Deans' stroke musings

Changing stroke rehab and research worldwide now.Time is Brain!Just think of all the trillions and trillions of neurons that DIE each day because there are NO effective hyperacute therapies besides tPA(only 12% effective). I have 493 posts on hyperacute therapy, enough for researchers to spend decades proving them out. These are my personal ideas and blog on stroke rehabilitation and stroke research. Do not attempt any of these without checking with your medical provider. Unless you join me in agitating, when you need these therapies they won't be there.

What this blog is for:

Shortly after getting out of the hospital and getting NO information on the process or protocols of stroke rehabilitation and recovery I started searching on the internet and found that no other survivor received useful information. This is an attempt to cover all stroke rehabilitation information that should be readily available to survivors so they can talk with informed knowledge to their medical staff. It's quite disgusting that this information is not available from every stroke association and doctors group.
My back ground story is here:http://oc1dean.blogspot.com/2010/11/my-background-story_8.html

Thursday, April 20, 2017

Circadian Variations in Body Temperature Linked to Consciousness Level in Brain-Injured Patients

Might be useful for locked-in-syndrome. You better hope your ER doctors are up-to-date on all the latest.
http://dgnews.docguide.com/circadian-variations-body-temperature-linked-consciousness-level-brain-injured-patients?
For people with severe brain injuries, the rhythm of daily fluctuations in body temperature is related to their level of consciousness, according to a study published in the April 19, 2017, online issue of the journal Neurology.
“Our study suggests that the closer the body temperature patterns of a severely brain injured person are to those of a healthy person’s circadian rhythm, the better they scored on tests of recovery from coma, especially when looking at arousal, which is necessary for consciousness,” said Christine Blume, PhD, University of Salzburg, Salzburg, Austria.
In healthy people, daily variations in body temperature closely follow the sleep-wake cycle. Other studies have found that disruptions to the sleep-wake cycle may affect various aspects of health like the immune system and short-term memory. During a normal sleep-wake cycle, the body’s core temperature fluctuates and can drop 1 to 2 degrees during the early morning hours.
For the current study, researchers monitored 18 people with severe brain injuries, those with unresponsive wakefulness syndrome and those in a minimally conscious state. For 1 week, researchers continually monitored the body temperatures of participants with external skin sensors. With that temperature data, they were able to determine the length of the circadian rhythm for each person. Length of temperature cycles of participants ranged from 23.5 to 26.3 hours.
The researchers also evaluated the level of consciousness for each person with the Coma Recovery Scale-Revised, measuring things like response to sound and ability to open eyes with or without stimulation. They found that those who scored better on that scale had body temperature patterns that more closely aligned with a healthy 24-hour rhythm.
“This is the first time an association has been found between circadian variations in body temperature and arousal in brain-injured patients,” said Dr. Blume. “Importantly, arousal is essential for consciousness. Circadian variations are something doctors should keep in mind when diagnosing patients. The time of the day when patients are tested could be crucial. Also, doctors may want to consider creating environments for patients that mimic the light patterns of night and day to help achieve a normal sleep-wake cycle. The hope is that this may help bring a person with a severe brain injury closer to consciousness.”
The researchers tested bright light stimulation on 8 participants for 1 week and found positive effects in 2 patients. Dr. Blume said that larger studies are needed to test the hypothesis that bright light is indeed beneficial for patients.
One limitation of the study was that magnetic resonance imaging data was not available to evaluate the extent of brain damage, especially in the hypothalamus, the portion of the brain where the body clock is located.
Dr. Blume suggests that future studies look at the relationship between body temperature rhythms and other body rhythms like hormone patterns and rest-activity cycles.
SOURCE: American Academy of Neurology

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