1175 SLEEP-WAKE CYCLE AND EARLY NEUROLOGICAL RECOVERY AFTER MODERATE TO SEVERE TRAUMATIC BRAIN INJURY
Bibliographic record
Abstract
We recently demonstrated that the sleep-wake cycle is severely altered in the acute stage of moderate to severe traumatic brain injuries (TBI). In general, these patients have short sleep and wake bouts dispersed over the 24 h. This study aimed to explore whether early markers of TBI severity predict acute sleep-wake cycle disturbances. Moreover, it aimed to verify the relationship between the sleep-wake cycle and the acute cognitive recovery. We included 37 non-sedated patients (age 30 ± 14 yo, 25 males) hospitalized for moderate to severe TBI. We used two severity markers that are available in the first hours following TBI, namely the initial Glasgow Coma Scale (GCS) score and the delay to recover the ability to sustain visual fixation. Once patients had reached medical stability, we used continuous actigraphy to document the sleep-wake cycle, and a consolidated sleep-wake cycle was defined by a daytime activity ratio > 80%. A short neuropsychological assessment was performed in a subsample of 13 patients. Correlation analyses were conducted between sleep-wake variables, TBI severity markers and performance on neuropsychological tests. Patients had a median GCS score of 7 (range 3–13) and spent 6 ± 6 days without visual fixation in the intensive care unit. Once patient had reached medical stability, they had 5 ± 4 days of non-consolidated sleep-wake cycle. The number of days without sleep-wake cycle consolidation correlated with the initial GCS score (ρ=0.35; p=0.04) and the delay before recovering visual fixation (r=0.45; p<0.01). Moreover, more altered sleep-wake cycle was associated with poorer performance on cognitive screening, episodic memory, language and logical reasoning tests carried before hospital discharge (r varying from -0.5 to -0.7, p<0.05, n=13). Our results support emerging evidence showing that early markers of TBI severity gathered in the first few hours after TBI can predict acute sleep-wake cycle alterations. The reappearance of consolidated sleep-wake cycle was associated with better cognitive recovery; still the directionality (or bidirectionality) of this relationship needs to be further investigated. The research was supported by the Canadian Institutes of Health Research (CIHR) and by the Fonds pour la recherche du Québec, Santé (FRQS)
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".