Somatic Responses Research Articles

Preemptive Epidural Analgesia for Postoperative Pain Relief Revisited: Comparison of Combination of Buprenorphine and Neostigmine with Combination of Buprenorphine and Ketamine in Lower Abdominal Surgeries, A Double-blind Randomized Trial.

Context:Postoperative pain relief provides subjective comfort to patient in addition to blunting of autonomic and somatic reflex responses to pain, subsequently enhancing restoration of function by allowing the patient to breathe, cough, and move easily.Aims:The aim is to evaluate and compare the effects of neostigmine + buprenorphine and ketamine + buprenorphine for preemptive epidural analgesia for postoperative pain relief in patients undergoing abdominal surgeries under general anesthesia (GA).Settings and Design:A double-blind randomized trial.Subjects and Methods:A total of 60 American Society of Anesthesiologists physical status Classes I and II patients undergoing abdominal surgeries under GA were taken up for the study. They were randomly allocated into two groups, Group A and Group B of thirty patients each. Preemptive epidural analgesia for postoperative pain relief was provided by a combination of neostigmine 1 μg/kg + buprenorphine 2 μg/kg in Group A patients and ketamine 1 mg/kg + buprenorphine 2 μg/kg in Group B patients after induction of GA but before surgical incision. Postoperatively, vital parameters, pain score, requirement of top up doses, and side effects in the two groups were observed and recorded at 2, 4, 6, 10, 18, and 22 h.Statistical Analysis Used:Mean values within each of the Group A and Group B were compared using one-way analysis of variance (one-way ANOVA). Mean values between Group A and Group B were compared using double analysis of variance (two-way ANOVA).Results:Group A patients had a significant analgesia (visual analog scale [VAS] pain scores reduced significantly from 54.6 ± 6.3 at 2 h to 8.1 ± 8.9 at 22 h postoperatively). Group B patients had significant analgesia too (VAS pain scores reduced significantly from 36 ± 12.5 at 2 h to 5.3 ± 10.9 at 22 h postoperatively). There was however no significant difference between the two groups with respect to the degree of postoperative analgesia on comparison of VAS scores, effect on vital parameters, and incidence of side effects.Conclusions:Either of the two combinations, neostigmine 1 μg/kg + buprenorphine μg/kg or ketamine 1 mg/kg + buprenorphine 2 μg/kg can be safely used for preemptive epidural analgesia for postoperative pain relief in patients undergoing abdominal surgeries under GA.

The effect of bilateral intrapleural infusion of lidocaine with fentanyl versus only lidocaine in relieving pain after coronary artery bypasses surgery.

Background and Objective:Pain control during surgery in order to cause analgesia and reduce the somatic and autonomic response may decrease the morbidity. Intrapleural catheter embedding during surgery under direct vision of surgeon is safe and easy and without potential risk of thoracic epidural block. The aim of this study was to investigate the effect of bilateral intrapleural infusion of lidocaine with fentanyl versus only lidocaine in relieving pain after coronary artery bypass surgery.Methods:In this prospective randomized double blind clinical trial,130 adult patients undergoing elective CABG with age range of 20 to 60 years were divided into two groups receiving either lidocaine and fentanyl (group A) or lidocaine (group B). The analgesia was evaluated every two hours in all intubated and non-intubated patients using Visual analog scale (VAS) and data were analyzed using SPSS software package.Results:Of all patients, 67 (51.5%) were males and 63 (48.5%) were females. The average age of subjects was 53.49 ± 5.099 years. Mean pain score six hours after the surgery was statistically different between the groups at all times.Conclusion:The pain in patients receiving combination of lidocaine and fentanyl is less than patients receiving only lidocaine.

The Clinical Effectiveness of the Bispectral Index (BIS) To Reduce the Risk of Awareness for Elective Surgical Patients Undergoing General Anesthesia: A Prospective, Randomized, Double-Blind, Controlled Trial

The Clinical Effectiveness of the Bispectral Index (BIS) To Reduce the Risk of Awareness for Elective Surgical Patients Undergoing General Anesthesia: A Prospective, Randomized, Double-Blind, Controlled Trial

Go for broke: The role of somatic states when asked to lose in the Iowa Gambling Task

