Archive for November, 2022

[WEB] Neurology, Neuroscience & Neurosurgery websites – UCL

Posted by Kostas Pantremenos in Neuroplasticity, resources on November 30, 2022

Neurology, Neuroscience & Neurosurgery websites

Neuro-websites

Neuro-gateways

Neuro-organisations

Neuro-history

  • Cyber Museum of Neurosurgery (USA)
  • History of Medicine – an online version of the classic annotated bibliography commonly known as “Garrison-Morton”, listing classic publications for many areas of medicine including neuro-topics, many pre-date the coverage of search sources such as Pubmed.
  • History of Neurosurgery at Massachusetts General Hospital & Harvard Medical School (USA)
  • History of Neuroscience by Eric H. Chudler, Ph.D., Research Assistant Professor, Dept. of Anesthesiology, University of Washington
  • Harvey Cushing/John Hay Whitney Medical Library Yale University (USA)
  • Images from the History of Medicine (USA) – a searchable collection of about 100,000 images from the prints and photograph collection of the National Library of Medicine.
  • ECHO (Exploring and Collecting History Online) from the Center for History and New Media, George Mason University. Database concerned with the history of science, technology and industry.
  • Whonamedit.com is a biographical dictionary of medical eponyms and is also useful for finding bibliographical dates
  • Nobel Prize – more than 7000 documents about the Nobel prizes. Including portraits and biographies of laureates. Includes Carlsson, Greengard & Kandel, Prize for Physiology or Medicine 2000 “for their discoveries concerning signal transduction in the nervous system”.
  • Wellcome Trust (UK) – History of Medical Collection: a free catalogue of evaluated, high quality Internet resources and websites relating to the history of medicine and allied sciences, covering all aspects of the history of health and development of medical knowledge.

Neuro-people

Including online directories of neurologists, neurosurgeons & neuroscientists:

Neuro-images

  • anatomy tv – an interactive 3D human anatomy for UCL users. No login is required if you access the service via the Primal Pictures link while connected to the UCL network (or access via Desktop@UCL Anywhere when working offsite).  Unfortunately NHS access to this resource has ceased, as NHS funding was no longer available to support this subscription.
  • flickr – photo/image-sharing site with many images freely available for re-use through Creative Commons arrangements.
  • HONmedia – a repository of medical images and videos covering 1,700 topics and themes.
  • NHS Scotland Photo Library – a resource for the NHS providing photography for use in communication materials.
  • University of Iowa Digital Library – includes Charles Bell’s classic images of trepanning.
  • US NLM Images from the History of Medicine. searchable collection of over 65,000 images.
  • Visible Body (Argosy) – “the most comprehensive human anatomy visualization tool available” 3D models of over 1,700 anatomical structures, including all major organs and systems of the human body. Compatible with Internet Explorer.
  • Wellcome Collection YouTube Channel (UK) – videos relating to medical history from the Wellcome Collection.

Medical Terminoloy

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[ARTICLE] Systematic Development of the ReWin Application: A Digital Therapeutic Rehabilitation Innovation for People With Stroke-related Disabilities in India – Full Text

Posted by Kostas Pantremenos in Apps, Assistive Technology, Tele/Home Rehabilitation on November 30, 2022

Abstract

This is a viewpoint paper that aims to describe the systematic approach to the development of a technology-driven stroke rehabilitation innovation to manage disabilities following a stroke at home in India. This paper intends to sensitize public health innovators and intervention development experts about the important aspects that need to be considered to develop a culturally sensitive, patient-centered, scalable solution for stroke care using technology. Stroke has been the second-leading cause of death and the third-leading cause of disability globally for the past 3 decades. The emerging technological innovations for stroke care were predominantly designed and developed by digital technology experts as stand-alone products with very minimal efforts to explore their feasibility, acceptability, and, more importantly, scalability. Hence, a digital therapeutic rehabilitation innovation for people with stroke-related disabilities in India was systematically developed and is being evaluated. ReWin is an innovation that is technologically driven and envisions digital therapeutics as a medium for the provision of rehabilitation to persons with disabilities. It is conceptualized and developed based on the International Classification of Functioning, Disability and Health. ReWin encompasses specific technological aspects to enable its scientific framework and conceptualization to suit the context and needs of stroke care providers and consumers. The framework is built with 2 separate applications, one for the providers and one for the patients and caregivers. Each of these applications has a specific inbuilt design to add data about the demographic details of the user, stroke severity using the National Institute of Health Stroke Scale, and self-assessment of disability measured by the modified Barthel Index. Users can communicate with each other and decide on their therapeutic goals, therapy training information, and progress remotely from where they are. The ultimate outcome expected from the ReWin innovation is a continuum of care for stroke survivors that is effective, safe, and of good quality. Systematic development cannot make the intervention scalable. The intervention needs to be evaluated for its feasibility, acceptability, and effectiveness. Currently, ReWin is being evaluated for its feasibility and acceptability. The evaluation of ReWin will provide an opportunity to develop a scalable solution for empowering therapists and persons with disabilities, in general, to objectively self-manage their treatment. Findings from this study will also provide valuable information about the resources required to deliver such interventions in resource-constrained settings like India.

