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[WEB SITE] Brains Tend to Work in Sync During Music Therapy, Study Suggests

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The brains of a patient and therapist become synchronized during a music therapy session, a breakthrough that could improve future interactions between patients and therapists, researchers suggest.

The research, published in the journal Frontiers in Psychology, was carried out by Professor Jorg Fachner and Dr Clemens Maidhof of Anglia Ruskin University (ARU).

In the study, they used a procedure called hyperscanning, which is designed to record activity in two brains at the same time, allowing them to better understand how people interact.

During the session documented in the study, classical music was played as the patient discussed a serious illness in her family. Both patient and therapist wore EEG (electroencephalogram) caps containing sensors, which capture electrical signals in the brain, and the session was recorded in sync with the EEG using video cameras, a media release from Anglia Ruskin University explains.

Music therapists work towards “moments of change,” where they make a meaningful connection with their patient. At one point during this study, the patient’s brain activity shifted suddenly from displaying deep negative feelings to a positive peak. Moments later, as the therapist realized the session was working, her scan displayed similar results. In subsequent interviews, both identified that as a moment when they felt the therapy was really working.

The researchers examined activity in the brain’s right and left frontal lobes where negative and positive emotions are processed, respectively. By analyzing hyperscanning data alongside video footage and a transcript of the session, the researchers were able to demonstrate that brain synchronization occurs, and also show what a patient-therapist “moment of change” looks like inside the brain.

“This study is a milestone in music therapy research,” says lead author Jorg Fachner, Professor of Music, Health and the Brain at Anglia Ruskin University (ARU), in the release.

“Music therapists report experiencing emotional changes and connections during therapy, and we’ve been able to confirm this using data from the brain.

“Music, used therapeutically, can improve well-being, and treat conditions including anxiety, depression, autism and dementia. Music therapists have had to rely on the patient’s response to judge whether this is working, but by using hyperscanning we can see exactly what is happening in the patient’s brain,” he continues.

“Hyperscanning can show the tiny, otherwise imperceptible, changes that take place during therapy. By highlighting the precise points where sessions have worked best, it could be particularly useful when treating patients for whom verbal communication is challenging. Our findings could also help to better understand emotional processing in other therapeutic interactions,” he concludes.

[Source(s): Anglia Ruskin University, Science Daily]

 

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[WEB PAGE] Music Therapy Improves Symptoms and Behaviors of Palliative Care Patients

—Music therapy interventions have led to improved outcomes for patients with a number of common conditions. The effects of patient characteristics, goals, and interventions on outcomes aren’t fully understood, however. A recent study was designed to get some answers.

Does music truly have the power to heal? A recent study, published in American Journal of Hospice and Palliative Medicine, suggests that it does. According to the authors, music therapy improves a host of symptoms, including pain, anxiety, depression, and shortness of breath, among others.1

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Music therapy, an evidence-based practice, involves addressing patients’ individualized goals through a therapeutic relationship with a board-certified music therapist (MT-BC),2 who can help patients address their physical, social, emotional, psychological, and spiritual needs.3Interventions include playing instruments, listening to music, choosing songs, singing, songwriting, music-assisted relaxation/imagery, and improvisation.

Previous studies have reported improved outcomes with music therapy; however, the effects of patient goals, patient characteristics, and music therapist interventions haven’t been investigated in-depth.

Research that strikes a chord

“Our study looks more in-depth at music therapy interventions and their effects on symptoms,” explains Lisa M. Gallagher, MT-BC, of the Cleveland Clinic Arts & Medicine Institute, in Lyndhurst, Ohio. “We also had the opportunity to utilize a database of over 1500 patient records and were able to obtain statistically significant results with the largest number of patients researched to date—293 who met all study inclusion criteria.”

The objectives of the study included the following:

  • To describe patient characteristics, patient goals, and interventions used by the music therapist
  • To assess the impact of music therapy sessions on outcomes
  • To identify which patient characteristics, goals, and interventions had an effect on outcomes

This retrospective study included data obtained from music therapy sessions held between September 2000 and May 2012. “Sessions were conducted with patients and any family members present,” Gallagher says. “These included addressing any symptoms such as pain, anxiety, depression, shortness of breath, and mood, while also working on other goals, such as coping and relaxation. We had patients rate the level of their symptoms before and after the sessions, and we were able to investigate the level of change that occurred.” Moreover, therapists examined changes in vocalization, facial expression, and body movement.

Interventions were classified according to 6 main categories, including music-assisted relaxation, music listening, verbal/emotional participation (verbal processing, lyric analysis, etc.), verbal/cognitive participation (music discussion, songwriting, etc.), vocal participation (singing and humming), and physical participation (clapping, foot-tapping, playing instruments). In the majority of the sessions, the MT-BC used more than 1 intervention.

