References of "Laureys, Steven"
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See detailPain perception in disorders of consciousness: Neuroscience, clinical care, and ethics in dialogue
Demertzi, Athina ULg; Racine, Eric; Bruno, Marie-Aurélie ULg et al

in Neuroethics (2013), 6(1), 37-50

Pain, suffering and positive emotions in patients in vegetative state/unresponsive wakefulness syndrome (VS/UWS) and minimally conscious states (MCS) pose clinical and ethical challenges. Clinically, we ... [more ▼]

Pain, suffering and positive emotions in patients in vegetative state/unresponsive wakefulness syndrome (VS/UWS) and minimally conscious states (MCS) pose clinical and ethical challenges. Clinically, we evaluate behavioural responses after painful stimulation and also emotionally-contingent behaviours (e.g., smiling). Using stimuli with emotional valence, neuroimaging and electrophysiology technologies can detect subclinical remnants of preserved capacities for pain <br />which might influence decisions about treatment limitation. To date, no data exist as to how healthcare providers think about end-of-life options (e.g., withdrawal of artificial nutrition and hydration) in the presence or absence of pain in non-communicative patients. Here, we aimed to better clarify this issue by re-analyzing previously published data on pain <br />perception (Prog Brain Res 2009 177, 329–38) and end-of-life decisions (J Neurol 2010 258, 1058–65) in patients with disorders of consciousness. In a sample of 2259 European healthcare professionals we found that, for VS/UWS more respondents agreed with treatment withdrawal when they considered that VS/UWS patients did not feel pain (77%) as compared to those who thought VS/UWS did feel pain (59%). This interaction was influenced by religiosity and professional <br />background. For MCS, end-of-life attitudes were not influenced by opinions on pain perception. Within a contemporary ethical context we discuss (1) the evolving scientific understandings of pain perception and their relationship to existing clinical and ethical guidelines; (2) the discrepancies of attitudes within (and between) healthcare providers and their consequences for <br />treatment approaches, and (3) the implicit but complex relationship between pain perception and attitudes toward life-sustaining treatments. [less ▲]

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See detailQuality of life and end-of-life decisions after brain injury
Demertzi, Athina ULg; Gosseries, Olivia ULg; LEDOUX, Didier ULg et al

in Warren, N; Manderson, L (Eds.) Reframing disability and quality of life: a global perspective (2013)

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See detailPupil responses allow communication in locked-in syndrome patients.
Stoll, Josef; Chatelle, Camille ULg; Carter, Olivia et al

in Current biology : CB (2013), 23(15), 647-8

For patients with severe motor disabilities, a robust means of communication is a crucial factor for their well-being [1]. We report here that pupil size measured by a bedside camera can be used to ... [more ▼]

For patients with severe motor disabilities, a robust means of communication is a crucial factor for their well-being [1]. We report here that pupil size measured by a bedside camera can be used to communicate with patients with locked-in syndrome. With the same protocol we demonstrate command-following for a patient in a minimally conscious state, suggesting its potential as a diagnostic tool for patients whose state of consciousness is in question. Importantly, neither training nor individual adjustment of our system's decoding parameters were required for successful decoding of patients' responses. [less ▲]

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See detailReanalysis of "Bedside detection of awareness in the vegetative state: a cohort study" - Authors' reply.
Cruse, Damian; Chennu, Srivas; Chatelle, Camille ULg et al

in Lancet (2013), 381(9863), 291-2

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See detailSpasticity after stroke: Physiology, assessment and treatment
Thibaut, Aurore ULg; Chatelle, Camille ULg; Ziegler, Erik ULg et al

in Brain Injury (2013), 27(10), 1093-1105

Spasticity following a stroke occurs in about 30% of patients. The mechanisms underlying this disorder, however, are not well understood. This review aims to define spasticity, describe hypotheses ... [more ▼]

