Sleep/Wake Modulation of Polysomnographic Patterns has Prognostic Value in Pediatric Unresponsive Wakefulness Syndrome

Molteni, Erika; Avantaggiato, Paolo; Formica, Francesca; Pastore, Valentina; Colombo, Katia; Galbiati, Sara; Arrigoni, Filippo; Strazzer, Sandra

doi:10.5664/jcsm.6052

Cited by 11 publications

(22 citation statements)

References 45 publications

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“…Up to now, there are several automated systems applicable to sleep staging in physiological or mild pathological conditions, but they are often difficult to apply to the disrupted sleep patterns occurring in DOC patients. A suitable consensus on the inspective procedure that homogeneously quantifies and characterizes different sleep stages, based on polygraphic patterns is fundamental in setting-up “targeted” quantitative automatic methods, as proposed by Molteni et al ( 42 ), and needs to be developed and applied more consistently.…”

Section: Discussionmentioning

confidence: 99%

EEG Assessment in Patients With Disorders of Consciousness: Aims, Advantages, Limits, and Pitfalls

et al. 2021

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This study presents a brief review of literature exploring simple EEG-polygraphic examinations and procedures that can be carried out at a patient's bedside. These include EEG with a common electrode array and sleep evaluation. The review briefly discusses more complex analytical techniques, such as the application of advanced EEG signal processing methods developed by our research group, to define what type of consistent markers are suitable for clinical use or to better understand complex patient conditions. These advanced analytical techniques aim to detect relevant EEG-based markers that could be useful in evaluating patients and predicting outcomes. These data could contribute to future developments in research.

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Section: Discussionmentioning

confidence: 99%

EEG Assessment in Patients With Disorders of Consciousness: Aims, Advantages, Limits, and Pitfalls

et al. 2021

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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%

“…8 In DOC patients sleep phases are morphed or absent due to acquired brain damages, which does not allow for a direct application of staging. 9 Therefore, arbitrary scales has been proposed, to grade DOC sleep architecture based on visual inspection of recordings. 9,10 Unfortunately, there is no standard procedure in this field and current approaches are incoherent, which precludes the comparisons of results between different studies and does not lead toward a standard, clinically applicable procedure.…”

Section: Doc and Sleepmentioning

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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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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“…Electroencefalografía (EEG) y estudios polisomnográficos (PSG). El EEG en reposo ayuda al diagnóstico y pronóstico de los trastornos de conciencia considerando que la reorganización de los ritmos posteriores y presencia de elementos de sueño están asociados a un pronóstico favorable 48 . Avantaggiato et al 49 , en un primer trabajo de PSG en un grupo de niños y adolescentes con TPC, reafirma la relevancia de los husos de sueño como marcadores pronósticos para mejoras de conciencia desde EV/EVSR a ECM (cuyo patrón de base es similar a un paciente sano) y agrega que mientras más alto es el nivel de complejidad en la señal PSG, habrá mejor resultado funcional.…”

Section: Exámenes Paraclínicos Para Evaluar Pacientes Con Compromiso unclassified

Trastornos prolongados de conciencia en pediatría, una mirada actual

et al. 2021

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Los niños que permanecen con un Trastorno Prolongado de Conciencia (TPC) presentan un complejo desafío clínico, ético y legal para médicos y cuidadores. Se define TPC cualquier trastorno de la conciencia que continúa durante al menos 4 semanas después de una lesión cerebral de aparición repentina. El TPC incluye las subcategorías de estado vegetativo/estado de vigilia sin respuesta (EV/ SVSR) y el estado de mínima conciencia (ECM). Los niños con TPC carecen de capacidad para tomar decisiones respecto a su cuidado y tratamiento, las que deben tomarse sobre la base de sus mejores beneficios. Estos beneficios pueden variar de paciente a paciente, entre médicos, familia y público general llevando a conflictos, en sus esfuerzos respectivos para hacer lo que creen correcto para el paciente. El diagnóstico se basa en evaluaciones clínicas que por sí solas, tienen hasta un 45% de errores, por lo que deben complementarse con guías clínicas estandarizadas y en ocasiones estudios paraclínicos. Otro aspecto que dificulta la evaluación son las redenominaciones, definiciones y subcategorizaciones cambiantes de los TPC, que en algunos casos varían entre diferentes estudios a nivel internacional. El objetivo de esta revisión es presentar una puesta al día de los diferentes TPC, su definición, subcategorización, etiología, pronóstico, evaluación integral y manejo en Pediatría y contribuir a la mejor práctica clínica en base a la evidencia actual disponible.

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Sleep/Wake Modulation of Polysomnographic Patterns has Prognostic Value in Pediatric Unresponsive Wakefulness Syndrome

Abstract: The differential measure of electroencephalographic activity during sleep and wake in the beta band and, more incisively, SPPUWS can help in determining the capability to recover from pediatric UWS well before the confirmation provided by suitable clinical scales.

Cited by 11 publications

References 45 publications

EEG Assessment in Patients With Disorders of Consciousness: Aims, Advantages, Limits, and Pitfalls

EEG Assessment in Patients With Disorders of Consciousness: Aims, Advantages, Limits, and Pitfalls

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

Trastornos prolongados de conciencia en pediatría, una mirada actual

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