References of "Vanhaudenhuyse, Audrey"
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See detailIs oral feeding compatible with an unresponsive wakefulness syndrome?
MELOTTE, Evelyne ULiege; MAUDOUX, Audrey ULiege; DELHALLE, Sabrina ULiege et al

in Journal of Neurology (in press)

The aim of the study is to explore the possibility of oral feeding in unresponsive wakefulness syndrome/vegetative state (UWS/VS) patients. Method: We reviewed the clinical information of 68 UWS/VS ... [more ▼]

The aim of the study is to explore the possibility of oral feeding in unresponsive wakefulness syndrome/vegetative state (UWS/VS) patients. Method: We reviewed the clinical information of 68 UWS/VS patients (mean age 45 ± 11; range 16-79 years) searching for mention of oral feeding. UWS/VS diagnosis was made after repeated behavioural assessments using the Coma Recovery Scale–Revised. Patients also had complementary neuroimaging evaluations (positron emission tomography, functional magnetic resonance imaging and electroencephalography and diffusion tensor imaging). Results: Out of the 68 UWS/VS patients, only two could resume oral feeding (3%). The first patient had oral feeding (only liquid and semi liquid) in addition to gastrostomy feeding and the second one could achieve full oral feeding (liquid and mixed solid food). Clinical assessments concluded that they fulfilled the criteria for a diagnosis of UWS/VS. Results from neuroimaging and neurophysiology were typical for the first patient with regard to the diagnosis of UWS/VS but atypical for the second patient. Conclusion: Oral feeding that implies a full and complex oral phase could probably be considered as a sign of consciousness. However, we actually do not know which components are necessary to consider the swallowing conscious as compared to reflex. We also discussed the importance of swallowing assessment and management in all patients with altered state of consciousness. [less ▲]

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See detailTranscranial direct current stimulation unveils covert consciousness
Thibaut, Aurore ULiege; Chatelle, Camille ULiege; VANHAUDENHUYSE, Audrey ULiege et al

in Brain Stimulation (in press)

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See detailPsychological interventions influence patients' attitudes and beliefs about their chronic pain.
VANHAUDENHUYSE, Audrey ULiege; Gillet, Aline; MALAISE, Nicole ULiege et al

in Journal of Traditional and Complementary Medicine (in press)

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See detailA method for independent component graph analysis of resting-state fMRI. Brain and Behavior 2017, in press
Ribeiro de Paula, Demetrius; Ziegler, Erik; Abeyasinghe, P et al

in Brain and Behavior (in press)

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See detailDisorders of consciousness: new advances in neuroimaging techniques
Soddu, Andrea ULiege; Bruno, Marie-Aurélie ULiege; VANHAUDENHUYSE, Audrey ULiege et al

in Zanotti, Bruno (Ed.) Vegetative State (in press)

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See detailIs oral feeding compatible with an unresponsive wakefulness syndrome?
MELOTTE, Evelyne ULiege; MAUDOUX, Audrey ULiege; DELHALLE, Sabrina ULiege et al

Conference (2017, May)

INTRODUCTION AND AIMS Vegetative state/Unresponsive wakefulness syndrome (VS/UWS) is defined by the presence of eye-opening and the absence of awareness and voluntary movement (Laureys et al., 2010). VS ... [more ▼]

INTRODUCTION AND AIMS Vegetative state/Unresponsive wakefulness syndrome (VS/UWS) is defined by the presence of eye-opening and the absence of awareness and voluntary movement (Laureys et al., 2010). VS/UWS patients classically receive hydration and nutrition through an enteral feeding tube. We present the cases of two patients that were diagnosed as VS/UWS but were able to resume oral feeding. It is however unclear if the presence of oral feeding is compatible with the diagnosis of VS/UWS or if this observation should lead to a modification of the diagnosis. METHODS AND RESULTS We retrospectively reviewed the clinical information of 65 VS/UWS patients (aged 45±12; range 16-85 years) evaluated at the CHU hospital of Liege searching for mention of oral feeding. VS/UWS diagnosis was made after repeated behavioral assessments using the standardized Coma Recovery Scale–Revised (CRS-R, (Teasdale & Jennet, 1974)) in association with complementary evaluations using neuroimaging techniques. Of the 65 VS/UWS patients, two could resume oral feeding (3%). One could achieve full oral feeding (mixed texture and liquid) and the other had oral feeding (liquid and semi-liquid) in addition to gastrostomy feeding. Neuroimaging evaluations showed in both patients a massive decrease in the spontaneous brain activity and its functional connectivity (using functional magnetic resonance imaging), bilateral cerebral cortex hypometabolism (fronto- parietal associative areas, posterior parietal areas, cingulate cortices, precuneus) and preserved metabolism in the brainstem and cerebellum (using positron emission tomography). CONCLUSIONS Oral feeding is rare in VS/UWS patients (3% in our cohort). Based on neuroimaging results, this behaviour does not seem to be incompatible with the diagnosis of VS/UWS but the neuromecanistic root, which allows this behavior, still needs to be elucidate. This study also emphasizes the importance of systematic swallowing evaluation in patients with altered state of consciousness regardless of their level of consciousness. Moreover, tactile oro-facial stimulation, manual therapy, taste stimulation and therapeutic feeding can be another “gateway” to interact with these patients and improve their quality of life. [less ▲]

