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Objective and personalized longitudinal assessment of a pregnant patient with post severe brain trauma.

Torres EB, Lande B - Front Hum Neurosci (2015)

Bottom Line: These patterns could blindly identify the time preceding the baby's delivery by C-section when the patient systematically brought her hand to her abdominal area.Changes in temperature were sharp and accompanied by systematic changes in the statistics of the motions that rendered her dominant wrist's micro-movements more systematically reliable and predictable than those of the non-dominant writst.The new analytics paired with wearable sensing technology may help track the day-by-day individual progression of a patient with post brain trauma in clinical settings and in the home environment.

View Article: PubMed Central - PubMed

Affiliation: Department of Psychology, Computational Biomedicine Imaging and Modeling Center, Computer Science, Neuroscience and Rutgers Center for Cognitive Science, Rutgers the State University of New Jersey New Brunswick, NJ, USA.

ABSTRACT

Background: Following severe trauma to the brain (whether internally generated by seizures, tumors or externally caused by collision with or penetration of objects) individuals may experience initial coma state followed by slow recovery and rehabilitation treatment. At present there is no objective biometric to track the daily progression of the person for extended periods of time.

Objective: We introduce new analytical techniques to process data from physically wearable sensors and help track the longitudinal progression of motions and physiological states upon the brain trauma. Setting and Participant: The data used to illustrate the methods were collected at the hospital settings from a pregnant patient in coma state. The patient had brain trauma from a large debilitating seizure due to a large tumor in the right pre-frontal lobe.

Main measures: We registered the wrist motions and the surface-skin-temperature across several daily sessions in four consecutive months. A new statistical technique is introduced for personalized analyses of the rates of change of the stochastic signatures of these patterns.

Results: We detected asymmetries in the wrists' data that identified in the dominant limb critical points of change in physiological and motor control states. These patterns could blindly identify the time preceding the baby's delivery by C-section when the patient systematically brought her hand to her abdominal area. Changes in temperature were sharp and accompanied by systematic changes in the statistics of the motions that rendered her dominant wrist's micro-movements more systematically reliable and predictable than those of the non-dominant writst.

Conclusions: The new analytics paired with wearable sensing technology may help track the day-by-day individual progression of a patient with post brain trauma in clinical settings and in the home environment.

No MeSH data available.


Related in: MedlinePlus

Brain views after tumor removal. Two different views of the right frontal lobe upon removal of the tumor (affected area marked by arrow).
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Figure 1: Brain views after tumor removal. Two different views of the right frontal lobe upon removal of the tumor (affected area marked by arrow).

Mentions: AB is a 39-year-old, right handed woman who was pregnant when diagnosed with a grade 2 oligoastrocytoma on 03/05/14 after worsening headaches, fatigue, nausea and some degree of confusion which prompted an MRI scan. The MRI revealed on 03/07/14 a right frontal lobe mass lesion (8.5 × 5) with characteristics suggestive of oligodendroglioma. Surgical excision was recommended by the neurologist and scheduled for 03/12/14 in consultation with her high-risk Ob/Gyn. On the morning of 03/13/14 AB suffered an acute neurological decompensation with loss of consciousness and nonreactive dilated right pupil, sluggishly responsive pupil and decorticate posturing. It was thought that she had a seizure. She was intubated and given Mannitol and hyperventilated for probable increased intracranial pressure. A STAT CT of the brain revealed cerebral edema with uncal herniation. She underwent surgical decompression, a right hemicraniectomy with tumor debulking (see Figure 1 showing brain after surgical removal of the tumor). EEG upon surgery did not reveal seizure activity. Postoperative exams included decerebrate posturing, CT and MRI. These tests revealed extensive hemorrhagic infarct or cytotoxic edema involving multiple vascular territories in the bilateral parietal temporal and occipital lobes, as well as bilateral (right more than left) thalami. Small foci of ischemia were also found on the right mid-brain, pons and right cerebellar hemisphere.