The Somatic Marker Hypothesis (SMH) posits that somatic states develop and guide advantageous decision making by “marking” disadvantageous options (i.e., arousal increases when poor options are considered). This assumption was tested using the standard Iowa Gambling Task (IGT) in which participants win/lose money by selecting among four decks of cards, and an alternative version, identical in both structure and payoffs, but with the aim changed to lose as much money as possible. This “lose” version of the IGT reverses which decks are advantageous/disadvantageous; and so reverses which decks should be marked by somatic responses – which we assessed via skin conductance (SC). Participants learned to pick advantageously in the original (Win) IGT and in the (new) Lose IGT. Using multilevel regression, some variability in anticipatory SC across blocks was found but no consistent effect of anticipatory SC on disadvantageous deck selections. Thus, while we successfully developed a new way to test the central claims of the SMH, we did not find consistent support for the SMH.

Psychotherapeutic treatment of traumatized refugees in Germany

Traumatic experiences resulting from war and violence can lead to abroad spectrum of psychological and somatic stress responses. The psychological strain of traumatized refugees is frequently aggravated by specific post-migration stressors. The current healthcare provision in Germany is characterized by many restrictions. The different residence permits are associated with alimited access to medical and psychotherapeutic services. In addition, there are several barriers limiting access of this group of patients to the healthcare system (e. g. low level of training of mental healthcare staff, language barriers and lack of financing for interpreters). Empirical studies have shown that traumatized refugees profit from existing trauma-focused and evidence-based interventions. Treatment is associated with particular challenges and issues (e. g. use of interpreters, migration and culture-specific as well as legal aspects). Specialized treatment centers for traumatized refugees use amultidisciplinary treatment approach, which includes psychotherapeutic, medical and social work interventions as well as assistance with the residential status and integration programs.

English

The first objective of this study was to assess and optimize somatic embryo production in a genetically diverse range of cacao genotypes. The primary and secondary somatic embryogenesis response of eight promising cacao clones and a positive control was evaluated using modified versions of standard protocols. The second objective was to optimize the efficiency of primary somatic embryogenesis for a commercially important cacao clone, CCN 51, which has proven to be quite recalcitrant to standard protocols, relative to CCN 10, a clone also included in our analysis. The efficiency of the overall process was assessed by determining the number of somatic embryos produced per starting somatic tissue explant, as well as the quality of embryos (normal vs. abnormal) produced. Donor floral explants were subjected to five tissue culture steps, each 15-25 days in duration. Although all studied genotypes produced primary somatic embryos, most of them originated only from brown or brown-white callus. Overall, flower petals performed better than staminodes, and our best performing genotype yielded an average of 7-10 embryos produced in brown callus explants with embryogenic response during primary somatic embryogenesis procedures. In conclusions our analysis from a pilot in a small-scale are: 1) it is possible to achieve a high production of plants by somatic embryogenesis, although the efficiency is highly genotype-dependent; it is therefore necessary to optimize hormone balance and hormone type, as well as the explant type for each genotype, 2) through the use of secondary somatic embryogenesis, it is possible to increase somatic embryogenesis production at least ten-fold, and 3) the observed response variation between genotypes may reflect differences in endogenous and exogenously-supplied hormones. The importance of adapting the tissue culture protocol to the genotype is discussed. Key words: Somatic embryogenesis, 2,4-D, cellular competence, propagation, abnormalities, ethylene, cacao.