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See detail2 Years outcome of patients in unresponsive wakefulness syndrome/vegetative state and minimally conscious state
Cassol, Helena ULiege; LEDOUX, Didier ULiege; Bruno, Marie-Aurélie et al

Poster (2017, March)

INTRODUCTION: Following severe acute brain damage, patients typically evolve from coma to an unresponsive wakefulness syndrome/vegetative state (UWS/VS; wakefulness without awareness) and later to a ... [more ▼]

INTRODUCTION: Following severe acute brain damage, patients typically evolve from coma to an unresponsive wakefulness syndrome/vegetative state (UWS/VS; wakefulness without awareness) and later to a minimally conscious state (MCS; fluctuating but consistent nonreflex behaviors). MCS is subcategorized in MCS+ (i.e., command following) and MCS- (i.e., visual pursuit, localization of noxious stimulation or contingent behaviours). Reliable and consistent interactive communication and/or functional use of objects indicate the next boundary – emergence from MCS (EMCS). To date, there is still no reliable predictive model of recovery from the UWS/VS and the MCS. A better understanding of patients' outcome would help in decisions regarding patients’ care and rehabilitation, as well as end-of-life decisions. METHODS: We collected demographic information, acute care history and longitudinal follow-up of patients in UWS/VS and MCS admitted in 15 expert centers in Belgium (via the Belgian Federal Public Service Health). Patients were evaluated at 1, 3, 6, 12 and 24 months post injury with the Coma Recovery Scale-Revised and the diagnosis was based on internationally accepted criteria of UWS/VS, MCS or EMCS. Results were considered significant at p<0.001. RESULTS: 24 months follow-up was available for 476 patients including 261 diagnosed in UWS/VS (88 traumatic, 173 non-traumatic) and 215 diagnosed in MCS (80 traumatic, 135 non-traumatic) one month after the injury. Patients who were in MCS one month after the insult were more likely to recover functional communication or object use after 24 months than patients in UWS/VS. Moreover, functional recovery occurred more often in MCS+ (79%) as compared to MCS- (29%), and mortality rate was more important in MCS- patients (68%) as compared to MCS+ (21%). Comparisons within UWS/VS and MCS groups based on etiology showed that traumatic patients had a better outcome at 24 months than non-traumatic patients. Among non-traumatic patients, no difference was found between anoxic patients and patients with other etiologies regarding functional recovery. CONCLUSION: Our study highlights that the outcome is significantly better for patients who are in MCS one month post-injury as compared to patients who remain in UWS/VS at that time. Concerning MCS patients, the outcome is significantly better for patients who are MCS+ one month post-injury as compared to patients who are MCS- at that time. This study also confirms that patients with traumatic etiology have better prognosis than patients with non-traumatic causes. [less ▲]

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See detailApprentissage d'auto-hypnose/self-care en oncologie. Pour qui? Comment? Pour quel intérêt?
Charland-Verville, Vanessa ULiege; FAYMONVILLE, Marie-Elisabeth ULiege; VANHAUDENHUYSE, Audrey ULiege et al

in Psycho-Oncologie (2017), 11

Les symptômes physiques les plus fréquemment liés au cancer et à ses traitements sont la douleur, les nausées et la fatigue. Ils peuvent influencer négativement la qualité de vie. Les interventions de ... [more ▼]

Les symptômes physiques les plus fréquemment liés au cancer et à ses traitements sont la douleur, les nausées et la fatigue. Ils peuvent influencer négativement la qualité de vie. Les interventions de groupe visant l’apprentissage de l’autohypnose, associé ou non à l’autobienveillance, ont démontré l’amélioration de l’adaptation des patients oncologiques. Le but de cette revue est de relever l’efficacité de l’hypnose dans la gestion des symptômes liés à la maladie et de mieux comprendre les mécanismes de la technique. [less ▲]

