Absence of sleep spindles in human medial and basal temporal lobes

Interpretation of the Intracranial Electroencephalogram of the Human Hippocampus

Understanding and discriminating the normal and abnormal elements of the intracranial electroencephalogram (iEEG) is essential in decision-making for epilepsy surgery. The hippocampus is widely acknowledged as a key structure in decision-making processes for surgical treatment in temporal lobe epilepsy and epilepsies that involve the mesial temporal structures. This review will provide a summary of the current state of our knowledge and understanding regarding normal and abnormal features of the iEEG of the human hippocampus.

Hippocampal spindles and barques are normal intracranial electroencephalographic entities

OBJECTIVE

To assess whether hippocampal spindles and barques are markers of epileptogenicity.

METHODS

Focal epilepsy patients that underwent stereo-electroencephalography implantation with at least one electrode in their hippocampus were selected (n = 75). The occurrence of spindles and barques in the hippocampus was evaluated in each patient. We created pairs of pathologic and pathology-free groups according to two sets of criteria: 1. Non-invasive diagnostic criteria (patients grouped according to focal epilepsy classification). 2. Intracranial neurophysiological criteria (patient's hippocampi grouped according to their seizure onset involvement).

RESULTS

Hippocampal spindles and barques appear equally often in both pathologic and pathology-free groups, both for non-invasive (P_spindles = 0.73; P_barques = 0.46) and intracranial criteria (P_spindles = 0.08; P_barques = 0.26). In Engel Class I patients, spindles occurred with similar incidence both within the non-invasive (P = 0.67) and the intracranial criteria group (P = 0.20). Barques were significantly more frequent in extra-temporal lobe epilepsy defined by either non-invasive (P = 0.01) or intracranial (P = 0.01) criteria.

CONCLUSIONS

Both spindles and barques are normal entities of the hippocampal intracranial electroencephalogram. The presence of barques may also signify lack of epileptogenic properties in the hippocampus.

SIGNIFICANCE

Understanding that hippocampal spindles and barques do not reflect epileptogenicity is critical for correct interpretation of epilepsy surgery evaluations and appropriate surgical treatment selection.

The distinctive sleep pattern of the human calcarine cortex: a stereo-electroencephalographic study

STUDY OBJECTIVES

The aim of this study was to describe the spontaneous electroencephalographic (EEG) features of sleep in the human calcarine cortex, comparing them with the well-established pattern of the parietal cortex.

METHODS

We analyzed presurgical intracerebral EEG activity in calcarine and parietal cortices during non-rapid eye movement (NREM) and rapid eye movement (REM) sleep in seven patients with drug-resistant focal epilepsy. The time course of the EEG spectral power and NREM vs REM differences was assessed. Sleep spindles were automatically detected. To assess homeostatic dynamics, we considered the first vs second half of the night ratio in the delta frequency range (0.5-4 Hz) and the rise rate of delta activity during the first sleep cycle.

RESULTS

While the parietal area showed the classically described NREM and REM sleep hallmarks, the calcarine cortex exhibited a distinctive pattern characterized by: (1) the absence of sleep spindles; (2) a large similarity between EEG power spectra of NREM and REM; and (3) reduced signs of homeostatic dynamics, with a decreased delta ratio between the first and the second half of the night, a reduced rise rate of delta activity during the first NREM sleep cycle, and lack of correlation between these measures.

CONCLUSIONS

Besides describing for the first time the peculiar sleep EEG pattern in the human calcarine cortex, our findings provide evidence that different cortical areas may exhibit specific sleep EEG pattern, supporting the view of sleep as a local process and promoting the idea that the functional role of sleep EEG features should be considered at a regional level.

Heterogeneous profiles of coupled sleep oscillations in human hippocampus

Cross-frequency coupling of sleep oscillations is thought to mediate memory consolidation. While the hippocampus is deemed central to this process, detailed knowledge of which oscillatory rhythms interact in the sleeping human hippocampus is lacking. Combining intracranial hippocampal and non-invasive electroencephalography from twelve neurosurgical patients, we characterized spectral power and coupling during non-rapid eye movement (NREM) and rapid eye movement (REM) sleep. Hippocampal coupling was extensive, with the majority of channels expressing spectral interactions. NREM consistently showed delta–ripple coupling, but ripples were also modulated by slow oscillations (SOs) and sleep spindles. SO–delta and SO–theta coupling, as well as interactions between delta/theta and spindle/beta frequencies also occurred. During REM, limited interactions between delta/theta and beta frequencies emerged. Moreover, oscillatory organization differed substantially between i) hippocampus and scalp, ii) sites along the anterior-posterior hippocampal axis, and iii) individuals. Overall, these results extend and refine our understanding of hippocampal sleep oscillations.

