Journal of neuroimaging : official journal of the American Society of Neuroimaging
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Randomized Controlled Trial
Extending communication for patients with disorders of consciousness.
The difficulty of distinguishing disorders of consciousness from certain disorders of communication leads to the possibility of false diagnosis. Our aim is to communicate with patients with disorders of consciousness through asking them to answer questions with "yes/no" by performing mental imagery tasks using functional magnetic resonance imaging (fMRI). ⋯ The results from 2 patients provide independent support of similar work by others with 3 T fMRI, and demonstrate broader clinical utility for these tests at 1.5 T despite lower signal-to-noise ratio. Based on the control results, mental calculation adds a robust imagery task for use in future studies of this kind.
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Randomized Controlled Trial
Functional imaging of the cerebellum and basal ganglia during predictive motor timing in early Parkinson's disease.
The basal ganglia and the cerebellum have both emerged as important structures involved in the processing of temporal information. ⋯ We conclude that both the cerebellum and striatum are involved in predictive motor timing tasks. The cerebellar activity is associated exclusively with the postponement of action until the right moment, whereas both the cerebellum and striatum are needed for successful adaptation of motor actions from one trial to the next. We found a general ''hypoactivation'' of basal ganglia and cerebellum in early stage PD relative to HC, indicating that even in early stages of the PD there could be functional perturbations in the motor system beyond striatum.
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Randomized Controlled Trial
Clinical-radiological severity mismatch phenomenon: patients with severe neurological deficits without matching infarction on computed tomographic scan.
The objective was to determine the long-term outcome of patients with severe persistent neurological deficits without a large infarction on computed tomographic (CT) scan. ⋯ We observed that approximately one-fourth of patients with severe neurological deficits have clinical-radiological severity mismatch. Such patients appear to have a high rate of favorable outcomes at 1 year.
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Randomized Controlled Trial Multicenter Study Comparative Study Clinical Trial
CLOTBUST: design of a randomized trial of ultrasound-enhanced thrombolysis for acute ischemic stroke.
Intravenous tissue plasminogen activator (TPA) therapy can be monitored with 2 MHz transcranial Doppler (TCD). This article describes the design of CLOTBUST (combined lysis of thrombus in brain ischemia using transcranial ultrasound and systemic TPA), the first prospective international multicenter randomized clinical trial of noninvasive externally applied ultrasound to enhance systemic thrombolysis in human stroke. ⋯ The aim of phase II CLOTBUST trial is to determine the rates of early complete recanalization and dramatic/early clinical recovery in TPA + TCD and TPA groups. The sample size is set at 126 patients since a medium effect size (.50) is anticipated for TPA + TCD group vs TPA alone to achieve combined primary end-point.
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Randomized Controlled Trial Multicenter Study Clinical Trial
SonoVue in transcranial Doppler investigations of the cerebral arteries.
The authors investigated the safety and diagnostic potential of a new ultrasound contrast agent (SonoVue) using transcranial color-coded duplex sonography (TCCS). ⋯ The results obtained from this multicenter study demonstrate that the administration of SonoVue to patients with ischemic cerebrovascular disease who undergo TCCS examination of cerebral vessels improves the visualization of intracranial arteries, providing a dose-dependent contrast enhancement and a clinically useful duration of signal enhancement related to the dose. During this multicenter study, SonoVue proved to be a safe and well-tolerated compound.