scholarly journals Sleep slow-wave homeostasis and cognitive functioning in children with electrical status epilepticus in sleep

SLEEP ◽  
2020 ◽  
Vol 43 (11) ◽  
Author(s):  
Bart van den Munckhof ◽  
Silvano R Gefferie ◽  
Suus A M van Noort ◽  
Heleen C van Teeseling ◽  
Mischa P Schijvens ◽  
...  
Keyword(s):  
Status Epilepticus ◽  
Slow Wave ◽  
Behavioral Problems ◽  
Rem Sleep ◽  
Epileptiform Activity ◽  
Slow Waves ◽  
Epileptic Focus ◽  
Test Results ◽  
Cross Sectional ◽  
Synaptic Homeostasis

Abstract Study Objectives Encephalopathy with electrical status epilepticus in sleep (ESES) is characterized by non-rapid eye movement (non-REM)-sleep-induced epileptiform activity and acquired cognitive deficits. The synaptic homeostasis hypothesis describes the process of daytime synaptic potentiation balanced by synaptic downscaling in non-REM-sleep and is considered crucial to retain an efficient cortical network. We aimed to study the overnight decline of slow waves, an indirect marker of synaptic downscaling, in patients with ESES and explore whether altered downscaling relates to neurodevelopmental and behavioral problems. Methods Retrospective study of patients with ESES with at least one whole-night electroencephalogram (EEG) and neuropsychological assessment (NPA) within 4 months. Slow waves in the first and last hour of non-REM-sleep were analyzed. Differences in slow-wave slope (SWS) and overnight slope course between the epileptic focus and non-focus electrodes and relations to neurodevelopment and behavior were analyzed. Results A total of 29 patients with 44 EEG ~ NPA combinations were included. Mean SWS decreased from 357 to 327 µV/s (−8%, p < 0.001) across the night and the overnight decrease was less pronounced in epileptic focus than in non-focus electrodes (−5.6% vs. −8.7%, p = 0.003). We found no relation between SWS and neurodevelopmental test results in cross-sectional and longitudinal analyses. Patients with behavioral problems showed less SWS decline than patients without and the difference was most striking in the epileptic focus (−0.9% vs. −8.8%, p = 0.006). Conclusions Slow-wave homeostasis—a marker of synaptic homeostasis—is disturbed by epileptiform activity in ESES. Behavioral problems, but not neurodevelopmental test results, were related to severity of this disturbance.

scholarly journals The Aging Slow Wave: A Shifting Amalgam of Distinct Slow Wave and Spindle Coupling Subtypes Define Slow Wave Sleep Across the Human Lifespan

SLEEP ◽  
2021 ◽  
Author(s):  
Brice V McConnell ◽  
Eugene Kronberg ◽  
Peter D Teale ◽  
Stefan H Sillau ◽  
Grace M Fishback ◽  
...  
Keyword(s):  
Slow Wave ◽  
Neurological Disease ◽  
Mixed Model ◽  
Slow Wave Sleep ◽  
Sleep Stage ◽  
Slow Waves ◽  
Cross Sectional ◽  
Relative Contribution ◽  
Human Lifespan ◽  
Development And Aging

Abstract Study Objectives Slow wave and spindle coupling supports memory consolidation, and loss of coupling is linked with cognitive decline and neurodegeneration. Coupling is proposed to be a possible biomarker of neurological disease, yet little is known about the different subtypes of coupling that normally occur throughout human development and aging. Here we identify distinct subtypes of spindles within slow wave upstates and describe their relationships with sleep stage across the human lifespan. Methods Coupling within a cross-sectional cohort of 582 subjects was quantified from stages N2 and N3 sleep across ages 6-88 years old. Results were analyzed across the study population via mixed model regression. Within a subset of subjects, we further utilized coupling to identify discrete subtypes of slow waves by their coupled spindles. Results Two different subtypes of spindles were identified during the upstates of (distinct) slow waves: an “early-fast” spindle, more common in stage N2 sleep, and a “late-fast” spindle, more common in stage N3. We further found stages N2 and N3 sleep contain a mixture of discrete subtypes of slow waves, each identified by their unique coupled-spindle timing and frequency. The relative contribution of coupling subtypes shifts across the human lifespan, and a deeper sleep phenotype prevails with increasing age. Conclusions Distinct subtypes of slow waves and coupled spindles form the composite of slow wave sleep. Our findings support a model of sleep-dependent synaptic regulation via discrete slow wave/spindle coupling subtypes and advance a conceptual framework for the development of coupling-based biomarkers in age-associated neurological disease.

