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Reconstructing Covert Consciousness: Neural Decoding as a Novel Consciousness Assessment.
Neurology
February 2025
Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia.
Determining the level of consciousness in patients with brain injury-and more fundamentally, establishing what they can experience-is ethically and clinically impactful. Patient behaviors may unreliably reflect their level of consciousness: a subset of unresponsive patients demonstrate covert consciousness by willfully modulating their brain activity to commands through fMRI or EEG. However, current paradigms for assessing covert consciousness remain fundamentally limited because they are insensitive, rely on imperfect assumptions of functional neuroanatomy, and do not reflect the spectrum of conscious experience.
View Article and Find Full Text PDFLong-Term Treatment With Ocrelizumab in Patients With Early-Stage Relapsing MS: Nine-Year Data From the OPERA Studies Open-Label Extension.
Neurology
February 2025
Department of Neurology and Center of Clinical Neuroscience, First Medical Faculty, General University Hospital and Charles University, Prague, Czech Republic.
Background And Objectives: Patients with multiple sclerosis (MS) may demonstrate better disease control when treatment is initiated on high-efficacy disease-modifying therapies (DMTs) from onset. This subgroup analysis assessed the long-term efficacy and safety profile of the high-efficacy DMT ocrelizumab (OCR) as first-line therapy for early-stage relapsing MS (RMS).
Methods: Post hoc exploratory analyses of efficacy and safety were performed in a subgroup of treatment-naive patients with RMS who received ≥1 dose of OCR in the multicenter OPERA I/II (NCT01247324/NCT01412333) studies.
Intraprocedural Three-Dimensional Imaging Registration Optimizes Magnetic Resonance Imaging-Guided Focused Ultrasound and Facilitates Novel Applications.
Oper Neurosurg (Hagerstown)
November 2024
Department of Neurosurgery, University of Pennsylvania Health System, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA.
Background And Objective: Transcranial magnetic resonance-guided focused ultrasound (MRgFUS) has revolutionized ablative treatment of essential tremor in recent years. However, limitations in precision targeting may account for suboptimal efficacy and significant side effects. We describe a simple intraprocedural three-dimensional image-guided lesion shaping technique that can improve overall outcomes of MRgFUS for essential tremor and facilitate expansion to novel indications.
View Article and Find Full Text PDFUltra-Low-Field Portable Brain Magnetic Resonance Imaging in Patients With Cardiac Devices: Current Evidence and Future Directions.
ASAIO J
January 2025
From the Division of Cardiac Surgery, Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland.
The use of cardiac devices, including mechanical circulatory support (MCS), cardiac implantable electronic devices (CIEDs), and pacing wires, has increased and significantly improved survival in patients with severe cardiac failure. However, these devices are frequently associated with acute brain injuries (ABIs) including ischemic strokes, intracranial hemorrhages, seizures, and hypoxic-ischemic brain injury which contribute substantially to morbidity and mortality. Computed tomography (CT) and magnetic resonance imaging (MRI), the standard imaging modalities for ABI diagnosis, can pose significant challenges in this patient population due to the risks associated with patient transportation and the incompatibility of ferromagnetic components of certain cardiac devices with high magnetic field of the MRI.
View Article and Find Full Text PDFRight Ventricular Myocardial Infarction: Pathophysiology, Diagnosis, and Therapeutic Approaches.
Cardiol Rev
January 2025
Departments of Cardiology and Medicine, New York Medical College and Westchester Medical Center, Valhalla, NY.
Right ventricular myocardial infarction (RVMI) is a significant and distinct form of acute myocardial infarction associated with considerable morbidity and mortality. It occurs most commonly due to proximal right coronary artery obstruction, often in conjunction with inferior myocardial infarction. RVMI poses unique diagnostic and therapeutic challenges due to the anatomical and functional differences between the right and left ventricles.
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