Spasticity following a stroke occurs in about 30% of patients. The mechanisms underlying this disorder, however, are not well understood. This review aims to define spasticity, describe hypotheses explaining its development after a stroke, give an overview of related neuroimaging studies as well as a description of the most common scales used to quantify the degree of spasticity and finally explore which treatments are currently being used to treat this disorder. The lack of consensus is highlighted on the basis of spasticity and the associated absence of guidelines for treatment, use of drugs and rehabilitation programmes. Future studies require controlled protocols to determine the efficiency of pharmacological and non-pharmacological treatments for spasticity. Neuroimaging may help predict the occurrence of spasticity and could provide insight into its neurological basis. [less ▲]

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See detailComa and disorders of consciousness: scientific advances and practical considerations for clinicians
Bodart, Olivier ULg; Laureys, Steven ULg; Gosseries, Olivia ULg

in Seminars in Neurology (2013), 33

Recently, neuroscientists and clinicians have seen the rapid evolution of diagnoses in disorders of consciousness. The unresponsive wakefulness syndrome–vegetative state, the minimally conscious state ... [more ▼]

Recently, neuroscientists and clinicians have seen the rapid evolution of diagnoses in disorders of consciousness. The unresponsive wakefulness syndrome–vegetative state, the minimally conscious state plus and minus, and the functional locked-in syndrome have been defined using new neuroimaging techniques. Diffusion tensor imaging, positron emission tomography, functional magnetic resonance imaging, electroen- cephalography, and transcranial magnetic stimulation techniques have all promoted important discoveries in the field of disorders of consciousness. This has led to a better understanding of these patients’ condition and to the development of new prognosis, therapeutic, and communication tools. However, low sensitivity and artifacts problems need to be solved to bring these new technologies to the single-patient level; they also need to be studied in larger scale and randomized control trials. In addition, new ethics questions have arisen and need to be investigated. [less ▲]

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See detailLooking for the self in pathological unconsciousness.
Demertzi, Athina ULg; Vanhaudenhuyse, Audrey ULg; Brédart, Serge ULg et al

in Frontiers in Human Neuroscience (2013), 7

There is an intimate relationship between consciousness and the notion of self. By studying patients with disorders of consciousness, we are offered with a unique lesion approach to tackle the neural ... [more ▼]

There is an intimate relationship between consciousness and the notion of self. By studying patients with disorders of consciousness, we are offered with a unique lesion approach to tackle the neural correlates of self in the absence of subjective reports. Studies employing neuroimaging techniques point to the critical involvement of midline anterior and posterior cortices in response to the passive presentation of self-referential stimuli, such as the patient’s own name and own face. Also, resting state studies show that these midline regions are severely impaired as a function of the level of consciousness. Theoretical frameworks combining all this progress surpass the functional localization of self-related cognition and suggest a dynamic system-level approach to the phenomenological complexity of subjectivity. Importantly for non-communicating patients suffering from disorders of consciousness, the clinical translation of these technologies will allow medical professionals and families to better comprehend these disorders and plan efficient medical management for these patients. [less ▲]

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See detailA multiscale method for a robust detection of the default mode network.
Baquero, Katherine; Gómez, Francisco; Cifuentes, Christian et al

Poster (2013)

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See detailLa stimulation transcranienne a courant continu : un nouvel outil de neurostimulation.
Thibaut, Aurore ULg; Chatelle, Camille ULg; Gosseries, Olivia ULg et al

in Revue Neurologique (2013), 169

Transcranial direct current stimulation (tDCS) is a safe method to modulate cortical excitability. Anodal stimulation can improve the stimulated area's functions whereas cathodal stimulation reduces them ... [more ▼]

Transcranial direct current stimulation (tDCS) is a safe method to modulate cortical excitability. Anodal stimulation can improve the stimulated area's functions whereas cathodal stimulation reduces them. Currently, a lot of clinical trials have been conducted to study the effect of tDCS on post-stroke motor and language deficits, in depression, chronic pain, memory impairment and tinnitus in order to decrease symptoms. Results showed that, if an effect is observed with tDCS, it does not persist over time. Current studies suggest that direct current stimulation is a promising technique that helps to improve rehabilitation after stroke, to enhance cognitive deficiencies, to reduce depression and to relieve chronic pain. Moreover, it is a safe, simple and cheap device that could be easily integrated in a rehabilitation program. [less ▲]

