Polysomnographic Sleep Patterns in Children and Adolescents in Unresponsive Wakefulness Syndrome

Avantaggiato, Paolo; Molteni, Erika; Formica, Francesca; Gigli, Gian Luigi; Valente, Mariarosaria; Lorenzut, Simone; Biase, Stefano de; Arcieri, Salvatore; Locatelli, Federica; Strazzer, Sandra

doi:10.1097/htr.0000000000000122

Cited by 25 publications

(44 citation statements)

References 46 publications

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“…Most of the studies in the field rely on a visual inspection of polysomnography recordings, which has severe limitation in terms of reproducibility and cost. 9,10,36,37 This paper proposes a fully parametric approach to both parametrization and quantification/classification, from the very beginning based explicitly on the classical EEG features known from visual analysis. Each stage of the procedure is a result of a carefully crafted bottom-up design, where at each step we strive to include as much a priori knowledge as possible:…”

Section: Discussionmentioning

confidence: 99%

“…2. or anti-epileptic drugs) can also be a potential confounding variable. 37 For example, medications of patient #08, diagnosed as MCS+ at the first assessment, who after few months regained full consciousness, included Baclofen (GABA derivative) and Sirdalud (tizanidine). This was the most likely cause of the sparsity (nearly absence) and very low amplitudes of sleep spindles, causing low score of his sleep profiles.…”

Section: Predicted Classmentioning

confidence: 99%

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Parametric Description of EEG Profiles for Assessment of Sleep Architecture in Disorders of Consciousness

Zieleniewska

Duszyk

Różański

et al. 2019

Int. J. Neur. Syst.

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We propose a fully parametric approach to the assessment of sleep architecture, based upon the classical electroencephalographic criteria, applicable also to the recordings of patients with disorders of consciousness (DOC). Sleep spindles and slow waves are automatically detected from the matching pursuit decomposition of overnight EEG recordings. Their evolution can be presented in the form of EEG profiles, yielding a continuous description of sleep architecture, compatible with the classical criteria used in sleep staging. We propose assessment of these EEG profiles by five parameters, which can be combined by a linear classifier, assessing the quality of sleep architecture. Proposed methodology is evaluated on 59 overnight EEG recordings from 19 patients from a hospital for children with severe brain damage, in relation to their behavioral diagnosis according to the Coma Recovery Scale-Revised. Presented results indicate robustness of the proposed approach, which may serve as a valuable aid in diagnosis of DOC patients. Complete software environment for computing and presentation of EEG profiles is freely available from http://svarog.pl .

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Section: Discussionmentioning

confidence: 99%

Section: Predicted Classmentioning

confidence: 99%

Parametric Description of EEG Profiles for Assessment of Sleep Architecture in Disorders of Consciousness

Zieleniewska

Duszyk

Różański

et al. 2019

Int. J. Neur. Syst.

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“…In patients with DOC the presence or absence of normal sleep features such as different sleep stages, sleep spindles and sleep slow waves has been associated with behavioural outcome and was hypothesized to reflect global functional brain integrity ( Avantaggiato et al, 2015 , Cheliout-Heraut et al, 2001 , Cologan et al, 2013 , de Biase et al, 2014 , Landsness et al, 2011 , Malinowska et al, 2013 , Rossi Sebastiano et al, 2015 ). More specifically, sleep spindles and sleep slow waves are known to involve thalamocortical and corticocortical circuits (e.g., Riedner et al, 2011 , Schabus et al, 2007 ) and thus, might be suitable markers for preserved thalamocortical and frontoparietal connectivity, which in turn has been related to consciousness ( Laureys and Schiff, 2012 ).…”

Section: Introductionmentioning

confidence: 99%

“…While, in recent years, many complementary neurophysiological methods for the assessment of DOC have been investigated in adults, very few have been applied to children. In fact, the only studies reporting more than single cases, investigated the presence or absence of sleep stages and sleep spindles in children with DOC ( Avantaggiato et al, 2015 , Cheliout-Heraut et al, 2001 ). Compared to adult patients, paediatric patients hold the additional difficulty that differences in brain activity result not only from brain injury but also depend on brain maturation.…”

Section: Introductionmentioning

confidence: 99%

High-density electroencephalographic recordings during sleep in children with disorders of consciousness

Mouthon

Hedel

Meyer-Heim

et al. 2016

NeuroImage: Clinical

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IntroductionA large number of studies have investigated neural correlates of consciousness in adults. However, knowledge about brain function in children with disorders of consciousness (DOC) is very limited. We suggest that EEG recordings during sleep are a promising approach. In healthy adults as well as in children, it has been shown that the activity of sleep slow waves (EEG spectral power 1–4.5 Hz), the primary characteristic of deep sleep, is dependent on use during previous wakefulness. Thus the regulation of slow wave activity (SWA) provides indirect insights into brain function during wakefulness.MethodsIn the present study, we investigated high-density EEG recordings during sleep in ten healthy children and in ten children with acquired brain injury, including five children with DOC and five children with acquired brain injury without DOC. We used the build-up of SWA to quantify SWA regulation.ResultsChildren with DOC showed a global reduction in the SWA build-up when compared to both, healthy children and children with acquired brain injury without DOC. This reduction was most pronounced over parietal brain areas. Comparisons within the group of children with DOC revealed that the parietal SWA build-up was the lowest in patients showing poor outcome. Longitudinal measurements during the recovery period showed an increase in parietal SWA build-up from the first to the second sleep recording.ConclusionsOur results suggest that the reduced parietal SWA regulation may represent a characteristic topographical marker for brain network dysfunction in children with DOC. In the future, the regulation of SWA might be used as a complementary assessment in adult and paediatric patients with DOC.

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“…from current literature on clinical and instrumental measures for diagnosis and prognosis of patients with DoC. (4,13,14) Questions about respondents' profession, country, institutional setting (i.e. post-acute rehabilitation, chronic facilities or nursing home), and age of admitted patients were included in the first section of the survey.…”

Section: Survey Questionnairementioning

confidence: 99%

International survey on diagnostic and prognostic procedures in pediatric disorders of consciousness

et al. 2019

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Polysomnographic Sleep Patterns in Children and Adolescents in Unresponsive Wakefulness Syndrome

Abstract: Polysomnography can be used as a prognostic tool, as it can help determine the capability to recover from a pediatric UWS and predict outcome well before the confirmation provided by suitable clinical scales.

Cited by 25 publications

References 46 publications

Parametric Description of EEG Profiles for Assessment of Sleep Architecture in Disorders of Consciousness

Parametric Description of EEG Profiles for Assessment of Sleep Architecture in Disorders of Consciousness

High-density electroencephalographic recordings during sleep in children with disorders of consciousness

International survey on diagnostic and prognostic procedures in pediatric disorders of consciousness

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