Recovery of consciousness after acute brain injury: a narrative review

Journal of Intensive Care, Journal Year: 2024, Volume and Issue: 12(1)

Published: Sept. 26, 2024

Abstract Background Disorders of consciousness (DoC) are frequently encountered in both, acute and chronic brain injuries. In many countries, early withdrawal life-sustaining treatments is common practice for these patients even though the accuracy predicting recovery debated delayed can be seen. this review, we will discuss theoretical concepts pathophysiology, explore effective strategies management, accurate prediction long-term clinical outcomes. We also address research challenges. Main text DoC characterized by alterations arousal and/or content, being classified as coma, unresponsive wakefulness syndrome/vegetative state, minimally conscious confusional state. Patients with willful modulation activity detectable functional MRI or EEG but not behavioral examination a state known covert cognitive motor dissociation. This may every 4th 5th patient without evidence verbal command following has been identified an independent predictor recovery. Underlying mechanisms uncertain intact thalamocortical projections maybe essential. Insights into underlying major importance provide framework to conceptualize treatment approaches, including medical, mechanical, electoral stimulation. Conclusions beginning gain insights DoC, identifying novel advanced prognostication tools improve predictions, starting targeted support patients. It essential determine how advancements implemented benefit across range settings global societal systems. The Curing Coma Campaign highlighted gaps knowledge provides roadmap advance field coma science goal DoC.

Language: Английский

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Dexmedetomidine Improves Anxiety-like Behaviors in Sleep-Deprived Mice by Inhibiting the p38/MSK1/NFκB Pathway and Reducing Inflammation and Oxidative Stress

Brain Sciences, Journal Year: 2023, Volume and Issue: 13(7), P. 1058 - 1058

Published: July 11, 2023

(1) Background: Sleep deprivation (SD) triggers a range of neuroinflammatory responses. Dexmedetomidine can improve sleep deprivation-induced anxiety by reducing response but the mechanism is unclear; (2) Methods: The model was established using an interference rod device. An open field test and elevated plus maze were used to detect emotional behavior mice. Mouse cortical tissues subjected RNA sequence (RNA-seq) analysis. Western blotting immunofluorescence expression p38/p-p38, MSK1/p-MSK1, NFκBp65/p- NFκBp65. Inflammatory cytokines detected enzyme-linked immunosorbent assay (ELISA); (3) Results: SD triggered anxiety-like behaviors in mice closely associated with inflammatory responses MAPK pathway (as demonstrated transcriptome analysis). led increased levels p-p38, p-MSK1, p-NFκB. P38 inhibitor SB203580 confirm important role p38/MSK1/NFκB SD-induced neuroinflammation. (Dex) effectively improves sleep-deprived attenuating oxidative stress cerebral cortex, mainly inhibiting activation pathway; (4) Conclusions: Dex inhibits pathway, thus cortex

Language: Английский

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Tracking the effects of propofol, sevoflurane and (S)-ketamine anesthesia using an unscented Kalman filter-based neural mass model

Journal of Neural Engineering, Journal Year: 2023, Volume and Issue: 20(2), P. 026023 - 026023

Published: March 9, 2023

Abstract Objective . Neural mass model (NMM) has been widely used to investigate the neurophysiological mechanisms of anesthetic drugs induced general anesthesia (GA). However, whether parameters NMM could track effects still unknown. Approach. We proposed using cortical (CNMM) infer potential mechanism three different (i.e. propofol, sevoflurane, and (S)-ketamine) GA, we employed unscented Kalman filter (UKF) any change in raw electroencephalography (rEEG) frontal area during GA. did this by estimating population gain [i.e. excitatory/inhibitory postsynaptic (EPSP/IPSP, i.e. parameter A / B CNMM) time constant rate EPSP/IPSP a b CNMM). compared rEEG simulated EEG (sEEG) from perspective spectrum, phase-amplitude coupling (PAC), permutation entropy (PE). Main results Under estimated A, , for propofol/sevoflurane or (S)-ketamine), sEEG had similar waveforms, time-frequency spectra, PAC patterns GA drugs. The PE curves derived high correlation coefficients (propofol: 0.97 ± 0.03, sevoflurane: 0.96 (S)-ketamine: 0.98 0.02) determination ( R 2 ) 0.86 0.68 0.30, 0.70 0.18). Except each drug CNMM can differentiate wakefulness non-wakefulness states. Compared with simulation parameters, UKF-based lower tracking accuracy under four B, a, Significance. demonstrate that combination UKF neural activities their interpret drug’s effect on brain, be as new index depth monitoring.

Language: Английский

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Ventral subiculum promotes wakefulness through several pathways in male mice

Neuropsychopharmacology, Journal Year: 2024, Volume and Issue: 49(9), P. 1468 - 1480

Published: May 11, 2024

Language: Английский

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A cortical locus for modulation of arousal states

bioRxiv (Cold Spring Harbor Laboratory), Journal Year: 2024, Volume and Issue: unknown

Published: May 26, 2024

Fluctuations in global arousal are key determinants of spontaneous cortical activity and function. Several subcortical structures, including neuromodulator nuclei like the locus coeruleus (LC), involved regulation arousal. However, much less is known about role circuits that provide top-down inputs to arousal-related structures. Here, we investigated a major subdivision prefrontal cortex, anterior cingulate cortex (ACC), modulation. Pupil size, facial movements, heart rate, locomotion were used as non-invasive measures behavioral state. We designed closed loop optogenetic system based on machine vision found real time inhibition ACC during pupil dilations suppresses ongoing events. In contrast, inhibiting control region had no effect Fiber photometry recordings showed scales with magnitude spontaneously occurring dilations/face movements independently locomotion. Moreover, activation increases addition modulating arousal, responses salient sensory stimuli scaled size evoked dilations. Consistent sustaining saliency-linked events, suppressed inactivation. Finally, our results comparing norepinephrinergic LC neuron support for initiation events which modulated by ACC. Collectively, experiments identify site momentary foundation understanding cortical-subcortical dynamics underlying modulation states.

Language: Английский

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