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See detailVariation in monitoring and treatment policies for intracranial hypertension in traumatic brain injury: A survey in 66 neurotrauma centers participating in the CENTER-TBI study
Cnossen, M. C.; Huijben, J. A.; van der Jagt, M. et al

in Critical Care (2017), 21(1),

Background: No definitive evidence exists on how intracranial hypertension should be treated in patients with traumatic brain injury (TBI). It is therefore likely that centers and practitioners ... [more ▼]

Background: No definitive evidence exists on how intracranial hypertension should be treated in patients with traumatic brain injury (TBI). It is therefore likely that centers and practitioners individually balance potential benefits and risks of different intracranial pressure (ICP) management strategies, resulting in practice variation. The aim of this study was to examine variation in monitoring and treatment policies for intracranial hypertension in patients with TBI. Methods: A 29-item survey on ICP monitoring and treatment was developed on the basis of literature and expert opinion, and it was pilot-tested in 16 centers. The questionnaire was sent to 68 neurotrauma centers participating in the Collaborative European Neurotrauma Effectiveness Research in Traumatic Brain Injury (CENTER-TBI) study. Results: The survey was completed by 66 centers (97% response rate). Centers were mainly academic hospitals (n=60, 91%) and designated level I trauma centers (n=44, 67%). The Brain Trauma Foundation guidelines were used in 49 (74%) centers. Approximately 90% of the participants (n=58) indicated placing an ICP monitor in patients with severe TBI and computed tomographic abnormalities. There was no consensus on other indications or on peri-insertion precautions. We found wide variation in the use of first- and second-tier treatments for elevated ICP. Approximately half of the centers were classified as using a relatively aggressive approach to ICP monitoring and treatment (n=32, 48%), whereas the others were considered more conservative (n=34, 52%). Conclusions: Substantial variation was found regarding monitoring and treatment policies in patients with TBI and intracranial hypertension. The results of this survey indicate a lack of consensus between European neurotrauma centers and provide an opportunity and necessity for comparative effectiveness research. © 2017 The Author(s). [less ▲]

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See detailThe repetition of behavioral assessments in diagnosis of disorders of consciousness.
Wannez, Sarah ULiege; Heine, Lizette ULiege; Thonnard, Marie et al

in Annals of Neurology (2017), 81(6), 883-889

OBJECTIVE: To determine whether repeated examinations using the Coma Recovery Scale-Revised (CRS-R) have an impact on diagnostic accuracy of patients with disorders of consciousness and to provide ... [more ▼]

OBJECTIVE: To determine whether repeated examinations using the Coma Recovery Scale-Revised (CRS-R) have an impact on diagnostic accuracy of patients with disorders of consciousness and to provide guidelines regarding the number of assessments required for obtaining a reliable diagnosis. METHODS: One hundred twenty-three adult patients with chronic disorders of consciousness were referred to our tertiary center. They were assessed at least six times with the CRS-R within a 10-day period. Clinical diagnoses based on one, two, three, four, and five Coma Recovery Scale-Revised assessments were compared with a reference diagnosis (ie, the highest behavioral diagnosis obtained after six evaluations) using nonparametric statistics. Results were considered significant at p < 0.05 corrected for multiple comparisons. RESULTS: The number of assessments had a significant effect on the clinical diagnosis. Up to the fourth examination, the diagnosis was still statistically different from the reference diagnosis based on six CRS-R assessments. Compared to this reference diagnosis, the first evaluation led to 36% of misdiagnoses. INTERPRETATION: The number of CRS-R assessments has an impact on the clinical diagnosis of patients with chronic disorders of consciousness. Up to the fourth examinations, behavioral fluctuations may still impact the diagnostic accuracy. We here suggest performing at least five assessments in each patient with disorders of consciousness within a short time interval (eg, 2 weeks) to reduce misdiagnosis. Ann Neurol 2017;81:883-889 Ann Neurol 2017;81:883-889. [less ▲]

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See detailFeasibility of Oral Feeding in Patients with Disorders of Consciousness
MAUDOUX, Audrey ULiege; Breuskin, I; Gosseries, Olivia ULiege et al

in Schnakers, C; LAUREYS, Steven (Eds.) Coma and Disorders of Consciousness, Second Edition (2017)

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See detailMirror efficiency in the assessment of visual pursuit in patients in minimally conscious state.
Wannez, Sarah ULiege; VANHAUDENHUYSE, Audrey ULiege; Laureys, Steven ULiege et al

in Brain Injury (2017)

