BIS Scores Research Articles

Neurophysiological Correlates of Trait Impulsivity in Parkinson's Disease.

BackgroundImpulsivity is common in people with Parkinson’s disease (PD), with many developing impulsive compulsive behavior disorders (ICB). Its pathophysiological basis remains unclear.ObjectivesWe aimed to investigate local field potential (LFP) markers of trait impulsivity in PD and their relationship to ICB.MethodsWe recorded subthalamic nucleus (STN) LFPs in 23 PD patients undergoing deep brain stimulation implantation. Presence and severity of ICB were assessed by clinical interview and the Questionnaire for Impulsive-Compulsive Disorders in PD-Rating Scale (QUIP-RS), whereas trait impulsivity was estimated with the Barratt Impulsivity Scale (BIS-11). Recordings were obtained during the off dopaminergic states and the power spectrum of the subthalamic activity was analyzed using Fourier transform-based techniques. Assessment of each electrode contact localization was done to determine the topography of the oscillatory activity recorded.ResultsPatients with (n = 6) and without (n = 17) ICB had similar LFP spectra. A multiple regression model including QUIP-RS, BIS-11, and Unified PD Rating Scale-III scores as regressors showed a significant positive correlation between 8–13 Hz power and BIS-11 score. The correlation was mainly driven by the motor factor of the BIS-11, and was irrespective of the presence or absence of active ICB. Electrode contact pairs with the highest α power, which also correlated most strongly with BIS-11, tended to be more ventral than contact pairs with the highest beta power, which localize to the dorsolateral motor STN.ConclusionsOur data suggest a link between α power and trait impulsivity in PD, irrespective of the presence and severity of ICB.

Relationship between behavioral inhibition and approach motivation systems (BIS/BAS) and intrinsic brain network connectivity in adult cannabis users.

Dampened behavioral inhibition and overactive behavioral approach motivation systems (i.e. BIS/BAS) are associated with cannabis use disorder (CUD), although the underlying neural mechanisms of these alterations have not yet been examined. The brain’s executive control network (ECN) plays a role in decision-making and is associated with BIS/BAS. In this study, we tested the hypothesis that altered ECN resting-state functional connectivity (rsFC) underlies dysfunctional behavioral inhibition and approach motivation in cannabis users. To that end, we collected resting-state functional magnetic resonance imaging scans in 86 cannabis using adults and 59 non-using adults to examine group differences in the relationship between ECN rsFC and BIS/BAS. Our results showed that BIS was positively correlated with left ECN rsFC in cannabis users, while it was positively correlated with right ECN rsFC in non-users. There was a trend-level moderation effect of group on the association between BIS/BAS and ECN rsFC, showing a weaker association in BIS/BAS and ECN rsFC in cannabis users compared to non-users. An exploratory mediation analysis found that the severity of CUD mediated the relationship between users’ BIS scores and left ECN rsFC. These findings suggest that cannabis use may lead to dysregulation in typical ECN functional organization related to BIS/BAS.

Effect of BIS monitoring on sevoflurane consumption in patients undergoing breast cancer surgeries under general anesthesia\u2014a prospective observational study

BackgroundThe bispectoral index (BIS), a parameter derived from electroencephalogram, has been used to assess the depth of anesthesia. The objectives of this study were to evaluate the effect of BIS monitoring on sevoflurane consumption and recovery profile at the end of anesthesia. After obtaining Institutional Review Board approval and written informed consent, 25 American Society of Anesthesiologists (ASA) physical status classification 1 and 2 patients undergoing breast cancer surgeries who had BIS monitoring in addition to standard ASA monitoring (BIS GROUP) were compared against 25 controls (control group). In the control group, adequate depth of anesthesia was maintained using routine clinical parameters like heart rate (HR), mean arterial pressure (MAP), and minimum alveolar concentration (MAC) of sevoflurane, while in the BIS group, it was maintained by keeping the BIS score between 40 and 60 (mean 50). Data including demographics, sevoflurane consumption, hemodynamic variables, and recovery profile at the end of anesthesia was assessed in terms of time for eye opening (TEO), time for motor response (TMR), time for extubation (TE), and modified Aldrete scoring (MAS).ResultsThe mean sevoflurane consumption was lower (P = 0.019) in the BIS group. TEO (P = 0.001), TMR (P = 0.0001), and TE (0.003) were shorter in the BIS group. Difference in MAS between the 2 groups was not statistically significant (P = 0.085).ConclusionsBIS monitoring during anesthesia resulted in significant reduction in the sevoflurane consumption. Patients who had BIS monitoring awoke earlier and had better recovery profile at the end of anesthesia.