Abstract PR344

Background & Objectives: Bispectral index (BIS) is considered very useful to guide anaesthesia care in elderly patients, but it is controversial for the evaluation of the adequacy of analgesia. This study compared the BIS changes in response to loss of consciousness (LOC) and loss of somatic response (LOS) to nociceptive stimuli between elderly and young patients receiving intravenous target-controlled infusion (TCI) of propofol and remifentanil. Materials & Methods: This study was performed on 52 elderly patients (aged 65~78 yr) and 52 young patients (aged 25~58 yr), ASA physical status I or II. Anaesthesia was induced with propofol administered by TCI. A standardized noxious electrical stimulus (transcutaneous electrical nerve stimulation, TENS) was applied (50 Hz, 80 mA, 0.25 ms pulses for 4 s) to the ulnar nerve at increasing remifentanil effective-site concentration (Ce) until patients lost somatic response to TENS. Changes in awake, prestimulus, poststimulus BIS, heart rate (HR), mean arterial pressure (MAP), pulse oxygen saturation (SpO2), predicted plasma concentration (Cp), predicted effective-site concentration (Ce) of propofol and remifentanil at both LOC and LOS clinical points were investigated. Results: BISLOC in elderly group 65.4±9.7 was higher than that in young patient group (65.4±9.7 vs 57.6±12.3) (t=21.58, P<0.0001) after TCI propofol, and the propofol Ce at LOC was 1.6±0.3 μg/ml in elderly patients, which was significantly lower than that in young patients (2.3±0.5 μg/ml) (t=7.474, P<0.0001). As nociceptive stimulation induced BIS to increase, the mean of BIS maximum values after TENS was significantly higher than that before TENS in both age groups (t=8.902 and t=8.019, P<0.0001). With increasing Ce of remifentanil until patients lost somatic response to TENS, BISLOS was the same as the BISLOC in elderly patients (65.6±10.7 vs 65.4±9.7), and there were no marked differences between elderly and young patient groups in BISawake, BISLOS and Ce of remifentanil required for LOS. Conclusion: In elderly patients, BIS can be used as indicator for hypnotic-analgesic balance, and be helpful to guide the optimal administration of propofol and remifentanil individually. Disclosure of Interest: None declared

Postnatal changes in glutamatergic inputs of jaw-closing motoneuron dendrites.

Dendrites of masseter (jaw-closing) motoneurons (MMNs) are well developed and ramify extensively throughout the trigeminal motor nucleus and often extend into the adjacent reticular formation. It is possible that the dendrites have active properties, which are altered with the development of the orofacial musculoskeletal system. Thus, we examined the changes in somatic voltage responses evoked by photostimulation of the MMN dendrites by laser photolysis of caged glutamate from postnatal day (P) 2-5 and 9-12 rats. We photostimulated 39 spots that were arranged around each recorded neuron in a concave shape and found that the dendritic stimulation induced somatic depolarization in the presence of tetrodotoxin in all MMNs. With increasing photostimulation intensity, the responses grew in amplitude up to a certain threshold, where a step-like increase in amplitude occurred. In 75% of P2-5 MMNs, the step-like increase in amplitude, which was blocked by 20μM D(-)-2-amino-5-phosphonovaleric acid application, corresponded to the NMDA spikes/plateau potentials. In contrast, at P9-12 the responses became significantly smaller in amplitude and shorter in duration and only one neuron out of 12 MMNs showed NMDA spikes/plateau potentials. These results suggest that the glutamatergic responses evoked by photostimulation of the MMN dendrites change during the first two postnatal weeks, and these changes may be involved in the transition from suckling to chewing during postnatal development.

Somatic stimulation causes frontoparietal cortical changes in neonates: a functional near-infrared spectroscopy study.

Palmar and plantar grasp are the foremost primitive neonatal reflexes and functions. Persistence of these reflexes in infancy is a sign of evolving cerebral palsy. Our aims were to establish measurement feasibility in a clinical setting and to characterize changes in oxyhemoglobin (HbO) and deoxyhemoglobin (HbD) concentration in the bilateral frontoparietal cortex in unsedated neonates at the crib-side using functional near-infrared spectroscopy (fNIRS). We hypothesized that bilateral concentration changes will occur upon somatic central and peripheral somatic stimulation. Thirteen preterm neonates (five males) underwent time 1, and six (two males) returned for time 2 (mean [Formula: see text] and 47.0 weeks, respectively). Signals from a total of 162 somatic stimuli responses were measured. Response amplitude, duration, and latency were log-transformed and compared between palmar, plantar, and oromotor stimuli using linear mixed models, adjusted for cap, electroencephalogram abnormality, time (1 versus 2), and Sarnat score, if necessary. The oromotor stimulus resulted in a 50% greater response than the palmar or plantar stimuli for HbO left and right hemisphere duration ([Formula: see text]). There were no other statistically significant differences between stimuli for any other outcome ([Formula: see text]). Utilizing fNIRS in conjunction with occupational and physical therapy maneuvers is efficacious to study modifiable and restorative neurophysiological mechanisms.

Hypnotizability and Placebo Analgesia in Waking and Hypnosis as Modulators of Auditory Startle Responses in Healthy Women: An ERP Study.

