Neocortical and Mesial Temporal Sleep Spindles Are Reduced in Children with Focal Epilepsy and Developmental Delay
Bibliographic record
Abstract
Background/Purpose: Drug-resistant focal epilepsy in children is often accompanied by developmental delay. Recent analyses of intracranial EEG have highlighted the importance of local components of sleep in mesial temporal structures and the neocortex for permanent acquisition of new skills and knowledge. It is, however, poorly understood how epileptic activity interferes with normal psychomotor development. We hypothesized that sleep spindles in the neocortex and in mesial temporal structures are reduced in children with focal epilepsy and developmental delay. Methods: Intracranial EEG, recorded with depth electrodes or subdural grid electrodes, was retrospectively analyzed in consecutive patients with drug-resistant focal epilepsy. Children with severe developmental delay (group 1) were compared with subjects with mild or no developmental delay (group 2). A representative 30-minute interval of NREM sleep was selected for analysis. Sleep spindles were visually identified in a referential montage. Post-implantation MRI was reviewed to identify contacts located in the neocortex and in mesial temporal regions. Results: A total of 16 patients (age 2–12 years) were included and intracranial EEG from 740 electrode contacts was analyzed. The median rate of sleep spindles was lower in children with epilepsy and severe developmental delay (group 1, n = 8 patients) than in patients with mild or no developmental delay (group 2, n = 8 patients; p < 0.05). A reduction of spindles was found both for the neocortex ( p < 0.05) and for mesial temporal structures ( p < 0.05), and both inside the seizure onset zone (SOZ; p < 0.05) and in non-SOZ contacts ( p < 0.05). Conclusion: In children with drug-resistant focal epilepsy, developmental delay was associated with a reduction of neocortical and mesial temporal sleep spindles. This suggests that disruption of local sleep in both regions might contribute to developmental delay. Future analyses of intracranial sleep microstructure could provide further insights into the underlying mechanisms. Publication History Article published online: 13 November 2023 © 2023. Thieme. All rights reserved. Georg Thieme Verlag KG Rüdigerstraße 14, 70469 Stuttgart, Germany
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.003 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.002 | 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 source (direct Gemma or distilled Codex), 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".