Sleep patterns may reveal comatose patients with hidden consciousness

Columbia University Irving Medical Center

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NEW YORK, NY (March 3, 2025)--Several studies in the past decade have revealed that up to a quarter of unresponsive patients with recent brain injuries may possess a degree of consciousness that’s normally hidden from their families and physicians.

New research from Columbia University and NewYork-Presbyterian may soon help physicians identify unresponsive brain-injury patients with hidden consciousness who are likely to achieve long-term recovery by looking for brain waves that are indicative of normal sleep patterns. 

“We’re at an exciting crossroad in neurocritical care where we know that many patients appear to be unconscious, but some are recovering without our knowledge. We're starting to lift the lid a little bit and find some signs of recovery as it's happening,” says Jan Claassen, associate professor of neurology at Columbia University Vagelos College of Physicians and Surgeons, who led the study.

“Families of my patients ask me all the time, will my mother wake up? How is my mother going to look in three, six, or 12 months? Very often we cannot guide them very precisely, and it’s crucial that we improve our predictions to guide their decision making.”

 

Sleep and consciousness

Claassen, who is also chief of critical care and hospitalist neurology at NewYork-Presbyterian/Columbia University Irving Medical Center, has previously developed sophisticated techniques to identify patients with hidden consciousness by analyzing a patient’s EEG recordings as they are presented with a command in the neurocritical  care unit. The techniques detect EEG brain wave activity indicating that the patient can hear and understand their physicians’ instructions (to open and close their hand, for example) even though the patients do not physically respond. 

But the techniques can be difficult to implement and can yield false-negative results.

Claassen decided to focus on sleep, as brain circuits that are fundamental for consciousness, including cognitive motor dissociation, are also critical to control sleep.

“I’m always thinking about how my work can be best implemented and used in the real world, and looking at sleep made sense practically and scientifically,” Claassen says. “Sleep brain waves are easy to record and do not require intervention from the care team.”

Sleep spindles predict recovery

In the new study, the researchers looked through EEG recordings of overnight brain activity in 226 comatose patients who also underwent the more complex testing for cognitive motor dissociation.

“The electrical activity during sleep looks relatively chaotic, and then occasionally in some patients, these very organized, fast frequencies appear,” Claassen says.

These bursts—called sleep spindles—often preceded the detection of cognitive motor dissociation with the more complex method, the return of consciousness, and long-term recovery.

“Spindles happen normally during sleep and they’re showing some level of organization in the brain, suggesting circuits between the thalamus and cortex needed for consciousness are intact.”

About one-third of patients had well-defined sleep spindles, including about half of patients with cognitive motor dissociation. 

Patients with sleep spindles and cognitive motor dissociation were more likely to recover consciousness and functional independence. Among those with sleep spindles and cognitive motor dissociation, 76% of patients showed evidence of consciousness by the time they were discharged from the hospital. A year later, 41% of these patients had recovered neurological function, with either minor deficits or a moderate disability, and were able to care for themselves during the day. Only 29% of patients with neither sleep spindles nor cognitive motor dissociation showed signs of consciousness by the time they were discharged and just 7% regained neurological function a year later. 

Even though these findings don’t prove that inducing sleep spindles would translate to better outcomes, they raise the possibility that improving a patient’s sleep—possibly by changing their environment—may promote their recovery. “If you think about the ICU environment, it is rather disruptive for a good night’s sleep. There is noise everywhere, alarms going off, clinicians touching them, 24/7. This is all for a good reason, but it’s hard to sleep in that environment,” Claassen says. 

Moving toward clinical practice

Claassen cautions that the findings only apply to patients with recent injuries, not those with long-term disorders of consciousness. For most patients in the current study, normal sleep spindles appeared within days of the initial injury.

And the predictors were not perfect: 19 of 139 patients who did not show sleep spindles or signs of cognitive motor dissociation did recover consciousness. Other data will likely be needed to make more accurate predictions.

“I see these spindles as a way to direct more sophisticated testing to the patients most likely to benefit,” Claassen says. “The techniques are not ready for use in clinical practice yet, but this is something that we’re actively working on right now.” 