Bipolar disorder’s treatment and impulsivity

IntroductionImpulsivity is not a classical psychiatric diagnosis like schizophrenia, depression, bipolar or borderline personality disorder. It is a symptom that could occur in almost all psychiatric disorders and in some neurological or systemic diseases.ObjectivesIn this study we examine the influence of bipolar disorder’s (BD) treatment on the impulsivity.MethodsWe performed a cross sectional study on 30 patients diagnosed with BD and consulting at the Psychiatric department of HediChaker Hospital. Patients were euthymic during the time of the study confirmed by administration Young Mania Rating Scale (YMRS) and Montgomery Depression Rating Scale (MDRS). The socio-demographic data and treatment models were obtained. Impulsivity was evaluated using the Barratt Impulsiveness Scale (BIS-11).ResultsThe study sample consisted of 30 patients (10 men and 20 women). The mean age of the sample was 45.83 years (SD= 11. 63). Seventeen patients (56.7%) were married. Half of the participants were using an association of mood stabilizer (MS) and an antipsychotic (AP), 36.7% and 13.3% were receiving respectively only mood stabilizer or an antipsychotic. The mean BIS11 score was 75. 60 (SD=5.51) and 76.7% had a high level of impulsivity. No correlation was found between the level of impulsivity (BIS-11 scores) and using MS, AP or MS+AP (p=0.199; p=0.933; p=0.195).ConclusionsFurther studies should be realized to identify pharmacological treatment of impulsivity among people with BD.

Impulsivity and socio-demographic variables among bipolar disorder patients

IntroductionImpulsivity is a psychiatric symptom that seems to be more prevalent in some mental disorders such as bipolar disorders (BD). It is a trait that seems to be influenced by many socio-demographic variables across BD.ObjectivesThe aim of our study is to examine the relationship between impulsivity and these variables.MethodsWe performed a cross sectional study on 30 patients diagnosed with BD and consulting at the Psychiatric department of Hedi Chaker Hospital. Patients were euthymic during the time of the study confirmed by administration Young Mania Rating Scale (YMRS) and Montgomery Depression Rating Scale (MDRS). The socio-demographic data was obtained. Impulsivity was evaluated using the Barratt Impulsiveness Scale (BIS-11)ResultsThe study sample consisted of 30 patients (10 men and 20 women). The mean age of the sample was 45.83 years (SD= 11. 63). Seventeen patients (56.7%) were married. More than half of the subjects (76.7%) were unemployed and 26.7% were not educated. Of the studied patients 83.3% were drug free, 43.3% were smoker and 16.7% were alcoholic. The mean BIS11 score was 75. 60 (SD=5.51) and 76.7% had a high level of impulsivity. No correlation was found between the level of impulsivity (BIS-11 scores) and age, gender, marital status, being a current smoker, using drug or alcohol or job status (p=0.082; p=0.760; p=0.087: p=0.977; p=0.847; p=0.708).ConclusionsFurther studies should be realized to fully characterize impulsivity in BD and, therefore, make it a target for future therapeutic models.

A randomised study of comfort during bronchoscopy comparing conscious sedation and anaesthetist-controlled general anaesthesia, including the utility of bispectral index monitoring.

