Sleep-dependent memory consolidation – What can be learnt from children?

Cardiopulmonary coupling estimated sleep quality and memory in children with obstructive sleep-disordered breathing

OBJECTIVE

To investigate the association between sleep quality/stability and memory in children with sleep-disordered breathing.

METHODS

Children aged 5-12 years with suspected sleep-disordered breathing who visited the Sleep Center of Beijing Children's Hospital, from June 2022 to March 2023 were enrolled. All patients underwent polysomnography (PSG) and cardiopulmonary coupling monitoring (CPC) analysis based on the photoplethysmogram, and memory tests (immediate and delayed recognition and recall) before sleep and after sleep, respectively. In the CPC analysis, high frequency coupling (HFC) as percentage of total sleep time is stable sleep. A sleep quality index (SQI) integrates HFC, sleep duration and sleep fragmentation. The correlation between memory function and sleep quality/stability was analyzed. Cyclic variation in heart rate was quantified as a sleep apnea indicator (SAI).

RESULTS

Patients were divided into three groups based on HFC: low (<60), moderate (60-80) and high (>80). A total of 152 children were included in the study, 100 males and 52 females, with an average age of 8.2 ± 1.7 years.HFC% was negatively correlated with AHI and OAHI (r: -0.32,p: <0.01; r: -0.31, p: <0.01), while LFC% was positively correlated with AHI and OAHI (r: 0.29, p: <0.01; r: 0.28, p: <0.01). The SQI and HFC was positively correlated with the delayed recall test score(r: 0.19, p: <0.05), and with the recognition consolidation rate (r: 0.23, p: <0.05). In contrast, LFC was negatively correlated with delayed recall test score (r:0.19, p: <0.05), delayed recognition score (r:0.15,p < 0.05), and recognition consolidation rate (r:0.21, p: <0.01). SAI was negatively correlated with Recognition consolidation rate score (r: -0.17, p: <0.05).

CONCLUSIONS

Sleep stability assessed via CPC may reflect a risk biomarker for memory function in children with OSA.

Relations between 24-h movement behaviors, declarative memory, and hippocampal volume in early childhood

This study aimed to determine if 24-h movement behaviors (sedentary time, physical activity, and sleep), considered independently and together, were associated with declarative memory and hippocampal volume in late early childhood. Observational data were obtained from preschool-aged children (timepoint 1: n = 35 children, 3.9 ± 0.5 years; 6 months later: n = 28 children, 4.5 ± 0.5 years). Movement behaviors were measured with actigraphy. Outcomes were declarative memory and hippocampal subregion volumes. Multilevel models explored movement behaviors independently as absolute values, and with both absolute total activity, 24-h sleep duration, and night sleep efficiency. Movement behaviors were also explored as compositions in linear regression models. In independent models, sleep duration and moderate to vigorous physical activity were positively associated with total and right hippocampal volumes, respectively. When examined together, children meeting sleep recommendations were more likely to have larger total, right and left hemisphere, body, and tail hippocampal volumes. In our sample of preschool children, we observed positive associations between sleep duration and hippocampal volume, independent of age. To improve our understanding of the connections between 24-h behaviors and brain health in early childhood, larger samples that also consider the context and subcomponents of movement behaviors may be warranted.

Distinct mechanisms for online and offline motor skill learning across human development

The human central nervous system (CNS) undergoes tremendous changes from childhood to adulthood and this may affect how individuals at different stages of development learn new skills. Here, we studied motor skill learning in children, adolescents, and young adults to test the prediction that differences in the maturation of different learning mechanisms lead to distinct temporal patterns of motor learning during practice and overnight. We found that overall learning did not differ between children, adolescents, and young adults. However, we demonstrate that adult-like skill learning is characterized by rapid and large improvements in motor performance during practice (i.e., online) that are susceptible to forgetting and decay over time (i.e., offline). On the other hand, child-like learning exhibits slower and less pronounced improvements in performance during practice, but these improvements are robust against forgetting and lead to gains in performance overnight without further practice. The different temporal dynamics of motor skill learning suggest an engagement of distinct learning mechanisms in the human CNS during development. In conclusion, adult-like skill learning mechanisms favor online improvements in motor performance whereas child-like learning mechanisms favors offline behavioral gains. RESEARCH HIGHLIGHTS: Many essential motor skills, like walking, talking, and writing, are acquired during childhood, and it is colloquially thought that children learn better than adults. We investigated dynamics of motor skill learning in children, adolescents, and young adults. Adults displayed substantial improvements during practice that was susceptible to forgetting over time. Children displayed smaller improvements during practice that were resilient against forgetting. The distinct age-related characteristics of these processes of acquisition and consolidation suggest that skill learning relies on different mechanisms in the immature and mature central nervous system.

Age differences in generalization, memory specificity, and their overnight fate in childhood

Memory enables generalization to new situations, and memory specificity that preserves individual episodes. This study investigated generalization, memory specificity, and their overnight fate in 141 4- to 8-year-olds (computerized memory game; 71 females, tested 2020-2021 in Germany). The results replicated age effects in generalization and memory specificity, and a contingency of generalization on object conceptual properties and interobject semantic proximity. Age effects were stronger in generalization than in memory specificity, and generalization was more closely linked to the explicit regularity knowledge in older than in younger children. After an overnight delay, older children retained more generalized and specific memories and showed greater gains but only in generalization. These findings reveal distinct age differences in generalization and memory specificity across childhood.

Impaired episodic verbal memory recall after 1 week and elevated forgetting in children after mild traumatic brain injury - results from a short-term longitudinal study

Objective

There is preliminary evidence that children after traumatic brain injury (TBI) have accelerated long-term forgetting (ALF), i.e., an adequate learning and memory performance in standardized memory tests, but an excessive rate of forgetting over delays of days or weeks. The main aim of this study was to investigate episodic memory performance, including delayed retrieval 1 week after learning, in children after mild TBI (mTBI).

Methods

This prospective study with two time-points (T1: 1 week after injury and T2: 3-6 months after injury), included data of 64 children after mTBI and 57 healthy control children aged between 8 and 16 years. We assessed episodic learning and memory using an auditory word learning test and compared executive functions (interference control, working memory, semantic fluency and flexibility) and divided attention between groups. We explored correlations between memory performance and executive functions. Furthermore, we examined predictive factors for delayed memory retrieval 1 week after learning as well as for forgetting over time.

Results

Compared to healthy controls, patients showed an impaired delayed recall and recognition performance 3-6 months after injury. Executive functions, but not divided attention, were reduced in children after mTBI. Furthermore, parents rated episodic memory as impaired 3-6 months after injury. Additionally, verbal learning and group, but not executive functions, were predictive for delayed recall performance at both time-points, whereas forgetting was predicted by group.

Discussion

Delayed recall and forgetting over time were significantly different between groups, both post-acutely and in the chronic phase after pediatric mTBI, even in a very mildly injured patient sample. Delayed memory performance should be included in clinical evaluations of episodic memory and further research is needed to understand the mechanisms of ALF.

