Functional magnetic resonance imaging under anaesthesia of a patient with severe chronic disorders of consciousness.

Clinical Case: We report on a 19-year old male patient who is recovering from near-drowning. The patient was admitted for re-evaluation in a Minimally Conscious State.

Method: A regular functional Magnetic Resonance Imaging was not possible due to complex motor tics of the patient with sudden flexion and extension movements of arms and legs as well as opisthotonic retroflexion of the head and trunk.

Effects of long-duration space flights on characteristics of the vertical gaze fixation reaction.

The aim of the study was to examine effects of long-duration exposure to weightlessness on characteristics of the vertical gaze fixation reaction (GFR). The subjects were to perform the target acquisition task on visual stimuli that appeared at a distance of 16 deg. up- and down from the primary position in a random order.

The vegetative state--a syndrome in search of a name.

In 2002, Bryan Jennett chose the caption "A syndrome in search of a name" for the first chapter of his book "The vegetative state--medical facts, ethical and legal dilemmas", which, in summary, can be taken as his legacy. Jennett coined the term "VegetativeState" (VS), which became the preferential name for the syndrome of wakeful unresponsiveness in the English literature, with the intention to specify the concern and dilemmas in connection with the naming "vegetative", "persistent" and "permanent". In Europe, Apallic Syndrome (AS) is still in use.

Mild traumatic brain injury.

Traumatic Brain Injury (TBI) is among the most frequent neurological disorders. Of all TBIs 90% are considered mild with an annual incidence of 100–300/100.000.

Cortical excitability changes in patients with sleep-wake disturbances after traumatic brain injury.

Although chronic sleepiness is common after head trauma, the cause remains unclear. Transcranial magnetic stimulation (TMS) represents a useful complementary approach in the study of sleep pathophysiology. We aimed to determine in this study whether post-traumatic sleep-wake disturbances (SWD) are associated with changes in excitability of the cerebral cortex.

Variability of BOLD response evoked by foot vibrotactile stimulation: influence of vibration amplitude and stimulus waveform.

The aim of the present was study to evaluate cortical and subcortical neural responses on vibrotactile stimulation of the food and to assess somatosensory evoked BOLD responses in dependence of vibration amplitude and stimulus waveform. Sixteen healthy male subjects received vibrotactile stimulation at the sole of the right foot. The vibration stimulus was delivered through a moving magnet actuator system (MMAS).

Alterations of characteristics of horizontal gaze fixation reaction in long-term space flights.

The study was performed to explore effects of long-duration SF on the characteristics of horizontal gaze fixation reaction (hGFR). Changes in GFR observed in long-duration space flight (SF) point out to serious disturbances of the VOR system due to, apparently, altered vestibular activity. Two strategies of reaction adaptation to the microgravity conditions were discovered in cosmonauts of civic occupations and pilots.

[Scuba diving -- a therapeutic option for patients with paraplegia].

Objective: Spasticity is often a handicap in paraplegics and interferes with quality of life. Medical therapeutic options (e.g.

Contact force- and amplitude-controllable vibrating probe for somatosensory mapping of plantar afferences with fMRI.

Purpose: To study cerebral responses evoked from mechanoreceptors in the human foot sole using a computer-controlled vibrotactile stimulation system.

Materials And Methods: The stimulation system consisted of two stationary moving magnet actuators with indentors to gently contact and vibrate the foot sole during functional MRI (fMRI) experiments. To allow independent settings of contact force (0-20 N) and intensity of vibration (frequency range=20-100 Hz) the actuators were controlled by a digital servo loop.

Human brain structures related to plantar vibrotactile stimulation: a functional magnetic resonance imaging study.

The purpose of this study was to investigate the sensorimotor cortex response to plantar vibrotactile stimulation using a newly developed MRI compatible vibration device. Ten healthy subjects (20-45 years) were investigated. Vibrotactile stimulation of the sole of the foot with a frequency of 50 Hz and a displacement of 1 mm was performed during fMRI (echo-planar imaging sequence at 1.

The influence of microgravity on memorized arm movements.

To investigate sensory and motor functions in microgravity, goal-oriented arm movements were performed by 9 cosmonauts in weightlessness. The ability to reproduce predefined motor patterns was examined pre-, in-, and post-flight under two different paradigms: In a first test, the cosmonaut had to reproduce passively learned movements with eyes closed, while in the second test, the cosmonaut learned the pattern with eyes open. The different learning paradigms effected the metric parameters of the memorized stimulus pattern while the influence of the different gravity levels resulted in significant offsets and torsions of the reproduced figures.

