Twitches emerge postnatally during quiet sleep in human infants and are synchronized with sleep spindles

Slumber under pressure: REM sleep and stress response

Sleep, a state of reduced responsiveness and distinct brain activity, is crucial across the animal kingdom. This review explores the potential adaptive functions of REM sleep in adapting to stress, emphasizing its role in memory consolidation, emotional regulation, and threat processing. We further explore the underlying neural mechanisms linking stress responses to REM sleep. By synthesizing current findings, we propose that REM sleep allows animals to "rehearse" or simulate responses to danger in a secure, offline state, while also maintaining emotional balance. Environmental factors, such as predation risk and social dynamics, further influence REM sleep. This modulation may enhance survival by optimizing stress responses while fulfilling physiological needs in animals. Insights into REM sleep's role in animals may shed light on human sleep in the context of modern stressors and sleep disruptions. This review also explores the complex interplay between stress, immunity, sleep disruptions-particularly involving REM sleep-and their evolutionary underpinnings.

Infant sleep EEG features at 4 months as biomarkers of neurodevelopment at 18 months

BACKGROUND

Sleep parameters evolve in parallel with neurodevelopment. Sleep participates in synaptic homeostasis and memory consolidation and infant sleep parameters correlate with later aspects of early childhood cognition.

METHODS

Typically developing, term-born infants had a diurnal sleep-EEG at 4 months and Griffiths III developmental assessment at 18 months. EEG analysis included sleep macrostructure (i.e. durations of total sleep and sleep stages, and latencies to sleep and REM), sleep spindle features, and quantitative EEG features (qEEG): interhemispheric connectivity and spectral power. We assessed the correlations between these EEG features and Griffiths III quotients.

RESULTS

Sleep recordings from 92 infants were analyzed. Sleep latency was positively associated with the Griffiths III Foundations of Learning subscale and N3 sleep duration was positively correlated with the Personal-Social-Emotional subscale. Sleep spindle synchrony was negatively associated with Eye and Hand Coordination, Personal-Social-Emotional, Gross Motor, and General Development quotients. Sleep spindle duration was negatively associated with the Personal-Social-Emotional and Gross Motor subscales. In some sleep states, delta 1 and 2 EEG spectral power and interhemispheric coherence measures were correlated with subscale quotients.

CONCLUSION

Certain sleep features in the EEG of 4-month-old infants are associated with neurodevelopment at 18 months and may be useful early biomarkers of neurodevelopment.

IMPACT

This study shows that the EEG during infant sleep may provide insights into later neurodevelopmental outcomes. We have examined novel EEG sleep spindle features and shown that spindle duration and synchrony may help predict neurodevelopmental outcomes. Sleep macrostructure elements such as latency to sleep, N3 duration, and qEEG features such as interhemispheric coherence and spectral power measures at 4 months may be useful for the assessment of future neurodevelopmental outcomes. Due to exceptional neuroplasticity in infancy, EEG biomarkers of neurodevelopment may support early and targeted intervention to optimize outcomes.

REM refines and rescues memory representations: a new theory

Despite extensive evidence on the roles of nonrapid eye movement (NREM) and REM sleep in memory processing, a comprehensive model that integrates their complementary functions remains elusive due to a lack of mechanistic understanding of REM's role in offline memory processing. We present the REM Refining and Rescuing (RnR) Hypothesis, which posits that the principal function of REM sleep is to increase the signal-to-noise ratio within and across memory representations. As such, REM sleep selectively enhances essential nodes within a memory representation while inhibiting the majority (Refine). Additionally, REM sleep modulates weak and strong memory representations so they fall within a similar range of recallability (Rescue). Across multiple NREM-REM cycles, tuning functions of individual memory traces get sharpened, allowing for integration of shared features across representations. We hypothesize that REM sleep's unique cellular, neuromodulatory, and electrophysiological milieu, marked by greater inhibition and a mixed autonomic state of both sympathetic and parasympathetic activity, underpins these processes. The RnR Hypothesis offers a unified framework that explains diverse behavioral and neural outcomes associated with REM sleep, paving the way for future research and a more comprehensive model of sleep-dependent cognitive functions.

