2024
Cognitive Motor Dissociation in Disorders of Consciousness
Bodien Y, Allanson J, Cardone P, Bonhomme A, Carmona J, Chatelle C, Chennu S, Conte M, Dehaene S, Finoia P, Heinonen G, Hersh J, Kamau E, Lawrence P, Lupson V, Meydan A, Rohaut B, Sanders W, Sitt J, Soddu A, Valente M, Velazquez A, Voss H, Vrosgou A, Claassen J, Edlow B, Fins J, Gosseries O, Laureys S, Menon D, Naccache L, Owen A, Pickard J, Stamatakis E, Thibaut A, Victor J, Giacino J, Bagiella E, Schiff N. Cognitive Motor Dissociation in Disorders of Consciousness. New England Journal Of Medicine 2024, 391: 598-608. PMID: 39141852, DOI: 10.1056/nejmoa2400645.Peer-Reviewed Original ResearchConceptsFunctional magnetic resonance imagingTask-based fMRICognitive motor dissociationDisorders of consciousnessComa Recovery Scale-RevisedCognitive tasksMotor dissociationObserved responseBrain injuryVerbal commandsBrain traumaScale-RevisedMagnetic resonance imagingDisordersBrainParticipantsEtiological factorsAssociated with younger ageElectroencephalographyCohort of personsResonance imagingProspective cohort studyTaskElectroencephalography dataMedian ageNeuroethics, Covert Consciousness, and Disability Rights: What Happens When Artificial Intelligence Meets Cognitive Motor Dissociation?
Fins J, Shulman K. Neuroethics, Covert Consciousness, and Disability Rights: What Happens When Artificial Intelligence Meets Cognitive Motor Dissociation? Journal Of Cognitive Neuroscience 2024, 36: 1667-1674. PMID: 38579252, DOI: 10.1162/jocn_a_02157.Peer-Reviewed Original ResearchConceptsCognitive motor dissociationCovert consciousnessBrain injuryRight-to-die movementOvert behaviorEEG studiesCognitive activityMotor dissociationSevere brain injuryNormative challengesModes of assessmentDisability biasClinical practiceNormative reasonsGenerate speechEthical challengesArtificial intelligenceAlphabet soupAnticipatory governanceTranslational researchBrain injury, medical progress, and the disability paradox: Towards an Americans with Abilities Act
Fins J, Shulman K, Wright M, Shapiro Z. Brain injury, medical progress, and the disability paradox: Towards an Americans with Abilities Act. Neurorehabilitation 2024, 54: 141-147. PMID: 38217618, DOI: 10.3233/nre-230118.Peer-Reviewed Original ResearchConceptsDisability lawLegal protection of patientsInterface of medicineProtection of patientsAmerican jurisprudenceConstitutional protectionLegal protectionLawConstitutive elementsNewfound abilityMedical progressProtectionJurisprudenceLegislationBrain injuryAmericanModerate to severe brain injuryDisabilityParadoxBrain injury professionalsProfessionalsADASevere brain injuryBrain
2023
Thalamic deep brain stimulation in traumatic brain injury: a phase 1, randomized feasibility study
Schiff N, Giacino J, Butson C, Choi E, Baker J, O’Sullivan K, Janson A, Bergin M, Bronte-Stewart H, Chua J, DeGeorge L, Dikmen S, Fogarty A, Gerber L, Krel M, Maldonado J, Radovan M, Shah S, Su J, Temkin N, Tourdias T, Victor J, Waters A, Kolakowsky-Hayner S, Fins J, Machado A, Rutt B, Henderson J. Thalamic deep brain stimulation in traumatic brain injury: a phase 1, randomized feasibility study. Nature Medicine 2023, 29: 3162-3174. PMID: 38049620, PMCID: PMC11087147, DOI: 10.1038/s41591-023-02638-4.Peer-Reviewed Original ResearchConceptsTraumatic brain injuryDeep brain stimulationExecutive controlProcessing speedBrain stimulationImprove executive controlCentral lateral (CL) nucleusTrail-Making TestChronic phase of recoveryBrain injuryYears post-injuryFrontostriatal networkEfficacy of deep brain stimulationExecutive functionConverging evidenceLimit quality of lifeEfficacy measuresMsTBIPhase of recoveryPost-injuryRandomized feasibility studyThalamic deep brain stimulationQuality of lifeParticipantsProtocol non-complianceSubject and Family Perspectives from the Central Thalamic Deep Brain Stimulation Trial for Traumatic Brain Injury: Part II.