BackgroundThe difference in patient comfort with conscious sedation versus general anaesthesia for bronchoscopy has not been adequately assessed in a randomised trial. This study aimed to assess if patient comfort during bronchoscopy with conscious sedation is noninferior to general anaesthesia.Methods96 subjects were randomised to receive conscious sedation or general anaesthesia for bronchoscopy. The primary outcome was subject comfort. Secondary outcomes included willingness to undergo a repeat procedure if necessary and level of sedation assessed clinically and by bispectral index (BIS) monitoring.ResultsThere was no significant difference between subject comfort scores (difference −0.01, 95% CI −0.63–0.61 on a 10-point scale; p=0.97) or willingness to undergo a repeat procedure (97.7% versus 91.8%, 95% CI −4.8–15.5%; p=0.37). Deeper levels of sedation in the general anaesthesia cohort was confirmed with both clinical and BIS monitoring. There was no significant difference in diagnostic accuracy (conscious sedation 93.9%, 95% CI 80.4–98.3% versus general anaesthesia 86.5%, 95% CI 72.0–94.1%; p=0.43). There were more complications (29.6%, 95% CI 18.2–44.2% versus 6.1%, 95% CI 2.1–16.5%; p<0.01) in the general anaesthesia group. There was no relationship between high BIS scores and subject discomfort. BIS levels <40 during a procedure were associated with increased complications.ConclusionConscious sedation is not inferior to general anaesthesia in providing patient comfort during bronchoscopy, despite lighter sedation, and is associated with fewer complications and comparable diagnostic accuracy. BIS monitoring may have a role in preventing complications associated with deeper sedation.

The Influence of Substance Abuse on Inhibition Capacities and Risky Decision in a Group of Outpatient Schizophrenia Patients

Objective Substance abuse is common among patients with schizophrenia, is related to worse course and outcome of illness. Unfortunately, little is known about how substance abuse affects the cognitive function of schizophrenia patients, whose cognitive function is often already comprised. Neurocognitive functioning includes inhibition control and decision-making, and both schizophrenia and substance use disorder are related to impairments of inhibition control. However, the influence of substance abuse on inhibition capacities among schizophrenia patients is unclear. Methods: This study measured the influence of substance use disorder on inhibition capacities and risky decision-making in a group of 39 schizophrenia patients that were evaluated using a socio-demographic questionnaire and clinical assessment using the Positive and Negative Syndromes Scale for Schizophrenia. To assess inhibition control we utilized the Matching Familiar Figure Test (MFFT) and the Stroop task, and to evaluate decision-making we used the Iowa Gambling Task (IGT) and self-report questionnaire, the Barratt Impulsiveness Scale. Results: Univariate analysis found significant differences between the groups with regard to criminal history (χ2 = 5.97, p=.015), smoking status (χ2 = 12.30, p<.001), and total BIS score (t= −2.69, df = 37, p=.01). Our model did not find a significant effect of substance abuse on the first response time and number of errors on the MFFT or in the total interference index of Stroop performance and net score on risky decision-making in the IGT. The two groups did not differ significantly either in first response time or in number of errors on the MFFT (F = 0.54, p=.47, d = 0.24, 95% CI [-0.4, 0.88]; F = 0.28, p=.60, d = 0.61, 95% CI [0, 1.26], respectively), nor did they differ in the total interference index of the Stroop task (F(1)=0.49, p=.49, d = 0.25, 95% CI [-0.38, 0.88]). Conclusion: The analyses did not detect any statistically significant effect of substance abuse on inhibition control or risky decision-making processes in outpatients diagnosed with schizophrenia, despite increased impulsivity, criminal history and smoking status. These results neither support nor disprove previous findings.

The Relationship Between Behavioral Inhibition and Behavioral Activation Systems, Impulsiveness, and Internet Gaming Disorder Among Students of Different Ages.