OBJECTIVE: Visual pursuit should be tested with a mirror in patients with disorders of consciousness. This stimulus was indeed more efficient than a person or an object, and the auto-referential aspect ... [more ▼]

OBJECTIVE: Visual pursuit should be tested with a mirror in patients with disorders of consciousness. This stimulus was indeed more efficient than a person or an object, and the auto-referential aspect was supposed to be the key feature. The present study tested the hypothesis that the mirror was more efficient because of its self-aspect. METHODS: The mirror was compared (1) to the patient's picture and to the picture of a famous face, in 22 patients in minimally conscious state and (2) to the patient's picture and a fake mirror, which had dynamical and bright aspects of the mirror, without reflecting the face, in 26 other patients in minimally conscious state. RESULTS: The mirror was more efficient than the patient's picture, which was not statistically different from the famous face. The second part of the study confirmed the statistical difference between the mirror and the picture. However, the fake mirror was neither statistically different from the mirror nor from the picture. CONCLUSIONS: Although our results suggest that the hypothesis proposed by previous studies was partly wrong, they confirm that the mirror is the best stimulus to use when assessing visual pursuit. [less ▲]

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See detailHypnose : un outil de modulation cérébrale ?
VANHAUDENHUYSE, Audrey ULiege; STAQUET, Cécile ULiege; Rousseaux, Floriane ULiege et al

in Froger; Laffont; Dupeyron (Eds.) et al La plasticité cérébrale. (2017)

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See detailSedation of Patients With Disorders of Consciousness During Neuroimaging: Effects on Resting State Functional Brain Connectivity.
KIRSCH, Murielle ULiege; Guldenmund, Pieter; Bahri, Mohamed Ali ULiege et al

in Anesthesia and Analgesia (2017), 124(2),

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See detailPrevalence of coma-recovery scale-revised signs of consciousness in patients in minimally conscious state
Wannez, Sarah ULiege; Gosseries, Olivia ULiege; Azzolini, Deborah et al

in Neuropsychological Rehabilitation (2017)

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See detailResting-state Network-specific Breakdown of Functional Connectivity during Ketamine Alteration of Consciousness in Volunteers
BONHOMME, Vincent ULiege; VANHAUDENHUYSE, Audrey ULiege; Demertzi, Athina ULiege et al

in Anesthesiology (2016), 125(5), 873-878

Background: Consciousness-altering anesthetic agents disturb connectivity between brain regions composing the resting-state consciousness networks (RSNs). The default mode network (DMn), executive control ... [more ▼]

Background: Consciousness-altering anesthetic agents disturb connectivity between brain regions composing the resting-state consciousness networks (RSNs). The default mode network (DMn), executive control network, salience network (SALn), auditory network, sensorimotor network (SMn), and visual network sustain mentation. Ketamine modifies consciousness differently from other agents, producing psychedelic dreaming and no apparent interaction with the environment. The authors used functional magnetic resonance imaging to explore ketamine-induced changes in RSNs connectivity. Methods: Fourteen healthy volunteers received stepwise intravenous infusions of ketamine up to loss of responsiveness. Because of agitation, data from six subjects were excluded from analysis. RSNs connectivity was compared between absence of ketamine (wake state [W1]), light ketamine sedation, and ketamine-induced unresponsiveness (deep sedation [S2]). Results: Increasing the depth of ketamine sedation from W1 to S2 altered DMn and SALn connectivity and suppressed the anticorrelated activity between DMn and other brain regions. During S2, DMn connectivity, particularly between the medial prefrontal cortex and the remaining network (effect size β [95% CI]: W1 = 0.20 [0.18 to 0.22]; S2 = 0.07 [0.04 to 0.09]), and DMn anticorrelated activity (e.g., right sensory cortex: W1 = −0.07 [−0.09 to −0.04]; S2 = 0.04 [0.01 to 0.06]) were broken down. SALn connectivity was nonuniformly suppressed (e.g., left parietal operculum: W1 = 0.08 [0.06 to 0.09]; S2 = 0.05 [0.02 to 0.07]). Executive control networks, auditory network, SMn, and visual network were minimally affected. Conclusions: Ketamine induces specific changes in connectivity within and between RSNs. Breakdown of frontoparietal DMn connectivity and DMn anticorrelation and sensory and SMn connectivity preservation are common to ketamine and propofol-induced alterations of consciousness. [less ▲]

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See detailHypnose: on it’s very existence
VANHAUDENHUYSE, Audrey ULiege

Conference (2016, April 16)

Detailed reference viewed: 47 (11 ULiège)