[Multidisciplinary concussion management recommendations].

Concussions represent a major public health concern due to their high prevalence and the risk of long-term consequences. In some patients, they can lead to persistent post-concussion symptoms lasting for several months or even years, significantly impacting their quality of life. To date, no curative treatment exists for this syndrome, but early and appropriate management plays a key role in preventing long-term complications.

A neuroscientific model of near-death experiences.

Near-death experiences (NDEs) are episodes of disconnected consciousness that typically occur in situations that involve an actual or potential physical threat or are perceived as such, and the experiences are characterized by a rich content with prototypical mystical features. Several explanatory theories for NDEs have been proposed, ranging from psychological or neurophysiological to evolutionary models. However, these concepts were often formulated independently, and, owing to the fragmented nature of research in this domain, integration of these ideas has been limited.

On-Chip Planar Metasurfaces for Magnetic Sensors with Greatly Enhanced Sensitivity.

Metamaterials with engineered structures have been extensively investigated for their capability to manipulate optical, acoustic, or thermal waves. In particular, magnetic metamaterials with precise geometry, shape, size and arrangement of their elemental blocks may be used to concentrate, focus, or guide magnetic fields. In this work, we show the potential of using soft-magnetic permalloy (Py) metasurfaces to tailor the physical properties of other magnetic structures at the local scale.

A pilot human study using ketamine to treat disorders of consciousness.

Post-comatose disorders of consciousness (DoC) represent persistent neurological conditions with limited therapeutic options and a poor prognosis. Recent works advocate for exploring the effects of psychedelics to enhance brain complexity in DoC and ameliorate their consciousness. We investigated sub-anesthetic concentration of the atypical psychedelic ketamine for treating post-comatose prolonged DoC through a double-blind, placebo-controlled, cross-over trial involving three adult patients.

Apomorphine for prolonged disorders of consciousness: a multimodal open-label study.

Background: Apomorphine is a dopaminergic candidate therapy to improve recovery in patients with prolonged disorders of consciousness (PDoC). Behavioural improvements were previously described in non-controlled case series, but its efficacy and neural mechanisms remain largely unknown. This open-label controlled study using multimodal outcome measures investigates the action of apomorphine in severely brain-injured patients.

Nociception Coma Scale-Revised with Personalized Painful Stimulus Versus Standard Stimulation in Persons with Disorders of Consciousness: An International Multicenter Study.

Persons with disorders of consciousness (DoCs) may perceive pain without being able to communicate their discomfort. The Nociception Coma Scale (NCS) and its revised form (NCS-R) have been proposed to assess nociception in persons with DoCs. The main aim of this international multicenter study was to confirm (or not) our preliminary results and compare the NCS-R scores of standard stimulus (NCS-R-SS) to scores of personalized painful stimuli (NCS-R-PS).

Investigation of Mode-Induced Spin Wave Transmission Blockage by In Situ Nanoscale Grooves.

In the pursuit of advancing spin-wave optics, the propagation of magnetostatic surface spin-waves is investigated in a uniform permalloy waveguide with in-situ nanopatterned grooves created through Atomic Force Microscopy nanolithography and Focused Ion Beam etching. The study unveils that the introduction of narrow constrictions and grooves leads to a non-monotonic reduction of the transmitted spin-wave signal intensity as the spin-wave pathway is shrinked. The remarkable feature that a stronger signal extinction is obtained for a narrow groove compared to a spin-waveguide interrupted by a full gap, where only inefficient transport through dipolar coupling is allowed, is highlighted.

Noninvasive Readout of the Kinetic Inductance of Superconducting Nanostructures.

The energy landscape of multiply connected superconducting structures is ruled by fluxoid quantization due to the implied single-valuedness of the complex wave function. The transitions and interaction between these energy states, each defined by a specific phase winding number, are governed by classical and/or quantum phase slips. Understanding these events requires the ability to probe, noninvasively, the state of the ring.

Swallowing Assessment in Post-Comatose Patients: A Feasibility Study on the SWADOC Tool.

After a severe brain injury and a coma, patients may develop disorders of consciousness (DoC), frequently accompanied by severe dysphagia. The evaluation and therapy of swallowing are therefore essential aspects of their management. Objectives: This study aims to evaluate the SWallowing Assessment in Disorders of Consciousness (SWADOC) tool in the assessment of swallowing in post-comatose patients.

