Terrellantonsen2965
A downside of Deep Brain Stimulation (DBS) for Parkinson's Disease (PD) is that cognitive function may deteriorate postoperatively. Electroencephalography (EEG) was explored as biomarker of cognition using a Machine Learning (ML) pipeline.
A fully automated ML pipeline was applied to 112 PD patients, taking EEG time-series as input and predicted class-labels as output. The most extreme cognitive scores were selected for class differentiation, i.e. best vs. worst cognitive performance (n=20 per group). 16,674 features were extracted per patient; feature-selection was performed using a Boruta algorithm. A random forest classifier was modelled; 10-fold cross-validation with Bayesian optimization was performed to ensure generalizability. The predicted class-probabilities of the entire cohort were compared to actual cognitive performance.
Both groups were differentiated with a mean accuracy of 0.92; using only occipital peak frequency yielded an accuracy of 0.67. Class-probabilities and actual cognitive performance were negatively linearly correlated (β=-0.23 (95% confidence interval (-0.29, -0.18))).
Particularly high accuracies were achieved using a compound of automatically extracted EEG biomarkers to classify PD patients according to cognition, rather than a single spectral EEG feature.
Automated EEG assessment may have utility for cognitive profiling of PD patients during the DBS screening.
Automated EEG assessment may have utility for cognitive profiling of PD patients during the DBS screening.
Cortico-cortical evoked potential (CCEP) by single-pulse electrical stimulation (SPES) is useful to investigate effective connectivity and cortical excitability. We aimed to clarify the safety of CCEPs.
We retrospectively analyzed 29 consecutive patients with intractable partial epilepsy undergoing chronic subdural grid implantation and CCEP recording. Repetitive SPES (1Hz) was systematically applied to a pair of adjacent electrodes over almost all electrodes. We evaluated the incidences of afterdischarges (ADs) and clinical seizures.
Out of 1283 electrode pairs, ADs and clinical seizures were observed in 12 and 5 pairs (0.94% and 0.39%, per electrode pair) in 7 and 3 patients (23.3% and 10.0%, per patient), respectively. Of the 18-82 pairs per patient, ADs and clinical seizures were induced in 0-4 and 0-3 pairs, respectively. Stimulating 4 SOZ (seizure onset zone) (2.5%) and 8 non-SOZ pairs (0.75%) resulted in ADs. We observed clinical seizures in stimulating 4 SOZ (2.5%) and 1 non-SOZ pair (0.09%). The incidence of clinical seizures varied significantly between SOZ and non-SOZ stimulations (p=0.001), while the difference in AD incidence tended towards significance (p=0.058).
Although caution should be taken in stimulating SOZ, CCEP is a safe procedure for presurgical evaluation.
CCEP is safe under the established protocol.
CCEP is safe under the established protocol.
This study aimed to assess the white matter (WM) functional hubs and abnormal functional connectivity pattern in adolescents with schizophrenia (AOS) and to explore the potential mechanisms.
Based on resting-state fMRI data, we measured the WM functional connectivity density (FCD) at local- and long- ranges in 39 AOS and 31 healthy controls (HCs). Group comparison was conducted between the two groups. Ceralasertib datasheet Spearman rank correlation analysis between the altered WM FCD and clinical PANSS scores was performed.
In the local scale, the functional hubs of the WM were mainly located in the corona radiata and cerebellum. Compared with HCs, AOS patients exhibited decreased FCD in the superior corona radiata. link2 In the long-range, the functional hubs of the WM were mainly located in the external capsule and pons. AOS patients exhibited increased FCD in the cingulum but decreased FCD in the right dorsal raphe nuclei (DR). Furthermore, the aberrant long-range FCD in the right DR was inversely proportional to the clinical symptoms.
These findings indicated that the pathophysiology of schizophrenia may also lie in WM functional dysconnectivity.
The current results provided initial evidence for the hypothesis of abnormal WM functional connectivity in schizophrenia.
The current results provided initial evidence for the hypothesis of abnormal WM functional connectivity in schizophrenia.
Non-invasive brain stimulation (NIBS) is beneficial to many neurological and psychiatric disorders by modulating neuroplasticity and cortical excitability. However, recent studies evidence that single type of NIBS such as transcranial direct current stimulation (tDCS) does not have meaningful clinical therapeutic responses due to their small effect size. Transcranial near-infrared stimulation (tNIRS) is a novel form of NIBS. Both tNIRS and tDCS implement its therapeutic effects by modulating cortical excitability but with different mechanisms. We hypothesized that simultaneous tNIRS and tDCS is superior to single stimulation, leading to a greater cortical excitability.
Sixteen healthy subjects participated in a double-blind, sham-controlled, cross-over designed study. Motor evoked potentials (MEPs) were used to measure motor cortex excitability. The changes of MEP were calculated and compared in the sham condition, tDCS stimulation condition, tNIRS condition and the simultaneous tNIRS and anodal tDCS condition.
tDCS alone and tNIRS alone both elicited higher MEP after stimulation, while the MEP amplitude in the simultaneous tNIRS and tDCS condition was significantly higher than either tNIRS alone or tDCS alone. The enhancement lasted up to at least 30 minutes after stimulation, indicating simultaneous 820nm tNIRS with 2mA anodal tDCS have a synergistic effect on cortical plasticity.
Simultaneous application of tNIRS with tDCS produces a stronger cortical excitability effect.