Fins J, Wright M, Shulman K, Henderson J, Schiff N. Subject and Family Perspectives from the Central Thalamic Deep Brain Stimulation Trial for Traumatic Brain Injury: Part II. Cambridge Quarterly Of Healthcare Ethics 2023, 1-24. PMID: 37850455, DOI: 10.1017/s0963180123000518.Peer-Reviewed Original ResearchFamily perspectiveTraumatic brain injuryOn-going careTrail-Making-TestDecision-making capacitySevere traumatic brain injuryBrain injurySupportive counselingStimulation trialsNarrative responsesPost-trial accessVoluntary informed consentPost-operative interviewsFamily membersSocial reintegrationMarkers of executive functionCognitive functionFamily dynamicsInformed consentPart BDeep brain stimulation trialsInterviewsExecutive functionDevice trialsTrialsA Descriptive Analysis of Access to Assistive Technology in Children With Acquired Brain Injury: The Right to Assistive Devices
Fins J, Knitter J, Mukherjee D, Conti K, Donleavy-Hiller B, Gerber L, Hersh J, Kotorac-Erlbaum R, Milch B, Klein S. A Descriptive Analysis of Access to Assistive Technology in Children With Acquired Brain Injury: The Right to Assistive Devices. Journal Of Head Trauma Rehabilitation 2023, 39: 152-159. PMID: 37492972, PMCID: PMC10811270, DOI: 10.1097/htr.0000000000000876.Peer-Reviewed Original ResearchConceptsSkilled nursing facilityMedical recordsAcquired Brain InjuryHospital outpatient departmentsModerate to severe brain injuryBrain injuryTime to deliveryPotential adverse implicationsAssistive technologyNursing facilitiesSelf-carePediatric cliniciansFostering social integrationImprove mobilityInsurance coverageOutpatient departmentRetrospective chart review of patientsChart review of patientsRetrospective chart reviewAssessment delayInpatient statusVulnerable childrenDescriptive analysisMedical statusLongitudinal trackingPrognostic humility and ethical dilemmas after severe brain injury: Summary, recommendations, and qualitative analysis of Curing Coma Campaign virtual event proceedings
Kreitzer N, Murtaugh B, Creutzfeldt C, Fins J, Manley G, Sarwal A, Dangayach N. Prognostic humility and ethical dilemmas after severe brain injury: Summary, recommendations, and qualitative analysis of Curing Coma Campaign virtual event proceedings. Frontiers In Human Neuroscience 2023, 17: 1128656. PMID: 37063099, PMCID: PMC10102639, DOI: 10.3389/fnhum.2023.1128656.Peer-Reviewed Original ResearchSurrogates of patientsSevere acute brain injuryPrognostic uncertaintyFamily members/caregiversHealthcare systemUnited States health systemState health systemBrain injuryCare of patientsCuring Coma CampaignMultidisciplinary group of expertsEthical dilemmasLong-term disabilityExpert discussionNeurocritical Care SocietyCare effortsHealth systemSub-themesThematic analysisQuality rehabilitationQualitative analysisMultidisciplinary groupCarePrognostic certaintyAcute brain injury
2022
Subject and Family Perspectives from the Central Thalamic Deep Brain Stimulation for Traumatic Brain Injury Study: Part I
Fins J, Wright M, Henderson J, Schiff N. Subject and Family Perspectives from the Central Thalamic Deep Brain Stimulation for Traumatic Brain Injury Study: Part I. Cambridge Quarterly Of Healthcare Ethics 2022, 31: 419-443. PMID: 36398511, DOI: 10.1017/s0963180122000226.Peer-Reviewed Original ResearchConceptsCentral thalamic deep brain stimulationVoluntary informed consentTraumatic brain injuryDecision-making authorityBrain injuryDeep brain stimulationTherapeutic misconceptionCognitive restorationBrain stimulationAgency of subjectsInformed consentSevere traumatic brain injuryTraumatic brain injury studiesThalamic deep brain stimulationConsentTreatment of traumatic brain injuryEnrollment decisionsBrain injury studiesFamily perspectiveInterpersonal interactionsDecisionCognitive disabilitiesStudy enrollmentReturn to workSocial structureSyndromes in Search of a Name: Disorders of Consciousness, Neuroethics, and Nosological Humility
