Pharmacological therapies for early and long-term recovery in disorders of consciousness: current knowledge and promising avenues DOI Creative Commons

Rosalie Girard Pepin,

Fatemeh Seyfzadehdarabad, David Williamson

et al.

Expert Review of Neurotherapeutics, Journal Year: 2025, Volume and Issue: unknown, P. 1 - 21

Published: May 7, 2025

Disorders of consciousness (DoC) are characterized by impaired arousal and/or awareness, ranging from coma to unresponsive wakefulness syndrome, minimally conscious state, and cognitive motor dissociation. Pharmacological treatment options remain limited, complicated the heterogeneity etiologies, such as traumatic brain injury, stroke, infections. The lack rigorous clinical trials has led off-label use treatments, often without clear mechanistic understanding, posing challenges for effective patient care. In this perspective, authors report on key studies concerning effectiveness pharmacological interventions, including dopaminergic GABAergic agents, antidepressants, statins, anticonvulsants, in promoting recovery DoC. Robust longitudinal needed, with priority given early subacute phase intervention. Outcomes should be better defined, considering immediate responses medication while also increasing emphasis long-term quality life. Unified functional frameworks needed guide research foster collaboration. Furthermore, a shift toward personalized medicine would benefit heterogeneous population. Moving forward, assessing efficacy more unconventional or 'paradoxical' plans will essential. expect an increased AI tools identify factors that best predict responses.

Language: Английский

Psilocybin for disorders of consciousness: a case-report study DOI Creative Commons
Paolo Cardone, Pablo Núñez, Naji Alnagger

et al.

Clinical Neurophysiology, Journal Year: 2025, Volume and Issue: unknown

Published: March 1, 2025

Language: Английский

Citations

0

H‐current modulation of cortical Up and Down states DOI
Leonardo Dalla Porta, Almudena Barbero‐Castillo, José Manuel Sanchez‐Sanchez

et al.

The Journal of Physiology, Journal Year: 2025, Volume and Issue: unknown

Published: March 28, 2025

Abstract Understanding the link between cellular processes and brain function remains a key challenge in neuroscience. One crucial aspect is interplay specific ion channels network dynamics. This work reveals role for h‐current, hyperpolarization‐activated cationic current, shaping cortical slow oscillations. Cortical oscillations are generated not only during wave sleep deep anaesthesia, but also association with disorders of consciousness lesions. exhibit rhythmic periods activity (Up states) alternating silent (Down states). By progressively reducing h‐current both slices computational model, we observed Up states transformed into prolonged plateaus sustained firing, while Down were significantly extended. transformation led to fivefold reduction oscillation frequency. In biophysical recurrent identified mechanisms underlying this dynamics: an increased neuronal input resistance membrane time constant, increasing responsiveness even weak inputs. A partial block therefore resulted change state. HCN (hyperpolarization‐activated cyclic nucleotide‐gated) channels, which generate known targets neuromodulation, suggesting potential pathways dynamic control rhythms. image Key points We investigated emergent dynamics, specifically states, slices. Blocking lasting up 4 s. elongated oscillatory frequency decreased. model replicated these findings allowed us explore mechanisms. An increase constant rise excitability, synaptic firing rates. Our results highlight significant controlling patterns, making it relevant target neuromodulators regulating states.

Language: Английский

Citations

0

Neural models for detection and classification of brain states and transitions DOI Creative Commons
Arnau Marin-Llobet, Arnau Manasanch, Leonardo Dalla Porta

et al.

Communications Biology, Journal Year: 2025, Volume and Issue: 8(1)

Published: April 11, 2025

Exploring natural or pharmacologically induced brain dynamics, such as sleep, wakefulness, anesthesia, provides rich functional models for studying states. These allow detailed examination of unique spatiotemporal neural activity patterns that reveal function. However, assessing transitions between states remains computationally challenging. Here we introduce a pipeline to detect and their in the cerebral cortex using dual-model Convolutional Neural Network (CNN) self-supervised autoencoder-based multimodal clustering algorithm. This approach distinguishes slow oscillations, microarousals, wakefulness with high confidence. Using chronic local field potential recordings from rats, our method achieved global accuracy 91%, up 96% certain For transitions, report an average 74%. Our were trained leave-one-out methodology, allowing broad applicability across subjects pre-trained deployments. It also features confidence parameter, ensuring only highly cases are automatically classified, leaving ambiguous unsupervised classifier further expert review. presents reliable efficient tool state labeling analysis, applications basic clinical neuroscience.

Language: Английский

Citations

0

Pharmacological therapies for early and long-term recovery in disorders of consciousness: current knowledge and promising avenues DOI Creative Commons

Rosalie Girard Pepin,

Fatemeh Seyfzadehdarabad, David Williamson

et al.

Expert Review of Neurotherapeutics, Journal Year: 2025, Volume and Issue: unknown, P. 1 - 21

Published: May 7, 2025

Disorders of consciousness (DoC) are characterized by impaired arousal and/or awareness, ranging from coma to unresponsive wakefulness syndrome, minimally conscious state, and cognitive motor dissociation. Pharmacological treatment options remain limited, complicated the heterogeneity etiologies, such as traumatic brain injury, stroke, infections. The lack rigorous clinical trials has led off-label use treatments, often without clear mechanistic understanding, posing challenges for effective patient care. In this perspective, authors report on key studies concerning effectiveness pharmacological interventions, including dopaminergic GABAergic agents, antidepressants, statins, anticonvulsants, in promoting recovery DoC. Robust longitudinal needed, with priority given early subacute phase intervention. Outcomes should be better defined, considering immediate responses medication while also increasing emphasis long-term quality life. Unified functional frameworks needed guide research foster collaboration. Furthermore, a shift toward personalized medicine would benefit heterogeneous population. Moving forward, assessing efficacy more unconventional or 'paradoxical' plans will essential. expect an increased AI tools identify factors that best predict responses.

Language: Английский

Citations

0