Abstract:
:The mass media have recently pointed out the likelihood of diagnostic errors in post-coma patients. Late recoveries of consciousness, even after 20 years, might indicate hidden misdiagnoses that are not corrected over a long period of time. The rate of misdiagnoses of patients in a vegetative state is very high when based on behavioral assessment strategies alone. An extremely restrictive motor repertoire, as occurs in locked-in patients, seems to be the major factor responsible for diagnostic confusion. Functional neuroimaging techniques are regarded as promising tools in unearthing covert awareness in behaviorally unresponsive patients who are unable to produce any motor output. However, unless we believe that these patients persistently live in an unconvincing Cartesian-like state, in which thinking and acting are mutually dissociated, we have to admit that a new taxonomy for low responsive states is called for. This taxonomy should take into account the possible syndromic overlap between disorders of consciousness and locked-in syndrome. We should suspect a "locked-in state" in behaviorally unresponsive patients unless we reach strong evidence that such is not the case; this is the only way to avoid dramatic misdiagnoses.
journal_name
J Neurotraumajournal_title
Journal of neurotraumaauthors
Pistoia F,Sarà Mdoi
10.1089/neu.2009.1257subject
Has Abstractpub_date
2012-09-01 00:00:00pages
2328-31issue
13eissn
0897-7151issn
1557-9042journal_volume
29pub_type
杂志文章abstract::Endothelial progenitor cells (EPCs) play a key role in tissue repair and regeneration. Previous studies have shown a positive correlation between the number of circulating EPCs and clinical outcomes of patients with traumatic brain injury (TBI). A recent study has further shown that intravenous infusion of human umbil...
journal_title:Journal of neurotrauma
pub_type: 杂志文章
doi:10.1089/neu.2013.2996
更新日期:2013-12-15 00:00:00
abstract::In various animal and human studies, early administration of 17β-estradiol, a strong antioxidant, anti-inflammatory, and anti-apoptotic agent, significantly decreases the severity of injury in the brain associated with cell death. Estrone, the predominant estrogen in postmenopausal women, has been shown to be a promis...
journal_title:Journal of neurotrauma
pub_type: 杂志文章
doi:10.1089/neu.2011.2274
更新日期:2012-08-10 00:00:00
abstract::Spinal cord injury can have a range of debilitating effects, permanently impacting a patient's quality of life. Initially thought to be an immune privileged site, the spinal cord is able to mount a timely and well organized inflammatory response to injury. Intricate immune cell interactions are triggered, typically co...
journal_title:Journal of neurotrauma
pub_type: 杂志文章,评审
doi:10.1089/neu.2014.3429
更新日期:2014-11-01 00:00:00
abstract::A significant outflow of neurotransmitters and metabolites with associated enhanced cortical excitation occurs after concussive head trauma. Cellular changes in the acute post-injury period cannot be observed directly in humans, and as such, require indirect evidence from systems sufficiently sensitive to central neur...
journal_title:Journal of neurotrauma
pub_type: 杂志文章
doi:10.1089/neu.2015.3968
更新日期:2016-05-01 00:00:00
abstract::Proton magnetic resonance spectroscopy (1H-MRS) offers a unique insight into brain cellular metabolism following traumatic brain injury (TBI). The aim of the present study was to assess change in neurometabolite markers of brain injury during the recovery period following TBI. We studied 19 TBI patients at 1.5, 3, and...
journal_title:Journal of neurotrauma
pub_type: 杂志文章
doi:10.1089/089771500415382
更新日期:2000-08-01 00:00:00
abstract::Noise exposure is known to induce cell death signaling in the cochlea. Since c-Jun N-terminal kinase (JNK) signaling is known to induce both cell survival and apoptosis, the present study focused on early changes (within 24 h) after impulse noise exposure, inquiring whether cell death is always related to phosphorylat...
journal_title:Journal of neurotrauma
pub_type: 杂志文章
doi:10.1089/neu.2007.0346
更新日期:2008-01-01 00:00:00
abstract::Neuropsychological studies in electrical injury patients have reported deficits in attention, learning, and working memory, but the neural substrates of these deficits remain poorly characterized. In this study we sought to examine whether electrical injury subjects demonstrate abnormal patterns of brain activation du...
journal_title:Journal of neurotrauma
pub_type: 杂志文章
doi:10.1089/neu.2008.0867
更新日期:2009-10-01 00:00:00
abstract::The relative safety and efficacy of direct versus indirect methods of spinal cord stimulation for the production of descending motor-evoked responses was studied in pentobarbital-anesthetized rats (n = 39). Electrical stimuli were delivered for 1 h, either directly to the cord dorsum using silver ball electrodes or in...
