Ferrillo F, Beelke M, Nobili L
Center of Sleep Medicine, Chair of Neurophysiopathology, DISMR, University of Genoa, Genoa, Italy.
Clin Neurophysiol. 2000 Sep;111 Suppl 2:S65-73. doi: 10.1016/s1388-2457(00)00404-1.
The temporal course of sleep interictal epileptic discharges (IEDs) has been studied focusing their relationship with the temporal course of the main sleep-EEG frequency bands that is thought to reflect the action of different synchronization neural mechanisms. The existence of a mutually exclusive mechanism between spindles and delta waves should be reflected in a mutually exclusive facilitation of IEDs activation by slow wave activity (SWA) and sigma activity (SA) during synchronized NREM sleep.
We reanalyzed data from 19 children and 15 adult patients affected by different partial epileptic syndromes. The temporal series of SWA, SA and theta band (TB), derived from spectral analysis, were obtained from a spike-free and pathologic alteration-free derivation, controlateral to the most active lead, where the IEDs count was performed. Relationships between SA, SWA and TB and time series of IEDs were tested by means of correlation techniques after data normalization.
A positive correlation of spike distribution with SWA time course has been found in the majority of adults. Only a few adult patients showed IEDs that were correlated with SA or TB. Conversely SA was shown to be positively correlated with spiking in many different epileptic syndromes of childhood. Moreover, in the contest of the NREM sleep cycle an inverse relationship between the SWA and SA mode of spike activation has been detected.
Overall results give evidence that 3 main rhythmic spectral components that characterize sleep EEG can exert positive influences on IEDs production. Our studies demonstrate that within NREM sleep the facilitating influences on IEDs production exerted separately by either spindle activity or delta synchronization mechanisms can be detected. Moreover, a mutually exclusive mechanism between SA and SWA oscillations is detectable in the opposite relationship of the correlation between IEDs and the two bands in the central part of the NREM cycle.
研究睡眠间期癫痫样放电（IEDs）的时间进程，重点关注其与主要睡眠脑电图频段时间进程的关系，这些频段被认为反映了不同同步神经机制的作用。纺锤波和慢波之间相互排斥的机制应体现在非快速眼动睡眠（NREM）同步期间，慢波活动（SWA）和西格玛活动（SA）对IEDs激活的相互排斥的促进作用上。
我们重新分析了19名儿童和15名成年患者的数据，这些患者患有不同的部分性癫痫综合征。通过频谱分析得出的SWA、SA和θ频段（TB）的时间序列，是从与最活跃导联对侧的无棘波且无病理改变的导联获得的，在该导联进行IEDs计数。在数据标准化后，通过相关技术测试SA、SWA和TB与IEDs时间序列之间的关系。
在大多数成年人中发现棘波分布与SWA时间进程呈正相关。只有少数成年患者的IEDs与SA或TB相关。相反，在儿童的许多不同癫痫综合征中，SA与棘波呈正相关。此外，在NREM睡眠周期中，检测到棘波激活的SWA和SA模式之间存在反比关系。
总体结果表明，表征睡眠脑电图的3个主要节律性频谱成分可对IEDs产生积极影响。我们的研究表明，在NREM睡眠期间，可以检测到纺锤波活动或δ同步机制分别对IEDs产生的促进作用。此外，在NREM周期中部，IEDs与这两个频段的相关性呈相反关系，可检测到SA和SWA振荡之间的相互排斥机制。
