scholarly journals Persistence of Neuronal Alterations in Alcohol-Dependent Patients at Conclusion of the Gold Standard Withdrawal Treatment: Evidence From ERPs

2021 ◽  
Vol 12 ◽  
Author(s):  
André Kuntz ◽  
Pascal Missonnier ◽  
Anne Prévot ◽  
Grégoire Favre ◽  
François R. Herrmann ◽  
...  
Keyword(s):  
Alcohol Withdrawal ◽  
Event Related Potential ◽  
Auditory Oddball ◽  
Long Run ◽  
Withdrawal Treatment ◽  
Lower Amplitude ◽  
Long Term Follow Up ◽  
Task Conditions ◽  
Alcohol Dependent

Background: One of the main challenges for clinicians is to ensure that alcohol withdrawal treatment is the most effective possible after discharge. To address this issue, we designed a pilot study to investigate the efficacy of the rehabilitation treatment on the main stages of information processing, using an electroencephalographic method. This topic is of main importance as relapse rates after alcohol withdrawal treatment remain very high, indicating that established treatment methods are not fully effective in all patients in the long run.Method: We examined in alcohol-dependent patients (ADP) the effects of the benzodiazepine-based standard detoxification program on event-related potential components at incoming (D0) and completion (D15) of the treatment, using tasks of increasing difficulty (with and without workload) during an auditory oddball target paradigm. Untreated non-alcohol-dependent-volunteers were used as matching controls.Results: At D0, ADP displayed significantly lower amplitude for all ERP components in both tasks, as compared to controls. At D15, this difference disappeared for the amplitude of the N1 component during the workload-free task, as well as the amplitude of the P3b for both tasks. Meanwhile, the amplitude of the N2 remained lower in both tasks for ADP. At D0, latencies of N2 and P3b in both task conditions were longer in ADP, as compared to controls, whilst the latency of N1 was unchanged. At D15, the N2 latency remained longer for the workload condition only, whereas the P3b latency remained longer for the workload-free task only.Conclusion: The present pilot results provide evidence for a persistence of impaired parameters of ERP components, especially the N2 component. This suggests that neural networks related to attention processing remain dysfunctional. Longitudinal long-term follow-up of these patients is mandatory for further assessment of a link between ERP alterations and a later risk of relapse.

Chiari Malformation Presenting in Adults: A Surgical Experience in 127 Cases

Neurosurgery ◽  
1983 ◽  
Vol 12 (4) ◽  
pp. 377-390 ◽  
Author(s):  
Walter Joseph Levy ◽  
Laura Mason ◽  
Joseph F. Hahn
Keyword(s):  
Chiari Malformation ◽  
Complex Disease ◽  
Pathological Condition ◽  
Disease Process ◽  
Central Canal ◽  
Surgical Anatomy ◽  
Long Run ◽  
Long Term Follow Up ◽  
History Of

Abstract We reviewed 127 patients who were operated upon for adult presentation Chiari malformation and made six conclusions: (a) The clinical examination remains crucial in the diagnosis. (b) The surgical anatomy is highly varied. (c) Syrinxes can be missed on preoperative contrast studies. (d By a conservative grading system, we determined that 46%; of the patients improved during long term follow-up. One-quarter deteriorated over the long run in spite of any treatment. (e) The overall results did not differ whether the treatment was plugging of the central canal plus decompression or decompression alone. (f) In patients with progression, plugging of the central canal obtained superior results. A review of the literature shows that the natural history of this complex disease process has not been established. This history is needed to identify the course of what may be several important factors that lead to the pathological condition in this disease.

scholarly journals 5: Long-term Follow-up of Pre-operative Infant Event-related Potential in Children with Craniosynostosis

2021 ◽  
Vol 9 (7S) ◽  
pp. 24-24
Author(s):  
Alexandra Junn ◽  
Jacob Dinis ◽  
Alvaro Reategui ◽  
Jenny Yang ◽  
John A. Persing ◽  
...  
Keyword(s):  
Event Related Potential ◽  
Long Term Follow Up

