' '
Deutsch | English    

Forschungsdatenbank PMU-SQQUID

Cortical excitability changes in patients with sleep-wake disturbances after traumatic brain injury.
Nardone, R; Bergmann, J; Kunz, A; Caleri, F; Seidl, M; Tezzon, F; Gerstenbrand, F; Trinka, E; Golaszewski, S;
J Neurotrauma. 2011; 28(7): 1165-1171.
Originalarbeiten (Zeitschrift)


Bergmann Jürgen
Golaszewski Stefan
Kunz Alexander
Nardone Raffaele
Seidl Martin
Trinka Eugen


Although chronic sleepiness is common after head trauma, the cause remains unclear. Transcranial magnetic stimulation (TMS) represents a useful complementary approach in the study of sleep pathophysiology. We aimed to determine in this study whether post-traumatic sleep-wake disturbances (SWD) are associated with changes in excitability of the cerebral cortex. TMS was performed 3 months after mild to moderate traumatic brain injury (TBI) in 11 patients with subjective excessive daytime sleepiness (EDS; defined by the Epworth Sleepiness Scale ≥10), 12 patients with objective EDS (as defined by mean sleep latency <5 on multiple sleep latency tests), 11 patients with fatigue (defined by daytime tiredness without signs of subjective or objective EDS), 10 patients with post-traumatic hypersomnia "sensu strictu," and 14 control subjects. Measures of cortical excitability included central motor conduction time, resting motor threshold (RMT), short-latency intracortical inhibition (SICI), and intracortical facilitation to paired-TMS. RMT was higher and SICI was more pronounced in the patients with objective EDS than in the control subjects. In the other patients all TMS parameters did not differ significantly from the controls. Similarly to that reported in patients with narcolepsy, the cortical hypoexcitability may reflect the deficiency of the excitatory hypocretin/orexin-neurotransmitter system. These observations may provide new insights into the causes of chronic sleepiness in patients with TBI. A better understanding of the pathophysiology of post-traumatic SWD may also lead to better therapeutic strategies in these patients.

Useful keywords (using NLM MeSH Indexing)




Brain Injuries/complications

Brain Injuries/physiopathology*

Case-Control Studies

Cerebral Cortex/physiopathology*

Disorders of Excessive Somnolence/diagnosis*

Disorders of Excessive Somnolence/etiology

Disorders of Excessive Somnolence/physiopathology*




Middle Aged


Transcranial Magnetic Stimulation/methods


Young Adult

Find related publications in this database (Keywords)

excessive daytime sleepiness
sleep-wake disturbances
transcranial magnetic stimulation
traumatic brain injury