Fins J. Syndromes in Search of a Name: Disorders of Consciousness, Neuroethics, and Nosological Humility. 2022, 163-175. DOI: 10.1007/978-3-031-04935-4_18.Peer-Reviewed Original ResearchDisorders of consciousnessBrain injuryCognitive motor dissociationStruggle for ConsciousnessRecognition of consciousnessVegetative stateDiagnostic categorizationLimits of knowledgePermanent vegetative stateNosologyPersistent vegetative stateMotor dissociationCovert consciousnessNormative importanceBrainDisordersChronic vegetative stateConsciousnessSocial integrationHumilityEvolving storyNeuroimagingNeuroscienceMindfulnessRightsCognitive-Motor Dissociation Following Pediatric Brain Injury
Kim N, O'Sullivan J, Olafson E, Caliendo E, Nowak S, Voss H, Lowder R, Watson W, Ivanidze J, Fins J, Schiff N, Hill N, Shah S. Cognitive-Motor Dissociation Following Pediatric Brain Injury. Neurology Clinical Practice 2022, 12: 248-257. PMID: 35733619, PMCID: PMC9208423, DOI: 10.1212/cpj.0000000000001169.Peer-Reviewed Original ResearchCognitive-motor dissociationCognitive functionParticipants' EEGSemantic processing of wordsCovert cognitionBrain injuryProcessing of wordsIntact semantic processingIdentifying such personsResponses to auditory stimuliDiverse batteryCognitive abilitiesMinimally conscious stateCognitive-motorCognitive capacityPediatric brain injuryCommunication attemptsAuditory stimuliAged 9CognitionNeuroimagingMotor outputConscious stateParticipantsBrainProlonged Unconsciousness is Common in COVID‐19 and Associated with Hypoxemia
Waldrop G, Safavynia S, Barra M, Agarwal S, Berlin D, Boehme A, Brodie D, Choi J, Doyle K, Fins J, Ganglberger W, Hoffman K, Mittel A, Roh D, Mukerji S, Der Nigoghossian C, Park S, Schenck E, Salazar‐Schicchi J, Shen Q, Sholle E, Velazquez A, Walline M, Westover M, Brown E, Victor J, Edlow B, Schiff N, Claassen J. Prolonged Unconsciousness is Common in COVID‐19 and Associated with Hypoxemia. Annals Of Neurology 2022, 91: 740-755. PMID: 35254675, PMCID: PMC9082460, DOI: 10.1002/ana.26342.Peer-Reviewed Original ResearchConceptsCessation of mechanical ventilationAssociated with hypoxemiaMedian timeMechanical ventilationAssociated with more severe hypoxemiaDays of hypoxemiaEvidence of structural brain injurySevere coronavirus disease 2019Cox proportional hazards modelsArterial partial pressure of oxygenImpairment of consciousnessSevere COVID-19Survivors of severe COVID-19Proportional hazards modelArterial partial pressureBrain injuryStructural brain injurySevere hypoxemiaCohort studyLife-sustaining therapyEndotracheal intubationHypoxemiaProlonged unconsciousnessPartial pressure of oxygenPatientsEthics and the 2018 Practice Guideline on Disorders of Consciousness
Peterson A, Young M, Fins J. Ethics and the 2018 Practice Guideline on Disorders of Consciousness. Neurology 2022, 98: 712-718. PMID: 35277446, PMCID: PMC9071367, DOI: 10.1212/wnl.0000000000200301.Peer-Reviewed Original ResearchDignity of Risk, Reemergent Agency, and the Central Thalamic Stimulation Trial for Moderate to Severe Brain Injury.