scholarly journals Periodic Slow Waves Presenting as Ictal Electroencephalography Findings in Complex Partial Status Epilepticus

2018 ◽  
Vol 10 (2) ◽  
pp. 199-206
Author(s):  
Daisuke Yasugi ◽  
Takeshi Sasaki ◽  
Go Taniguchi
Keyword(s):  
Status Epilepticus ◽  
Epileptiform Activity ◽  
Clinical Signs ◽  
Slow Waves ◽  
Elderly Males ◽  
Partial Status Epilepticus ◽  
Epileptic Discharges ◽  
Criteria For Diagnosis ◽  
Complex Partial Status Epilepticus ◽  
Partial Status

The diagnosis of nonconvulsive status epilepticus (NCSE) largely relies on electroencephalography (EEG) findings, but the existing diagnostic criteria for EEG results are sometimes inconsistent. Much debate has centered on periodic epileptic discharges (PEDs) and their relationship with seizures. The recently published Salzburg Consensus Criteria for diagnosis of NCSE, which consider PEDs to be ictal findings under several conditions, have been proven to have high diagnostic accuracy. However, the criteria do not include periodic slow waves (PSWs) and do not consider these as overall ictal electrographic changes. Here, we report 2 cases of complex partial status epilepticus in which routine EEG showed PSWs without epileptiform activity during the clinical ictal phase. Both patients were elderly males who had histories of seizures and presented with impaired consciousness and signs such as aphasia or tongue automatism that indicated a temporal lobe origin. After we administered antiepileptic drugs (AED), the clinical signs and periodic EEG slow waves disappeared. These cases show that PSWs may appear as ictal electrographic changes in NCSE. When PSWs accompany clinical signs suggestive of NCSE, they should be considered ictal findings, and physicians should administer AED.

Short-Duration Epileptic Discharges Show a Distinct Phase Preference During Ongoing Hippocampal Slow Oscillations

2010 ◽  
Vol 104 (4) ◽  
pp. 2194-2202 ◽  
Author(s):  
Philip H. de Guzman ◽  
Farhang Nazer ◽  
Clayton T. Dickson
Keyword(s):  
Short Duration ◽  
Temporal Lobe ◽  
Slow Wave ◽  
Rem Sleep ◽  
Slow Wave Sleep ◽  
Epileptiform Activity ◽  
Epileptic Activity ◽  
Network Synchronization ◽  
State Dependent ◽  
Oscillatory Pattern

Non-REM (slow-wave) sleep has been shown to facilitate temporal lobe epileptiform events, whereas REM sleep seems more restrictive. This state-dependent modulation may be the result of the enhancement of excitatory synaptic transmission and/or the degree of network synchronization expressed within the hippocampus of the temporal lobe. The slow oscillation (SO), a ∼1 Hz oscillatory pattern expressed during non-REM sleep and urethane anesthesia, has been recently shown to facilitate the generation, maintenance, and propagation of stimulus-evoked epileptiform activity in the hippocampus. To further address the state-dependent modulation of epileptic activity during the SO, we studied the properties of short-duration interictal-like activity generated by focal application of penicillin in the hippocampus of urethane-anesthetized rats. Epileptiform spikes were larger but only slightly more prevalent during the SO as opposed to the theta (REM-like) state. More notably, however, epileptic spikes had a significant tendency to occur just following the peak negativity of ongoing SO cycles. Because of the known phase-dependent changes in 1) synaptic excitability (just following the positive peak of the SO) and 2) network synchronization (during the negative peak of the SO), these results suggest that it is the synchrony and not the changes in synaptic excitability that lead to the facilitation of epileptiform activity during sleep-like slow wave states.

scholarly journals The Aging Slow Wave: A Shifting Amalgam of Distinct Slow Wave and Spindle Coupling Subtypes Define Slow Wave Sleep Across the Human Lifespan

2020 ◽  
Author(s):  
Brice V. McConnell ◽  
Eugene Kronberg ◽  
Peter D. Teale ◽  
Grace M. Fishback ◽  
Rini I. Kaplan ◽  
...  
Keyword(s):  
Slow Wave ◽  
Cognitive Aging ◽  
Neurological Disease ◽  
Mixed Model ◽  
Slow Wave Sleep ◽  
Sleep Stage ◽  
Slow Waves ◽  
Cross Sectional ◽  
Relative Contribution ◽  
Human Lifespan