Introduction

Stroke has been the second-leading cause of death and the third-leading cause of disability globally for the past 3 decades [1]. There have been several innovations to meet the growing need for stroke rehabilitation in the community [2]. Most recently, the approach to innovations for stroke rehabilitation has amalgamated the strengths of technology and digital therapeutics [3]. However, these technological innovations for stroke care were predominantly designed and developed by digital technology experts as stand-alone products with very minimal efforts to explore their feasibility, acceptability, and more importantly, scalability [4]. Perhaps this could be one reason why these technologically driven rehabilitation innovations have not been optimally used in primary stroke care, especially in the context of low- and middle-income countries including India.

As recommended by the Medical Research Council, United Kingdom, the development of innovative interventions, especially those that are complex, must be systematic and phased [5]. This will enable the design as well as the development of context-specific, culturally sensitive, and patient-centered interventions [6]. It is also important that these technological innovations connect patients with providers of rehabilitation. Most of the innovations for stroke rehabilitation that are available in the market are aimed at supporting stroke survivors or stroke service providers [7]. This potentially creates a gap in the continuum of care between the users and providers of stroke care, and therefore, the supply of rehabilitation services could never meet the demands [8]. The development of innovative stroke rehabilitation interventions that consider the aspects of feasibility, acceptability, and scalability is therefore of utmost public health importance [9]. It also stresses the importance of innovations targeting the continuum of care, especially for a condition like a stroke, which results in a long-term permanent disability [10].

In this paper, we aim to describe the systematic approach to the development of a technology-driven stroke rehabilitation innovation to manage disabilities following a stroke at home in India. The innovation is called ReWin. ReWin is a digital therapeutics platform conceptualized, developed, and owned by TNQ InGage Technologies, a company based out of Chennai, India. It is an innovation that was systematically designed with the utmost consideration for scalability and a continuum of care. This paper intends to sensitize public health innovators and intervention development experts about the important aspects that the authors considered to develop the ReWin innovation, which is a culturally sensitive, patient-centered, scalable solution for stroke care using technology in India. The paper highlights the technical as well as scientific aspects of the ReWin innovation and its implications for addressing the growing burden of stroke and the demand for stroke care in India as well as in similar contexts. […]

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Figure 3. Mobile-based therapeutic videos.
Figure 4. Wireless sensor for active, active-assisted, and passive therapeutic exercise.
Figure 5. Headset of the head-mounted display for stroke rehabilitation.

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[WEB] Spasticity 101

Posted by Kostas Pantremenos in Spasticity on November 30, 2022

ByACCESSWIRE

A debilitating yet treatable common condition after a stroke

MISSION, KS / ACCESSWIRE / November 28, 2022 / (Family Features) In the year following a stroke, about 1 in 3 stroke survivors will experience spasticity, a common post-stroke condition which causes muscle stiffness due to involuntary muscle contractions. Most commonly affecting the elbow, wrist and ankle, the condition may make it difficult to do activities people were able to do before their stroke like dressing, brushing their teeth or walking.

Family Features, Monday, November 28, 2022, Press release picture

More than 3 million stroke survivors may wrestle with reduced independence and increased reliance on caregivers due to spasticity. The condition is particularly common in younger stroke survivors.

After a stroke, the way your brain communicates with your muscles may change. Muscles may be stiff or resistant to stretching. They may involuntarily contract or have a smaller range of motion.

“While there’s no cure for spasticity, working with your care team to find the best treatment options for you can help provide comfort, relief and independence,” said Richard D. Zorowitz, MD, volunteer past chair of the American Heart Association’s Stroke Council Rehabilitation and Recovery Committee and chief medical informatics officer and outpatient attending physician at MedStar National Rehabilitation Network.

