Sleep homeostasis, seizures, and cognition in children with focal epilepsy

Abstract

To investigate the link between sleep disruption and cognitive impairment in childhood epilepsy by studying the effect of epilepsy on sleep homeostasis, as reflected in slow-wave activity (SWA). Method:We examined SWA from overnight EEG-polysomnography in 19 children with focal epilepsy (mean [SD] age 11 years 6 months [3 years], range 6 years 6 months-15 years 6 months; 6 females, 13 males) and 18 age-and sex-matched typically developing controls, correlating this with contemporaneous memory consolidation task scores, full-scale IQ, seizures, and focal interictal discharges.Results: Children with epilepsy did not differ significantly from controls in overnight SWA decline (p = 0.12) or gain in memory performance with sleep (p = 0.27). SWA was lower in patients compared to controls in the first hour of non-rapid eye movement sleep (p = 0.021), although not in those who remained seizure-free (p = 0.26). Full-scale IQ did not correlate with measures of SWA in patients or controls. There was no significant difference in SWA measures between focal and non-focal electrodes.Interpretation: Overnight SWA decline is conserved in children with focal epilepsy and may underpin the preservation of sleep-related memory consolidation in this patient group. Reduced early-night SWA may reflect impaired or immature sleep homeostasis in those with a higher seizure burden.

Impaired sleep homeostasis in children with epilepsy

“…Figure 2 shows the age dependency of SWA. 1 Firstly, we see some evidence of the still evolving brain maturation, presumably between the ages of 6 years and 8 years. This small detail, which is in line with previous reports, 4 is concealed using the linear fit.…”

“…Figure 2 shows the age dependency of SWA 1 . Firstly, we see some evidence of the still evolving brain maturation, presumably between the ages of 6 years and 8 years.…”

“…With special care as to sources, design, use of state-of-the-art methods, and analysis criteria, we can arrive at well-grounded conclusions with the potential to guide clinical trials on a more optimal scale in the future. The paper by Eriksson et al 1 investigates the content and evolution of slow-wave activity (SWA) during sleep in children with epilepsy and typically developing children. It aims at understanding the mechanisms that disrupt normal cognitive development of children with epilepsy.…”

“…The paper by Eriksson et al 1 investigates the content and evolution of slow‐wave activity (SWA) during sleep in children with epilepsy and typically developing children. It aims at understanding the mechanisms that disrupt normal cognitive development of children with epilepsy.…”

Epilepsy is a continuing disease

“…Long‐term recordings encompassing life activities also provide insights into features of brain states when individuals with epilepsy are not having seizures 4 . Brain states can be approached using various EEG signal processing methods that focus on frequency and/or time domain analysis.…”