The database included 5970 music therapy sessions spread among 1570 patients who were at least 18 years old and reported a minimum of 1 incidence of depression, anxiety, mood, pain, or shortness of breath before and after their session. For patients who participated in more than 1 session, only data from the first session was included.

What the study revealed

The final analysis included 293 patients with complete data on all primary outcome measures. Of these patients, most (67%) were women, with a median age of 61 years and a cancer diagnosis (93%). Lung cancer, hematologic cancers, breast cancer, and gastrointestinal cancer were the most common. The most frequent reasons for referral to music therapy were enjoyment (23%); relief of anxiety (16%), pain (13%), or depression (12%); and support (7%).

Significant improvements in the mean scores from pre- to post-session were reported for pain, depression, anxiety, shortness of breath, mood, facial expression, and vocalization. No significant improvement was reported for body movement. Positive verbal responses were recorded for 96% of patients; 4% had ambivalent responses or no response. (Demographics and cancer diagnosis did not impact outcomes.)

“We found that vocal and emotional interventions were the two most effective interventions for improving symptoms,” Gallagher says. “Perhaps the only surprise was the level of response—for instance, that 96% had a positive response to their experience and that both clinical and statistical significance were demonstrated.”

Ending on a high note

In this study, the greatest percentage of patients achieved clinically relevant improvements in mood, vocalization, and facial expression. These results also demonstrate that, going forward, no intervention changes are required based on age, gender, or diagnosis.

Limitations of the study included the use of observational behavioral data and the potential for reporting bias. Furthermore, data were missing for patients who experienced severe pain or high anxiety, had fallen asleep, were actively dying, or participated in sessions that were interrupted.

“There are a few other questions that we would like to investigate,” says Gallagher. “These include the cost-effectiveness and duration of music therapy; the validation of scales for mood, anxiety, and depression; and a more in-depth look at specific interventions used to address goals with patients and families.”

“I knew at a gut level that music therapy was effective,” Gallagher continues, adding that the current study helped to demonstrate that. Music therapy is an evidence-based profession that provides value-based healthcare to a wide variety of patients, including palliative medicine patients.”

Published: March 01, 2018

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[WEB SITE] How does music therapy work? Brain study sheds light

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Music therapy works, but no one is really sure how. Now, a novel type of brain scan may provide key insight.

man listening to music

Music is a powerful thing. In fact, it forms the basis of a type of therapy, the aptly named “music therapy.”

During sessions, a music therapist attempts to form a bond with their client in order to enhance well-being and improve confidence, communication skills, awareness, and attention.

There are several types of music therapy. Some involve simply listening to relaxing music while talking. Others involve making music with instruments, which can be particularly effective for those who struggle to communicate verbally.

One type, known as the Bonny Method of Guided Imagery and Music (GIM) aims to facilitate discussion. The therapist plays music and asks the client to describe the images that come to mind.

Trials have found benefits to music therapy, but how it works remains unclear.

Using GIM as their focus, a team led by two experts from Anglia Ruskin University, in the United Kingdom — Prof. Jörg Fachner and Clemens Maidhof, Ph.D. — set out to find the answer. Their findings appear in the journal Frontiers in Psychology.

Discovering important moments

The goal of a music therapist is to reach a “moment of change” in which they can strengthen their connection with their client. Therapists and clients often describe feeling in sync, and now there is evidence to prove it.

In the current study, the researchers used hyperscanning — a procedure that can simultaneously record two people’s brain activities — to study a music therapist’s session with a client.

The method, says lead author Prof. Fachner, “can show the tiny, otherwise imperceptible, changes that take place during therapy.”

The therapist and client wore EEG caps to record the electrical signaling in their brains, and the session was filmed. Ultimately, the researchers hoped to learn more about how the individuals interacted.

“Music, used therapeutically, can improve well-being and treat conditions including anxietydepressionautism, and dementia. Music therapists have had to rely on the patient’s response to judge whether this is working, but by using hyperscanning we can see exactly what is happening in the patient’s brain,” says Prof. Fachner.

Once the recordings were complete, the researchers asked the therapist, client, and two other GIM therapy experts to watch the video and each note down three moments of change, as well as one unimportant moment.

A clear connection

The team examined their answers for overlap to see whether any points were of interest to all four participants. A couple of moments fell into this category.

With that knowledge, Prof. Fachner and Maidhof examined the EEG readings from those moments. They paid particular attention to the areas of the brain that process positive and negative emotions.

Surprisingly, they came up with an image that illustrates a moment of change inside the brain.

When the client’s brain switched from negative emotions to positive ones, their EEG recording clearly showcased this. A few moments later, the therapist’s brain showed the exact same pattern.

Both the therapist and client later identified this moment as a point when they felt that the session was working. Not only were their thoughts in sync, but their brain activity, too.

The researchers also noted increased activity in both participants’ visual cortexes during these moments of change.

More effective therapy

It is unlikely that other case studies will provide the exact same results, due to the personalized nature of therapy. But more research will need to go into therapist-client relationships before the synchronicity can be confirmed.