Visual artificial grammar learning across 1 year in 7-year-olds and adults

Acquiring sequential information is of utmost importance, for example, for language acquisition in children. Yet, the long-term storage of statistical learning in children is poorly understood. To address this question, 27 7-year-olds and 28 young adults completed four sessions of visual sequence learning (Year 1). From this sample, 16 7-year-olds and 20 young adults participated in another four equivalent sessions after a 12-month-delay (Year 2). The first three sessions of each year used Stimulus Set 1, and the last session used Stimulus Set 2 to investigate transfer effects. Each session consisted of alternating learning and test phases in a modified artificial grammar learning task. In Year 1, 7-year-olds and adults learned the regularities and showed transfer to Stimulus Set 2. Both groups retained their final performance level over the 1-year period. In Year 2, children and adults continued to improve with Stimulus Set 1 but did not show additional transfer gains. Adults overall outperformed children, but transfer effects were indistinguishable between both groups. The current results suggest that long-term memory traces are formed from repeated sequence learning that can be used to generalize sequence rules to new visual input. However, the current study did not provide evidence for a childhood advantage in learning and remembering sequence rules.

Children exhibit a developmental advantage in the offline processing of a learned motor sequence

Changes in specific behaviors across the lifespan are frequently reported as an inverted-U trajectory. That is, young adults exhibit optimal performance, children are conceptualized as developing systems progressing towards this ideal state, and older adulthood is characterized by performance decrements. However, not all behaviors follow this trajectory, as there are instances in which children outperform young adults. Here, we acquired data from 7-35 and >55 year-old participants and assessed potential developmental advantages in motor sequence learning and memory consolidation. Results revealed no credible evidence for differences in initial learning dynamics among age groups, but 7- to 12-year-old children exhibited smaller sequence-specific learning relative to adolescents, young adults and older adults. Interestingly, children demonstrated the greatest performance gains across the 5 h and 24 h offline periods, reflecting enhanced motor memory consolidation. These results suggest that children exhibit an advantage in the offline processing of recently learned motor sequences.

Sleep duration trajectories and cognition in early childhood: A systematic review

Sleep is dynamic in childhood and studies have shown the relationship between sleep and cognition in children. As the human brain is the most plastic during childhood, the study of longitudinal sleep patterns and neurocognition is an important research area. We aimed to systematically review studies that investigated sleep duration trajectories and cognition in typically-developing children. We searched four databases for articles published between 2003 to October 2023. We included observation studies of children with sleep duration trajectories as a predictor and outcomes related to cognition, memory, language, developmental milestones, intelligence or executive function. We excluded studies where children had atypical development or completed the sleep and neurocognitive assessments after six and 12 years of age respectively. Out of 752 articles identified, 511 were screened and 23 full texts were assessed. The selected studies included three single trajectory and four multiple group trajectories studies. We found associations between both types of trajectories and cognitive development. Overall, children with longer sleep trajectories or more mature sleep pattern with rapid decrease in sleep duration, had better performance scores in developmental assessment tools, and intelligence tests. Findings for language and executive functioning were mixed, whereby some studies found associations and others did not.

Children extract a new linguistic rule more quickly than adults

Children achieve better long-term language outcomes than adults. However, it remains unclear whether children actually learn language more quickly than adults during real-time exposure to input-indicative of true superior language learning abilities-or whether this advantage stems from other factors. To examine this issue, we compared the rate at which children (8-10 years) and adults extracted a novel, hidden linguistic rule, in which novel articles probabilistically predicted the animacy of associated nouns (e.g., "gi lion"). Participants categorized these two-word phrases according to a second, explicitly instructed rule over two sessions, separated by an overnight delay. Both children and adults successfully learned the hidden animacy rule through mere exposure to the phrases, showing slower response times and decreased accuracy to occasional phrases that violated the rule. Critically, sensitivity to the hidden rule emerged much more quickly in children than adults; children showed a processing cost for violation trials from very early on in learning, whereas adults did not show reliable sensitivity to the rule until the second session. Children also showed superior generalization of the hidden animacy rule when asked to classify nonword trials (e.g., "gi badupi") according to the hidden animacy rule. Children and adults showed similar retention of the hidden rule over the delay period. These results provide insight into the nature of the critical period for language, suggesting that children have a true advantage over adults in the rate of implicit language learning. Relative to adults, children more rapidly extract hidden linguistic structures during real-time language exposure. RESEARCH HIGHLIGHTS: Children and adults both succeeded in implicitly learning a novel, uninstructed linguistic rule, based solely on exposure to input. Children learned the novel linguistic rules much more quickly than adults. Children showed better generalization performance than adults when asked to apply the novel rule to nonsense words without semantic content. Results provide insight into the nature of critical period effects in language, indicating that children have an advantage over adults in real-time language learning.

Sleep spindle maturity promotes slow oscillation-spindle coupling across child and adolescent development

The synchronization of canonical fast sleep spindle activity (12.5-16 Hz, adult-like) precisely during the slow oscillation (0.5-1 Hz) up peak is considered an essential feature of adult non-rapid eye movement sleep. However, there is little knowledge on how this well-known coalescence between slow oscillations and sleep spindles develops. Leveraging individualized detection of single events, we first provide a detailed cross-sectional characterization of age-specific patterns of slow and fast sleep spindles, slow oscillations, and their coupling in children and adolescents aged 5-6, 8-11, and 14-18 years, and an adult sample of 20- to 26-year-olds. Critically, based on this, we then investigated how spindle and slow oscillation maturity substantiate age-related differences in their precise orchestration. While the predominant type of fast spindles was development-specific in that it was still nested in a frequency range below the canonical fast spindle range for the majority of children, the well-known slow oscillation-spindle coupling pattern was evident for sleep spindles in the adult-like canonical fast spindle range in all four age groups-but notably less precise in children. To corroborate these findings, we linked personalized measures of fast spindle maturity, which indicate the similarity between the prevailing development-specific and adult-like canonical fast spindles, and slow oscillation maturity, which reflects the extent to which slow oscillations show frontal dominance, with individual slow oscillation-spindle coupling patterns. Importantly, we found that fast spindle maturity was uniquely associated with enhanced slow oscillation-spindle coupling strength and temporal precision across the four age groups. Taken together, our results suggest that the increasing ability to generate adult-like canonical fast sleep spindles actuates precise slow oscillation-spindle coupling patterns from childhood through adolescence and into young adulthood.

Sleep Patterns in Children With Blindness: A Comparison With Normally Sighted Peers

Purpose

Studies showing problematic sleep patterns in blind and visually impaired children are often based on (parent) self-report. The purpose was to compare sleep patterns of blind children to normally sighted peers using objective measures.

Methods

In this cross-sectional study, 100 blind (best-corrected visual acuity <3/60) and 100 age- and gender-matched normally sighted children aged 7 to 17 years wore a digital activity monitoring device for 1 week. Sleep quantity (i.e., total sleep time and total time in bed) and sleep quality (number of awakenings, latency, efficiency, wake after sleep onset [WASO], and sleep fragmentation index) were measured. Adjusted linear regression analyses were used to model group differences in sleep parameters.