Stepping-like movements in humans with complete spinal cord injury induced by epidural stimulation of the lumbar cord: electromyographic study of compound muscle action potentials.

Study Design: It has been previously demonstrated that sustained nonpatterned electric stimulation of the posterior lumbar spinal cord from the epidural space can induce stepping-like movements in subjects with chronic, complete spinal cord injury. In the present paper, we explore physiologically related components of electromyographic (EMG) recordings during the induced stepping-like activity.

Objectives: To examine mechanisms underlying the stepping-like movements activated by electrical epidural stimulation of posterior lumbar cord structures.

Initiating extension of the lower limbs in subjects with complete spinal cord injury by epidural lumbar cord stimulation.

We provide evidence that the human spinal cord is able to respond to external afferent input and to generate a sustained extension of the lower extremities when isolated from brain control. The present study demonstrates that sustained, nonpatterned electrical stimulation of the lumbosacral cord--applied at a frequency in the range of 5-15 Hz and a strength above the thresholds for twitches in the thigh and leg muscles--can initiate and retain lower-limb extension in paraplegic subjects with a long history of complete spinal cord injury. We hypothesize that the induced extension is due to tonic input applied by the epidural stimulation to primary sensory afferents.

Slowing of human arm movements during weightlessness: the role of vision.

The human motor system responds to weightlessness by the slowing of movement. It has been suggested that deficits in visuo-motor co-ordination cause this effect. We studied the mechanisms of the slowing of movement in three long-term missions to the Russian space station Mir.

EFNS guideline on mild traumatic brain injury: report of an EFNS task force.

In 1999, a Task Force on Mild Traumatic Brain Injury (MTBI) was set up under the auspices of the European Federation of Neurological Societies. Its aim was to propose an acceptable uniform nomenclature for MTBI and definition of MTBI, and to develop a set of rules to guide initial management with respect to ancillary investigations, hospital admission, observation and follow-up.

Epidural electrical stimulation of posterior structures of the human lumbosacral cord: 3. Control Of spasticity.

Objectives: The purpose of this study was to evaluate the effect of spinal cord stimulation (SCS) on severe spasticity of the lower limbs in patients with traumatic spinal cord injury (SCI) under close scrutiny of the site and parameters of stimulation.

Materials And Methods: Eight SCI patients (four women, four men) were included in the study. Levels of spasticity before and during stimulation were compared according to a clinical rating scale and by surface electrode polyelectromyography (pEMG) during passive flexion and extension of the knee, supplemented by a pendulum test with the stimulating device switched either on or off over an appropriate period.

Adolf Hitler's Parkinson's disease and an attempt to analyse his personality structure.

It has been proved that Adolf Hitler suffered from idiopathic Parkinson's disease. No indication for postencephalitic parkinsonism was found in the clinical symptoms or the case history. Professor Max de Crinis established his diagnosis of Parkinson's disease in Hitler early in 1945 and informed the SS leadership, who decided to initiate treatment with a specially prepared 'antiparkinsonian mixture' to be administered by a physician.

The effect of head-to-trunk position on the direction of arm movements before, during, and after space flight.

This contribution deals with the examination of the consequences of different head-to-trunk positions on arm movements under normal gravity and during prolonged space flight. One of the objectives of this study was to investigate the influence of weightlessness on the condition of the spatial analysis system. Aimed arm movements in the horizontal plane (pointings towards two visual targets) were recorded, first with eyes open, head straight (learning part), then with eyes closed, head straight and during yaw or roll position of the head (performance part).

Presence of Klùver-Bucy syndrome as a positive prognostic feature for the remission of traumatic prolonged disturbances of consciousness.

After severe brain injury a prolonged disturbance of consciousness may occur, sometimes with transient apallic syndrome (awakening without awareness of self and surroundings). Klùver-Bucy is described in the literature as a typical post-traumatic remission phase, in which the patients show an increase of oral automatisms and/or of sexual drive. The study describes Klùver-Bucy syndrome as a sign associated with favourable prognosis in the outcome of traumatic disturbances of consciousness in survivors of head trauma.