Significance of circadian rhythms in severely brain-injured patients A clue to consciousness?

Christine Blume, Julia Lechinger, Nayantara Santhi, Renata del Giudice, Maria-Teresa Gnjezda, Gerald Pichler, Monika Scarpatetti, Johann Donis, Gabriele Michitsch, Manuel Schabus

Research output: Contribution to journalArticlepeer-review

42 Citations (Scopus)
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Objective: To investigate the relationship between the presence of a circadian body temperature rhythm and behaviorally assessed consciousness levels in patients with disorders of consciousness (DOC; i.e., vegetative state/unresponsive wakefulness syndrome or minimally conscious state). Methods: In a cross-sectional study, we investigated the presence of circadian temperature rhythms across 6 to 7 days using external skin temperature sensors in 18 patients with DOC. Beyond this, we examined the relationship between behaviorally assessed consciousness levels and circadian rhythmicity. Results: Analyses with Lomb-Scargle periodograms revealed significant circadian rhythmicity in all patients (range 23.5-26.3 hours). We found that especially scores on the arousal subscale of the Coma Recovery Scale-Revised were closely linked to the integrity of circadian variations in body temperature. Finally, we piloted whether bright light stimulation could boost circadian rhythmicity and found positive evidence in 2 out of 8 patients. Conclusion: The study provides evidence for an association between circadian body temperature rhythms and arousal as a necessary precondition for consciousness. Our findings also make a case for circadian rhythms as a target for treatment as well as the application of diagnostic and therapeuticmeans at times when cognitive performance is expected to peak.
Original languageEnglish
Pages (from-to)1933-1941
Number of pages9
Issue number20
Early online date19 Apr 2017
Publication statusPublished - 16 May 2017
Externally publishedYes


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