Markers of too little effort or too much alertness during neuropsychological assessment: Demonstration with perioperative changes.

Objective: Cognitive assessment is based on performance in different tests. However, this performance might be hindered by lack of effective effort on the one hand, and by too much stress on the other hand. Despite their known impact, there are currently no effective tools for measuring cognitive effort or stress effect during cognitive assessment.

Intraoperative EEG-based monitors: are we looking under the lamppost?

Purpose Of Review: While electroencephalogram (EEG)-based depth of anesthesia monitors have been in use clinically for decades, there is still a major debate concerning their efficacy for detecting awareness under anesthesia (AUA). Further utilization of these monitors has also been discussed vividly, for example, reduction of postoperative delirium (POD).It seems that with regard to reducing AUA and POD, these monitors might be applicable, under specific anesthetic protocols.

Association Between Risk of Stroke and Delirium After Cardiac Surgery and a New Electroencephalogram Index of Interhemispheric Similarity.

Objectives: Neurologic complications after surgery (stroke, delirium) remain a major concern despite advancements in surgical and anesthetic techniques. The authors aimed to evaluate whether a novel index of interhemispheric similarity, the lateral interconnection ratio (LIR), between 2 prefrontal electroencephalogram (EEG) channels could be associated with stroke and delirium following cardiac surgery.

Design: Retrospective observational study.

Evaluating a Novel EEG-Based Index for Stroke Detection Under Anesthesia During Mechanical Thrombectomy.

Background: The rapid identification of acute stroke (AS) during and after anesthesia might lead to early interventions and improved outcomes. We investigated a novel 2-channel electroencephalogram (EEG)-based marker for stroke detection-the lateral interconnection ratio (LIR)-in AS patients having endovascular thrombectomy (EVT) with general anesthesia (GA) or sedation. The LIR in 2 reference groups of patients without postoperative neurological complications was used for comparison.

Identifying Recall Under Sedation by a Novel EEG Based Index of Attention-A Pilot Study.

Overview: Recall is an accepted consequence of sedation. But due to the very low prevalence of the more devastating awareness under anesthesia (AUA), it might be of value to assess first the efficacy of new markers for AUA by their efficacy in discovering the more prevalent recall under sedation (RUS). In this pilot study we assessed whether a novel index for attentional effort, the cognitive effort index (CEI), derived in real-time from one forehead EEG channel, could differentiate between patients with or without RUS.

A Theoretical Comprehensive Framework for the Process of Theories Formation.

Scientists rely more and more upon computerized data mining and artificial intelligence to analyze data sets and identify association rules, which serve as the basis of evolving theories. This tendency is likely to expand, and computerized intelligence is likely to take a leading role in scientific theorizing. While the ever-advancing technology could be of great benefit, scientists with expertise in many research fields do not necessarily understand thoroughly enough the various assumptions, which underlie different data mining methods and which pose significant limitations on the association rules that could be identified in the first place.

Real-time monitoring of barriers to patient engagement for improved rehabilitation: a protocol and representative case reports.

Purpose: There is ample evidence that patient engagement is of major clinical importance in rehabilitation, and it seems this engagement is based upon effective allocation of attention to the tasks during the rehabilitation session. It is possible to discern two types of barriers which hinder attentive engagement: (1) dysfunctional affective coping and (2) limited cognitive recruitment and specifically attention deficit. These barriers might be general for a given patient, due to pre-morbid or co-morbid dysfunctions.

Differential signaling patterns of stimulated bone marrow-derived dendritic cells under α1-antitrypsin-enriched conditions.

Dendritic cells (DCs) mature upon an inflammatory trigger. However, an inflammatory trigger can lead to a semi-mature phenotype, allowing DCs to evoke tolerance and expedite the resolution of inflammation. This duality likely involves context-dependent modulation of inflammatory signaling.

Bedside patient engagement monitor for rehabilitation in disorders of consciousness - demonstrative case-reports.

Aim: A chronic disorder of consciousness (DOC) is a devastating condition for the patients and their families. Achieving improved communication with patients in this state is of utmost importance. Over recent years we have seen some progress in the development of rehabilitation protocols for patients with DOC by which the patient's limited actions impact the environment (e.

The Effects of Anesthetics on the Cortex-Lessons From Event-Related Potentials.

Consciousness while under general anesthesia is a dreadful condition. Various electroencephalogram (EEG)-based technologies have been developed, on the basis of empirical evidence, in order to identify this condition. However, certain electrophysiological phenomena, which seem strongly related with depth of anesthesia in some drugs, appear less consistent with those of other anesthetic drugs.

A New Index of Coordinated Posterior and Anterior Evoked EEG to Detect Recall Under Sedation - A Pilot Study.

EEG-based technologies may be limited in identifying recall under sedation (RUS). We developed a novel index, posteriorization/anteriorization (P/A) index, based on auditory evoked EEG signal and assessed whether it could differentiate between patients with or without RUS. Methods: EEG and BIS were sampled from 3 groups: 1.

A pilot study on the electrophysiological monitoring of patient's engagement in post-stroke physical rehabilitation.

This study discusses the feasibility of an electrophysiological monitor for patient engagement during rehabilitation sessions. While patient engagement has a significant clinical role, it is not obvious how its real-time monitoring could be used. We designed this study to provide further support for the feasibility of such a tool based on the Brain Engagement Index (BEI), and to discuss clinical usefulness and its evaluation.

Neuropsychiatric Disorders as Erratic Attention Regulation - Lessons from Electrophysiology.

