A new study suggests that sleep spindles, or bursts of brain activity during the non-dreaming stage of sleep, could help predict the recovery of consciousness and independent functioning in patients who have suffered a brain injury.
Researchers from Columbia University and the NewYork-Presbyterian healthcare system, US, found that unresponsive patients with a recent brain injury could possess a degree of hidden consciousness. This finding could be crucial for families and doctors managing such cases.
The study, published in the journal Nature Medicine, analyzed electroencephalograms (EEG) recordings of brain activity in 226 comatose patients taken over a night. According to lead researcher Jan Claassen, an associate professor of neurology at Columbia University, the electrical activity during sleep appeared chaotic but occasionally featured organized bursts of fast frequencies known as sleep spindles.
These sleep spindles were often associated with the detection of cognitive motor dissociation (CMD)—a condition in which a patient appears unresponsive but shows evidence of brain activity. The researchers observed that patients with sleep spindles and CMD were more likely to recover consciousness and achieve functional independence.
“Spindles happen normally during sleep and indicate some level of organization in the brain, suggesting that circuits between the thalamus and cortex needed for consciousness are intact,” Claassen explained.
The study found that sleep spindles were present in approximately one-third of behaviorally unresponsive patients after acute brain injury. These spindles frequently preceded the detection of CMD and were a promising complementary predictor for recovery of consciousness and functional independence.
The researchers reported that 76% of patients with sleep spindles and CMD showed evidence of consciousness by the time they were discharged from the hospital. A year later, 41% of these patients had recovered neurological function, with either minor deficits or moderate disability, enabling them to care for themselves during the day.
While the findings do not prove that inducing sleep spindles would lead to better outcomes, they raise the possibility that improving a patient’s sleep may promote recovery. Additionally, 19 of the 139 patients in the study who did not show sleep spindles or signs of CMD did recover consciousness, suggesting that other information will likely be needed for more accurate predictions.
This study highlights the potential of sleep spindles as a valuable predictor of recovery in brain injury patients, offering hope for improved management and treatment strategies in the future.
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