TY  - THES
A1  - Real, Ruben
T1  - Living with severe motor impairments – from consciousness to quality of life
T1  - Leben mit schweren motorischen Einschränkungen – Bewusstsein und Lebensqualität
N2  - The impact of acquired severe motor impairments is pervasive and may lead to a complete loss of communication and voluntary motor control, rendering the patient behaviourally unresponsive. In routine clinical care it may thus be unclear, whether some of these patients are even conscious. Given that finding a cure is unlikely, care focuses on providing the best possible quality of life (QoL), and knowing its predictors might contribute to that aim. Patients who still can communicate often report a high QoL, and several predictors have been identified. However, many instruments used to assess QoL require at least residual verbal and motor abilities. Thus, a method to assess QoL independent of these requirements is desirable. In addition, many instruments assume QoL to be temporarily stable, and little information is available on predictors of instantaneous QoL, i.e. QoL as it fluctuates from moment to moment throughout the day.
N2  - Die Auswirkungen erworbener motorischer Einschränkungen sind verheerend, und können bis hin zu einem völligen Verlust der Kommunikationsfähigkeit und Willkürmotorik führen. In der klinischen Praxis bedeutet dies, dass bei einigen Patienten unklar ist, ob sie überhaupt bei Bewusstsein sind. Da bei vielen dieser Erkrankungen eine Heilung derzeit unwahrscheinlich ist, steht die Förderung einer möglichst hohen Lebensqualität (LQ) im Fokus der Behandlung. Unabdingbare Voraussetzung hierzu ist eine genaue Kenntnis möglicher Prädiktoren der LQ. Bei Patienten, mit denen noch kommuniziert werden kann, konnten einer Reihe von Prädiktoren der --meist hohen-- LQ identifiziert werden. Alle bislang verwendeten Instrumente erfordern jedoch zumindest residuale motorische und verbale Fähigkeiten, so dass ein Verfahren zur Erfassung der LQ, welches nicht oder kaum auf diese Fähigkeiten angewiesen ist, wünschenswert ist. Des Weiteren unterstellen viele Instrumente zur Erfassung der LQ eine Zeitstabilität der LQ, so dass vergleichsweise weniger Informationen über Prädiktoren der momentanen LQ vorliegen, beispielsweise Fluktuationen der LQ im Tagesverlauf.
KW  - Myatrophische Lateralsklerose
KW  - Lebensqualität
KW  - N400
KW  - P300
KW  - Ereigniskorreliertes Potenzial
KW  - Amyotrophe Lateralsklerose
KW  - Apallisches Syndrom
KW  - Elektroencephalographie
Y1  - 2015
U6  - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-138562
ER  - 
TY  - JOUR
A1  - Erlbeck, Helena
A1  - Kübler, Andrea
A1  - Kotchoubey, Boris
A1  - Veser, Sandra
T1  - Task instructions modulate the attentional mode affecting the auditory MMN and the semantic N400
JF  - Frontiers in Human Neuroscience
N2  - Event-related potentials (ERPs) have been proven to be a useful tool to complement clinical assessment and to detect residual cognitive functions in patients with disorders of consciousness. These ERPs are of ten recorded using passive or unspecific instructions. Patient data obtained this way are then compared to data from healthy participants, which are usually recorded using active instructions. The present study investigates the effect of attentive modulations and particularly the effect of activevs. passive instruction on the ERP components mismatch negativity (MMN) and N400. A sample of 18 healthy participants listened to three auditory paradigms: anoddball, aword priming, and a sentence paradigm. Each paradigm was presented three times with different instructions: ignoring auditory stimuli, passive listening, and focused attention on the auditory stimuli. After each task, the participants indicated their subjective effort. The N400 decreased from the focused task to the passive task, and was extinct in the ignore task. The MMN exhibited higher amplitudes in the focused and passive task compared to the ignore task. The data indicate an effect of attention on the supratemporal component of the MMN. Subjective effort was equally high in the passive and focused tasks but reduced in the ignore task. We conclude that passive listening during EEG recording is stressful and attenuates ERPs, which renders the interpretation of the results obtained in such conditions difficult.
KW  - ERP
KW  - priming
KW  - selective attention
KW  - event-related potentials
KW  - vigilance decrement
KW  - brain potentials
KW  - vegetative state
KW  - consciousness
KW  - component
KW  - predicts recovery
KW  - mismatch negativity
KW  - attention
KW  - instruction
KW  - N400
KW  - MMN
Y1  - 2014
U6  - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-115553
VL  - 8
IS  - 654
ER  -