Still, Prof. Fachner described the study as “a milestone in music therapy research.”

Music therapists report experiencing emotional changes and connections during therapy, and we’ve been able to confirm this using data from the brain.”

Prof. Jörg Fachner

He adds that the study has further implications than just proving a point. He explains, “By highlighting the precise points where sessions have worked best, it could be particularly useful when treating patients for whom verbal communication is challenging.”

The findings could also make music therapy more effective by exposing when and how a therapist should intervene for maximum efficacy.

And, as Prof. Fachner notes, studies such as this may “help [researchers] better understand emotional processing in other therapeutic interactions.”

 

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[WEB SITE] Head MRI: Uses, results, and what to expect – Educational

What to know about head and brain MRI scans

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Doctors use MRI scans to diagnose and monitor head injuries and to check for abnormalities in the head or brain.

Magnetic resonance imaging (MRI) scans provide 3-D images of specific body parts. The scan produces highly detailed images from every angle. Depending on the purpose of the scan, a doctor may recommend contrast, which is a substance that a person takes beforehand. It helps the images to be more clearly defined.

An MRI scan is painless and noninvasive. The length of the procedure varies, depending on the situation.

In this article, we take a close look at head MRI scans in adults and children. We discuss their uses, what to expect during a scan, and how a person receives the results.

Purpose and uses of head MRI scans

Man having head and brain MRI

An MRI scan can provide detailed imagery of soft tissue.

MRI scans allow doctors to see what is happening inside the body. These scans do not produce radiation, unlike CT scans and X-rays.

MRI scans use strong magnetic forces and radio waves to create images. They can scan bone, organs, and tissue, which makes them ideal for a complex body part like the head.

MRI scans show a higher level of detail than other imaging techniques, especially in soft tissue. This is important when examining the brain or brain stem for damage or disease.

A doctor may recommend an MRI head scan if they suspect that a person has:

Procedure and what to expect during a head MRI

A head MRI is noninvasive. When a person arrives at the clinic, a doctor or technician will talk them through the process and tell them what to expect.

Preparation

First, a healthcare professional will ask a series of questions about a person’s medical history.

Radiographers also need to know if a woman is pregnant. Doctors tend not to recommend MRI scans during pregnancy, because it is unclear whether the magnetic force can affect fetal development.

They will also ask if a person has any metallic objects, such as piercings, metal plates, watches, or jewelry. These can interfere with the scan, and a person must remove them before entering the scanner.

Other metallic objects that can interfere with a scan include:

  • brain aneurysm clips
  • cochlear implants
  • dental fillings and bridges
  • eye implants
  • metallic fragments in the eyes or blood vessels
  • metal plates, wires, screws, or rods
  • surgical clips or staples

A healthcare team member will usually ask a person to put on a hospital gown. They will store a person’s clothes and any jewelry in a safe locker until the scan is finished.

During the scan

The technician will bring the person into the room that contains the MRI scanner. The person will lie on a sliding trolley, and the technician may cover them with a sheet.

The technician will then position the trolley so that the person’s head and neck are inside the MRI scanner. They will leave the room and speak to the person through a radio.

People should be aware of the following:

  • Pillows or foam blocks on the trolley will keep the head in the right position.
  • MRI machines make a lot of noise, so expect to hear loud hums, knocking sounds, and general electronic noise. Technicians will usually provide headphones or earplugs.
  • People must stay very still inside the scanner to ensure clear, accurate images. If a person moves, they may have to repeat the scan. If someone, such as a person with Parkinson’s, has trouble lying still, a technician may offer restraints to help.
  • Every MRI machine has a call button. If a person feels anxious or wants to stop the procedure, they can press the call button and talk to the medical staff.
  • Most tattoos are safe in an MRI. However, some inks contain traces of metal, which can cause heat or discomfort during a scan. If a person feels any discomfort, they should tell the radiographer.

The medical team may offer anesthetics or sedatives to people who have extreme claustrophobia.

If a person has taken a sedative, they should avoid driving themselves home. Also, a person needs time to recover from an anesthetic at the medical center. In the event of an allergic reaction, the healthcare team will keep the person under observation.

Types of MRI scanner

MRI scanner machine

MRI machines come in a range of sizes.

Several types of scanners can provide a head MRI. The size of the machine will depend on the purpose of the scan and whether the person has claustrophobia.

Types of scanner include:

  • Closed bore. These look like enormous tubes, which a person enters by lying on a sliding bench.
  • Short bore. In this type of machine, the tubular part is shorter, making it less likely to trigger claustrophobia.
  • Wide bore. The opening of the tubular area can be around 70 centimeters in these machines.
  • Open MRI. These come in a variety of shapes. They can have an open side or top.

The narrower the bore, the more detailed the image will be.

Head MRI scans with contrast vs. no contrast

Contrast is a magnetic substance. If a person drinks or receives an injection of contrast before a scan, it can help to improve the image. The majority of MRI scans do not require contrast.