AbstractStudy ObjectivesSlow wave and spindle coupling supports memory consolidation, and loss of coupling is linked with cognitive decline and neurodegeneration. Coupling is proposed to be a possible biomarker of neurological disease, yet little is known about the different subtypes of coupling that normally occur throughout human development and aging. Here we identify distinct subtypes of spindles within slow wave upstates and describe their relationships with sleep stage across the human lifespan.MethodsCoupling within a cross-sectional cohort of 582 subjects was quantified from stages N2 and N3 sleep across ages 6-88 years old. Results were analyzed across the study population via mixed model regression. Within a subset of subjects, we further utilized coupling to identify discrete subtypes of slow waves by their coupled spindles.ResultsTwo different subtypes of spindles were identified during the upstates of (distinct) slow waves: an “early-fast” spindle, more common in stage N2 sleep, and a “late-fast” spindle, more common in stage N3. We further found stages N2 and N3 sleep are composed of two discrete subtypes of slow waves, each identified by their unique coupled-spindle timing and frequency. The relative contribution of coupling subtypes shifts across the human lifespan, and a deeper sleep phenotype prevails during old age.ConclusionsDistinct subtypes of slow waves and coupled spindles form the composite of slow wave sleep. Our findings support a model of sleep-dependent synaptic regulation via discrete slow wave/spindle coupling subtypes and advance a conceptual framework for the development of coupling-based biomarkers in age-associated neurological disease.Statement of SignificanceSlow waves of nonrapid eye movement sleep couple with sleep spindles in a process hypothesized to support memory functions. This coupling has recently gained interest as a possible biomarker of cognitive aging and onset of Alzheimer’s disease. Most studies have been limited by an assumption that all slow waves (and coupled spindles) are fundamentally the same physiological events. Here we demonstrate that distinct subtypes of slow waves and their coupled spindles can be identified in human sleep. A mixture of different slow wave and spindle subtypes shifts in composition during lighter versus deeper sleep, and aging favors the deep sleep subtypes. These data should inform any future attempts to use slow wave sleep as a biomarker or clinical interventional target.

scholarly journals Relationship of anxiety with emotional and behavioral problem in Madrasah Tsanawiyah Hidayatullah Islamic boarding school students, Denpasar

2020 ◽  
Vol 1 (1) ◽  
pp. 1-4
Author(s):  
Rabiatul Udawiyah ◽  
Lely Setyawati ◽  
Cokorda Bagus Jaya Lesmana
Keyword(s):  
Behavioral Problems ◽  
Behavioral Problem ◽  
Boarding School ◽  
Cross Sectional Study ◽  
Emotional And Behavioral Problems ◽  
Test Results ◽  
School Students ◽  
Cross Sectional ◽  
Relationship Of ◽  
The Relationship

Background: Emotional and behavioral problem are persistent and recurring problem that observed in teenagers specifically students. Anxiety is the most common mental health problem found in Islamic boarding school students. This research aims to find out the relationship of anxiety with emotional and behavioral problem in Madrasah Tsanawiyah, Hidayatullah Islamic Boarding School Students, Denpasar. Patients and Methods: The study was an analytical cross-sectional study with 89 students met inclusion and exclusion criteria. This research used the Strength and Difficulties Questionnaire (SDQ) to measure emotional and behavioral problems and Beck Anxiety Inventory (BAI) to measure the student’s anxiety level. The correlation was analyzed by using Spearman’s correlation test. Results: Forty-five (50.8%) students experience abnormal emotional and behavioral problems with 30 (30%) the students mostly had moderate level anxiety. The correlation between the anxiety with emotional and behavioral problems had an R value of 0.366 (p<0.001). Conclusion: There was a moderate positive relationship between anxiety with emotional and behavioral problems in Madrasah Tsanawiyah Islamic boarding school Hidayatullah students.

scholarly journals Levetiracetam and N-Cadherin Antibody Alleviate Brain Pathology Without Reducing Early Epilepsy Development After Focal Non-convulsive Status Epilepticus in Rats

2021 ◽  
Vol 12 ◽  
Author(s):  
Una Avdic ◽  
Matilda Ahl ◽  
My Andersson ◽  
Christine T. Ekdahl
Keyword(s):  
Status Epilepticus ◽  
Microglial Activation ◽  
Morphological Changes ◽  
Epileptiform Activity ◽  
Neuronal Cell ◽  
Additional Treatment ◽  
Epileptic Focus ◽  
Convulsive Status Epilepticus ◽  
Brain Pathology ◽  
Clinical Value

