Evaluation of circadence to predict the outcome of a vegetative state

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Abstract

Coma in a true sense of dreamlike state lasts no more than 3 weeks, after which it enters the vegetative stage of recovery of consciousness, except in those patients who died or regained conscious wakefulness. The number of registered cases of vegetative state reaches 100 per 1 million population (S.Ashwal et al., 1996). This category of patients remains terra incognita even for an interdisciplinary analysis of neurologists and emergency physicians. Meanwhile, the emotional and financial costs of care for this category of patients is the most significant. In search of prognostic criteria for selection of a vegetative state the authors applied to the analysis of one of the earliest in the phylogeny of the autonomic functions - sleep. Based on the hypothesis: no sleep recovery - there can be recovery of cognitive status, on the basis of the rehabilitation clinic of the Clinical Brain Institute in the period from 2008 to 2014 conducted polysomnographic study of 64 patients in a vegetative state, and 10 patients evaluated the dynamics of the concentration of melatonin in the blood during treatment. Preliminary results indicate a direct relationship between these modalities circadian status and outcome of a vegetative state.

About the authors

A. A Belkin

Clinical Institute of the Brain; Ural State Medical University of the Ministry of Health of the Russian Federation

Email: belkin@neuro-ural.ru
д-р мед. наук, проф. ФГБОУ ВО УГМУ, дир. АНО КИМ 623700, Russian Federation, Sverdlovsk region, Berezovskiy, ul. Shilovskaya, d. 28/6; 620028, Russian Federation, Yekaterinburg, ul. Repina, d. 3

E. V Alekseeva

Clinical Institute of the Brain

зав. сомнологической лаб. АНО КИМ 623700, Russian Federation, Sverdlovsk region, Berezovskiy, ul. Shilovskaya, d. 28/6

A. M Alasheev

Ural State Medical University of the Ministry of Health of the Russian Federation

канд. мед. наук, ассистент каф. анестезиологии и реаниматологии ФГБОУ ВО УГМУ 620028, Russian Federation, Yekaterinburg, ul. Repina, d. 3

N. S Davydova

Ural State Medical University of the Ministry of Health of the Russian Federation

д-р мед. наук, проф., зав. каф. анестезиологии и реаниматологии ФГБОУ ВО УГМУ 620028, Russian Federation, Yekaterinburg, ul. Repina, d. 3

I. N Leyderman

Clinical Institute of the Brain; Ural State Medical University of the Ministry of Health of the Russian Federation

д-р мед. наук, проф. ФГБОУ ВО УГМУ, зав. отд. реанимации АНО КИМ 623700, Russian Federation, Sverdlovsk region, Berezovskiy, ul. Shilovskaya, d. 28/6; 620028, Russian Federation, Yekaterinburg, ul. Repina, d. 3

P. N Nikov

Clinical Institute of the Brain

ст. лаб. сомнологической лаборатории АНО КИМ 623700, Russian Federation, Sverdlovsk region, Berezovskiy, ul. Shilovskaya, d. 28/6

E. A Pinchuk

Clinical Institute of the Brain

канд. мед. наук, врач-невролог АНО КИМ 623700, Russian Federation, Sverdlovsk region, Berezovskiy, ul. Shilovskaya, d. 28/6

T. Yu Safonova

Clinical Institute of the Brain

канд. мед. наук, врач-терапевт АНО КИМ 623700, Russian Federation, Sverdlovsk region, Berezovskiy, ul. Shilovskaya, d. 28/6

M. P Semyannikova

Clinical Institute of the Brain

врач-сомнолог АНО КИМ 623700, Russian Federation, Sverdlovsk region, Berezovskiy, ul. Shilovskaya, d. 28/6

E. G Fedorov

Clinical Institute of the Brain

ст. технолог нейрофизиологической лаб. АНО КИМ 623700, Russian Federation, Sverdlovsk region, Berezovskiy, ul. Shilovskaya, d. 28/6

V. A Belkin

Clinical Institute of the Brain

врач-невролог АНО КИМ 623700, Russian Federation, Sverdlovsk region, Berezovskiy, ul. Shilovskaya, d. 28/6

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