Investigating Sleep Microarchitecture in Focal-onset Epilepsy Patients Compared to Healthy Controls: A Prospective Neurophysiological Study
Abstract number :
3.26
Submission category :
3. Neurophysiology / 3C. Other Clinical EEG
Year :
2024
Submission ID :
480
Source :
www.aesnet.org
Presentation date :
12/9/2024 12:00:00 AM
Published date :
Authors :
Presenting Author: Shania Sheth, BHSc Candidate – Queen’s University
Garima Shukla, MBBS, MD, DM, FRCPC – Queen's University
Zaitoon Shivji, PhD Candidate – Queen’s University
Stuart Fogel, PhD – University of Ottawa
Lysa Boisse Lomax, MD, MSc, FRCPC, CSCN (EEG) – Queen's University
Gavin Winston, BM BCh, MA, PhD, EMBA, FRCP, CSCN (EEG) – Queen's University
Helen Driver, PhD, RPSGT, DABSM, Somnologist, CCSH – Queen’s University
Rationale: Sleep remains the central node connecting multiple important clinical aspects in individuals with epilepsy, including seizure control, mood and behavior, and cognition with a complex inter-relationship with each. Sleep quality and macroarchitecture has been reported to be significantly affected among people with epilepsy (PWE), especially in drug-resistant focal-onset epilepsy (DRFE). There remains a knowledge gap about how sleep microarchitecture is affected in PWE. This study was aimed at assessing non-rapid-eye movement (NREM) sleep microarchitecture in patients with DRFE in comparison to healthy controls.
Methods: Consecutive consenting patients with confirmed diagnosis of DRFE, admitted to our Epilepsy Monitoring Unit, over a 3-year period (2019-2022), were enrolled (n=55). Overnight polysomnography (PSG) was conducted without medication tapering on the first night of admission in a silent single room in the unit. Additionally, healthy controls who performed an overnight PSG during the 3-year period (2019-2022) were also enrolled based on age-sex matching characteristics (n=54). Routine sleep scoring was conducted according to the American Academy of Sleep Medicine (AASM) 2012 guidelines. Following deidentified data transfer, automated sleep spindle and slow wave analysis was conducted using previously published validated methods. Data was analysed using R studio with application of, either a T-test or Mann-Whitney U Test, based on the type of variables and normality of data distribution.
Results: A total of 55 patients with DRFE (33F, mean age 41.8 ± 15.6 years) and 55 healthy age and sex matched controls were included in this study. At the vertex (Cz), sleep spindle density in non-rapid-eye-movement (NREM) sleep stage-2 (N2) was significantly higher among DRFE patients than controls (medians[IQRs], 5.09[1.4] vs 4.5[1.4]). Patients with DRFE also had significantly lower Cz-N2 spindle frequency and significantly higher spindle amplitude, number and duration, during N2. Additionally, their slow wave density measured at the frontal region (Fz) in stage N3 was also significantly higher than controls (medians[IQRs], 22.4[5.8] vs 21.1[4.03]), along with higher N3 slow wave duration, number and area as well as significantly lower N3 slow wave frequency.
Conclusions: This study provides novel data demonstrating significant changes in sleep microarchitecture among patients with drug resistant focal epilepsy, compared with healthy controls. The observed differences in spindle and slow wave oscillatory, density and morphology characteristics could be multi-factorial and further research exploring these factors could provide potential targets for therapeutic interventions for sleep-related comorbidities in epilepsy.
Funding: No funding was received.
Neurophysiology