Abstract
According to the Centers for Disease Control and Prevention (CDC), traumatic brain injury (TBI) is the leading cause of loss of consciousness, long-term disability, and death in children and young adults (age 1 to 44). Currently, there are no United States Food and Drug Administration (FDA) approved pharmacological treatments for post-TBI regeneration and recovery, particularly related to permanent disability and level of consciousness. In some cases, long-term disorders of consciousness (DoC) exist, including the vegetative state/unresponsive wakefulness syndrome (VS/UWS) characterized by the exhibition of reflexive behaviors only or a minimally conscious state (MCS) with few purposeful movements and reflexive behaviors. Electroceuticals, including non-invasive brain stimulation (NIBS), vagus nerve stimulation (VNS), and deep brain stimulation (DBS) have proved efficacious in some patients with TBI and DoC. In this review, we examine how electroceuticals have improved our understanding of the neuroanatomy of consciousness. However, the level of improvements in general arousal or basic bodily and visual pursuit that constitute clinically meaningful recovery on the Coma Recovery Scale-Revised (CRS-R) remain undefined. Nevertheless, these advancements demonstrate the importance of the vagal nerve, thalamus, reticular activating system, and cortico-striatal-thalamic-cortical loop in the process of consciousness recovery.
Highlights
Traumatic Brain Injury and ConsciousnessTraumatic brain injury (TBI) is defined as an injury caused by an external force that results in the disruption of normal brain function
Electroceuticals: Implications for the Department of Pharmacology, Midwestern University, Downers Grove, IL 60515, USA; Chicago College of Osteopathic Medicine, Midwestern University, Downers Grove, IL 60515, USA; Abstract: According to the Centers for Disease Control and Prevention (CDC), traumatic brain injury (TBI) is the leading cause of loss of consciousness, long-term disability, and death in children and young adults
Traumatic brain injury (TBI) is defined as an injury caused by an external force that results in the disruption of normal brain function
Summary
Traumatic brain injury (TBI) is defined as an injury caused by an external force that results in the disruption of normal brain function. We define consciousness, severe DoCs, and describe clinical screening mechanisms and clinically relevant scoring systems utilized for diagnosing severe DoCs. we address current pharmaceuticals and electroceuticals described in case studies and/or evaluated in clinical trials that are used to treat severe DoCs. we discuss how. Consciousness these advanced clinical scoring systems, pharmaceuticals, and electroceutical therapeutics have contributed to our knowledge of thebasic neuroanatomy consciousness. Systems in the brain consciousness mediate sensory, motor, LevelsThe of consciousness areresponsible generallyfor assessed via three parameters: alertness memory, and emotional functions that give rise to one’s perceptions and emotions [12,13]. Requires function of sensory andto motor cortical regionstoand circuits to Awareness enable perception of and response stimuli [15,16]. 1) [17].1) [17]
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