Additional information

Jan Claassen, MD, is also medical director of the neurological intensive care unit at NewYork-Presbyterian/Columbia University Irving Medical Center.  

“Sleep spindles as a predictor of cognitive motor dissociation and recovery of consciousness after acute brain injury,” was published March 3 in Nature Medicine.

Authors (all from Columbia and NewYork-Presbyterian): Elizabeth E Carroll, Qi Shen, Vedant Kansara, Nicole Casseon, Andrew Michalak, Itamar Niesvizky-Kogan, Jaehyung Lim, Amy Postelnik, Matthew J Viereck, Satoshi Egawa, Joshua Kahan, Jerina C Carmona, Lucy Kruger, You Lim Song, Angela Velazquez, Catherine A Schevon, Sander Connolly, Shivani Ghoshal, Sachin Agarwal, David Roh, Soojin Park, Paul Kent, and Jan Claassen.

The study was supported by grants from the National Institutes of Health (R01NS106104, R01LM011826, and UL1TR001873).

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Columbia University Irving Medical Center (CUIMC) is a clinical, research, and educational campus located in New York City. Founded in 1928, CUIMC was one of the first academic medical centers established in the United States of America. CUIMC is home to four professional colleges and schools that provide global leadership in scientific research, health and medical education, and patient care including the Vagelos College of Physicians and Surgeons, the Mailman School of Public Health, the College of Dental Medicine, the School of Nursing. For more information, please visit cuimc.columbia.edu. 

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Journal

Nature Medicine

Method of Research

Experimental study

Subject of Research

People

Article Title

Sleep spindles as a predictor of cognitive motor dissociation and recovery of consciousness after acute brain injury

Article Publication Date

3-Mar-2025

COI Statement

See paper for disclosures.

 

Scientists discover potential for serious harm from chemical loophole

Unregulated toxic chemicals are used in everyday products

Green Science Policy Institute

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The scientific community has long believed that polymers—very large molecules—are too big to migrate out of products into people and therefore pose no health risks. As a result, polymers have largely evaded regulation. For example, polymers are exempt from the major toxics acts: Toxic Substances Control Act in the U.S. and REACH in the E.U. However, a breakthrough peer-reviewed study published today in Nature Sustainability demonstrates that polymers used as flame retardants can break down into smaller harmful chemicals.

“Our study suggests polymers can act as a trojan horse for toxic chemicals,” said Da Chen, senior author and scientist at Jinan University in China. “They are added to products as inert large molecules, but over time they can degrade, exposing us to their harmful breakdown products.”

The researchers tested two polymeric brominated flame retardants (polyBFRs) that were developed as “non-toxic” alternatives to banned flame retardants. They found that both polyBFRs broke down into dozens of types of smaller molecules. Toxicity testing of these smaller molecules in zebrafish showed significant potential for causing mitochondrial dysfunction and developmental and cardiovascular harm.

The scientists went on to search for these polymer break-down products in the environment and, further raising alarm, detected them in soil, air, and dust. The levels were highest near electronic waste recycling facilities and lessened moving away from the facilities. These results confirm that the use of polyBFRs in electronics leads to the release of toxic breakdown products into the environment with potential for human and wildlife exposure and harm.

“Widespread use of these polyBFRs in electronics may result in exposures when these products are manufactured, when they’re in our homes, and when they’re discarded or recycled,” said Miriam Diamond, co-author and professor at the University of Toronto. “Since it is suspected that production volumes are very high (the chemical industry does not disclose the volumes), the potential for pollution—and resulting serious harm to people and wildlife— greatly concerns me.”

The chemical producers and their trade groups promote polyBFRs as environmentally friendly and non-hazardous substitutes for banned monomeric flame retardants (e.g., hexabromocyclododecane and decabromodiphenyl ether) to meet flammability standards for electronics, building materials, and vehicles. However, real-world fire-safety benefits for many of these standards have not been demonstrated. 

The study also has implications for other types of polymers used in consumer products such as per- and polyfluoroalkyl substances (PFAS). PFAS polymers have been put into textiles including children’s uniforms, food packaging, and cosmetics to name a few uses. Similar to this study, previous research has shown that fluorinated polymers contain numerous impurities and release smaller toxic molecules. Although the producers of PFAS argue that fluorinated polymers should be exempt from regulation, scientists maintain that fluorinated polymers are members of the class of PFAS and that the use of the whole class of PFAS should be avoided.

