Article (Scientific journals)
Sleep in patients with disorders of consciousness characterized by means of machine learning
Wielek, Tomasz; Lechinger, Julia; Wislowska, Malgorzata et al.
2018In PLoS ONE, 13 (1), p. 0190458
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Keywords :
Disorders of consciousness; REM sleep
Abstract :
[en] Sleep has been proposed to indicate preserved residual brain functioning in patients suffering from disorders of consciousness (DOC) after awakening from coma. However, a reliable characterization of sleep patterns in this clinical population continues to be challenging given severely altered brain oscillations, frequent and extended artifacts in clinical recordings and the absence of established staging criteria. In the present study, we try to address these issues and investigate the usefulness of a multivariate machine learning technique based on permutation entropy, a complexity measure. Specifically, we used long-term poly-somnography (PSG), along with video recordings in day and night periods in a sample of 23 DOC; 12 patients were diagnosed as Unresponsive Wakefulness Syndrome (UWS) and 11 were diagnosed as Minimally Conscious State (MCS). Eight hour PSG recordings of healthy sleepers (N = 26) were additionally used for training and setting parameters of supervised and unsupervised model, respectively. In DOC, the supervised classification (wake, N1, N2, N3 or REM) was validated using simultaneous videos which identified periods with prolonged eye opening or eye closure.The supervised classification revealed that out of the 23 subjects, 11 patients (5 MCS and 6 UWS) yielded highly accurate classification with an average F1-score of 0.87 representing high overlap between the classifier predicting sleep (i.e. one of the 4 sleep stages) and closed eyes. Furthermore, the unsupervised approach revealed a more complex pattern of sleep-wake stages during the night period in the MCS group, as evidenced by the presence of several distinct clusters. In contrast, in UWS patients no such clustering was found. Altogether, we present a novel data-driven method, based on machine learning that can be used to gain new and unambiguous insights into sleep organization and residual brain functioning of patients with DOC.
Disciplines :
Neurosciences & behavior
Author, co-author :
Wielek, Tomasz;  Laboratory for Sleep, Cognition and Consciousness, Centre for Cognitive Neuroscience (CCNS), University of Salzburg, Salzburg, Austria
Lechinger, Julia;  Laboratory for Sleep, Cognition and Consciousness, Centre for Cognitive Neuroscience (CCNS), University of Salzburg, Salzburg, Austria
Wislowska, Malgorzata;  Laboratory for Sleep, Cognition and Consciousness, Centre for Cognitive Neuroscience (CCNS), University of Salzburg, Salzburg, Austria
Blume, Christine;  Laboratory for Sleep, Cognition and Consciousness, Centre for Cognitive Neuroscience (CCNS), University of Salzburg, Salzburg, Austria
Ott, Peter;  ITS Informationstechnik and System-Management, Salzburg University of Applied Sciences, Salzburg, Austria
Wegenkittl, Stefan;  ITS Informationstechnik and System-Management, Salzburg University of Applied Sciences, Salzburg, Austria
Del Giudice, Renata;  Laboratory for Sleep, Cognition and Consciousness, Centre for Cognitive Neuroscience (CCNS), University of Salzburg, Salzburg, Austria
Heib, Dominik P. J.;  Laboratory for Sleep, Cognition and Consciousness, Centre for Cognitive Neuroscience (CCNS), University of Salzburg, Salzburg, Austria
Mayer, Helmut A.;  Department of Computer Sciences, University of Salzburg, Salzburg, Austria
Laureys, Steven  ;  Université de Liège - ULiège > GIGA : Coma Group
Pichler, Gerald;  Apallic Care Unit, Neurological Division, Albert Schweitzer Hospital Graz, Graz, Austria
Schabus, Manuel;  Laboratory for Sleep, Cognition and Consciousness, Centre for Cognitive Neuroscience (CCNS), University of Salzburg, Salzburg, Austria
Language :
English
Title :
Sleep in patients with disorders of consciousness characterized by means of machine learning
Publication date :
2018
Journal title :
PLoS ONE
eISSN :
1932-6203
Publisher :
Public Library of Science
Volume :
13
Issue :
1
Pages :
e0190458
Peer reviewed :
Peer Reviewed verified by ORBi
Available on ORBi :
since 29 April 2020

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