Key result
Chronic disorders of consciousness linked to paroxysmal sympathetic hyperactivity and disrupted ACTH and cortisol rhythms.
Why the study?
Patients with chronic disorders of consciousness present with diverse pathological functional alterations, including sympathetic hyperactivity and hormonal changes, prompting assessment of these systems.
What is the severity of paroxysmal sympathetic hyperactivity and the function of the pituitary-adrenal system in patients with chronic disorders of consciousness?
RCT (n=54)
depending on assessment on the Coma Recovery Scale-Revised scale
What is the severity of paroxysmal sympathetic hyperactivity and the function of the pituitary-adrenal system in patients with chronic disorders of consciousness?
Patients with chronic disorders of consciousness exhibit paroxysmal sympathetic hyperactivity and disrupted daily rhythms of ACTH and cortisol secretion.
PSH and HPA axis disruption may warrant monitoring in chronic DOC; hypothesis-generating for targeted interventions, with prospective trials needed.
Patients with chronic disorders of consciousness (CDoC) have various variants of the pathological organization of functions including sympathetic hyperactivity and hormonal changes. The objective: to determine the severity of paroxysmal sympathetic hyperactivity (PSH), the function of the pituitary-adrenal system in patients with CDoC. Subjects and Methods. 54 patients with CDoC were enrolled in the study. Patients were randomized in the groups depending on assessment on the Coma Recovery Scale-Revised scale and CRS-R index calculation. PSH severity was assessed 7 times a day for two days. During the first week from the moment of admission, blood sampling was performed 7 times a day to study the levels of ACTH and cortisol. Results. PSH syndrome was detected in all groups, there were no significant dependencies of its severity on the time of day. There were no significant differences in the levels of ACTH and cortisol during the day. Conclusions: PSH syndrome is observed in most patients with CDoC. In patients with CDoC, the daily rhythm of ACTH and cortisol secretion are disrupted.
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Rybakov et al. (2022) conducted an RCT in chronic disorders of consciousness (CDoC) (n=54). Chronic disorders of consciousness were associated with paroxysmal sympathetic hyperactivity and disrupted daily rhythms of ACTH and cortisol secretion, with no significant time-of-day dependencies.
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