Background and Aims: Internet Gaming Disorder (IGD), which is an underlying symptom classified as a behavioral addiction disorder, has many related social problems that have garnered the bulk of attention in recent research. However, its psychological/behavioral mechanism is still unclear. The purpose of the current study was to explore the relationship between IGD and impulsivity which is regulated by behavioral inhibition and activation among different age groups.Methods: A total of 1,525 students completed Young's Internet Addiction Test (IAT), Online Game Addiction Questionnaire, the Behavioral Inhibition System/Behavioral Activation System (BIS/BAS) scales, and the Barratt Impulsiveness Scale-11 (BIS-11).Results: (1) The prevalence of IGD in different ages students was 10.3%. (2) BIS, BAS-Fun seeking (BAS-F), and BIS-11 scores indicated that there were significant differences between IGD and non-IGD individuals. (3) BIS showed significant differences in different grades (i.e., between undergraduates and middle school students with IGD; F = 3.10, p < 0.05). (4) The IAT scores demonstrated a significant positive correlation with BIS scores (r = 0.375, p < 0.05) among undergraduates with IGD; IAT scores of high school students with IGD were negatively correlated with BAS-Reward (BAS-R) (r = −0.28, p < 0.05).5)BIS and BIS-11 together could explain 14.9% variance of IGD among the college group; BAS-R and BAS-F together could explain 16.7% variance of IGD among the high school group (p < 0.05).Conclusions: The relationships between IGD and BIS, BAS-F, BAS-D, BIS-11 scores differed due to the age group of individuals tested.

Comparison of recovery profiles of propofol and sevoflurane anesthesia with bispectral Index monitoring In general anesthesia: Running title: Recovery profiles: Propofol vs sevoflurane

Introduction: Introduction of more rapid and short-acting volatile anesthetics and intravenous anesthetics has allowed anesthesiologists to achieve a recovery profile that facilitates rapid emergence after general anesthesia. Both propofol and sevoflurane provide rapid induction and faster recovery by titrating the depth of anesthesia based on the BIS Index during maintenance. The objectives of the study were analysis of hemodynamic parameters, changes in the BIS Index, recovery characteristics, postoperative complications. Methods: Following IRB approval, an observational study was conducted in 60 patients of ASA grade I-II, aged 18-60 years undergoing surgical procedures under general anesthesia. Patients were randomly divided into two groups, with 30 patients each receiving propofol infusion (Group P) or sevoflurane (Group S) to maintain anesthesia. The requirement of anesthetic agents was titrated by BIS monitoring. BIS score was held between 40 to 60. Results: Hemodynamic parameters like heart rate and mean arterial pressure (MAP) were comparable in both groups. During recovery, the meantime to spontaneous ventilation, eye-opening, hand squeezing, following verbal command, extubation, stating the name, and mean time to achieve modified Aldrete's score of ≥ 9 from the cessation of the anesthetic drug was significantly shorter in Group S as compared to Group P. PONV was noted as a postoperative complication in the sevoflurane group. Conclusion: In our study, sevoflurane provided rapid emergence and faster recovery with stable hemodynamic. However, propofol appears to be an excellent alternative to sevoflurane for maintenance of anesthesia as it also provides fast recovery with a lower incidence of PONV

Clinical Comparison of 5mm Mini-incision Laparoendoscopic Single-Site Hysterectomy and Traditional Laparoendoscopic Single-Site Hysterectomy