Results

Data of 163 children were included. Blind children spent significantly less total time in bed in minutes (β, -31; 95% confidence interval, -56 to -6) and had a lower total sleep time (-41; -66 to -17), smaller number of awakenings (-2.8; -4.5 to -1.0), a lower WASO (-10; -16 to -5), and a more efficient sleep pattern (1.5; 0.1 to 2.8) compared to normally sighted children.

Conclusions

Although sleep quantity and recommended hours of sleep per night were lower among blind children than normally sighted children, their sleep quality was better. This contradicts findings of self-report studies and warrants further studies to measure sleep objectively. Further, the discrepancy between previous findings and our findings regarding sleep quality may be explained by the house rules of the boarding schools attended by blind children, which may facilitate improved sleep hygiene.

Associations of activity, sedentary, and sleep behaviors with cognitive and social-emotional health in early childhood

Background

Early childhood is important for cognitive and social-emotional development, and a time in which to promote healthy movement behaviors (sedentary behavior, physical activity, and sleep). Movement behaviors may have interactive influences on cognition and social-emotional factors in young children, but most previous research has explored them independently. The purpose of this study was to determine if movement behaviors are associated with measures of cognitive and social-emotional health in young children and if so, to describe optimal compositions of movement behaviors of a daily cycle for such outcomes.

Methods

Children (n = 388, 33 to 70 months, 44.6% female) from a clinical trial (ClinicalTrials.gov ID: NCT03285880, first posted September 18, 2017) wore accelerometers on their wrists for 24-h for 9.56 ± 3.3 days. Movement behavior compositions consisted of time spent in sedentary behaviors, light intensity physical activity, moderate to vigorous intensity physical activity (MVPA), and sleep. Outcomes were cognitive (receptive vocabulary, declarative and procedural memory, and executive attention) and social-emotional measures (temperament and behavioral problems). Compositional linear regression models with isometric log ratios were used to investigate the relations between the movement behavior composition and the cognitive and social-emotional health measures. If a significant association was found between the composition and an outcome, we further explored the "optimal" 24-h time-use for said outcome.

Results

Movement behavior compositions were associated with receptive vocabulary. The composition associated with the predicted top five percent of vocabulary scores consisted of 12.1 h of sleep, 4.7 h of sedentary time, 5.6 h of light physical activity, and 1.7 h of MVPA.

Conclusions

While behavior compositions are related to vocabulary ability in early childhood, our findings align with the inconclusiveness of the current evidence regarding other developmental outcomes. Future research exploring activities within these four movement behaviors, that are meaningful to cognitive and social-emotional development, may be warranted.

Supplementary Information

The online version contains supplementary material available at 10.1186/s44167-023-00016-6.

Do naps benefit novel word learning? Developmental differences and white matter correlates

Memory representations of newly learned words undergo changes during nocturnal sleep, as evidenced by improvements in explicit recall and lexical integration (i.e., after sleep, novel words compete with existing words during online word recognition). Some studies have revealed larger sleep-benefits in children relative to adults. However, whether daytime naps play a similar facilitatory role is unclear. We investigated the effect of a daytime nap (relative to wake) on explicit memory (recall/recognition) and lexical integration (lexical competition) of newly learned novel words in young adults and children aged 10-12 years, also exploring white matter correlates of the pre- and post-nap effects of word learning in the child group with diffusion weighted MRI. In both age groups, a nap maintained explicit memory of novel words and wake led to forgetting. However, there was an age group interaction when comparing change in recall over the nap: children showed a slight improvement whereas adults showed a slight decline. There was no evidence of lexical integration at any point. Although children spent proportionally more time in slow-wave sleep (SWS) than adults, neither SWS nor spindle parameters correlated with over-nap changes in word learning. For children, increased fractional anisotropy (FA) in the uncinate fasciculus and arcuate fasciculus were associated with the recognition of novel words immediately after learning, and FA in the right arcuate fasciculus was further associated with changes in recall of novel words over a nap, supporting the importance of these tracts in the word learning and consolidation process. These findings point to a protective role of naps in word learning (at least under the present conditions), and emphasize the need to better understand both the active and passive roles that sleep plays in supporting vocabulary consolidation over development.

Preferential consolidation of emotional reactivity during sleep: A systematic review and meta-analysis

Many studies have investigated whether sleep affects cognitively unmodulated reactivity to emotional stimuli. These studies operationalize emotion regulation by using subjective and/or objective measures to compare pre- and post-sleep reactivity to the same emotional stimuli. Findings have been inconsistent: some show that sleep attenuates emotional reactivity, whereas others report enhanced or maintained reactivity. Across-study methodological differences may account for discrepant findings. To resolve the questions of whether sleep leads to the attenuation, enhancement, or maintenance of emotional reactivity, and under which experimental conditions particular effects are observed, we undertook a synthesized narrative and meta-analytic approach. We searched PubMed, PsycINFO, PsycARTICLES, Web of Science, and Cochrane Library databases for relevant articles, using search terms determined a priori and search limits of language = English, participants = human, and dates = January 2006–June 2021. Our final sample included 24 studies that investigated changes in emotional reactivity in response to negatively and/or positively valenced material compared to neutral material over a period of sleep compared to a matched period of waking. Primary analyses used random effects modeling to investigate whether sleep preferentially modulates reactivity in response to emotional stimuli; secondary analyses examined potential moderators of the effect. Results showed that sleep (or equivalent periods of wakefulness) did not significantly affect psychophysiological measures of reactivity to negative or neutral stimuli. However, self-reported arousal ratings of negative stimuli were significantly increased post-sleep but not post-waking. Sub-group analyses indicated that (a) sleep-deprived participants, compared to those who slept or who experienced daytime waking, reacted more strongly and negatively in response to positive stimuli; (b) nap-exposed participants, compared to those who remained awake or who slept a full night, rated negative pictures less negatively; and (c) participants who did not obtain substantial REM sleep, compared to those who did and those exposed to waking conditions, had attenuated reactivity to neutral stimuli. We conclude that sleep may affect emotional reactivity, but that studies need more consistency in methodology, commitment to collecting both psychophysiological and self-report measures, and should report REM sleep parameters. Using these methodological principles would promote a better understanding of under which conditions particular effects are observed.

Sleep Fosters Odor Recognition in Children with Attention Deficit Hyperactivity Disorder but Not in Typically Developing Children

Prior experience represents a prerequisite for memory consolidation across various memory systems. In the context of olfaction, sleep was found to enhance the consolidation of odors in adults but not in typically developing children (TDC), likely due to differences in pre-experience. Interestingly, unmedicated children with attention deficit hyperactivity disorder (ADHD), a neurodevelopmental condition related to dopamine dysfunction, showed lower perceptive thresholds for odors, potentially allowing for more odor experience compared to TDC. We investigated sleep-associated odor memory consolidation in ADHD. Twenty-eight children with ADHD and thirty age-matched TDC participated in an incidental odor recognition task. For the sleep groups (ADHD: n = 14, TDC: n = 15), the encoding of 10 target odorants took place in the evening, and the retention of odorants was tested with 10 target odorants and 10 distractor odorants the next morning. In the wake groups (ADHD: n = 14, TDC: n = 15), the time schedule was reversed. Odor memory consolidation was superior in the ADHD sleep group compared to the TDC sleep and the ADHD wake groups. Intensity and familiarity ratings during encoding were substantially higher in ADHD compared to TDC. Sleep-associated odor memory consolidation in ADHD is superior to TDC. Abundant pre-experience due to lower perceptive thresholds is suggested as a possible explanation. Olfaction might serve as a biomarker in ADHD.