Abstract 3920: Epilepsy as a Long-Term Complication After Cerebral Venous Thrombosis

Stroke ◽  
2012 ◽  
Vol 43 (suppl_1) ◽  
Author(s):  
Carlos Cantu-Brito ◽  
Erwin Chiquete ◽  
Antonio Arauz ◽  
Marlon Merloz-Benitez
Keyword(s):  
Risk Factors ◽  
Venous Thrombosis ◽  
Cerebral Venous Thrombosis ◽  
Clinical Presentation ◽  
Thrombotic Event ◽  
Long Run ◽  
Increased Risk ◽  
Long Term Follow Up

Background. Seizures is a very common clinical presentation of cerebral venous thrombosis (CVT); however, little is known about the future risk of epilepsy in patients suffering CVT. Our objective was to analyze risk factors for epilepsy in a long-term follow-up after CVT. Methods. This is a cohort descriptive study of consecutive non-selected patients with acute cerebrovascular disease, systematically registered from 1986 to 2010 in a third-level referral center of Mexico City. Here we analyzed 340 patients who survived the first 6 months after CVT, who were not epileptic at baseline and for whom complete long-term information on neurological outcome was available. Results. Seizures occurred in 183 (54%) patients, in 26% of them as a clinical presentation and 74% at some point during follow-up. Focal motor seizures occurred in 6.5%, secondary generalized focal seizures in 13.8% and generalized tonic-clonic seizures in 22.4%. Status epilepticus occurred in 13 (7%) cases. In all, during a median follow-up of 28 months (range 2 to 288 months), epilepsy was present in 14.7% (27.3% of those who presented seizures). In a multivariate analysis adjusted for multiple confounders, risk factors associated with an increased risk of epilepsy during follow-up were presenting seizures as a clinical presentation [odds ratio (OR): 4.32, 95% confidence interval (CI): 2.20-8.48], pregnancy and puerperium (OR: 2.03, 95% CI: 1.11-3.71) and thrombosis of the longitudinal sinus (OR: 1.86, 95% CI: 1.01-3.41). Conclusion. Seizures are common at CVT presentation, but risk increases during the acute phase after thrombotic event. Most seizures resolve during the first month, but epilepsy occurred in 15% of patients with CVT in the long run.

International Subarachnoid Trial in the Long Run

Neurosurgery ◽  
2010 ◽  
Vol 66 (6) ◽  
pp. 1166-1169 ◽  
Author(s):  
Daniel M. S. Raper ◽  
Rodney Allan
Keyword(s):  
Intracranial Aneurysms ◽  
Randomized Study ◽  
Patient Characteristics ◽  
Risk Of Death ◽  
Long Run ◽  
Long Term Follow Up ◽  
Neurosurgical Treatment ◽  
Methodological Problems ◽  
Ruptured Intracranial Aneurysms

Abstract The International Subarachnoid Trial (ISAT), the largest prospective randomized study into endovascular and neurosurgical treatment of ruptured intracranial aneurysms, recently reported long-term follow-up in The Lancet Neurology. In this cohort, the risk of death at 5 years was significantly lower in the coiled group, but the proportion of survivors who were independent was not statistically different between the groups, and rebleeding was higher in the coiled group. This article critically evaluates the long-term ISAT data from an evidence-based perspective and places it in the context of the overall approach to treatment of ruptured intracranial aneurysms. ISAT has been a strong driver of change in the management of ruptured aneurysms. Nevertheless, the evidence for the superiority in coiling in the long term should not be assumed from ISAT data alone. Potential biases of patient characteristics and national referral patterns, as well as the methodological problems already described from the original trial, contribute to the difficulty in interpreting differences in long-term outcomes. These new data should be regarded as Level 2b evidence, suitable for treatment recommendations but not guidelines.