Some common symptoms include painful muscle spasms; difficulty stretching muscles; stiffness in the arm, hand, leg and ankle; an arm folded and pressed against the chest with a curled wrist and fingers; an involuntary tight fist; pointed foot; curled toes; and overactive reflexes.

If left untreated, spasticity can cause painful and debilitating bone and joint deformities. Experts stress seeing a doctor as soon as symptoms develop. Assessment of the condition is critical in developing a treatment plan based on individual needs and goals, the severity of the condition and overall health.

Management plans may include targeted injections of botulinum toxin, oral medications, intrathecal baclofen pump therapy, physical therapy or other methods to improve the muscles’ ability to stretch and regain range of motion. Home modifications such as assistive devices and other adaptations to increase independence and safety may also help.

If you or a loved one is dealing with spasticity after a stroke, talk to your doctor or health care team about options to treat and manage it. Find resources and tools to help at Stroke.org/Spasticity. Spasticity education made possible through funding by Ipsen.

Family Features, Monday, November 28, 2022, Press release picture

Knowing the Signs of Stroke Saved One Man’s Life

When Herbert “Hub” Miller worked as a global leader for an international agriculture science company, his boss ended every meeting with a reminder of the “FAST” acronym to recognize the signs of stroke: Face drooping, Arm weakness, Speech difficulties and Time to call 911.

“I’d sit back and think, ‘Here comes the whole FAST speech again; let’s move on,’” Miller said. “I didn’t know I’d ever use it on myself.”

In April 2021, Miller was working from home when he experienced throbbing head pain. As other symptoms began appearing, the 42-year-old remembered those meetings and checked off the symptoms: His face was numb, his left arm drooped and he struggled to form words.

It turned out to be a hemorrhagic stroke, a ruptured blood vessel bleeding into the brain. Miller’s odds of surviving weren’t good, but it wasn’t until he was recovering in intensive care that he understood the full impact of the stroke. It caused abnormal increases in muscle tone causing stiffness, pain and spasms known as spasticity, leaving him with mobility and cognitive challenges.

After the stroke, Miller struggled with once-simple tasks like drawing a clock, completing a word puzzle and playing memory games.

“Spasticity changed my life and added an additional hurdle to my stroke recovery,” Miller said. “Without being able to open and close my left hand, I can’t write, type or drive like I used to. Those are things most of us take for granted until we can’t do them.”

Miller worked on his penmanship at the same time his youngest son learned to write in the first grade. Miller asked the teacher to send home extra worksheets, and father and son did homework together.

“I don’t measure my success day by day, but when I look back to a year ago and where I am today, I am grateful every day how far I have come,” he said.

Photo courtesy of Getty Images (patient undergoing physical therapy)

Michael French
mfrench@familyfeatures.com
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editors.familyfeatures.com

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[BLOG POST] GENERAL MEDICAL SITES WITH NEUROLOGY SECTIONS

Posted by Kostas Pantremenos in resources on November 30, 2022

  1. Uptodate has a neurology section with a good search function but needs a subscription. It is text intensive.
  2. Medscape has a very good and extensive neurology section listed alphabetically, and it is free!
  3. BMJ Best Practice also lists neurology topics alphabetically but requires access
  4. BMJ Neurology resources page has a few important neurology links
  5. The Cochrane Library is searchable using neurology as search terms; as far as I can see, most if not all, contents are free
  6. Scholarpedia appears to be a growing site with a helpful neuroscience section worth keeping an eye on.
  7. Medline is the go-to resource for current articles on everything medical. It is however difficult to confirm which articles are relevant or reliable
  8. Trip Database is another huge searchable resource including neurology

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[WEB] Getting Disability Benefits With Epilepsy

Posted by Kostas Pantremenos in Epilepsy on November 29, 2022


Medically reviewed by
Amit M. Shelat, D.O.

Article written by
Annie Keller

  • Different types of disability benefits are available for people with epilepsy who qualify.
  • Applications for disability depend on your inability to work.
  • You may appeal if you are denied disability benefits.

Sometimes even the best accommodations at work aren’t enough to help you keep your job when you have epilepsy. “I can get a job, but I just can’t keep it,” said one MyEpilepsyTeam member in regards to unpredictable seizures. Loss of consciousness, convulsive seizures, and the sleepiness that follows many epileptic seizures can be too much to continue working.

When people with epilepsy can no longer work, many in the United States seek Social Security disability benefits. Disability benefits help replace lost income when people with epilepsy have to leave their jobs. “When work caused too much stress that caused my seizures, I knew it was time to apply for disability,” a MyEpilepsyTeam member wrote.