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See detailAltered network properties of the fronto-parietal network and the thalamus in impaired consciousness
Crone, Julia Sophia; Soddu, Andrea ULg; Höller, Yvonne et al

in NeuroImage: Clinical (2013)

Recovery of consciousness has been associated with connectivity in the frontal cortex and parietal regions modulated by the thalamus. To examine this model and to relate alterations to deficits in ... [more ▼]

Recovery of consciousness has been associated with connectivity in the frontal cortex and parietal regions modulated by the thalamus. To examine this model and to relate alterations to deficits in cognitive functioning and conscious processing, we investigated topological network properties in patients with chronic disorders of consciousness recovered from coma. Resting state fMRI data of 34 patients with unresponsive wakefulness syndrome and 25 in minimally conscious state were compared to 28 healthy controls.We investigated global and local network characteristics. Additionally, behavioralmeasureswere correlatedwith the localmetrics of 28 regionswithin the fronto-parietal network and the thalamus. In chronic disorders of consciousness, modularity at the global level was reduced suggesting a disturbance in the optimal balance between segregation and integration.Moreover, network properties were altered in several regionswhich are associatedwith conscious processing (particularly, inmedial parietal, and frontal regions, aswell as in the thalamus). Between minimally conscious and unconscious patients the local efficiency of medial parietal regions differed. Alterations in the thalamus were particularly evident in non-conscious patients.Most of the regions affected in patientswith impaired consciousness belong to the so-called ‘rich club’ of highly interconnected central nodes. Disturbances in their topological characteristics have severe impact on information integration and are reflected in deficits in cognitive functioning probably leading to a total breakdown of consciousness. [less ▲]

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See detailThalamus, Brainstem and Salience Network Connectivity Changes During Propofol-Induced Sedation and Unconsciousness
Guldenmund, Justus Pieter ULg; Demertzi, Athina ULg; BOVEROUX, Pierre ULg et al

in Brain connectivity (2013), 3

In this functional magnetic resonance imaging study, we examined the effect of mild propofol sedation and propofol-induced unconsciousness on resting state brain connectivity, using graph analysis based ... [more ▼]

In this functional magnetic resonance imaging study, we examined the effect of mild propofol sedation and propofol-induced unconsciousness on resting state brain connectivity, using graph analysis based on independent component analysis and a classical seed-based analysis. Contrary to previous propofol research, which mainly emphasized the importance of connectivity in the default mode network (DMN) and external control network (ECN), we focused on the salience network, thalamus, and brainstem. The importance of these brain regions in brain arousal and organization merits a more detailed examination of their connectivity response to propofol. We found that the salience network disintegrated during propofol-induced unconsciousness. The thalamus decreased connectivity with the DMN, ECN, and salience network, while increasing connectivity with sensorimotor and auditory/insular cortices. Brainstem regions disconnected from the DMN with unconsciousness, while the pontine tegmental area increased connectivity with the insulae during mild sedation. These findings illustrate that loss of consciousness is associated with a wide variety of decreases and increases of both cortical and subcortical connectivity. It furthermore stresses the necessity of also examining resting state connectivity in networks representing arousal, not only those associated with awareness. [less ▲]

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See detailOur rapidly changing understanding of acute and chronic disorders of consciousness: challenges for neurologists
Gantner, Sylvia ULg; BODART, Olivier ULg; Laureys, Steven ULg et al

in Future Neurology (2013), 8(1), 43-54

A number of recent studies suggest that some ‘vegetative state’ patients have been misdiagnosed, judging by their ability to follow commands and in some cases even communicate through brain activity. Such ... [more ▼]