Co-developing sleep-wake and sensory foundations for cognition in the human fetus and newborn

In older children and adults, cognition builds upon waking sensory experience which is consolidated during sleep. In the fetus and newborn, sensory input is instead largely experienced during sleep. The nature of these sensory inputs differs within sleep, between active and quiet sleep, as well as versus wakefulness. Here, sleep-wake organisation in the fetus and newborn is reviewed, and then its interaction with sensory inputs discussed with a focus on somatosensory and auditory modalities. Next, these ideas are applied to how neurological insults affect early development, using fetal growth restriction as a test case. Finally, the argument is made that taking account of sleep-wake state during perinatal functional neuroimaging can better index sensorimotor, language, and cognitive brain activities, potentially improving its diagnostic and prognostic value. To sum up, sensory and sleep-wake functions go hand in hand during early human development. Perturbation of these twinned functions by neurological insults may mediate later neurodevelopmental deficits. Perinatal neuroimaging has the potential to track these trajectories, feasibly identifying opportunities to therapeutically intervene.

Exploring Developmental Connections: Sleep Patterns, Self-Locomotion, and Vocabulary Growth in Early Childhood

Current research indicates likely developmental connections between the evolution of sleep patterns, motor skills progression, and the expansion of vocabulary. These connections are grounded in the well-established role of sleep in memory and learning, as well as in the cascading effects on language development of the acquisition of new motor skills. However, no study has so far undertaken a comprehensive and systematic examination of these connections or explored their developmental trajectory over time. Yet understanding vocabulary development depends on considering development in the sleep regulation and motor domains, to provide a biologically grounded explanation of how early lexicons are built and strengthened. This study investigates the links between vocabulary growth and two significant changes occurring over the first 2 years of life: self-initiated locomotion and the consolidation of overnight sleep. Our results reveal mutual associations between these domains, which tend to emerge during periods of marked developmental change in language, motor skills, and sleep patterns regulation. Moreover, these associations were observed to change over time, suggesting dynamic interconnections between these developmental domains. Our findings point toward the importance of investigating vocabulary development from a dynamic systems perspective, as the product of continuous interactions between cognition, the body and the environment.

The effect of group size on sleep in a neotropical bat, Artibeus jamaicensis

Sleep is associated with many costs, but is also important to survival, with a lack of sleep impairing cognitive function and increasing mortality. Sleeping in groups could alleviate sleep-associated costs, or could introduce new costs if social sleeping disrupts sleep. Working with the Jamaican fruit bat (Artibeus jamaicensis), we aimed to: (1) describe sleep architecture, (2) assess how sleeping in groups affects sleep, and (3) quantify total sleep time and identify rapid eye movement (REM) sleep using behavioral indicators that complement physiological evidence of sleep. Twenty-five adult bats were captured in Panama and recorded sleeping in an artificial roost enclosure. Three bats were fitted with an electromyograph and accelerometer and video recorded sleeping alone in controlled laboratory settings. The remaining 22 bats were assigned to differing social configurations (alone, dyad, triad, and tetrad) and video recorded sleeping in an outdoor flight cage. We found that sleep was highly variable among individuals (ranging from 2 h 53 min to 9 h 39 min over a 12-h period). Although we did not detect statistically significant effects and our sample size was limited, preliminary trends suggest that male bats may sleep longer than females, and individuals sleeping in groups may sleep longer than individuals sleeping alone. We also found a high correspondence between total sleep time quantified visually and quantified using actigraphy (with a 2-min immobility threshold) and identified physiological correlates of behaviorally-defined REM. These results serve as a starting point for future work on the ecology and evolution of sleep in bats and other wild mammals.

The importance of sleep for the developing brain

Purpose of review

This paper summarizes recent research regarding the possible contribution of sleep to brain development. Major milestones in brain development and the methods used to track these changes are reviewed. Changes in sleep, at both behavioral and neural levels, that take place during the same developmental periods are discussed. Finally, a few empirical examples that have contributed new knowledge regarding how sleep contributes to brain development are highlighted.

Recent findings

Empirical examples demonstrating associations between development of sleep and the brain include: predictive associations between SWA topography and myelin development, associations between SWS and hippocampal development, and links between sleep duration and both white matter volume and whole-brain functional connectivity in developing populations.

Summary

There is evidence that sleep is important for the developing brain. However, studies utilizing longitudinal, objective measures of sleep, high-resolution brain imaging, and behavioral measures across developmental are critical for understanding sleep function.

