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[Infographic] Moderate & Severe TBI

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[WEB SITE] Narcissistic personality disorder – Symptoms and causes – Mayo Clinic

Overview

Narcissistic personality disorder — one of several types of personality disorders — is a mental condition in which people have an inflated sense of their own importance, a deep need for excessive attention and admiration, troubled relationships, and a lack of empathy for others. But behind this mask of extreme confidence lies a fragile self-esteem that’s vulnerable to the slightest criticism.

A narcissistic personality disorder causes problems in many areas of life, such as relationships, work, school or financial affairs. People with narcissistic personality disorder may be generally unhappy and disappointed when they’re not given the special favors or admiration they believe they deserve. They may find their relationships unfulfilling, and others may not enjoy being around them.

Treatment for narcissistic personality disorder centers around talk therapy (psychotherapy).

Symptoms

Signs and symptoms of narcissistic personality disorder and the severity of symptoms vary. People with the disorder can:

  • Have an exaggerated sense of self-importance
  • Have a sense of entitlement and require constant, excessive admiration
  • Expect to be recognized as superior even without achievements that warrant it
  • Exaggerate achievements and talents
  • Be preoccupied with fantasies about success, power, brilliance, beauty or the perfect mate
  • Believe they are superior and can only associate with equally special people
  • Monopolize conversations and belittle or look down on people they perceive as inferior
  • Expect special favors and unquestioning compliance with their expectations
  • Take advantage of others to get what they want
  • Have an inability or unwillingness to recognize the needs and feelings of others
  • Be envious of others and believe others envy them
  • Behave in an arrogant or haughty manner, coming across as conceited, boastful and pretentious
  • Insist on having the best of everything — for instance, the best car or office

At the same time, people with narcissistic personality disorder have trouble handling anything they perceive as criticism, and they can:

  • Become impatient or angry when they don’t receive special treatment
  • Have significant interpersonal problems and easily feel slighted
  • React with rage or contempt and try to belittle the other person to make themselves appear superior
  • Have difficulty regulating emotions and behavior
  • Experience major problems dealing with stress and adapting to change
  • Feel depressed and moody because they fall short of perfection
  • Have secret feelings of insecurity, shame, vulnerability and humiliation

When to see a doctor

People with narcissistic personality disorder may not want to think that anything could be wrong, so they may be unlikely to seek treatment. If they do seek treatment, it’s more likely to be for symptoms of depression, drug or alcohol use, or another mental health problem. But perceived insults to self-esteem may make it difficult to accept and follow through with treatment.

If you recognize aspects of your personality that are common to narcissistic personality disorder or you’re feeling overwhelmed by sadness, consider reaching out to a trusted doctor or mental health provider. Getting the right treatment can help make your life more rewarding and enjoyable.

Causes

It’s not known what causes narcissistic personality disorder. As with personality development and with other mental health disorders, the cause of narcissistic personality disorder is likely complex. Narcissistic personality disorder may be linked to:

  • Environment ― mismatches in parent-child relationships with either excessive adoration or excessive criticism that is poorly attuned to the child’s experience
  • Genetics ― inherited characteristics
  • Neurobiology — the connection between the brain and behavior and thinking

Risk factors

Narcissistic personality disorder affects more males than females, and it often begins in the teens or early adulthood. Keep in mind that, although some children may show traits of narcissism, this may simply be typical of their age and doesn’t mean they’ll go on to develop narcissistic personality disorder.

Although the cause of narcissistic personality disorder isn’t known, some researchers think that in biologically vulnerable children, parenting styles that are overprotective or neglectful may have an impact. Genetics and neurobiology also may play a role in development of narcissistic personality disorder.

Complications

Complications of narcissistic personality disorder, and other conditions that can occur along with it, can include:

  • Relationship difficulties
  • Problems at work or school
  • Depression and anxiety
  • Physical health problems
  • Drug or alcohol misuse
  • Suicidal thoughts or behavior

Prevention

Because the cause of narcissistic personality disorder is unknown, there’s no known way to prevent the condition. However, it may help to:

  • Get treatment as soon as possible for childhood mental health problems
  • Participate in family therapy to learn healthy ways to communicate or to cope with conflicts or emotional distress
  • Attend parenting classes and seek guidance from therapists or social workers if needed

via Narcissistic personality disorder – Symptoms and causes – Mayo Clinic

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[Infographic] Sequelae of Brain Injury

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[Infographic] What Depression Feels & Looks Like

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[ARTICLE] A new lower limb portable exoskeleton for gait assistance in neurological patients: a proof of concept study – Full Text

Abstract

Background

Few portable exoskeletons following the assist-as-needed concept have been developed for patients with neurological disorders. Thus, the main objectives of this proof-of-concept study were 1) to explore the safety and feasibility of an exoskeleton for gait rehabilitation in stroke and multiple sclerosis patients, 2) to test different algorithms for gait assistance and measure the resulting gait changes and 3) to evaluate the user’s perception of the device.