The doctor and radiologist will decide if contrast is necessary, and a person takes it orally or by injection.

Contrast travels to organs and tissue through the bloodstream. The MRI procedure is the same, whether or not it requires contrast.

Contrast makes tissues and organs stand out on the MRI image. This can illuminate early abnormal tissue growth, including tumors. Receiving an early diagnosis can help improve a person’s outlook.

Scans related to the following issues can require contrast:

There is a small chance that a person may have an allergic reaction to contrast materials. Before administering the contrast, a doctor will ask about:

  • allergies
  • current medications
  • medical history
  • recent illnesses or operations

After taking the contrast, a person should check for any side effects. Report any adverse effects to a healthcare provider.

Results

The radiographer will review and interpret the scans. They will then contact the doctor with the results. This can take several days unless it was an emergency scan.

A person can request to see their scans by asking their doctor. The doctor may need a follow-up scan, and they will explain why.

Costs

The costs of an MRI procedure, and how much insurance will cover, varies.

There may also be associated costs, for contrast, anesthesia, and additional procedures.

Speak to the healthcare provider for an accurate estimate.

Head MRI scans in children

Doctor showing child MRI results

A doctor can explain the MRI process to children before undergoing the procedure.

Medical procedures can be scary. It is important for a caregiver to find out the details and explain them to the child beforehand, to reduce any anxiety. Some hospitals have leaflets that help to explain certain procedures.

Head MRI scans for children are almost identical to those for adults. The main difference is the use of a coil.

An MRI coil fits around the child’s head as they lie or sit in the machine because their heads are smaller.

Young children and babies find it hard to stay still for long, and the healthcare provider may recommend an intravenous sedative. The medical team will monitor them throughout the procedure.

Usually, a caregiver stays with the child during the scan. If this is not possible, the caregiver can often wait in the radiographer’s station.

Summary

Head MRI scans are an important tool for diagnosing and monitoring. They can indicate changes in tissue, which is vital in assessing many conditions, particularly those affecting the brain.

Unlike X-rays and CT scans, MRI scans do not involve radiation. They present no risk, apart from triggering certain anxieties or claustrophobia. There are ways to prevent this from happening.

MRI scanners are being improved all the time. With the new generation of scanners, the aim is to cut down scan times and enhance accuracy.

 

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[ARTICLE] Psychological Resilience Is Associated With Participation Outcomes Following Mild to Severe Traumatic Brain Injury – Full Text

Traumatic brain injury (TBI) causes physical and cognitive-behavioral impairments that reduce participation in employment, leisure, and social relationships. Demographic and injury-related factors account for a small proportion of variance in participation post-injury. Personal factors such as resilience may also impact outcomes. This study aimed to examine the association of resilience alongside demographic, injury-related, cognitive, emotional, and family factors with participation following TBI. It was hypothesized that resilience would make an independent contribution to participation outcomes after TBI. Participants included 245 individuals with mild-severe TBI [Mage = 44.41, SDage = 16.09; post traumatic amnesia (PTA) duration M 24.95 days, SD 45.99] who completed the Participation Assessment with Recombined Tools-Objective (PART-O), TBI Quality of Life Resilience scale, Family Assessment Device General Functioning Scale, Rey Auditory Verbal Learning Test, National Adult Reading Test, and Hospital Anxiety and Depression Scale an average 4.63 years post-injury (SD3.02, R 0.5–13). Multiple regression analyses were used to examine predictors of PART-O scores as the participation measure. Variables in the model accounted for a significant 38% of the variability in participation outcomes, F(13, 211) = 9.93, p < 0.05, R2 = 0.38, adjusted R2 = 0.34. Resilience was a significant predictor of higher participation, along with shorter PTA duration, more years since injury, higher education and IQ, and younger age. Mediation analyses revealed depression mediated the relationship between resilience and participation. As greater resilience may protect against depression and enhance participation this may be a focus of intervention.

Introduction

Following traumatic brain injury (TBI), participation in employment, education, leisure, and relationships is often significantly reduced, leaving individuals substantially less integrated in their communities (14). As a result, many individuals spend increased time at home, straining family and other relationships (5). Given that TBI occurs commonly during young adulthood (6), participation deficits coincide with a critical period of development in which individuals are completing education, establishing a vocation, leaving home, and forming important lifelong relationships. Failure to attain these goals may profoundly impact their sense of self, mental health and general well-being. Reduced participation often extends beyond the acute recovery period and continues to be associated with poorer quality of life up to two decades after injury (7). Arguably participation in these life roles, including employment, education, leisure and relationships, represents one of the most important and objective indicators of injury outcomes.

