Twenty-four-hour rhythmicities in disorders of consciousness are associated with a favourable outcome.

Autor: Gobert F; Neuro-Intensive care unit, Hospices Civils de Lyon, Neurological hospital Pierre-Wertheimer, 59 Boulevard Pinel, Bron, France. florent.gobert01@chu-lyon.fr.; Trajectoires Team, Lyon Neuroscience Research Centre (Université Claude Bernard Lyon 1, INSERM U1028, CNRS UMR5292), Bâtiment Inserm 16 avenue Doyen Lépine, Bron, France. florent.gobert01@chu-lyon.fr.; CAP Team (Cognition Auditive et Psychoacoustique), Lyon Neuroscience Research Centre (Université Claude Bernard Lyon 1, INSERM U1028, CNRS UMR5292), 95 boulevard Pinel, Bron, France. florent.gobert01@chu-lyon.fr., Corneyllie A; CAP Team (Cognition Auditive et Psychoacoustique), Lyon Neuroscience Research Centre (Université Claude Bernard Lyon 1, INSERM U1028, CNRS UMR5292), 95 boulevard Pinel, Bron, France., Bastuji H; Sleep medicine centre, Hospices Civils de Lyon, Bron, F-69677, France.; Neuropain Team, Lyon Neuroscience Research Centre (Université Claude Bernard Lyon 1, INSERM U1028, CNRS UMR5292), 59 Boulevard Pinel, Bron, France., Berthomier C; PHYSIP SA, Paris, France., Thevenet M; CAP Team (Cognition Auditive et Psychoacoustique), Lyon Neuroscience Research Centre (Université Claude Bernard Lyon 1, INSERM U1028, CNRS UMR5292), 95 boulevard Pinel, Bron, France., Abernot J; CAP Team (Cognition Auditive et Psychoacoustique), Lyon Neuroscience Research Centre (Université Claude Bernard Lyon 1, INSERM U1028, CNRS UMR5292), 95 boulevard Pinel, Bron, France., Raverot V; Hormone Laboratory, Hospices Civils de Lyon, Neurological hospital Pierre-Wertheimer, 59 Boulevard Pinel, Bron, France., Dailler F; Neuro-Intensive care unit, Hospices Civils de Lyon, Neurological hospital Pierre-Wertheimer, 59 Boulevard Pinel, Bron, France., Guérin C; Intensive care unit, Hospices Civils de Lyon, Croix-Rousse hospital, 103 Grande-Rue de la Croix-Rousse, Lyon, France.; Intensive care unit, Hospices Civils de Lyon, Édouard Herriot hospital, 5 Place d'Arsonval, 69003, Lyon, France., Gronfier C; Waking team (Integrative Physiology of the Brain Arousal Systems), Lyon Neuroscience Research Centre, INSERM UMRS 1028, CNRS UMR 5292, Université Claude Bernard Lyon 1, Université de Lyon, Lyon, France., Luauté J; Trajectoires Team, Lyon Neuroscience Research Centre (Université Claude Bernard Lyon 1, INSERM U1028, CNRS UMR5292), Bâtiment Inserm 16 avenue Doyen Lépine, Bron, France.; Neuro-rehabilitation unit, Hospices Civils de Lyon, Neurological hospital Pierre-Wertheimer, 59 Boulevard Pinel, Bron, France., Perrin F; CAP Team (Cognition Auditive et Psychoacoustique), Lyon Neuroscience Research Centre (Université Claude Bernard Lyon 1, INSERM U1028, CNRS UMR5292), 95 boulevard Pinel, Bron, France.
Jazyk: angličtina
Zdroj: Communications biology [Commun Biol] 2023 Nov 29; Vol. 6 (1), pp. 1213. Date of Electronic Publication: 2023 Nov 29.
DOI: 10.1038/s42003-023-05588-2
Abstrakt: Fluctuations of consciousness and their rhythmicities have been rarely studied in patients with a disorder of consciousness after acute brain injuries. 24-h assessment of brain (EEG), behaviour (eye-opening), and circadian (clock-controlled hormones secretion from urine) functions was performed in acute brain-injured patients. The distribution, long-term predictability, and rhythmicity (circadian/ultradian) of various EEG features were compared with the initial clinical status, the functional outcome, and the circadian rhythmicities of behaviour and clock-controlled hormones. Here we show that more physiological and favourable patterns of fluctuations are associated with a higher 24 h predictability and sharp up-and-down shape of EEG switches, reminiscent of the Flip-Flop model of sleep. Multimodal rhythmic analysis shows that patients with simultaneous circadian rhythmicity for brain, behaviour, and hormones had a favourable outcome. Finally, both re-emerging EEG fluctuations and homogeneous 24-h cycles for EEG, eye-opening, and hormones appeared as surrogates for preserved functionality in brainstem and basal forebrain, which are key prognostic factors for later improvement. While the recovery of consciousness has previously been related to a high short-term complexity, we suggest in this exploratory study the importance of the high predictability of the 24 h long-term generation of brain rhythms and highlight the importance of circadian body-brain rhythms in awakening.
(© 2023. The Author(s).)
Databáze: MEDLINE
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