Sleep-Disordered Breathing and Spinal Cord Injury: Challenges and Opportunities

Sankari, Abdulghani; Martin, Jennifer L.; Badr, M. Safwan

doi:10.1007/s40675-017-0093-0

Cited by 14 publications

(9 citation statements)

References 45 publications

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“…However, even though assisted coughing techniques have been progressively introduced during the years of study, precise data on its use or other physiotherapy techniques were not available. It would also be desirable to have information on lung function data and breathing during sleep in our patients to be able to assess periods of hypoventilation or the coexistence of sleep apnoeas, which are frequent in spinal cord injuries [27][28][29]. For purposes of the predictive model analysis, we clumped several respiratory complications all together.…”

Section: Discussionmentioning

confidence: 99%

Predictors of respiratory complications in patients with C5–T5 spinal cord injuries

et al. 2020

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Study design Retrospective chart audit. Objectives Describing the respiratory complications and their predictive factors in patients with acute traumatic spinal cord injuries at C5-T5 level during the initial hospitalization. Setting Hospital Vall d'Hebron, Barcelona. Methods Data from patients admitted in a reference unit with acute traumatic injuries involving levels C5-T5. Respiratory complications were defined as: acute respiratory failure, respiratory infection, atelectasis, non-hemothorax pleural effusion, pulmonary embolism or haemoptysis. Candidate predictors of these complications were demographic data, comorbidity, smoking, history of respiratory disease, the spinal cord injury characteristics (level and ASIA Impairment Scale) and thoracic trauma. A logistic regression model was created to determine associations between potential predictors and respiratory complications. Results We studied 174 patients with an age of 47.9 (19.7) years, mostly men (87%), with low comorbidity. Coexistent thoracic trauma was found in 24 (19%) patients with cervical and 35 (75%) with thoracic injuries (p < 0.001). Respiratory complications were frequent (53%) and were associated to longer hospital stay: 83.1 (61.3) and 45.3 (28.1) days in patients with and without respiratory complications (p < 0.001). The strongest predictors of respiratory complications were: previous respiratory disease (OR 5.4, 95% CI: 1.5-19.2), complete motor function impairment (AIS A-B) (OR 4.7, 95% CI: 2.4-9.5) and concurrent chest trauma (OR 3.73, 95% CI: 1.8-7.9). Conclusions Respiratory complications are common in traumatic spinal cord injuries between C5-T5. We identified previous respiratory disease, complete motor function impairment and the coexistence of thoracic trauma as predictors of respiratory complications. Identification of patients at risk might help clinicians to implement preventive strategies.

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Section: Discussionmentioning

confidence: 99%

Predictors of respiratory complications in patients with C5–T5 spinal cord injuries

et al. 2020

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“…Obstructive sleep apnea is noted in approximately 20% of individuals with muscular dystrophies or acid maltase deficiency (Pompe's disease), 25% of those with thoracic spinal cord injury and in 33% with cervical spinal cord injury. Central apneas during sleep are commonly seen in individuals with spinal cord injury, with a prevalence of 63% to 88% in cervical spinal cord injuries and 13% to 38% in upper thoracic spinal cord injuries 31 . Diaphragmatic weakness and dysfunction may also lead to hypopneas or pseudocentral respiratory events in phasic REM sleep.…”

Section: Pathophysiology and Clinical Presentationmentioning

confidence: 99%

Sleep disordered breathing: Assessment and therapy in the age of emerging neuromuscular therapies

Gurbani

Pascoe

Katz

et al. 2020

Pediatric Pulmonology

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The term neuromuscular disease (NMD) encompasses a large variety of disorders that result in abnormal muscle function. Although it may be conventional to relate the use of this term to the most common muscular diseases (Duchenne muscular dystrophy [DMD], spinal muscular atrophy [SMA], and amyotrophic lateral sclerosis, etc), it is important to extend the term to pathologies manifested by severe neurologic (brain and spinal cord) malformations and injuries. In many of these scenarios, there are common mechanisms that contribute to sleep disordered breathing (SDB) and respiratory insufficiency although comorbidities may be somewhat different. Advances in the understanding of these diseases and their natural history, and increasing availability of mechanical ventilation to these patients have improved survival. The development of novel genetic and molecular therapies (as in the cases of DMD, SMA, and X‐linked myotubular myopathy) provides an opportunity to use SDB as a reasonable outcome measure while also allowing the use of polysomnography as a validation tool in the assessments of effectiveness of therapies. We seek to provide an understanding of SDB in NMDs, and in the same light, would like to begin the conversation of thinking about weaning respiratory support when possible.

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“…Some studies highlighted the cognitive impact of breathing disorders like sleep apnea induced by the tetraplegia in chronic [75]. Sleep apnea concerns up to 91% of these chronic complete SCI patients [76]. More severe chronic apnea was associated with decrease performance in verbal attention and concentration, immediate and short-term memory, cognitive flexibility, internal scanning and working Proceedings of the 8th Graz Brain-Computer Interface Conference 2019 DOI: 10.3217/978-3-85125-682-6-48 memory.…”

Section: Additional Factors and Observations That Need To Be Accounte...mentioning

confidence: 99%

Why BCIs work poorly with the patients who need them the most?

Séguin¹,

Maby²,

Mattout³

2019

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A major objective of Brain-Computer interfaces (BCI) is to restore communication and control in patients with severe motor impairments, like people with Locked-in syndrome. These patients are left only with limited eye and eyelid movements. However, they do not benefit from efficient BCI solutions, yet. Different signals can be used as commands for non-invasive BCI: mu and beta rhythm desynchronization, evoked potentials and slow cortical potentials. Whatever the signal, clinical studies show a dramatic loss of performance in severely impaired patients compared to healthy subjects. Interestingly, the control principle is always the same, namely the replacement of an impossible (overt) movement by a (covert) attentional command. Drawing from the premotor theory of attention, from neuroimaging findings about the functional anatomy of spatial attention, from clinical observations and from recent computational accounts of attention for both action and perception, we explore the hypothesis that these patients undergo negative plasticity that extends their impairment from overt to covert attentional processes.

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Sleep-Disordered Breathing and Spinal Cord Injury: Challenges and Opportunities

Cited by 14 publications

References 45 publications

Predictors of respiratory complications in patients with C5–T5 spinal cord injuries

Predictors of respiratory complications in patients with C5–T5 spinal cord injuries

Sleep disordered breathing: Assessment and therapy in the age of emerging neuromuscular therapies

Why BCIs work poorly with the patients who need them the most?

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