Halász Péter, Bódizs Róbert, Ujma Péter Przemyslaw, Fabó Dániel, Szűcs Anna
National Institute of Clinical Neuroscience, Amerikai út 57. Budapest, H-1145, Hungary.
Semmelweis University, Institute of Behavioral Sciences, Nagyvárad tér 4, Budapest, H-1089, Hungary.
Epilepsy Res. 2019 Feb;150:95-105. doi: 10.1016/j.eplepsyres.2018.11.008. Epub 2019 Jan 31.
The aim of this review is to summarize and discuss the strong bond between NREM sleep and epilepsy underlain by the shared link and effect on brain plasticity. Beyond the seizure occurrence rate, sleep relatedness may manifest in the enhancement of interictal epileptic discharges (spikes and pathological ripples). The number of the discharges as well as their propagation increase during NREM sleep, unmasking the epileptic network that is hidden during wakefulness. The interictal epileptic discharges associate with different sleep constituents (sleep slow waves, spindling and high frequency oscillations); known to play essential role in memory and learning. We highlight three major groups of epilepsies, in which sleep-related plastic functions suffer an epileptic derailment. In absence epilepsy mainly involving the thalamo-cortical system, sleep spindles transform to generalized spike-wave activity. In mesio-temporal epilepsy affecting the hippocampal declarative memory system, the sharp wave ripples derail to dysfunctional epileptic oscillations (spikes and pathological ripples). Idiopathic childhood epilepsies affecting the perisylvian network may progress to catastrophic status electricus during NREM sleep. In these major epilepsies, NREM sleep has a pivotal role in the development and course of the disorder. Epilepsy is born in-, and exhibits its pathological properties during NREM sleep. Interictal discharges are important causative agents in this process.
本综述的目的是总结和讨论非快速眼动睡眠（NREM睡眠）与癫痫之间的紧密联系，这种联系基于两者对大脑可塑性的共同影响。除了癫痫发作率外，睡眠相关性还可能表现为发作间期癫痫放电（棘波和病理性涟漪）的增强。这些放电的数量及其传播在NREM睡眠期间会增加，从而揭示出清醒时隐藏的癫痫网络。发作间期癫痫放电与不同的睡眠成分（睡眠慢波、纺锤波和高频振荡）相关；这些成分已知在记忆和学习中起重要作用。我们重点介绍了三大类癫痫，其中与睡眠相关的可塑性功能出现了癫痫性紊乱。在主要累及丘脑 - 皮质系统的失神癫痫中，睡眠纺锤波转变为全身性棘慢波活动。在影响海马陈述性记忆系统的内侧颞叶癫痫中，尖波涟漪转变为功能失调的癫痫性振荡（棘波和病理性涟漪）。影响外侧裂周围网络的特发性儿童癫痫在NREM睡眠期间可能进展为灾难性癫痫持续状态。在这些主要癫痫中，NREM睡眠在疾病的发生和发展过程中起关键作用。癫痫在NREM睡眠中产生，并在其中表现出其病理特性。发作间期放电是这一过程中的重要致病因素。
