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Developing an EEG-based model to predict awakening after cardiac arrest using partial processing with the BIS Engine.
Anesthesiology
January 2025
Department of Anesthesiology, Brigham and Women's Hospital and Harvard Medical School, Boston MA, USA.
Introduction: Accurate prognostication in comatose survivors of cardiac arrest is a challenging and high-stakes endeavor. We sought to determine whether internal EEG subparameters extracted by the Bispectral Index (BIS) monitor, a device commonly used to estimate depth-of-anesthesia intraoperatively, could be repurposed to predict recovery of consciousness after cardiac arrest.
Methods: In this retrospective cohort study, we trained a 3-layer neural network to predict recovery of consciousness to the point of command following versus not based on 48 hours of continuous EEG recordings in 315 comatose patients admitted to a single US academic medical center after cardiac arrest (Derivation cohort: N=181; Validation cohort: N=134).
Intracerebroventricular anaerobic dopamine in Parkinson's disease with L-dopa-related complications: a phase 1/2 randomized-controlled trial.
Nat Med
January 2025
Parkinson's Disease Centre of Excellence, Department of Neurology, Univeristy of Lille, CHU Lille, INSERM U1172-Degenerative & Vascular Cognitive Disorders, Lille, France.
Continuous compensation for cerebral dopamine deficiency represents an ideal treatment for Parkinson's disease. Dopamine does not cross the digestive and blood-brain barriers and is rapidly oxidized. The new concept is the intracerebroventricular administration of anaerobic dopamine (A-dopamine) using an abdominal pump connected to a subcutaneous catheter implanted in the third ventricle, near the striatum.
View Article and Find Full Text PDFNeural Voices of Patients with Severe Brain Injury?
Camb Q Healthc Ethics
January 2025
Center for Consciousness Science, University of Michigan, Ann Arbor, MI, USA.
Studies have shown that some covertly conscious brain-injured patients, who are behaviorally unresponsive, can reply to simple questions via neuronal responses. Given the possibility of such neuronal responses, Andrew Peterson et al. have argued that there is warrant for some covertly conscious patients being included in low-stakes medical decisions using neuronal responses, which could protect and enhance their autonomy.
View Article and Find Full Text PDFAdaptive Platform Trials in Stroke.
Stroke
January 2025
Berry Consultants LLC, Austin, TX (E.L., A.M.C., S.M.B., R.J.L.).
Clinical trials of treatments for stroke have generally utilized 2-arm, randomized designs to evaluate a single intervention against a control. Running separate clinical trials, with each addressing a single therapeutic question, is resource intensive and slows evidence generation, especially in a field with rapidly expanding treatment options and evolving practices. Platform trials-randomized clinical trials designed to evaluate multiple interventions that may enter and exit the ongoing platform based on a master protocol-accelerate the investigation of multiple therapeutic options within a single infrastructure.
View Article and Find Full Text PDFOptical coherence tomography in secondary progressive multiple sclerosis: cross-sectional and longitudinal exploratory analysis from the MS-SMART randomised controlled trial.
J Neurol Neurosurg Psychiatry
December 2024
Queen Square Multiple Sclerosis Centre, Department of Neuroinflammation, UCL Queen Square Institute of Neurology, Faculty of Brain Sciences, University College London, London, UK.
Background: Optical coherence tomography (OCT) inner retinal metrics reflect neurodegeneration in multiple sclerosis (MS). We explored OCT measures as biomarkers of disease severity in secondary progressive MS (SPMS).
Methods: We investigated people with SPMS from the Multiple Sclerosis-Secondary Progressive Multi-Arm Randomisation Trial OCT substudy, analysing brain MRIs, clinical assessments and OCT at baseline and 96 weeks.
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