Sleep as a driver of pre- and postnatal brain development

In 1966, Howard Roffwarg proposed the ontogenic sleep hypothesis, relating neural plasticity and development to rapid eye movement (REM) sleep, a hypothesis that current fetal and neonatal sleep research is still exploring. Recently, technological advances have enabled researchers to automatically quantify neonatal sleep architecture, which has caused a resurgence of research in this field as attempts are made to further elucidate the important role of sleep in pre- and postnatal brain development. This article will review our current understanding of the role of sleep as a driver of brain development and identify possible areas for future research. IMPACT: The evidence to date suggests that Roffwarg's ontogenesis hypothesis of sleep and brain development is correct. A better understanding of the relationship between sleep and the development of functional connectivity is needed. Reliable, non-invasive tools to assess sleep in the NICU and at home need to be tested in a real-world environment and the best way to promote healthy sleep needs to be understood before clinical trials promoting and optimizing sleep quality in neonates could be undertaken.

Bedtime to the brain: how infants' sleep behaviours intertwine with non-rapid eye movement sleep electroencephalography features

Adequate sleep is critical for development and facilitates the maturation of the neurophysiological circuitries at the basis of cognitive and behavioural function. Observational research has associated early life sleep problems with worse later cognitive, psychosocial, and somatic health outcomes. Yet, the extent to which day-to-day sleep behaviours (e.g., duration, regularity) in early life relate to non-rapid eye movement (NREM) neurophysiology-acutely and the long-term-remains to be studied. We measured sleep behaviours in 32 healthy 6-month-olds assessed with actimetry and neurophysiology with high-density electroencephalography (EEG) to investigate the association between NREM sleep and habitual sleep behaviours. Our study revealed four findings: first, daytime sleep behaviours are related to EEG slow-wave activity (SWA). Second, night-time movement and awakenings from sleep are connected with spindle density. Third, habitual sleep timing is linked to neurophysiological connectivity quantified as delta coherence. And lastly, delta coherence at 6 months predicts night-time sleep duration at 12 months. These novel findings widen our understanding that infants' sleep behaviours are closely intertwined with three particular levels of neurophysiology: sleep pressure (determined by SWA), the maturation of the thalamocortical system (spindles), and the maturation of cortical connectivity (coherence). The crucial next step is to extend this concept to clinical groups to objectively characterise infants' sleep behaviours 'at risk' that foster later neurodevelopmental problems.

A Thalamocortical Perspective on Sleep Spindle Alterations in Neurodevelopmental Disorders

Purpose of Review

Neurodevelopmental disorders are a group of conditions that affect the development and function of the nervous system, typically arising early in life. These disorders can have various genetic, environmental, and/or neural underpinnings, which can impact the thalamocortical system. Sleep spindles, brief bursts of oscillatory activity that occur during NREM sleep, provide a unique in vivo measure of the thalamocortical system. In this manuscript, we review the development of the thalamocortical system and sleep spindles in rodent models and humans. We then utilize this as a foundation to discuss alterations in sleep spindle activity in four of the most pervasive neurodevelopmental disorders-intellectual disability, attention deficit hyperactivity disorder, autism, and schizophrenia.

Recent Findings

Recent work in humans has shown alterations in sleep spindles across several neurodevelopmental disorders. Simultaneously, rodent models have elucidated the mechanisms which may underlie these deficits in spindle activity. This review merges recent findings from these two separate lines of research to draw conclusions about the pathogenesis of neurodevelopmental disorders.

Summary

We speculate that deficits in the thalamocortical system associated with neurodevelopmental disorders are exquisitely reflected in sleep spindle activity. We propose that sleep spindles may represent a promising biomarker for drug discovery, risk stratification, and treatment monitoring.

Blindness affects the developmental trajectory of the sleeping brain

Sleep plays a crucial role in brain development, sensory information processing, and consolidation. Sleep spindles are markers of these mechanisms as they mirror the activity of the thalamocortical circuits. Spindles can be subdivided into two groups, slow (10-13 Hz) and fast (13-16 Hz), which are each associated with different functions. Specifically, fast spindles oscillate in the high-sigma band and are associated with sensorimotor processing, which is affected by visual deprivation. However, how blindness influences spindle development has not yet been investigated. We recorded nap video-EEG of 50 blind/severely visually impaired (BSI) and 64 sighted children aged 5 months to 6 years old. We considered aspects of both macro- and micro-structural spindles. The BSI children lacked the evolution of developmental spindles within the central area. Specifically, young BSI children presented low central high-sigma and high-beta (25-30 Hz) event-related spectral perturbation and showed no signs of maturational decrease. High-sigma and high-beta activity in the BSI group correlated with clinical indices predicting perceptual and motor disorders. Our findings suggest that fast spindles are pivotal biomarkers for identifying an early developmental deviation in BSI children. These findings are critical for initial therapeutic intervention.

