Sleep, Circadian Rhythms, and Epilepsy

Daley, Joseph T.; DeWolfe, Jennifer

doi:10.1007/s11940-018-0534-1

Cited by 17 publications

(13 citation statements)

References 62 publications

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“…However, the electrode integrity assessment was only performed in two studies using ad hoc observational assessment of physiological target engagement [29] or infrequent impedance measurement [33]. Compared with listed studies in Table 1, our suggested model provides round-the-clock physiological monitoring (here ECG) for long-term VNS experiments, which is critical for investigating closed-loop therapy [35] or effects on sleep and circadian cycles [36]. More importantly, weekly electrode impedance measurements were performed to confirm the durability of the implanted electrodes.…”

Section: Discussionmentioning

confidence: 99%

A Rodent Model for Long-Term Vagus Nerve Stimulation Experiments

2019

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Aim: Investigations into the benefits of vagus nerve stimulation (VNS) using rodents have led to promising findings for treating clinical disorders. However, the majority of research has been limited to acute timelines. We developed a rodent model for longitudinal assessment of VNS and validated it with a long-term experiment incorporating continuous physiological monitoring. While the primary aim was not to investigate the effects of VNS on the cardiovascular system, we analyzed cardiovascular parameters to demonstrate the model's capabilities in a long-term stimulation-and-recording setup. Materials & methods: Rats were implanted with a cuff electrode around the cervical vagus nerve and electrocardiogram monitoring devices were implanted in the peritoneal cavity. We also designed a connector mount for seamless access to the cuff electrode for VNS in awake-behaving rats. Results & conclusion: Results signified easy-to-interface VNS system, electrode robustness and discernible physiological signals in a long-term setup. Analysis of the cardiovascular parameters revealed some transient effects during VNS. Our proposed model enables long-term VNS experiments along with physiological monitoring in unanesthetized rats.

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Section: Discussionmentioning

confidence: 99%

A Rodent Model for Long-Term Vagus Nerve Stimulation Experiments

2019

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“…This pronounced effect of sleep is probably related to the strong pathophysiological connection that sleep shares with epilepsy. The bidirectional interactions between sleep, epilepsy, and ASMs are well-known; however, recently, several authors highlighted the rhythmic patterns of epileptic seizures and EEG discharges related to vigilance states and circadian variation in excitatory and inhibitory balance (16,17). The overall impairment of the sleep-wake cycle due to the COVID-19 emergency may affect both PwE and PwoE; however, sleep fragmentation and sleep deprivation may induce in PwE an increase of EEG epileptiform abnormalities (18) and seizure worsening even through an increase in cortical excitability (19).…”

Section: Figure 3 | (A)mentioning

confidence: 99%

Epilepsy Care in the Time of COVID-19 Pandemic in Italy: Risk Factors for Seizure Worsening

et al. 2020

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In early 2020, Italy struggled with an unprecedented health emergency related to the COVID-19 pandemic. Medical care of chronic neurological diseases, such as epilepsy, is being sorely neglected. In this national survey, we aimed at understanding the impact of COVID-19 lockdown on the care of people with epilepsy (PwE) and identifying PwE risk factors for seizure worsening to direct telemedicine efforts. Methods: We administered a 48-items online survey (published on April 11, 2020) including socio-demographic, epilepsy-related, and psychometric variables (BDI-II for depression, GAD-7 for anxiety, and PSQI for sleep) to PwE and people without epilepsy (PwoE). Regression analysis identified predictors of seizure worsening. Results: We collected responses from 456 PwE (344 females) and 472 PwoE (347 females). Outpatient examinations of PwE were postponed in 95% of cases. One-third of PwE complained of issues with epilepsy management, but only 71% of them reached the treating physician and solved their problems. PwE had worse depressive and anxiety symptoms (higher BDI-II and GAD-7 scores; p < 0.001) than PwoE. Sleep quality was equally compromised in both groups (47 and 42%). Sixty-seven PwE (18%) reported seizure worsening, which was best explained by the number of anti-seizure medications (ASM) of chronic therapy and the severity of sleep disorder. Conclusions: During the current COVID-19 pandemic, a significant percentage of PwE experienced difficulties in follow-up and a seizure number increase, in particular those chronically taking more ASMs and with poor sleep quality. This dramatic experience outlines the urgent need for validation and implementation of telemedicine services for epileptic patients in order to provide regular follow-up.

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“…Of course, extensive further research is needed to demonstrate a more precise link between specific sleep stages and rhythms with next‐day functioning, as well as rigorous safety testing of adaptive DBS in sleep to ensure that it does not worsen sleep or motor and cognitive outcomes. If successful, however, this approach may have ramifications even beyond PD and may serve as a prototype for other neurological diseases for which sleep is a comorbidity such as other neurodegenerative disorders and epilepsy 208‐212 …”

Section: Can Sleep Disturbances Seen In Pd Be Reversed?mentioning

confidence: 99%

“…If successful, however, this approach may have ramifications even beyond PD and may serve as a prototype for other neurological diseases for which sleep is a comorbidity such as other neurodegenerative disorders and epilepsy. [208][209][210][211][212]…”

Section: Effect Of Conventional Dbs On Sleepmentioning

confidence: 99%

The Neurophysiology of Sleep in Parkinson's Disease

et al. 2021

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Sleep disturbances are among the most common nonmotor complications of Parkinson's disease (PD), can present in prodromal stages, and progress with advancing disease. In addition to being a symptom of neurodegeneration, sleep disturbances may also contribute to disease progression. Currently, limited options exist to modulate sleep disturbances in PD. Studying the neurophysiological changes that affect sleep in PD at the cortical and subcortical level may yield new insights into mechanisms for reversal of sleep disruption. In this article, we review cortical and subcortical recording studies of sleep in PD with a particular focus on dissecting reported electrophysiological changes. These studies show that slow-wave sleep and rapid eye movement sleep are both notably disrupted in PD. We further explore the impact of these electrophysiological changes and discuss the potential for targeting sleep via stimulation therapy to modify PD-related motor and nonmotor symptoms.

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Sleep, Circadian Rhythms, and Epilepsy

Cited by 17 publications

References 62 publications

A Rodent Model for Long-Term Vagus Nerve Stimulation Experiments

A Rodent Model for Long-Term Vagus Nerve Stimulation Experiments

Epilepsy Care in the Time of COVID-19 Pandemic in Italy: Risk Factors for Seizure Worsening

The Neurophysiology of Sleep in Parkinson's Disease

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