The hidden rhythms of epilepsy: exploring biological clocks and epileptic seizure dynamics

Acta Epileptologica, Journal Year: 2025, Volume and Issue: 7(1)

Published: Jan. 3, 2025

Abstract Epilepsy, characterized by recurrent seizures, is influenced biological rhythms, such as circadian, seasonal, and menstrual cycles. These rhythms affect the frequency, severity, timing of although precise mechanisms underlying these associations remain unclear. This review examines role clocks, particularly core circadian genes Bmal1 , Clock Per Cry in regulating neuronal excitability epilepsy susceptibility. We explore how sleep-wake cycle, non-rapid eye movement sleep, increases risk discuss modulation neurotransmitters like gamma-aminobutyric acid glutamate. clinical implications, including chronotherapy which refers to practice medical treatments align with body's natural rhythm. Chronotherapy aligns anti-seizure medication administration rhythms. also rhythm-based neuromodulation strategies, adaptive deep brain stimulation, may dynamically change stimulation response predicted seizures patients, provide additional therapeutic options. emphasizes potential integrating rhythm analysis into personalized management, offering novel approaches optimize treatment improve patient outcomes. Future research should focus on understanding individual variability seizure harnessing technological innovations enhance prediction, precision treatment, long-term management.

Language: Английский

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The Reciprocal Relationship between Sleep and Epilepsy

Journal of Personalized Medicine, Journal Year: 2024, Volume and Issue: 14(1), P. 118 - 118

Published: Jan. 20, 2024

The relationship between sleep and epilepsy is bidirectional. Certain syndromes predominantly or exclusively manifest during sleep, with seizures frequently originating from non-rapid eye movement (NREM) sleep. Interictal epileptiform discharges observed on electroencephalograms are most likely to be activated the deep NREM stage known as N3. Conversely, discharges, anti-seizure medications (ASMs), well other therapies can exert detrimental effects architecture. Moreover, co-occurrence of disorders has potential exacerbate seizure control. Understating crucial for healthcare providers. Addressing managing sleep-related problems in individuals potentially contribute improved control overall well-being. At same time, improving improve quality quantity, thus further health epilepsy.

Language: Английский

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The Hypno-PC: Uncovering Sleep Dynamics Through Principal Component Analysis and Hidden Markov Modelling of Electrophysiological Signals

Published: Jan. 16, 2025

The conventional approach to sleep analysis relies on pre-defined, visually scored stages derived from electrophysiological signals. This manual method demands substantial effort and is influenced by subjective assessments, implicitly assuming that these categories accurately reflect underlying biological processes. Recent advancements indicate low-dimensional representations of complex brain activity can provide objective means identifying states. These approaches potentially uncover inherent patterns within sleep, offering valuable insights into its organization. In this study, we applied Principal Component Analysis (PCA) spectral features extracted high-density EEG, EOG, EMG, ECG recorded overnight at both 30– 4-second resolutions. Notably, the first principal component—the “Hypno-PC”—strongly aligns with hypnogram time scales. Subsequently, employed a Gaussian Hidden Markov Model (GHMM) delineate discrete states in PCA-transformed data quantify their temporal dynamics. Using minimal supervision (less than 0.5% labeled) cross-subject approach, model achieved alignment standard labels comparable typical inter-rater agreement. Finally, independent component (ICA) was PCA space, decomposing it an set components represent distinct physiological integrated use PCA, GHMM, ICA provides reproducible scalable methodology traditional staging, while more flexible comprehensive perspective Our findings data-driven, unsupervised methods effectively intrinsic dynamics advancing automated enhancing our understanding

Language: Английский

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Epilepsy as a Wilding of Sleep

Current Treatment Options in Neurology, Journal Year: 2025, Volume and Issue: 27(1)

Published: Jan. 20, 2025

Language: Английский

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Fatigue, sleep quality, depression symptoms, and antiseizure medication resistance in patients with newly diagnosed epilepsy

