References of "Functional Neurology"
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See detailEffect of zolpidem in chronic disorders of consciousness: a prospective open-label study.
Thonnard, Marie ULg; Gosseries, Olivia ULg; Demertzi, Athina ULg et al

in Functional Neurology (2014)

Zolpidem has been reported as an "awakening drug" in some patients with disorders of consciousness (DOC). We here present the results of a prospective openlabel study in chronic DOC patients. Sixty ... [more ▼]

Zolpidem has been reported as an "awakening drug" in some patients with disorders of consciousness (DOC). We here present the results of a prospective openlabel study in chronic DOC patients. Sixty patients (35±15 years; 18 females; mean time since insult ± SD: 4±5.5 years; 31 with traumatic etiology) with a diagnosis of vegetative state/unresponsive wakefulness syndrome (n=28) or minimally conscious state (n=32) were behaviorally assessed using the Coma Recovery Scale-Revised (CRS-R) before and one hour after administration of 10 mg of zolpidem. At the group level, the diagnosis did not change after intake of zolpidem (p=0.10) and CRS-R total scores decreased (p=0.01). Twelve patients (20%) showed improved behaviors and/or CRS-R total scores after zolpidem administration but in only one patient was the diagnosis after zolpidem intake found to show a significant improvement (functional object use), which suggested a change of diagnosis. However, in this patient, a double-blind placebo-controlled trial was performed in order to better specify the effects of zolpidem, but the patient, on this trial, failed to show any clinical improvements. The present open-label study therefore failed to show any clinically significant improvement (i.e., change of Effect of zolpidem in chronic disorders of consciousness: a prospective open-label study diagnosis) in any of the 60 studied chronic DOC patients. [less ▲]

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See detailResting-state EEG study of comatose patients: a connectivity and frequency analysis to find differences between vegetative and minimally conscious states.
Lehembre, Remy ULg; Bruno, Marie-Aurélie ULg; Vanhaudenhuyse, Audrey ULg et al

in Functional Neurology (2012), 27(1), 41-47

The aim of this study was to look for differences in the power spectra and in EEG connectivity measures between patients in the vegetative state (VS/UWS) and patients in the minimally conscious state (MCS ... [more ▼]

The aim of this study was to look for differences in the power spectra and in EEG connectivity measures between patients in the vegetative state (VS/UWS) and patients in the minimally conscious state (MCS). The EEG of 31 patients was recorded and analyzed. Power spectra were obtained using modern multitaper methods. Three connectivity measures (coherence, the imaginary part of coherency and the phase lag index) were computed. Of the 31 patients, 21 were diagnosed as MCS and 10 as VS/UWS using the Coma Recovery Scale-Revised (CRS-R). EEG power spectra revealed differences between the two conditions. The VS/UWS patients showed increased delta power but decreased alpha power compared with the MCS patients. Connectivity measures were correlated with the CRS-R diagnosis; patients in the VS/UWS had significantly lower connectivity than MCS patients in the theta and alpha bands. Standard EEG recorded in clinical conditions could be used as a tool to help the clinician in the diagnosis of disorders of consciousness. [less ▲]

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See detailAutomated EEG entropy measurements in coma, vegetative state/unresponsive wakefulness syndrome and minimally conscious state
Gosseries, Olivia ULg; Schnakers, Caroline ULg; LEDOUX, Didier ULg et al

in Functional Neurology (2011)

Monitoring the level of consciousness in brain injured patients with disorders of consciousness is crucial as it provides diagnostic and prognostic information. Behavioral assessment remains the gold ... [more ▼]

