Sleep and epilepsy: A clinical and pathophysiological overview

Revue Neurologique, Journal Year: 2023, Volume and Issue: 179(7), P. 687 - 702

Published: Aug. 17, 2023

Language: Английский

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Electroencephalogram synchronization measure as a predictive biomarker of Vagus nerve stimulation response in refractory epilepsy: A retrospective study

PLoS ONE, Journal Year: 2024, Volume and Issue: 19(6), P. e0304115 - e0304115

Published: June 11, 2024

There are currently no established biomarkers for predicting the therapeutic effectiveness of Vagus Nerve Stimulation (VNS). Given that neural desynchronization is a pivotal mechanism underlying VNS action, EEG synchronization measures could potentially serve as predictive response. Notably, an increased brain in delta band has been observed during sleep–potentially due to activation thalamocortical circuitry, and interictal epileptiform discharges more frequently sleep. Therefore, investigation metrics sleep provide valuable insight into excitatory-inhibitory balance pro-epileptogenic state, be pathological patients exhibiting poor response VNS. A 19-channel-standard system was used collect data from 38 individuals with Drug-Resistant Epilepsy (DRE) who were candidates implantation. An metric–the Weighted Phase Lag Index (wPLI)—was extracted before implantation compared between wakefulness, responders (R) non-responders (NR). In band, higher wPLI found wakefulness NR only. However, this difference any state R NR. During within alpha negative correlation percentage seizure reduction after Overall, our results suggest efficacy may present circuitry interesting insights prerequisites responding VNS, order avoid unnecessary implantations showing efficacy.

Language: Английский

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Diazepam nasal spray administration is effective to control seizure clusters irrespective of time of day

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

Published: May 24, 2024

Introduction Neurologic circadian influences, including sleep/wake transitions, processes (e.g., hormonal variation), and behavioral patterns consumption of food oral medications), may affect seizure patterns. Specific seizures have been reported depending on type, onset location, severity; however, data for patients with clusters effectiveness rescue therapy by time day are limited. Methods We conducted post hoc analyses using patient diary from the phase 3 safety study diazepam nasal spray, which is indicated acute treatment in epilepsy aged ≥6 years. Patients were administered age- weight-based doses; second doses could be if needed to control a cluster. assessed clock timing seizure-cluster along second-dose use as proxy effectiveness. Treatment-emergent adverse events recorded. Results Seizure-cluster was observed generally highest during mornings late evenings lowest early evening middle night. Second-dose not consistently associated specific day. The profile consistent that expected previous studies spray. Conclusion These results suggest spray can effectively at any

Language: Английский

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Pro-ictal, rather than pre-ictal, brain state marked by global critical slowing and local gamma power increase

medRxiv (Cold Spring Harbor Laboratory), Journal Year: 2024, Volume and Issue: unknown

Published: Nov. 1, 2024

ABSTRACT Objective The pre-surgical evaluation of epilepsy relies on the electrophysiological recordings spontaneous seizures. During this period drug dose decreases increase likelihood seizures transitioning brain from a low to high seizure state, so-called pro-ictal state. This study aimed identify dynamic changes characteristic transition 386 ten-minute segments intracranial EEG 29 patients with drug-refractory temporal lobe epilepsy. Methods We studied dynamics through mean phase locking value and relative power in gamma band, autocorrelation function width. further explored interactions factors, such as rate interictal spikes frequency oscillations, circadian multi-day cycles, clinical outcomes. Results observed significant increases epileptogenic zone, critical slowing both zone presumably healthy cortex. These were linked spike oscillations rate. Conclusions Brain changed slow time scale - beginning end interval but did not change short-term during pre-ictal interval, thus could reflect changes. Significance highlight indices markers states, well their potential track seizure-related mechanisms presurgical patients. Highlights Study drug-resistant Increasing susceptibility is marked by rise network-wide slowing. Changes occur over days, minutes before seizures, suggesting phenomenon evaluation.

Language: Английский

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