Numerous variables have been associated with participation outcomes post-TBI, including injury-related and demographic variables as well as post-injury environmental and personal factors. Injury severity, cognitive difficulties, and limb injuries with related pain and impact on mood, affect an individual’s ability to engage socially and often present significant barriers to education and employment (816). Injury severity is a particularly well-researched predictor of participation outcomes, with duration of post traumatic amnesia (PTA) having the most robust association (1721). With respect to demographic factors, younger age, higher premorbid education level, higher premorbid IQ, and being employed prior to injury have all been associated with better participation outcomes (102229). Notably, older age at injury has been found to predict both worse participation overall as well as progressively worsening participation over time (10). Although gender does not appear to be directly associated with participation (30), it may have an indirect association, for example through mood and pre-injury education (14). Post-injury psychological functioning, particularly depression and anxiety, are also important predictors of participation outcomes (10123133). The impact of family functioning on participation is thought to be both direct, and through association with emotional well-being (3435).

Due to this broad range of factors influencing outcome, research has moved toward a multivariate approach to prediction of participation outcomes following TBI (24363738). These models contribute to a more comprehensive understanding of participation outcomes; however, the average amount of variance accounted for by predictive models is around 30% (21). This suggests there are additional predictive factors yet to be identified. One such factor that has increasingly gained scholarly recognition, due its positive association with quality of life and well-being outcomes among different clinical populations, is resilience.

Resilience has been conceptualized as a process of adaptation to adversity or the ability to bounce back after trauma or adversity. Resilience arguably influences the extent to which a person is able to resume important life roles after an injury. Resilience may impact participation outcomes directly through facilitating or promoting return to normal life or the development and achievement of new life goals (39), and indirectly through its effects on improved well-being, quality of life and psychological adjustment. Participating in employment, education, leisure, and relationships represent fundamental areas of participation. Resilience has been positively associated with physical and emotional well-being in individuals with cancer (40), Parkinson’s disease (41), diabetes (42), chronic spinal cord injury (43), multiple sclerosis, spina bifida, stroke, and posttraumatic stress disorder (4445). There has been less resilience research in TBI, with only one study to date examining the association between resilience and participation. Notably, it has been suggested that the study of resilience after TBI poses a distinct challenge, in that the skills characteristically associated with resilience are typically impaired after TBI (4547). For example, resilience requires emotional stability, a positive outlook, good problem-solving skills and social perception (47); however, TBI is commonly associated with impaired executive functioning (4849), irritability and aggression (5051), depression (3345), and difficulties with social perception (52).

The little research that has focused on resilience after TBI has been largely limited to patients with mild TBI, in whom no studies have examined impact on participation. In this group, greater resilience has been associated with less reporting of post-concussional and post-traumatic stress symptoms (5355), reduced fatigue, insomnia, stress, and depressive symptoms, as well as better quality of life (56). One study found that greater pre-injury resilience was significantly associated with greater post-concussion symptom severity 1 month post-injury (57), perhaps reflecting insufficient time for participants to “bounce back” (44), or overrating of pre-injury resilience levels, a phenomenon known as the “Good Old Days”(58).

Only three studies have examined resilience in individuals with moderate to severe TBI, of which one examined an association with participation. Marwitz et al. (39), conducted a large (n = 195) longitudinal study and found that resilience was significantly associated with participation over the first 12 months post-injury (39). Other studies have associated higher resilience in individuals with moderate to severe TBI with fewer depressive and anxiety symptoms, better emotional adjustment, use of task oriented coping and greater social support (4445). However, one of these studies used a sample of individuals who were actively seeking help with adjusting to changes post-injury, possibly biasing the sample toward those experiencing greater adjustment problems (45).

The aim of the present study was to examine the relative association of resilience, as well as demographic, injury-related, cognitive, emotional, and family factors with participation (productivity, social relations and leisure) following mild to severe TBI. To the best of our knowledge, this is the first study to examine the association between resilience and participation outcomes more than 12 months after mild to severe TBI. This critically extends previous research by examining the impact of resilience across the spectrum of TBI severity, from mild to severe, and how this association influences outcomes beyond the acute post-injury period. It was hypothesized that resilience would make an independent contribution to participation after TBI, in a model that would include demographic variables (gender, age, pre-morbid IQ, education, pre-injury employment), injury variables (injury severity, cognitive functioning, limb injury, time since injury) and post-injury personal and environmental factors (depression, anxiety, family support).[…]

 

Continue —> Frontiers | Psychological Resilience Is Associated With Participation Outcomes Following Mild to Severe Traumatic Brain Injury | Neurology

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[WEB SITE] Christiana Care Health System opens first Epilepsy Monitoring Unit in Delaware

 

To increase access to advanced neurological care, Christiana Care Health System has opened the first Epilepsy Monitoring Unit (EMU) in the First State.