Transient Destabilization of Declarative Memory—Opposing Impact of Physical Exercise or Rest after Encoding in Typically Developing Children and Children with Attention Deficit Hyperactivity Disorder but No Difference after Subsequent Sleep

Background: Children are especially sensitive to a broad range of influences and show a remarkable capacity for learning. One prominent example is declarative memory, which may be influenced by a variety of factors and is impaired in attention deficit hyperactivity disorder (ADHD). Exercise and sleep, or both combined, might foster declarative memory. Methods: Here, 12 typically developing children (TDC) and 12 age-matched children with ADHD participated in an exercise and rest condition before a night in the sleep laboratory. Declarative memory was encoded before exercise or rest and retrieved before and after a night of sleep. Results: Exercise in TDC but rest in ADHD lead to a transient destabilization of declarative memory, while there were no more differences after a night of sleep. Rapid eye movement (REM) sleep latency was prolonged after exercise in both groups. Conclusions: Exercise leads to opposing effects on immediate declarative memory formation. The factors or contexts that promote or hinder declarative memory formation in children ADHD and TDC differ, and further work is needed to determine the recommendations for declarative learning in children with ADHD.

Anodal Transcranial Direct Current Stimulation Over Prefrontal Cortex Slows Sequence Learning in Older Adults

Aging is associated with declines in sensorimotor function. Several studies have demonstrated that transcranial direct current stimulation (tDCS), a form of non-invasive brain stimulation, can be combined with training to mitigate age-related cognitive and motor declines. However, in some cases, the application of tDCS disrupts performance and learning. Here, we applied anodal tDCS either over the left prefrontal cortex (PFC), right PFC, supplementary motor complex (SMC), the left M1, or in a sham condition while older adults (n = 63) practiced a Discrete Sequence Production (DSP), an explicit motor sequence, task across 3 days. We hypothesized that stimulation to either the right or left PFC would enhance motor learning for older adults, based on the extensive literature showing increased prefrontal cortical activity during motor task performance in older adults. Contrary to our predictions, stimulation to the right and left PFC resulted in slowed motor learning, as evidenced by a slower reduction rate of reduction of reaction time and the number of sequence chunks across trials relative to sham in session one and session two, respectively. These findings suggest an integral role of the right PFC early in sequence learning and a role of the left PFC in chunking in older adults, and contribute to mounting evidence of the difficultly of using tDCS in an aging population.

Effects of Sleep on Language and Motor Consolidation: Evidence of Domain General and Specific Mechanisms

The current study explores the effects of time and sleep on the consolidation of a novel language learning task containing both item-specific knowledge and the extraction of grammatical regularities. We also compare consolidation effects in language and motor sequence learning tasks, to ask whether consolidation mechanisms are domain general. Young adults learned to apply plural inflections to novel words based on morphophonological rules embedded in the input, and learned to type a motor sequence using a keyboard. Participants were randomly assigned into one of two groups, practicing each task during either the morning or evening hours. Both groups were retested 12 and 24 hours post-training. Performance on frequent trained items in the language task stabilized only following sleep, consistent with a hippocampal mechanism for item-specific learning. However, regularity extraction, indicated by generalization to untrained items in the linguistic task, as well as performance on motor sequence learning, improved 24 hours post-training, irrespective of the timing of sleep. This consolidation process is consistent with a frontostriatal skill-learning mechanism, common across the language and motor domains. This conclusion is further reinforced by cross-domain correlations at the individual level between improvement across 24 hours in the motor task and in the low-frequency trained items in the linguistic task, which involve regularity extraction. Taken together, our results at the group and individual levels suggest that some aspects of consolidation are shared across the motor and language domains, and more specifically, between motor sequence learning and grammar learning.

How do children with autism spectrum disorder form gist memory during sleep? A study of slow oscillation-spindle coupling

Sleep is assumed to support memory through an active systems consolidation process that does not only strengthen newly encoded representations but also facilitates the formation of more abstract gist memories. Studies in humans and rodents indicate a key role of the precise temporal coupling of sleep slow oscillations (SO) and spindles in this process. The present study aimed at bolstering these findings in typically developing (TD) children, and at dissecting particularities in SO-spindle coupling underlying signs of enhanced gist memory formation during sleep found in a foregoing study in children with autism spectrum disorder (ASD) without intellectual impairment. Sleep data from 19 boys with ASD and 20 TD boys (9-12 years) were analyzed. Children performed a picture-recognition task and the Deese-Roediger-McDermott (DRM) task before nocturnal sleep (encoding) and in the next morning (retrieval). Sleep-dependent benefits for visual-recognition memory were comparable between groups but were greater for gist abstraction (recall of DRM critical lure words) in ASD than TD children. Both groups showed a closely comparable SO-spindle coupling, with fast spindle activity nesting in SO-upstates, suggesting that a key mechanism of memory processing during sleep is fully functioning already at childhood. Picture-recognition at retrieval after sleep was positively correlated to frontocortical SO-fast-spindle coupling in TD children, and less in ASD children. Critical lure recall did not correlate with SO-spindle coupling in TD children but showed a negative correlation (r = -.64, p = .003) with parietal SO-fast-spindle coupling in ASD children, suggesting other mechanisms specifically conveying gist abstraction, that may even compete with SO-spindle coupling.

REM Sleep EEG Activity and Clinical Correlates in Adults With Autism

We tested the hypothesis of an atypical scalp distribution of electroencephalography (EEG) activity during Rapid Eye Movement (REM) sleep in young autistic adults. EEG spectral activity and ratios along the anteroposterior axis and across hemispheres were compared in 16 neurotypical (NT) young adults and 17 individuals with autism spectrum disorder (ASD). EEG spectral power was lower in the ASD group over the bilateral central and right parietal (beta activity) as well as bilateral occipital (beta, theta, and total activity) recording sites. The NT group displayed a significant posterior polarity of intra-hemispheric EEG activity while EEG activity was more evenly or anteriorly distributed in ASD participants. No significant inter-hemispheric EEG lateralization was found. Correlations between EEG distribution and ASD symptoms using the Autism Diagnostic Interview-Revised (ADI-R) showed that a higher posterior ratio was associated with a better ADI-R score on communication skills, whereas a higher anterior ratio was related to more restricted interests and repetitive behaviors. EEG activity thus appears to be atypically distributed over the scalp surface in young adults with autism during REM sleep within cerebral hemispheres, and this correlates with some ASD symptoms. These suggests the existence in autism of a common substrate between some of the symptoms of ASD and an atypical organization and/or functioning of the thalamo-cortical loop during REM sleep.

