Ketamine offers promising new therapeutic options for difficult-to-treat depression. The efficacy of treatment response, including ketamine, has been intricately linked to EEG measures of vigilance. This research investigated the interplay between intravenous ketamine and alterations in brain arousal, quantified through EEG vigilance assessments in two distinct cohorts of depressed patients (original dataset: n = 24; testing dataset: n = 24). Clinical response was defined as a decrease from baseline of >33% on the Montgomery-Åsberg Depression Rating Scale (MADRS) 24 h after infusion. EEG recordings were obtained pre-, start-, end- and 24 h post- infusion, and the resting EEG was automatically scored using the Vigilance Algorithm Leipzig (VIGALL). Relative to placebo (sodium chloride 0.9%), ketamine increased the amount of low-vigilance stage B1 at end-infusion. This increase in B1 was positively related to serum concentrations of ketamine, but not to norketamine, and was independent of clinical response. In contrast, treatment responders showed a distinct EEG pattern characterized by a decrease in high-vigilance stage A1 and an increase in low-vigilance B2/3, regardless of whether placebo or ketamine had been given. Furthermore, pretreatment EEG differed between responders and non-responders with responders showing a higher percentage of stage A1 (53% vs. 21%). The logistic regression fitted on the percent of A1 stages was able to predict treatment outcomes in the testing dataset with an area under the ROC curve of 0.7. Ketamine affects EEG vigilance in a distinct pattern observed only in responders. Consequently, the percentage of pretreatment stage A1 shows significant potential as a predictive biomarker of treatment response.Clinical Trials Registration: https://www.clinicaltrialsregister.eu/ctr-search/trial/2013-000952-17/CZ Registration number: EudraCT Number: 2013-000952-17.

• MeSH
• bdění MeSH
• depresivní porucha unipolární * farmakoterapie   MeSH
• elektroencefalografie MeSH
• ketamin * farmakologie   terapeutické užití   MeSH
• lidé MeSH
• mozek MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH

Interictal very high-frequency oscillations (VHFOs, 500-2000 Hz) in a resting awake state seem to be, according to a precedent study of our team, a more specific predictor of a good outcome of the epilepsy surgery compared to traditional interictal high-frequency oscillations (HFOs, 80-500 Hz). In this study, we retested this hypothesis on a larger cohort of patients. In addition, we also collected patients' sleep data and hypothesized that the occurrence of VHFOs in sleep will be greater than in resting state. We recorded interictal invasive electroencephalographic (iEEG) oscillations in 104 patients with drug-resistant epilepsy in a resting state and in 35 patients during sleep. 21 patients in the rest study and 11 patients in the sleep study met the inclusion criteria (interictal HFOs and VHFOs present in iEEG recordings, a surgical intervention and a postoperative follow-up of at least 1 year) for further evaluation of iEEG data. In the rest study, patients with good postoperative outcomes had significantly higher ratio of resected contacts with VHFOs compared to HFOs. In sleep, VHFOs were more abundant than in rest and the percentage of resected contacts in patients with good and poor outcomes did not considerably differ in any type of oscillations. In conclusion, (1) our results confirm, in a larger patient cohort, our previous work about VHFOs being a specific predictor of the area which needs to be resected; and (2) that more frequent sleep VHFOs do not further improve the results.

• MeSH
• bdění MeSH
• elektroencefalografie metody   MeSH
• epilepsie * MeSH
• lidé MeSH
• refrakterní epilepsie * chirurgie   MeSH
• spánek MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH

The impedance is a fundamental electrical property of brain tissue, playing a crucial role in shaping the characteristics of local field potentials, the extent of ephaptic coupling, and the volume of tissue activated by externally applied electrical brain stimulation. We tracked brain impedance, sleep-wake behavioral state, and epileptiform activity in five people with epilepsy living in their natural environment using an investigational device. The study identified impedance oscillations that span hours to weeks in the amygdala, hippocampus, and anterior nucleus thalamus. The impedance in these limbic brain regions exhibit multiscale cycles with ultradian (∼1.5-1.7 h), circadian (∼21.6-26.4 h), and infradian (∼20-33 d) periods. The ultradian and circadian period cycles are driven by sleep-wake state transitions between wakefulness, nonrapid eye movement (NREM) sleep, and rapid eye movement (REM) sleep. Limbic brain tissue impedance reaches a minimum value in NREM sleep, intermediate values in REM sleep, and rises through the day during wakefulness, reaching a maximum in the early evening before sleep onset. Infradian (∼20-33 d) impedance cycles were not associated with a distinct behavioral correlate. Brain tissue impedance is known to strongly depend on the extracellular space (ECS) volume, and the findings reported here are consistent with sleep-wake-dependent ECS volume changes recently observed in the rodent cortex related to the brain glymphatic system. We hypothesize that human limbic brain ECS changes during sleep-wake state transitions underlie the observed multiscale impedance cycles. Impedance is a simple electrophysiological biomarker that could prove useful for tracking ECS dynamics in human health, disease, and therapy.SIGNIFICANCE STATEMENT The electrical impedance in limbic brain structures (amygdala, hippocampus, anterior nucleus thalamus) is shown to exhibit oscillations over multiple timescales. We observe that impedance oscillations with ultradian and circadian periodicities are associated with transitions between wakefulness, NREM, and REM sleep states. There are also impedance oscillations spanning multiple weeks that do not have a clear behavioral correlate and whose origin remains unclear. These multiscale impedance oscillations will have an impact on extracellular ionic currents that give rise to local field potentials, ephaptic coupling, and the tissue activated by electrical brain stimulation. The approach for measuring tissue impedance using perturbational electrical currents is an established engineering technique that may be useful for tracking ECS volume.

