Predicting Traumatic Brain Injury Post-Trauma Using Temporal Attention on Sleep-Wake Data.

Background: Traumatic Brain Injury (TBI) is a major public health concern, and accurate classification is essential for effective treatment and improved patient outcomes. Sleep/wake behavior has emerged as a potential biomarker for TBI classification, yet the optimal time window in which to identify sleep/wake changes after TBI remains unclear.

Methods: We evaluated daily longitudinal sleep/wake data from a prospective cohort of more than 2,000 emergency department patients with and without blood biomarker-documented TBI (Glial Fibrillary Acidic Protein - GFAP $ > 268 \frac{pg}{ml}$). We utilized a deep learning model to identify the impact of time from trauma and duration of data collection on the model's ability to distinguish between TBI-positive (TBI+) and TBI-negative (TBI-) cases.

Results: Our analysis showed that sleep/wake data from the first 7 days after TBI most accurately identified TBI. Sleep-wake data from the first 7, 14, and 21 days after trauma achieved sensitivity/specificity of 81%/25%, 40%/66%, and 45%/58%, respectively. F1 scores of deep learning models developed from the first 7, 14, and 21 days were 22%, 21%, and 20%, respectively.

Conclusions: The results suggest that early sleep/wake data has promise for assisting with TBI identification.

Significance: In the future, the incorporation of sleep/wake derived biomarkers into TBI identification tools could assist in the identification of individuals with potential TBI for further screening and intervention.