Phase-dependent offline enhancement of human motor memory

BACKGROUND

Skill learning engages offline activity in the primary motor cortex (M1). Sensorimotor cortical activity oscillates between excitatory trough and inhibitory peak phases of the mu (8-12 Hz) rhythm. We recently showed that these mu phases influence the magnitude and direction of neuroplasticity induction within M1. However, the contribution of M1 activity during mu peak and trough phases to human skill learning has not been investigated.

OBJECTIVE

To evaluate the effects of phase-dependent TMS during mu peak and trough phases on offline learning of a newly-acquired motor skill.

METHODS

On Day 1, three groups of healthy adults practiced an explicit motor sequence learning task with their non-dominant left hand. After practice, phase-dependent TMS was applied to the right M1 during either mu peak or mu trough phases. The third group received sham TMS during random mu phases. On Day 2, all subjects were re-tested on the same task to evaluate offline learning.

RESULTS

Subjects who received phase-dependent TMS during mu trough phases showed increased offline skill learning compared to those who received phase-dependent TMS during mu peak phases or sham TMS during random mu phases. Additionally, phase-dependent TMS during mu trough phases elicited stronger whole-brain broadband oscillatory power responses than phase-dependent TMS during mu peak phases.

CONCLUSIONS

We conclude that sensorimotor mu trough phases reflect brief windows of opportunity during which TMS can strengthen newly-acquired skill memories.

Lights Out: Examining Sleep in Children with Vision Impairment

Sleep is crucial for development across cognitive, physical, and social-emotional domains. Sleep quality and quantity impact domains of daytime functioning, attainment, and global development. Previous work has explored sleep profiles in typically developing children and children with developmental disorders such as Down syndrome and Williams Syndrome, yet there is a complete absence of published work regarding the sleep profiles of children with vision impairment aged 4–11 years. This is the first known study that examines the sleep profiles in children with vision impairment (n = 58) in comparison to 58 typically developing children (aged 4–11 years) in the UK. Sleep was measured using the Childhood Sleep Habits Questionnaire (CSHQ; parental report), actigraphy and sleep diaries. Results showed group differences in subjective CSHQ scores but not objective actigraphy measures. Surprisingly, the findings revealed disordered sleep (namely, poor sleep quantity) in both groups. Discordance between CSHQ and actigraphy measures could represent heightened awareness of sleeping problems in parents/caregivers of children with vision impairment. The implications of this study extend beyond group comparison, examining disordered sleep in ‘typically developing’ children, exploring the potential role of light perception and the importance of sleep quality and quantity in both groups.

The relation between sleep and neurocognitive development in infancy and early childhood: A neuroscience perspective

Sleep is essential for human life. It has different characteristics in the early stages of life compared to later periods: during development, qualitative and quantitative changes in sleep features occur such as the onset of REM/NREM sleep at 3 months, the progressive increase of night sleep duration, and the reduction of total sleep time. Sleep seems to be essential in the cognitive functions' development, especially in the first period of life. Indeed, higher rates of night sleep at the age of 12 and 18 months are associated with higher executive functions' performance. Furthermore, memory consolidation occurs during sleep and sleep contributes to children's learning not only in retaining information but also in organizing memories most efficiently. Therefore, sleep problems could cause negative effects on some features of cognitive development like memory, executive functions, and learning process. There is also an intimate relationship between sleep and regulation of emotional brain functions, with a link between sleep disturbance and behavioral problems.

Sleep's role in memory consolidation: What can we learn from atypical development?

Research conducted over the last century has suggested a role for sleep in the processes guiding healthy cognition and development, including memory consolidation. Children with intellectual and developmental disabilities (IDDs) tend to have higher rates of sleep disturbances, which could relate to behavior issues, developmental delays, and learning difficulties. While several studies examine whether sleep exacerbates daytime difficulties and attention deficits in children with IDDs, this chapter focuses on the current state of knowledge regarding sleep and memory consolidation in typically developing (TD) groups and those at risk for learning difficulties. In particular, this chapter summarizes the current literature on sleep-dependent learning across developmental disabilities, including Down syndrome, Williams syndrome, Autism Spectrum Disorder, and Learning Disabilities (Attention-Deficit/Hyperactivity Disorder and Dyslexia). We also highlight the gaps in the current literature and identify challenges in studying sleep-dependent memory in children with different IDDs. This burgeoning new field highlights the importance of considering the role of sleep in memory retention across long delays when evaluating children's memory processes. Further, an understanding of typical and atypical development can mutually inform recent theories of sleep's role in memory.

Word learning and verbal working memory in children with developmental language disorder

BACKGROUND AND AIMS

Previous research into word learning in children with developmental language disorder (DLD) indicates that the learning of word forms and meanings, rather than form-referent links, is problematic. This difficulty appears to arise with impaired encoding, while retention of word knowledge remains intact. Evidence also suggests that word learning skills may be related to verbal working memory. We aimed to substantiate these findings in the current study by exploring word learning over a series of days.

METHODS

Fifty children with DLD (mean age 6; 11, 72% male) and 54 age-matched typically developing (TD) children (mean age 6; 10, 56% male) were taught eight novel words across a four-day word learning protocol. Day 1 measured encoding, Days 2 and 3 measured re-encoding, and Day 4 assessed retention. At each day, word learning success was evaluated using Naming, Recognition, Description, and Identification tasks.

RESULTS

Children with DLD showed comparable performance to the TD group on the Identification task, indicating an intact ability to learn the form-referent links. In contrast, children with DLD performed significantly worse for Naming and Recognition (signifying an impaired ability to learn novel word forms), and for Description, indicating problems establishing new word meanings. These deficits for the DLD group were apparent at Days 1, 2, and 3 of testing, indicating impairments with initial encoding and re-encoding; however, the DLD and TD groups demonstrated a similar rate of learning. All children found the retention assessments at Day 4 difficult, and there were no significant group differences. Finally, verbal working memory emerged as a significant moderator of performance on the Naming and Recognition tasks, such that children with DLD and poor verbal working memory had the lowest levels of accuracy.

CONCLUSIONS

This study demonstrates that children with DLD struggle with learning novel word forms and meanings, but are unimpaired in their ability to establish new form-referent links. The findings suggest that the word learning deficit may be attributed to problems with encoding, rather than with retention, of new word knowledge; however, further exploration is required given the poor performance of both groups for retention testing. Furthermore, we found evidence that an impaired ability to learn word forms may only be apparent in children who have DLD and low levels of verbal working memory.

IMPLICATIONS

When working with children with DLD, speech-language pathologists should assess word learning using tasks that evaluate the ability to learn word forms, meanings, and form-referent links to develop a profile of individual word learning strengths and weaknesses. Clinicians should also assess verbal working memory to identify children at particular risk of word learning deficits. Future research should explore the notion of optimal intervention intensity for facilitating word learning in children with poor language and verbal working memory.

