By V. Grompel. University of Missouri-Columbia. 2017.
A method to detect pre-ictal activity that is representative (specific and sensitive) to the pre-ictal epilepsy state for any patient 20 mg erectafil with visa, usually with implanted electrodes on the surface of the brain or within the brain 2. A technique to process information from these electrodes and generate an output signal with a threshold to indicate a possible seizure state in development 3. An efferent or control method to take the output signal and generate a subconscious effect that would abort or stop the seizure in germination so that it would not occur The critical aspect of these aims of an ideal system is that the patient should not know about the detection or treatment; if a seizure occurs, the system is a clinical failure. While it is much easier to detect a highly synchronized seizure event, once a seizure has started treatment is too late because the patient has already lost awareness and the clinical implications have already occurred. However, in some seizure states, the goal is not necessarily to prevent all seizures; the goal may be to reduce the number significantly, similar to vagus nerve stimulation. The need for a demand or feedback control system remains controversial, par- ticularly because several (completely empirical) open-loop stimulation studies in humans (constant anterior or medial thalamus stimulation, constant or intermittent STN stimulation, and vagus nerve stimulation) are currently in progress. The con- sensus is that constant stimulation is theoretically much less effective than some © 2005 by CRC Press LLC Implanted Brain EEG Electrodes EEG Processing in Implanted Chip to Detect Pre-Ictal State Prior to Seizure Occurrence Interruption of Pre-Ictal Seizure State by Focal Treatment within Critical Brain Region, Using Implanted Electrode/Catheter FIGURE 6. The final component may be most efficient if administered near the origin of the seizure, but could also be a systemic injection, for example. However, a demand system requires the hypothesis that the development of a seizure may be both detectable and also critically inter- rupted during the build-up period, before an inter-ictal hyperexcitable occurrence generalizes to include more and more cortex. The location of such electrical recordings depends upon the level at which ictal activity is to be interrupted. For example, if a seizure is already generalized throughout much of the cortex and is bilateral, almost anywhere over the scalp or deep structures may be sufficient because the signal is highly propagated. However, at this late stage, the brain has © 2005 by CRC Press LLC already been significantly involved with the seizure and will undergo interruption of ongoing function and post-ictal changes. The more desirable detection would reside in a region close to the hyperexcitable zone, such as hippocampal depth electrodes for mesial temporal lobe complex partial seizures.
Con- versely an increase in power in a frequency band is termed an event-related syn- chronization (ERS) of the neuronal population discount 20mg erectafil with visa. Because of the well-established ERD of both mu and beta rhythms at the time of movement onset, and their reappearance when movement stops, they are commonly equated with “inhibition” or “deactivation” of the motor cortex. Even if the inhibitory duty cycle is more than 50%, there is a regular period of depolarization following the inhibition. Neglecting this dichotomy can severely limit the usefulness of many ideas about the function of rhythms in sensorimotor cortex. The appearance of a strong LFP oscillation in a cortical area does have an influence on trains of action potentials. Most importantly, pyramidal tract (PT) neurons are entrained to the oscillatory LFPs in the motor cortex,12,13 thereby conveying the oscillation to spinal motoneurons. As a result of these findings in the past 10 years, consensus seems to be settling on the hypothesis that motor cortical rhythms accompany intervals of stationary sensorimotor processing. The duration of an oscillatory potential would correspond to an episode of relatively stable activity in the neuronal territory exhibiting it. Shifts in power among frequency bands, or in correlation strength among oscillatory potentials in different regions, indicate functional transitions within the motor system from one state to another. During stationary (postural) states, cortical oscillations provide an economic way of driving motor units. Partial synchronization of the discharge of corticomotoneuronal cells would allow them to recruit motor units while maintaining as low a firing rate as possible. It is possible that motor cortical oscillations may provide an economical means of driving motor units or spinal interneurons during dynamic as well as stationary phases of motor control. The circuitry for generating theta oscillations was localized to superficial cortical layers. Rhythmic activity required intact glutamatergic transmission as well as inhibition. By analogy with the hippocampus, the inhibitory interneurons in the network probably have a slow spiking frequency, and terminate on distal dendrites of pyramidal neurons. Although the circuit to generate it may be present, theta rhythm is not conspic- uous in motor cortical recordings.
The most famous case of the use of hypnosis in treating dermatological conditions was a report by the physician A purchase 20mg erectafil visa. Mason of his treatment of a patient with congenital ichthyosiform erythroderma of Brocq (fish skin 100 disease). Although carefully controlled studies are not viable owing to the relatively infrequent occurrence of this particular condition, similar results 101,102 were obtained by two subsequent medical practitioners. The role of hypnosis in 78–80 dermatology has more commonly been demonstrated in the alleviation of warts. In 78 one study, those who received hypnotic suggestions for wart removal demonstrated a 50% cure rate (as assessed by the number of warts lost and the percentage of wart loss at a 6-week follow-up). This was significantly higher than the rate achieved by participants who had been assigned to a waiting list control or who had received a cold laser placebo treatment. There have been a number of reviews supporting the potential for hypnosis to 103 treat dermatological disorders. With increasingly rigorous studies, researchers are beginning to identify the specific variables associated with successful outcome, but there is insufficient information at present to confidently assert that the positive results are due 104 exclusively to hypnosis. Given that hypnotic interventions are often used as a component of a more complex treatment and that certain studies use hypnotic techniques that are not explicitly defined 105 as such, a clear picture has not yet emerged as to the importance of hypnosis as a primary component in successful medical treatment. However, with the encouraging preliminary results of well-designed studies, researchers remain optimistic about demonstrating the usefulness of hypnotic techniques above and beyond that of other psychological interventions. Alongside these efforts at validating efficacy, future research will have to elucidate the mechanism by which verbal suggestions during hypnosis might affect physiological changes. HYPNOSIS AS A RESEARCH TOOL We have presented hypnosis both as a tool for affecting change and as a phenomenon in its own right, including the psychological and physiological components of that phenomenon. Many have argued for the importance of hypnosis as a research tool—a tool to examine cognitive functioning of normal and pathological conditions—by inducing certain mental states in healthy subjects. Research has challenged conventional models of automatic and obligatory word recognition, by demonstrating reduced SIE when individuals are given suggestions to see the presented words as meaningless characters of a foreign 107 language.
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