Epilepsy, Sleep
Conditions
Keywords
Benign epilepsy with centro-temporal spikes, Continuous spike waves in slow wave sleep, Electroencephalography, Sleep, slow wave
Brief summary
Background: Close relationship exists between sleep slow wave (SSW) and the generation of spike wave in NREM-sleep. SSW are cortically generated oscillations alternating between excitatory depolarization (Up-phase of the SSW) and inhibitory hyperpolarization (Down-phase of the SSW). It has been shown experimentally that with increasing synchrony of slow neuronal oscillations SSW turn into spike waves. Acoustic pulses applied in correspondence to the SSW Up-phase enhance the amplitude of the subsequent SSW. Conversely, tones delivered at the SSW Downphase have a disruptive effect on the following SSW. Participants: Patients with epilepsy and spike waves in NREM-sleep. Objective: Modification of spike wave frequency, amplitude and spreading during NREM sleep by acoustic pulses applied at the Up- or Down-phase of SSW.
Interventions
DEVICEAcoustic pulses
Acoustic pulses applied during NREM sleep slow waves Up-phase or Down-phase. The acoustic stimulus will be delivered by speakers with a volume of about 50 dB.
Sponsors
University Children's Hospital, Zurich
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
BASIC_SCIENCE
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
4 Years to 12 Years
Healthy volunteers
No
Inclusion criteria
* Participants with Rolandic epilepsy/BECTS * Participants with ESES/CSWS * Participants with generalized spike waves in sleep * EEG within 6 months before study night consistent with the diagnosis
Exclusion criteria
* Clinically significant concomitant acute or chronic disease * Seizure frequency \>1/week, history of convulsive status epilepticus or seizures provoked by sleep deprivation * Severe sleep problems * Treatment with corticosteroids, immunosuppressive or vagus nerve stimulation
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Spike wave index | Change baseline (without) and with acoustic pulses in the same NREM period: 45 minutes | Change of spike wave index during acoustic pulses applied at the Up- or Down-phase of sleep slow waves. Spike wave index given in percent and calculated by number of seconds within 10 second windows with spike waves over the whole 15 minutes of the block design part. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Spike wave amplitude | Change baseline (without) and with acoustic pulses in the same NREM period: 45 minutes | Change of spike wave amplitude (in microvolts) during acoustic pulses applied at the Up- or Down-phase of sleep slow waves. Amplitudes of maximum spike will be analyzed in 10 seconds periods of the first and the last 100 seconds of every part of the block design. EEG source derivation will be used for the analysis. The mean of the 3 highest amplitudes of each 10 seconds period will be determined and the mean of the 10 periods will presented in mean and SD. |
| Spike wave spreading | Change baseline (without) and with acoustic pulses in the same NREM period: 45 minutes | Change of spike wave spreading during acoustic pulses applied at the Up- or Down-phase of sleep slow waves. Spreading will be analyzed in 10 seconds periods of the first and the last 100 seconds of every part of the block design. EEG source derivation will be used for the analysis. Maximum spike wave spreading (number of electrodes involved) visible in 3 spike waves of each 10 second period will be determined and the mean of the 10 periods will presented in mean and SD. |
| Spike wave index in the NREM (2) period following the NREM (1) period with acoustic pulses | Change baseline (NREM 1) and NREM 2: expected average of 1 hour | Change of spike wave index in the NREM period following the NREM period with acoustic pulses applied at the Up- or Down-phase of sleep slow waves. Over the first 15 minutes of the following NREM period: Spike wave index given in percent and calculated by number of seconds within 10 second windows with spike waves . |
| Spike wave amplitude in the NREM (2) period following the NREM (1) period with acoustic pulses | Change baseline (NREM 1) and NREM 2: expected average of 1 hour | Change of spike wave amplitude (in microvolts) in the NREM period following the NREM period with acoustic pulses applied at the Up- or Down-phase of sleep slow waves. Amplitudes of maximum spike will be analyzed in 10 seconds periods of the first and the last 100 seconds of the following NREM period. EEG source derivation will be used for the analysis. The mean of the 3 highest amplitudes of each 10 seconds period will be determined and the mean of the 10 periods will presented in mean and SD. |
| Spike wave spreading in the NREM (2) period following the NREM (1) period with acoustic pulses | Change baseline (NREM 1) and NREM 2: expected average of 1 hour | Change of spike wave spreading in the NREM period following the NREM period with acoustic pulses applied at the Up- or Down-phase of sleep slow waves. Spreading will be analyzed in 10 seconds periods of the first and the last 100 seconds of the following NREM period. EEG source derivation will be used for the analysis. Maximum spike wave spreading (number of electrodes involved) visible in 3 spike waves of each 10 second period will be determined and the mean of the 10 periods will presented in mean and SD. |
Countries
Switzerland
Outcome results
None listed