TY - JOUR
T1 - The prognostic value of sleep patterns in disorders of consciousness in the sub-acute phase
AU - Arnaldi, Dario
AU - Terzaghi, Michele
AU - Cremascoli, Riccardo
AU - De Carli, Fabrizio
AU - Maggioni, Giorgio
AU - Pistarini, Caterina
AU - Nobili, Flavio
AU - Moglia, Arrigo
AU - Manni, Raffaele
PY - 2016/2/1
Y1 - 2016/2/1
N2 - Objective: This study aimed to evaluate, through polysomnographic analysis, the prognostic value of sleep patterns, compared to other prognostic factors, in patients with disorders of consciousness (DOCs) in the sub-acute phase. Methods: Twenty-seven patients underwent 24-polysomnography and clinical evaluation 3.5 ± 2 months after brain injury. Their clinical outcome was assessed 18.5 ± 9.9 months later. Polysomnographic recordings were evaluated using visual and quantitative indexes. A general linear model was applied to identify features able to predict clinical outcome. Clinical status at follow-up was analysed as a function of the baseline clinical status, the interval between brain injury and follow-up evaluation, patient age and gender, the aetiology of the injury, the lesion site, and visual and quantitative sleep indexes. Results: A better clinical outcome was predicted by a visual index indicating the presence of sleep integrity (p = 0.0006), a better baseline clinical status (p = 0.014), and younger age (p = 0.031). Addition of the quantitative sleep index strengthened the prediction. Conclusions: More structured sleep emerged as a valuable predictor of a positive clinical outcome in sub-acute DOC patients, even stronger than established predictors (e.g. age and baseline clinical condition). Significance: Both visual and quantitative sleep evaluation could be helpful in predicting clinical outcome in sub-acute DOCs.
AB - Objective: This study aimed to evaluate, through polysomnographic analysis, the prognostic value of sleep patterns, compared to other prognostic factors, in patients with disorders of consciousness (DOCs) in the sub-acute phase. Methods: Twenty-seven patients underwent 24-polysomnography and clinical evaluation 3.5 ± 2 months after brain injury. Their clinical outcome was assessed 18.5 ± 9.9 months later. Polysomnographic recordings were evaluated using visual and quantitative indexes. A general linear model was applied to identify features able to predict clinical outcome. Clinical status at follow-up was analysed as a function of the baseline clinical status, the interval between brain injury and follow-up evaluation, patient age and gender, the aetiology of the injury, the lesion site, and visual and quantitative sleep indexes. Results: A better clinical outcome was predicted by a visual index indicating the presence of sleep integrity (p = 0.0006), a better baseline clinical status (p = 0.014), and younger age (p = 0.031). Addition of the quantitative sleep index strengthened the prediction. Conclusions: More structured sleep emerged as a valuable predictor of a positive clinical outcome in sub-acute DOC patients, even stronger than established predictors (e.g. age and baseline clinical condition). Significance: Both visual and quantitative sleep evaluation could be helpful in predicting clinical outcome in sub-acute DOCs.
KW - Coma
KW - EEG
KW - Minimally conscious state
KW - Sleep
KW - Vegetative state
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U2 - 10.1016/j.clinph.2015.10.042
DO - 10.1016/j.clinph.2015.10.042
M3 - Article
C2 - 26610323
AN - SCOPUS:84957940837
VL - 127
SP - 1445
EP - 1451
JO - Clinical Neurophysiology
JF - Clinical Neurophysiology
SN - 1388-2457
IS - 2
ER -