A number of recent studies suggest that some ‘vegetative state’ patients have been misdiagnosed, judging by their ability to follow commands and in some cases even communicate through brain activity. Such studies highlight the difficulty in forming a diagnosis based only on behavioral assessments. We think that neuroimaging and electrophysiology methods will be used more frequently in clinical settings, integrated with existing behavioral assessments. Such efforts are expected to lead to a more accurate understanding of individual patients’ cognitive abilities or even provide prognostic indicators. In terms of treatment planning (i.e., pain management and end-of-life decision-making), patients with disorders of consciousness are now offered the possibility of expressing their preferences by means of brain–computer interfaces. What remains to be clarified is the degree to which such indirect responses can be considered reliable and of legal representation. [less ▲]

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See detailDetecting Consciousness with a Brain-computer Interface
Noirhomme, Quentin ULg; Lesenfants, Damien ULg; Lehembre, Remy ULg et al

in Pons, J. L.; Torricelli, D.; Pajaro, M. (Eds.) Converging Clinical and Engineering Research on Neurorehabilitation (2012, November)

Recent electrophysiological and neuroimaging studies showed command-specific changes in EEG or fMRI signals of unresponsive patients providing motor-independent evidence of conscious thoughts. These ... [more ▼]

Recent electrophysiological and neuroimaging studies showed command-specific changes in EEG or fMRI signals of unresponsive patients providing motor-independent evidence of conscious thoughts. These promising results have paved the way for a new application for Brain-computer Interface (BCI): detecting consciousness in patients with disorders of consciousness (DOC). In the present abstract, we review the first results obtained by BCI-like applications in patients with DOC and discuss the challenges facing BCI research. We believe that patients with DOC may benefit from BCI based diagnosis. BCIs may detect changes in the signal in response to command and, in some cases, may permit communication. [less ▲]

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See detailComa and disorders of consciousness
Charland-Verville, Vanessa ULg; Laureys, Steven ULg

Conference (2012, November)

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See detailThe neuroscience of tinnitus: Perspectives from human neuroimaging studies
Maudoux, Audrey ULg; Vanneste, Sven; De Ridder, Dirk et al

Conference (2012, November)

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See detailMemories of Near-Death experiences are they memories of imagined events?
Thonnard, Marie ULg; Charland-Verville, Vanessa ULg; Brédart, Serge ULg et al

Poster (2012, October 27)

Background: The phenomenon of Near-Death Experiences (NDEs) has always intrigued but is still not fully explained despite numerous theories and studies. Since reports of NDEs are proposed to be imagined ... [more ▼]

Background: The phenomenon of Near-Death Experiences (NDEs) has always intrigued but is still not fully explained despite numerous theories and studies. Since reports of NDEs are proposed to be imagined events (French, 2001), and since memories of imagined events have, on average, fewer phenomenological characteristics than real event memories (e.g. Johnson et al., 1988), we here compared phenomenological characteristics of NDEs reports with memories of imagined and real events. Methods: We included 3 groups of coma survivors (8 patients with NDE as defined by the Greyson NDE scale – the “NDE memory group”- , 6 patients without NDE but with memory of their coma – the “coma memory group” – and 7 patients without memories of their coma – the “no memory group”) and a group of 18 age-matched healthy volunteers. Five memories were assessed using Memory Characteristics Questionnaire (MCQ – Johnson et al., 1988): target memory (NDE for NDE memory group, coma memory for coma memory group, and first childhood memory for no memory and control groups), old and recent real event memories and old and recent imagined event memories. Results: In NDE group, NDE memories showd more characteristics than memories of imagined and real events (p<0.02). These memories contain more self-referential and emotional information and have better clarity than memories of coma (all p<0.02). Conclusion: The present study showed that NDE memories contain more characteristics than real event memories and coma memories. Thus, they cannot be considered as classic imagined event memories. On the contrary, their physiological origins could lead them to be really perceived although not lived in the reality. Further work is needed to better understand this phenomenon [less ▲]

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See detailFunctional connectivity changes in hypnotic state measured by fMRI
Demertzi, Athina ULg; Soddu, Andrea ULg; VANHAUDENHUYSE, Audrey ULg et al

Conference (2012, September 06)

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