We evaluated the influence of hypnotizability, pain expectation, placebo analgesia in waking and hypnosis on tonic pain relief. We also investigated how placebo analgesia affects somatic responses (eye blink) and N100 and P200 waves of event-related potentials (ERPs) elicited by auditory startle probes. Although expectation plays an important role in placebo and hypnotic analgesia, the neural mechanisms underlying these treatments are still poorly understood. We used the cold cup test (CCT) to induce tonic pain in 53 healthy women. Placebo analgesia was initially produced by manipulation, in which the intensity of pain induced by the CCT was surreptitiously reduced after the administration of a sham analgesic cream. Participants were then tested in waking and hypnosis under three treatments: (1) resting (Baseline); (2) CCT-alone (Pain); and (3) CCT plus placebo cream for pain relief (Placebo). For each painful treatment, we assessed pain and distress ratings, eye blink responses, N100 and P200 amplitudes. We used LORETA analysis of N100 and P200 waves, as elicited by auditory startle, to identify cortical regions sensitive to pain reduction through placebo and hypnotic analgesia. Higher pain expectation was associated with higher pain reductions. In highly hypnotizable participants placebo treatment produced significant reductions of pain and distress perception in both waking and hypnosis condition. P200 wave, during placebo analgesia, was larger in the frontal left hemisphere while placebo analgesia, during hypnosis, involved the activity of the left hemisphere including the occipital region. These findings demonstrate that hypnosis and placebo analgesia are different processes of top-down regulation. Pain reduction was associated with larger EMG startle amplitudes, N100 and P200 responses, and enhanced activity within the frontal, parietal, and anterior and posterior cingulate gyres. LORETA results showed that placebo analgesia modulated pain-responsive areas known to reflect the ongoing pain experience.

Disenchanting Secularization

Disenchanting Secularization

Cutoff Scores for MMPI-2 and MMPI-2-RF Cognitive-Somatic Validity Scales for Psychometrically Defined Malingering Groups in a Military Sample.

This research examined cutoff scores for MMPI-2 and MMPI-2-RF validity scales specifically developed to assess non-credible reporting of cognitive and/or somatic symptoms. The validity scales examined included the Response Bias Scale (RBS), the Symptom Validity Scales (FBS, FBS-r), Infrequent Somatic Responses scale (Fs), and the Henry-Heilbronner Indexes (HHI, HHI-r). Cutoffs were developed by comparing a psychometrically defined non-malingering group with three psychometrically defined malingering groups (probable, probable to definite, and definite malingering) and a group that combined all malingering groups. The participants in this research were drawn from a military sample consisting largely of patients with traumatic brain injury (mostly mild traumatic brain injury). Specificities for cutoffs of at least 0.90 are provided. Sensitivities, predictive values, and likelihood ratios are also provided. RBS had the largest mean effect size (d) when the malingering groups were compared to the non-malingering group (d range=1.23-1.58).

Body, Comity, and the Civil War Band: Thoughts on Music and Poetry

Civil War bands, indispensable to both Union and Confederate troops, were employed by officers to keep morale high during times of rest and relaxation, and to instill regional pride during times of battle. I engage in an inquiry into the functions of the Civil War band in order to highlight the nature of music as it offers at one moment the emotional integration of camaraderie and at another moment the impetus to spur soldiers to combat. As a means of investigating such cases, I start with the poem “Union Camp Music,” included in my recent book of poems, Cyclorama, and conclude with a discussion of the receptive functions activated by both poetry and music in the listeners of each art form. Both poetry and music depend upon bodily reactions, the former relying more upon a referentiality inherent to meaning, the latter upon a nonreferentiality that can turn intention obscure. Both art forms, nonetheless, retain as a primary effect, the performer-to-listener synchrony that derives from somatic response.

On First Looking into Derrida's Glas

This essay attempts to ‘read’ the first page of Jacques Derrida's Glas, while at the same time reporting as best I can what actually goes on when I make this effort of reading. I try to exemplify in detail my claim that what goes on in reading is much stranger and more complex that one might think. An intricate series of events took place when I first received Glas in the mail and opened it, reading first the single-sheet insert and then looking at the cover, the title page, and, finally, the first page of the text proper. In my case, at least, in addition to trying to make sense of the words on the page, all sorts of somatic and affective responses were involved, as well as a constant unsuccessful attempt to create a coherent mental image based not only on the way the words are arranged on the page (in two columns), but also on the bewildering complexity of what the words say.

