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.

Clinical, Neurophysiological, and Genetic Predictors of Recovery in Patients With Severe Acquired Brain Injuries (PRABI): A Study Protocol for a Longitudinal Observational Study / Hakiki, Bahia; Donnini, Ida; Romoli, Anna Maria; Draghi, Francesca; Maccanti, Daniela; Grippo, Antonello; Scarpino, Maenia; Maiorelli, Antonio; Sterpu, Raisa; Atzori, Tiziana; Mannini, Andrea; Campagnini, Silvia; Bagnoli, Silvia; Ingannato, Assunta; Nacmias, Benedetta; De Bellis, Francesco; Estraneo, Anna; Carli, Valentina; Pasqualone, Eugenia; Comanducci, Angela; Navarro, Jorghe; Carrozza, Maria Chiara; Macchi, Claudio; Cecchi, Francesca. - In: FRONTIERS IN NEUROLOGY. - ISSN 1664-2295. - ELETTRONICO. - 13:(2022), pp. 0-0. [10.3389/fneur.2022.711312]

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

Hakiki, Bahia;Donnini, Ida;Romoli, Anna Maria;Grippo, Antonello;Scarpino, Maenia;Sterpu, Raisa;Atzori, Tiziana;Bagnoli, Silvia;Ingannato, Assunta;Nacmias, Benedetta;Estraneo, Anna;Comanducci, Angela;Macchi, Claudio;Cecchi, Francesca
2022

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.
2022
13
0
0
Hakiki, Bahia; Donnini, Ida; Romoli, Anna Maria; Draghi, Francesca; Maccanti, Daniela; Grippo, Antonello; Scarpino, Maenia; Maiorelli, Antonio; Sterpu, Raisa; Atzori, Tiziana; Mannini, Andrea; Campagnini, Silvia; Bagnoli, Silvia; Ingannato, Assunta; Nacmias, Benedetta; De Bellis, Francesco; Estraneo, Anna; Carli, Valentina; Pasqualone, Eugenia; Comanducci, Angela; Navarro, Jorghe; Carrozza, Maria Chiara; Macchi, Claudio; Cecchi, Francesca
File in questo prodotto:
Non ci sono file associati a questo prodotto.

I documenti in FLORE sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.

Utilizza questo identificatore per citare o creare un link a questa risorsa: https://hdl.handle.net/2158/1259322
Citazioni
  • ???jsp.display-item.citation.pmc??? ND
  • Scopus 6
  • ???jsp.display-item.citation.isi??? 7
social impact