Article (Scientific journals)
Sleep in the unresponsive wakefulness syndrome and minimally conscious state
Cologan, Victor; Drouot, Xavier; Parapatics, Silvia et al.
2013In Journal of Neurotrauma, 30 (5), p. 339-346
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Keywords :
Consciousness; Unresponsive wakefulness syndrome; Minimally conscious state; Sleep; Trauma; Anoxia; Stroke; Brain injury; Electrophysiology
Abstract :
[en] 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). 24h polysomnography was performed in 20 patients in a UWS (n=10) or in a MCS (n=10) due to brain injury. The data were first tested for the presence of a sleep-wake cycle and the observed sleep patterns were compared to standard scoring criteria. Sleep spindles, slow waves 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 5 MCS and 3 VS/UWS patients. Sleep stages did not always match the standard scoring criteria which therefore needed to be adapted. Sleep spindles were more present in patients who clinically improved within 6 months. Slow wave sleep was present in 8 MCS and 3 VS/UWS patients but never in the ischemic etiology. Rapid eye movement sleep, and therefore dreaming which is a form of consciousness, was present in all MCS and 3 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.
Research Center/Unit :
GIGA CRC (Cyclotron Research Center) In vivo Imaging-Aging & Memory - ULiège
Disciplines :
Author, co-author :
Cologan, Victor ;  Université de Liège - ULiège > Accès au site
Drouot, Xavier;  Hôpital Henri Mondor, Paris, France > Neurologie > Centre du sommeil
Parapatics, Silvia;  Université médicale de Vienne > Psychiatrie et psychothérapie
Delorme, Arnaud;  Centre National de la Recherche Scientifique - CNRS > CERCO
Gruber, Georg;  Université médicale de Vienne, Autriche > Psychiatrie et psychothérapie
MOONEN, Gustave  ;  Centre Hospitalier Universitaire de Liège - CHU > Neurologie Sart Tilman
Laureys, Steven  ;  Université de Liège - ULiège > Centre de recherches du cyclotron
Language :
Title :
Sleep in the unresponsive wakefulness syndrome and minimally conscious state
Alternative titles :
[fr] Le sommeil dans le syndrome d'éveil non répondant et l'état de conscience minimale
Publication date :
March 2013
Journal title :
Journal of Neurotrauma
Publisher :
Mary Ann Liebert, Inc., Larchmont, United States - New York
Volume :
Issue :
Pages :
Peer reviewed :
Peer Reviewed verified by ORBi
Name of the research project :
Le sommeil chez les patients en état de conscience altéré
Funders :
FRIA - Fonds pour la Formation à la Recherche dans l'Industrie et dans l'Agriculture [BE]
Commentary :
This is the first study of sleep in brain-injured patients based on 24H polysomnography and multicentric data analysis.
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