“To escape regulation, flame retardant and PFAS producers are increasingly pivoting to polymers for use in everyday products,” said Arlene Blum, co-author and Executive Director of the Green Science Policy Institute. “As a result, problematic polymers emit toxic small molecules from products we touch, sit on, wear, and keep in our homes. Regulators need to close this loophole to protect consumers—especially children—from the possibility of serious chemical harm.”

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Journal

Nature Sustainability

DOI

10.1038/s41893-025-01513-z 

Subject of Research

Animals

Article Title

Environmental impacts of polymeric flame retardant breakdown

Article Publication Date

3-Mar-2025

 

Goethe University explores new social media horizons

Bluesky joins existing offer as a new channel featuring news about the university, research, science, the promotion of young talent and career opportunities

Goethe University Frankfurt

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Goethe University Frankfurt’s Bluesky profile

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Credit: Nina Ittermann / Goethe University Frankfurt

FRANKFURT. Goethe University’s latest news on university life, research, science, the promotion of young talent and careers is now available on Bluesky. The university chose Bluesky as a new central social media communications channel because it considers the platform to be a forward-thinking alternative to X, and one that is becoming increasingly important to science and research. Bluesky’s advantages over other platforms played a vital role in this decision:

• Decentralized network: Bluesky offers more openness, transparency and participation, as well as a more even distribution of power than centrally organized networks such as X.
• Familiar user interface: The platform’s user interface is similar to that of X, making it easier for researchers, students and interested parties to switch.
• More control for users:
  • Since Bluesky users can customize their algorithms to personalize their feed, they have more control over the content they see.
  • Bluesky users can better determine which accounts they want to interact with.
  • Data protection and ID checks rest in the hands of Bluesky users.
• Transparent moderation systems and rules.
• Open access: Bluesky has been open to anyone interested in joining the platform since February 2024 and now has more than 30 million users (according to its own data, as of January 2025).
• Bluesky is ad-free (for now), which promotes authentic communication.

As part of a concerted move involving more than 60 German-speaking universities and research institutions, Goethe University Frankfurt in January announced its decision to discontinue its activities on X (formerly Twitter). Many more institutions of higher learning and research have since followed suit. The decision to leave X is based on changes in the platform’s orientation, which increasingly favor the dissemination of fake news and disinformation, and constitute problematic communication practices. Goethe University core values such as academic freedom, diversity, democratic discourse and fact-based cooperation are no longer compatible with these platform developments. Beyond that, scientific topics no longer generate any significant reach on X.

Goethe University’s central communication is now available on Bluesky at:
https://bsky.app/profile/goetheuni.bsky.social

Faculties, institutions and university members who would like to use Bluesky as an alternative or supplement to their existing social media activities can contact the PR and Communications Office with any questions. Goethe University's other central social communications channels include Instagram, Facebook, LinkedIn and YouTube.

 

Two video games created to improve hand and wrist rehabilitation

Universidad Carlos III de Madrid

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Controller for patient rehabilitation

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Credit: UC3M

Universidad Carlos III de Madrid (UC3M), in collaboration with Escuela Politécnica del Ecuador and the ASEPEYO hospitals in Barcelona and Madrid, has developed a system of exercise video games (or exergames) that promotes the rehabilitation of people with mobility problems in their hands and wrists. The system also provides data to therapists so that they can analyse their patients’ progress during the recovery stage.

The two video games, called “Peter Jumper” and “Andromeda”, have been developed on the free Unity platform and are arcade-type games (i.e., games similar to arcade machines). Their aim is to make the physical activity of the injured limb rewarding, generating motivation so that the patient can become more involved in the treatment and enhance the results of the rehabilitation.

In addition to the software, the system is composed of a specialized electromechanical controller, called “eJamar”, which is capable of measuring, through specialized sensors, the entire range of motion of the hand and wrist, as well as the patient's grip strength. The system, in turn, is able to store this information during each session, so that a specialist can consult the patient's condition and check their progress over time, automatically recording metrics (strength profiles, fatigue, reaction times, etc.) that cannot be obtained using traditional methods. A paper on the development of this system was recently published in the scientific journal Applied Sciences.

