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睡眠相关认知功能在中央颞区棘波良性癫痫谱中的作用。

The role of sleep-related cognitive functions in the spectrum of benign epilepsy with centro-temporal spikes.

机构信息

Sleep Center, Neurocenter of Southern Switzerland, Civic Hospital of Lugano (EOC), via Tesserete 46, 6903, Lugano, Switzerland.

Department of Pediatric Neurology and Developmental Medicine, University of Basel Children's Hospital, Basel, Switzerland.

出版信息

Eur J Pediatr. 2019 Aug;178(8):1129-1137. doi: 10.1007/s00431-019-03413-9. Epub 2019 Jun 21.

Abstract

Heterogeneous cognitive deficits have been described in the spectrum of benign epilepsy with centro-temporal spikes, which strongly correlate with the intensity of interictal epileptiform discharges and its spreading, in particular during sleep, mostly within the perisylvian cognitive network. The aim of this review is to discuss current findings regarding the connection between sleep alterations and cognitive function in the spectrum of benign epilepsy with centro-temporal spikes. A longer sleep onset latency is the only evident sleep macrostructure alteration reported in the spectrum of benign epilepsy with centro-temporal spikes. On a microstructural level, a higher spike count of descending compared to ascending slopes of sleep cycles, an impairment of slow wave downscaling, and amplitude and slope of slow waves were found in the spectrum of benign epilepsy with centro-temporal spikes. Moreover, children with benign epilepsy with centro-temporal spikes had a reduced non-rapid eye movement sleep instability, in terms of cyclic alternating pattern, similar to that found in children with attention-deficit hyperactivity disorders and in children with obstructive sleep apnea and centro-temporal spike during sleep. Children with benign epilepsy with centro-temporal spikes have a known comorbidity with attention-deficit hyperactivity disorders and obstructive sleep apnea.Conclusion: Considering the common sleep microstructure alterations, the presence of attention deficit and hyperactivity and/or sleep apnea may be a considered warning sign in the case of benign epilepsy with centro-temporal spikes. What is Known: • Sleep related-cognitive deficits have been described in the spectrum of benign epilepsy with centro-temporal spikes. The degree of sleep alterations may predict the neurocognitive outcome, and help clinicians to choose the right treatment. What is New: • Considering the common sleep microstructure alterations, attention deficit and sleep apnea, may be a considered warning signs.

摘要

良性癫痫伴中央颞区棘波的频谱中存在异质性认知缺陷,这些缺陷与发作间期棘波放电的强度及其传播密切相关,尤其是在睡眠期间,主要在大脑边缘认知网络内。本综述旨在讨论目前关于良性癫痫伴中央颞区棘波频谱中睡眠改变与认知功能之间关系的研究结果。良性癫痫伴中央颞区棘波频谱中唯一明显的睡眠宏观结构改变是睡眠潜伏期延长。在微观结构水平上,与睡眠周期的上升斜率相比,下降斜率的棘波计数较高,慢波下调制受损,慢波的幅度和斜率较低,在良性癫痫伴中央颞区棘波频谱中发现。此外,良性癫痫伴中央颞区棘波的儿童的非快速眼动睡眠不稳定性降低,就周期性交替模式而言,与注意力缺陷多动障碍儿童以及阻塞性睡眠呼吸暂停和睡眠中中央颞区棘波儿童相似。良性癫痫伴中央颞区棘波的儿童存在注意力缺陷多动障碍和阻塞性睡眠呼吸暂停的已知共病。结论:鉴于常见的睡眠微观结构改变,存在注意力缺陷、多动和/或睡眠呼吸暂停可能是良性癫痫伴中央颞区棘波的一个考虑警示信号。已知的是:• 在良性癫痫伴中央颞区棘波的频谱中描述了与睡眠相关的认知缺陷。睡眠改变的程度可能预测神经认知结局,并有助于临床医生选择正确的治疗方法。新的是:• 鉴于常见的睡眠微观结构改变,注意力缺陷和睡眠呼吸暂停可能是一个考虑的警示信号。

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