Characteristics of Infradian and Circadian Rhythms in the Persistent Vegetative State

Guan, Junwen; You, Chao; Liu, Y; Liu, Y; Zhang, R; Wang, Z

doi:10.1177/147323001103900625

Cited by 8 publications

(6 citation statements)

References 26 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Isono et al [14] also reported an absence of EEG sleep-wake changes in 4 out of 12 VS patients. High variability has also been observed in other physiological circadian rhythms in VS and MCS, including body temperature and hormone levels [15,16], blood pressure and heart rate [16,17], and sleep-related erections [18]. Circadian-like variations in arousal have also been reported in both VS and MCS patients, as indexed by fluctuating behavioral abilities across the day [19].…”

Section: Introductionmentioning

confidence: 99%

Actigraphy assessments of circadian sleep-wake cycles in the Vegetative and Minimally Conscious States

Cruse

Thibaut

Demertzi

et al. 2013

BMC Med

View full text Add to dashboard Cite

BackgroundThe Vegetative and Minimally Conscious States (VS; MCS) are characterized by absent or highly disordered signs of awareness alongside preserved sleep-wake cycles. According to international diagnostic guidelines, sleep-wake cycles are assessed by means of observations of variable periods of eye-opening and eye-closure. However, there is little empirical evidence for true circadian sleep-wake cycling in these patients, and there have been no large-scale investigations of the validity of this diagnostic criterion.MethodsWe measured the circadian sleep-wake rhythms of 55 VS and MCS patients by means of wrist actigraphy, an indirect method that is highly correlated with polysomnographic estimates of sleeping/waking.ResultsContrary to the diagnostic guidelines, a significant proportion of patients did not exhibit statistically reliable sleep-wake cycles. The circadian rhythms of VS patients were significantly more impaired than those of MCS patients, as were the circadian rhythms of patients with non-traumatic injuries relative to those with traumatic injuries. The reliability of the circadian rhythms were significantly predicted by the patients' levels of visual and motor functioning, consistent with the putative biological generators of these rhythms.ConclusionsThe high variability across diagnoses and etiologies highlights the need for improved guidelines for the assessment of sleep-wake cycles in VS and MCS, and advocates the use of actigraphy as an inexpensive and non-invasive alternative.

show abstract

Section: Introductionmentioning

confidence: 99%

Actigraphy assessments of circadian sleep-wake cycles in the Vegetative and Minimally Conscious States

Cruse

Thibaut

Demertzi

et al. 2013

BMC Med

View full text Add to dashboard Cite

show abstract

“…Circadian and multiday cycles in human physiology have been described in normal health and disease [24][25][26][27][28][29][30][31] . Of particular interest multiday cycles, including circaseptan 32 (weekly) and circamonthly 33 cycles, have been identified in the regulation of immune, 26 endocrine, 28,34 metabolic, 35 and cardiovascular 36,37 systems, in human behavior, 32 as well as in brain excitability 17,20 and seizure risk. [2][3][4][5][6]12 Prior work on naturally occurring human and canine epilepsy has established that multiday cycles are common, with evidence for grouplevel circa-weekly, bi/tri-weekly, and monthly cycles.…”

Section: Introductionmentioning

confidence: 99%

Multimodal wearable sensors inform cycles of seizure risk

Gregg

Attia

Nasseri

et al. 2022

Preprint

View full text Add to dashboard Cite

Objective: Seizure unpredictability is a major source of disability for people with epilepsy. Recent work using chronic brain recordings has established that for many individuals with epilepsy seizure risk is not random, but corresponds to circadian and multiday (multidien) cycles in brain excitability. Here, we aimed to evaluate whether multimodal wearable device recordings can characterize cycles of seizure risk, and compare wearables performance with concurrent brain recordings. Methods: Fourteen subjects underwent long-term ambulatory monitoring with a multimodal wrist worn device (measuring heart rate, heart rate variability, accelerometry, tonic and phasic electrodermal activity, temperature) and an implanted responsive neurostimulation system (measuring interictal epileptiform abnormalities (IEA) and electrographic seizures). Wavelet time-frequency analyses identified circadian and multiday cycles in wearable and brain recordings. Circular statistics assessed seizure phase locking to cycles in physiology. Results: Ten subjects met inclusion criteria. The mean recording duration was 232 days. Seven subjects had reliable electrographic seizure detections (mean 76 seizures). Seizure phase locking to multiday cycles occurred in six (IEA), five (temperature), four (heart rate, phasic electrodermal activity), and three (accelerometry, heart rate variability, tonic electrodermal activity) subjects. Seizure phase locking to residual HR multiday cycles (HR after regression of correlated physical activity (ACC)) increased to six subjects. Interpretation: Long timescale cyclical changes in wearable recordings are common in epilepsy, and seizures occur at preferred phases of these cycles for many individuals, with implications for seizure risk forecasting. Broadly accessible wearable technology can provide new insights into the chronobiology of epilepsy.

show abstract

“…A previous study examining circadian rhythm variables of 3 UWS patients', including systolic blood pressure, diastolic blood pressure and heart rate. The authors report circadian periods of 24.25 h, 24.18 h, and 24.14 h [15]. In studies on healthy participants where environmental cues were controlled, the circadian period changes to something close to the free-running period [11,[17][18][19].…”

Section: Opinionmentioning

confidence: 99%

“…This free-running rhythm deviates from its normal cycle and it is usually longer than 24 h, around 24.18 h [11][12][13]. In fact, circadian rhythms of electrophysiology, skin temperature, hormone secretion, as well as blood pressure and heart rate [14,15] have been observed in some patients with UWS and MCS. However, when exposing to monochromatic light during night, MCS patients and healthy person displayed lightinduced suppression of melatonin but patients in UWS didn't displayed it [16].…”

Section: Opinionmentioning

confidence: 99%

Circadian Rhythm of Patients with Disorders of Consciousness

2018

OAJNN

View full text Add to dashboard Cite

Patients with Disorders of Consciousness (DOC) exhibit arousal fluctuations, showing periods of circadian sleep-wake. Circadian rhythms are the outward manifestation of an endogenous timing system. The diagnosis of patients does not only rely on behavioral responsiveness during process, but also based on the rhythm of patients. Therefore, it is important to know the circadian rhythm of DOC patients. We also need to be aware of the importance of adjusting circadian rhythm for DOC patient in diagnosis and treatment.

show abstract

Characteristics of Infradian and Circadian Rhythms in the Persistent Vegetative State

Cited by 8 publications

References 26 publications

Actigraphy assessments of circadian sleep-wake cycles in the Vegetative and Minimally Conscious States

Actigraphy assessments of circadian sleep-wake cycles in the Vegetative and Minimally Conscious States

Multimodal wearable sensors inform cycles of seizure risk

Circadian Rhythm of Patients with Disorders of Consciousness

Contact Info

Product

Resources

About