Objective: To investigate the feasibility of 5mm mini-•incision Laparoendoscopic Single-Site hysterectomy and Laparoendoscopic Single-Site hysterectomy in terms of safety, postoperative pain and cosmetic effect. Methods: The medical records of 19 patients who underwent hysterectomy with 5mm mini-•incision Laparoendoscopic Single-Site Surgery (LESS) or traditional Laparoendoscopic Single-Site Sugery in the Affiliated Changzhou No. 2 People’s Hospital of Nanjing Medical University from December 2017 to June 2020 were retrospectively analyzed, including 6 cases in the group of 5mm mini-•incision Laparoendoscopic Single-Site hysterectomy through umbilical ordinary incision (5mm) and 13 cases in the group of traditional Laparoendoscopic Single-Site hysterectomy through umbilical ordinary incision (1.5cm-3cm). Collect and compare the intraoperative blood loss, the operative time, the postoperative hemoglobin descender, the postoperative hospital stays, the probability of postoperative wound infection, the total cost, Visual analogue scale (VAS) of 12 hours after surgery, VAS of 24 hours after surgery and postoperative Body Image Questionnaire (BIQ, including Body Image scale, BIS and Cosmetic Score, CS) in the two groups. Results: There was no intraoperative complication happened, and there was no significant difference between the two groups in the forms of the intraoperative blood loss, operative time, postoperative hospital stays, postoperative hemoglobin descender, the probability of postoperative wound infection, the total cost, VAS of 24 hours after surgery and CS (P > 0.05). But the VAS of 12 hours after surgery of the 5mm mini-•incision Laparoendoscopic Single-Site hysterectomy was lower than traditional Laparoendoscopic Single-Site hysterectomy (1.17±0.14 vs. 2.33±0.19), the BIS of the former was higher than the later (19.83±0.15 vs 19.16±0.28), and importantly the difference was statistically significant (P < 0.05). Conclusion: Laparoendoscopic Single-Site through 5mm mini-incision is safe and feasible. Compared with traditional Laparoendoscopic Single-Site Hysterectomy through ordinary incision, it can not only significantly reduce postoperative pain, but also bring more satisfactory postoperative cosmetic effect.

Bispectral index analysis in general anesthesia: An observational study

Introduction: Bispectral index monitoring (BIS) is one of the major techniques used in monitoring depth of anesthesia. The present study was carried out to observe the changes in BIS values vis-a-vis the changes in hemodynamic parameters during the standard general anaesthesia practices in our institute. Materials and Methods: This prospective observational study was carried out in 50 ASA I/II elective surgeries in adults under general anesthesia. Conditions and drugs likely to interfere with BIS values were excluded. Anesthesia protocol was kept uniform. Patients were induced with IV propofol 2mg/kg, IV pentazocine 0.5mg /kg and IV vecuronium 0.1mg/kg. Patients were intubated with appropopriate size endotracheal tube and oxygen, nitrous oxide, halothane and vecuronium were used for maintanence of anesthesia. Patients were reversed with IV neostigmine 0.05mg/kg and I V Atropine 20mcg/kg. The BIS values, hemodymanic changes, recovery characteristics (including awareness) were noted. Correlation between BIS scores and hemodynamic parameters was assessed. Results: There were predictable changes in BIS scores with the standard anesthesia technique followed in the present study. Similarly, hemodynamic changes were also on the expected lines during the course of anesthesia. However, the correlation between BIS score and hemodynamics could not be established. Conclusion: Bispectral Index Monitor is a useful tool to assess the depth of anesthesia in standard anesthetic management. Alterations in anesthetic management and drug dosages can be guided by BIS scores. Cost factor and the need to use updated and refined versions of the software are the possible limitations. Keywords: Electroencephalography, Consciousness monitors, Anesthesia, General, Hemodynamics.

Trait impulsivity in Juvenile Myoclonic Epilepsy.

ObjectiveImpulsivity is a multidimensional construct that can predispose to psychopathology. Meta‐analysis demonstrates an association between response impulsivity and Juvenile Myoclonic Epilepsy (JME), a common genetic generalized epilepsy. Here, we test the hypotheses that trait impulsivity is (i) elevated in JME compared to controls; (ii) moderated by specific seizure characteristics; and (iii) associated with psychiatric adverse effects of antiepileptic drugs (AEDs).Methods322 participants with JME and 126 age and gender‐matched controls completed the Barratt’s Impulsiveness Scale (BIS‐brief) alongside information on seizure history and AED use. We compared group BIS‐brief scores and assessed associations of JME BIS‐brief scores with seizure characteristics and AED adverse effects.ResultsThe mean BIS‐brief score in JME was 18.1 ± 4.4 compared with 16.2 ± 4.1 in controls (P = 0.0007). Elevated impulsivity was associated with male gender (P = 0.027), frequent absence seizures (P = 0.0004) and lack of morning predominance of myoclonus (P = 0.008). High impulsivity significantly increased the odds of a psychiatric adverse event on levetiracetam (P = 0.036), but not any other psychiatric or somatic adverse effects.InterpretationTrait impulsivity is elevated in JME and comparable to scores in personality and neurotic disorders. Increased seizure frequency and absence of circadian seizure pattern moderate BIS score, suggesting disruption of both cortico‐striatal and thalamocortical networks as a shared mechanism between seizures and impulsivity in JME. These findings warrant consideration of impulsivity as a distinct target of intervention, and as a stratifying factor for AED treatment in JME, and perhaps other types of epilepsy. The role of impulsivity in treatment adherence and psychosocial outcome requires further investigation.