The process of applying for a disability claim can feel intimidating. Filing an appeal for a rejected claim can also prove challenging. Understanding the process ahead of time, including what the U.S. Social Security Administration (SSA) considers to determine disability, can ease the process.

Disability Benefit Programs in the United States

There are two different federal disability programs, Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI). To qualify for either, you must have a disability that limits your ability to work.

Funded through payroll taxes, SSDI gives disability benefits to those who have held full-time jobs in the recent past. If you are approved, you can receive benefits in the sixth month following your disability designation. You will then be eligible for Medicare 24 months after you became disabled.

SSI gives disability benefits to those who are considered low-income; a work history is not a requirement. Once you are approved, you should start to receive benefits in the next month. You may also be eligible for SSI back payments if you became disabled prior to your approval.

In most states, if you qualify for SSI, you are also eligible for Medicaid. In some states and territories — Alaska, Idaho, Kansas, Nebraska, Nevada, Oregon, Utah, and the Northern Mariana Islands — you will need to apply for Medicaid and SSI separately, though the requirements for both are the same. “Where I live, to receive Medicaid, you have to be working but stay under a certain income,” one MyEpilepsyTeam member shared.

“It is possible to work,” another member said. “But you would have to talk to the Social Security Administration specialist and find out how many hours you can work without getting fined or losing the Social Security benefits.”

Eligibility criteria for SSI recipients varies across states.

Almost every state provides an SSI supplement, with exceptions including Arizona, Mississippi, North Dakota, and West Virginia. The eligibility rules for supplements vary by state.

There is an asset (or “resources”) cap for receiving Supplemental Security Income. Individuals with more than $2,000 of assets and couples with more than $3,000 in assets lose eligibility. The SSA has a list of which resources are considered. Your home, household belongings, and one personal vehicle are not factored into the total.

If you have very limited funds and a work history, you may be eligible to receive SSDI and SSI.

Defining Disability

In determining your eligibility for disability benefits, the Social Security Administration will evaluate the following criteria:

  • You are likely ineligible for benefits if you earn $1,260 or more a month. If you earn less, you may still be eligible; the amount you receive may be reduced.
  • You must be incapable of performing basic tasks required for most jobs, including standing, walking, lifting, sitting, and remembering. You must not have been able to perform these tasks for at least 12 months.
  • You must have a recognized disability. The Social Security Administration provides a Listing of Impairments that prevent working. Epilepsy is on the list, under Neurological Disorders. You can still be eligible even if your specific medical condition isn’t listed.
  • You must be unable to perform any work you’ve done previously. A work history is not a prerequisite for receiving SSI.
  • You must be unable to engage in what the SSA calls “substantial gainful activity.” The Social Security Administration will consider your diagnosis, age, medical history, education, and work history, as well as any other marketable skills.

Applying for SSDI and SSI

People with epilepsy face considerable paperwork when applying for disability benefits. The Social Security Administration offers a checklist of necessary application information. Below is a summary of what you’ll need to provide.

Information About Yourself and Your Family

  • Your full legal name, date of birth, and Social Security number
  • Full names and dates of birth of your current or previous spouses, and dates of marriage, divorce, or death
  • Full names and dates of birth of your children
  • Bank account information

Medical Evidence About Your Epilepsy

  • The name and contact information for your neurologist and other medical providers who can discuss your condition and the type of seizures you have (e.g., tonic-clonic, absence, complex partial).
  • A complete list of medications, both past and present, along with any side effects you’ve experienced from them, as well as results for medical tests such as CT scans, MRI, and EEGs.
  • A description of how epilepsy impacts your ability to do activities like shopping, cooking, cleaning, and other tasks of daily living.

Total Employment History

  • Earnings from the past year
  • Any current employers or ones you have worked for in the past two years
  • A complete work history from the last 15 years, including any jobs from before you became disabled
  • Whether you are getting or intend to receive workers’ compensation
  • Dates of any military service

Documents

  • Birth certificate
  • Social Security card
  • Proof of citizenship
  • W-2 or other tax forms from the previous year
  • Any medical records about your condition
  • Proof of any workers’ compensation you have received

Members of MyEpilepsyTeam shared their application experiences. “If you can’t find all the paperwork, [it] helps if you recall where you were hospitalized and when,” one member wrote.

