Sleep, oscillations, and epilepsy

Bernard, Christophe; Frauscher, Birgit; Gelinas, Jennifer N.; Timofeev, Igor

doi:10.1111/epi.17664

Cited by 9 publications

(6 citation statements)

References 110 publications

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“…People with epilepsy often experience disruptions in their sleep architecture ( Bernard et al, 2023 ). However, previous research found no correlation between nighttime sleep architecture or interruptions of sleep and a 24 h delayed recall of verbal and non-verbal memory in people with epilepsy ( Fitzgerald et al, 2013 ).…”

Section: Discussionmentioning

confidence: 99%

The effects of slow wave sleep characteristics on semantic, episodic, and procedural memory in people with epilepsy

Höller,

Eyjólfsdóttir,

Van Schalkwijk

et al. 2024

Front. Pharmacol.

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Slow wave sleep (SWS) is highly relevant for verbal and non-verbal/spatial memory in healthy individuals, but also in people with epilepsy. However, contradictory findings exist regarding the effect of seizures on overnight memory retention, particularly relating to procedural and non-verbal memory, and thorough examination of episodic memory retention with ecologically valid tests is missing. This research explores the interaction of SWS duration with epilepsy-relevant factors, as well as the relation of spectral characteristics of SWS on overnight retention of procedural, verbal, and episodic memory. In an epilepsy monitoring unit, epilepsy patients (N = 40) underwent learning, immediate and 12 h delayed testing of memory retention for a fingertapping task (procedural memory), a word-pair task (verbal memory), and an innovative virtual reality task (episodic memory). We used multiple linear regression to examine the impact of SWS duration, spectral characteristics of SWS, seizure occurrence, medication, depression, seizure type, gender, and epilepsy duration on overnight memory retention. Results indicated that none of the candidate variables significantly predicted overnight changes for procedural memory performance. For verbal memory, the occurrence of tonic-clonic seizures negatively impacted memory retention and higher psychoactive medication load showed a tendency for lower verbal memory retention. Episodic memory was significantly impacted by epilepsy duration, displaying a potential nonlinear impact with a longer duration than 10 years negatively affecting memory performance. Higher drug load of anti-seizure medication was by tendency related to better overnight retention of episodic memory. Contrary to expectations longer SWS duration showed a trend towards decreased episodic memory performance. Analyses on associations between memory types and EEG band power during SWS revealed lower alpha-band power in the frontal right region as significant predictor for better episodic memory retention. In conclusion, this research reveals that memory modalities are not equally affected by important epilepsy factors such as duration of epilepsy and medication, as well as SWS spectral characteristics.

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Section: Discussionmentioning

confidence: 99%

The effects of slow wave sleep characteristics on semantic, episodic, and procedural memory in people with epilepsy

Höller,

Eyjólfsdóttir,

Van Schalkwijk

et al. 2024

Front. Pharmacol.

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“…The network effects of tDCS are also dependent on brain state, with cathodal tDCS having greater effects during a task while anodal tDCS has greater effects during rest ( Li et al, 2019 ). Epileptic brain activity, both seizures and IEDs, are often more prevalent during certain states of arousal such as sleep in both focal epilepsy and in GGE ( Bernard et al, 2023 ). This shows that the probability of epileptic activity is modulated by the global state of the brain which relates to cortical excitability.…”

Section: Discussionmentioning

confidence: 99%

Transcranial electrical stimulation during functional magnetic resonance imaging in patients with genetic generalized epilepsy: a pilot and feasibility study

Cohen,

Steinbrenner,

Piper

et al. 2024

Front. Neurosci.