Specially outfitted private hospital rooms in the Transition Neuro Unit at Christiana Hospital provide state-of-the-art equipment for video and audio monitoring. In the rooms, brain waves are tracked with electroencephalography (EEG) and electrical activity in the heart is recorded with electrocardiography (EKG), helping clinicians understand what is happening during a seizure. To further enhance safety, nurses assist patients whenever they are out of their bed. And patients wear mobility vests that connect to a stationary lift, a system that allows patients to move around a room – and prevents them from falling if they have a seizure. This is one of the few EMUs in the U.S. that uses a patient lift to prevent falls.

Epilepsy is a central nervous system disorder, in which brain activity becomes abnormal, leading to seizures or periods of unusual behavior, sensations or loss of awareness. The U.S. Centers for Disease Control and Prevention report that there are 3.4 million Americans with epilepsy and there is a growing incidence of the disease among the adult population in Delaware, especially among people 60 and older.

“Our community deserves the very best in neurological care,” said Valerie Dechant, M.D., physician leader, Neuroscience Service Line, and medical director, Neurocritical Care and Acute Neurologic Services. “Our new Epilepsy Monitoring Unit will enable us to serve the complex neurologic needs of our adult patients.”

Christiana Care’s EMU is part of a larger effort to establish an epilepsy center of excellence, so adults of any age can receive the highest quality routine and specialty care for seizure disorders.

“We want to help patients who believe they have been over-diagnosed or under-diagnosed so they can see improvement in their lives,” said Neurologist John R. Pollard, M.D., medical director of the new EMU.

While most patients with epilepsy are successfully treated by a general neurologist or epileptologist, a significant number of patients have persistent fainting or seizure episodes – or they have unwanted side effects from medications. This new facility enables physicians to work more closely with these patients to understand their seizures and determine appropriate treatment.

“Typically, these patients visit an EMU where they may stay for several days so they can be safely taken off medications, inducing seizures that are recorded and studied so a proper diagnosis and treatment can be planned,” said Christy L. Poole, RN, BSN CRNI CCRC, a neurosciences program manager. Visiting an EMU to induce a seizure could be a source of anxiety for patients and their families.

“Our staff works with patients and families to reduce any fear by providing information on what to expect, stressing procedures that enhance patient safety and making the stay as pleasant as possible,” said Susan Craig, MSN, RNIII-BC, epilepsy clinical nurse practice coordinator.

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[WEB SITE] Researchers develop new prediction method for epileptic seizures

Epileptic seizures strike with little warning and nearly one third of people living with epilepsy are resistant to treatment that controls these attacks. More than 65 million people worldwide are living with epilepsy.

Now researchers at the University of Sydney have used advanced artificial intelligence and machine learning to develop a generalized method to predict when seizures will strike that will not require surgical implants.

Dr Omid Kavehei from the Faculty of Engineering and IT and the University of Sydney Nano Institute said: “We are on track to develop an affordable, portable and non-surgical device that will give reliable prediction of seizures for people living with treatment-resistant epilepsy.”

In a paper published this month in Neural Networks, Dr Kavehei and his team have proposed a generalized, patient-specific, seizure-prediction method that can alert epilepsy sufferers within 30 minutes of the likelihood of a seizure.

Dr Kavehei said there had been remarkable advances in artificial intelligence as well as micro- and nano-electronics that have allowed the development of such systems.

“Just four years ago, you couldn’t process sophisticated AI through small electronic chips. Now it is completely accessible. In five years, the possibilities will be enormous,” Dr Kavehei said.

The study uses three data sets from Europe and the United States. Using that data, the team has developed a predictive algorithm with sensitivity of up to 81.4 percent and false prediction rate as low as 0.06 an hour.

“While this still leaves some uncertainty, we expect that as our access to seizure data increases, our sensitivity rates will improve,” Dr Kavehei said.

Carol Ireland, chief executive of Epilepsy Action Australia, said: “Living with constant uncertainty significantly contributes to increased anxiety in people with epilepsy and their families, never knowing when the next seizure may occur.

“Even people with well controlled epilepsy have expressed their constant concern, not knowing if or when they will experience a seizure at work, school, traveling or out with friends.

“Any progress toward reliable seizure prediction will significantly impact the quality of life and freedom of choice for people living with epilepsy.”

Dr Kavehei and lead author of the study, Nhan Duy Truong, used deep machine learning and data-mining techniques to develop a dynamic analytical tool that can read a patient’s electroencephalogram, or EEG, data from a wearable cap or other portable device to gather EEG data.

Wearable technology could be attached to an affordable device based on the readily available Raspberry Pi technology that could give a patient a 30-minute warning and percentage likelihood of a seizure.

An alarm would be triggered between 30 and five minutes before a seizure onset, giving patients time to find a safe place, reduce stress or initiate an intervention strategy to prevent or control the seizure.

Dr Kavehei said an advantage of their system is that is unlikely to require regulatory approval, and could easily work with existing implanted systems or medical treatments.

The algorithm that Dr Kavehei and team have developed can generate optimized features for each patient. They do this using what is known as a ‘convolutional neural network’, that is highly attuned to noticing changes in brain activity based on EEG readings.