Therapeutic Advances in Neurological Disorders, Journal Year: 2025, Volume and Issue: 18

Published: Jan. 1, 2025

Background: Complaints of fatigue and poor sleep quality are common in patients with epilepsy. Fatigue may precipitate seizures, have higher frequency seizures more likely to symptoms depression. Objectives: This study aims determine the association baseline antiseizure medication (ASM) resistance newly diagnosed epilepsy (PWNDE). We also evaluate whether is mediated by depression symptoms. Methods: performed a prospective cohort PWNDE at comprehensive center Northeast China between June 2020 May 2024. Fatigue, quality, were assessed baseline. All followed for 24 months ASM-resistant Cox proportional hazard regression models used estimate ratios (HRs) ASM resistance. Models fitted restricted cubic spline test linear nonlinear shapes each association. Mediation analysis was mediating effects severity on fatigue, Results: A total 189 (59 cases 130 ASM-responsive controls) included final analysis. Baseline (HR, 1.98; 95% confidence interval (CI), 1.094–3.583, p = 0.024) 2.193; CI, 1.29–3.729, 0.004) associated an increased after full adjustments. There exists Severity Scale score ( P 0.012). Depression partly effect resistance, proportions 18.5% 23.7% quality. Conclusion: risk The severity. These findings emphasize that depression, this be unrelated intake.

Language: Английский

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Oscillatory and nonoscillatory sleep electroencephalographic biomarkers of the epileptic network

Epilepsia, Journal Year: 2024, Volume and Issue: 65(10), P. 3038 - 3051

Published: Aug. 24, 2024

In addition to the oscillatory brain activity, nonoscillatory (scale-free) components of background electroencephalogram (EEG) may provide further information about complexity underlying neuronal network. As epilepsy is considered a network disease, such scale-free metrics might help delineate epileptic Here, we performed an analysis sleep (spindle, slow wave, and rhythmic spectral power) (H exponent) intracranial EEG using multiple interictal features estimate whether how they deviate from normalcy in 38 adults with drug-resistant epilepsy.

Language: Английский

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High‐Frequency Oscillations in Self‐Limited Epilepsy With Centrotemporal Spikes: Potential Predictors of Attention Deficit Hyperactivity Disorder?

International Journal of Developmental Neuroscience, Journal Year: 2025, Volume and Issue: 85(3)

Published: April 29, 2025

ABSTRACT Objective The aim of this study was to examine the possible effect HFOs detected in children with SeLECTS, who have rolandic spikes or without ADHD, predicting cognitive comorbidities fully automatic ripple detector program we developed. Methods A total 40 patients diagnosed SeLECTS at least a 1‐year follow‐up were included study. divided into two groups: those only and SeLECTS+ADHD. For detection, EEG data recorded for 10 min during non‐REM stage 2 sleep sampling frequency 2000 Hz analysed MATLAB environment. After each channel filtered 80–200 Hz, detection made automatically developed program. Results At one 29 (72.5%). number both groups had mean 1435.8 ± 1626.9 (5–6183). region found be statistically significantly higher SeLECTS+ADHD group ( p = 0.042). ripples mean: 9.5 26.5 (0–158). highest count patient group; 158 counted, distribution 33 centrotemporal 125 frontal region. 0.009) ratio ‘Fz‐Cz’ electrode + ADHD 0.009, 0.019, respectively). Significance Our showed that presence interictal scalp has neurocognitive comorbidities. We think analysis can used as potential biomarker predict

Language: Английский

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The effects of slow wave sleep characteristics on semantic, episodic, and procedural memory in people with epilepsy

