Narcoleptic Patients Show Fragmented EEG-Microstructure During Early NREM Sleep
Narcoleptic Patients Show Fragmented EEG-Microstructure During Early NREM Sleep
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DOI：
10.1007/s10548-014-0387-1
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发表时间：
2015-07-01
期刊：
影响因子：
2.7
通讯作者：
Laufs, Helmut
中科院分区：
文献类型：
--
作者：
Kuhn, Alena;Brodbeck, Verena;Laufs, Helmut
发作性睡病是一种睡眠-觉醒周期的慢性紊乱，在睡眠阶段之间有病理转移。这些突变是由睡眠调节触发器机制引起的，该机制在发作性睡症中不稳定，脑电图振荡没有明显改变。在这里，我们关注的问题是嗜睡病的病理是否反映在脑电图的微观状态模式。分析12例发作性睡患者和32例正常人的30个通道清醒和非快速眼动睡眠脑电图。将优势振幅地形图拟合到脑电图中得到时序图。比较两组间各图谱的平均微状态持续时间、比率总时间（RTT）、全局解释方差（GEV）和迁移概率。N1 9例，N2 5例，N3仅4例。健康受试者均达到N2以上，19例达到N3以上。健康受试者在清醒和所有非快速眼动睡眠阶段均可发现4个优势图谱。在N3期间，发作性睡病患者显示了额外的第五张地图。发作性睡患者的平均微状态持续时间明显短于对照组，在深度睡眠中最为明显。发作性睡病患者的单图GEV和RTT也发生改变。意识到我们的低样本量的局限性，发作性睡病患者在睡眠中表现出类似清醒的特征，这反映在较短的微状态持续时间上。这些脑电图微结构的改变可能反映了清醒特征的大脑状态侵入睡眠，以及睡眠调节触发器机制的不稳定，不仅导致了快速眼动睡眠和非快速眼动睡眠之间的病理切换，而且也导致了非快速眼动睡眠本身，这可能导致脑电图微结构的断裂。
Narcolepsy is a chronic disorder of the sleep-wake cycle with pathological shifts between sleep stages. These abrupt shifts are induced by a sleep-regulating flip-flop mechanism which is destabilized in narcolepsy without obvious alterations in EEG oscillations. Here, we focus on the question whether the pathology of narcolepsy is reflected in EEG microstate patterns. 30 channel awake and NREM sleep EEGs of 12 narcoleptic patients and 32 healthy subjects were analyzed. Fitting back the dominant amplitude topography maps into the EEG led to a temporal sequence of maps. Mean microstate duration, ratio total time (RTT), global explained variance (GEV) and transition probability of each map were compared between both groups. Nine patients reached N1, 5 N2 and only 4 N3. All healthy subjects reached at least N2, 19 also N3. Four dominant maps could be found during wakefulness and all NREM- sleep stages in healthy subjects. During N3, narcolepsy patients showed an additional fifth map. The mean microstate duration was significantly shorter in narcoleptic patients than controls, most prominent in deep sleep. Single maps' GEV and RTT were also altered in narcolepsy. Being aware of the limitation of our low sample size, narcolepsy patients showed wake-like features during sleep as reflected in shorter microstate durations. These microstructural EEG alterations might reflect the intrusion of brain states characteristic of wakefulness into sleep and an instability of the sleep-regulating flip-flop mechanism resulting not only in pathological switches between REM- and NREM-sleep but also within NREM sleep itself, which may lead to a microstructural fragmentation of the EEG.