Focal non-convulsive status epilepticus (fNCSE) is a neurological condition characterized by a prolonged seizure that may lead to the development of epilepsy. Emerging experimental evidence implicates neuronal death, microglial activation and alterations in the excitatory and inhibitory synaptic balance as key features in the pathophysiology following fNCSE. We have previously reported alterations in the excitatory adhesion molecule N-cadherin in rats with fNCSE originating from the hippocampus that subsequently also develop spontaneous seizures. In this study, fNCSE rats were treated intraperitoneally with the conventional anti-epileptic drug levetiracetam in combination with intraparenchymal infusion of N-cadherin antibodies (Ab) for 4 weeks post-fNCSE. The N-cadherin Ab was infused into the fornix and immunohistochemically N-cadherin Ab-stained neurons were detected within the dorsal hippocampal structures as well as in superjacent somatosensory cortex. Continuous levetiracetam treatment for 4 weeks post-fNCSE reduced microglia activation, including cell numbers and morphological changes, partly decreased neuronal cell loss, and excitatory post-synaptic scaffold protein PSD-95 expression in selective hippocampal structures. The additional treatment with N-cadherin Ab did not reverse neuronal loss, but moderately reduced microglial activation, and further reduced PSD-95 levels in the dentate hilus of the hippocampus. Despite the effects on brain pathology within the epileptic focus, neither monotherapy with systemic levetiracetam nor levetiracetam in combination with local N-cadherin Ab administration, reduced the amount of focal or focal evolving into bilateral convulsive seizures, seizure duration, or interictal epileptiform activity during 1 month of continuous electroenephalogram recordings within the hippocampus after fNCSE. Behavioral tests for spatial memory, anxiety, social interaction and anhedonia did not detect gross behavioral differences between fNCSE rats with or without treatment. The results reveal the refractory features of the present rodent model of temporal lobe epilepsy following fNCSE, which supports its clinical value for further therapeutic studies. We identify the persistent development of epilepsy following fNCSE, in spite of partly reduced brain pathology within the epileptic focus.

FAKTOR PERSONAL YANG BERHUBUNGAN DENGAN KOMITMEN ORGANISASI PERAWAT RSUD EMBUNG FATIMAH BATAM

2020 ◽  
Vol 5 (3) ◽  
pp. 875
Author(s):  
Asfri Sri Rahmadeni
Keyword(s):  
Organizational Commitment ◽  
Turnover Rate ◽  
Sampling Technique ◽  
Hospital Nurses ◽  
Test Results ◽  
Personal Factors ◽  
High Turnover ◽  
Chi Square ◽  
Cross Sectional ◽  
Chi Square Test

<p class="Normal1"><em>Commitment is the attitude or behavior of likes or dislikes shown by someone against the organization at work. Indonesia is recorded as a nurse who has a low organizational commitment (76%) so it harms services. This phenomenon in the hospital can be seen from the indicator of the high turnover rate of nurses which reaches 30.9% which exceeds the standard &lt;5%. Many factors affect organizational commitment. The purpose of this study was to analyze the Personal Factors Associated with Organizational Commitment of Hospital Nurses. This study is a cross-sectional analytic study and purposive sampling technique with a sample of 59 nurses. Chi-Square test results obtained personal factors that have a relationship with organizational commitment Nurse Hospital is age with p = 0,000 and education with p = 0,000, personal factors not related to organizational commitment are gender p = 1,053 and years of service with p = 1,147. Hospitals should conduct research/surveys on Organizational Commitment periodically as an evaluation material in the context of the organization's development and development in the future</em>.</p>

Faktor yang Berhubungan dengan Penggunaan Partograf dalam Persalinan oleh Bidan Praktik Mandiri

2020 ◽  
Vol 2 (2) ◽  
pp. 72-80
Author(s):  
Niluh Nita Silfia
Keyword(s):  
Total Population ◽  
Sampling Technique ◽  
Population Data ◽  
Statistical Test ◽  
Influential Factor ◽  
Test Results ◽  
Cross Sectional ◽  
Factors Associated ◽  
Survey Results ◽  
Research Criteria

Partographs are guidelines for childbirth observations that will facilitate labor assistants in first identifying emergency cases and complications for mothers and fetuses. Preliminary survey at the Sigi Community Health Sub-Center (Pustu) of the 8 Pustu midwives found two midwives (25%) to complete a complete partograph, six midwives (75%) incomplete. The purpose of this study was to determine the determinant factors associated with the use of partographs in labor. The design of this study used observational analytic methods with a cross-sectional approach. 24 BPM survey results were obtained with 30 samples of midwives who met the research criteria and data completeness. The sampling technique was by the total population. Data analysis used logistic regression. The multivariate analysis results showed that APN training was the most influential factor in the use of partographs in labor by midwives. Statistical test results obtained a POR value of 37.7 (95% CI 12.1 - 60.2). This study suggests that midwives must have APN certificates to be valid in providing services.

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