No abstract

A brief session of rightward prismatic adaptation (R-PA) has been shown to alleviate neglect symptoms in patients with right hemispheric damage, very likely by switching hemispheric dominance of the ventral attentional network (VAN) from the right to the left and by changing task-related activity within the dorsal attentional network (DAN). We have investigated this very rapid change in functional organisation with a network approach by comparing restingstate connectivity before and after a brief exposure i) to R-PA (14 normal subjects; experimental condition) or ii) to plain glasses (12 normal subjects; control condition). A whole brain analysis (comprising 129 regions of interest) highlighted R-PA-induced changes within a bilateral, fronto-temporal network, which consisted of 13 nodes and 11 edges; all edges involved one of 4 frontal nodes, which were part of VAN. The analysis of network characteristics within VAN and DAN revealed a R-PA-induced decrease in connectivity strength between nodes and a decrease in local efficiency within VAN but not within DAN. These results indicate that the resting-state connectivity configuration of VAN is modulated by R-PA, possibly by decreasing its modularity.

BackgroundPulmonary manifestations of COVID-19 pneumonia are well known. However, COVID-19 is also associated with a range of vascular manifestations such as embolism, congestion, and perfusion changes. Regarding congestion, research from different groups has suggested arteriovenous anastomosis dysregulation as a contributing factor. In this study, we aim to better describe the changes in vascular volume in affected lung zones and to relate them to pathophysiological hypotheses.MethodsWe performed automatic vascular volume extraction in 10 chest CTs of patients, including 2 female and 8 male with a mean age of 63.5 ± 9.3 years, diagnosed with COVID-19 pneumonia. We compared the proportion of vascular volumes between manually segmented regions of lung parenchyma with and without signs of pneumonia.ResultsThe proportion of vascular volume was significantly higher in COVID (CVasc) compared to non-COVID (NCVasc) areas. We found a mean difference (DVasc) of 5% and a mean ratio (RVasc) of 3.7 between the two compartments (p < 0.01).ConclusionVascular volume in COVID-19 affected lung parenchyma is augmented relative to normal lung parenchyma, indicating venous congestion and supporting the hypothesis of pre-existing intra-pulmonary arteriovenous shunts.

Purpose Hypnosis is useful for diminishing distress during medical procedures. This study investigated the efficacy of virtually augmented self-hypnosis as an adjunctive non-pharmacological method for procedural pain and anxiety relief during endovascular interventions (EVI). Methods We compared an immersive distraction experience (clinicaltrials.gov identifier NCT04561596) featuring virtual reality (VR) using a head-mounted display versus treatment as usual (TAU). Patients followed the “Aqua” module (Oncomfort™) consisting of a scuba dive and breathing exercises. They experienced a self-induced dissociative state similar to clinical hypnosis without direct intervention of a professional. Enrollment followed a 1:1 randomized open study (VR or TAU). Patients’ feelings were evaluated just before and after the procedure, and 3 months following intervention. Anxiety was evaluated using the State Trait Anxiety Inventory (STAI) and pain (sensory, emotional, and memory) with a visual analogue scale (VAS). Results This study included 100 patients. Mean anxiety (pre-post) was significantly reduced within groups and between groups (difference of 4.2 points, p = 0.016). The percentage of responders to anxiety lowering were 76 and 46% for VR and TAU, respectively (p = 0.004). The two groups did not significantly differ in mean sensory-intensity and affective emotional pain (pre-post) using VAS, in negative memories concerning remembered pain at 3 months (difference > 1 from immediate post-procedural reported pain intensity), mean procedural time, or the need for analgesic or sedative drugs. Conclusions VR self-hypnosis has the potential to improve the management of patients’ distress during radiological procedures. It is safe and effective for reducing anxiety during EVI.