TY - JOUR
T1 - Clinical, Neurophysiological, and Genetic Predictors of Recovery in Patients With Severe Acquired Brain Injuries (PRABI)
T2 - A Study Protocol for a Longitudinal Observational Study
AU - Hakiki, Bahia
AU - Donnini, Ida
AU - Romoli, Anna Maria
AU - Draghi, Francesca
AU - Maccanti, Daniela
AU - Grippo, Antonello
AU - Scarpino, Maenia
AU - Maiorelli, Antonio
AU - Sterpu, Raisa
AU - Atzori, Tiziana
AU - Mannini, Andrea
AU - Campagnini, Silvia
AU - Bagnoli, Silvia
AU - Ingannato, Assunta
AU - Nacmias, Benedetta
AU - De Bellis, Francesco
AU - Estraneo, Anna
AU - Carli, Valentina
AU - Pasqualone, Eugenia
AU - Comanducci, Angela
AU - Navarro, Jorghe
AU - Carrozza, Maria Chiara
AU - Macchi, Claudio
AU - Cecchi, Francesca
N1 - Funding Information:
This study was funded by RICERCA CORRENTE 2020 from IRCCS Don Gnocchi.
Publisher Copyright:
Copyright © 2022 Hakiki, Donnini, Romoli, Draghi, Maccanti, Grippo, Scarpino, Maiorelli, Sterpu, Atzori, Mannini, Campagnini, Bagnoli, Ingannato, Nacmias, De Bellis, Estraneo, Carli, Pasqualone, Comanducci, Navarro, Carrozza, Macchi and Cecchi.
PY - 2022/2/28
Y1 - 2022/2/28
N2 - 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.
AB - 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.
KW - disorders of consciousness
KW - genetics
KW - neurophysiology
KW - rehabilitation
KW - severe acquired brain injuries
UR - http://www.scopus.com/inward/record.url?scp=85127323282&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85127323282&partnerID=8YFLogxK
U2 - 10.3389/fneur.2022.711312
DO - 10.3389/fneur.2022.711312
M3 - Article
AN - SCOPUS:85127323282
SN - 1664-2295
VL - 13
JO - Frontiers in Neurology
JF - Frontiers in Neurology
M1 - 711312
ER -