Diversion of cerebrospinal fluid (CSF) is a common neurosurgical procedure for control of intracranial pressure (ICP) in the acute phase after traumat…

Author Summary Brain-machine interfaces (BMI) for closed-loop control of anesthesia have the potential to enable fully automated and precise control of brain states in patients requiring anesthesia care. Medically-induced coma is one such drug-induced state in which the brain is profoundly inactivated and unconscious and the electroencephalogram (EEG) pattern consists of bursts of electrical activity alternating with periods of suppression, termed burst suppression. Medical coma is induced to treat refractory intracranial hypertension and uncontrollable seizures. The state of coma is often required for days, making accurate manual control infeasible. We develop a BMI that can automatically and precisely control the level of burst suppression in real time in individual rodents. The BMI consists of novel estimation and control algorithms that take as input the EEG activity, estimate the burst suppression level based on this activity, and use this estimate as feedback to control the drug infusion rate in real time. The BMI maintains precise control and promptly changes the level of burst suppression while avoiding overshoot or undershoot. Our work demonstrates the feasibility of automatic reliable and accurate control of medical coma that can provide considerable therapeutic benefits.

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The Adventures in Comaland trope as used in popular culture. A character is unconscious and near-death, and has an abnormally realistic dream. The world may …

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OVERVIEW: What every practitioner needs to know Are you sure your patient has myxedema coma? What are the typical findings for this disease? Myxedema coma

The ultrasound treatment brought a 25-year-old brain injury patient back to full consciousness. Kristopher SturgisA new study out of UCLA has shown promis

Research on therapies that may rouse a patient in a persistent vegetative state needs to include the ethical considerations of waking a patient in a state of incomplete recovery.

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This lesson is an interdisciplinary approach to introducing Virtual Reality (VR) immersions through the lens of disability studies.

Background Different non-pharmacological techniques, including hypnosis and virtual reality (VR) are currently used as complementary tools in the treatment of anxiety, acute and chronic pain. A new technique called virtual reality hypnosis (VRH), which encompasses a combination of both tools, is regularly used although its benefits and underlying mechanisms remain unknown to date. With the goal to improve our understanding of VRH combination effects, it is necessary to conduct randomised and controlled research trials in order to understand their clinical interest and potential benefits. Methods Patients (n = 100) undergoing cardiac surgery at the Liège University Hospital will be randomly assigned to one of four conditions (control, hypnosis, VR or VRH). Each patient will receive two sessions of one of the techniques: one the day before the surgery and one the day after. Physiological assessments will be made on the monitor and patients will rate their levels of anxiety, fatigue, pain, absorption and dissociation. Discussion This study will help to expand knowledge on the application of virtual reality, hypnosis and VRH in the specific context of cardiac and intensive care procedures, and the influence of these non-pharmacological techniques on patient’s anxiety, fatigue, pain and phenomenological experience. Trial registration ClinicalTrials.gov: NCT03820700. Date registered on 29 January 2019. Study recruitment date: October 6, 2018. Study anticipated completion date: December 28, 2020.

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In 2016, a team reported that a 25-year-old man recovering from a coma had made remarkable progress following a treatment to jump-start his brain using ultrasound. Now, researchers report that two more patients with severe brain injuries have also made impressive progress thanks to the same technique.