Hessisch Oldendorf

Researchers are investigating better ways to assess consciousness levels in patients who have suffered severe brain injury. This study focuses on disorders of consciousness such as coma, Unresponsive Wakefulness Syndrome (UWS), and Minimally Conscious State (MCS). Accurate assessment is important for planning treatment, predicting outcomes, and making ethical decisions. While behavioral assessments are the current standard, they can sometimes misclassify patients. This study evaluates two behavioral tools, the widely used Coma Recovery Scale-Revised (CRS-R) and a newer, quicker tool called the Simplified Evaluation of CONsciousness Disorders (SECONDs). The goal is to improve diagnostic accuracy and clinical usefulness in neurological rehabilitation settings. The study involves using the SECONDs tool to assess patients during the subacute phase after severe brain injury. Participants also undergo evaluation with the CRS-R, which examines various functions including auditory, visual, motor, and communication abilities. The SECONDs tool is designed to focus on key behavioral signs linked to minimal consciousness while being more time-efficient. Researchers will compare results from both assessments to check consistency and clinical relevance. Follow-up will include a functional outcome assessment 12 months after the initial evaluation through structured telephone interviews with relatives or legal representatives. During the study, patients will receive structured behavioral assessments using both SECONDs and CRS-R. Researchers will collect and analyze diagnostic data to determine how well SECONDs performs in routine neurorehabilitation. Functional status and long-term outcomes will be tracked to evaluate the predictive value of these assessments. The main outcome measure is the agreement between SECONDs and CRS-R scores 6 to 8 days after admission to neurological rehabilitation. The study aims to support the use of time-efficient tools for improving diagnosis and care in patients with disorders of consciousness.

Researchers are evaluating how passive listening to preferred music affects the level of consciousness in patients who have severe brain injuries and disorders of consciousness, such as coma, unresponsive wakefulness syndrome, or minimally conscious state. These patients often have impaired motor and visual responses, so auditory stimulation like music may help activate brain networks and emotional systems. Previous studies suggest music can improve psychological and physical states, but evidence is limited and inconsistent, especially in this patient group. This study aims to compare passive music listening with other auditory conditions during early neurological rehabilitation. The study is a prospective, double-blind, controlled, and randomized trial involving 66 patients undergoing early neurological and neurosurgical rehabilitation after severe brain damage. Participants are randomly assigned to one of three groups: listening to preferred music, listening to an audiobook, or hearing silence. Each intervention lasts 30 minutes per day for 28 days, delivered through headphones. Before the intervention, patients undergo MRI scans, consciousness assessments, and neurophysiological tests. These assessments are repeated weekly during the intervention and again after the study period. Participants will be closely monitored throughout the study with weekly evaluations using the Coma-Recovery-Scale-Revised to measure changes in consciousness. Additional MRI and neurophysiological exams are performed at the end to evaluate brain function. The total study duration per patient is up to 38 days, including preliminary, intervention, and follow-up phases. Researchers aim to observe improvements in the level of consciousness and understand the effects of music therapy compared to other auditory stimulations or no stimulation.

Researchers are studying the long-term neuropsychological effects of aneurysmal subarachnoid hemorrhage (aSAH), focusing on memory problems often seen in patients despite no clear brain damage on scans. The study aims to understand if these memory issues are linked to shrinkage of the hippocampus, a brain area important for memory. This research looks at patients early after their hemorrhage, in contrast to prior studies that examined patients much later. The study involves 29 patients in neurological rehabilitation with mild to moderate aSAH (Hunt & Hess grade I or II). Within the first week after joining the study, participants undergo a brain MRI scan using a high-resolution 3D sequence to measure hippocampal volume. Alongside this, they complete detailed neuropsychological tests focusing on memory and attention functions to explore the relationship between hippocampal size and cognitive performance. During the study, participants receive a thorough neuropsychological assessment and structural MRI to monitor brain changes and cognitive abilities. Researchers will measure changes in hippocampal volume within two weeks and assess memory function in relation to these changes. The study also ensures safety by excluding patients with contraindications to MRI and monitors health status. Participation involves a single evaluation period soon after admission to rehabilitation, with all data collected within that timeframe.

Cognitive problems like memory loss, trouble finding words, and difficulty with orientation and perception are common in stroke patients. Low levels of magnesium in the blood have been linked to these cognitive issues one month after a stroke, but it's unclear whether these problems are caused by magnesium deficiency or the stroke itself. This research investigates the relationship between blood magnesium levels, stroke severity, and cognitive function in stroke patients. Stroke patients admitted to a stroke unit will have their initial blood magnesium levels and stroke severity measured using several scales including the National Institutes of Health Stroke Scale, Scandinavian Stroke Scale, and modified Rankin Scale. Cognitive abilities will be assessed within the first three days using two tests: the Kölner Neuropsychologische Screening for stroke patients and the Mini Mental Status Test. These measures will be repeated at 4 weeks, 3 months, and at discharge from the clinic, which may be due to recovery, transfer, or other outcomes. If a patient undergoes an MRI scan, their attention network will also be examined. Participants will be involved in cognitive testing and stroke severity assessments multiple times during the study. Researchers will monitor changes in magnesium levels and cognitive scores over time. The study will evaluate the incidence of cognitive impairments after stroke, differences between types of stroke, and possible influences of age and gender. Outcome measures include serum magnesium concentration, cognitive test scores, stroke severity ratings, and length of hospital stay, observed up to 6 months after admission.

Researchers are studying patients with disorders of consciousness (DOC) such as coma, unresponsive wakefulness syndrome, or minimally conscious state. These conditions often result from brain injuries like stroke, traumatic brain injury, or hypoxic-ischemic encephalopathy. The study aims to find factors that predict how well patients recover consciousness during early neurological rehabilitation and to understand their medium and long-term outcomes. This observational study will include 130 patients over 36 months in a single neurological rehabilitation center. At the start, routine clinical data, disease severity, and functional status are recorded. Within the first week, patients undergo MRI scans, EEG, and evoked potential tests. The level of consciousness is measured weekly using the Coma-Recovery-Scale-Revised (CRS-R). After eight weeks, MRI, EEG, and evoked potentials are repeated. Follow-up assessments using the Glasgow Outcome Scale-Revised occur at 3, 6, and 12 months. Participants will be closely monitored throughout the study with weekly evaluations of consciousness, functional status, complications, and comorbidities. The primary outcome measures changes in functional status at 8 weeks. Researchers will gather comprehensive data from imaging, neurological tests, and clinical scales to track recovery progress. The total study period includes initial assessments, repeated testing at week 8, and follow-ups extending to one year after rehabilitation begins.