The Journal of neuropsychiatry and clinical neurosciences
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J Neuropsychiatry Clin Neurosci · Jan 2012
ReviewWhat are the opportunities for EEG-based monitoring of delirium in the ICU?
Recognition of delirium in intensive care unit (ICU) patients is poor, despite the use of screening tools. Electroencephalography (EEG) with a limited number of electrodes and automatic processing may be a more sensitive approach for delirium monitoring. ⋯ The relative power of the theta and alpha frequency band most often (7/14 studies) distinguished delirium from non-delirium subjects. Given the feasibility for continuous EEG monitoring in ICU, EEG delirium monitoring in ICU patients is promising.
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J Neuropsychiatry Clin Neurosci · Jan 2012
Clinical TrialAssociations between bilateral subthalamic nucleus deep brain stimulation (STN-DBS) and anxiety in Parkinson's disease patients: a controlled study.
The authors explored the associations between subthalamic nucleus deep brain stimulation (STN-DBS) and anxiety in Parkinson's disease (PD) patients. Recent research suggests that anxiety may be one of the earliest manifestations of PD; however, the lack of a dopamine-medication control group is a major limitation of these studies. Authors paired a group of 31 bilateral STN-DBS PD patients (STN-DBS group) with 31 dopamine-medicated PD patients (Medication-control group) and used various psychological assessment scales for group evaluations. ⋯ Anxiety scores remained stable before 3rd-month Stimulator Power-On, but got worse after that time. In the STN-DBS group, S-AI was positively related to motor symptoms and life quality preoperatively and 4 months postoperatively, but, in the Medication group, this correlation existed throughout the study. PD-related anxiety decreased in STN-DBS patients because of the improvement in motor function for a short time; however, as the voltages and pulse-widths grew higher with time, the PD-related anxiety became worse.
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J Neuropsychiatry Clin Neurosci · Jan 2012
Human medial forebrain bundle (MFB) and anterior thalamic radiation (ATR): imaging of two major subcortical pathways and the dynamic balance of opposite affects in understanding depression.
The medial forebrain bundle (MFB), a key structure of reward-seeking circuitry, remains inadequately characterized in humans despite its vast importance for emotional processing and development of addictions and depression. Using Diffusion Tensor Imaging Fiber Tracking (DTI FT) the authors describe potential converging ascending and descending MFB and anterior thalamic radiation (ATR) that may mediate major brain reward-seeking and punishment functions. Authors highlight novel connectivity, such as supero-lateral-branch MFB and ATR convergence, caudally as well as rostrally, in the anterior limb of the internal capsule and medial prefrontal cortex. These anatomical convergences may sustain a dynamic equilibrium between positive and negative affective states in human mood-regulation and its various disorders, especially evident in addictions and depression.