Spectral EEG Analysis and Sleepwalking Defense: Unreliable Scientific Evidence

Pressman, Mark R.; Mahowald, Mark W.; Schenck, Carlos H.; Bornemann, Michel Cramer; Banerjee, Dev; Howell, Michael J.; Buchanan, Peter R.; Avidan, Alon Y.

doi:10.5664/jcsm.3380

Cited by 7 publications

(7 citation statements)

References 16 publications

(20 reference statements)

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“…[4][5][6][7] However, no cutoff has been validated and polysomnography is currently of limited value in differentiating patients with DOAs from normal sleepers. 8 The aims of this study were (1) to develop a visual scoring method of SWS microstructure and SWS-related motor behaviors in a large group of drug-free adults with clinically defined severe DOAs, (2) to compare the vPSG results in patients with DOAs and in a group of healthy subjects to define cutoff values for DOA diagnosis, and (3) to validate these thresholds in a second independent group of adults with DOAs.…”

mentioning

confidence: 99%

Diagnostic criteria for disorders of arousal: A video‐polysomnographic assessment

Lopez

Shen

Chenini

et al. 2018

Annals of Neurology

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mentioning

confidence: 99%

Diagnostic criteria for disorders of arousal: A video‐polysomnographic assessment

Lopez

Shen

Chenini

et al. 2018

Annals of Neurology

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“…The data presented in support of this case did not rely on the visual scoring of SWS% and made no mention hypersynchronous delta (HSDWA) which Pressman et al 1 note have not contributed to diagnosis of SW.…”

Section: Other Mistaken Implications Re: Cartwright and Guilleminaultmentioning

confidence: 53%

“…Pressman et al 1 raise the question whether a low SWA in the fi rst NREM cycle, measured after the fact (not months or years) but specifi cally in this case eight months after the incident, can be a reliable marker of a predisposition to SW. The authors of the critique point out that the studies showing high reliability within subjects of the profi le of the R Cartwright and C Guilleminault spectral analysis sleep EEG wave forms, were not conducted on SW subjects and have not been shown to be stable over the extended period that usually occurs between an event that results in a criminal charge and a subsequent sleep study.…”

Section: Was the Methods Appropriate?mentioning

confidence: 99%

Slow Wave Activity Is Reliably Low in Sleepwalkers: Response to Pressman et al. Letter to the Editor

Cartwright

Guilleminault

2014

Journal of Clinical Sleep Medicine

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W e thank the editor for the opportunity to respond to the letter by Pressman et al. 1 This is a critique of the article by Cartwright and Guilleminault 2 recently published in the Journal of Clinical Sleep Medicine. We address the salient points their letter raised: The aim of our article Was the method appropriate?We based the method for our study on the hypotheses proposed by Espa et al. 4 as the conditions necessary to precipitate an occurrence of a SWS parasomnia. "The occurrence of SWS parasomnia requires not only a SWS pressure increase but also SWS arousal enhancement." This is the push/pull model that Pressman argued was a theory that only Cartwright held in the debate he refers the reader to review. [5][6][7][8] He argued forcefully and repeatedly that SW only occurred with an increase of SWS and that this was the accepted wisdom. In fact the two variable model was stated earlier by Broughton et al. 9 in describing the Ken Parks case. "These typical polysomnographic features of sleepwalkers suggest the coexistence of both pressure for deep sleep (SWS) and of heightened arousal causing inability to sustain such sleep." This opposite pressure model was used in the Pilon et al. 10 study which succeeded in eliciting sleepwalking events in the laboratory by combining increasing pressure for SWS by a prior period of sleep deprivation and increasing arousals from sleep by delivering auditory tones during the recovery sleep. Neither of these manipulations was successful when applied singly. It was this opposite pressure model that we tested in the case study reported in our recent paper.The evidence presented in court supported both pressures were present in the defendant on the night of the event (he had a period of prior sleep deprivation and excessive caffeine intake during the day before the event). Thus the conditions for a SW event were present. Furthermore we pointed out that "the additional history of snoring and a mild breathing disorder validated in the PSG may be a contributing cause of his low SWA, high CAP rate and arousal into non-conscious acts when sleep deprived and over-caffeinated."Pressman et al. 1 raise the question whether a low SWA in the fi rst NREM cycle, measured after the fact (not months or years) but specifi cally in this case eight months after the incident, can be a reliable marker of a predisposition to SW. The authors of the critique point out that the studies showing high reliability within subjects of the profi le of the

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“…75 The reliability of this analysis in a forensic setting has been seriously questioned on the grounds of the lack of sufficient sensitivity, specificity, and stability over the time. 76 In particular, according to some studies, [77][78][79] arousals from deep sleep and hypersynchronous delta waves lack sufficient sensitivity and specificity to be used as diagnostic markers. 10 In their rebuttal, Cartwright and Guilleminault claimed that several studies make "a low slow wave activity a strong candidate to be a manifestation of the genetic vulnerability to abnormal delta arousals and therefore likely to be a stable characteristic of sleep."…”

Section: Discussionmentioning

confidence: 99%

Sleep-Related Violence and Sexual Behavior in Sleep: A Systematic Review of Medical-Legal Case Reports

Ingravallo

Poli

Gilmore

et al. 2014

Journal of Clinical Sleep Medicine

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Spectral EEG Analysis and Sleepwalking Defense: Unreliable Scientific Evidence

Cited by 7 publications

References 16 publications

Diagnostic criteria for disorders of arousal: A video‐polysomnographic assessment

Diagnostic criteria for disorders of arousal: A video‐polysomnographic assessment

Slow Wave Activity Is Reliably Low in Sleepwalkers: Response to Pressman et al. Letter to the Editor

Sleep-Related Violence and Sexual Behavior in Sleep: A Systematic Review of Medical-Legal Case Reports

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