Sleep After Traumatic Brain Injury

Traumatic brain injury (TBI) is an important cause of death and disability at all ages in the world. Complete functional recovery is not always complete, and, often, persistent symptoms may last for a long time. Sleep disorders and sleep-wake alterations are among the most common complications both in the acute and chronic phases after the trauma, and they may have a negative impact on daily activities and on quality of life of these patients. Sleep and sleep-wake cycle are not always carefully assessed in patients after TBI, they are overlooked, and often patients have a persistent excessive daytime sleepiness, even for years after the TBI, without receiving a proper diagnosis and treatment. Moreover, scientific evidence has been provided for the role of sleep in neuroprotection and recovery after brain injury; hence, promoting an optimal sleep function and early diagnosing and treating sleep disorders may be helpful for rehabilitation and functional recovery of patients after TBI

Toward higher-performance bionic limbs for wider clinical use

Funding Information: We were supported by the Academy of Finland (I.V.), Austrian Federal Ministry of Science (A.S. and O.C.A.), Bertarelli Foundation (S.M.), the European Union (A.S., D.F., K.-P.H., O.C.A., R.B. and S.M.), the European Research Council (A.S., D.F. and O.C.A.), German Federal Ministry of Education and Research BMBF (K.-P.H. and T.S.), the German National Research Foundation (T.S.), the Royal British Legion (A.M.J.B.), the Swedish Innovation Agency (VINNOVA) (R.B.), the Swedish Research Council (R.B.), the Swiss National Competence Center in Research (NCCR) in Robotics (S.M.), US Department of Defense (R.B. and H.H.), US Department of Veterans Affairs (D.T.), US Department of Veterans Affairs Rehabilitation Research and Development Service (R.F.ff.W.), US National Institute on Disability, Independent Living and Rehabilitation Research (H.H. and T.K.), US National Institutes of Health (D.T., H.H., L.J.H. and R.F.ff.W.), US National Institute on Neurological Disorders and Stroke (R.F.ff.W.), USNational Institute on Bioimaging and Bioengineering (R.F.ff.W.) and US National Science Foundation (H.H.). Publisher Copyright: © 2021, Springer Nature Limited.Most prosthetic limbs can autonomously move with dexterity, yet they are not perceived by the user as belonging to their own body. Robotic limbs can convey information about the environment with higher precision than biological limbs, but their actual performance is substantially limited by current technologies for the interfacing of the robotic devices with the body and for transferring motor and sensory information bidirectionally between the prosthesis and the user. In this Perspective, we argue that direct skeletal attachment of bionic devices via osseointegration, the amplification of neural signals by targeted muscle innervation, improved prosthesis control via implanted muscle sensors and advanced algorithms, and the provision of sensory feedback by means of electrodes implanted in peripheral nerves, should all be leveraged towards the creation of a new generation of high-performance bionic limbs. These technologies have been clinically tested in humans, and alongside mechanical redesigns and adequate rehabilitation training should facilitate the wider clinical use of bionic limbs.Peer reviewe