Affiliation:
1. Analytical Neurophysiology Lab, Montreal Neurological Institute and Hospital, McGill University , Montreal , Canada
2. Hospital Group Ostallgaeu-Kaufbeuren, Department of Pediatrics , Kaufbeuren , Germany
3. Medical University Innsbruck, Department of Pediatrics , Innsbruck , Austria
4. Montreal Neurological Institute and Hospital, McGill University , Montreal , Canada
5. Department of Medicine and Center for Neuroscience Studies, Queen’s University; Kingston , Ontario , Canada
Abstract
Abstract
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.
Funder
Canadian Institutes of Health Research
Hewitt Foundation
Savoy Epilepsy Foundation
Publisher
Oxford University Press (OUP)
Subject
Physiology (medical),Neurology (clinical)
Cited by
4 articles.
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