Focal epilepsy impacts rapid eye movement sleep microstructure.

Autor:	Schiller K; Analytical Neurophysiology Lab, Montreal Neurological Institute and Hospital, McGill University, Montreal, Canada.; Hospital Group Ostallgaeu-Kaufbeuren, Department of Pediatrics, Kaufbeuren, Germany.; Medical University Innsbruck, Department of Pediatrics, Innsbruck, Austria., von Ellenrieder N; Montreal Neurological Institute and Hospital, McGill University, Montreal, Canada., Avigdor T; Analytical Neurophysiology Lab, Montreal Neurological Institute and Hospital, McGill University, Montreal, Canada., El Kosseifi C; Analytical Neurophysiology Lab, Montreal Neurological Institute and Hospital, McGill University, Montreal, Canada., Abdallah C; Analytical Neurophysiology Lab, Montreal Neurological Institute and Hospital, McGill University, Montreal, Canada., Minato E; Analytical Neurophysiology Lab, Montreal Neurological Institute and Hospital, McGill University, Montreal, Canada., Gotman J; Montreal Neurological Institute and Hospital, McGill University, Montreal, Canada., Frauscher B; Analytical Neurophysiology Lab, Montreal Neurological Institute and Hospital, McGill University, Montreal, Canada.; Department of Medicine and Center for Neuroscience Studies, Queen's University; Kingston, Ontario, Canada.
Jazyk:	angličtina
Zdroj:	Sleep [Sleep] 2023 Feb 08; Vol. 46 (2).
DOI:	10.1093/sleep/zsac250
Abstrakt:	Study Objectives: Whereas there is plenty of evidence on the influence of epileptic activity on non-rapid eye movement (NREM) sleep macro- and micro-structure, data on the impact of epilepsy on rapid eye movement (REM) sleep remains sparse. Using high-density electroencephalography (HD-EEG), we assessed global and focal disturbances of sawtooth waves (STW) as cortically generated sleep oscillations of REM sleep in patients with focal epilepsy. Methods: Twenty-two patients with drug-resistant focal epilepsy (13 females; mean age, 32.6 ± 10.7 years; 12 temporal lobe epilepsy) and 12 healthy controls (3 females; 24.0 ± 3.2 years) underwent combined overnight HD-EEG and polysomnography. STW rate, duration, frequency, power, spatial extent, IED rates and sleep homeostatic properties were analyzed. Results: STW rate and duration were reduced in patients with focal epilepsy compared to healthy controls (rate: 0.64/min ± 0.46 vs. 1.12/min ± 0.41, p = .005, d = -0.98; duration: 3.60 s ± 0.76 vs. 4.57 ± 1.00, p = .003, d = -1.01). Not surprisingly given the fronto-central maximum of STW, the reductions were driven by extratemporal lobe epilepsy patients (rate: 0.45/min ± 0.31 vs. 1.12/min ± 0.41, p = .0004, d = -1.35; duration: 3.49 s ± 0.92 vs. 4.57 ± 1.00, p = .017, d = -0.99) and were more pronounced in the first vs. the last sleep cycle (rate first cycle patients vs. controls: 0.60/min ± 0.49 vs. 1.10/min ± 0.55, p = .016, d = -0.90, rate last cycle patients vs. controls: 0.67/min ± 0.51 vs. 0.99/min ± 0.49, p = .11, d = -0.62; duration first cycle patients vs. controls: 3.60s ± 0.76 vs. 4.57 ± 1.00, p = .003, d = -1.01, duration last cycle patients vs. controls: 3.66s ± 0.84 vs. 4.51 ± 1.26, p = .039, d = -0.80). There was no regional decrease of STWs in the region with the epileptic focus vs. the contralateral side (all p > .05). Conclusion: Patients with focal epilepsy and in particular extratemporal lobe epilepsy show a global reduction of STW activity in REM sleep. This may suggest that epilepsy impacts cortically generated sleep oscillations even in REM sleep when epileptic activity is low. (© The Author(s) 2022. Published by Oxford University Press on behalf of Sleep Research Society. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)
Databáze:	MEDLINE
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