Other technologies being developed typically require surgical implants or rely on high levels of feature engineering for each patient. Such engineering requires an expert to develop optimized features for each prediction task.

An advantage of Dr Kavehei’s methodology is that the system learns as brain patterns change, requiring minimum feature engineering. This allows for faster and more frequent updates of the information, giving patients maximum benefit from the seizure prediction algorithm.

The next step for the team is to apply the neural networks across much larger data sets of seizure information, improving sensitivity. They are also planning to develop a physical prototype to test the system clinically with partners at the University of Sydney’s Westmead medical campus.

 

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[WEB SITE] Antiepileptic drug use linked to increased risk of Alzheimer’s and dementia

The use of antiepileptic drugs is associated with an increased risk of Alzheimer’s disease and dementia, according to a new study from the University of Eastern Finland and the German Center for Neurodegenerative Diseases, DZNE. Continuous use of antiepileptic drugs for a period exceeding one year was associated with a 15 percent increased risk of Alzheimer’s disease in the Finnish dataset, and with a 30 percent increased risk of dementia in the German dataset.

Some antiepileptic drugs are known to impair cognitive function, which refers to all different aspects of information processing. When the researchers compared different antiepileptic drugs, they found that the risk of Alzheimer’s disease and dementia was specifically associated with drugs that impair cognitive function. These drugs were associated with a 20 percent increased risk of Alzheimer’s disease and with a 60 percent increased risk of dementia.

The researchers also found that the higher the dose of a drug that impairs cognitive function, the higher the risk of dementia. However, other antiepileptic drugs, i.e. those which do not impair cognitive processing, were not associated with the risk.

“More research should be conducted into the long-term cognitive effects of these drugs, especially among older people,” Senior Researcher Heidi Taipale from the University of Eastern Finland says.

Besides for epilepsy, antiepileptic drugs are used in the treatment of neuropathic pain, bipolar disorder and generalized anxiety disorder. This new study is the largest research on the topic so far, and the first to investigate the association in terms of regularity of use, dose and comparing the risk between antiepileptic drugs with and without cognitive-impairing effects. The results were published in the Journal of the American Geriatrics Society.

The association of antiepileptic drug use with Alzheimer’s disease was assessed in Finnish persons diagnosed with Alzheimer’s disease and their controls without the disease. This study is part of the nationwide register-based MEDALZ study, which includes all 70,718 persons diagnosed with Alzheimer’s disease in Finland during 2005-2011 and their 282,862 controls. The association of antiepileptic drug use with dementia was investigated in a sample from a large German statutory health insurance provider, Allgemeine Ortskrankenkasse (AOK). The dataset includes 20,325 persons diagnosed with dementia in 2004-2011, and their 81,300 controls.

via Antiepileptic drug use linked to increased risk of Alzheimer’s and dementia

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[TED Talks] 5 Must watch TED Talks About Depression

Hello, my name is Faith and I’ve been managing depression and anxiety for as long as I can remember. I started this blog to share my tips and tricks and help other bad ass babes kick ass on their mental health journey. I have an online support group you can join for free here. If you need help finding a mental health care provider call 1-800-662-HELP (4357) or visit BetterHelp to talk to a certified therapist online at an affordable price.

This post contains affiliate links, you can read my full disclosure policy here.

I went down the rabbit hole of TED talks again and I thought I would share these awesome TED talks about depression. These aren’t all uplifting but sometimes you need to hear some realness. Positivety kind of feels like a big pile of garbage when you’re depressed anyways (if you’ve ever tried to watch a motivational talk when you’re depressed you probably know what I’m talking about). If you’re depressed and looking for resources checkout my articles on depression and download my free mental health planner.

David Burns talks about using cognitive therapy to treat his depressed patients. He helps his clients to change how they think in order to change how they feel.

Kevin Breel talks about breaking the stigma of depression. If you are feeling depressed and feel like you are along trust me you’re not. There are lots of us out here struggling with depression. I have a mental health support group on Facebookthat you can join if you are looking to connect with other people who are struggling with mental health.

Zindel Segal has been treating his depressed clients by teaching them to appreciate the present moment. Try out the techniques in his talk and see if you think they can help you.

I love her story about communicating with her 2 year old in a positive way. She started trying to practice unconditional positive regard with her kids and then started trying to practice giving unconditional positive regard on herself.

Here’s a kids TED talk from a girl that was hospitalized from depression and anxiety.

Thanks for checking out my post. If you’re looking for more motivation checkout my post of bad ass commencement speeches. I have a ton of mental health resources on my site that I hope you’ll checkout like my free mental health planner or my posts related to anxiety and depression.

 

via TED Talks About Depression – Radical Transformation Project

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[WEB SITE] Coping With Emotional Changes After Stroke for Families

Coping With Emotional Changes After Stroke-blog

As a stroke survivor, you can face major life changes. In the aftermath of a stroke, you may experience a sense of loss that is rooted in the feeling that you’ve lost the life you had before your stroke, or your independence. These strong emotional reactions take a toll.

