Heightened Delta Power during Slow-Wave-Sleep in Patients with Rett Syndrome Associated with Poor Sleep Efficiency.
Heightened Delta Power during Slow-Wave-Sleep in Patients with Rett Syndrome Associated with Poor Sleep Efficiency.
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DOI：
10.1371/journal.pone.0138113
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发表时间：
2015
期刊：
影响因子：
3.7
通讯作者：
Kadam SD
中科院分区：
文献类型：
--
作者：
Ammanuel S;Chan WC;Adler DA;Lakshamanan BM;Gupta SS;Ewen JB;Johnston MV;Marcus CL;Naidu S;Kadam SD
睡眠问题在Rett综合征（RTT）中很常见，但对睡眠功能障碍的脑电图（EEG）生物标志物了解甚少。本研究的目的是分析定量脑电图（qEEG）生物标志物的时间演变，从女孩（2-9岁）诊断RTT使用非传统的自动化协议记录过夜脑电图。在这项研究中，EEG频谱分析确定了代表8- 9小时夜间睡眠EEG中额叶、中央和枕叶导联（AP轴）慢波睡眠（SWS）的高δ功率周期，比较了年龄匹配的有和没有RTT的女孩。自动算法定量了每个频谱频率波形的已识别SWS周期内的曲线下面积（AUC）。年龄匹配的RTT和对照EEG均显示出EEG导联中记录的δ波功率沿前后（AP）沿着的相似增加趋势。RTT EEG的SWS睡眠周期数显著较少;因此，在SWS中花费的总时间在RTT中也显著较低。相比之下，每个SWS周期内的Δ功率的AUC在RTT中显著升高，并且在连续周期内保持升高，这与对照EEG不同，对照EEG在连续周期中显示Δ功率的过夜降低。与这些SWS循环相关的伽马波功率与对照组相似。然而，在对照组（2-5岁vs.6 -9岁）中检测到γ功率与年龄的负相关（r =-0.59; p<0.01）。在RTT中丢失。较差的% SWS（即，在SWS过夜的时间）也是由年轻年龄组驱动的。RTT中癫痫发作的发生率与显著较低的SWS周期数相关。因此，RTT中SWS的qEEG生物标志物随时间演变，并与临床严重程度显著相关。
Sleep problems are commonly reported in Rett syndrome (RTT); however the electroencephalographic (EEG) biomarkers underlying sleep dysfunction are poorly understood. The aim of this study was to analyze the temporal evolution of quantitative EEG (qEEG) biomarkers in overnight EEGs recorded from girls (2–9 yrs. old) diagnosed with RTT using a non-traditional automated protocol. In this study, EEG spectral analysis identified high delta power cycles representing slow wave sleep (SWS) in 8–9h overnight sleep EEGs from the frontal, central and occipital leads (AP axis), comparing age-matched girls with and without RTT. Automated algorithms quantitated the area under the curve (AUC) within identified SWS cycles for each spectral frequency wave form. Both age-matched RTT and control EEGs showed similar increasing trends for recorded delta wave power in the EEG leads along the antero-posterior (AP). RTT EEGs had significantly fewer numbers of SWS sleep cycles; therefore, the overall time spent in SWS was also significantly lower in RTT. In contrast, the AUC for delta power within each SWS cycle was significantly heightened in RTT and remained heightened over consecutive cycles unlike control EEGs that showed an overnight decrement of delta power in consecutive cycles. Gamma wave power associated with these SWS cycles was similar to controls. However, the negative correlation of gamma power with age (r = -.59; p<0.01) detected in controls (2–5 yrs. vs. 6–9 yrs.) was lost in RTT. Poor % SWS (i.e., time spent in SWS overnight) in RTT was also driven by the younger age-group. Incidence of seizures in RTT was associated with significantly lower number of SWS cycles. Therefore, qEEG biomarkers of SWS in RTT evolved temporally and correlated significantly with clinical severity.