Randomized, Placebo-Controlled Trial of Biofeedback for the Treatment of Rumination.

We previously demonstrated that rumination is produced by an unperceived, somatic response to food ingestion, and we developed an original biofeedback technique based on electromyography (EMG)-guided control of abdomino-thoracic muscular activity. Our aim was to demonstrate the superiority of biofeedback vs. placebo for the treatment of rumination. Randomized, placebo-controlled trial performed in a referral center. Consecutive patients who fulfilled the Rome III criteria for rumination (18 women, 6 men; 19-79 years age) were selected and all included in the study; 1 patient assigned to placebo withdrew because of an unrelated accident. Abdomino-thoracic muscle activity after a challenge meal was recorded by EMG. The patients in the biofeedback group were shown the signal and instructed to control muscle activity, whereas the patients in the placebo group were not shown the signal and were given oral simethicone. Each patient underwent 3 sessions over a 10-day period. number of rumination events as measured by questionnaires for 10 consecutive days before and after intervention. Patients on biofeedback (n=12) but not on placebo (n=11) effectively learned to reduce intercostal activity (by 51±6% vs. 10±7% increment on placebo; P<0.001) and anterior wall muscle activity (by 52±4% vs. 9±2% increment on placebo; P<0.001). Biofeedback treatment resulted in a 74±6% reduction in rumination activity (from 29±6 before to 7±2 daily events after intervention) vs. 1±14% on placebo; P=0.001 (from 21±2 before to 21±4 daily events after intervention). Rumination can be effectively corrected by biofeedback-guided control of abdomino-thoracic muscular activity.

Pharmacological characterization of repeated administration of the first generation abused synthetic cannabinoid CP47,497.

A series of in vivo and in vitro assays were conducted to characterize the pharmacological effects of the first generation abused synthetic cannabinoid CP47,497, a racemic bicyclic cannabinoid that is similar in structure to the potent, high-efficacy synthetic cannabinoid CP55,940. CP47,497 was less efficacious than CP55,940 in activating G-proteins and dose-dependently produced common CB1 receptor-dependent pharmacological effects (i.e. catalepsy, hypothermia, antinociception, and hypolocomotion). CP47,497 also substituted for Δ9-tetrahydrocannabinol (THC) in the mouse drug discrimination, indicating that both drugs elicited a similar interceptive stimulus. The pharmacological effects of CP47,497 underwent tolerance following repeated administration and showed cross-tolerance following repeated THC administration, further suggesting a common cannabimimetic mechanism of action. Finally, the CB1 receptor antagonist rimonabant precipitated similar magnitudes of somatic withdrawal responses in mice treated repeatedly with THC or CP47,497. Taken together, these data verify the acute cannabimimetic effects of CP47,497, and indicate tolerance and dependence following repeated administration. The assays used here provide a straightforward approach to characterize the emerging next generation of abused synthetic cannabinoids.

"False feigners": Examining the impact of non-content-based invalid responding on the Minnesota Multiphasic Personality Inventory-2 Restructured Form content-based invalid responding indicators.

Misinterpretation of non-content-based invalid (e.g., random, fixed) responding as overreporting or underreporting is likely to adversely impact test interpretation and could bias inferences about examinee intentions. We examined the impact of non-content-based invalid responding on the following Minnesota Multiphasic Personality Inventory-2 Restructured Form (MMPI-2-RF) content-based invalid responding indicators: Infrequent Responses (F-r), Infrequent Psychopathology Responses (FP-r), Infrequent Somatic Responses (FS), Symptom Validity (FBS-r), Response Bias Scale (RBS), Uncommon Virtues (L-r), and Adjustment Validity (K-r). In 4 samples from which invalid responders were excluded, we systematically inserted increasing percentages of random, acquiescent, or counter-acquiescent item responses ranging from 0% to 100% and examined the impact that non-content-based invalid response styles had on the content-based invalid responding indicators. F-r, FP-r, FS, RBS, and L-r were susceptible to non-content-based invalid responding, whereas FBS-r and K-r were unaffected. Individuals with Variable Response Inconsistency (VRIN-r) and True Response Inconsistency (TRIN-r) elevations were removed, and the frequencies of content-based invalid responding elevations were then reexamined for false indications of feigning. Findings were consistent across samples and emphasize the need to screen for non-content-based invalid responding before screening for content-based invalid responding in the assessment of personality and psychopathology. VRIN-r and TRIN-r were useful in detecting most-but not all-cases of non-content-based invalid responding. A small but meaningful percentage of the remaining individuals were misclassified as overreporters (i.e., false feigners) by FP-r and FS. Clinicians should interpret FP-r and FS with some caution in the presence of moderate levels of non-content-based invalid responding. Post hoc examinations of scale characteristics indicated that the most susceptible scales were brief, consisted of rarely endorsed items, included a relatively high percentage of true-keyed items, and required a low percentage of endorsed items to reach clinical significance. (PsycINFO Database Record

