ArticleAnnals of clinical and translational neurology2023
Preliminary evidence of a relationship between sleep spindles and treatment response in epileptic encephalopathy.
Article in Annals of clinical and translational neurology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.
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Who cites it
11 citing papers in PubMed, 11 citations in OpenAlex.
- Fast sleep spindles as a potential prognostic marker of developmental outcome in infantile epileptic spasms syndrome.Epilepsia open · 2026Article
- Auditory-evoked changes in slow oscillations and spindles correlate with memory consolidation in children with epilepsy and controls.Clinical neurophysiology : official journal of the International Federation of Clinical Neurophysiology · 2026Article
- Review
- [Landau-Kleffner Syndrome and Continuous Spike-and-Wave During Sleep Syndrome: Comparison of Clinical, Neurophysiological, and Neuropsychological Characteristics].Revista de neurologia · 2025Article
- Fast ripple band high-frequency activity associated with thalamic sleep spindles in pediatric epilepsy.Clinical neurophysiology : official journal of the International Federation of Clinical Neurophysiology · 2025Article
- Mechanistic insights into the interaction between epilepsy and sleep.Nature reviews. Neurology · 2025Review
- Association of Sleep Spindle Rate With Memory Consolidation in Children With Rolandic Epilepsy.Neurology · 2025Article
- Thalamic epileptic spikes disrupt sleep spindles in patients with epileptic encephalopathy.Brain : a journal of neurology · 2024Article
- Impaired sleep-dependent memory consolidation predicted by reduced sleep spindles in Rolandic epilepsy.bioRxiv : the preprint server for biology · 2024Article
- Automated sleep staging on reduced channels in children with epilepsy.Frontiers in neurology · 2024Article
- Epilepsy Surgery for Cognitive Improvement in Epileptic Encephalopathy.Neurosurgery clinics of North America · 2024Review
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Authors and funding
6 authors at 2 institutions in 1 country.
Funding
Abstract
objectiveEpileptic encephalopathy with spike-wave activation in sleep (EE-SWAS) is a challenging neurodevelopmental disease characterized by abundant epileptiform spikes during non-rapid eye movement (NREM) sleep accompanied by cognitive dysfunction. The mechanism of cognitive dysfunction is unknown, but treatment with high-dose diazepam may improve symptoms. Spike rate does not predict treatment response, but spikes may disrupt sleep spindles. We hypothesized that in patients with EE-SWAS: (1) spikes and spindles would be anti-correlated, (2) high-dose diazepam would increase spindles and decrease spikes, and (3) spindle response would be greater in those with cognitive improvement.
methodsConsecutive EE-SWAS patients treated with high-dose diazepam that met the criteria were included. Using a validated automated spindle detector, spindle rate, duration, and percentage were computed in pre- and post-treatment NREM sleep. Spikes were quantified using a validated automated spike detector. The cognitive response was determined from a chart review.
resultsSpindle rate was anti-correlated with the spike rate in the channel with the maximal spike rate (p = 0.002) and averaged across all channels (p = 0.0005). Spindle rate, duration, and percentage each increased, and spike rate decreased, after high-dose diazepam treatment (p ≤ 2e-5, all tests). Spindle rate, duration, and percentage (p ≤ 0.004, all tests) were increased in patients with cognitive improvement after treatment, but not those without. Changes in spindle rate but not changes in spike rate distinguished between groups.
interpretationThese findings confirm thalamocortical disruption in EE-SWAS, identify a mechanism through which benzodiazepines may support cognitive recovery, and introduce sleep spindles as a promising mechanistic biomarker to detect treatment response in severe epileptic encephalopathies.
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