Psychopathological Comorbidities and Clinical Variables in Patients With Medication Overuse Headache

The psychopathological profile of patients with medication overuse headache (MOH) appears to be particularly complex. To better define it, we evaluated their performance on a targeted psychological profile assessment. We designed a case-control study comparing MOH patients and matched healthy controls (HC). Headache frequency, drug consumption, HIT-6, and MIDAS scores were recorded. All participants filled in the following questionnaires: Beck Depression Inventory-II Edition (BDI-2), trait subtest of State-Trait Anxiety Inventory (STAI-Y), Difficulties in Emotion Regulation Scale (DERS), Barratt Impulsiveness Scale (BIS-11), Toronto Alexithymia Scale (TAS-20). The primary endpoint was to establish if MOH patients have an altered psychopathological profile. The secondary endpoint was to establish whether the worst profile correlates with the worsening of headache and disability measures. We enrolled 48 consecutive MOH patients and 48 HC. MOH patients showed greater difficulty in recognition/regulation of emotions (DERS, TAS-20), depression (BDI-2), anxiety (STAI-Y), and impulsiveness (BIS-11). We found a positive correlation among DERS, BDI-2, STAI-Y, and BIS scores and MIDAS and HIT-6 scores and among DERS and headache frequency and drug consumption. MOH patients showed a high rate of emotion regulation difficulties, depression, and anxiety, which may negatively affect their headaches. The ability to regulate/recognize emotions may play a central role in sustaining medication overuse.

Depression and Impulsivity Self-Assessment Tools to Identify Dopamine Agonist Side Effects in Patients With Pituitary Adenomas.

Background: Dopamine agonists (DA) are the first line therapy for prolactinoma and symptomatic hyperprolactinemia; use as an adjuvant treatment for acromegaly and Cushing's disease is rare. Some patients develop de novo psychiatric symptoms or have exacerbation of pre-existing conditions during DA therapy. A practical, clinically sensitive depression and impulse control disorders (ICD; particularly hypersexuality and gambling disorders) detection tool is important for identifying at risk patients. The Barratt Impulsivity Scale (BIS-11) and the 9-item Patient Health Questionnaire (PHQ-9) are sensitive in identifying impulsivity and depression.Objective: Detail use of the BIS-11 and PHQ-9 as screening tools for depression and ICD in patients with pituitary disease at a high-volume academic pituitary center.Methods: DA-treated and naïve patients with pituitary disease were included. Patients with a known history of depression or psychiatric disorder were excluded. PHQ-9 standardized interpretation criteria were utilized to classify depression severity. For BIS-11, threshold was established based on previous studies. Statistical analysis was with SPSS version 25.Results: Seventy-six DA-treated and 27 naïve patients were included. Moderate and moderately severe depression were more prevalent in DA-treated patients; severe depression only found in DA-treated patients. A normal BIS-11 score was noted in 76.69%; higher scores (not significant) were noted in DA-treated patients. There was a positive correlation between higher BIS-11 and PHQ-9 scores; higher in DA-treated patients (r = 0.52, p < 0.001) than DA-naïve patients. Patients with BIS-11 scores ≥60 were younger and received lower cumulative DA doses compared to patients with BIS scores <60. There was no association between male sex and BIS-11 ≥60 and male sex did not increase the odds of increased scores (OR = 0.66, CI95% 0.25–1.76, p = 0.41). No significant difference was found for macroadenoma, prolactin levels, testosterone levels, hypogonadism, testosterone replacement in men, and increased impulsivity or depression scores.Conclusion: Use of PHQ-9 and BIS-11 is practical for routine screening of depression and ICD during outpatient pituitary clinic visits for patients with pituitary disease both naïve to treatment and during DA therapy. We recommend close follow-up after initiation of DA therapy for younger patients, regardless of dose.