• MeSH
• bdění fyziologie   MeSH
• elektrická impedance MeSH
• hipokampus MeSH
• lidé MeSH
• mozek fyziologie   MeSH
• spánek REM * fyziologie   MeSH
• spánek * fyziologie   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Research Support, N.I.H., Extramural MeSH
• Research Support, U.S. Gov't, Non-P.H.S. MeSH

Objective.Long-term intracranial electroencephalography (iEEG) in freely behaving animals provides valuable electrophysiological information and when correlated with animal behavior is useful for investigating brain function.Approach.Here we develop and validate an automated iEEG-based sleep-wake classifier for canines using expert sleep labels derived from simultaneous video, accelerometry, scalp electroencephalography (EEG) and iEEG monitoring. The video, scalp EEG, and accelerometry recordings were manually scored by a board-certified sleep expert into sleep-wake state categories: awake, rapid-eye-movement (REM) sleep, and three non-REM sleep categories (NREM1, 2, 3). The expert labels were used to train, validate, and test a fully automated iEEG sleep-wake classifier in freely behaving canines.Main results. The iEEG-based classifier achieved an overall classification accuracy of 0.878 ± 0.055 and a Cohen's Kappa score of 0.786 ± 0.090. Subsequently, we used the automated iEEG-based classifier to investigate sleep over multiple weeks in freely behaving canines. The results show that the dogs spend a significant amount of the day sleeping, but the characteristics of daytime nap sleep differ from night-time sleep in three key characteristics: during the day, there are fewer NREM sleep cycles (10.81 ± 2.34 cycles per day vs. 22.39 ± 3.88 cycles per night;p< 0.001), shorter NREM cycle durations (13.83 ± 8.50 min per day vs. 15.09 ± 8.55 min per night;p< 0.001), and dogs spend a greater proportion of sleep time in NREM sleep and less time in REM sleep compared to night-time sleep (NREM 0.88 ± 0.09, REM 0.12 ± 0.09 per day vs. NREM 0.80 ± 0.08, REM 0.20 ± 0.08 per night;p< 0.001).Significance.These results support the feasibility and accuracy of automated iEEG sleep-wake classifiers for canine behavior investigations.

• MeSH
• bdění fyziologie   MeSH
• elektroencefalografie metody   MeSH
• elektrokortikografie MeSH
• psi MeSH
• spánek REM fyziologie   MeSH
• spánek * fyziologie   MeSH
• stadia spánku * fyziologie   MeSH
• zvířata MeSH
• Check Tag
• psi MeSH
• zvířata MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Research Support, N.I.H., Extramural MeSH
• Research Support, U.S. Gov't, Non-P.H.S. MeSH

Before coronavirus disease 2019 (COVID-19) emerged, proning had been demonstrated to improve oxygenation in those with acute hypoxic respiratory failure and be performed in non-intensive care settings. This benefit was further exemplified by the COVID-19 pandemic, leading to awake prone positioning (APP). We assessed the efficacy of routine APP versus standard care in preventing death and invasive mechanical ventilation (IMV) in non-intubated hypoxic COVID-19 patients. PubMed, Cochrane Library, Scopus, and medRxiv databases were used from January 1st, 2020, to January 15th, 2022, to identify randomized controlled trials (RCTs). Routine APP group were encouraged to be self-prone, whereas the standard care group received care according to local clinical practice and allowed APP crossover as rescue therapy. We included eight COVID-19 RCTs assessing 809 APP vs. 822 standard care patients. APP group had less IMV requirement (26.5% vs. 30.9%; OR - odds ratio 0.77; P=0.03) than the standard care group, with subgroup analysis showing greater benefit (32.5% vs. 39.1%; OR 0.75; P=0.02) for those mainly requiring oxygen support of non-invasive mechanical ventilation (NIMV) and high-flow nasal cannula (HFNC). The time to IMV initiation was similar (mean 8.3 vs. 10.0 days; P=0.66) for patients requiring NIMV and HFNC. Patients mainly receiving supplemental oxygen and non-rebreather masks had improved oxygenation parameters, although not statistically significant. Other outcomes involving all-cause hospital mortality, hospital and ICU (intensive care unit) length of stay, and adverse events were comparable. APP appeared to be an important modality for reducing IMV requirements, especially in those requiring NIMV and HFNC.