Some MyEpilepsyTeam members faced obstacles in documenting their symptoms. “The SSI people need proof (in person) of your disability. The problem is, seizures are random,” wrote one member.

“My seizures are very controlled, about 3-4 per year, and I don’t qualify,” another MyEpilepsyTeam member disclosed.

You can apply for SSDI online if you:

  • Have never been married
  • Were born in the United States
  • Are between 18 and 65
  • Are not currently receiving benefits

If you don’t meet any of those criteria, you can still apply at a local Social Security office or over the phone.

Appealing a Disability Application Rejection

Processing an application for disability benefits takes an average of three to five months. It can take even longer to get approved.

Most people are not approved the first time they apply. From 2009 through 2018, only 21 percent of applicants were approved on their first attempt. If you are denied the first time, you can appeal the decision. This is a simple process, and your case will be evaluated by someone who did not evaluate your application the first time. Only around 2 percent of these initial appeals were successful from 2009 to 2018.

If necessary, you have the option to file a second appeal. The second appeal includes a hearing by an administrative law judge, trained in disability laws, who will consider all of your evidence.

You may have a disability attorney represent you at this hearing. Some law firms even specialize in disability cases. A MyEpilepsyTeam member recommended enlisting legal counsel early on: “[The appeals process] can take a long time. The only way to get it done quicker is to hire an attorney and stop trying to do it yourself. “

If you are denied at this level, you can ask the Appeals Council to consider and rule on your case. About 8 percent of SSDI claims between 2009 and 2018 were approved during a hearing with an administrative law judge or the Appeals Council.

If your claim is again denied, the final remaining option is a federal court hearing. One MyEpilepsyTeam member had to go this route: “I was denied three times, then went to the federal level, and I got it.”

Waiting for approval of your disability benefits can be stressful. MyEpilepsyTeam members have shared advice on how to cope with the evaluation process and tips on getting approved.

  • “One of the most important things is to have a lot of documentation. [Document] everything on your condition.”
  • “Any doctor that you’ve seen who knows and has files on your epilepsy, get a copy of it all. They need proof that you have this disorder.”
  • “Be sure the doctors explain the diagnosis and how it limits/affects [your ability to work].”
  • “You may have to hire a lawyer briefly when you apply; it will just speed things along.”
  • “Send a letter when you reapply telling them how much it affects your life in every way.”
  • “Keep trying, and tell your neurologist or family doctor — when filling out the papers — everything you can that is going wrong in your life.”

Consider These International Resources

If you’d like to research more about disability benefits in countries outside of the United States, check out these resources, listed by country:

Get Support From People Who Understand

MyEpilepsyTeam is the social network for people with epilepsy and their loved ones. More than 109,000 members come together to ask questions, give advice, and share their stories with others who understand life with epilepsy.

Have you applied for Social Security disability benefits for epilepsy? Do you have any advice about the process? Comment below or start a conversation on MyEpilepsyTeam.

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[WEB] What is a Neuropsychologist?

Posted by Kostas Pantremenos in Educational on November 29, 2022

iStock-1164644244_Feature_1168x760.jpg
Andrey Popov/iStockphoto

A neuropsychologist is someone who can assess people who are having problems with memory, thinking, or concentration or who have experienced changes in personality, behavior, awareness, or language. Neuropsychologists—who have doctoral degrees in psychology and specialized training in neuroscience and nervous system disorders such as dementia, stroke, and epilepsy— administer standardized cognitive and behavioral tests to better determine patients’ levels of difficulty.

In addition to performing tests, neuropsychologists conduct thorough examinations, including reviews of symptoms and medications and interviews with patients and sometimes family members, who may provide more detailed descriptions of any changes they’ve observed in the patients.

During typical cognitive tests, a patient may be asked to review lists of words that the neuropsychologist will ask them to repeat at different points during visits. For another test, a patient studies a design on a piece of paper and re-creates it using colored blocks. Each test assesses memory or other cognitive functions such as reasoning, language, or visuospatial abilities. The neuropsychologist tries to identify patterns that point to different brain disorders. The interviews, the test results, and the history of the patient’s symptoms help a neuropsychologist determine if the patient’s responses are normal for his or her age, identify key abnormalities, and consider which disorder may be causing the disturbance.

Evaluations usually employ a set battery of tests. Additional questions are tailored to each person, based on education, occupation, and past experiences. For example, a memory test for someone with a graduate degree and a technical job might involve remembering a list of 15 words. For someone with a high school diploma and a job in the service industry, it might be a list of 10 words. This allows the neuropsychologist to detect patterns on a simpler test that might be missed on a harder test if it was beyond the scope of the patient’s experience.