Monitoring the level of consciousness in brain injured patients with disorders of consciousness is crucial as it provides diagnostic and prognostic information. Behavioral assessment remains the gold standard for assessing consciousness but previous studies have shown a high rate of misdiagnosis. This study aimed to investigate the usefulness of electroencephalography (EEG) entropy measurements in differentiating unconscious (coma or vegetative) from minimally conscious patients. Left fronto-temporal EEG recordings (10-minute resting state epochs) were prospectively obtained in 56 patients and 16 age-matched healthy volunteers. Patients were assessed in the acute (≤1 month post-injury;n=29) or chronic (>1 month post-injury; n=27) stage. The etiology was traumatic in 23 patients. Automated online EEG entropy calculations (providing an arbitrary value ranging from 0 to 91) were compared with behavioral assessments (Coma Recovery Scale-Revised) and outcome. EEG entropy correlated with Coma Recovery Scale total scores (r=0.49). Mean EEG entropy values were higher in minimally conscious (73±19; mean and standard deviation) than in vegetative/unresponsive wakefulness syndrome patients (45±28). Receiver operating characteristic analysis revealed an entropy cut-off value of 52 differentiating acute unconscious from minimally conscious patients (sensitivity 89% and specificity 90%). In chronic patients, entropy measurements offered no reliable diagnostic information. EEG entropy measurements did not allow prediction of outcome. User-independent time-frequency balanced spectral EEG entropy measurements seem to constitute an interesting diagnostic – albeit not prognostic – tool for assessing neural network complexity in disorders of consciousness in the acute setting. Future studies are needed before using this tool in routine clinical practice, and these should seek to improve automated EEG quantification paradigms in order to reduce the remaining false negative and false positive findings. [less ▲]

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See detailResting state activity in patients with disorders of consciousness.
Soddu, Andrea ULg; Vanhaudenhuyse, Audrey ULg; Demertzi, Athena et al

in Functional Neurology (2011), 26(1), 37-43

Recent advances in the study of spontaneous brain activity have demonstrated activity patterns that emerge with no task performance or sensory stimulation; these discoveries hold promise for the study of ... [more ▼]

Recent advances in the study of spontaneous brain activity have demonstrated activity patterns that emerge with no task performance or sensory stimulation; these discoveries hold promise for the study of higher-order associative network functionality. Additionally, such advances are argued to be relevant in pathological states, such as disorders of consciousness (DOC), i.e., coma, vegetative and minimally conscious states. Recent studies on resting state activity in DOC, measured with functional magnetic resonance imaging (fMRI) techniques, show that functional connectivity is disrupted in the task-negative or the default mode network. However, the two main approaches employed in the analysis of resting state functional connectivity data (i.e., hypothesis-driven seed-voxel and data-driven independent component analysis) present multiple methodological difficulties, especially in non-collaborative DOC patients. Improvements in motion artifact removal and spatial normalization are needed before fMRI resting state data can be used as proper biomarkers in severe brain injury. However, we anticipate that such developments will boost clinical resting state fMRI studies, allowing for easy and fast acquisitions and ultimately improve the diagnosis and prognosis in the absence of DOC patients' active collaboration in data acquisition. [less ▲]

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See detailInstrumental investigations in primary headache. An updated review and new perspectives
Friberg, L.; Sandrini, G.; Janig, W. et al

in Functional Neurology (2003), 18(3, JUL-SEP), 127-144

While some instrumental techniques are clearly useful for differentiating symptomatic forms from primary headache, the usefulness of certain other techniques, neurophysiological investigations in ... [more ▼]

While some instrumental techniques are clearly useful for differentiating symptomatic forms from primary headache, the usefulness of certain other techniques, neurophysiological investigations in particular, in clinical practice is still debated. A Task Force of the European Federation of Neurological Societies has recently proposed guidelines and recommendations on the use of neurophysiological tests and neuroimaging procedures in non-acute headache. This article reviews many of the most important literature references relevant to this topic and looks at the prospects for future research. [less ▲]

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See detailFrom neurophysiology to genetics: cortical information processing in migraine underlies familial influences--a novel approach
Sandor, P. S.; Afra, J.; Proietti Cecchini, A. P. et al

in Functional Neurology (2000), 15(Suppl 3), 68-72

Migraine patients show impaired cortical information processing between attacks with deficient habituation of pattern-reversal visual evoked potentials (VEP), and strong intensity dependence of auditory ... [more ▼]