• MeSH
• bdění MeSH
• COVID-19 * terapie   MeSH
• kyslík MeSH
• lidé MeSH
• oxygenoterapie škodlivé účinky   MeSH
• pronační poloha MeSH
• randomizované kontrolované studie jako téma MeSH
• syndrom dechové tísně * MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• metaanalýza MeSH
• přehledy MeSH
• systematický přehled MeSH

Úvod a cíle: Mezi nově zaváděné postupy u operací nádorů mozku patří tzv. awake kraniotomie. Jedná se o operaci mozku při vědomí, kdy jsou monitorovány řečové a jazykové funkce logopedem za aktivní účasti pacienta. Cílem takto vedené operace je zachování řečových a jazykových funkcí pacienta a zároveň co největší možný rozsah resekce nádoru mozku. V příspěvku jsou shrnuty dosavadní zkušenosti a poznatky ve FN Ostrava. Metodika: Retrospektivní hodnocení úspěšnosti provedených awake kraniotomií s exstirpacemi nádorů mozku v elokventních oblastech mozku. Kritériem úspěšnosti awake kraniotomie bylo zachování řečových a jazykových schopností pacientů po operaci ve srovnání s jejich stavem před operací. Popis postupů, předoperačních vyšetření a intraoperačního testování klinickým logopedem. Výsledky: Porovnáním výsledků testování řečových a jazykových funkcí u 54 pacientů, operovaných v letech 2013–2021, před awake kraniotomií a po ní bylo zjištěno, že u 40 z 54 pacientů nedošlo po operaci ke zhoršení řečových a jazykových funkcí. Z logopedického hlediska se tak jedná o 74% úspěšnost. Závěr: Awake kraniotomie je novým postupem zaváděným při operacích gliomů mozku v elokventních řečových zónách. Metoda přispívá značnou měrou k zachování řečových a jazykových kompetencí pacienta a tím i k zachování kvality jeho života.

Introduction and aims: An awake craniotomy is one of the newly introduced procedures for brain tumor surgery. It is a brain operation where speech and language functions are monitored by a clinical speech therapist with the active participation of the patient who is awake during the procedure. The aim of such an operation is to preserve the speech and language functions of the patient as well as resection of the brain tumor to the greatest possible extent. This paper summarizes the current experience and knowledge of awake craniotomy at the University Hospital in Ostrava. Methodology: Retrospective evaluation of the success of performed awake craniotomies with extirpations of tumors located in eloquent regions of the brain. The criterion for the success of awake craniotomy was the preservation of patient’s speech and language skills after surgery compared to their condition before surgery. Description of procedures, preoperative examinations, and intraoperative testing by a clinical speech therapist. Results: By comparing the results of testing speech and language functions in a group of 54 patients operated between 2013 and 2021 before and after awake craniotomy, it was found that in 40 of 54 patients there was no deterioration of speech and language functions after surgery. From a speech therapy perspective, this is a 74% success rate. Conclusion: Awake craniotomy is a new procedure introduced during brain glioma operations in eloquent regions of the speech zones. The method contributes significantly to the preservation of the patient’s speech and language competences and thus to the preservation of his quality of life.

• Klíčová slova
• awake kraniotomie,
• MeSH
• bdění MeSH
• klinická logopedie * MeSH
• kraniotomie * metody   MeSH
• lidé MeSH
• nádory mozku chirurgie   MeSH
• peroperační monitorování * metody   MeSH
• řeč MeSH
• retrospektivní studie MeSH
• zapojení pacienta MeSH
• Check Tag
• lidé MeSH

STUDY OBJECTIVES: Recurrent isolated sleep paralysis (RISP) is a rapid eye movement (REM) parasomnia characterized by a dissociative state with characteristics of REM sleep and wakefulness. Pathophysiology has not yet been clarified and very little research has been performed using objective polysomnographic measures with inconsistent results. The main aim of our study was to find whether higher REM sleep fragmentation is consistent with the theory of state dissociation or whether signs of dissociation can be detected by spectral analysis. METHODS: A total of 19 participants in the RISP group and 19 age- and gender-matched participants in the control group underwent two consecutive full-night video-polysomnography recordings with 19-channel electroencephalography. Apart from sleep macrostructure, other REM sleep characteristics such as REM sleep arousal index, percentage of wakefulness and stage shifts within REM sleep period were analyzed, as well as power spectral analysis during REM sleep. RESULTS: No difference was found in the macrostructural parameters of REM sleep (percentage of REM sleep and REM latency). Similarly, no significant difference was detected in REM sleep fragmentation (assessed by REM sleep arousal index, percentage of wakefulness and stage shifts within REM sleep). Power spectral analysis showed higher bifrontal beta activity in the RISP group during REM sleep. CONCLUSIONS: The results showed an underlying persistent trait of higher cortical activity that may predispose patients with sleep paralysis to be more likely to experience recurrent episodes, without any apparent macrostructural features including higher REM sleep fragmentation.

