ORBi: Cologan Victor - Sleep in the unresponsive wakefulness syndrome and minimally conscious state

Reference : Sleep in the unresponsive wakefulness syndrome and minimally conscious state


	Document type :	Scientific journals : Article
	Discipline(s) :	Human health sciences : Neurology
	To cite this reference:	http://hdl.handle.net/2268/132759

Title :	Sleep in the unresponsive wakefulness syndrome and minimally conscious state
Language :	English
Alternative title :	[fr] Le sommeil dans le syndrome d'éveil non répondant et l'état de conscience minimale
Author, co-author :	Cologan, Victor [Université de Liège - ULg > > > Accès au site http://www.coma.ulg.ac.be/data]
	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 - ULg > > Centre de recherches du cyclotron >]
Publication date :	Mar-2013
Journal title :	Journal of Neurotrauma
Publisher :	Mary Ann Liebert, Inc.
Volume :	30
Issue/season :	5
Pages :	339-346
Audience :	International
ISSN :	0897-7151
City :	Larchmont
Country :	NY
Keywords :	[en] 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 units :	Centre de Recherches du Cyclotron - CRC
Funders :	Fonds pour la formation à la Recherche dans l'Industrie et dans l'Agriculture (Communauté française de Belgique) - FRIA
Name of the research project :	Le sommeil chez les patients en état de conscience altéré
Target :	Researchers ; Professionals ; Students ; General public
Permalink :	http://hdl.handle.net/2268/132759
DOI :	10.1089/neu.2012.2654
Commentary :	This is the first study of sleep in brain-injured patients based on 24H polysomnography and multicentric data analysis.

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