Sleep organization pattern as a prognostic marker at the subacute stage of post-traumatic coma

Valente, Mariarosaria; Placidi, Fabio; Oliveira, Andréa J.; Bigagli, A; Morghen, I; Proietti, R.; Gigli, Gian Luigi

doi:10.1016/s1388-2457(02)00218-3

Cited by 103 publications

(48 citation statements)

References 14 publications

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“…[26][27][28][29] Sleep research is of particular interest in brain-injured patients with various etiologies because it can bring to light relationships between sleep patterns and functional neuroanatomy. In particular, the quality and quantity of spindles seem to provide a new index of the severity of the thalamocortical injury in the VS/UWS and MCS (Fig.…”

Section: Discussionmentioning

confidence: 99%

Sleep in the Unresponsive Wakefulness Syndrome and Minimally Conscious State

Cologan

Drouot

Parapatics

et al. 2013

Journal of Neurotrauma

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The goal of our study was to investigate different aspects of sleep, namely the sleep-wake cycle and sleep stages, in the vegetative state/unresponsive wakefulness syndrome (VS/UWS), and minimally conscious state (MCS). A 24-h polysomnography was performed in 20 patients who were in a UWS (n = 10) or in a MCS (n = 10) because of brain injury. The data were first tested for the presence of a sleep-wake cycle, and the observed sleep patterns were compared with standard scoring criteria. Sleep spindles, slow wave sleep, and rapid eye movement sleep were quantified and their clinical value was investigated. According to our results, an electrophysiological sleep-wake cycle was identified in five MCS and three VS/UWS patients. Sleep stages did not always match the standard scoring criteria, which therefore needed to be adapted. Sleep spindles were present more in patients who clinically improved within 6 months. Slow wave sleep was present in eight MCS and three VS/UWS patients but never in the ischemic etiology. Rapid eye movement sleep, and therefore dreaming that is a form of consciousness, was present in all MCS and three VS/UWS patients. In conclusion, the presence of alternating periods of eyes-open/eyes-closed cycles does not necessarily imply preserved electrophysiological sleep architecture in the UWS and MCS, contrary to previous definition. The investigation of sleep is a little studied yet simple and informative way to evaluate the integrity of residual brain function in patients with disorders of consciousness with possible clinical diagnostic and prognostic implications.

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Section: Discussionmentioning

confidence: 99%

Sleep in the Unresponsive Wakefulness Syndrome and Minimally Conscious State

Cologan

Drouot

Parapatics

et al. 2013

Journal of Neurotrauma

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“…Valente et al 30 reported that the presence of organized sleep patterns in the recovery phase after severe traumatic brain injury was highly predictive of a better cognitive and functional outcome.…”

Section: Discussionmentioning

confidence: 99%

Correlation between sleep and cognitive functions after hemispheric ischaemic stroke

Siccoli¹,

Rölli-Baumeler²,

Achermann³

et al. 2008

Euro J of Neurology

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Background: The aim of this study was to test the hypothesis of a link between sleep and cognitive functions, particularly memory and attention, after stroke. Methods: We studied 11 consecutive patients with first‐ever hemispheric ischaemic stroke within eight days after symptoms onset and nine of them at least three months after stroke. Sleep EEG was recorded with a portable system. Cognitive functions were assessed using a standardized battery of tests allowing the estimation of the most relevant domains of cognition. Five age‐matched healthy subjects served as controls. Results: The patients were aged 43 ± 12 years (18–59). In five patients stroke was right‐sided and in six patients left‐sided. In the acute stroke phase a correlation between attention and amounts of slow wave sleep (SWS), Rapid eye movement (REM) sleep and sleep efficiency was found. In the recovery phase verbal/figural memory and attention significantly improved in most patients. Furthermore, an association between (i) verbal/figural (non‐verbal) memory and amounts of SWS, REM sleep and sleep efficiency, and between (ii) attention and sleep efficiency was observed. Conclusions: The results point to a link between sleep and cognitive functions and their recovery after hemispheric stroke. Further studies are needed to determine the specific nature of this link.

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“…Dans les années 1960, on considérait déjà les patterns d'EEG ressemblant au sommeil comme des marqueurs pronostiques favorables chez les patients cérébrolésés [10,11] et il a ensuite été montré que le sommeil tend à s'améliorer pendant la rééducation, tout comme le rétablissement du fonctionnement cognitif [12]. Depuis, quelques études ont soutenu que les fuseaux et le sommeil paradoxal sont prédictifs d'une évolution clinique positive pouvant même atteindre la récupération complète [13,14]. Au contraire, les patients ne montrant aucun stade de sommeil standards sont associés à mauvais pronostique pouvant aller jusqu'à la mort.…”

Section: Comaunclassified

Le sommeil chez les patients en état de conscience altérée

Cologan¹

2011

Coma Et États De Conscience Altérée

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Sleep organization pattern as a prognostic marker at the subacute stage of post-traumatic coma

Cited by 103 publications

References 14 publications

Sleep in the Unresponsive Wakefulness Syndrome and Minimally Conscious State

Sleep in the Unresponsive Wakefulness Syndrome and Minimally Conscious State

Correlation between sleep and cognitive functions after hemispheric ischaemic stroke

Le sommeil chez les patients en état de conscience altérée

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