During the examination, the neuropsychologist may measure reaction time to questions and consistency of answers to provide a fuller picture of the situation and to make recommendations for care, if needed. As the specialty has grown, neuropsychologists have begun seeing patients at earlier stages, which allows patients and families to plan for the future and start treatments sooner.

Patients may need just one visit, which can last two to six hours, depending on the questions asked and level of the patients’ function. After the examination, the neuropsychologist’s assessments and recommendations are sent to the patient’s doctor or neurologist. Recommendations may include referrals to occupational or speech therapists, brain scans, driving evaluations, and tips for making the patient’s house less cluttered and confusing. Neuropsychologists also may provide referrals to support groups and counseling for caregivers.

The neuropsychologist may ask a patient to come back with a family member for a follow-up visit. If a patient has a progressive disorder, the neuropsychologist may schedule a later visit to assess any changes and make new recommendations.

Neuropsychologists may be part of a neurology or gerontology practice or may be in private practice. They also may work with neuropsychiatrists—psychiatrists who focus on behavioral illnesses related to brain disorders. Subscribe to Our Email Newsletter!Subscribe Now

Not all insurance companies cover visits with neuropsychologists. Patients and families should check with their insurance providers. Medicare may pay some of the cost, and additional fees may be covered by supplemental insurance.

Dr. Weintraub is a neuropsychologist and professor of psychiatry and behavioral sciences at the Feinberg School of Medicine at Northwestern University in Chicago.

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[BLOG POST] Which are the most useful neurological applications?

Posted by Kostas Pantremenos in Apps, resources on November 29, 2022

It is no exaggeration to say our lives revolve around apps. These handy devices bring knowledge to our fingertips at the tap of the finger, or the click of a mouse . They promise easy access to a world of information, often digested to size. Some offer tools to simplify our practice. Neurology is, or should be, no exception.

Apple Store according to the New York Times. Wolf Gang on Flikr. https://www.flickr.com/photos/wolfgangkuhnle/4163909778
Apple Store according to the New York Times. Wolf Gang on Flikr. https://www.flickr.com/photos/wolfgangkuhnle/4163909778

So what are the tools out there making neurological practice easier and handier? What are these practical shortcuts making clinical work more efficient? I browsed the web and found some useful neurology applications, and have grouped them as follows:

CLINICAL MANAGEMENT APPS

APPS THAT AID THE CLINICAL EXAMINATION

  • Neuro Toolkit. This is only available for the iphone or ipad. A review on Neurology Times says it is ‘an up-to-date, simple and straightforward app’ that contains medical calculators and clinical scoring scales. It also received a favourable review in Neurology journal.
  • 5-minute Neurology Consult. The blurb on google play says Neurology Consult ‘provides instant access to comprehensive, clinically-oriented, must-have information on all disorders of the nervous system’.
  • Neurology a-pocket cards.
  • Neurology Exam Tools promises a flashlight and tuning fork which should lighten the neurologists tool case but it is not clear how efficiently.
  • Neuro Localizer sounds self-explanatory and is developed by neurologists.
  • Neurology pocket app with explanatory video below:

APPS ORIENTED TOWARDS CLINICAL SCORING

PATIENT SELF-MANAGEMENT APPS

Rubik apps. Cesar Poyatos on Flikr. https://www.flickr.com/photos/cpoyatos/5791320785
Rubik apps. Cesar Poyatos on Flikr. https://www.flickr.com/photos/cpoyatos/5791320785

DISEASE-SPECIFIC APPS 

ANATOMY APPS

JOURNAL APPS

ALLIED NEUROLOGICAL SPECIALTIES APPS 

Neurochecklists, our own comprehensive neurology information source, is still web-based, but an app will follow soon so watch out!