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Sleep oscillations in human hippocampus exhibit cross-frequency coupling during non-rapid eye movement sleep

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Coupling occurs between various frequency pairs, including slow oscillation, delta, theta, spindle, beta, and ripple bands

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Oscillatory organization varies between hippocampus and scalp, sites along the hippocampal axis, and individuals

Autoimmune Epilepsy and/or Limbic Encephalitis Can Lead to Changes in Sleep Spindles

Introduction

Sleep disorders have been described in patients with autoimmune limbic encephalitis (LE). The changes in sleep structure were also reported. Recently sleep spindle abnormalities such as asynchronous or prolonged spindles were observed children with LE.

Methods

We studied the sleep and number of sleep spindles in the continuous electroencephalography-polysomnography (EEG-PSG) recordings of 6 patients with autoimmune epilepsy and/or LE. The longest NREM 2 period was selected. We evaluated the spindle density (spindles per minute), and compared that to the spindle densities of epilepsy patients with bilateral hippocampal sclerosis and healthy controls.

Results

We have demonstrated that patients with autoimmune epilepsy and/or LE had reduced slow wave sleep with decreased number of sleep spindles. The mean number of spindles in 60 seconds was 5.86±5.03 in patients with autoimmune epilepsy and/or LE. But spindle density was higher in two control groups (10.6±1.65 and 9.95±0.79).

Conclusions

The sleep abnormalities in LE can result from the disruption of thalamo-limbic circuits, and lead to changes in spindle wave activity. Although density of spindles decreased with acute lesions in thalamo-limbic circuits, the relations with structural lesions or chronicity of disease are not clear. That may be related to functional disruption of neural circuitry.

Spatiotemporal characteristics of sleep spindles depend on cortical location

Since their discovery almost one century ago, sleep spindles, 0.5-2s long bursts of oscillatory activity at 9-16Hz during NREM sleep, have been thought to be global and relatively uniform throughout the cortex. Recent work, however, has brought this concept into question but it remains unclear to what degree spindles are global or local and if their properties are uniform or location-dependent. We addressed this question by recording sleep in eight patients undergoing evaluation for epilepsy with intracranial electrocorticography, which combines high spatial resolution with extensive cortical coverage. We find that spindle characteristics are not uniform but are strongly influenced by the underlying cortical regions, particularly for spindle density and fundamental frequency. We observe both highly isolated and spatially distributed spindles, but in highly skewed proportions: while most spindles are restricted to one or very few recording channels at any given time, there are spindles that occur over widespread areas, often involving lateral prefrontal cortices and superior temporal gyri. Their co-occurrence is affected by a subtle but significant propagation of spindles from the superior prefrontal regions and the temporal cortices towards the orbitofrontal cortex. This work provides a brain-wide characterization of sleep spindles as mostly local graphoelements with heterogeneous characteristics that depend on the underlying cortical area. We propose that the combination of local characteristics and global organization reflects the dual properties of the thalamo-cortical generators and provides a flexible framework to support the many functions ascribed to sleep in general and spindles specifically.

Sleep Spindles as an Electrographic Element: Description and Automatic Detection Methods

Sleep spindle is a peculiar oscillatory brain pattern which has been associated with a number of sleep (isolation from exteroceptive stimuli, memory consolidation) and individual characteristics (intellectual quotient). Oddly enough, the definition of a spindle is both incomplete and restrictive. In consequence, there is no consensus about how to detect spindles. Visual scoring is cumbersome and user dependent. To analyze spindle activity in a more robust way, automatic sleep spindle detection methods are essential. Various algorithms were developed, depending on individual research interest, which hampers direct comparisons and meta-analyses. In this review, sleep spindle is first defined physically and topographically. From this general description, we tentatively extract the main characteristics to be detected and analyzed. A nonexhaustive list of automatic spindle detection methods is provided along with a description of their main processing principles. Finally, we propose a technique to assess the detection methods in a robust and comparable way.

