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Significance of circadian rhythms in severely brain-injured patients. A clue to consciousness?

Blume, C, Lechinger, J, Santhi, Nayantara, del Giudice, R, Gnjezda, M-T, Pichler, G, Scarpatetti, M, Donis, J, Michitsch, G and Schabus, M (2017) Significance of circadian rhythms in severely brain-injured patients. A clue to consciousness? Neurology, 88 (20). pp. 1933-1941.

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Abstract

Objective: To investigate the relationship between the presence of a circadian body temperature rhythm and behaviourally assessed consciousness levels in patients with disorders of consciousness (DOC, i.e. vegetative state/unresponsive wakefulness syndrome [VS/UWS] or minimally conscious state [MCS]). Methods: In a cross-sectional study, we investigated the presence of circadian temperature rhythms across six to seven days using external skin temperature sensors in 18 patients suffering from DOC. Beyond this; we examined the relationship between behaviourally assessed consciousness levels and circadian rhythmicity. Results: Interestingly, analyses with Lomb-Scargle periodograms revealed significant circadian rhythmicity in all patients (range 23.5-26.3h). We found that especially scores on the arousal subscale of the Coma Recovery Scale-Revised (CRS-R) were closely linked to the integrity of circadian variations in body temperature. Finally, we piloted whether bright light stimulation could boost circadian rhythmicity and found positive evidence in two out of eight patients. Conclusion: In conclusion, the study provides first evidence for an association between circadian body temperature rhythms and arousal as a necessary precondition for consciousness. Thereby, our findings also make a case for circadian rhythms as a target for treatment as well as the application of diagnostic and therapeutic means at times when cognitive performance is expected to peak.

Item Type: Article
Subjects : Biosciences and Medicine
Divisions : Faculty of Health and Medical Sciences > School of Biosciences and Medicine
Authors :
NameEmailORCID
Blume, CUNSPECIFIEDUNSPECIFIED
Lechinger, JUNSPECIFIEDUNSPECIFIED
Santhi, NayantaraN.Santhi@surrey.ac.ukUNSPECIFIED
del Giudice, RUNSPECIFIEDUNSPECIFIED
Gnjezda, M-TUNSPECIFIEDUNSPECIFIED
Pichler, GUNSPECIFIEDUNSPECIFIED
Scarpatetti, MUNSPECIFIEDUNSPECIFIED
Donis, JUNSPECIFIEDUNSPECIFIED
Michitsch, GUNSPECIFIEDUNSPECIFIED
Schabus, MUNSPECIFIEDUNSPECIFIED
Date : 19 April 2017
Identification Number : 10.​1212/​WNL.​0000000000003942
Copyright Disclaimer : Copyright © 2017 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the American Academy of Neurology. This is an open access article distributed under the terms of the Creative Commons Attribution License 4.0 (CC BY), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Related URLs :
Depositing User : Symplectic Elements
Date Deposited : 07 Mar 2017 16:19
Last Modified : 05 Jul 2017 11:32
URI: http://epubs.surrey.ac.uk/id/eprint/813705

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