Want to explore further? You may check these links out:

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[ARTICLE] Neurostimulation for Functional Recovery After Traumatic Brain Injury: Current Evidence and Future Directions for Invasive Surgical Approaches – Full Text

Posted by Kostas Pantremenos in TBI on November 28, 2022

Abstract

We aim to provide a comprehensive review of the current scientific evidence supporting the use of invasive neurostimulation in the treatment of deficits associated with traumatic brain injury (TBI), as well as to identify future directions for research and highlight important questions that remain unaddressed. Neurostimulation is a treatment modality with expanding applications in modern medical practice. Targeted electrical stimulation of specific brain regions has been shown to increase synaptogenesis and enhance structural reorganization of neuronal networks. This underlying therapeutic effect might be of high value for patients suffering from TBI because it could modulate neuronal connectivity and function of areas that are partially or completely spared after injury. The current published literature exploring the application of invasive neurostimulation for the treatment of functional deficits associated with TBI is scarce but promising. Rodent models have shown that targeted stimulation of the hippocampus or connecting structures can result in significant cognitive recovery, while stimulation of the motor cortex and deep cerebellar nuclei is associated with motor improvements. Data from clinical studies are extremely limited; single-patient reports and case series found neurostimulation to be effective in relieving motor symptoms, improving visuospatial memory, and supporting emotional adjustment. Looking forward, it will be important to identify stimulation targets and paradigms that can maximize improvement over multiple functional domains. It will also be important to corroborate the observed behavioral improvements with histological, electrophysiological, and radiological evidence. Finally, the impact of biological variables such as sex and age on the treatment outcomes needs to be explored.

Neuromodulation describes the alteration of neuronal activity through the delivery of a chemical or electrical stimulus to specific neural targets in the body.1 The stimulus acts to modulate the firing rate of neuronal impulses, potentially modifying the structural arrangement and strength of synaptic connections not only within the target area itself but also across interconnected brain regions.2 The goal of therapeutic neuromodulation is to drive the reconfiguration of targeted neuronal circuits into a high-level change that improves behavior and functional capacity. The underlying mechanism by which neuromodulation modifies neuronal synapses may involve facilitation or inhibition of neuronal depolarization and remains a topic of active scientific debate.3-6

Several techniques have been used to deliver stimuli and alter the neuronal activity within the nervous system. Pharmacological approaches with neurotransmitter-based compounds have traditionally been used as part of pharmacological management for some neurological conditions. Nonpharmacological approaches, also known as “neurostimulation,” rely on the use of electrical impulses and magnetic currents to deliver stimuli to a specific area in the nervous system. In most cases, the mechanistic goal is to modulate neural activity in such a way as to disrupt pathological activity responsible for disease manifestation or, in the case of traumatic brain injury (TBI), modulate neural activity to promote functional reorganization.

A wide range of techniques have been developed to achieve neurostimulation. Transcranial magnetic stimulation (TMS) is a noninvasive neurostimulation method that involves passing current through coils to generate a magnetic field onto the targeted area. Another type of noninvasive neurostimulation is transcranial direct current stimulation (tDCS), where electrodes are placed directly on the subject’s scalp to generate an electric current that is intended to penetrate the skull and modulate neural activity. More invasive approaches can take the form of deep brain stimulation (DBS), whereby an electrode is implanted in a targeted subcortical brain region, or can involve superficial delivery of electrical current to the cortical surface. Although the noninvasive nature of TMS and tDCS give those techniques a perceived advantage over their invasive counterparts, experience has shown that invasive methods offer a more reliable and precise approach to stimulate the targeted areas at the desired frequency, amplitude, and pulse width. Furthermore, the extensive clinical experience with DBS over the years has led to significant improvements in safety and consistency.7,8

The application of neurostimulation in the treatment of medical conditions is wide and continues to expand as research groups continually identify novel uses and benefits of this technology. While most frequently used in the treatment of Parkinson disease, essential tremor, and dystonia, neurostimulation provides benefit in a range of other conditions including epilepsy,9 chronic headaches,10 bladder and bowel incontinence,11 depression,12 obsessive-compulsive disorders,13 Tourette syndrome,14 stroke recovery,15 and hypertension.16 […]

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[VIDEO] The 10 most viewed neurology videos on Youtube – The Neurology Lounge

Posted by Kostas Pantremenos in Video on November 28, 2022

The Neurology Lounge has already reviewed the changing terrain of neurology, throwing a light on the increasing role of social media, online video sites, and online databases, all competing and complementing the classroom and the clinic. Our previous posts on this subject include:

Outstanding neurology video channels and sites

Which are the most reliable neurology reference sources?

Which are the most useful neurological applications?

Youtube remains the clear leader when it comes to videos. Buried among the cat and dog snippets, hiding behind the crazy stunts and funny clips, and camouflaged by the ubiquitous vlogs, are many enlightening neurological stuff. And of the many neurology videos on Youtube, some have attracted more attention than others. Is there a secret? There’s only one way to find out!

Here then are the top 10 most viewed neurology videos on Youtube:

10.