journal_title:Journal of neurotrauma
pub_type: 杂志文章
doi:10.1089/neu.1991.8.27
更新日期:1991-04-01 00:00:00
abstract::Although mechanisms involved in progression of cell death in spinal cord injury (SCI) have been studied extensively, few are clear targets for translation to clinical application. One of the best-understood mechanisms of cell survival in SCI is phosphatidylinositol-3-kinase (PI3K)/Akt and associated downstream signali...
journal_title:Journal of neurotrauma
pub_type: 杂志文章
doi:10.1089/neu.2018.6294
更新日期:2019-09-15 00:00:00
abstract::Central nervous system injuries such as focal brain ischemia and trauma are known to initiate inflammatory reactions. To demonstrate the involvement of adhesion molecules in these inflammatory responses, we have observed significant increases of ICAM-1 and ELAM-1 mRNA expression in the ischemic cortex of rats by means...
journal_title:Journal of neurotrauma
pub_type: 杂志文章,评审
doi:10.1089/neu.1995.12.825
更新日期:1995-10-01 00:00:00
abstract::The rat hippocampus is hypersensitive to secondary cerebral ischemia after mild traumatic brain injury (TBI). An unconfirmed assumption in previous studies of mild TBI followed by forebrain ischemia has been that antecedent TBI did not alter cerebral blood flow (CBF) dynamics in response to secondary ischemia. Using l...
journal_title:Journal of neurotrauma
pub_type: 杂志文章
doi:10.1089/neu.1998.15.615
更新日期:1998-08-01 00:00:00
abstract::Restraint stress (RS) protects auditory function against acoustic trauma by activating glucocorticoid receptors (GR) in the cochlea. In a search for the signaling pathways downstream to GR that may be involved in RS-induced protection we report here (1) a downregulation of phosphorylated extracellular signal-regulated...
journal_title:Journal of neurotrauma
pub_type: 杂志文章
doi:10.1089/neu.2008.0874
更新日期:2009-10-01 00:00:00
abstract::A retrospective case-control study was undertaken to determine the best technique to measure neural canal encroachment at each lumbar level following burst fracture and its relationship to the presence of neurologic deficit. Only patients with postinjury CT scans demonstrating a disrupted posterior body with a retropu...
journal_title:Journal of neurotrauma
pub_type: 杂志文章
doi:10.1089/neu.1994.11.711
更新日期:1994-12-01 00:00:00
abstract::Anesthetics can either promote or inhibit the development of neurogenic pulmonary edema (NPE) after central nervous system (CNS) injury. The influence of isoflurane was examined in male Wistar rats using 1.5%, 2%, 2.5%, 3%, 4%, or 5% isoflurane in air. Epidural balloon compression of the thoracic spinal cord was perfo...
journal_title:Journal of neurotrauma
pub_type: 杂志文章
doi:10.1089/neu.2006.0252
更新日期:2007-09-01 00:00:00
abstract::The detection of neuron-specific proteins in blood might allow quantification of the degree of neuropathology in experimental and clinical contexts. We have been studying a novel blood biomarker of axonal injury, the heavily phosphorylated axonal form of the high molecular weight neurofilament subunit NF-H (pNF-H). We...
journal_title:Journal of neurotrauma
pub_type: 杂志文章
doi:10.1089/neu.2007.0488
更新日期:2008-09-01 00:00:00
abstract::Prognostic biomarkers for post-injury outcome are necessary for the development of neuroprotective and antiepileptogenic treatments for traumatic brain injury (TBI). We hypothesized that T2 relaxation magnetic resonance imaging (MRI) predicts the progression of perilesional cortical pathology and epileptogenesis. The ...
journal_title:Journal of neurotrauma
pub_type: 杂志文章
doi:10.1089/neu.2019.6796
更新日期:2020-12-01 00:00:00
abstract::Abstract Traumatic brain injury (TBI) induces microglial activation, which can contribute to secondary tissue loss. Activation of mGluR5 reduces microglial activation and inhibits microglial-mediated neurodegeneration in vitro, and is neuroprotective in experimental models of CNS injury. In vitro studies also suggest ...
journal_title:Journal of neurotrauma
pub_type: 杂志文章
doi:10.1089/neu.2012.2589
更新日期:2013-03-01 00:00:00
abstract::The protective effect of chlorpromazine on rat spinal cord injury was investigated using a dynamic impact model. A 10 g weight was dropped 5 cm on an impounder placed on the exposed spinal cord at the T-11 level. Changes in potassium concentration on the epidural surface of the injured spinal cord were measured using ...
journal_title:Journal of neurotrauma
pub_type: 杂志文章
doi:10.1089/neu.1989.6.153
更新日期:1989-10-01 00:00:00
abstract::The purpose of this paper is to present results from methodologies used in our laboratory that are targeted toward identifying specific brain injury thresholds. Results from studying one form of brain injury, diffuse axonal injury, are presented in this report. Physical models, or surrogates, of the skull-brain comple...
