NICHOLAS D contact SCHIFF

..These findings support developing systematic characterizations of the severely injured brain and suggest that some patients may benefit from improved diagnostic assessments...

..We discuss the possibilities of linking neuromodulation techniques to underlying neuronal mechanisms underpinning cognitive rehabilitation maneuvers. Ethical considerations surrounding the development of these strategies are reviewed...

..A model accounting for present therapeutic strategies is proposed...

..Such ongoing fluctuations of central thalamic activity likely reflect a mix of influences, including variations in moment-to-moment levels of motivation, arousal, and availability of cognitive resources...

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..Recent neuroimaging investigations have explored the use of mental imagery tasks as proxies for an overt motor response, in which patients are asked to imagine performing a task, such as "Imagine yourself swimming."..

..This brief review places a small number of recent studies into a broader historical context and identifies important challenges for further development of this area of research...

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..Measuring evolving changes in underlying brain function and dynamics post-injury and post-treatment frames future investigative work...

..The article concludes with some observations on the heart-brain interface and future research directions in the context of recovery from severe brain injury...

..Although limited in number, available studies already provide important insights into underlying brain mechanisms that may help guide development of such assessment strategies...

..The variations in cerebral metabolism in chronic PVS patients indicate that some cerebral regions can retain partial function in catastrophically injured brains...

..Several pathophysiological mechanisms that might limit further recovery in MCS patients are considered. Implications for future research directions and possible therapeutic strategies are reviewed...

..The phase advance generated by attention of the adapted responses suggests that the attentional gain control operates in some ways like a contrast gain control utilizing a neural measure of contrast to influence dynamics...

..These considerations suggest a role for the reticular nucleus in modulating long distance cortical communication...

..To better understand to which degree resting state patterns reflect neuronal network function, we are comparing network patterns of normal subjects with those having severe brain lesions in a small pilot study...

..Areas of initial focus would be to define the epidemiology of the minimally conscious state, elucidate mechanisms of recovery, and identify clinically useful diagnostic and prognostic markers that will aid decision making at the bedside...

..Results of this preliminary study revealed that CT/DBS can lead to an improvement, a decrement, a mixed or have no effect on behavior...

..We describe ethical challenges faced in clinical research involving medical devices and offer several cautionary notes about its funding and the interplay of market forces and scientific inquiry and suggest some reforms...

..In this review we will assess the various neurophysiological studies currently at our disposal to evaluate and follow the clinical course of patients who have suffered severe brain injuries...

..We propose that axonal regrowth may underlie these findings and provide a biological mechanism for late recovery. Our results are discussed in the context of recent experimental studies that support this inference...

..The timing and frequency characteristics of these signals suggest that the nature of this perisaccadic modulation varies across the cortex...

..Our data comprise the first demonstration that the temporal pattern of DBS can be used to elevate its effectiveness, and also point the way toward the use of nonlinear dynamics in the exploration of means to optimize DBS...

..Taken together, these studies indicate that electrical stimulation of the central thalamus may enhance cognitive performance through neocortical and hippocampal neuronal activation and specific regulation of gene expression...

..We estimate that the mouse connectivity project could be completed within five years with a comparatively modest budget...

..We compare our results with evidence for slow fluctuations in human functional imaging studies and other electrophysiologic studies in nonhuman primates...

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..We discuss the problems of evidence-based neurorehabilitation in disorders of consciousness, and recent functional neuroimaging data obtained in the vegetative state and minimally conscious state...

..Neuroimaging techniques remain important tools for clinical research that will extend our understanding of the underlying mechanisms of these disorders...

..Without such studies, these patients will continue to remain categorically excluded from advances in medical diagnostics and therapeutics. ..

..The long-range goal of the studies proposed here is to provide a foundation for rational therapies for chronic cognitive disabilities following complex brain injuries. ..

..While these are long-range goals, and the studies proposed here do not represent direct investigations of these possibilities, completion of these experiments is necessary and logical step toward these goals. ..

..Without such studies, these patients will continue to remain categorically excluded from advances in medical diagnostics and therapeutics. ..

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