Prospective relations between sleep in preschool years and academic achievement at school entry

It is often assumed that adequate sleep is a key ingredient of children's school success. Research to date, however, suggests modest associations between child sleep and academic achievement. Adopting a developmental perspective, this report investigates the associations between age-related changes in sleep across the preschool period and academic achievement at school entry. Sleep was assessed by actigraphy at ages 2, 3 and 4 among 128 children from mostly White middle-class families, and their performance in reading and mathematics was tested in Grade 1. The results revealed that children whose sleep duration decreased more rapidly across the preschool period showed better performance in both reading and mathematics. These results suggest that age-related developments may be a key characteristic of sleep in the preschool years.

The power of children's sleep - Improved declarative memory consolidation in children compared with adults

Post-learning slow wave sleep (SWS) is known to support declarative memory consolidation. As SWS is more abundant in young population, we suggested that sleep-dependent memory consolidation processes could occur at a faster pace in school-aged children. After learning new associations between non-objects and their functions, retrieval performance was tested in 30 children (7–12 years) and 34 adults (20–30 years) during an immediate (IR) and a delayed retrieval (DR) session separated by either a Sleep or a Wake condition. Sleep led to stabilized memory retrieval performance only in children, not in adults, whereas no age-related difference was observed after a similar period of wakefulness. Hence, our results suggest more efficient sleep-dependent declarative memory consolidation processes in children compared with adults, an effect potentially ascribed to more abundant and deeper SWS during childhood.

Long-term verbal memory deficit and associated hippocampal alterations in 22q11.2 deletion syndrome

Chromosome 22q11.2 deletion syndrome (22q11.2DS) is a genetic disease associated with an increased risk for schizophrenia and a specific cognitive profile. In this paper, we challenge the current view of spared verbal memory in 22q11.2DS by investigating verbal memory consolidation processes over an extended time span to further qualify the neuropsychological profile. Our hypotheses are based on brain anomalies of the medial temporal lobes consistently reported in this syndrome.Eighty-four participants (45 with 22q11.2DS), aged 8-24 years old, completed a verbal episodic memory task to investigate long-term memory on four different time delays. We compared trajectories of forgetting between groups (22q11.2DS vs. controls) and analyzed performance inside the 22q11.2DS sample through cluster analyses. Potential links between memory performance and volume of the hippocampal subfields were examined.We showed accelerated long-term forgetting (ALF) in the 22q11.2DS group, visible after a delay of one day. Using mixed models, we showed significant differences in the shape of memory trajectories between subgroups of participants with 22q11.2DS. These sub-groups differed in terms of memory recognition, intellectual functioning, positive psychotic symptoms and grey matter volume of hippocampal subfields but not in terms of age.In conclusion, by investigating memory processes on longer delays than standardized memory tasks, we identified deficits in long-term memory consolidation leading to ALF in 22q11.2DS. Nevertheless, we showed that a subgroup of patients had larger memory consolidation deficit associated with lower intellectual functioning, higher rates of positive psychotic symptoms and hippocampal alterations.

No effect of targeted memory reactivation during sleep on retention of vocabulary in adolescents

Re-exposure of newly acquired vocabulary during sleep improves later memory recall in healthy adults. The success of targeted memory reactivation (TMR) during sleep presumably depends on the presence of slow oscillations (i.e., EEG activity at a frequency of about 0.75 Hz). As slow oscillating activity is at its maximum during adolescence, we hypothesized that TMR is even more beneficial at this developmental stage. In the present study, adolescents aged 11 to 13 learnt Dutch vocabulary in the evening and were tested on recall performance the next morning. Half of the words were presented via loudspeakers during post-learning periods of NREM (Non Rapid Eye Movement) sleep in order to stimulate memory reactivation. Unexpectedly, TMR during sleep did not improve memory on the behavioral level in adolescents. On the oscillatory level, successful reactivation during sleep resulted in the characteristic increase in theta power over frontal brain regions, as reported in adults. However, we observed no increase in spindle power during successful reactivation. Possible factors that may explain the lacking effect of TMR in adolescents in this study such as differences in learning abilities and pre-sleep performance levels are discussed.

Acoustic closed-loop stimulation during sleep improves consolidation of reward-related memory information in healthy children but not in children with attention-deficit hyperactivity disorder

Study Objectives

Slow oscillations (SO) during slow-wave sleep foster the consolidation of declarative memory. Children with attention-deficit hyperactivity disorder (ADHD) display deficits in the sleep-associated consolidation of declarative memory, possibly due to an altered function of SO. The present study aimed at enhancing SO activity using closed-looped acoustic stimulation during slow-wave sleep in children with ADHD.

Methods

A total of 29 male children (14 with ADHD; aged 8–12 years) participated in a double-blind, placebo-controlled study trial. Children spent two experimental nights in a sleep lab, one stimulation night and one sham night. A declarative learning task (word-pair learning) with a reward condition was used as a primary outcome. Secondary outcome variables were a procedural memory (serial reaction time) and working memory (WM; n-back) task. Encoding of declarative and procedural memory took place in the evening before sleep. After sleep, the retrieval took place followed by the n-back task.

Results

The stimulation successfully induced SO activity during sleep in children with and without ADHD. After stimulation, only healthy children performed better on high-rewarded memory items (primary outcome). In contrast, there were indications that only children with ADHD benefitted from the stimulation with respect to procedural as well as WM performance (secondary outcome).

Conclusions

We were able to show that the acoustic closed-loop stimulation can be applied to enhance SO activity in children with and without ADHD. Our data indicate that SO activity during sleep interacts with subsequent memory performance (primary outcome: rewarded declarative memory; secondary outcome: procedural and WM) in children with and without ADHD.

Sleep electroencephalography and brain maturation: developmental trajectories and the relation with cognitive functioning

Sleep has a crucial role in brain functioning and cognition, and several sleep electroencephalography (EEG) hallmarks are associated with intellectual abilities, neural plasticity, and learning processes. Starting from this evidence, a growing interest has been raised regarding the involvement of the sleep EEG in brain maturation and cognitive functioning during typical development (TD). The aim of this review is to provide a general framework about the maturational changes and the functional role of the human sleep EEG during TD from birth to late adolescence (≤22 years). The reviewed findings show large developmental modifications in several sleep EEG hallmarks (slow wave activity, sleep spindles, theta activity, and cyclic alternating pattern) during TD, and many studies support the notion of an active role of sleep slow wave activity in supporting brain maturation. Moreover, we focus on the possible relation between sleep microstructure, intelligence, and several memory domains (declarative, emotional, procedural), showing that sleep EEG oscillations seem involved in intellectual abilities and learning processes during TD, although results are often conflicting and divergent from findings in adults. Starting from the present literature, we propose that larger methodological uniformity, greater attention to the topographical and maturational aspects of the sleep EEG oscillations and their mutual interactions, and a higher number of longitudinal studies will be essential to clarify the role of the sleep EEG in cognitive functioning during TD.

