Analysis of Italian regulations on pathways of care for patients in a vegetative or minimally conscious state.

Different rehabilitation models for persons diagnosed with disorders of consciousness have been proposed in Europe during the last decade. In Italy, the Ministry of Health has defined a national healthcare model, although, to date, there is a lack of information on how this has been implemented at regional level. The INCARICO project collected information on different regional regulations, analysing ethical aspects and mapping care facilities (numbers of beds and medical units) in eleven regional territories. The researchers found a total of 106 laws; differences emerged both between regions and versus the national model, showing that patients with the same diagnosis may follow different pathways of care. An ongoing cultural shift from a treatment-oriented medical approach towards a care-oriented integrated biopsychosocial approach was found in all the welfare and healthcare systems analysed. Future studies are needed to explore the relationship between healthcare systems and the quality of services provided.

P300 latency Jitter occurrence in patients with disorders of consciousness: Toward a better design for Brain Computer Interface applications.

In this study the P300 latency jitter has been explored in an EEG data set collected from a group of patients with disorders of consciousness (DOC; n=13) that was administered with an auditory Oddball paradigm under passive and active conditions. A method based on wavelet transform was applied to estimate single trial P300 waveforms. Preliminary results showed that 5 Vegetative State (VS) and 8 Minimally Conscious Staten (MCS) patients exhibited significantly higher values of P300 latency jitter as compared to those obtained from a control group of 12 healthy subjects. In addition, the magnitude of the P300 latency jitter negatively correlated with patients' clinical status. The existence of such phenomenon might substantially limit an effective use of Brain Computer Interface systems for communication.

Potentiation of ischemia-related behavioral alterations by electro-acupuncture in gerbils.

Gerbils subjected to global ischemia or sham-ischemia received electro-acupuncture (EA) or sham EA at points 26 Du (Renzhong) and 8 Du (Junsuo). All animals were then tested for motor activity in an open field, and for spontaneous alternation in a T maze. Results show that EA alone did not affect any behavioral parameter. Ischemia alone increased motor activity without significantly interfering with spontaneous alternation. EA in ischemic gerbils potentiated the increase of motor activity and elicited a decrease in spontaneous alternation. Thus, our data show an interaction between global ischemia and EA applied at specific acupoints which, however, consists of a potentiation rather than an alleviation of the behavioral alterations consecutive to the ischemic insult.