Frontiers in Pharmacology, Journal Year: 2024, Volume and Issue: 15

Published: April 25, 2024

Slow wave sleep (SWS) is highly relevant for verbal and non-verbal/spatial memory in healthy individuals, but also people with epilepsy. However, contradictory findings exist regarding the effect of seizures on overnight retention, particularly relating to procedural non-verbal memory, thorough examination episodic retention ecologically valid tests missing. This research explores interaction SWS duration epilepsy-relevant factors, as well relation spectral characteristics procedural, verbal, memory. In an epilepsy monitoring unit, patients (N = 40) underwent learning, immediate 12 h delayed testing a fingertapping task (procedural memory), word-pair (verbal innovative virtual reality (episodic memory). We used multiple linear regression examine impact duration, SWS, seizure occurrence, medication, depression, type, gender, retention. Results indicated that none candidate variables significantly predicted changes performance. For occurrence tonic-clonic negatively impacted higher psychoactive medication load showed tendency lower Episodic was by displaying potential nonlinear longer than 10 years affecting Higher drug anti-seizure related better Contrary expectations trend towards decreased Analyses associations between types EEG band power during revealed alpha-band frontal right region significant predictor conclusion, this reveals modalities are not equally affected important factors such characteristics.

Language: Английский

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The Differing Effects of Sleep on Ictal and Interictal Network Dynamics in Drug‐Resistant Epilepsy

Annals of Neurology, Journal Year: 2023, Volume and Issue: 95(1), P. 42 - 56

Published: Sept. 15, 2023

Sleep has important influences on focal interictal epileptiform discharges (IEDs), and the rates spatial extent of IEDs are increased in non-rapid eye movement (NREM) sleep. In contrast, influence sleep seizures is less clear, its effects seizure topography poorly documented. We evaluated NREM ictal spatiotemporal dynamics contrasted these with network dynamics.We included patients drug-resistant epilepsy who underwent continuous intracranial electroencephalography (iEEG) depth electrodes. Patients were selected if they had 1 to 3 from each vigilance state, wakefulness sleep, within a 48-hour window, under same antiseizure medication. A 10-minute epoch iEEG was per detected automatically. total 25 (13 women; aged 32.5 ± 7.1 years) included.The onset pattern, duration, propagation, latency high-frequency activity did not differ significantly between (all p > 0.05). IED distribution compared (p < 0.001, Cliff's d = 0.48 0.49). The overlap states higher for (57.1 40.1%) than (41.7 46.2%; 0.51).In contrast IEDs, does affect dynamics. This suggests that once brain surpasses threshold, it will follow underlying epileptic irrespective state. These findings offer valuable insights into neural have clinical implications localizing foci. ANN NEUROL 2023.

Language: Английский

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Transcranial electrical stimulation during functional magnetic resonance imaging in patients with genetic generalized epilepsy: a pilot and feasibility study

Frontiers in Neuroscience, Journal Year: 2024, Volume and Issue: 18

Published: March 19, 2024

Objective A third of patients with epilepsy continue to have seizures despite receiving adequate antiseizure medication. Transcranial direct current stimulation (tDCS) might be a viable adjunct treatment option, having been shown reduce epileptic in focal epilepsy. Evidence for the use tDCS genetic generalized (GGE) is scarce. We aimed establish feasibility applying during fMRI GGE study acute neuromodulatory effects tDCS, particularly on sensorimotor network activity. Methods Seven healthy controls and three received simultaneous acquisition while watching movie. Three conditions were applied: anodal, cathodal sham. Periods 60 s without applied between each condition. Changes cortex connectivity evaluated by calculating mean degree centrality across eight nodes defined Automated Anatomical Labeling atlas (primary motor (precentral left right), supplementary area (left mid-cingulum postcentral gyrus right)), conditions, participant. Results Simultaneous tDCS-fMRI was well tolerated both adverse effects. Anodal reduced (Friedman’s ANOVA Dunn’s multiple comparisons test; adjusted p = 0.02 0.03 respectively). Mean sham condition not different rest (adjusted 0.94). Conclusion Applying feasible safe small group GGE. caused significant reduction participants. This initial research supports using guide understand modulation that facilitate its clinical application future.

Language: Английский

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