Sleep homeostasis, seizures, and cognition in children with focal epilepsy. (7th September 2022)

• Record Type: Journal Article
• Authors: Eriksson, Maria H.; Baldeweg, Torsten; Pressler, Ronit; Boyd, Stewart G.; Huber, Reto; Cross, J. Helen; Bölsterli, Bigna K.; Chan, Samantha Y. S.
• Is Part Of: Developmental medicine & child neurology. Volume 65:Number 5(2023)
• Page Start: 701
• Page End: 711
• Publication Date: 2022-09-07
• Subjects: Child development -- Periodicals; Pediatric neurology -- Periodicals; 616.8
• DOI: 10.1111/dmcn.15403
• Languages: English
• ISSNs: 0012-1622

Abstract

Abstract: Aim: 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. What this paper adds: The decline in slow‐wave activity (SWA) across the night, reflecting global synaptic downscaling, was preserved in children with focal lesional epilepsies. Sleep benefited memory consolidation in this group of patients, as in typically developing children. Reduced early‐night SWA was associated with increased likelihood of a subsequent seizure. What this paper adds: The decline in slow‐wave activity (SWA) across the night, reflecting global synaptic downscaling, was preserved in children with focal lesional epilepsies. Sleep benefited memory consolidation in this group of patients, as in typically developing children. Reduced early‐night SWA was associated with increased likelihood of a subsequent seizure. In this study, we investigated the link between sleep homeostasis, as reflected in slow‐wave activity (SWA), and cognitive impairment in children with epilepsy. We used overnight EEG‐polysomnography and contemporaneous measures of memory performance and full‐scale IQ in 19 children with focal epilepsy and 18 typically developing controls. Both groups of children showed an overnight decline in SWA (a & b) across electrodes (c), and a benefit of sleep to memory consolidation. Children with a higher seizure burden showed less SWA in the first hour of sleep compared to controls. This original article is commented on by Amzica on pages 598–599 of this issue.