Elevated Serum Ceruloplasmin Levels Are Associated with Higher Impulsivity in People with Parkinson's Disease.

Background Heightened impulsivity has been reported in a subset of people with Parkinson's disease (PwP) and is considered a risk factor for the development of impulse control disorders (ICDs). However, at present, there are no recognised biochemical markers of heightened impulsivity. Objectives To determine if ceruloplasmin, a serum marker involved in the regulation of iron and copper homeostasis, is associated with trait impulsivity in PwP. Methods The study measured serum ceruloplasmin and impulsivity using the Barratt Impulsiveness Scale (BIS-11) in an Australian cohort of 214 PwP. Multivariate general linear models (GLMs) were used to identify whether higher serum ceruloplasmin levels (>75th percentile) were significantly predictive of BIS-11 scores. Results Serum ceruloplasmin was higher in females with PD (p < 0.001) and associated with MDS-UPDRS III, Hoehn and Yahr, and ACE-R scores (p < 0.05). When correcting for covariates, higher serum ceruloplasmin concentrations were associated with the 2nd order nonplanning impulsivity and with the 1st order self-control and cognitive complexity impulsivity domains. Conclusions Higher serum ceruloplasmin levels are independently associated with heightened nonplanning impulsivity in PwP. Thus, serum ceruloplasmin levels may have clinical utility as a marker for heightened impulsivity in PD.

Effect of remifentanil-based fast-track anesthesia on postoperative analgesia and sedation in adult patients undergoing transthoracic device closure of ventricular septal defect

ObjectiveTo investigate the effect of remifentanil-based fast-track anesthesia on analgesia and sedation after transthoracic device closure of ventricular septal defects (VSDs) in adult patients.MethodsA retrospective analysis was performed on 59 patients aged 21–53 years who underwent transthoracic device closure of VSDs from January 2019 to September 2019. According to the different anesthesia strategies, the patients were divided into the R group (using remifentanil-based anesthesia, n = 33) and the S group (using sufentanil-based anesthesia, n = 26). Patient-related clinical data, postoperative analgesia, and sedation scores were collected and analyzed.ResultsThere was no significant difference in age, gender, body weight, and operation time between the group R and the group S (P > 0.05). There was also no significant difference in intraoperative hemodynamic changes, BIS scores, postoperative analgesia, and sedation scores between the two groups (P > 0.05). The duration of mechanical ventilation, the length of ICU stay, and hospital stay in the group R were significantly lower than those in the group S (P < 0.05).ConclusionRemifentanil-based fast-track anesthesia is effective for adult patients undergoing transthoracic device closure of VSDs, which may shorten the mechanical ventilation duration, the ICU and hospital stay of patients.

Investigation of the Association between Bispectral index and Body Temperature during Abdominal Surgery; An Observational Study

Objective: Bispectral index (BIS) is mainly used for drug titration and is well correlated with drug concentration and hypnosis. Our aim was to present the correlation between hypothermia and BIS during abdominal surgery.&#x0D; Methods: The study was conducted in patients with American Society of Anesthesiologists (ASA) score I-III, aged between 18-60 y, who had undergone abdominal operation in general surgery theatre. Body temperature and BIS scores whenawake, after anesthesia induction, after tracheal intubation and every 5 minutes during the operation, and afterextubation were measured and recorded.&#x0D; Results: Three hundred patients were included to the study. Repeated measure regression analysis of BIS scores with the body temperature at distinct time points did not show a significant relationship. None of the patients had a body temperature lower than 35°C.&#x0D; Conclusions: As a result of our study, we can say that temperature decrease up to 35°C may not have an effect on BIS scores, and BIS maybe used safely to indicate hypnosis level at temperatures 35°C and above during abdominal surgery.