9. 

8.

7.

6.

5. 

4.

3.

2.

1.

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If there is any lesson here, it’s all about the simple things. No complicated syndromes, no convoluted guidelines. In some cases, no master at all! Viewers just want to see the complex simplified!

PS. To widen the variety of video sources, I have restricted each source to one video.

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[WEB] Kessler and BrainQ Partner on EMAGINE Stroke Rehab Trial

Posted by Kostas Pantremenos in Caregivers, Neuroplasticity, REHABILITATION, Tele/Home Rehabilitation on November 28, 2022

Kessler and BrainQ Partner on EMAGINE Stroke Rehab Trial

Researchers from Kessler Foundation and Kessler Institute for Rehabilitation are enrolling participants in a national trial of a breakthrough device for improving recovery after stroke. Kessler locations in West Orange and Saddle Brook, NJ, are among the 20 sites across the US participating in the EMAGINE Stroke Recovery Trial, which pairs therapeutic exercise with stimulation of the brain through an investigational wearable device.

Steven Kirshblum, MD, is principal investigator and Ghaith Androwis, PhD is co-primary investigator for the Kessler study.

“Given the broad impact that stroke has on individuals, families, and caregivers, as well as health care services and our economy, the benefits of improving the outcomes for stroke rehabilitation are substantial,” noted Steven Kirshblum, MD, chief medical officer for Kessler Foundation and Kessler Institute for Rehabilitation. Dr. Kirshblum also serves as chair of the Department of Physical Medicine and Rehabilitation at Rutgers New Jersey Medical School.

“Too often stroke results in long-term disability that adversely affects quality of life,” Dr. Kirshblum continued. “Now we know that with early and intensive intervention, stroke survivors have the capability to regain function. The EMAGINE trial capitalizes on this neuroplasticity of the brain and spinal cord by augmenting standard rehabilitation with electromagnetic stimulation and making therapy available in different settings, including the home,” he explained.

Each site plans to enroll individuals within four to 21 days of moderate-to-severe ischemic stroke. At Kessler, three participants to date have been enrolled in the study, which is randomized, sham-controlled, and double-blinded, according to Dr. Androwis, senior research scientist in the Center for Mobility and Rehabilitation Engineering Research at Kessler Foundation and director of the Center’s Rehabilitation Robotics and Research Laboratory.

The first participant has completed the nine-week protocol, which comprises 45 one-hour sessions administered five times a week. During each session, the participant performs therapeutic exercises while wearing the device, which fits over their head and torso without interrupting the participant’s ability to perform functional tasks with their upper extremities.

“Given the promising results of our already completed BrainQ trial in persons with chronic spinal cord injury, we are excited to study the potential benefits of this non-invasive brain and spine stimulation intervention in persons disabled by stroke,” said Dr. Androwis.

Using machine learning, the BQ device targets affected areas of the brain with electromagnetic field therapy. The therapy, which is low intensity and frequency tuned, is administered along with the current standard for physical and occupational therapy, toward the goal of facilitating neurorecovery. Preliminary findings were promising, which prompted the FDA to award Breakthrough Device Designation to BrainQ’s device in 2021.   

BrainQ’ s developers see the device’s potential for a flexible continuum of therapy, from acute care, through rehabilitation and after discharge for at-home use. “Being able to stay engaged in therapy throughout the recovery process is a unique aspect of the EMAGINE study,” Androwis emphasized. “Participants can access this investigational therapy from home, with oversight by a trained caregiver and remote monitoring by a member of the study team.” 

“We are pleased that true leaders in rehabilitative research and clinical care, including Kessler Foundation and Kessler Institute, are our partners in the EMAGINE trial,” said Yotam Drechsler, CEO of BrainQ. “Together, we are striving toward our common goal – to transform the future of stroke rehabilitation by restoring lost mobility through innovative technology applied to home-based solutions.”

Eligible participants are recruited from Kessler Institute for Rehabilitation, a Select Medical inpatient rehabilitation hospital that provides rehabilitative care for stroke and other disabling conditions. In-patients undergoing stroke rehabilitation are evaluated for their eligibility by the Kessler study team.

The study is funded by BrainQ, developer of the investigational device.

[Source(s): Kessler Foundation, EurekAlert; Photo Credit: BrainQ]

Related Content:
BrainQ Stroke Rehab Device Study Suggests Encouraging Results
Brooks Rehabilitation Participates in EMAGINE National Stroke Recovery Trial Using Breakthrough Technology

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