Fins J, Wright M. Dignity of Risk, Reemergent Agency, and the Central Thalamic Stimulation Trial for Moderate to Severe Brain Injury. Perspectives In Biology And Medicine 2022, 65: 307-315. PMID: 35938438, DOI: 10.1353/pbm.2022.0026.Peer-Reviewed Original Research
2021
Disorders of Consciousness, Disability Rights and Triage During the COVID-19 Pandemic
Fins J. Disorders of Consciousness, Disability Rights and Triage During the COVID-19 Pandemic. The Journal Of Philosophy Of Disability 2021, 1: 211-229. DOI: 10.5840/jpd20218174.Peer-Reviewed Original ResearchNew York State Task Force on LifeStruggle for ConsciousnessVentilator allocation guidelinesDisorders of consciousnessTask ForceNot consciousnessEthical integritySpring surgeAllocation guidelinesCOVID-19 pandemicClinical ethicistsAuthorsNew YorkCOVID-19LawBrain injuryConsciousnessDisordersEthicistsNewPeopleMotor outputEthics
2020
Personalized Connectome Mapping to Guide Targeted Therapy and Promote Recovery of Consciousness in the Intensive Care Unit
Edlow B, Barra M, Zhou D, Foulkes A, Snider S, Threlkeld Z, Chakravarty S, Kirsch J, Chan S, Meisler S, Bleck T, Fins J, Giacino J, Hochberg L, Solt K, Brown E, Bodien Y. Personalized Connectome Mapping to Guide Targeted Therapy and Promote Recovery of Consciousness in the Intensive Care Unit. Neurocritical Care 2020, 33: 364-375. PMID: 32794142, PMCID: PMC8336723, DOI: 10.1007/s12028-020-01062-7.Peer-Reviewed Original ResearchConceptsIntensive care unitPromote recovery of consciousnessRecovery of consciousnessIntravenous methylphenidateEarly recovery of consciousnessPromote early recoveryPhase 2aDrug-related adverse eventsCare unitAscending arousal networkEscalating daily dosesHighest tolerated doseAcute severe traumatic brain injuryDose-finding studyOutcome measuresBrain injurySerum half-lifeMaximal serum concentrationPrimary outcome measureWithdrawal of life-sustaining therapyDrug’s pharmacodynamic propertiesSecondary outcome measuresMagnetic resonance imagingOpen-labelPharmacodynamic criteriaThe Neglect of Persons with Severe Brain Injury in the United States: An International Human Rights Analysis.
Ezer T, Wright M, Fins J. The Neglect of Persons with Severe Brain Injury in the United States: An International Human Rights Analysis. Health And Human Rights 2020, 22: 265-278. PMID: 32669806, PMCID: PMC7348445.Peer-Reviewed Original ResearchConceptsHuman rights analysisFreedom of expressionBlock to treatmentUnited StatesRights analysisLife of personsExperiences of personsTraumatic incidentsQuality of life of personsPersonsScientific progressNeglectMedical advancesBrain injuryInadequate accessLawViolationStateSignificant medical advancesFreedomEqualityInstitutionalizationUnitsInternationalPolicy
2019
Disorders of Consciousness in Clinical Practice
Fins J. Disorders of Consciousness in Clinical Practice. 2019, 449-478. DOI: 10.1093/med/9780190208875.003.0011.Peer-Reviewed Original ResearchEnd-of-life careEnd-of-lifeLong-term careImpaired decision-making capacityDisorders of consciousnessClinical practiceDecision-making capacityAncillary care obligationsVulnerable populationsProfessional obligationsCareMinimally conscious stateNeuroimaging assessmentsIntensive careCare obligationsDiagnostic classificationBrain injuryCommunication strategiesCovert consciousnessClinicInitial presentationConscious stateEthical implicationsPatientsRehabilitation
2018
Assessment of Covert Consciousness in the Intensive Care Unit
Edlow B, Fins J. Assessment of Covert Consciousness in the Intensive Care Unit. Journal Of Head Trauma Rehabilitation 2018, 33: 424-434. PMID: 30395042, PMCID: PMC6317885, DOI: 10.1097/htr.0000000000000448.Peer-Reviewed Original ResearchConceptsFunctional magnetic resonance imagingTraumatic brain injuryAcute severe traumatic brain injurySevere traumatic brain injuryIntensive care unitCovert consciousnessEthical challengesIntensive care unit patientsTask-based functional magnetic resonance imagingTask-based fMRILife-sustaining therapyWithdrawal of life-sustaining therapyCare unitEthical frameworkBehavioral assessmentCritically ill patientsEvaluation normsMagnetic resonance imagingConsciousnessBrain injuryGoals of careClinical scenariosIll patientsRecovered consciousnessTreatment decisionsConstructive Disappointment and Disbelief: Building a Career in Neuroethics
Fins J. Constructive Disappointment and Disbelief: Building a Career in Neuroethics. Cambridge Quarterly Of Healthcare Ethics 2018, 27: 544-553. PMID: 30198463, DOI: 10.1017/s0963180118000063.Peer-Reviewed Original ResearchRights language and disorders of consciousness: a call for advocacy
Fins J, Wright M. Rights language and disorders of consciousness: a call for advocacy. Brain Injury 2018, 32: 670-674. PMID: 29393694, DOI: 10.1080/02699052.2018.1430377.Peer-Reviewed Original ResearchConceptsCivil rightsDisability rights lawsRights of PersonsRights-based argumentsReintegration of peopleRights lawUN ConventionRights languageProvision of rehabilitationRightsSociety itselfCivil societyIntegration of peopleReintegrationSocietyMedical mainstreamCare sectorCare of peopleBrain injuryPersonsLawMaximal integrationConventionBrain injury rehabilitationDisorders of consciousness