Assessment of Cognitive Function with Sleep Spindle Characteristics in Adults with Epilepsy
Bibliographic record
Abstract
Objective. Epilepsy may cause chronic cognitive impairment by disturbing sleep plasticity. Sleep spindles play a crucial role in sleep maintenance and brain plasticity. This study explored the relationship between cognition and spindle characteristics in adult epilepsy. Methods. Participants underwent one-night sleep electroencephalogram recording and neuropsychological tests on the same day. Spindle characteristics during N2 sleep were extracted using a learning-based system for sleep staging and an automated spindle detection algorithm. We investigated the difference between cognitive subgroups in spindle characteristics. Multiple linear regressions were applied to analyze associations between cognition and spindle characteristics. Results. Compared with no/mild cognitive impairment, epilepsy patients who developed severe cognitive impairment had lower sleep spindle density, the differences mainly distributed in central, occipital, parietal, middle temporal, and posterior temporal ( <a:math xmlns:a="http://www.w3.org/1998/Math/MathML" id="M1"> <a:mi>P</a:mi> <a:mo><</a:mo> <a:mn>0.05</a:mn> </a:math> ), and had relatively long spindle duration in occipital and posterior temporal <c:math xmlns:c="http://www.w3.org/1998/Math/MathML" id="M2"> <c:mfenced open="(" close=")"> <c:mrow> <c:mi>P</c:mi> <c:mo><</c:mo> <c:mn>0.05</c:mn> </c:mrow> </c:mfenced> </c:math> . Mini-Mental State Examination (MMSE) was associated with spindle density (pars triangularis of the inferior frontal gyrus (IFGtri): <g:math xmlns:g="http://www.w3.org/1998/Math/MathML" id="M3"> <g:mi>β</g:mi> <g:mo>=</g:mo> <g:mn>0.253</g:mn> </g:math> , <i:math xmlns:i="http://www.w3.org/1998/Math/MathML" id="M4"> <i:mi>P</i:mi> <i:mo>=</i:mo> <i:mn>0.015</i:mn> </i:math> , and <k:math xmlns:k="http://www.w3.org/1998/Math/MathML" id="M5"> <k:mi>P</k:mi> <k:mo>.</k:mo> <k:mtext>adjust</k:mtext> <k:mo>=</k:mo> <k:mn>0.074</k:mn> </k:math> ) and spindle duration (IFGtri: <m:math xmlns:m="http://www.w3.org/1998/Math/MathML" id="M6"> <m:mi>β</m:mi> <m:mo>=</m:mo> <m:mo>−</m:mo> <m:mn>0.262</m:mn> </m:math> , <o:math xmlns:o="http://www.w3.org/1998/Math/MathML" id="M7"> <o:mi>P</o:mi> <o:mo>=</o:mo> <o:mn>0.004</o:mn> </o:math> , and <q:math xmlns:q="http://www.w3.org/1998/Math/MathML" id="M8"> <q:mi>P</q:mi> <q:mo>.</q:mo> <q:mtext>adjust</q:mtext> <q:mo>=</q:mo> <q:mn>0.030</q:mn> </q:math> ). Montreal Cognitive Assessment (MoCA) was associated with spindle duration (IFGtri: <s:math xmlns:s="http://www.w3.org/1998/Math/MathML" id="M9"> <s:mi>β</s:mi> <s:mo>=</s:mo> <s:mo>−</s:mo> <s:mn>0.246</s:mn> </s:math> , <u:math xmlns:u="http://www.w3.org/1998/Math/MathML" id="M10"> <u:mi>P</u:mi> <u:mo>=</u:mo> <u:mn>0.010</u:mn> </u:math> , and <w:math xmlns:w="http://www.w3.org/1998/Math/MathML" id="M11"> <w:mi>P</w:mi> <w:mo>.</w:mo> <w:mtext>adjust</w:mtext> <w:mo>=</w:mo> <w:mn>0.055</w:mn> </w:math> ). Executive Index Score (MoCA-EIS) was associated with spindle density (IFGtri: <y:math xmlns:y="http://www.w3.org/1998/Math/MathML" id="M12"> <y:mi>β</y:mi> <y:mo>=</y:mo> <y:mn>0.238</y:mn> </y:math> , <ab:math xmlns:ab="http://www.w3.org/1998/Math/MathML" id="M13"> <ab:mi>P</ab:mi> <ab:mo>=</ab:mo> <ab:mn>0.019</ab:mn> </ab:math> , and <cb:math xmlns:cb="http://www.w3.org/1998/Math/MathML" id="M14"> <cb:mi>P</cb:mi> <cb:mo>.</cb:mo> <cb:mtext>adjust</cb:mtext> <cb:mo>=</cb:mo> <cb:mn>0.087</cb:mn> </cb:math> ; parietal: <eb:math xmlns:eb="http://www.w3.org/1998/Math/MathML" id="M15"> <eb:mi>β</eb:mi> <eb:mo>=</eb:mo> <eb:mn>0.227</eb:mn> </eb:math> , <gb:math xmlns:gb="http://www.w3.org/1998/Math/MathML" id="M16"> <gb:mi>P</gb:mi> <gb:mo>=</gb:mo> <gb:mn>0.017</gb:mn> </gb:math> , and <ib:math xmlns:ib="http://www.w3.org/1998/Math/MathML" id="M17"> <ib:mi>P</ib:mi> <ib:mo>.</ib:mo> <ib:mtext>adjust</ib:mtext> <ib:mo>=</ib:mo> <ib:mn>0.082</ib:mn> </ib:math> ) and spindle duration (parietal: <kb:math xmlns:kb="http://www.w3.org/1998/Math/MathML" id="M18"> <kb:mi>β</kb:mi> <kb:mo>=</kb:mo> <kb:mo>−</kb:mo> <kb:mn>0.230</kb:mn> </kb:math> , <mb:math xmlns:mb="http://www.w3.org/1998/Math/MathML" id="M19"> <mb:mi>P</mb:mi> <mb:mo>=</mb:mo> <mb:mn>0.013</mb:mn> </mb:math> , and <ob:math xmlns:ob="http://www.w3.org/1998/Math/MathML" id="M20"> <ob:mi>P</ob:mi> <ob:mo>.</ob:mo> <ob:mtext>adjust</ob:mtext> <ob:mo>=</ob:mo> <ob:mn>0.065</ob:mn> </ob:math> ). Attention Index Score (MoCA-AIS) was associated with spindle duration (IFGtri: <qb:math xmlns:qb="http://www.w3.org/1998/Math/MathML" id="M21"> <qb:mi>β</qb:mi> <qb:mo>=</qb:mo> <qb:mo>−</qb:mo> <qb:mn>0.233</qb:mn> </qb:math> , <sb:math xmlns:sb="http://www.w3.org/1998/Math/MathML" id="M22"> <sb:mi>P</sb:mi> <sb:mo>=</sb:mo> <sb:mn>0.017</sb:mn> </sb:math> , and <ub:math xmlns:ub="http://www.w3.org/1998/Math/MathML" id="M23"> <ub:mi>P</ub:mi> <ub:mo>.</ub:mo> <ub:mtext>adjust</ub:mtext> <ub:mo>=</ub:mo> <ub:mn>0.081</ub:mn> </ub:math> ). Conclusions. The findings suggested that the altered spindle activity in epilepsy with severe cognitive impairment, the associations between the global cognitive status of adult epilepsy and spindle characteristics, and specific cognitive domains may relate to spindle characteristics in particular brain regions.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".