Attention related electrophysiological waves, such as P300, often deviate from norm in various populations of neuropsychiatric patients. For example, the amplitude is often smaller and the latency is often longer in major depressive disorder, in bipolar disorder and in schizophrenia. On the other hand, in other neuropsychiatric populations, it is often possible to note the opposite phenomena of larger P300 amplitude and shorter latency in comparison with norm, but only for a specific subset of stimuli.

Depletion of B cells rejuvenates the peripheral B-cell compartment but is insufficient to restore immune competence in aging.

Aging is associated with increasing prevalence and severity of infections caused by a decline in bone marrow (BM) lymphopoiesis and reduced B-cell repertoire diversity. The current study proposes a strategy to enhance immune responsiveness in aged mice and humans, through rejuvenation of the B lineage upon B-cell depletion. We used hCD20Tg mice to deplete peripheral B cells in old and young mice, analyzing B-cell subsets, repertoire and cellular functions in vitro, and immune responsiveness in vivo.

Monitoring Migraine Cycle Dynamics with an Easy-to-Use Electrophysiological Marker-A Pilot Study.

Migraine attacks can cause significant discomfort and reduced functioning for days at a time, including the pre-ictal and post-ictal periods. During the inter-ictsal period, however, migraineurs seem to function normally. It is puzzling, therefore, that event-related potentials of migraine patients often differ in the asymptomatic and inter-ictal period.

Simple Electroencephalographic Treatment-Emergent Marker Can Predict Repetitive Transcranial Magnetic Stimulation Antidepressant Response-A Feasibility Study.

Objectives: Prefrontal repetitive transcranial magnetic stimulation (rTMS) repeated daily for 4 to 6 weeks is used to treat major depressive disorder, but more than 50% of patients do not achieve significant response. Here we test the validity of a simple electroencephalographic (EEG) marker that predicts nonresponse to rTMS. Such a marker could potentially increase rTMS effectiveness by directing nonresponders to alternative treatments or by guiding early modification of stimulation parameters.

Monitoring Attention in ADHD with an Easy-to-Use Electrophysiological Index.

Attention deficit hyperactivity disorder (ADHD) involves characteristic electroencephalographic (EEG) activity. We developed a single-channel EEG marker for attention: the Brain Engagement Index (BEI'). In this study, we evaluated the use of BEI' for distinguishing between ADHD patients and controls, and for monitoring the effect of pharmacological treatment on ADHD patients.

An EEG Tool for Monitoring Patient Engagement during Stroke Rehabilitation: A Feasibility Study.

Objective: Patient engagement is of major significance in neural rehabilitation. We developed a real-time EEG marker for attention, the Brain Engagement Index (BEI). In this work we investigate the relation between the BEI and temporary functional change during a rehabilitation session.

A Pilot Study of Possible Easy-to-Use Electrophysiological Index for Early Detection of Antidepressive Treatment Non-Response.

Introduction: The evaluation of response to pharmacological treatment in MDD requires 4-8 weeks. Therefore, the ability to predict response, and especially lack of response to treatment, as early as possible after treatment onset or change, is of prime significance. Many studies have demonstrated significant results regarding the ability to use EEG and ERP markers, including attention-associated markers such as P300, for early prediction of response to treatment.

Exploration of α1-antitrypsin treatment protocol for islet transplantation: dosing plan and route of administration.

Life-long weekly infusions of human α1-antitrypsin (hAAT) are currently administered as augmentation therapy for patients with genetic AAT deficiency (AATD). Several recent clinical trials attempt to extend hAAT therapy to conditions outside AATD, including type 1 diabetes. Since the endpoint for AATD is primarily the reduction of risk for pulmonary emphysema, the present study explores hAAT dose protocols and routes of administration in attempt to optimize hAAT therapy for islet-related injury.

A Possible Common Neurophysiologic Basis for MDD, Bipolar Disorder, and Schizophrenia: Lessons from Electrophysiology.

There is ample electrophysiological evidence of attention dysfunction in the EEG/ERP signal of major depressive disorder (MDD), bipolar disorder, and schizophrenia. The reduced attention-related ERP waves show much similarity between MDD, bipolar disorder, and schizophrenia, raising the question whether there are similarities in the neurophysiologic process that underlies attention dysfunction in these pathologies. The present work suggests that there is such a unified underlying neurophysiologic process, which results in reduced attention in the three pathologies.

Migraine as dysfunctional drive reduction: Insight from electrophysiology.

Migraine is a prevalent disease, which may cause significant discomfort and reduced functioning for days, including the preictal and postictal periods. During the interictal period, however, migraineurs seem to function normally. It is puzzling, therefore, that event-related potentials (ERPs) of migraine patients often differ at the group level also in the asymptomatic, interictal phase, both in early and later ERP waves.

B Cell Development in the Bone Marrow Is Regulated by Homeostatic Feedback Exerted by Mature B Cells.

Cellular homeostasis in the B cell compartment is strictly imposed to balance cell production and cell loss. However, it is not clear whether B cell development in the bone marrow is an autonomous process or subjected to regulation by the peripheral B cell compartment. To specifically address this question, we used mice transgenic for human CD20, where effective depletion of B lineage cells is obtained upon administration of mouse anti-human CD20 antibodies, in the absence of any effect on other cell lineages and/or tissues.

Murine peripheral NK-cell populations originate from site-specific immature NK cells more than from BM-derived NK cells.

Murine NK cells can be divided by the expression of two cell surface markers, CD27 and Mac-1 (a.k.a.