Exploring the Significance of Cognitive Motor Dissociation on Patient Outcome in Acute Disorders of Consciousness.

Cognitive motor dissociation (CMD) is characterized by a dissociation between volitional brain responses and motor control, detectable only through techniques such as electroencephalography (EEG) and functional magnetic resonance imaging. Hence, it has recently emerged as a major challenge in the assessment of patients with disorders of consciousness. Specifically, this review focuses on the prognostic implications of CMD detection during the acute stage of brain injury.

Neuro-orthopaedic assessment and management in patients with prolonged disorders of consciousness: A review.

Background: Following a severe acquired brain injury, neuro-orthopaedic disorders are commonplace. While these disorders can impact patients' functional recovery and quality of life, little is known regarding the assessment, management and treatment of neuro-orthopaedic disorders in patients with disorders of consciousness (DoC).

Objective: To describe neuro-orthopaedic disorders in the context of DoC and provide insights on their management and treatment.

International survey on the implementation of the European and American guidelines on disorders of consciousness.

Diagnostic, prognostic, and therapeutic procedures for patients with prolonged disorders of consciousness (pDoCs) vary significantly across countries and clinical settings, likely due to organizational factors (e.g., research vs.

A protocol for a multicenter randomized and personalized controlled trial using rTMS in patients with disorders of consciousness.

Background: Improving the functional recovery of patients with DoC remains one of the greatest challenges of the field. Different theories exist about the role of the anterior (prefrontal areas) versus posterior (parietal areas) parts of the brain as hotspots for the recovery of consciousness. Repetitive transcranial magnetic stimulation (rTMS) is a powerful non-invasive brain stimulation technique for the treatment of DoC.

Sham-controlled randomized multicentre trial of transcranial direct current stimulation for prolonged disorders of consciousness.

Background And Purpose: Transcranial direct current stimulation (tDCS) has been shown to improve signs of consciousness in a subset of patients with disorders of consciousness (DoC). However, no multicentre study confirmed its efficacy when applied during rehabilitation. In this randomized controlled double-blind study, the effects of tDCS whilst patients were in rehabilitation were tested at the group level and according to their diagnosis and aetiology to better target DoC patients who might repond to tDCS.

Assessment and management of pain/nociception in patients with disorders of consciousness or locked-in syndrome: A narrative review.

The assessment and management of pain and nociception is very challenging in patients unable to communicate functionally such as patients with disorders of consciousness (DoC) or in locked-in syndrome (LIS). In a clinical setting, the detection of signs of pain and nociception by the medical staff is therefore essential for the wellbeing and management of these patients. However, there is still a lot unknown and a lack of clear guidelines regarding the assessment, management and treatment of pain and nociception in these populations.

Gender Specificities in Sleep Disturbances following Mild Traumatic Brain Injury: A Preliminary Study.

Mild traumatic brain injury (mTBI), or concussion, can lead to persistent cognitive and functional symptoms that impede quality of life to a varying extent. This condition is referred to as post-concussive syndrome (PCS). Sleep disturbances are part of it but their distribution among different genders remains scarcely investigated.

Predicting Long-Term Recovery of Consciousness in Prolonged Disorders of Consciousness Based on Coma Recovery Scale-Revised Subscores: Validation of a Machine Learning-Based Prognostic Index.

Prognosis of prolonged Disorders of Consciousness (pDoC) is influenced by patients' clinical diagnosis and Coma Recovery Scale-Revised (CRS-R) total score. We compared the prognostic accuracy of a novel Consciousness Domain Index (CDI) with that of clinical diagnosis and CRS-R total score, for recovery of full consciousness at 6-, 12-, and 24-months post-injury. The CDI was obtained by a combination of the six CRS-R subscales via an unsupervised machine learning technique.

High-speed heating of the skin using a contact thermode elicits brain responses comparable to CO laser-evoked potentials.

Objective: To compare nociceptive event-related brain potentials elicited by a high-speed contact-thermode vs an infrared CO laser stimulator.

Methods: Contact heat-evoked potentials (CHEPs) and CO laser-evoked potentials (LEPs) were recorded in healthy volunteers using a high-speed contact-thermode (>200 °C/s) and a temperature-controlled CO laser. In separate experiments, stimuli were matched in terms of target surface temperature (55 °C) and intensity of perception.