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1- Neuroscience Research Center, Guilan University of Medical Sciences, Rasht, Iran 2 Guilan Road Trauma Research Center, Guilan University of Medical Sciences, Rasht, Iran. 2 Guilan Road Trauma Research Center, Guilan University of Medical Sciences, Rasht, Iran
2- Neuroscience Research Center, Guilan University of Medical Sciences, Rasht, Iran 2 Guilan Road Trauma Research Center, Guilan University of Medical Sciences, Rasht, Iran. 2 Guilan Road Trauma Research Center, Guilan University of Medical Sciences, Rasht, Iran , sh.yousefzadeh@gmail.com
Abstract:   (31 Views)
Background & Aim: Here, the main objective is the determination of prognostic imaging and clinical markers of chronic posttraumatic sleep-wake disorders (PTSWDs) with an especial focus on the early cognitive and executive dysfunctions after TBI. The prevalence of post-traumatic psychiatric disorders (PTPDs) in the various sleep disorders is also investigated.
Methods & Materials/Patients: In a longitudinal assay, 165 qualified patients with blunt TBI were studied. Demographic, imaging and clinical characteristics were recorded. The presence of acute posttraumatic cognitive deficits and anxiety, depression and headache were measured by standard scales during discharge. Executive function was scored by the verbal fluency task. Several subjective questionnaires were applied to screen the chronic PTSWDs at 6 months after the onset of TBI. All variables were compared between patients or those with and without PTSWDs using appropriate statistical tests.
Results: Of 146 patients remaining in the follow-up study 35% manifested PTSWDs, with insomnia and Excessive Daytime Sleepiness (EDS) being the most common types. A poor executive function was observed in all PTSWDs patients as compared to those without PTSWDs, with only insomnia and hypersomnia patients demonstrating the acute depression. Hypersomnia was also significantly related to bilateral brain contusion. The insomnia mostly comorbid with fatigue was predicted by mild injury, cortical lesions in the frontal lobe and acute severe headache. However, the patients who experienced the brain stem and diffusion lesions of right hemisphere were prone to EDS that was mainly accompanied by aggression.
Conclusion: The predictive role of acute executive dysfunction has been clarified in this study. It might suggest that early neurorehabilitative interventions targeting the impaired neural circuits of executive function and mood processing may accelerate and facilitate the optimal neuro-functional recovery leading to minimizing the persistent sleep disturbances.
 
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Type of Study: Research | Subject: Trauma

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