It is normal to experience emotions ranging from frustration, anxiety, and depression to a sense of grief, or even guilt, anger, and denial after such a monumental change. Realizing that these emotions are normal, and that you are not alone in experiencing them, is an important step to acknowledging and coping with them in a healthy way. By doing this, you avoid becoming overwhelmed, thus avoiding further difficulties during your recovery.

Reasons for Emotional Changes After a Stroke

Young Man At Balcony In Depression Suffering Emotional Crisis And Grief

A stroke causes physical damage to your brain. Feeling or behaving differently after a stroke may be connected to the area of your brain that was damaged. If the area of your brain that controls personality or emotion is affected, you may be susceptible to changes in your emotional response or everyday behavior. Strokes may also cause emotional distress due to the suddenness of their occurrence. As with any traumatic life experience, it may take time for you to accept and adapt to the emotional trauma of having experienced a stroke.

Emotional Changes a Stroke Might Cause

PseudoBulbar Affect

crying

Sometimes referred to as “reflex crying,” “emotional lability,” or “labile mood,” Pseudobulbar Affect (PBA) is a symptom of damage to the area of the brain that controls expression of emotions. Characteristics of the disorder include rapid changes in mood, such as suddenly bursting into tears and stopping just as suddenly, or even beginning to laugh at inappropriate times.

Depression

depressed

If you are feeling sad, hopeless, or helpless after having suffered a stroke, you may be experiencing depression. Other symptoms of depression may include irritability or changes to your eating and sleeping habits. Talk to your doctor if you are experiencing any of these symptoms, as it may be necessary to treat with prescription antidepressants or therapy to avoid it becoming a road block to your recovery.

Anxiety

anxiety

Anxiety is quite common after a stroke. You may have feelings of uneasiness or fears about your health; this is normal and healthy. However, if your anxiety does not subside in time and you feel overwhelmed, you may be dealing with an anxiety disorder, which requires help from your doctor or a mental health professional.

Medical staff will perform an informal evaluation to check for anxiety while you are in the hospital. Often, this involves a quick discussion with hospital staff, during which they will ask you if you have any worries or fears about your health. This evaluation may also involve hospital staff asking your family members if they have noticed a change in your mood or behavior. It is important that you are kept in the loop about any issues that may present themselves, and that you are provided with as much information about your health and treatment options as possible.

Symptoms of anxiety to watch for may include irritability or trouble concentrating. You may also experience trouble sleeping due to your mind racing about your health. Sometimes, you can become tired easily, even if well rested.

Physical symptoms may also present themselves. These symptoms include a racing heart and restlessness and are often coupled with a sense of overwhelming worry or dread. If you find yourself avoiding your normal activities, such as grocery shopping, visiting friends, going for walks, or spending a large portion of your day dwelling on things you are worried about, you may have an anxiety disorder. Your doctor can recommend that you visit a psychologist to help cope with and eventually overcome anxiety.

Other Emotional Reactions

You may experience a range of other emotional reactions after a stroke, including anger and frustration. Additional symptoms may be a sense of apathy or a lack of motivation to accomplish things you typically enjoy.

Coping With Changing Emotions

Physician Ready To Examine Patient And Help

There are many ways to treat the emotional changes associated with a stroke. The first step is discussing how you feel, as well as any concerns you may have about your health with your doctor. One treatment option is counseling, which involves speaking about your distressing thoughts and feelings with a mental health professional or therapist. Simply talking about the way you are feeling can be helpful when coping with overwhelming emotions after experiencing a traumatic event such as a stroke.

Your doctor may also prescribe antidepressants or anti-anxiety medication to help you deal with the emotions involved with a stroke. While they are not a cure-all for emotional troubles, antidepressants change the levels of certain chemicals in your brain, alleviating the symptoms of depression and anxiety, lifting your mood, and making life feel more bearable while you’re recovering. It is important to stay in contact with your doctor if you decide to take medication, as it will not be effective for everyone and may have unpleasant side effects.

Seek Support or Professional Advice

A stroke can come on suddenly and have a monumental effect on your life. For this reason, it is common for many patients to struggle with emotional side effects following a stroke. You may suffer damage to the section of your brain that affects emotions, causing a change in personality or emotional expression known as Pseudobulbar Affect. You may also experience symptoms of anxiety or depression, along with feelings of anger, frustration, or uncharacteristic apathy.

It is important to discuss your emotional concerns with your doctor. You may need a prescription for antidepressants or anti-anxiety medication, or a recommendation to see a mental health professional who can help you form healthy coping mechanisms.


All content provided on this blog is for informational purposes only and is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. If you think you may have a medical emergency, call your doctor or 911 immediately. Reliance on any information provided by the Saebo website is solely at your own risk.

via Coping With Emotional Changes After Stroke for Families

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