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ObjectiveA third of patients with epilepsy continue to have seizures despite receiving adequate antiseizure medication. Transcranial direct current stimulation (tDCS) might be a viable adjunct treatment option, having been shown to reduce epileptic seizures in patients with focal epilepsy. Evidence for the use of tDCS in genetic generalized epilepsy (GGE) is scarce. We aimed to establish the feasibility of applying tDCS during fMRI in patients with GGE to study the acute neuromodulatory effects of tDCS, particularly on sensorimotor network activity.MethodsSeven healthy controls and three patients with GGE received tDCS with simultaneous fMRI acquisition while watching a movie. Three tDCS conditions were applied: anodal, cathodal and sham. Periods of 60 s without stimulation were applied between each stimulation condition. Changes in sensorimotor cortex connectivity were evaluated by calculating the mean degree centrality across eight nodes of the sensorimotor cortex defined by the Automated Anatomical Labeling atlas (primary motor cortex (precentral left and right), supplementary motor area (left and right), mid-cingulum (left and right), postcentral gyrus (left and right)), across each of the conditions, for each participant.ResultsSimultaneous tDCS-fMRI was well tolerated in both healthy controls and patients without adverse effects. Anodal and cathodal stimulation reduced mean degree centrality of the sensorimotor network (Friedman’s ANOVA with Dunn’s multiple comparisons test; adjusted p = 0.02 and p = 0.03 respectively). Mean degree connectivity of the sensorimotor network during the sham condition was not different to the rest condition (adjusted p = 0.94).ConclusionApplying tDCS during fMRI was shown to be feasible and safe in a small group of patients with GGE. Anodal and cathodal stimulation caused a significant reduction in network connectivity of the sensorimotor cortex across participants. This initial research supports the feasibility of using fMRI to guide and understand network modulation by tDCS that might facilitate its clinical application in GGE in the future.

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“…Another study looking at continuous intracranial electroencephalography and seizure diaries in patients with focal epilepsies found 5 seizure peak times (12 a.m., 3 a.m., 9 a.m., 2 p.m., and 6 p.m.) (9). Additionally, interictal activity may be associated with a circadian pattern that is specific to the individual patient (10). In a study of the association between interictal epileptiform activity and circadian and multidien rhythms, variability was shown among patients with epilepsy; however, stability was shown for individual patients for many years (11).…”

Section: Circadian Patterns Of Seizuresmentioning

confidence: 99%

Diazepam nasal spray administration is effective to control seizure clusters irrespective of time of day

Liow,

Wheless,

Cook

et al. 2024

Front. Neurol.

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IntroductionNeurologic circadian influences, including sleep/wake transitions, processes (e.g., hormonal variation), and behavioral patterns (e.g., consumption of food and oral medications), may affect seizure patterns. Specific circadian patterns of seizures have been reported depending on type, onset location, and severity; however, data on patterns for patients with seizure clusters and effectiveness of rescue therapy by time of day are limited.MethodsWe conducted post hoc analyses using patient diary data from the phase 3 safety study of diazepam nasal spray, which is indicated for acute treatment of seizure clusters in patients with epilepsy aged ≥6 years. Patients were administered age- and weight-based doses; second doses could be administered if needed to control a seizure cluster. We assessed clock timing of seizure-cluster onset along with second-dose use as a proxy for effectiveness. Treatment-emergent adverse events were recorded.ResultsSeizure-cluster onset was observed to be generally highest during mornings and late evenings and lowest in the early evening and middle of the night. Second-dose use was not consistently associated with a specific time of day. The safety profile was consistent with that expected from previous studies of diazepam nasal spray.ConclusionThese results suggest that diazepam nasal spray can be effectively administered at any time of day.

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Sleep, oscillations, and epilepsy

Cited by 9 publications

References 110 publications

The effects of slow wave sleep characteristics on semantic, episodic, and procedural memory in people with epilepsy

The effects of slow wave sleep characteristics on semantic, episodic, and procedural memory in people with epilepsy

Transcranial electrical stimulation during functional magnetic resonance imaging in patients with genetic generalized epilepsy: a pilot and feasibility study

Diazepam nasal spray administration is effective to control seizure clusters irrespective of time of day

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