• MeSH
• bdění fyziologie   MeSH
• elektroencefalografie MeSH
• lidé MeSH
• polysomnografie MeSH
• spánek REM * fyziologie   MeSH
• spánek fyziologie   MeSH
• spánková paralýza * komplikace   MeSH
• stadia spánku fyziologie   MeSH
• studie případů a kontrol MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH

Článek se zabývá indikacemi, praktickým provedením a komplikacemi awake kraniotomie. Awake kraniotomie je v současnosti často používanou metodou při operacích především difuzních nízkostupňových gliomů mozku. Umožňuje mít pod kontrolou během operace motoriku, řeč, verbální a neverbální sémantiku, emotivitu a do jisté míry i exekutivní funkce pacienta. V článku jsou rozebírány indikace metody, praktické provedení, komplikace a nastíněn způsob pooperační rehabilitace. Zmíněna je také úzká vazba awake kraniotomii a případnou pooperační onkologickou léčbou.

The article deals with the indications, practical realization and complications of awake craniotomy. Awake craniotomy is currently a frequently used method in the surgery of diffuse low-grade gliomas of the brain. It allows to monitor the patient's motor, speech, verbal and non-verbal semantics, emotionality and, to some extent, executive functions during the procedure. The indications of the method, practical implementation, complications and the postoperative rehabilitation are discussed. The close relationship between awake craniotomy and possible postoperative oncological treatment is also mentioned.

• Klíčová slova
• awake kranitomie, difuzní nízkostupňový gliom,
• MeSH
• adherence pacienta MeSH
• bdění MeSH
• gliom * chirurgie   MeSH
• kraniotomie * metody   MeSH
• kvalita života MeSH
• lidé MeSH
• mapování mozku metody   MeSH
• nádory mozku chirurgie   MeSH
• peroperační monitorování metody   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• přehledy MeSH

The Chinese Government quarantined Wuhan on 23 January 2020 and thereafter the Hubei province, affecting a total of 59 million citizens, to cease the spread of the coronavirus disease in 2019 (COVID-19). The effects of this lockdown on the psychological and mental health of both the affected and unaffected Chinese are largely unknown currently. We utilized one of the largest crowdsourced databases (Sleep as Android) that consisted of 15,681 sleep records from 563 users in China to estimate the change in the sleep pattern of Chinese users during the span of 30 December 2019 to 8 March 2020 with reference to 64,378 sleep records of 1,628 users for the same calendar period of years 2011-2019. The sleep pattern in China changed drastically after 23 January 2020 when the law of quarantine and suspension of Wuhan became effective. The two major findings are: (1) Chinese people increased their sleep duration by an average of 20 min and delayed their sleep onset by an average of 30 min at weekdays, while they maintained a similar sleep duration at weekends, and (2) larger changes were found in several subgroups, including those in Wuhan (80 sleep records from 3 users), female subjects, and those aged ≤ 24 years. Overall, Chinese people slept later and longer than usual during the COVID-19 pandemic quarantine.

• MeSH
• bdění * MeSH
• Betacoronavirus metabolismus   MeSH
• chytrý telefon MeSH
• cirkadiánní rytmus fyziologie   MeSH
• COVID-19 MeSH
• crowdsourcing * MeSH
• duševní zdraví MeSH
• epidemický výskyt choroby MeSH
• karanténa psychologie   MeSH
• koronavirové infekce patofyziologie   virologie   MeSH
• lidé MeSH
• pandemie MeSH
• poruchy spánku a bdění epidemiologie   MeSH
• SARS-CoV-2 MeSH
• spánek fyziologie   MeSH
• virová pneumonie patofyziologie   virologie   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• Geografické názvy
• Čína MeSH

• Klíčová slova
• spontánní pohybová aktivita,
• MeSH
• bdění účinky léků   MeSH
• centrální nervový systém účinky léků   MeSH
• kognice účinky léků   MeSH
• lidé MeSH
• modely nemocí na zvířatech MeSH
• orexiny * terapeutické užití   MeSH
• regulace chuti k jídlu účinky léků   MeSH
• spánek účinky léků   MeSH
• zvířata MeSH
• Check Tag
• lidé MeSH
• zvířata MeSH
• Publikační typ
• práce podpořená grantem MeSH
• přehledy MeSH