Ten years after – the post-treatment course of alcoholism

1993 ◽  
Vol 8 (2) ◽  
pp. 95-100 ◽  
Author(s):  
G Längle ◽  
K Mann ◽  
G Mundle ◽  
HW Schied
Keyword(s):  
Post Treatment ◽  
Patient Treatment ◽  
Treatment Programme ◽  
Follow Up Study ◽  
Long Term Follow Up ◽  
History Of ◽  
Long Term Studies ◽  
Alcohol Dependent

SummaryThe natural history of alcoholism is still a matter of debate. Very few studies have addressed the issue of the post-treatment course longitudinally. We present the results of a long-term follow-up study in ninety-six alcohol dependent patients who were treated in a combined in-patient and out-patient treatment programme. Two, five and ten years after the initial treatment in 1976, they were re-investigated. Ninety-four percent of the patients could be located ten years after treatment. Fifty-one percent were abstinent, 22% were deceased, 14% of the patients’ drinking was unchanged and 7% had improved. This outcome is discussed and compared with the results of other long-term studies.

scholarly journals Vocational Training for Disadvantaged Youth in Colombia: A Long-Term Follow-Up

2017 ◽  
Vol 9 (2) ◽  
pp. 131-143 ◽  
Author(s):  
Orazio Attanasio ◽  
Arlen GuarÍn ◽  
Carlos Medina ◽  
Costas Meghir
Keyword(s):  
Labor Market ◽  
Labor Market Outcomes ◽  
Cost Effective ◽  
Similar Amount ◽  
Market Outcomes ◽  
Long Run ◽  
Cost Effective Approach ◽  
Long Term Follow Up

We evaluate the long-term impacts of a randomized Colombian training and job placement program. Following the large short-term effects, we now find that the program effects persist, increasing formal participation and earnings contributions to social security and working in larger firms. By using a large administrative source we are also able to establish that the program improved both male and female labor market outcomes by a similar amount—a result that was not apparent with the smaller evaluation sample. The results point to a cost-effective approach to reducing informality and improving labor market outcomes in the long run. (JEL I28, J13, J24, J31, O15)

Alcohol Withdrawal: Neuroadaptation and Sensitization

CNS Spectrums ◽  
1999 ◽  
Vol 4 (1) ◽  
pp. 38-40,57-65 ◽  
Author(s):  
Howard C. Becker
Keyword(s):  
Alcohol Withdrawal ◽  
Brain Function ◽  
Cognitive Impairments ◽  
Treatment Strategies ◽  
Withdrawal Symptoms ◽  
Withdrawal Treatment ◽  
Sensitization Process ◽  
Research Findings

AbstractRepeated episodes of alcohol withdrawal may exacerbate the severity of future withdrawal occurrences. The progressive intensification of withdrawal symptoms may be manifested as a kindling-like mechanism. This sensitization process may reflect persistent perturbation in excitatory and inhibitory influences on brain function. Relapse is also thought to be affected by the kindling mechanism. Successive alcohol withdrawal experiences may also lead to neurologic damage and cognitive impairments. We review the research findings regarding the alcohol withdrawal kindling hypothesis and the implications of the kindling process on mechanisms of dependence, alcohol withdrawal treatment strategies, and the long-term repercussions of alcoholism.

scholarly journals Can Music Influence Patients With Disorders of Consciousness? An Event-Related Potential Study

2021 ◽  
Vol 15 ◽  
Author(s):  
Yajuan Hu ◽  
Fengqiong Yu ◽  
Changqing Wang ◽  
Xiaoxiang Yan ◽  
Kai Wang
Keyword(s):  
Predictive Value ◽  
Event Related Potential ◽  
Disorders Of Consciousness ◽  
Healthy Controls ◽  
Music Intervention ◽  
Auditory Event ◽  
Cognitive Component ◽  
Auditory Oddball ◽  
Before And After

