Annals of Neurology,
Journal Year:
2020,
Volume and Issue:
87(4), P. 618 - 632
Published: Jan. 29, 2020
Objective
Survivors
of
prolonged
(>2
weeks)
post–cardiac
arrest
(CA)
coma
are
expected
to
remain
permanently
disabled.
We
aimed
investigate
3
outlier
patients
who
ultimately
achieved
independent
functional
outcomes
after
post‐CA
identify
electroencephalographic
(EEG)
markers
their
recovery
potential.
For
validation
purposes,
we
also
evaluate
these
in
an
cohort
patients.
Methods
identified
with
late
from
(17–37
days)
following
CA
recovered
functionally
behavioral
levels.
performed
spectral
power
analyses
available
EEGs
during
prominent
burst
suppression
patterns
(BSP)
present
all
Using
identical
methods,
assessed
the
relationship
intraburst
and
a
prospectively
enrolled
chart
reviews
common
clinical,
imaging,
EEG
prognostic
variables
clinical
for
Results
All
lacked
evidence
overwhelming
cortical
injury
but
demonstrated
BSP
on
EEG.
Spectral
revealed
theta
(~4–7Hz)
feature
dominating
bursts
In
prospective
cohort,
similar
features
were
evident
favorable
outcomes;
unfavorable
showed
either
no
features,
transient
or
decreasing
frequencies
time.
Interpretation
peak
may
index
discuss
our
results
context
optimizing
metabolic
substrate
availability
stimulating
corticothalamic
system
coma.
ANN
NEUROL
2020;87:618–632
Intensive Care Medicine,
Journal Year:
2021,
Volume and Issue:
47(3), P. 265 - 281
Published: Feb. 26, 2021
A
decision
to
withdraw
life-sustaining
treatment
(WLST)
is
derived
by
a
conclusion
that
further
will
not
enable
patient
survive
or
produce
functional
outcome
with
acceptable
quality
of
life
the
and
treating
team
regard
as
beneficial.
Although
many
hospitalized
patients
die
under
such
circumstances,
controlled
donation
after
circulatory
determination
death
(cDCDD)
programs
have
been
developed
only
in
reduced
number
countries.
This
International
Collaborative
Statement
aims
at
expanding
cDCDD
world
help
countries
progress
towards
self-sufficiency
transplantation
offer
more
opportunity
organ
donation.
The
addresses
three
fundamental
aspects
pathway.
First,
it
describes
process
determining
prognosis
justifies
WLST,
should
be
prior
independent
any
consideration
which
transplant
professionals
must
participate.
Second,
establishes
permanent
cessation
circulation
brain
standard
determine
criteria.
Death
may
declared
an
elapsed
observation
period
5
min
without
brain,
confirms
absence
permanent.
Finally,
highlights
value
perfusion
repair
for
increasing
success
transplantation.
protocols
utilize
either
situ
ex
consistent
practice
each
country.
Methods
accomplish
normothermic
reperfusion
organs
preclude
restoration
invalidate
death.
Journal of Clinical Investigation,
Journal Year:
2020,
Volume and Issue:
unknown
Published: June 21, 2020
Neuromyelitis
optica
(NMO)
is
a
severe
inflammatory
autoimmune
CNS
disorder
triggered
by
binding
of
an
IgG
autoantibody
to
the
aquaporin
4
(AQP4)
water
channel
on
astrocytes.
Activation
cytolytic
complement
has
been
implicated
as
major
effector
tissue
destruction
that
secondarily
involves
myelin.
We
investigated
early
precytolytic
events
in
evolving
pathophysiology
NMO
mice
continuously
infusing
(NMO
patient
serum–derived
or
AQP4-specific
mouse
monoclonal),
without
exogenous
complement,
into
spinal
subarachnoid
space.
Motor
impairment
and
sublytic
NMO-compatible
immunopathology
were
dose
dependent,
AQP4
and,
unexpectedly,
microglia
dependent.
In
vivo
cord
imaging
revealed
striking
physical
interaction
between
astrocytes
required
signaling
from
C3a
fragment
their
upregulated
C3
protein.
Astrocytes
remained
viable
but
lost
AQP4.
Previously
unappreciated
crosstalk
involving
early-activated
CNS-intrinsic
components
microglial
receptor
appears
be
critical
driver
phase
lesion,
including
initial
motor
impairment.
Our
results
indicate
merit
consideration
potential
target
for
therapeutic
intervention.
Trends in Neurosciences,
Journal Year:
2019,
Volume and Issue:
43(1), P. 6 - 16
Published: Dec. 10, 2019
Ordinary
human
experience
is
embedded
in
a
web
of
causal
relations
that
link
the
brain
to
body
and
wider
environment.
However,
there
might
be
conditions
which
activity
supports
consciousness
even
when
fully
causally
isolated
from
its
Such
cases
would
involve
what
we
call
islands
awareness:
conscious
states
are
neither
shaped
by
sensory
input
nor
able
expressed
motor
output.
This
Opinion
paper
considers
such
occur,
including
ex
cranio
brains,
hemispherotomy,
cerebral
organoids.
We
examine
possible
methods
for
detecting
awareness,
consider
their
implications
ethics
nature
consciousness.
The American Journal of Bioethics,
Journal Year:
2020,
Volume and Issue:
21(1), P. 34 - 45
Published: Dec. 29, 2020
Human
brain
research
is
moving
into
a
dilemma.
The
best
way
to
understand
how
the
human
works
study
living
brains
in
beings,
but
ethical
and
legal
standards
make
it
difficult
do
powerful
with
actual
beings.
So
neuroscientists
have
developed
four
types
of
surrogates
for
bodies:
genetically
edited
non-human
animals,
human/non-human
chimeras,
neural
organoids,
ex
vivo
tissues.
These
new
rapidly
improving
models
offer
hope
understanding
function
better.
If
we
our
"too
good,"
they
may
themselves
deserve
some
kinds
respect
that
limited
This
article
an
initial
effort
outline