Methods

A cross-sectional study was conducted. Five patients were recruited (4 patients with stroke and 1 with multiple sclerosis). A robotic, one-degree-of-freedom, portable lower limb exoskeleton known as the Marsi Active Knee (MAK) was designed. Three control modes (the Zero Force Control mode, Mode 1 and Mode 3) were implemented. Spatiotemporal gait parameters were measured by the 10-m walking test (10MWT), the Gait Assessment and Intervention Tool (G.A.I.T.) and Tinetti Performance Oriented Mobility Assessment (gait subscale) before and after the trials. A modified QUEST 2.0 questionnaire was administered to determine each participant’s opinion about the exoskeleton. The data acquired by the MAK sensors were normalized to a gait cycle, and adverse effects were recorded.

Results

The MAK exoskeleton was used successfully without any adverse effects. Better outcomes were obtained in the 10MWT and G.A.I.T. when Mode 3 was applied compared with not wearing the device at all. In 2 participants, Mode 3 worsened the results. Additionally, Mode 3 seemed to improve the 10MWT and G.A.I.T. outcomes to a greater extent than Mode 1. The overall score for the user perception of the device was 2.8 ± 0.4 95% CI.

Conclusions

The MAK exoskeleton seems to afford positive preliminary results regarding safety, feasibility, and user acceptance. The efficacy of the MAK should be studied in future studies, and more advanced improvements in safety must be implemented.

Background

In 2015, neurological disorders accounted for 16.8% of the total deaths worldwide and 10.2% of the global disability-adjusted life-years (DALYs) [1]. These numbers have increased since 1990 due to growing size of the population and aging, and they are expected to continue to increase. By 2030, it is estimated that the population affected by neurological diseases will include as many as 1.136 million people [2]. In Spain, between 6.7–7.5 million people are affected by neurological diseases [3]. The total direct and indirect cost related to neurological diseases was 10.9 million euros in 2004 in this country [34].

Neurological diseases cause functional disturbances, including gait disabilities, that affect patients’ ability to perform activities of daily living [1]. Between 50 and 60% of patients with stroke still have some degree of motor impairment after a conventional rehabilitation period [5]. In multiple sclerosis (MS) patients, gait impairment is a major contributor to social, personal and economic burdens [6]. Thus, gait impairment is one of the main problems in patients with stroke or MS [78].

Due to the extent that gait impairment affects patients, gait rehabilitation is considered a key aspect of physical rehabilitation [9,10,11,12,13,14]. Currently, there is a growing interest in determining which characteristics of training should be involve in gait rehabilitation, as therapies are currently based on repetitive and intensive training and functional and feedback-based interventions [15,16,17]. These characteristics are aligned with the use of exoskeletons in gait rehabilitation. In recent years, this technology has been widely used in stroke and MS studies [18,19,20,21,22,23,24].

To the best of our knowledge, few portable exoskeletons that are lightweight and have the capability to execute or modify gait assistance algorithms have been developed, and a high degree of customization can be allowed by following the assist-as-needed concept [25] for gait assistance in stroke and MS patients. The exoskeleton evaluated in this study is a single-limb exoskeleton with actuation at the knee level (Fig. 1). Thus, the main objectives of this study were 1) to explore the safety and feasibility of the exoskeleton developed by the research team for gait rehabilitation in stroke and MS patients as a proof of concept, 2) to test different algorithms for gait assistance and measure the resulting gait changes and 3) to evaluate the user’s perception of the device.

figure1

Fig. 1 Marsi Active Knee (MAK) exoskeleton, by Marsi Bionics

 

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Continue —-> A new lower limb portable exoskeleton for gait assistance in neurological patients: a proof of concept study | Journal of NeuroEngineering and Rehabilitation | Full Text

