Increased sleep need and daytime sleepiness 6 months after traumatic brain injury: a prospective controlled clinical trial

In a controlled, prospective, electrophysiological study, Imbach et al. demonstrate increased sleep need and excessive daytime sleepiness 6 months after traumatic brain injury. Sleep is more consolidated after brain trauma, and an increase in sleep need is associated with intracranial haemorrhage. Trauma patients underestimate their increased sleep need and sleepines

Practice walking on a treadmill-mounted balance beam modifies beam walking sacral movement and alters performance in other balance tasks.

The goals of this study were to determine if a single 30-minute session of practice walking on a treadmill mounted balance beam: 1) altered sacral marker movement kinematics during beam walking, and 2) affected measures of balance during treadmill walking and standing balance. Two groups of young, healthy human subjects practiced walking on a treadmill mounted balance beam for thirty minutes. One group trained with intermittent visual occlusions and the other group trained with unperturbed vision. We hypothesized that the subjects would show changes in sacrum movement kinematics after training and that there would be group differences due to larger improvements in beam walking performance by the visual occlusions group. We also investigated if there was any balance transfer from training on the beam to treadmill walking (margin of stability) and to standing static balance (center of pressure excursion). We found significant differences in sacral marker maximal velocity after training for both groups, but no significant differences between the two groups from training. There was limited evidence of balance transfer from beam-walking practice to gait margin of stability for treadmill walking and for single leg standing balance, but not for tandem stance balance. The number of step-offs while walking on a narrow beam had the largest change with training (partial η2 = 0.7), in accord with task specificity. Other balance metrics indicative of transfer had lower effect sizes (partial η2<0.5). Given the limited transfer across balance training tasks, future work should examine how intermittent visual occlusions during multi-task training improve real world functional outcomes

Effects of cable sway, electrode surface area, and electrode mass on Electroencephalography signal quality during motion

<div>The data was saved in .bdf format and was collected using the BioSemi ActiveTwo system with for 4 electrodes, 2 placed on the top of the head, 2 placed on the back of the head. Sampling rate was 512 Hz.</div><div><br></div><div>There are three datasets:</div><div>a) Electrode Mass Recordings </div><div>b) Electrode Surface Area Recordings </div><div>c) Cable Sway Recordings </div><div><br></div><div>Each dataset was recorded in 4 blocks, so each folder contains the 4 recording blocks with the motion frequency conditions tested. The electrode mass experiment also contains the different mass conditions tested.</div><div><br></div><div>Mass Conditions:</div><div>1 x Electrode Mass</div><div>2 x Electrode Mass</div><div>3 x Electrode Mass</div><div><br></div><div>Motion Frequency Conditions:</div><div>0 = Motors Off</div><div>0p0 = 0 Hz </div><div>1p0 = 1 Hz </div><div>1p2 = 1.25 Hz </div><div>1p5 = 1.5 Hz </div><div>1p75 = 1.75 Hz </div><div>2p0 = 2 Hz</div><div><br></div><div>-nosignal = with no signal from the head</div><div>-signal = with signal from the head</div

Increased sleep need and daytime sleepiness 6 months after traumatic brain injury: a prospective controlled clinical trial.

Post-traumatic sleep-wake disturbances are common after acute traumatic brain injury. Increased sleep need per 24 h and excessive daytime sleepiness are among the most prevalent post-traumatic sleep disorders and impair quality of life of trauma patients. Nevertheless, the relation between traumatic brain injury and sleep outcome, but also the link between post-traumatic sleep problems and clinical measures in the acute phase after traumatic brain injury has so far not been addressed in a controlled and prospective approach. We therefore performed a prospective controlled clinical study to examine (i) sleep-wake outcome after traumatic brain injury; and (ii) to screen for clinical and laboratory predictors of poor sleep-wake outcome after acute traumatic brain injury. Forty-two of 60 included patients with first-ever traumatic brain injury were available for follow-up examinations. Six months after trauma, the average sleep need per 24 h as assessed by actigraphy was markedly increased in patients as compared to controls (8.3 ± 1.1 h versus 7.1 ± 0.8 h, P < 0.0001). Objective daytime sleepiness was found in 57% of trauma patients and 19% of healthy subjects, and the average sleep latency in patients was reduced to 8.7 ± 4.6 min (12.1 ± 4.7 min in controls, P = 0.0009). Patients, but not controls, markedly underestimated both excessive sleep need and excessive daytime sleepiness when assessed only by subjective means, emphasizing the unreliability of self-assessment of increased sleep propensity in traumatic brain injury patients. At polysomnography, slow wave sleep after traumatic brain injury was more consolidated. The most important risk factor for developing increased sleep need after traumatic brain injury was the presence of an intracranial haemorrhage. In conclusion, we provide controlled and objective evidence for a direct relation between sleep-wake disturbances and traumatic brain injury, and for clinically significant underestimation of post-traumatic sleep-wake disturbances by trauma patients