Retrospective review on effectiveness of high-amplitude penile vibratory stimulation for conservative sperm retrieval in anejaculatory men with spinal cord injury: an Asian case series.

High-amplitude penile vibratory stimulation (PVS) is recommended as the first line method for conservative sperm retrieval in anejaculatory Caucasian men with spinal cord injury (SCI). Evidence of its effectiveness in Asian population is lacking. We described the effectiveness of high amplitude PVS for conservative sperm retrieval in the anejaculatory local men with SCI. Records of all SCI patients referred for conservative sperm retrieval trial from August 2014 to August 2015 were screened. Those who failed in artificial stimulation methods for sperm retrieval including masturbation, prostatic massage and low amplitude PVS were subjected to high amplitude PVS using Viberect X3. Data pertaining to detailed neurological findings, time to ejaculate, seminal fluid volume and its gross appearance, somatic responses at ejaculation and any adverse events were retrieved. Successful outcome is defined as occurrence of antegrade ejaculation. Thirteen out of 16 patients fulfilled all study criteria. 46% of the patients had neurological level above T6 followed by 34% with neurological level between T7-T12. Preserved reflexogenic and spontaneous erection were reported by 84.6% and successful coitus was reported by 45.4% of the patients. The overall ejaculatory success using high amplitude, high-frequency vibratory stimulation in our study was 46.15%. Among the patients with lesion at T6 and above, the ejaculatory success rate was 66.7% while for the study subjects with lesions below T6 was 33.3%. In conclusion, PVS outcome for sperm retrieval in asian population is comparable to that of Caucasian population. Its use is highly applicable in local population.

Spectral entropy monitoring for adults and children undergoing general anaesthesia.

Spectral entropy monitoring for adults and children undergoing general anaesthesia.

Incidence of BRCA1 somatic mutations and response to neoadjuvant chemotherapy in Chinese women with triple-negative breast cancer

BackgroundThe prevalence of BRCA1 somatic mutations status in triple-negative breast cancer (TNBC) has not been well documented. The aims of this study were to determine the frequency of BRCA1 somatic mutations and to investigate the association between BRCA1 deleterious somatic mutation status and response to neoadjuvant chemotherapy in women with TNBC. MethodsTwo hundred and five TNBC patients without BRCA1 germline mutations were enrolled in this study. Fresh tumor tissues were available for this cohort of 205 patients, including 112 patients with fresh core needle biopsy tumor tissues before treatment and 93 patients with fresh tumor tissues procured after surgery. BRCA1 somatic mutations were determined in the tumor samples using PCR-direct sequencing assay. Among the 112 patients with core needle biopsy samples, 97 patients received neoadjuvant chemotherapy. ResultsEight patients (3.9%) carried a BRCA1 pathogenic somatic mutation in this cohort of 205 TNBC patients. These eight BRCA1 deleterious somatic mutations included five frameshift or nonsense mutations (c.191_212del22, c.1664delA, c.4674_4675+17del, c.3671_3672insTTCC, c.1162A>T), one splicing site mutation (c.134+2T>G) and two missense mutations (c.5511G>C and c.286G>A). No significant differences in tumor characteristics between BRCA1 deleterious somatic mutation carriers and non-carriers were observed. The pCR (pathologic complete response) rate was 32.0% in the 97 patients who received neoadjuvant chemotherapy. BRCA1 deleterious somatic mutation carriers (n=5) had a higher pCR rate than did non-carriers (n=92) (BRCA1 carriers vs non-carriers, 60.0% vs 30.4%, P=0.32), although it did not reach a significance due to a small sample size. ConclusionsA small subset of TNBC patients carried a BRCA1 deleterious somatic mutation; BRCA1 somatic mutation carriers are likely to respond to neoadjuvant chemotherapy.