 

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[ARTICLE] Application of Stem Cells in Stroke: A Multifactorial Approach – Full Text

Stroke has a debilitating effect on the human body and a serious negative effect on society, with a global incidence of one in every six people. According to the World Health Organization, 15 million people suffer stroke worldwide each year. Of these, 5 million die and another 5 million are permanently disabled. Motor and cognitive deficits like hemiparesis, paralysis, chronic pain, and psychomotor and behavioral symptoms can persist long term and prevent the patient from fully reintegrating into society, therefore continuing to add to the costly healthcare burden of stroke. Regenerative medicine using stem cells seems to be a panacea for sequelae after stroke. Stem cell-based therapy aids neuro-regeneration and neuroprotection for neurological recovery in patients. However, the use of stem cells as a therapy in stroke patients still needs a lot of research at both basic and translational levels. As well as the mode of action of stem cells in reversing the symptoms not being clear, there are several clinical parameters that need to be addressed before establishing stem cell therapy in stroke, such as the type of stem cells to be administered, the number of stem cells, the timing of dosage, whether dose-boosters are required, the route of administration, etc. There are upcoming prospects of cell-free therapy also by using exosomes derived from stem cells. There are several ongoing pre-clinical studies aiming to answer these questions. Despite still being in the development stage, stem cell therapy holds great potential for neurological rehabilitation in patients suffering from stroke.

Introduction

Stroke is one of the leading causes of chronic disability and mortality, with 102 million disability-adjusted life years lost annually (Steven, 2008). The Global Burden of Disease, Injuries, and Risk Factors Study (GBD 2015) reported a shift from communicable diseases toward non-communicable diseases like cerebrovascular events. While the incidence of stroke is decreasing in the developed world, it has peaked in low- and middle-income countries like India due to demographic transition and rapid shifts in the socioeconomic milieu (Thomson, 1998). The estimated adjusted prevalence rate of stroke is reported to have a range of 84–262/100,000 in rural and 334–424/100,000 in urban India (Wichterle et al., 2002Nagai et al., 2010).

The only neuroprotective agent developed for stroke in clinical use is recombinant tissue plasminogen activator (rtPA), which is employed for thrombolysis and has a therapeutic window of merely 3–4.5 h. There is thus a compelling need to develop therapeutic agents that extend beyond the first few hours after onset of stroke. This requires a paradigm shift to the usage of new strategies from neuroprotection to neuro-restoration that treat the injured or compromised brain tissue.

The majority of stroke survivors are left with some degree of disability, particularly upper limb dysfunction, despite several neurorehabilitation therapies. Physical therapy incorporating exercises, motor learning principles, motor cortex stimulation (using rTMS, TDCS), and assistive technologies aid the restoration of functional movements (Tae-Hoon and Yoon-Seok, 2012). The emergence of regenerative medicine has fueled interest across readers and clinicians to study its potential. Over the last decade, an enormous amount of work has been done exploring the potential of a variety of cells like adult stem cells, umbilical cord blood, and cells from adipose tissue and skin.

Pattern of Stroke Recovery

The recovery after stroke has been explained as a rich cascade of events encompassing cellular, molecular, genetic, demographic, and behavioral components. Such factors have been proven as covariates in therapeutic trials of restorative agents with a sound neurobiological basis. Advances in functional neuroimaging and brain mapping methods have provided a valuable parallel system of data collection for stroke recovery in humans. The recovery in a stroke-affected individual will largely depend on the size of lesion, the internal milieu of the brain injury, and the age and comorbid status of the patient. In general, the first epoch encompasses the initial hours after a stroke, when rapid change occurs in blood flow, edema, pro-inflammatory mechanisms. A second epoch is related to spontaneous behavioral recovery, which begins a few days after stroke onset and lasts several weeks. During this epoch, the brain is galvanized to initiate repair, as endogenous repair-related events reaching peak levels, suggesting a golden period for initiating exogenous restorative therapies. A third epoch begins weeks to months after stroke, when spontaneous behavioral gains have generally reached a plateau, and this stable state is responsive to many restorative interventions (Steven, 2008).