journal_title:Journal of neurotrauma
pub_type: 杂志文章
doi:10.1089/neu.1995.12.689
更新日期:1995-08-01 00:00:00
abstract::The striatum, together with the hippocampus, is one of the most vulnerable regions in the brain. Recently, genetic abnormalities or mutations have been linked to various neurodegenerative diseases, that is, Huntington's disease, Alzheimer's disease, amyotrophic lateral sclerosis (ALS), etc., but the processes from gen...
journal_title:Journal of neurotrauma
pub_type: 杂志文章
doi:10.1089/neu.2000.17.251
更新日期:2000-03-01 00:00:00
abstract::Physician prescribed rest after traumatic brain injury (TBI) is both commonplace and an increasingly scrutinized approach to TBI treatment. Although this practice remains a standard of patient care for TBI, research of patient outcomes reveals little to no benefit of prescribed rest after TBI, and in some cases prolon...
journal_title:Journal of neurotrauma
pub_type: 杂志文章
doi:10.1089/neu.2020.7389
更新日期:2021-01-20 00:00:00
abstract::Functional recovery is markedly restricted following traumatic brain injury (TBI), partly due to myelin-associated inhibitors including Nogo-A, myelin-associated glycoprotein (MAG) and oligodendrocyte myelin glycoprotein (OMgp), that all bind to the Nogo-66 receptor-1 (NgR1). In previous studies, pharmacological neutr...
journal_title:Journal of neurotrauma
pub_type: 杂志文章
doi:10.1089/neu.2009.1255
更新日期:2010-07-01 00:00:00
abstract::Our aim for this study was to quantitatively develop an early epidural hematoma (EDH) natural evolutionary curve and assess association of the most common radiological signs of initially nonsurgical supratentorial EDHs on early computed tomography (CT), in addition to their CT time for EDH enlargement. We retrospectiv...
journal_title:Journal of neurotrauma
pub_type: 杂志文章,多中心研究
doi:10.1089/neu.2013.3297
更新日期:2015-04-01 00:00:00
abstract::Traumatic brain injury (TBI) is a principal cause of long-term physical, cognitive, behavioral, and social deficits in young adults, which frequently coexist with a high incidence of substance abuse disorders. However, few studies have examined the long-term effects of TBI on the neuroendocrine-immune system. TBI was ...
journal_title:Journal of neurotrauma
pub_type: 杂志文章
doi:10.1089/neu.2006.23.1802
更新日期:2006-12-01 00:00:00
abstract::Pituitary adenylate cyclase activating polypeptide (PACAP) has several different actions in the nervous system. Numerous studies have shown its neuroprotective effects both in vitro and in vivo. Previously, it has been demonstrated that PACAP reduces brain damage in rat models of global and focal cerebral ischemia. Ba...
journal_title:Journal of neurotrauma
pub_type: 杂志文章
doi:10.1089/neu.2006.23.686
更新日期:2006-05-01 00:00:00
abstract::The translation of therapeutic interventions to humans with spinal cord injury with the goal of promoting growth and repair in the central nervous system could, inadvertently, drive mechanisms associated with the development of neuropathic pain. A framework is needed to evaluate the probability that a therapeutic inte...
journal_title:Journal of neurotrauma
pub_type: 杂志文章,meta分析
doi:10.1089/neu.2018.5960
更新日期:2019-05-01 00:00:00
abstract::Despite limited evidence to support the use of amantadine to enhance cognitive function after traumatic brain injury (TBI), the clinical use for this purpose is highly prevalent and is often based on inferred belief systems. The aim of this study was to assess effect of amantadine on cognition among individuals with a...
journal_title:Journal of neurotrauma
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1089/neu.2018.5767
更新日期:2018-10-01 00:00:00
abstract::Mild traumatic brain injury (mTBI) accounts for the majority of head trauma cases. Despite some lasting cognitive, emotional, and behavioral deficits, there are frequently no overt morphological defects, suggesting that changes may result from alterations in the physiology of individual neurons. We investigated hippoc...
journal_title:Journal of neurotrauma
pub_type: 杂志文章
doi:10.1089/neu.2011.2192
更新日期:2012-04-10 00:00:00
abstract::Whiplash injury, commonly encountered in road traffic accidents, is a major cause of morbidity. Its pathophysiology is not well understood, and diagnosis remains clinical. Imaging and electrophysiological methods have not provided objective diagnostic evidence. Availability of a sensitive and specific diagnostic metho...
journal_title:Journal of neurotrauma
pub_type: 杂志文章
doi:10.1089/neu.2006.0222
更新日期:2007-06-01 00:00:00
abstract::Closed-head concussive injury is one of the most common causes of traumatic brain injury (TBI). Isolated concussions frequently produce acute neurological impairments, and individuals typically recover spontaneously within a short time frame. In contrast, brain injuries resulting from multiple concussions can result i...
journal_title:Journal of neurotrauma
pub_type: 杂志文章
doi:10.1089/neu.2016.4679
更新日期:2017-10-01 00:00:00