Tiefschlaf-Stimulation nach traumatischen Hirnverletzungen (CONCSleep Study)

Approximately one third of children and adolescents experience at least one concussion before reaching adulthood. A concussion is a functional disturbance of the brain caused by an impact or force to the head. Although most children recover within weeks, around 30% develop persistent post-concussive symptoms, including headaches, dizziness, fatigue, sleep problems, cognitive difficulties such as impaired attention, concentration and memory, and emotional symptoms such as irritability, anxiety or low mood. These symptoms may affect school performance, social participation and everyday life, and can persist for months or even years after the injury. Previous studies suggest that disrupted sleep during the acute phase after concussion is particularly associated with impaired white matter integrity and prolonged recovery times. Preclinical studies have further shown that improving deep sleep, in particular, can substantially reduce nerve fibre damage and cognitive decline. In this study, we are now investigating the role of sleep in the recovery process after concussion in children and adolescents.

Procedures:

• Sleep monitoring and modulation: To examine sleep, we measure patients’ brain activity during sleep using a portable device, an electroencephalograph. Patients take the device home for seven nights. To enhance deep sleep, we use a non-invasive, non-pharmacological method: during sleep, quiet tones are played as soon as the slow, high-amplitude brain waves typical of deep sleep appear. This can strengthen these brain waves, and thereby deepen sleep, even though the tones are not consciously perceived by the recipient. This is comparable to a swing that moves more strongly when it is pushed at exactly the right moment. Through this study, we aim to analyse whether children whose sleep is deepened through stimulation also recover more quickly.
• Outcome measures: Before and after the sleep analysis, cognitive performance is assessed. Optionally, an MRI scan may also be performed. MRI does not involve X-rays and allows the microstructural properties of the brain to be examined in greater detail.

We hope to contribute to a better understanding of recovery after concussion and to develop new approaches for treating affected children and adolescents. The project pursues the long-term vision of making therapeutic use of the currently untapped window of sleep. We are regularly looking for interns, bachelor and master students. If you are interested in our projects, feel free to contact us at reto.huber@kispi.uzh.ch

Group Leader: Reto Huber
Project Leader: Florent Aziri
Co-Investigators: Niklaus Krayenbühl, Michelle Seiler, Florian Schaub, Ruth O'Gorman Tuura, Christian Baumann, Walter Karlen

Institutions:
Development Pediatrics, University Children’s Hospital Zurich
Neurosurgery, University Children’s Hospital Zurich
Emergency Department, University Children’s Hospital Zurich
Sports Medicine, University Children’s Hospital Zurich
MR Center, University Children’s Hospital Zurich
Neurology, University Hospital Zurich
Sensory-Motor Systems Lab, ETH Zurich

Previously involved: Joëlle Albrecht, Alina De Luca, Stella Maria Merakli, Stefan Altermatt, Barbara Brotschi, Maria Laura Ferster

• Ralf Loddenkemper-Stiftung
• ETH Stiftung
• HMZ SleepLoop