Polysomnographic and quantitative EEG analysis of subjects with long-term insomnia complaints associated with mild traumatic brain injury.
ABSTRACT The aims of this study were (1) to characterise the extent and nature of disrupted sleep in individuals with long-term sleep complaints subsequent to mild traumatic brain injury (MTBI), and (2) to determine whether sleep disturbances in MTBI subjects were more characteristic of psychophysiological, psychiatric, or idiopathic insomnia.
Nine MTBI patients (27.8 months post-injury; SD=15.5 months) and nine control subjects underwent polysomnographic testing and completed self-report questionnaires on sleep quality. Power spectral (FFT) analysis of the sleep onset period was conducted, with both the power and variability in power being quantified.
Individuals with MTBI exhibited long-term sleep difficulties, along with various cognitive and affective abnormalities. The MTBI group had 4% less efficient sleep (p=0.019), shorter REM onset latencies (p=0.011), and longer sleep onset latencies, although the latter were highly variable in the MTBI group (F-test: p=0.012). FFT analysis revealed greater intra-subject variability in the MTBI group in sigma, theta, and delta power during the sleep onset period.
MTBI patients with persistent sleep complaints differ significantly from controls on a number of electrophysiological outcomes, but could not be easily classified into existing insomnia subtypes.
Sleep disturbances can persist well after the injury in a subset of patients with MTBI.
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ABSTRACT: Chronic pain is a highly prevalent post-concussion symptom occurring in a majority of mild traumatic brain injury (mTBI) patients. About half of mTBI patients report sleep-wake disturbances. It is known that pain can alter sleep quality in this population, but the interaction between pain and sleep is not fully understood. This study aimed to identify how pain affects subjective sleep (Pittsburgh Sleep Quality Index PSQI), sleep architecture, and quantitative electroencephalographic (qEEG) brain activity following mTBI. Twenty-four mTBI patients complaining of sleep-wake disturbances, with and without pain (8 and 16, respectively), were prospectively recruited 45 (±22.7) days post-trauma on average. Data were compared with those of 18 healthy controls (no sleep or pain complaints). The PSQI, sleep architecture, and qEEG activity were analyzed. Pain was assessed using questionnaires and a 100-mm Visual Analogue Scale (VAS). mTBI patients reported three times poorer sleep quality than controls on the PSQI. Sleep architecture significantly differed between mTBI patients and controls, but was within normal range. Global qEEG showed lower delta (deep sleep) and higher beta and gamma power (arousal) at certain EEG derivations in mTBI patients compared to controls (p<0.04). However, mTBI patients with pain showed greater increase in rapid EEG frequency bands, mostly during REM sleep, and beta bands in non-REM sleep compared to mTBI patients without pain and controls (p<0.001). Pain in mTBI patients was associated with more rapid qEEG activity, mostly during REM sleep, suggesting that pain is associated with poor sleep and is a critical factor in managing post-concussion symptoms.Journal of neurotrauma 03/2013; DOI:10.1089/neu.2012.2519 · 3.97 Impact Factor
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ABSTRACT: Recent studies show the possibility of using amorphous materials as current sensors. In this paper, the magnetoresistance effect existing in multilayer (Co<sub>50</sub>Ni<sub>25</sub>)<sub>10</sub> structures has been used to develop a current sensor susceptible to be fully integrated. Experimental results have been obtained to compare the properties of the anisotropic magnetoresistance effect (AMR) with commercial onesApplied Power Electronics Conference and Exposition, 1998. APEC '98. Conference Proceedings 1998., Thirteenth Annual; 03/1998
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ABSTRACT: The neurobehavioral sequelae of traumatic brain injury consist of a spectrum of somatic and neuropsychiatric symptoms. The neuropsychiatric symptoms are divided into cognitive and behavioral presentations. In the literature, these neurobehavioral sequelae have been called postconcussive symptoms, postconcussive syndrome, and postconcussive disorder; however, the authors of this review do not use this terminology because the symptoms are not restricted to patients with concussion but instead can be found in all traumatic brain injury patients of all injury severities. The development of neurobehavioral sequelae after traumatic brain injury is a multifactorial process. The patient evaluation requires a multidisciplinary approach in order to delineate physiologic dysfunction and place deficits in the context of the patient's preinjury and postinjury psychiatric status. Consequently, the evaluation of the posttraumatic brain injury patient with neurobehavioral sequelae requires a carefully structured history and physical examination with an emphasis on neurological and psychiatric function. Adjunctive evaluations must be tailored to the patient with neuroimaging, neurophysiological, and neuropsychiatric testing. Maximized outcomes may be achieved by the performance of a careful and detailed assessment that places complaints within the context of the individual.Mount Sinai Journal of Medicine A Journal of Translational and Personalized Medicine 04/2009; 76(2):163-72. DOI:10.1002/msj.20097 · 1.56 Impact Factor