During the initial phase of the research, the researchers identified certain requirements that had not been met by traditional upper extremity rehabilitation treatments. “We realized that training games (or serious games) were being used to support rehabilitation treatments, but that there were very few physical devices dedicated to promoting hand mobility and improving grip strength. So, it was precisely from this vacuum that the idea of designing a device to meet this need arose”, explains one of the study's authors, Andrés Fernando Cela Rosero, from the UC3M Department of Systems Engineering and Automation. 

The system, funded by Roboasset, i-REHAB project, which in turn is supported by the Instituto de Salud Carlos III (ISCIII) and co-financed by the European Union and iRoboCity2030-CM, which is supported by the R&D Activity Programmes in the Community of Madrid, has been approved by doctors and specialized personnel so that this rehabilitation technology is easy to implement in routine clinical practice. “In fact, we have already completed a series of tests with patients in rehabilitation stages and the results are very encouraging”, says another of the researchers, Edwin Daniel Oña Simbaña, also from the UC3M Department of Systems Engineering and Automation. “In this way, by combining a traditional treatment with 30 minutes of exercises with our exergames, patients have improved both their range of motion and their grip strength by up to 100%”, he adds. 

Another advantage of this device is that it can be used in a wide range of cases, from fractures or hand injuries to neurological pathologies such as stroke, multiple sclerosis or Parkinson's disease.

In turn, given the simplicity of the system, the researchers believe that these interactive video games can be a useful tool for telerehabilitation, as they can contribute to reducing the waiting list for patients to access these treatments. For this reason, the authors of the study encourage both health entities and users to try this technology in order to continue working in this line of research.

Bibliographic reference: Cela AF, Oña ED, Jardón A. (2024). eJamar: A Novel Exergame Controller for Upper Limb Motor Rehabilitation. Applied Sciences. 2024; 14(24):11676. https://doi.org/10.3390/app142411676

Video: https://youtu.be/XTqtEGaFCvw

 

Survey: Who has experienced discrimination and racism by the police?

New study by Goethe University Frankfurt and Hamburg Police Academy starts today

Goethe University Frankfurt

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A recent representative survey by the Integration Barometer of Germany's Expert Council on Integration and Migration (SVR) shows that respondents who are perceived as “foreign” are checked by the police about twice as often as those who are not perceived as such. The non-representative "Afrozensus" report comes to similar conclusions. It is therefore not without reason that the actions of police officers are increasingly becoming part of the public discourse. “Beyond identity checks, we still know far too little about racism and discrimination in police work,” explains Professor Tobias Singelnstein, criminologist and criminal law expert at Goethe University Frankfurt. Together with Eva Gross, Professor of Criminology and Sociology at Akademie der Polizei Hamburg [Hamburg Police Academy], he has now launched a study to fill this knowledge gap. The survey is part of the three-year collaborative project “Experiences of Racism and Discrimination in Police Contact” (RaDiPol), which involves ten researchers and which has received around €630,000 in funding from the German Research Foundation (DFG).

The representative population survey will take place from March 3 to April 3, 2025. It will involve 100,000 people randomly from the population registers of five major German cities (Berlin, Frankfurt a.M., Dresden, Hamburg, and Munich).  They will receive a letter with a link to an online questionnaire in which they can participate during the one-month survey period. “The more people who participate and provide us with their answers, the more accurate our assessment of this problematic situation becomes,” emphasizes Professor Eva Gross. The quantitative population survey will be complemented by 60 qualitative interviews with representatives of both the police and civil society groups, focusing on their different experiences and perspectives. Professor Tobias Singelnstein explains: “Our aim is to combine the results of the population survey with the assessments of the police officers who carry out state tasks in law enforcement or criminal investigations.” Most previous analyses have looked at the experiences of those affected and police perceptions separately.

 

Teaching kids how to become better US citizens

Fourth graders learn argumentation and thinking skills

Ohio State University

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COLUMBUS, Ohio – In our polarized society, a new study offers hope for the future: Even young children can learn to discuss and argue about meaningful problems in a respectful and productive way.