Sensorimotor foundations of speech perception in infancy

The perceptual system for speech is highly organized from early infancy. This organization bootstraps young human learners' ability to acquire their native speech and language from speech input. Here, we review behavioral and neuroimaging evidence that perceptual systems beyond the auditory modality are also specialized for speech in infancy, and that motor and sensorimotor systems can influence speech perception even in infants too young to produce speech-like vocalizations. These investigations complement existing literature on infant vocal development and on the interplay between speech perception and production systems in adults. We conclude that a multimodal speech and language network is present before speech-like vocalizations emerge.

An infant sleep electroencephalographic marker of thalamocortical connectivity predicts behavioral outcome in late infancy

Infancy represents a critical period during which thalamocortical brain connections develop and mature. Deviations in the maturation of thalamocortical connectivity are linked to neurodevelopmental disorders. There is a lack of early biomarkers to detect and localize neuromaturational deviations, which can be overcome with mapping through high-density electroencephalography (hdEEG) assessed in sleep. Specifically, slow waves and spindles in non-rapid eye movement (NREM) sleep are generated by the thalamocortical system, and their characteristics, slow wave slope and spindle density, are closely related to neuroplasticity and learning. Spindles are often subdivided into slow (11.0-13.0 Hz) and fast (13.5-16.0 Hz) frequencies, for which not only different functions have been proposed, but for which also distinctive developmental trajectories have been reported across the first years of life. Recent studies further suggest that information processing during sleep underlying sleep-dependent learning is promoted by the temporal coupling of slow waves and spindles, yet slow wave-spindle coupling remains unexplored in infancy. Thus, we evaluated three potential biomarkers: 1) slow wave slope, 2) spindle density, and 3) the temporal coupling of slow waves with spindles. We use hdEEG to first examine the occurrence and spatial distribution of these three EEG features in healthy infants and second to evaluate a predictive relationship with later behavioral outcomes. We report four key findings: First, infants' EEG features appear locally: slow wave slope is maximal in occipital and frontal areas, whereas slow and fast spindle density is most pronounced frontocentrally. Second, slow waves and spindles are temporally coupled in infancy, with maximal coupling strength in the occipital areas of the brain. Third, slow wave slope, fast spindle density, and slow wave-spindle coupling are not associated with concurrent behavioral status (6 months). Fourth, fast spindle density in central and frontocentral regions at age 6 months predicts overall developmental status at age 12 months, and motor skills at age 12 and 24 months. Neither slow wave slope nor slow wave-spindle coupling predict later behavioral development. We further identified spindle frequency as a determinant of slow and fast spindle density, which accordingly, also predicts motor skills at 24 months. Our results propose fast spindle density, or alternatively spindle frequency, as early EEG biomarker for identifying thalamocortical maturation, which can potentially be used for early diagnosis of neurodevelopmental disorders in infants. These findings are in support of a role of sleep spindles in sensorimotor microcircuitry development. A crucial next step will be to evaluate whether early therapeutic interventions may be effective to reverse deviations in identified individuals at risk.

Infant motor development predicts the dynamics of movement during sleep

The characteristics of infant sleep change over the first year. Generally, infants wake and move less at night as they grow older. However, acquisition of new motor skills leads to temporary increases in night waking and movement at night. Indeed, sleep-dependent movement at night is important for sensorimotor development. Nevertheless, little is known about how movement during sleep changes as infants accrue locomotor experience. The current study investigated whether infant sleep and movement during sleep were predicted by infants' walking experience. Seventy-eight infants wore an actigraph to measure physical activity during sleep. Parents reported when their infants first walked across a room >10 feet without stopping or falling. Infants in the midst of walking skill acquisition had worse sleep than an age-group estimate. Infants with more walk experience had more temporally sporadic movement during sleep and a steeper hourly increase in physical activity over the course of the night. Ongoing motor skill consolidation changes the characteristics of movement during sleep and may alter sleep state-dependent memory consolidation. We propose a model whereby changes in gross motor activity during night sleep reflect movement-dependent consolidation.