Migraine patients show impaired cortical information processing between attacks with deficient habituation of pattern-reversal visual evoked potentials (VEP), and strong intensity dependence of auditory cortical evoked potentials (IDAP). This could be a genetic trait as certain genetic patterns are known for evoked potentials in healthy subjects. VEP-habituation and IDAP were studied in 40 migraine patients, i.e. pairs of 20 parents and their children. We developed a novel approach based on Monte Carlo statistics to selectively assess vertical familial influences. Both groups, parents and children, were characterized by abnormal VEP-habituation and IDAP. However, similarity between related pairs was far more pronounced than similarity between unrelated pairs. Assessed with a novel statistical approach, familial influences proved to be highly significant in determining cortical information processing in migraineurs, thus supporting the important role of genetic factors. [less ▲]

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See detailClinical and para-clinical tests in the routine examination of headache patients.
Friberg, L.; Sandrini, G.; Janig, W. et al

in Functional Neurology (2000), 15 Suppl 3

Para-clinical examinations in the diagnosis and treatment control of headache patients vary considerably between clinics and headache centers. Among the neurological societies in Europe there has been a ... [more ▼]

Para-clinical examinations in the diagnosis and treatment control of headache patients vary considerably between clinics and headache centers. Among the neurological societies in Europe there has been a consensus that some common procedures and recommendations should be created. In the Fall of 1998, the European Federation of Neurological Societies (EFNS) commissioned a Task Force on Neurophysiological Tests and Imaging Procedures in Headache Patients. Members of the Task Force are the present authors and we have reviewed the literature on 1) neurophysiological tests (EEG and evoked potentials), 2) autonomic nervous system and clinical tests and 3) imaging and cerebrovascular tests (X-ray, CT, MR, fMRI, PET, SPECT and transcranial Doppler). The literature was carefully evaluated with respect to validity and strength of the data. The task was to reach conclusions about each technique in the form of guidelines for clinical use. Finally, selected areas for future research will be outlined. The extensive review and the guidelines will be published by the EFNS during 2000. [less ▲]

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See detailThe Pathophysiology of Migraine: A Review Based on the Literature and on Personal Contributions
Schoenen, Jean ULg

in Functional Neurology (1998), 13(1, Jan-Mar), 7-15

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See detailSuppression of Voluntary Temporalis Muscle Activity by Peripheral Limb Stimulations in Healthy Volunteers, Migraineurs and Tension-Type Headache Sufferes
Wang, W.; Schoenen, Jean ULg

in Functional Neurology (1996), 11(6, Nov-Dec), 307-15

We studied the inhibition of voluntary temporalis muscle activity after stimulations of extracephalic cutaneous or mixed nerves in 23 healthy volunteers, 29 patients suffering from migraine without aura ... [more ▼]

We studied the inhibition of voluntary temporalis muscle activity after stimulations of extracephalic cutaneous or mixed nerves in 23 healthy volunteers, 29 patients suffering from migraine without aura, 24 from episodic and 42 from chronic tension-type headache. Two successive EMG suppressions were induced bilaterally after stimulating at 40 mA the index finger or the median nerve, but not after stimulations of the sural or peroneal nerves. They differed from those obtained after labial commissure stimulation at 20 mA, i.e. the classic temporalis silent periods ES1 and ES2. Overall prevalence of index- (3%) and median nerve-induced (16%) early suppression was much lower than that of labial-induced ES1 (100%); prevalence of index-induced late suppression (index-"ES2") was 62% and that of median-"ES2" 48%, compared with 97% for labial-ES2. Latency and duration of index-/median-"ES2" were not significantly different between groups. Index-"ES2" occurred significantly more often in migraineurs (83%) than in controls (48%) suggesting that the spino-bulbar pathways involved in index-/median-"ES2" are hyperexcitable in migraine. [less ▲]

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See detailClinical Neurophysiology Studies in Headache: A Review of Data and Pathophysiological Hints
Schoenen, Jean ULg

in Functional Neurology (1992), 7(3, May-Jun), 191-204

In migraine between attacks EMG studies are normal. Recordings during attacks need to be performed. Temporalis exteroceptive silent period is useful in the differential diagnosis of headaches and sheds ... [more ▼]

In migraine between attacks EMG studies are normal. Recordings during attacks need to be performed. Temporalis exteroceptive silent period is useful in the differential diagnosis of headaches and sheds some light on the pathophysiology of tension-type headache. [less ▲]

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