Department of Neurology, Feinberg School of Medicine, Northwestern University, IL, USA; Comprehensive Epilepsy Center, Northwestern Memorial Hospital, Chicago, IL, USA.
Department of General Surgery, Trident Medical Center, North Charleston, SC, USA; Department of Neurosurgery, Massachusetts General Hospital, Boston, MA, USA.
Clin Neurophysiol. 2024 Jan;157:37-43. doi: 10.1016/j.clinph.2023.11.008. Epub 2023 Nov 20.
This study investigates variations in hippocampal barque occurrence during sleep and compares findings to respective variations of their scalp manifestation as 14&6/sec positive spikes.
From 11 epilepsy patients, 12 non-epileptogenic hippocampi with barques were identified for this study. Using the first seizure-free whole-night sleep stereo-encephalography (sEEG) recording, we performed sleep staging and measured the occurrence of barques and 14&6/sec positive spikes variants.
Hippocampal barques (total count: 9,183; mean count per record: 765.2 ± 251.2) occurred predominantly during non-rapid eye movement (NREM) II sleep (total: 5,744; mean: 478.6 ± 176.1; 62.2 ± 6.0%) and slow-wave sleep (SWS) (total: 2,950; mean: 245.83 ± 92.9; 32.0 ± 6.2%), with rare to occasional occurrence in NREM I (total: 85; mean: 7.0 ± 2.8; 0.9 ± 0.4%), rapid eye movement (REM) (total: 153; mean: 12.75 ± 4.0; 1.7 ± 0.6) and wakefulness (total: 251; mean: 20.9 ± 6.3; 2.9 ± 0.9%). Barque rate increased during SWS (mean: 2.7 ± 1.0 per min) compared to NREM II (2.2 ± 1.0 per min) and other states (wakefulness: 0.1 ± 0.0 per min; NREM I: 0.3 ± 0.1 per min; REM: 0.1 ± 0.0 per min). The 14&6/sec positive spikes variant (total count: 2,406; mean: 343.7 ± 106.7) was present in NREM II (total: 2,059; mean: 249.1 ± 100.2, 84.9 ± 3.6%) and SWS (total: 347; mean: 49.5 ± 12.8, 15.0 ± 3.6%) stages, and absent from the rest of sleep and wakefulness. While all 14&6/sec positive spikes correlated with barques, only 44.7 ± 6.1% of barques manifested as 14&6/sec positive spikes.
Hippocampal barques are predominant in NREM II and SWS, and tend to increase their presence during SWS. Their scalp manifestation as 14&6/sec positive spikes is confounded by wakefulness, REM and NREM I stages, and "masked" by the co-occurrence of NREM II and SWS slow waves, and overlapping reactive micro-arousal elements.
Our study highlighted the overnight profile of hippocampal barques, in relation to the respective profile of their scalp manifestation, the 14&6/sec positive spikes variant.
本研究调查了睡眠期间海马回波的变化，并将其与各自的头皮表现（14&6/sec 阳性棘波）的变化进行了比较。
从 11 例癫痫患者中，确定了 12 例无癫痫起源的海马回波。使用首次无发作的整个夜间睡眠立体脑电图（sEEG）记录，我们进行了睡眠分期，并测量了回波和 14&6/sec 阳性棘波变异的发生。
海马回波（总计数：9183；平均每记录计数：765.2±251.2）主要发生在非快速眼动（NREM）II 睡眠（总计数：5744；平均：478.6±176.1；62.2±6.0%）和慢波睡眠（SWS）（总计数：2950；平均：245.83±92.9；32.0±6.2%），在 NREM I（总计数：85；平均：7.0±2.8；0.9±0.4%）、快速眼动（REM）（总计数：153；平均：12.75±4.0；1.7±0.6%）和觉醒（总计数：251；平均：20.9±6.3；2.9±0.9%）中偶有发生。SWS 期间的回波率（平均：2.7±1.0 次/分钟）高于 NREM II（平均：2.2±1.0 次/分钟）和其他状态（觉醒：0.1±0.0 次/分钟；NREM I：0.3±0.1 次/分钟；REM：0.1±0.0 次/分钟）。14&6/sec 阳性棘波变异（总计数：2406；平均：343.7±106.7）存在于 NREM II（总计数：2059；平均：249.1±100.2，84.9±3.6%）和 SWS（总计数：347；平均：49.5±12.8，15.0±3.6%）阶段，而在其余的睡眠和觉醒中不存在。虽然所有的 14&6/sec 阳性棘波都与回波相关，但只有 44.7±6.1%的回波表现为 14&6/sec 阳性棘波。
海马回波主要发生在 NREM II 和 SWS 中，并且在 SWS 期间，它们的存在倾向于增加。它们在头皮上的表现（14&6/sec 阳性棘波）受到觉醒、REM 和 NREM I 阶段的干扰，并被 NREM II 和 SWS 慢波的同时出现“掩盖”，以及重叠的反应性微觉醒元素“掩盖”。
我们的研究强调了海马回波在整个夜间的特征，以及它们在头皮上的表现（14&6/sec 阳性棘波）的相应特征。