Interictal Hippocampal Spiking Influences the Occurrence of Hippocampal Sleep Spindles

OBJECTIVES

The significance of hippocampal sleep spindles and their relation to epileptic activity is still a matter of controversy. Hippocampal spindles have been considered a physiological phenomenon, an evoked response to afferent epileptic discharges, or even the expression of an epileptic manifestation. To address this question, we investigated the presence and rate of hippocampal spindles in focal pharmacoresistant epilepsy patients undergoing scalp-intracerebral electroencephalography (EEG).

DESIGN

Sleep recording with scalp-intracerebral EEG.

SETTING

Tertiary referral epilepsy center.

PATIENTS

Twenty-five epilepsy patients (extratemporal: n = 6, temporal: n = 15, and multifocal including the temporal lobe: n = 4).

INTERVENTIONS

N/A.

MEASUREMENTS AND RESULTS

We analyzed associations between hippocampal spindles and hippocampal electrophysiological findings (interictal spiking, seizure onset zone) and magnetic resonance imaging volumetry. Sixteen of 25 patients (64%) had hippocampal spindles (extratemporal epilepsy: 6/6; temporal epilepsy: 10/15; and multifocal epilepsy: 0/4; P = 0.005). Median spindle rate was 0.6 (range, 0.1-8.6)/min in nonrapid eye movement sleep. Highest spindle rates were found in hippocampi of patients with extratemporal epilepsy (P < 0.001). A negative association was found between hippocampal spiking activity and spindle rate (P = 0.003). We found no association between the presence (n = 21) or absence (n = 17) of hippocampal seizure onset zone and hippocampal spindle rate (P = 0.114), and between a normal (n = 30) or atrophic (n = 8) hippocampus and hippocampal spindle rate (P = 0.195).

CONCLUSIONS

Hippocampal spindles represent a physiological phenomenon, with an expression that is diminished in epilepsy affecting the temporal lobe. Hippocampal spiking lowered the rate of hippocampal spindles, suggesting that epileptic discharges may at least in part be a transformation of these physiological events, similar to the hypothesis considering generalized spike-and-waves a transformation of frontal spindles.

Scalp spindles are associated with widespread intracranial activity with unexpectedly low synchrony

In humans, the knowledge of intracranial correlates of spindles is mainly gathered from noninvasive neurophysiologic and functional imaging studies which provide an indirect estimate of neuronal intracranial activity. This potential limitation can be overcome by intracranial electroencephalography used in presurgical epilepsy evaluation. We investigated the intracranial correlates of scalp spindles using combined scalp and intracerebral depth electrodes covering the frontal, parietal and temporal neocortex, and the scalp and intracranial correlates of hippocampal and insula spindles in 35 pre-surgical epilepsy patients. Spindles in the scalp were accompanied by widespread cortical increases in sigma band energy (10–16 Hz): the highest percentages were observed in the frontoparietal lateral and mesial cortex, whereas in temporal lateral and mesial structures only a low or no simultaneous increase was present. This intracranial involvement during scalp spindles showed no consistent pattern, and exhibited unexpectedly low synchrony across brain regions. Hippocampal spindles were shorter and spatially restricted with a low synchrony even within the temporal lobe. Similar results were found for the insula. We suggest that the generation of spindles is under a high local cortical influence contributing to the concept of sleep as a local phenomenon and challenging the notion of spindles as widespread synchronous oscillations.

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Spindles in the scalp are accompanied by widespread cortical spindle activity.

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This activity is predominantly present in the frontoparietal lateral and mesial cortex.

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The intracranial involvement during scalp spindles shows no consistent pattern.

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The synchrony of spindles is unexpectedly low across different brain regions.

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Hippocampal spindles were shorter and occurred mostly not at time of scalp spindles.

Slow spindles' cortical generators overlap with the epileptogenic zone in temporal epileptic patients: an electrical source imaging study

OBJECTIVE

To determine whether temporal epileptic patients and normal volunteers display similar sleep spindles' cortical generators as determined by electrical source imaging (ESI), and whether such generators overlap in epilepsy patients with the epileptogenic zone identified by ESI.

METHODS

Twelve healthy subjects and twelve temporal lobe pharmaco-resistant epileptic patients underwent a 256-channel EEG recording during a daytime nap. Sleep spindles were analyzed off line, distinguishing slow (10-12 Hz) and fast (12-14 Hz) ones, and the final averaged signal was projected onto a MNI (Montreal Neurological Institute) space to localize cortical generators. The same procedure was performed for averaged epileptic spikes, obtaining their cortical source. Intra- and inter-group statistical analyses were conducted.