Protracted development of motor cortex constrains rich interpretations of infant cognition

Cognition in preverbal human infants must be inferred from overt motor behaviors such as gaze shifts, head turns, or reaching for objects. However, infant mammals - including human infants - show protracted postnatal development of cortical motor outflow. Cortical control of eye, face, head, and limb movements is absent at birth and slowly emerges over the first postnatal year and beyond. Accordingly, the neonatal cortex in humans cannot generate the motor behaviors routinely used to support inferences about infants' cognitive abilities, and thus claims of developmental continuity between infant and adult cognition are suspect. Recognition of the protracted development of motor cortex should temper rich interpretations of infant cognition and motivate more serious consideration of the role of subcortical mechanisms in early cognitive development.

The evolution and diversification of sleep

The evolutionary origins of sleep and its sub-states, rapid eye movement (REM) and non-REM (NREM) sleep, found in mammals and birds, remain a mystery. Although the discovery of a single type of sleep in jellyfish suggests that sleep evolved much earlier than previously thought, it is unclear when and why sleep diversified into multiple types of sleep. Intriguingly, multiple types of sleep have recently been found in animals ranging from non-avian reptiles to arthropods to cephalopods. Although there are similarities between these states and those found in mammals and birds, notable differences also exist. The diversity in the way sleep is expressed confounds attempts to trace the evolution of sleep states, but also serves as a rich resource for exploring the functions of sleep.

Open-ended movements structure sensorimotor information in early human development

Human behaviors, with whole-body coordination, involve large-scale sensorimotor interaction. Spontaneous bodily movements in the early developmental stage potentially lead toward acquisition of such coordinated behavior. These movements presumably contribute to the structuration of sensorimotor interaction, providing specific regularities in bidirectional information among muscle activities and proprioception. Whether and how spontaneous movements, despite being task-free, structure and organize sensorimotor interactions in the entire body during early development remain unknown. Herein, to address these issues, we gained insights into the structuration process of the sensorimotor interaction in neonates and 3-mo-old infants. By combining detailed motion capture and musculoskeletal simulation, sensorimotor information flows among muscle activities and proprioception throughout the body were obtained. Subsequently, we extracted spatial modules and temporal state in sensorimotor information flows. Our approach demonstrated that early spontaneous movements elicited body-dependent sensorimotor modules, revealing age-related changes in them, depending on the combination or direction. The sensorimotor interactions also displayed temporal non-random fluctuations analogous to those seen in spontaneous activities in the cerebral cortex and spinal cord. Furthermore, we found recurring state sequence patterns across multiple participants, characterized by a substantial increase in infants compared to the patterns in neonates. Therefore, early spontaneous movements induce the spatiotemporal structuration in sensorimotor interactions and subsequent developmental changes. These results implicated that early open-ended movements, emerging from a certain neural substrate, regulate the sensorimotor interactions through embodiment and contribute to subsequent coordinated behaviors. Our findings also provide a conceptual linkage between early spontaneous movements and spontaneous neuronal activity in terms of spatiotemporal characteristics.

Temperature-robust rapid eye movement and slow wave sleep in the lizard Laudakia vulgaris

During sleep our brain switches between two starkly different brain states - slow wave sleep (SWS) and rapid eye movement (REM) sleep. While this two-state sleep pattern is abundant across birds and mammals, its existence in other vertebrates is not universally accepted, its evolutionary emergence is unclear and it is undetermined whether it is a fundamental property of vertebrate brains or an adaptation specific to homeotherms. To address these questions, we conducted electrophysiological recordings in the Agamid lizard, Laudakia vulgaris during sleep. We found clear signatures of two-state sleep that resemble the mammalian and avian sleep patterns. These states switched periodically throughout the night with a cycle of ~90 seconds and were remarkably similar to the states previously reported in Pogona vitticeps. Interestingly, in contrast to the high temperature sensitivity of mammalian states, state switches were robust to large variations in temperature. We also found that breathing rate, micro-movements and eye movements were locked to the REM state as they are in mammals. Collectively, these findings suggest that two-state sleep is abundant across the agamid family, shares physiological similarity to mammalian sleep, and can be maintain in poikilothems, increasing the probability that it existed in the cold-blooded ancestor of amniotes.