Functional connectome-based biomarkers predict chronic codeine-containing cough syrup dependent

PurposeCodeine-containing cough syrup (CCS) is considered among the most popular drugs of abuse in adolescents worldwide. Accurate prediction and identification of CCS dependent (CCSD) users are crucial. This study aimed to identify a brain-connectome-based predictor of CCSD using a machine learning model based on a ten-fold cross-validation logistic regression (LR) classifier. Methods40 CCSD users and 40 healthy control (HC) subjects underwent functional magnetic resonance imaging to construct weight functional networks. Partial correlation analysis was used to analyze relations between abnormal network metrics and clinical characteristics (BIS total scores, CCS abuse duration, and mean CCS dose) in CCSD. A ten-fold cross-validation LR classifier was used to classify CCSD users and HC subjects. ResultsThe CCSD group showed significantly abnormal nodes and connections in the right posterior cingulate, right middle insula, bilateral prefrontal cortex, parietal lobe, temporal lobe, occipital lobe, and cerebellum. Furthermore, higher characteristic path length and lower clustering coefficient (Cp), global efficiency, and local efficiency (Eloc) were observed in the global topologies in CCSD. The abnormal global properties (Cp and Eloc) and node properties of the prefrontal cortex were significantly correlated with clinical characteristics (BIS-11 scores, CCS abuse duration) in CCSD. The LR classifier models demonstrated accuracy, sensitivity, specificity, precision, and AUC of 82.5%, 82.5%, 82.5%, 76.8%, and 82.5%. ConclusionsThese data demonstrate that abnormal functional connectome may be closely linked to clinical characteristics in CCSD. Functional connectome-based biomarkers can be a powerful tool for personalized diagnosis of CCSD in the future.

Increased large-scale inter-network connectivity in relation to impulsivity in Parkinson\u2019s disease

Impulsivity is a neuropsychiatric feature of Parkinson’s disease (PD). We investigated the pathophysiology of impulsivity in PD using resting-state functional magnetic resonance imaging (rs-fMRI). We investigated 45 patients with idiopathic PD and 21 healthy controls. Based on Barratt Impulsiveness Scale (BIS-11) score, PD patients were classified as higher (PD-HI) or lower impulsivity (PD-LI). Functional connectivity (FC) between various large-scale brain networks were analysed using the CONN toolbox. FC between the right frontoparietal network (FPN) and medial visual network (MVN) was significantly higher in PD-HI patients than PD-LI patients (false discovery rate [FDR]-adjusted p = 0.0315). FC between the right FPN and MVN had a significant positive correlation with total BIS-11 score (FDR-adjusted p = 0.010) and the attentional impulsivity (FDR-adjusted p = 0.046) and non-planning impulsivity subscale scores (FDR-adjusted p = 0.018). On the other hand, motor impulsivity subscale score had a significant negative correlation with the FC between the default-mode and salience networks (right supramarginal gyrus, FDR-adjusted p = 0.018; anterior cingulate cortex, FDR-adjusted p = 0.027); this trend was observed in healthy controls. The attentional and non-planning impulsivity, regarded as ‘cognitive’ impulsivity, may be associated with dysfunction in integration of perceptual information and flexible cognitive control in PD.

Not as simple as ABC: Analysis of tools to trigger MTP activation in Pediatric Trauma

Background: Early and accurate identification of pediatric trauma patients who will require massive transfusion (MT) is not well established. In adults, an ABC score >2 (defined by penetrating mechanism, positive FAST, SBP120) identifies trauma patients who require MT with sensitivity and specificity of 75 and 86%, respectively. We developed the BIS and ABCD scores and hypothesize they can improve the discriminate ability for predicting massive transfusion in children. Methods: Pediatric trauma patients who received …