Fragmentation of Slow Wave Sleep after Onset of Complete Locked-In State
1Institute of Medical Psychology and Behavioral Neurobiology, Eberhard Karls University Tübingen, Germany; 2Applied Neurotechnology Lab, Department of Psychiatry and Psychotherapy, University Hospital of Tübingen, Germany; 3Ospedale San Camillo, IRCCS, Venezia, Italy; 4Computer Engineering Department, Wilhelm-Schickard Institute for Computer Science, Eberhard Karls University Tübingen, Germany; 5Department of Psychology I, University of Würzburg; 6Health Technologies Department, TECNALIA, San Sebastian, Spain; 7Department of Neurosurgery, University Hospital of Tübingen, Germany; 8Research Group Human Media Interaction (HMI), Department of Electrical Engineering, Mathematics and Computer Science, (EEMCS) University of Twente, Enschede; 9Empirical Inference Department, Max Planck Institute for Biological Cybernetics, Tübingen, Germany
Locked-in syndrome (LIS) as a result of brainstem lesions or progressive neurodegenerative disorders, such as amyotrophic lateral sclerosis (ALS), is a severe medical condition in which a person is fully conscious but unable to move or talk. LIS can transition into complete locked-in syndrome (CLIS) in which residual abilities to communicate through muscle twitches are entirely lost. It is unknown how CLIS affects circadian rhythm and sleep/wake patterns. Here we report a 39-year-old ALS patient who transitioned from LIS to CLIS while brain activity was continuously recorded using electrocorticography (ECoG) over one month. While we found no circadian rhythm in heart rate and body temperature, transition into CLIS was associated with increased fragmentation of slow wave sleep (SWS) across the day. Total time in SWS did not change. SWS fragmentation might reflect progressive circadian system impairment and should be considered as a factor further limiting communication capabilities in these patients.
Soekadar SR; Born J; Birbaumer N; Bensch M; Halder S; Murguialday AR; Gharabaghi A; Nijboer F; Schölkopf B; Martens S. Fragmentation of slow wave sleep after onset of complete locked-in state. J Clin Sleep Med 2013;9(9):951-953.
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