Prior Knowledge Predicts Early Consolidation in Second Language Learning

Language learning occurs in distinct phases. Whereas some improvement is evident during training, offline memory consolidation processes that take place after the end of training play an important role in learning of linguistic information. The timing of offline consolidation is thought to depend on the type of task, with generalization of implicit knowledge suggested to take more time and sleep to consolidate. The current study aims to investigate individual differences in the timing of consolidation following learning of morphological inflections in a novel language in typical adults. Participants learned to make plural inflections in an artificial language, where inflection was based on morpho-phonological regularities. Participants were trained in the evening, and consolidation was measured after two intervals: 12 h (one night) and 36 h (two nights) post training. We measured both inflection of trained items, which may rely on item-specific learning, and generalization to new untrained items, which requires extraction of morpho-phonological regularities. The results for both trained and un-trained items showed two patterns of consolidation: early versus late, that is while some participants improved during the first night, others, who deteriorated in performance during the first night, improved in the later consolidation interval. Importantly, phonological awareness in L1 predicted early consolidation for trained items. Furthermore, there was no association between participants' consolidation trajectory in trained and untrained items. Our results suggest that consolidation timing depends on the interaction between task characteristics and individual abilities. Moreover, the results show that prior meta-linguistic knowledge predicts the quality of early consolidation processes. These results are consistent with studies in rodents and humans, showing that prior knowledge accelerates consolidation of newly learnt episodic memory. Finally, the rate of consolidation across exposures to the language might explain some of the variability found in the attained level of second language proficiency.

Online and offline contributions to motor learning change with practice, but are similar across development

Children show motor learning deficits relative to adults across a diverse range of tasks. One mechanism that has been proposed to underlie these differences is the contribution of online and offline components to overall learning; however, these tasks have almost focused exclusively on sequence learning paradigms which are characterized by performance gains in the offline phase. Here, we examined the role of online and offline learning in a novel motor task which was characterized by warm-up decrement, i.e., a performance loss, during the offline phase. In particular, using a relatively extended practice period, we examined if differences between children and adults persist across relatively long practice periods, and if the contribution of online and offline learning is affected by age and by practice itself. Two groups of children, 8-10 years and 11-13 years old, and one group of young adults (N = 30, n = 10/group) learned a novel task that required control of upper body movements to control a cursor on a screen. Participants learned the task over 5 days and we measured movement time as the primary task performance variable. Consistent with prior results, we found that 8-10 year olds had longer movement times compared to both 11-13 year olds and adults. We also found distinct changes in online and offline learning with practice; the amount of online learning decreased with practice, whereas offline learning was relatively stable across practice. However, there was no detectable effect of age group on either online or offline learning. These results suggest that age-related differences in learning among children 8-10 years old are persistent even after extended practice but are not necessarily accounted for by differences in online and offline learning.

The association between sleep and dual-task performance in preterm and full-term children: an exploratory study

OBJECTIVES

The present study explored associations between sleep and children's dual-task performance using cognitive-motor dual tasks (eg, walking and talking). Previous research with older adults indicated correlations between higher gait variability and unfavorable sleep continuity variables. Based on this research, as a first objective, we investigated similar correlations in a sample of children. Second, we explored correlations between dual-task performance and dimensions of sleep architecture. Third, we tested moderating effects of prematurity on these associations.

METHODS

In this study, 7-to 12-year-old children were tested in dual-task situations; of those, 39 were formerly preterm, and 59 were full-term born children. They were asked to walk and simultaneously perform different cognitive tasks. Gait was measured using an electronic walkway system. Sleep was measured using in-home sleep-electroencephalography.

RESULTS

After accounting for age and cognition, regression analyses revealed correlations between a higher number of awakenings after sleep onset and lower dual-task performance; concerning sleep architecture, analyses revealed correlations between a higher amount of rapid-eye-movement (REM) sleep and lower gait variability. Furthermore, associations between a higher amount of slow wave sleep (SWS) and children's higher cognitive performance were found. Moderation analyses indicated no effects of prematurity.

CONCLUSIONS

Our exploratory study suggests that a more disrupted sleep was related to children's poorer dual-task performance. Our findings support claims that REM sleep seems more related to performance in procedural tasks whereas SWS seems more related to performance in declarative tasks, suggesting that different sleep stages may support the processing of different performance types.

Brief period of post-encoding wakeful rest supports verbal memory retention in children aged 10–13 years

Evidence exists that a brief period of wakeful rest after learning can support the retention of memories, whereas a period filled with a cognitive task after learning can weaken the retention of memories. The present study in 10–13 year old children investigated whether wakeful resting after encoding is more beneficial for the retention of new verbal information than watching movies, which reflects a common everyday life/learning break activity in children at this age. Children encoded a word list. After immediate recall of this word list, they wakefully rested for 12 min. Next, children encoded another word list. After immediate recall of this word list, they watched animated short movies for 12 min. The order of the delay conditions (rest, movies) was counterbalanced across children. At the end of the experimental session, a surprise free recall test took place. Overall analyses revealed that while memory performance decreased over time in both the resting condition and movies condition, it decreased significantly more in the movies condition. These results indicate that wakeful resting supports the retention of verbal information in children aged 10–13 years.

Offline consolidation supersedes prior knowledge benefits in children's (but not adults') word learning

Prior linguistic knowledge is proposed to support the acquisition and consolidation of new words. Adults typically have larger vocabularies to support word learning than children, but the developing brain shows enhanced neural processes that are associated with offline memory consolidation. This study investigated contributions of prior knowledge to initial word acquisition and consolidation at different points in development, by teaching children and adults novel words (e.g., ballow) that varied in the number of English word-form "neighbours" (e.g., wallow, bellow). Memory for the novel word-forms was tested immediately after training, the next day and 1 week later, to assess the time-course of prior knowledge contributions. Children aged 7-9 years (Experiments 1, 3) and adults (Experiment 2) recalled words with neighbours better than words without neighbours when tested immediately after training. However, a period of offline consolidation improved overall recall and reduced the influence of word-form neighbours on longer term memory. These offline consolidation benefits were larger in children than adults, supporting theories that children have a greater propensity for consolidating phonologically distinctive language information. Local knowledge of just a single word-form neighbour was enough to enhance learning, and this led to the individual differences in word recall that were related to adults' global vocabulary ability. The results support the proposal that the relative contributions of different learning mechanisms change across the lifespan, and highlight the importance of testing theoretical models of word learning in the context of development.

Higher sleep spindle activity is associated with fewer false memories in adolescent girls

BACKGROUND

Sleep facilitates the extraction of semantic regularities amongst newly encoded memories, which may also lead to increased false memories. We investigated sleep stage proportions and sleep spindles in the recollection of adolescents' false memories, and their potential sex-specific differences.

METHODS

196 adolescents (mean age 16.9 y; SD = 0.1, 61% girls) underwent the Deese, Roediger & McDermott (DRM) false memory procedure and overnight polysomnography, with free recall the following morning. Sleep was scored manually into stages 1, 2, 3 and REM. Stage 2 sleep spindle frequency, density, and peak amplitude were used as measures of spindle activity for slow (10-13 Hz) and fast (13-16 Hz) ranges.

RESULTS

In girls, a lower number of critical lures was associated with higher spindle frequency (p ≤ 0.01), density (p ≤ 0.01), and amplitude (p = 0.03). Additionally, girls' longer sleep duration was associated with more intrusion words (p = 0.03), but not with critical lures. These associations survived adjustment for age, pubertal status, and intelligence. No significant results emerged in boys.

