Zubler Frédéric, Rubino Annalisa, Lo Russo Giorgio, Schindler Kaspar, Nobili Lino
"C. Munari" Center for Epilepsy Surgery, Department of Neuroscience, Niguarda Hospital, Milan, Italy.
Department of Neurology, Inselspital-Bern University Hospital, University of Bern, Bern, Switzerland.
Front Neurol. 2017 Jun 22;8:288. doi: 10.3389/fneur.2017.00288. eCollection 2017.
Interictal spikes (IS) are one of the major hallmarks of epilepsy. Understanding the factors promoting or suppressing IS would increase our comprehension of epilepsy and possibly open new avenues for therapy. Sleep strongly influences epileptic activity, and the modulatory effects of the different sleep stages on IS have been studied for decades. However, several aspects are still disputed, in particular the role of sleep spindles and slow waves in the activation of IS during Non-REM sleep. Here, we correlate the rate of IS with quantitative measures derived from stereo-EEG during one Non-REM cycle in 10 patients suffering from drug-resistant epilepsy due to type 2 focal cortical dysplasia. We show that the IS rate (ISR) is positively correlated with sigma power (a surrogate for sleep-spindle density) but negatively correlated with delta power (surrogate for slow wave activity). In addition, we present two new indices for quantifying the spatial and temporal instability of sleep. We found that both instability indices are correlated with a high ISR. The main contribution of this study is to confirm the suppressive effect of stable deep sleep on IS. This result might influence future guidelines for therapy of patients suffering from epilepsy and sleep disorders.
发作间期棘波（IS）是癫痫的主要特征之一。了解促进或抑制IS的因素将增进我们对癫痫的理解，并可能开辟新的治疗途径。睡眠对癫痫活动有强烈影响，不同睡眠阶段对IS的调节作用已被研究数十年。然而，仍有几个方面存在争议，特别是睡眠纺锤波和慢波在非快速眼动睡眠期间激活IS中的作用。在此，我们将10例因2型局灶性皮质发育不良导致药物难治性癫痫患者在一个非快速眼动周期内的IS发生率与立体脑电图得出的定量指标进行关联分析。我们发现，IS发生率（ISR）与西格玛功率（睡眠纺锤波密度的替代指标）呈正相关，但与德尔塔功率（慢波活动的替代指标）呈负相关。此外，我们提出了两个用于量化睡眠时空不稳定性的新指标。我们发现这两个不稳定性指标均与高ISR相关。本研究的主要贡献在于证实了稳定的深度睡眠对IS的抑制作用。这一结果可能会影响未来癫痫和睡眠障碍患者的治疗指南。