BackgroundLong-term disorders of consciousness (DOC) are a huge burden on both patients and their families. Previously, music intervention has been attempted as a potential therapy in DOC, with results indicating an enhancement of arousal and awareness; yet, to date, there are limited studies on music interventions in DOC with electroencephalogram monitoring. Meanwhile, prediction of awareness recovery is a challenge facing clinicians. The predictive value mismatch negativity (MMN), as a classical cognitive component in event-related potential, is still controversial. In this study, we use auditory event-related potential to probe the effect of music in DOC, and investigate whether music may improve the predictive value of MMN in awareness recovery.MethodsFourteen DOC patients were included in the prospective study. Auditory oddball electroencephalogram data were recorded twice with each patient, before and after 5 min of listening to a Chinese symphony that has joyful associations. The outcome was assessed 6 months later.ResultsSignificant differences of MMN amplitude were found between healthy controls and pre-music DOC patients (p < 0.001), but no significant differences were found between healthy controls and post-music DOC patients. The presence of MMN before music was not correlated with favorable outcome, and 50% of patients with MMN did not recover awareness. When MMN was absent, 50% of patients awoke. After listening to music, among the 11 patients who showed MMN, seven patients recovered awareness. When MMN was absent, no one recovered awareness.ConclusionsSome DOC patients, even those in a minimal consciousness state and those with unresponsive wakefulness syndrome (UWS), were affected by music. The MMN amplitude was elevated by the music to some extent. A single test of MMN did not have a good prognostic value of our study; however, retesting of MMN after stimulation with familiar music that has joyful associations might be valuable for observation and detection of possible recovery. The musical processing in DOC patients and the effect of musical therapeutic practices need further investigations.

Therapy and prevention for mental health: What if mental diseases are mostly not brain disorders?

2019 ◽  
Vol 42 ◽  
Author(s):  
John P. A. Ioannidis
Keyword(s):  
Mental Health ◽  
Mental Disease ◽  
Brain Disorders ◽  
Social Stressors ◽  
Labor Education ◽  
Mental Diseases ◽  
Long Term Follow Up ◽  
Political Decisions

AbstractNeurobiology-based interventions for mental diseases and searches for useful biomarkers of treatment response have largely failed. Clinical trials should assess interventions related to environmental and social stressors, with long-term follow-up; social rather than biological endpoints; personalized outcomes; and suitable cluster, adaptive, and n-of-1 designs. Labor, education, financial, and other social/political decisions should be evaluated for their impacts on mental disease.

Continuous Positive Airway Pressure (CPAP) Therapy for the Treatment of Hypernasality: A Single Case Study

2014 ◽  
Vol 24 (2) ◽  
pp. 48-58 ◽  
Author(s):  
Lakshmi Kollara ◽  
Graham Schenck ◽  
Jamie Perry
Keyword(s):  
Continuous Positive Airway Pressure ◽  
Airway Pressure ◽  
Positive Airway Pressure ◽  
Single Case ◽  
Treatment Method ◽  
Post Treatment ◽  
Subjective Perception ◽  
Cpap Therapy ◽  
Long Term Follow Up

Studies have investigated the applications of Continuous Positive Airway Pressure (CPAP) therapy in the treatment of hypernasality due to velopharyngeal dysfunction (VPD; Cahill et al., 2004; Kuehn, 1991; Kuehn, Moon, & Folkins, 1993; Kuehn et al., 2002). The purpose of this study was to examine the effectiveness of CPAP therapy to reduce hypernasality in a female subject, post-traumatic brain injury (TBI) and pharyngeal flap, who presented with signs of VPD including persistent hypernasality. Improvements in mean velopharyngeal orifice size, subjective perception of hypernasality, and overall intelligibility were observed from the baseline to 8-week post-treatment assessment intervals. Additional long-term assessments completed at 2, 3, and 4 months post-treatment indicated decreases in immediate post-treatment improvements. Results from the present study suggest that CPAP is a safe, non-invasive, and relatively conservative treatment method for reduction of hypernasality in selected patients with TBI. More stringent long-term follow up may indicate the need for repeated CPAP treatment to maintain results.

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