Mechanisms of Action of Stem Cells in Neural Repair

Stem cells have the capacity to differentiate into all types of cells. Exogenously administered cells appear to stimulate endogenous reparative processes and do not replace injured cerebral tissue. It was once thought that intravenously administered cells would home in on the injured site and replace the dead neurons, but the current ideology for the use of these cells holds that these cells release many trophic factors like VEGF, IGF, BDNF, and tissue growth factors that stimulate brain plasticity and recovery mechanisms. Upregulation of growth factors, prevention of ongoing cell death, and enhancement of synaptic connectivity between the host and graft are some of the common pathways through which intravenous stem cells work as “chaperones.” Regarding the timing of transplantation, preclinical studies have shown that cell therapy increases functional recovery after acute, sub-acute, and chronic stroke (Bliss et al., 2010), but few studies have compared different time windows, with differing results according to the model system and cell type studied. All of the possible modes of action of stem cells have been described in Figure 1.

Figure 1. Mechanisms of action of Mesenchymal Stem Cells in treating stroke.

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Continue —->  Frontiers | Application of Stem Cells in Stroke: A Multifactorial Approach | Neuroscience

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[WEB PAGE] MyoPro Delivers Meaningful Motor Function Improvements, Per Case Study

MyoPro Delivers Meaningful Motor Function Improvements, Per Case Study

A case report measuring the benefits of Myomo Inc’s MyoPro myoelectric orthosis, published recently in the Journal of Rehabilitation and Assistive Technologies Engineering, suggests that, “Despite long-standing traumatic brain injury, meaningful improvements in motor function were observed.”

Researchers studied a 42-year-old female, 29.5 years post-traumatic brain injury with diminished motor control/coordination and learned nonuse of the right arm. The research consisted of 9 weeks of in-clinic training followed by 9 weeks of at-home use.


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“During in-clinic training, active range of motion, tone, muscle power, Fugl-Meyer, box and blocks test, and Chedoke assessment score improved. During the home-use phase, decrease in tone was maintained and all other outcomes declined but were still better upon study completion than baseline,” the researchers write, according to a media release from Myomo Inc.

“This individual had a very limited use of her arm before intervention with the device. In addition to the therapeutic benefits we measured, the patient’s caregivers reported functional improvement in her home setting. It is very heartwarming to see these improvements in a person even this many years after injury. This research is continuing now with a larger population of patients.”

— lead author Svetlana Pundik, MD, MSc, Brain Plasticity and Neuro Recovery Laboratory, Louis Stokes Cleveland VA Medical Center

“MyoPro not only extends the limited therapy time available in the clinic to continue in the home, it may also restore a person’s ability to perform activities of daily living such as feeding one’s self and performing light household tasks. As a result, users see an improved quality of life, some may return to work, and they may reduce their overall healthcare costs.”

— Paul R. Gudonis, Myomo CEO

The study was funded by the US Department of Defense through an award to Dr Stefania Fatone at the Northwestern University Feinberg School of Medicine in Chicago and was conducted by a research team at the Louis Stokes Cleveland VA Medical Center led by Dr Svetlana Pundik.

Myomo Inc is a wearable medical robotics company that offers increased functionality for those suffering from neurological disorders and upper-limb paralysis.

[Source(s): Myomo Inc, Business Wire]

via MyoPro Delivers Meaningful Motor Function Improvements, Per Case Study – Rehab Managment

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[TED-Ed] The psychology of post-traumatic stress disorder

Many of us will experience some kind of trauma during our lifetime. Sometimes, we escape with no long-term effects. But for millions of people, those experiences linger, causing symptoms like flashbacks, nightmares, and negative thoughts that interfere with everyday life. Joelle Rabow Maletis details the science behind post-traumatic stress disorder, or PTSD.

via The psychology of post-traumatic stress disorder – Joelle | TED-Ed

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[WEB PAGE] PHYSICAL THERAPY MEASUREMENT APP

Mobile Measures is a mobile app that offers physical therapists and other providers access to outcome performance measures that assess fall risk, risk of hospitalization, frailty, and more. The app guides users to the best test for more than 40 different patient populations, calculates scores automatically, offers immediate interpretation of the results using the most up-to-date research, and shares results via email to enhance documentation and improve communication. With Mobile Measures, users can visualize the impact of their patient’s condition, track progress, and determine the effectiveness of treatments directly at the point of care, while improving efficiency. Mobile Measures is available on the App Store and Google Play. A free trial is available.

via PHYSICAL THERAPY MEASUREMENT APP | Lower Extremity Review Magazine

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