SummaryThe interaction of many poorly defined, physiological, pharmacological, and pathological factors make titration of general anaesthesia in the elderly difficult. There may be a potential clinical benefit using the processed electroencephalogram (EEG) to monitor hypnotic level in this population. We prospectively studied 16 patients aged over 65 years having hip fractures repaired under general anaesthesia by experienced anaesthetists blinded to Bispectral Index (BIS XP ) and Entropy values. Pre-induction EEG indices did not correlate with age or mini-mental state examination (MMSE). During maintenance of anaesthesia, BIS XP and Response Entropy (RE) values were within the recommended range of 40-60, 45% and 32% of the total time, respectively. BIS XP and Response Entropy (RE) values were above 60 for 11% and 13% of the total time, respectively, and below 40 for 44% and 55% of the total time, respectively. BIS XP correlated well with RE in 12 patients, but in the other four patients there was a difference of more than 20 points between BIS XP and RE.
Background
Our previous studies in PD have shown that both levodopa and expectancy of receiving levodopa reduce cortical excitability. We designed this study to evaluate how degree of expectancy and other individual factors modulate placebo response in Parkinson’s patients.
Methods
Twenty-six Parkinson’s patients were randomized to one of three groups: 0%, 50% and 100% expectancy of receiving levodopa. All subjects received placebo regardless of expectancy group. Subjects completed the NEO-Five Factor Inventory, General Perceived Self-Efficacy Scale, and Perceived Stress Scale. Cortical excitability was measured by the amplitude of motor evoked potential (MEP) evoked by transcranial magnetic stimulation. Objective physical fatigue of Extensor carpi radialis before and after placebo levodopa was also measured. Responders were defined as subjects who responded to the placebo levodopa with a decrease in MEP.
Results
Degree of expectancy had a significant effect on MEP response (p<0.05). Subjects in the 50% and 100% expectancy groups responded with a decrease in MEP, while those in the 0% expectancy group responded with an increase in MEP (p<0.05). Responders tended to be more open to experience than non-responders. There were no significant changes in objective physical fatigue between the expectancy groups, or between responders and non-responders.
Conclusions
Expectancy is associated with changes in cortical excitability. Further studies are needed to examine the relationship between personality and placebo effect in Parkinson’s patients.
The Ayurvedic nerve tonic herb Centella asiatica demonstrates potential neuro-regenerative properties in in vitro and in vivo models. The aims of the present study were to evaluate the safety and therapeutic effects of CAST (Indena ® , Milan, Italy) in humans with DN, while monitoring the stability of CAST during the trial period.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.