1,720,985 research outputs found
What is the role for EEG after sleep deprivation in the diagnosis of epilepsy? Issues, controversies, and future directions.
No full textIn patients with a first seizure, the identification of early sensitive and specific biomarkers for formulating a diagnosis of epilepsy is fundamental. Sleep deprivation (SD) has long been used as a means of enhancing EEG sensitivity in the diagnostic process. However, huge methodological differences among the studies addressing this topic have led to highly variable results and often confusing assumptions. Here, we provide a detailed description of the correlations between SD and epilepsy, along with their putative mechanistic explanations derived from experimental studies in animals and humans. We also outline the clinical studies evaluating the role of SD EEG and discuss them critically in terms of: (a) study design and SD EEG methodology; (b) EEG sensitivity and specificity; (c) the role of drug-induced sleep EEG and EEG during spontaneously occurring sleep; and (d) the relevance of patient features, syndromes, and subsyndromes, as well as their correlations with neuroimaging details. Finally, we propose specific studies that might increase the role of SD EEG in the diagnosis and prognosis of epilepsy
L'insonnia nella Medicina del Lavoro
No full textLa pubblicazione riporta alcune esperienze relative alla valutazione dell'insonnia in presenza di alcune attività lavorative a rischi
Jet lag syndrome and circadian disorders of the sleep-wake cycle
No full textCircadian rhythm sleep disorders (CRSDs) are related to alterations in circadian timekeeping system or misalignment between endogenous circadian rhythm and exogenous factors, such as desidered or socially required time schedules, that affect sleep timing or duration. The most commonly observed are jet lag disorder, advanced and delayed sleep phase disorder, free-running disorder, and irregular sleep-wake disorder. The clinical picture may include sleep loss, fatigue, cognitive and vigilance deterioration and hormonal and gastrointestinal distress. Therapeutic management involves interventions aimed at mitigating symptoms affecting sleep and vigilance, and facilitating adaptation to the desired circadian schedule. Appropriately, scheduled bright and dim light exposure and melatonin administration are the main therapeutic tools together with sleep hygiene and chronotherapy. Excessive daytime sleepiness may benefit from short strategic naps and caffeine, whereas bedtime hypnotics may have favorable effect on sleep latency and maintenance. Melatonin and appropriately timed bright light exposure are effective in enhancing new time zone adaption, particularly for stays longer than 3-5 days, whereas short stopover may not benefit
Transcranial magnetic stimulation and gait disturbances in Parkinson's disease: A systematic review
No full textTranscranial magnetic stimulation (TMS) may offer a reliable means of characterizing important pathophysiologic aspects of motor impairments in Parkinson's disease (PD). Moreover, high-frequency repetitive TMS (rTMS), especially if delivered bilaterally over motor cortical regions, can have beneficial effects on parkinsonian motor symptoms. However, only a few studies have investigated the effects of rTMS on freezing of gait (FOG) and other gait disturbances in PD. We aimed at investigating in this narrative review the usefulness of TMS for exploring the pathophysiology of gait impairment and at evaluating the therapeutic effects of rTMS in this context. The combination of rTMS and treadmill training was found to enhance the effect of physical therapy. Use of an H-coil enables stimulation of deep regions of the brain (for example medial prefrontal cortex) and may be used as a target for add-on therapy in the future. In contrast, theta burst stimulation has proven to be ineffective in treating gait disturbances in PD patients. Dual-mode NIBS, in particular preconditioning motor cortex rTMS by transcranial direct current stimulation, might also represent a novel therapeutic approach for patients with gait disturbances. Recent studies suggest that the supplementary motor area could be an appropriate target for brain stimulation when treating PD patients with FOG. Further large sample and well-designed clinical studies are required to evaluate how the possible positive effects of rTMS can be sustained over time and to determine the optimal stimulation protocols including target, stimulation intensity/duration and number of sessions
Psychological well-being of patients with insomnia and its relationship with anxiety and depression
No full textThe aims of the present study are to evaluate the impact of insomnia on psychological well-being and to examine the associations of insomnia and psychological well-being with anxiety and depression. Forty-one patients attending our hospital-based Centre for sleep medicine were administered scales for the evaluation of insomnia (ISI), anxiety (STAI-Y), depression (BDI-II) and psychological well-being (PWB). The scores were compared to those of a control group of 68 subjects attending the hospital for routine examinations or as accompanying persons. Significant differences between patients and controls were detected for anxiety and depression, as well as for psychological well-being. Even if subclinical on average, anxiety and depression symptoms were significantly related to poor psychological well-being, whereas insomnia per se was not. These findings suggest that patients with insomnia report a relevant impact on their psychological well-being, and that such an impact seems to be strongly associated with concomitant subthreshold symptoms of anxiety and depression. The implications for diagnosis and treatment are discussed
Going Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
- …
