Lancet neurology
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Advances over the past two decades in functional neuroimaging have provided new diagnostic and prognostic tools for patients with severe brain injury. Some of the most pertinent developments in this area involve the assessment of residual brain function in patients in the intensive care unit during the acute phase of severe injury, when they are at their most vulnerable and prognosis is uncertain. ⋯ Yet, technical and logistical challenges to clinical integration of these advanced neuroimaging techniques remain, such as the need for specialised expertise to acquire, analyse, and interpret data and to determine the appropriate timing for such assessments. Once these barriers are overcome, advanced functional neuroimaging technologies could improve diagnosis and prognosis for millions of patients worldwide.
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The number of long duration human spaceflights has increased substantially over the past 15 years, leading to the discovery of numerous effects on the CNS. Microgravity results in headward fluid shifts, ventricular expansion, an upward shift of the brain within the skull, and remodelling of grey and white matter. The fluid changes are correlated with changes to perivascular space and spaceflight associated neuro-ocular syndrome. ⋯ Another major concern is that galactic cosmic radiation, which spacefarers will be exposed to when going beyond the magnetosphere around Earth, might have a negative effect on CNS function. Research with rodents points to the potential disruptive effects of space radiation on blood-brain barrier integrity and brain structures. More work is needed to understand and mitigate these effects on the CNS before humans travel to Mars, as the flight durations will be longer than anyone has previously experienced.