Brain and behavior
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Randomized Controlled Trial Comparative Study
POCD in patients receiving total knee replacement under deep vs light anesthesia: A randomized controlled trial.
Clinical observation, as well as randomized controlled trials, indicated an increasing rate of postoperative cognitive dysfunction (POCD) with increasing depth of general anesthesia. However, the findings are subject to bias due to varying degree of analgesia. In this trial, we compared the rate of POCD between patients receiving light versus high anesthesia while holding analgesia comparable using nerve block. ⋯ In elderly patients receiving a total knee replacement, lighter anesthesia could reduce the rate of POCD with complete analgesia during surgery.
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Randomized Controlled Trial
Speech intelligibility in Parkinson's disease patients with zona incerta deep brain stimulation.
To investigate the effects of l-dopa (Levodopa) and cZi-DBS (deep brain stimulation in caudal zona incerta) on spontaneous speech intelligibility in patients with PD (Parkinson's disease). ⋯ cZi-DBS was shown to have smaller negative effects when evaluated from spontaneous speech compared to speech effects reported previously. The previously reported reduction in word-level intelligibility 12 months postoperatively was not transferred to spontaneous speech for most patients. Reduced intelligibility due to cZi stimulation was much more prominent 6 months postoperatively than at 12 months.
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Randomized Controlled Trial
Conscientiousness is modified by genetic variation in catechol-O-methyltransferase to reduce symptom complaints in IBS patients.
Attention to and perception of physical sensations and somatic states can significantly influence reporting of complaints and symptoms in the context of clinical care and randomized trials. Although anxiety and high neuroticism are known to increase the frequency and severity of complaints, it is not known if other personality dimensions or genes associated with cognitive function or sympathetic tone can influence complaints. Genetic variation in catechol-O-methyltransferase (COMT) is associated with anxiety, personality, pain, and response to placebo treatment. We hypothesized that the association of complaint reporting with personality might be modified by variation in the COMT val158met genotype. ⋯ These findings potentially broaden our understanding of the factors underlying clinical complaints to include the personality dimension of conscientiousness and its modification by COMT.