Polysomnography as a diagnosis and post-treatment follow-up tool in human African trypanosomiasis: A case study in an infant

Mpandzou, Ghislain Armel; Cespuglio, Raymond; Ngampo, Stéphane; Bandzouzi, B.; Bouteille, Bernard; Vincendeau, Philippe; Buguet, Alain

doi:10.1016/j.jns.2011.03.002

Cited by 14 publications

(6 citation statements)

References 11 publications

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“…This finding is also in accordance with a recent report that sleep alterations reflect HAT severity in children [19]. The present preliminary evidence of the efficacy of actigraphy in a child affected by HAT is of particular interest especially considering the great difficulty in the evaluation of clinical signs (such as inactivity and unusual behavior) in children of 1–6 years of age suffering from this disease [17].…”

Section: Discussionsupporting

confidence: 92%

“…In fact, in a prospective multinational study of a large cohort of HAT patients, sleeping disorder, subjectively reported by the patients mostly as insomnia, was found to be the leading clinical symptom of the disease [17]. Sleep alterations have been repeatedly proposed as main signs of central nervous system involvement in HAT [3], [15], [19], although their relationship with HAT staging is not yet fully established.…”

Section: Introductionmentioning

confidence: 99%

“…These disturbances are improved or reversed by treatment, indicating that they are disease-related signs [15], [20]. PSG has been proposed as a non-invasive technique also for the evaluation of children affected by HAT [19]. However, PSG recordings are cumbersome, relatively expensive and difficult to perform in resource-limited health centers, and may not, therefore, represent a routine procedure for HAT in the field.…”

Section: Introductionmentioning

confidence: 99%

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Actigraphy in Human African Trypanosomiasis as a Tool for Objective Clinical Evaluation and Monitoring: A Pilot Study

et al. 2012

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BackgroundHuman African trypanosomiasis (HAT) or sleeping sickness leads to a complex neuropsychiatric syndrome with characteristic sleep alterations. Current division into a first, hemolymphatic stage and second, meningoencephalitic stage is primarily based on the detection of white blood cells and/or trypanosomes in the cerebrospinal fluid. The validity of this criterion is, however, debated, and novel laboratory biomarkers are under study. Objective clinical HAT evaluation and monitoring is therefore needed. Polysomnography has effectively documented sleep-wake disturbances during HAT, but could be difficult to apply as routine technology in field work. The non-invasive, cost-effective technique of actigraphy has been widely validated as a tool for the ambulatory evaluation of sleep disturbances. In this pilot study, actigraphy was applied to the clinical assessment of HAT patients.Methods/Principal FindingsActigraphy was recorded in patients infected by Trypanosoma brucei gambiense, and age- and sex-matched control subjects. Simultaneous nocturnal polysomnography was also performed in the patients. Nine patients, including one child, were analyzed at admission and two of them also during specific treatment. Parameters, analyzed with user-friendly software, included sleep time evaluated from rest-activity signals, rest-activity rhythm waveform and characteristics. The findings showed sleep-wake alterations of various degrees of severity, which in some patients did not parallel white blood cell counts in the cerebrospinal fluid. Actigraphic recording also showed improvement of the analyzed parameters after treatment initiation. Nocturnal polysomnography showed alterations of sleep time closely corresponding to those derived from actigraphy.Conclusions/SignificanceThe data indicate that actigraphy can be an interesting tool for HAT evaluation, providing valuable clinical information through simple technology, well suited also for long-term follow-up. Actigraphy could therefore objectively contribute to the clinical assessment of HAT patients. This method could be incorporated into a clinical scoring system adapted to HAT to be used in the evaluation of novel treatments and laboratory biomarkers.

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Section: Discussionsupporting

confidence: 92%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Actigraphy in Human African Trypanosomiasis as a Tool for Objective Clinical Evaluation and Monitoring: A Pilot Study

et al. 2012

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“…These diseases may be indeed connected and we may learn more in the future about sleeping sickness also from the advances in the narcolepsy research. Nonetheless, loss of orexin neurons cannot explain all of the symptoms of sleeping sickness, since patients' sleep disruption appears to be reversed upon treatment (Mpandzou et al, 2011 ). Interestingly, prostaglandin D2 (PGD2), which induces NREM sleep, is significantly increased in the CSF of late stage sleeping sickness patients (Pentreath et al, 1990 ).…”

Section: Sleep and Circadian Disruption By Sleeping Sickness Infectiomentioning

confidence: 99%

Sleeping Sickness: A Tale of Two Clocks

Rijo‐Ferreira

Takahashi

2020

Front. Cell. Infect. Microbiol.

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Sleeping sickness is caused by a eukaryotic unicellular parasite known to infect wild animals, cattle, and humans. It causes a fatal disease that disrupts many rhythmic physiological processes, including daily rhythms of hormonal secretion, temperature regulation, and sleep, all of which are under circadian (24-h) control. In this review, we summarize research on sleeping sickness parasite biology and the impact it has on host health. We also consider the possible evolutionary advantages of sleep and circadian deregulation for the parasite.

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“…However, the presence of a PSG syndrome should trigger the decision to use conventional invasive tests. In children, the case of 30-month old girl E20 is demonstrative [38,39]. The sleepy child presented normal biological profiles at the first CSF examination.…”

Section: Diagnostic and Prognosis Value Of The Psg Syndromementioning

confidence: 99%

Management of African Trypanosomiasis of the Cns: Polysomnography As A Noninvasive Staging Tool

Buguet

Chapotot

Ngampo³

et al. 2012

Future Neurol.

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Human African trypanosomiasis staging follows human African trypanosomiasis diagnosis (trypanosomes in blood and/or lymph glands, trypanosome-positive). Staging determines treatment, as stage 2 medications are toxic and/or difficult to administer. It relies on cerebrospinal fluid examination: stage 1 (no cerebrospinal fluid trypanosome, trypanosome-negative; white blood cell count ≤5/µl); stage 2 (trypanosome-positive and/or white blood cell count ≥20/µl); intermediate stage (6–19 white blood cell/µl; trypanosome-negative). Lumbar puncture is repeated biannually during the 24-month post-treatment follow-up to confirm cure or detect relapse. Sleep disorders are major at stage 2, with a two-symptom polysomnographic syndrome: sleep–wake circadian disruptions; and sleep-onset rapid eye movement sleep periods. Polysomnography (PSG) was proposed as a noninvasive diagnostic tool, and 24-h PSG recordings were performed throughout a 5-year survey in Congo. Before treatment, 76 patients were included and recorded. Normal sleep–wake patterns occurred in 45 out of 47 stage 1 patients and in 16 out of 19 intermediate-stage patients. PSG syndrome was observed in seven out of ten stage 2 patients. During post-treatment follow-up, PSG syndrome occurrence indicated relapse at stage 2. Thus, noninvasive PSG may represent a valuable alternative for human African trypanosomiasis staging, especially in the post-therapeutic follow-up. The detection of a PSG syndrome would then provoke examination of the patient’s cerebrospinal fluid.

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Polysomnography as a diagnosis and post-treatment follow-up tool in human African trypanosomiasis: A case study in an infant

Cited by 14 publications

References 11 publications

Actigraphy in Human African Trypanosomiasis as a Tool for Objective Clinical Evaluation and Monitoring: A Pilot Study

Actigraphy in Human African Trypanosomiasis as a Tool for Objective Clinical Evaluation and Monitoring: A Pilot Study

Sleeping Sickness: A Tale of Two Clocks

Management of African Trypanosomiasis of the Cns: Polysomnography As A Noninvasive Staging Tool

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