal computer  anche se avranno la possibilit di poter dare una singola risposta per volta.

Per queste situazioni estreme, nessun ausilio tecnologico corrente è in grado di aiutare il paziente ad interagire con l'ambiente. Situazione che pone seri problemi etici, in quanto il trattamento medico può prolungare la vita dei pazienti,  lasciandoli però con una qualità della vita in uno stato di inaccettabile.

Per poter raggiungere questi risultati si sta lavorando per migliorare  gli attuali sistemi di BCI su tre componenti:

  • acquisizione del segnali (in ingresso - input),
  • classificazione dei segnali,
  • traduzione dei segnali (in uscita – output o feedback)

per adeguarli alle specificità di pazienti non responsivi o con bassa responsività che spesso mostrano: attenzione di breve durata, ed alterata attività elettrica del cervello.

Un quarto componente del progetto è l'applicazione. Esistono già oggi ausili tecnologici in grado controllabili tramite ssBCI. Oltre a classici paradigmi EEG, sarà utilizzata la tecnologia NIRS (Near Infrared Reflectance Spectroscopy - NIRS) in grado di fornire un segnale ad alta risoluzione spaziale. Le potenzialità offerte dai software che effettueranno l’elaborazione dei segnali digitali in ingresso consentiranno di automatizzare l’individuazione del miglior segnale cerebrale per ogni utente ottimizzandone la traduzione in azioni.

Prima di fornire questo soluzioni ai pazienti, è importante che la  diagnosi sia inequivocabile per poter definire la strategia riabilitativa e la soluzione tecnologica di supporto per l'interazione più appropriata.

Un approccio diagnostico gerarchico che parte dalla semplice presentazione di stimoli fino al controllo intenzionale, tramite l’utilizzo di ausili tecnologici basati sulla BCI, saranno sviluppati, convalidati e diffusi.

Brain Computer Interfaces for the Detection of Consciousness in Non-Responsive Patients
Boulogne-Billancourt, Francia 11 e 12 aprile 2012

Dr. Frédéric Pellas (Centre Hospitalier Universitaire Nimes, Francia), ha moderato il workshop e supportato l'interazione tra i relatori, il pubblico e gli scienziati DECODER.

 

Ultimo aggiornamento Lunedì 23 Aprile 2012 11:54
 

Brain-to-brain verbal communication in humans achieved for the first time

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Abstract

Human sensory and motor systems provide the natural means for the exchange of information between individuals, and, hence, the basis for human civilization. The recent development of brain-computer interfaces (BCI) has provided an important element for the creation of brain-to-brain communication systems, and precise brain stimulation techniques are now available for the realization of non-invasive computer-brain interfaces (CBI). These technologies, BCI and CBI, can be combined to realize the vision of non-invasive, computer-mediated brain-to-brain (B2B) communication between subjects (hyperinteraction). Here we demonstrate the conscious transmission of information between human brains through the intact scalp and without intervention of motor or peripheral sensory systems. Pseudo-random binary streams encoding words were transmitted between the minds of emitter and receiver subjects separated by great distances, representing the realization of the first human brain-to-brain interface. In a series of experiments, we established internet-mediated B2B communication by combining a BCI based on voluntary motor imagery-controlled electroencephalographic (EEG) changes with a CBI inducing the conscious perception of phosphenes (light flashes) through neuronavigated, robotized transcranial magnetic stimulation (TMS), with special care taken to block sensory (tactile, visual or auditory) cues. Our results provide a critical proof-of-principle demonstration for the development of conscious B2B communication technologies. More fully developed, related implementations will open new research venues in cognitive, social and clinical neuroscience and the scientific study of consciousness. We envision that hyperinteraction technologies will eventually have a profound impact on the social structure of our civilization and raise important ethical issues.

 

You can read the full study online in the journal PLOS One.

 

Ultimo aggiornamento Domenica 07 Settembre 2014 11:17
 
 

Smart Aircrew Integrated Life Support System

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"The computer seems to know more than anyone how well things are going, what has occurred, what is going to happen, and what to do about it", said AILSS engineering lead Cesar Gradilla.

In May 2004, The Naval Air Warfare Center Aircraft division (NAWCAD) contracted Dryden to test and evaluate a new system called SAILSS (Smart Aircrew Integrated Life Support System).

 

NASA F-18 preparing for a flight during
the Smart Aircrew Integrated
Life Support System tests.
(NASA photo)



SMART connotes intelligence. Smart systems know what to do and when to do it. Smart AILSS, or SAILSS, links the knowledge of aircrew medical state to the aircraft, and the computer not only knows what the aircraft is doing but how the aircrew is doing in response to those stresses imposed. But, what's unique is that the computer also controls the support systems helping the aircrew perform better, longer, and more confidently.

SAILSS monitors the pilot’s physiological data to determine state (e.g. pulse, breathing rates, oxygen, flow, brain wave and muscle activity) via sensors embedded in garments, mask and the helmet. The data collected is used to adjust the control of life support equipment, including the anti-G suit, positive pressure-breathing oxygen systems for G and high-altitude protection, and provides the capability to adjust the cooling flow to the ensemble.

The overall goal is to develop an integrated system that consists of a suite of sensors, signal processing, algorithms, control valves, and a computer. The current targeted sensors are: EEG and SpO2 in the helmet, EMG, ECG and RH in the sensor shirt, and respiration and mask flow/ pressure in the oxygen mask. The use of Near Infrared Spectroscopy (NIRS) will be investigated as an adjunct measure of cerebral oxygenation and consideration shall be made to incorporate this into the sensor suite within SAILSS. It is expected that arrays of sensors will be used to test and evaluate the most strategic sensor placement locations, albeit early in the program before refinement leads to a simpler approach. This is one of the major activities under SAILSS. Accordingly, the data acquisition and processing will be built to accommodate such approach. As this will be an iterative task the contractor expects full NAVY participation as the design and integration evolve.

The Navy Aircrew Integrated Life Support System (AILSS) team has just completed a first flight by NASA pilot Dana Purify of a state-of-the-art integrated computer system in an F/A-18 at the Dryden flight Research Center. As if taken from a chapter in a Star Wars episode, this marks the first time that a system of this kind has ever flown in an aircraft. The R2-D2 like system acquires real-time medical state data from the pilot and the aircraft and then controls the on-board systems based on the combined man and machine state and environment. First flight comes on the heels of two manned centrifuge evaluations in one year, demonstrating the closed loop computer control and real time data acquisition and decision making of the computer.

The First Flight occurred on July 1, 2004 and was a major milestone in the development of the state of the art integrated monitoring and control system technology that has been in work for over a decade.

Fonte: www.nasa.gov

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