 

Researchers at The Ohio State University found success in a social studies curriculum for fourth graders based on teaching what they called “civic competencies.”

 

Over the course of a school year, findings showed that the students participating in the curriculum significantly improved their argumentation skills and disciplinary thinking.

 

“This will give them the ability to collaborate, communicate effectively and consider multiple perspectives”, said Tzu-Jung Lin, co-author of the study and professor of educational psychology at The Ohio State University.

 

“We aim to help cultivate a new generation of responsible community members and citizens who can work together to help solve complex issues,” Lin said.

 

The study was published recently in the Journal of Social Studies Research.

 

The research involved 106 fourth-grade students and six social studies teachers from two public school districts in the Columbus area. They participated in a social studies curriculum called Digital Civic Learning (DCL), which was developed at Ohio State.

 

“Students as young as elementary school start to encounter important issues in the world around them that don’t have a right or wrong answer,” Lin said.

 

“What we are trying to do with the DCL curriculum is to teach children the process to be a better thinker about these issues and learn how to resolve conflicts around them.”

 

One part of the curriculum involved what is called disciplinary thinking.  This means teaching students how to read, write and think differently depending on the subject matter. In the DCL, students were taught four ways of thinking: geographic, economic, historical and civic.

 

“When students learn disciplinary thinking, they learn how professionals in each of these four disciplines approach a problem,” said co-author Haeun Park, a doctoral student in educational psychology at Ohio State.

 

“And later in the curriculum, students learn how to use all of those types of thinking in an interdisciplinary way. For example, students may learn to think about a specific problem from an economics point of view, but also from the view of an historian.”

This interdisciplinary approach can help students with their argumentation skills, which was the other focus of the curriculum. Students were taught how to develop an argument and counterargument about different positions using their disciplinary thinking skills.

 

In the classes, students honed their disciplinary thinking and argumentation skills through stories. The children were given a story about characters facing some sort of challenge, such as living in a food desert where healthy, affordable food options are limited.

 

“These stories are designed to be real-life problems that don’t have a set answer,” said study co-author Kevin Fulton, a doctoral student in educational psychology at Ohio State.

 

“The students can bring their own perspectives to the conversation, and they can agree on all the facts and disagree on what a good solution looks like.”

 

In order to measure how much the students learned from the DCL curriculum, the researchers had the students write essays at the beginning of the school year and at the end on meaningful problems that were relevant to their lives.

 

For example, one writing prompt had to do with a school lunch system that used AI to scan faces to see if the student owed money for their meals.

 

Students had to grapple with the negative ethical and privacy issues of the system as well as the positive user-friendly advantages and come to a decision about whether the AI system should be implemented.

 

Trained coders rated how well the students did on using disciplinary thinking and argumentation skills in their essays at the beginning of the year, and then again at the end.

 

The goal was to see if the students improved after taking the DCL curriculum.  Results showed they did.

 

For example, about 27% of students scored 3 out of 4 or above on claim-evidence integration (one of the argumentation skills) in their essays at the beginning of the course.  But that increased to 43% at the end of the course.

 

Use of disciplinary thinking also showed an increase from 27% to 48% after the DCL curriculum was completed.

 

The researchers said they are hopeful that a curriculum like this could help long-term in healing some of the fractures in our society.

 

“We believe that if we can embrace these civic competencies, we can find common ground, even with our different beliefs and different backgrounds,” Lin said.

 

“We can still work together as a group to solve our problems.”

 

The research was supported by a grant from the Institute of Education Sciences.

 

Other Ohio State co-authors were Adriana Martinez Calvit, Ziye Wen, Yue Sheng, Michael Glassman and Eric Anderman. Saetbyul Kim from the Korean Educational Development Institute was also a co-author.

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Journal

The Journal of Social Studies Research

DOI

10.1177/23522798241301436 

Method of Research

Experimental study

Subject of Research

People

Article Title

Cultivating Civic Competencies Through Immersive Inquiry: A Digital-age Approach to Fourth Grader’s Disciplinary Thinking and Argumentation