Hippocampal Sleep Spindles Are Reduced in Adult Patients with Pediatric-onset Focal Epilepsy and Cognitive Impairment
Abstract number :
1.151
Submission category :
3. Neurophysiology / 3A. Video EEG Epilepsy-Monitoring
Year :
2022
Submission ID :
2204643
Source :
www.aesnet.org
Presentation date :
12/3/2022 12:00:00 PM
Published date :
Nov 22, 2022, 05:25 AM
Authors :
Jan Schoenberger, MD – Universitätsklinikum Freiburg; Tian-Jia Liu, MD – Universitätsklinikum Freiburg; Victoria San Antonio-Arce, MD – Universitätsklinikum Freiburg; Kerstin Alexandra Klotz, MD – Universitätsklinikum Freiburg; Julia Jacobs, MD – Universitätsklinikum Freiburg
Rationale: Drug-resistant focal epilepsy is frequently accompanied by developmental delay and cognitive deficits - especially in patients with pediatric disease onset. Recent intracranial EEG analyses have highlighted local sleep features like hippocampal sleep spindles and their importance for cognition. It is poorly understood how epileptic activity interferes with normal cognitive development and why early epileptic encephalopathy can cause lasting cognitive impairment. We hypothesized that hippocampal sleep spindles are reduced in adult patients with pediatric-onset epilepsy and cognitive impairment, compared to patients with late-onset epilepsy and normal cognition.
Methods: Stereotactic electroencephalography (SEEG) recordings from mesial temporal structures were retrospectively analyzed in 43 consecutive subjects (age 17-59 years) with drug-resistant focal epilepsy. Patients had evident or suspected epileptogenesis in the mesial temporal lobe. Subjects with pediatric-onset epilepsy and severe cognitive impairment (group 1, n = 10 patients) were compared to subjects with adult-onset epilepsy and mild or no cognitive impairment (group 2, n = 33 patients). A representative 30-min interval of slow-wave sleep was selected for analysis. Sleep spindles were visually identified in a referential montage.
Results: The rate of hippocampal sleep spindles was significantly lower in adult patients with pediatric onset of epilepsy and severe cognitive impairment (group 1) than in patients with adult onset and mild or no deficits (group 2; p < 0.001, Wilcoxon rank sum test). Rates were significantly different between the different mesial temporal structures (p < 0.001, Kruskal-Wallis test): Spindle rate was highest in the parahippocampal gyrus, intermediate in the hippocampus, and lowest in the entorhinal cortex and amygdala. Seizure onset zone channels had significantly less spindles than the remaining non-seizure onset zone channels (p = 0.01, Wilcoxon rank sum test).
Neurophysiology