Twenty-four-hour rhythmicities in disorders of consciousness are associated with a favourable outcome - Équipe NeuroPain du CRNL : Intégration Centrale de la Douleur chez l'Homme
Article Dans Une Revue Communications Biology Année : 2023

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

Christian Berthomier
  • Fonction : Auteur

Résumé

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.
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Dates et versions

hal-04692059 , version 1 (09-09-2024)

Identifiants

Citer

Florent Gobert, Alexandra Corneyllie, Hélène Bastuji, Christian Berthomier, Marc Thevenet, et al.. Twenty-four-hour rhythmicities in disorders of consciousness are associated with a favourable outcome. Communications Biology, 2023, 6 (1), pp.1213. ⟨10.1038/s42003-023-05588-2⟩. ⟨hal-04692059⟩
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