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. 2022 Feb 28:13:711312.
doi: 10.3389/fneur.2022.711312. eCollection 2022.

Clinical, Neurophysiological, and Genetic Predictors of Recovery in Patients With Severe Acquired Brain Injuries (PRABI): A Study Protocol for a Longitudinal Observational Study

Bahia Hakiki  1 , Ida Donnini  1 , Anna Maria Romoli  1 , Francesca Draghi  1 , Daniela Maccanti  1 , Antonello Grippo  1 , Maenia Scarpino  1 , Antonio Maiorelli  1 , Raisa Sterpu  1 , Tiziana Atzori  1 , Andrea Mannini  1   2 , Silvia Campagnini  1   2 , Silvia Bagnoli  3 , Assunta Ingannato  3 , Benedetta Nacmias  1   3 , Francesco De Bellis  1 , Anna Estraneo  1 , Valentina Carli  1 , Eugenia Pasqualone  1 , Angela Comanducci  4 , Jorghe Navarro  4 , Maria Chiara Carrozza  2 , Claudio Macchi  1   5 , Francesca Cecchi  1   5
Affiliations

Clinical, Neurophysiological, and Genetic Predictors of Recovery in Patients With Severe Acquired Brain Injuries (PRABI): A Study Protocol for a Longitudinal Observational Study

Bahia Hakiki et al. Front Neurol. .

Abstract

Background: Due to continuous advances in intensive care technology and neurosurgical procedures, the number of survivors from severe acquired brain injuries (sABIs) has increased considerably, raising several delicate ethical issues. The heterogeneity and complex nature of the neurological damage of sABIs make the detection of predictive factors of a better outcome very challenging. Identifying the profile of those patients with better prospects of recovery will facilitate clinical and family choices and allow to personalize rehabilitation. This paper describes a multicenter prospective study protocol, to investigate outcomes and baseline predictors or biomarkers of functional recovery, on a large Italian cohort of sABI survivors undergoing postacute rehabilitation.

Methods: All patients with a diagnosis of sABI admitted to four intensive rehabilitation units (IRUs) within 4 months from the acute event, aged above 18, and providing informed consent, will be enrolled. No additional exclusion criteria will be considered. Measures will be taken at admission (T0), at three (T1) and 6 months (T2) from T0, and follow-up at 12 and 24 months from onset, including clinical and functional data, neurophysiological results, and analysis of neurogenetic biomarkers.

Statistics: Advanced machine learning algorithms will be cross validated to achieve data-driven prediction models. To assess the clinical applicability of the solutions obtained, the prediction of recovery milestones will be compared to the evaluation of a multiprofessional, interdisciplinary rehabilitation team, performed within 2 weeks from admission.

Discussion: Identifying the profiles of patients with a favorable prognosis would allow customization of rehabilitation strategies, to provide accurate information to the caregivers and, possibly, to optimize rehabilitation outcomes.

Conclusions: The application and validation of machine learning algorithms on a comprehensive pool of clinical, genetic, and neurophysiological data can pave the way toward the implementation of tools in support of the clinical prognosis for the rehabilitation pathways of patients after sABI.

Keywords: disorders of consciousness; genetics; neurophysiology; rehabilitation; severe acquired brain injuries.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Study timeline.
See this image and copyright information in PMC

References

    1. Masson F, Thicoipe M, Aye P, Mokni T, Senjean P, Schmitt V, et al. Epidemiology of severe brain injuries: a prospective population-based study. J Trauma Acute Care Surg. (2001) 51:481–9. 10.1097/00005373-200109000-00010 - DOI - PubMed
    1. 2a Consensus Conference Gravi Cerebrolesioni Acquisite—Documento finale della Giuria (2005).
    1. Hirschberg R, Giacino JT. The vegetative and minimally conscious states: diagnosis, prognosis and treatment. Neurol Clin. (2011) 29:773–86. 10.1016/j.ncl.2011.07.009 - DOI - PubMed
    1. Giacino JT, Ashwal S, Childs N, Cranford R, Jennett B, Katz DI, et al. The minimally conscious state: Definition and diagnostic criteria. Neurology. (2002) 58:349–53. 10.1212/WNL.58.3.349 - DOI - PubMed
    1. Bruno M-A, Vanhaudenhuyse A, Thibaut A, Moonen G, Laureys S. From unresponsive wakefulness to minimally conscious PLUS and functional locked-in syndromes: recent advances in our understanding of disorders of consciousness. J Neurol. (2011) 258:1373–84. 10.1007/s00415-011-6114-x - DOI - PubMed