Sleep, plasticity, and sensory neurodevelopment

A defining feature of early infancy is the immense neural plasticity that enables animals to develop a brain that is functionally integrated with a growing body. Early infancy is also defined as a period dominated by sleep. Here, we describe three conceptual frameworks that vary in terms of whether and how they incorporate sleep as a factor in the activity-dependent development of sensory and sensorimotor systems. The most widely accepted framework is exemplified by the visual system where retinal waves seemingly occur independent of sleep-wake states. An alternative framework is exemplified by the sensorimotor system where sensory feedback from sleep-specific movements activates the brain. We prefer a third framework that encompasses the first two but also captures the diverse ways in which sleep modulates activity-dependent development throughout the nervous system. Appreciation of the third framework will spur progress toward a more comprehensive and cohesive understanding of both typical and atypical neurodevelopment.

Intrinsic maturation of sleep output neurons regulates sleep ontogeny in Drosophila

The maturation of sleep behavior across a lifespan (sleep ontogeny) is an evolutionarily conserved phenomenon. Mammalian studies have shown that in addition to increased sleep duration, early life sleep exhibits stark differences compared with mature sleep with regard to sleep states. How the intrinsic maturation of sleep output circuits contributes to sleep ontogeny is poorly understood. The fruit fly Drosophila melanogaster exhibits multifaceted changes to sleep from juvenile to mature adulthood. Here, we use a non-invasive probabilistic approach to investigate the changes in sleep architecture in juvenile and mature flies. Increased sleep in juvenile flies is driven primarily by a decreased probability of transitioning to wake and characterized by more time in deeper sleep states. Functional manipulations of sleep-promoting neurons in the dorsal fan-shaped body (dFB) suggest that these neurons differentially regulate sleep in juvenile and mature flies. Transcriptomic analysis of dFB neurons at different ages and a subsequent RNAi screen implicate the genes involved in dFB sleep circuit maturation. These results reveal that the dynamic transcriptional states of sleep output neurons contribute to the changes in sleep across the lifespan.

Relations between sleep patterns early in life and brain development: A review

Sleep supports healthy cognitive functioning in adults. Over the past decade, research has emerged advancing our understanding of sleep's role in cognition during development. Infancy and early childhood are marked by unique changes in sleep physiology and sleep patterns as children transition from biphasic to monophasic sleep. Growing evidence suggests that, during development, there are parallel changes in sleep and the brain and that sleep may modulate brain structure and activity and vice versa. In this review, we survey studies of sleep and brain development across childhood. By summarizing these findings, we provide a unique understanding of the importance of healthy sleep for healthy brain and cognitive development. Moreover, we discuss gaps in our understanding, which will inform future research.

Roles for Sleep in Neural and Behavioral Plasticity: Reviewing Variation in the Consequences of Sleep Loss

Sleep is a vital physiological state that has been broadly conserved across the evolution of animal species. While the precise functions of sleep remain poorly understood, a large body of research has examined the negative consequences of sleep loss on neural and behavioral plasticity. While sleep disruption generally results in degraded neural plasticity and cognitive function, the impact of sleep loss can vary widely with age, between individuals, and across physiological contexts. Additionally, several recent studies indicate that sleep loss differentially impacts distinct neuronal populations within memory-encoding circuitry. These findings indicate that the negative consequences of sleep loss are not universally shared, and that identifying conditions that influence the resilience of an organism (or neuron type) to sleep loss might open future opportunities to examine sleep's core functions in the brain. Here, we discuss the functional roles for sleep in adaptive plasticity and review factors that can contribute to individual variations in sleep behavior and responses to sleep loss.

Impact of In Utero Exposure to Antiepileptic Drugs on Neonatal Brain Function

In utero brain development underpins brain health across the lifespan but is vulnerable to physiological and pharmacological perturbation. Here, we show that antiepileptic medication during pregnancy impacts on cortical activity during neonatal sleep, a potent indicator of newborn brain health. These effects are evident in frequency-specific functional brain networks and carry prognostic information for later neurodevelopment. Notably, such effects differ between different antiepileptic drugs that suggest neurodevelopmental adversity from exposure to antiepileptic drugs and not maternal epilepsy per se. This work provides translatable bedside metrics of brain health that are sensitive to the effects of antiepileptic drugs on postnatal neurodevelopment and carry direct prognostic value.

Sleep: Twitch in tempo

Sudden bursts of jerky movements during sleep, called twitches, aid early developmental brain wiring in mice. Translating these findings to humans, a new study reveals that quiet sleep twitches increase in early infancy and coordinate with sleep spindles to establish functional connectivity.