title: Dysautonomia and Clinical Outcome in Vegetative State.
abstract: A dramatic disorder tentatively attributed to diencephalic-hypothalamic damage or dysfunction, dysautonomia, affects recovery from brain injury. Its incidence, correlation with etiology, and relevance as a predictor of outcome were retrospectively surveyed in 333 patients in vegetative state (VS) for more than 2 weeks at admission. Outcome was assessed according to the Glasgow Outcome Scale. Data were treated statistically by multi-variate analyses. Dysautonomia occurred in 26.1% of patients, with greater incidence among post-traumatic (31.9%) than non-traumatic (15.8%) patients. Outcome was worse among non-traumatic than post-traumatic patients irrespective of dysautonomia, and worst among non-traumatic patients with dysautonomia. Dysautonomia proved common among patients in VS (with incidence depending on etiology and age) and influenced the patients' outcome through mechanisms still to be defined, but conceivably mediated by diencephalic-hypothalamic unbalance.
authors.affiliation: Sant'Anna Institute, Crotone, Italy.
authors.forename: Giuliano
authors.initials: G
authors.lastname: Dolce
authors.affiliation: Sant'Anna Institute, Crotone, Italy.
authors.forename: Maria
authors.initials: M
authors.lastname: Quintieri
authors.affiliation: Sant'Anna Institute, Crotone, Italy.
authors.forename: Elio
authors.initials: E
authors.lastname: Leto
authors.affiliation: Sant'Anna Institute, Crotone, Italy.
authors.forename: Michele
authors.initials: M
authors.lastname: Milano
authors.affiliation: Sant'Anna Institute, Crotone, Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: Pileggi
authors.affiliation: Department of Electronic, Informatics and Systemistics, University of Calabria, Cosenza, Italy.
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Lagani
authors.affiliation: Department of Electronic, Informatics and Systemistics, University of Calabria, Cosenza, Italy.
authors.forename: Loris
authors.initials: L
authors.lastname: Pignolo
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D023261:Glasgow Outcome Scale; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D018458:Persistent Vegetative State / Q000150:complications*; D054969:Primary Dysautonomias / Q000453:epidemiology*; D012189:Retrospective Studies