The simultaneous tNIRS and tDCS is a promising technology with exciting potential as a means of treatment, neuro-enhancement, or neuro-protection.
The simultaneous tNIRS and tDCS is a promising technology with exciting potential as a means of treatment, neuro-enhancement, or neuro-protection.
To describe EEG patterns of critical Coronavirus Disease 2019 (COVID-19) patients with suspicion of encephalopathy and test their association with clinical outcome.
EEG after discontinuation of sedation in all patients, and somesthesic evoked potentials and brainstem auditive evoked potentials when EEG did not show reactivity, were performed. Clinical outcome was assessed at day 7 and 14 after neurophysiological explorations.
33 patients were included for analysis. We found slowed background activity in 85% of cases, unreactive activity in 42% of cases, low-voltage activity in 21% of cases and rhythmic or periodic delta waves in 61% of cases. EEG epileptic events were never recorded. link3 Clinical outcome at day 14 was associated with unreactive background activity and tended to be associated with rhythmic or periodic delta waves and with low-voltage activity. Results of multimodal evoked potentials were in favor of a preservation of central nervous system somatosensory and auditory functions.
Among critical COVID-19 patients with abnormal arousal at discontinuation of sedation, EEG patterns consistent with encephalopathy are found and are predictive for short term clinical outcome.
The abnormal EEG with presence of periodic discharges and lack of reactivity could be related to encephalopathy linked to COVID-19.
The abnormal EEG with presence of periodic discharges and lack of reactivity could be related to encephalopathy linked to COVID-19.
To assess the accuracy of the rapid diagnostic test for malaria diagnosis in children under 5 years of age.
As of August 31, 2020, PubMed, Web of Science and Cochrane Library databases had been systematically searched. Relevant data were extracted and meta-analysis was carried out. A random effects model was used for subgroup analysis.
According to the inclusion criteria, a total of 26 studies were included in this meta-analysis. The pooled sensitivity and specificity were 0.92 (95% confidence interval 0.83-0.96) and 0.92 (0.86-0.95), the parasite-specific lactate dehydrogenase-based test were 0.96 (0.85-0.98) and 0.93 (0.86-0.95), the histidine-rich protein 2-based test were 0.94 (0.84-0.98) and 0.86 (0.77-0.91).
This meta-analysis showed that rapid diagnostic test had good accuracy in diagnosing malaria in children under 5 years of age. And the diagnostic performance of parasite-specific lactate dehydrogenase test was better than that of the histidine-rich protein 2 test.
This meta-analysis showed that rapid diagnostic test had good accuracy in diagnosing malaria in children under 5 years of age. And the diagnostic performance of parasite-specific lactate dehydrogenase test was better than that of the histidine-rich protein 2 test.Assessing the right ventricular function in patients with submassive pulmonary embolism (PE) is pivotal when determining the appropriate treatment pathway. We describe two cases of submassive PE requiring systemic thrombolysis, in which intravenous saline contrast demonstrated a noticeable lack of forward flow in the right ventricle. This technique potentially may indicate impending right ventricular functional collapse and the need for more aggressive intervention.
The degradation of muscle mass and loss of functional proteins due to catabolism are associated with adverse outcomes in critically ill patients. While an adequate supply of protein within a medical nutrition concept is suggested to minimize proteolysis, the specificities on appropriate dosage and timing are still under debate. The current study aimed to evaluate the effect of two different quantities of protein as part of a standardized energetically controlled nutrition therapy for the preservation of muscle mass in the later phase of critical illness.
A randomized controlled trial was conducted in 42 critically ill patients (age 65±15; 12 females; SAPS 45±11; TISS 20±7; SOFA-score 7±3). The subjects were randomly assigned to either the intervention (1.8g protein/kg body weight [BW]/d) or standard (1.2g protein/kg BW/d) group. Nutrient supply via enteral and/or parenteral nutrition was calculated based on the individual energy expenditure measured by indirect calorimetry and target protein content. Quadficant between-group differences (intervention effect, P=0.368; time x intervention effect, P=0.242). Illness scores and clinical outcomes showed no group differences.
In this single-center trial the increased amounts of protein (1.5g vs. 1.0g/kg BW/d) provided through medical nutrition therapy in the late phase of critical illness did not achieve a statistically significant impact on the loss of muscle mass in long-term immobilized ICU patients. Larger multi-center trials are needed to evaluate whether observed numerical differences in muscle mass could be a true finding, and will translate into improved clinical outcomes.
German Clinical Trials Register (http//www.drks.de/), DRKS-ID DRKS00013594.
German Clinical Trials Register (http//www.drks.de/), DRKS-ID DRKS00013594.
Previous studies have shown that a high baseline triglyceride-glucose (TyG) index is a potential risk factor for type 2 diabetes mellitus (T2DM). However, for a low TyG index, findings have been inconsistent. Moreover, the association between the baseline TyG index and incident T2DM in individuals with normal glycemic levels remains unclear. Therefore, this longitudinal study further examined and characterized the association between the baseline TyG index and incident T2DM in Japanese adults with normal glycemic levels. .
The participants (7857 men and 6440 women) were selected from the NAGALA (NAfld in the Gifu Area Longitudinal Analysis) study that was conducted from 2004 to 2015. Cox proportional hazards models were used to evaluate the associations between baseline TyG index and T2DM incidence, and a two-piecewise linear regression model was used to examine the threshold effect of the baseline TyG index on incident T2DM using a smoothing function.
During a median follow-up period of 5.26 (women) and 5.