Objective and personalized longitudinal assessment of a pregnant patient with post severe brain trauma.

Torres EB, Lande B - Front Hum Neurosci (2015)

Brain views after tumor removal. Two different views of the right frontal lobe upon removal of the tumor (affected area marked by arrow).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4362300&req=5

Figure 1: Brain views after tumor removal. Two different views of the right frontal lobe upon removal of the tumor (affected area marked by arrow).
Mentions: AB is a 39-year-old, right handed woman who was pregnant when diagnosed with a grade 2 oligoastrocytoma on 03/05/14 after worsening headaches, fatigue, nausea and some degree of confusion which prompted an MRI scan. The MRI revealed on 03/07/14 a right frontal lobe mass lesion (8.5 × 5) with characteristics suggestive of oligodendroglioma. Surgical excision was recommended by the neurologist and scheduled for 03/12/14 in consultation with her high-risk Ob/Gyn. On the morning of 03/13/14 AB suffered an acute neurological decompensation with loss of consciousness and nonreactive dilated right pupil, sluggishly responsive pupil and decorticate posturing. It was thought that she had a seizure. She was intubated and given Mannitol and hyperventilated for probable increased intracranial pressure. A STAT CT of the brain revealed cerebral edema with uncal herniation. She underwent surgical decompression, a right hemicraniectomy with tumor debulking (see Figure 1 showing brain after surgical removal of the tumor). EEG upon surgery did not reveal seizure activity. Postoperative exams included decerebrate posturing, CT and MRI. These tests revealed extensive hemorrhagic infarct or cytotoxic edema involving multiple vascular territories in the bilateral parietal temporal and occipital lobes, as well as bilateral (right more than left) thalami. Small foci of ischemia were also found on the right mid-brain, pons and right cerebellar hemisphere.

Bottom Line: These patterns could blindly identify the time preceding the baby's delivery by C-section when the patient systematically brought her hand to her abdominal area.Changes in temperature were sharp and accompanied by systematic changes in the statistics of the motions that rendered her dominant wrist's micro-movements more systematically reliable and predictable than those of the non-dominant writst.The new analytics paired with wearable sensing technology may help track the day-by-day individual progression of a patient with post brain trauma in clinical settings and in the home environment.

View Article: PubMed Central - PubMed

Affiliation: Department of Psychology, Computational Biomedicine Imaging and Modeling Center, Computer Science, Neuroscience and Rutgers Center for Cognitive Science, Rutgers the State University of New Jersey New Brunswick, NJ, USA.

ABSTRACT

Background: Following severe trauma to the brain (whether internally generated by seizures, tumors or externally caused by collision with or penetration of objects) individuals may experience initial coma state followed by slow recovery and rehabilitation treatment. At present there is no objective biometric to track the daily progression of the person for extended periods of time.

Objective: We introduce new analytical techniques to process data from physically wearable sensors and help track the longitudinal progression of motions and physiological states upon the brain trauma. Setting and Participant: The data used to illustrate the methods were collected at the hospital settings from a pregnant patient in coma state. The patient had brain trauma from a large debilitating seizure due to a large tumor in the right pre-frontal lobe.

Main measures: We registered the wrist motions and the surface-skin-temperature across several daily sessions in four consecutive months. A new statistical technique is introduced for personalized analyses of the rates of change of the stochastic signatures of these patterns.

Results: We detected asymmetries in the wrists' data that identified in the dominant limb critical points of change in physiological and motor control states. These patterns could blindly identify the time preceding the baby's delivery by C-section when the patient systematically brought her hand to her abdominal area. Changes in temperature were sharp and accompanied by systematic changes in the statistics of the motions that rendered her dominant wrist's micro-movements more systematically reliable and predictable than those of the non-dominant writst.

Conclusions: The new analytics paired with wearable sensing technology may help track the day-by-day individual progression of a patient with post brain trauma in clinical settings and in the home environment.

No MeSH data available.


Related in: MedlinePlus