CONCLUSIONS

In adolescent girls, higher spindle activity was associated with fewer critical lures being falsely recalled in the DRM paradigm. Unlike studies using adult participants, we did not observe any association between slow-wave sleep and false memory recollection.

Could Rolandic spikes be a prognostic factor of the neurocognitive outcome of children with BECTS?

INTRODUCTION

Rolandic epilepsy, also known as benign childhood epilepsy with centrotemporal spikes (BECTS), is one of the most common epileptic syndromes in previously healthy children. Despite what was known about the benignity of this syndrome, there is always more evidence about the involvement of the cognitive functions with different deficits in several domains to be investigated.

AIM OF THE STUDY

The aim of our study was to describe prognostic electroencephalogram (EEG) pattern of an adverse cognitive development to recognize patients at higher risk of lasting cognitive deficits that could need antiepileptic drugs (AEDs) or an improved neurocognitive therapy. In addition, we wanted to investigate the existence of a possible linkage between the number of interictal epileptiform discharges (IEDs) in the EEG and the more pronounced cognitive deficits.

MATERIAL AND METHODS

We performed a case-control study on a cohort of 16 patients (10 male and 6 female) aged 4-14, diagnosed with BECTS who underwent EEG, magnetic resonance imaging (MRI), and neurocognitive assessment at the Pediatric Neurology Unit at the Umberto I Hospital, Sapienza University of Rome. Patients were divided into two groups according to the percentage of IEDs evaluated based on their sleep EEG: group A with less than 50% of the entire EEG invaded by discharges in more than 70% of the total number of EEG performed, so-called with low or intermediate activation. On the contrary, group B had a high activation, with more than 50% of the entire EEG invaded by discharges in the same percentage of the EEG performed. All children were assessed based on a protocol designed to study neuropsychological functions with specific tests chosen depending on age (Wechsler Intelligence Scale for Children IV: WISC IV; Wechsler Preschool and Primary Scale of Intelligence III: WPPSI III). Groups were compared for cognitive outcomes achieved by each patient through Student's t-test with a significance level of p<0.05 (two-tailed).

RESULTS

There is no statistically significant difference in the cognitive outcomes of these patients: Student's t-test showed a statistical significance (p) for each cognitive index always higher than 0.05, demonstrating that the intellectual quotient (IQ) and all other indexes analyzed (verbal comprehension index (VCI), perceptual reasoning index (PRI), working memory index (WMI), and processing speed index (PSI)) are not affected by the difference in EEG anomalies presented by our patients. Interestingly, all patients had an IQ equal to or greater than the Italian average (12 out of 16 patients showed an IQ>100), with selective drops, particularly significant in the WMI and also in the PSI.

CONCLUSIONS

Our results clearly demonstrate the importance of a proper evaluation of patients with this kind of epilepsy, without paying attention only to those with the greatest number of IEDs or seizures because all of them had a neurocognitive impairment, especially in memory. These data may be reinforced by a larger sample for an even more significant statistical value. These results also highlight the importance of a neurocognitive therapy for these children to treat for their specific needs.

[Sleep and cognition in children and adolescents]

Sleep and cognition in children and adolescents Abstract. In this review, one of the most important functions of sleep was described: Its role in promoting cognitive processes in children and adolescents. Particularly, studies of older children and adolescents revealed that sleep interacts in a complex manner with cognitive performance. Moreover, it was shown that sleep supports long-term memory even in young children. This is true for many different long-term memory systems such as memory of factual information (declarative memory), language acquisition, and for reward-related learning, but less so for learning motor skills. Clinical implications arise from observing the consequences of sleep deficits in children and adolescents due to early school hours or due to clinical conditions like attention deficits hyperactive disorder (ADHD), sleep apnea syndrome or other sleep disturbances. Current research has only partially shown that the treatment of sleep problems also benefits cognitive and memory performance. Filling this gap remains an opportunity for further research.

Does Sleep Help Prevent Forgetting Rewarded Memory Representations in Children and Adults?

Sleep fosters the consolidation of rewarded memory representations in adults. However, sleep and its memory-supporting functions change through healthy development, and it is unclear whether sleep benefits the consolidation of rewarded memory representations in children as it does in adults. Based on previous findings, we expected sleep to benefit the consolidation of rewarded memory representations in children more than it does in adults. For that reason, 16 children (7–11 years) and 20 adults (21–29 years) participated in this experiment. During the encoding session, participants were asked to learn the location of 18 object pairs. Thereafter, one-half of the object locations were allocated to a high-rewarded condition and the other half to a low-rewarded condition. In the sleep condition, the encoding session took place in the evening (for children 7–8 pm, for adults 8–9 pm). After a fixed retention interval of 12 h the retrieval session was conducted the next morning (for children 7–8 am, for adults 8–9 am). In the wake condition, the time schedule was the same but reversed: the encoding session started in the morning (for children 7–8 am, for adults 8–9 am), and retrieval took place in the evening (for children 7–8 pm, for adults 8–9 pm). Sleep/wake had no impact on the memory performance regarding the low-rewarded memory items. In contrast, wakefulness in comparison to sleep reduced the memory performance on high-rewarded memory items. The interaction between sleep/wake and the degree of reward on memory performance was only significant in children. These results show that 12 h of wakefulness can deteriorate the memory performance for high-rewarded representations, whereas sleep can prevent the forgetting of these rewarded representations. It is discussed whether ontogenetic changes in sleep may play a role in conserving relevant but fragile memory representation.

Nonspecific Retroactive Interference in Children and Adults

Retroactive interference (RI) is a primary source of forgetting and occurs when new information disrupts or damages an existing memory. Prior research has shown that children are susceptible to RI when the to-be-remembered and interfering information are similar, but it is unclear whether they are also vulnerable to nonspecific RI . This form of interference occurs when a memory is disrupted by an unrelated and dissimilar distractor task, and the present study explored six- and seven-year-olds susceptibility to such nonspecific RI. In two experiments, participants learnt a list of words and completed a free recall test 5 min later. During the interval, participants either remained quiet (the control condition) or completed spot-the-difference puzzles (the interference condition). In Experiment 1, the children were highly susceptible to nonspecific interference, whereas a sample of adults were not affected by the interfering task. However, when a new sample of children were given more time to encode and retrieve the words in Experiment 2, they were able to resist interference. Nonspecific RI can damage children's memory, but they do have the ability to prevent this form of interference in certain circumstances.

Spotlight on daytime napping during early childhood

Daytime napping undergoes a remarkable change in early childhood, and research regarding its relationship to cognitive development has recently accelerated. In this review, we summarize our current understanding of this relationship focusing on children aged <5 years. First, we evaluate different studies on the basis of the experimental design used and the specific cognitive processes they investigate. Second, we analyze how the napping status of children may modulate the relationship between learning and napping. Third, the possible role of sleep spindles, ie, specific electroencephalographic components during sleep, in cognitive development is explored. We conclude that daytime napping is crucial in early memory development.