Publications by authors named "Athina Vrosgou"
Article Synopsis
- The study explores how health care professionals and surrogates (family members) of patients with severe neurological injuries perceive the use of Cognitive Motor Dissociation (CMD) in making decisions about goals of care (GoC) and research involvement.
- Findings show that 93% of participants would consider research participation if CMD indicated potential for recovery, compared to just 58% if CMD was negative.
- It highlights that health care professionals are more likely to alter GoC based on CMD results compared to surrogates, with religious beliefs influencing how strongly participants might change their goals of care.
Background: Patients with brain injury who are unresponsive to commands may perform cognitive tasks that are detected on functional magnetic resonance imaging (fMRI) and electroencephalography (EEG). This phenomenon, known as cognitive motor dissociation, has not been systematically studied in a large cohort of persons with disorders of consciousness.
Methods: In this prospective cohort study conducted at six international centers, we collected clinical, behavioral, and task-based fMRI and EEG data from a convenience sample of 353 adults with disorders of consciousness.
In unconscious appearing patients with acute brain injury, wilful brain activation to motor commands without behavioural signs of command following, known as cognitive motor dissociation (CMD), is associated with functional recovery. CMD can be detected by applying machine learning to EEG recorded during motor command presentation in behaviourally unresponsive patients. Identifying patients with CMD carries clinical implications for patient interactions, communication with families, and guidance of therapeutic decisions but underlying mechanisms of CMD remain unknown.
View Article and Find Full Text PDFObjectives: Low hemoglobin concentration impairs clinical hemostasis across several diseases. It is unclear whether hemoglobin impacts laboratory functional coagulation assessments. We evaluated the relationship of hemoglobin concentration on viscoelastic hemostatic assays in intracerebral hemorrhage (ICH) and perioperative patients admitted to an ICU.
View Article and Find Full Text PDFBackground: Little is known about the natural history of comatose patients with brain injury, as in many countries most of these patients die in the context of withdrawal of life-sustaining therapies (WLSTs). The accuracy of predicting recovery that is used to guide goals-of-care decisions is uncertain. We examined long-term outcomes of patients with ischemic or hemorrhagic stroke predicted by experienced clinicians to have no chance of meaningful recovery in Japan, where WLST in patients with isolated neurological disease is uncommon.
View Article and Find Full Text PDFBackground: Impaired consciousness is common in intensive care unit (ICU) patients, and an individual's degree of consciousness is crucial to determining their care and prognosis. However, there are no methods that continuously monitor consciousness and alert clinicians to changes. We investigated the use of physiological signals collected in the ICU to classify levels of consciousness in critically ill patients.
View Article and Find Full Text PDFBackground: Recovery trajectories of clinically unresponsive patients with acute brain injury are largely uncertain. Brain activation in the absence of a behavioural response to spoken motor commands can be detected by EEG, also known as cognitive-motor dissociation. We aimed to explore the role of cognitive-motor dissociation in predicting time to recovery in patients with acute brain injury.
View Article and Find Full Text PDFArticle Synopsis
- A study in Beijing, China, explored the barriers to medication adherence for stroke patients, highlighting the complexities of adherence in low- and middle-income settings.
- The research involved 36 participants, including patients, caregivers, and healthcare providers, and identified four key themes affecting medication adherence: patient knowledge and attitudes, insufficient interaction time with providers, lack of healthcare coordination, and high costs due to limited insurance.
- The findings suggest that addressing these barriers could lead to policy reforms and practice improvements, which could be applied to similar challenges in other urban areas of low- and middle-income countries.