RESULTS

Multiple, concomitant generators were detected in both populations for slow and fast spindles. Slow spindles in epileptics displayed higher source amplitude in comparison to healthy volunteers (Z=0.001), as well as a preferential localization over the affected temporal cortices (p=0.039). Interestingly, at least one of slow spindles' generators overlapped with the epileptogenic zone.

CONCLUSION

Slow spindles, but not fast ones, in temporal epilepsy are mainly generated by the affected temporal lobe.

SIGNIFICANCE

These results point to the strict relation between sleep and epilepsy and to the possible cognitive implications of spikes arising from memory-encoding brain structures.

Sleep spindles in humans: insights from intracranial EEG and unit recordings

Sleep spindles are an electroencephalographic (EEG) hallmark of non-rapid eye movement (NREM) sleep and are believed to mediate many sleep-related functions, from memory consolidation to cortical development. Spindles differ in location, frequency, and association with slow waves, but whether this heterogeneity may reflect different physiological processes and potentially serve different functional roles remains unclear. Here we used a unique opportunity to record intracranial depth EEG and single-unit activity in multiple brain regions of neurosurgical patients to better characterize spindle activity in human sleep. We find that spindles occur across multiple neocortical regions, and less frequently also in the parahippocampal gyrus and hippocampus. Most spindles are spatially restricted to specific brain regions. In addition, spindle frequency is topographically organized with a sharp transition around the supplementary motor area between fast (13-15 Hz) centroparietal spindles often occurring with slow-wave up-states, and slow (9-12 Hz) frontal spindles occurring 200 ms later on average. Spindle variability across regions may reflect the underlying thalamocortical projections. We also find that during individual spindles, frequency decreases within and between regions. In addition, deeper NREM sleep is associated with a reduction in spindle occurrence and spindle frequency. Frequency changes between regions, during individual spindles, and across sleep may reflect the same phenomenon, the underlying level of thalamocortical hyperpolarization. Finally, during spindles neuronal firing rates are not consistently modulated, although some neurons exhibit phase-locked discharges. Overall, anatomical considerations can account well for regional spindle characteristics, while variable hyperpolarization levels can explain differences in spindle frequency.

Density and frequency caudo-rostral gradients of sleep spindles recorded in the human cortex

STUDY OBJECTIVE

This study aims at providing a quantitative description of intrinsic spindle frequency and density (number of spindles/min) in cortical areas using deep intracerebral recordings in humans.

PATIENTS OR PARTICIPANTS

Thirteen patients suffering from pharmaco-resistant focal epilepsy and investigated through deep intracortical EEG in frontal, parietal, temporal, occipital, insular, and limbic cortices including the hippocampus were included.

METHODS

Spindle waves were detected from the ongoing EEG during slow wave sleep (SWS) by performing a time-frequency analysis on filtered signals (band-pass filter: 10-16 Hz). Then, spindle intrinsic frequency was determined using a fast Fourier transform, and spindle density (number of spindles per minute) was computed.

RESULTS

Firstly, we showed that sleep spindles were recorded in all explored cortical areas, except temporal neocortex. In particular, we observed the presence of spindles during SWS in areas such as the insular cortex, medial parietal cortex, occipital cortex, and cingulate gyrus. Secondly, we demonstrated that both spindle frequency and density smoothly change along the caudo-rostral axis, from fast frequent posterior spindles to slower and less frequent anterior spindles. Thirdly, we identified the presence of spindle frequency oscillations in the hippocampus and the entorhinal cortex.

CONCLUSIONS

Spindling activity is widespread among cortical areas, which argues for the fundamental role of spindles in cortical functions. Mechanisms of caudo-rostral gradient modulation in spindle frequency and density may result from a complex interplay of intrinsic properties and extrinsic modulation of thalamocortical and corticothalamic neurons.

Emergence of synchronous EEG spindles from asynchronous MEG spindles

Sleep spindles are bursts of rhythmic 10-15 Hz activity, lasting ∼0.5-2 s, that occur during Stage 2 sleep. They are coherent across multiple cortical and thalamic locations in animals, and across scalp EEG sites in humans, suggesting simultaneous generation across the cortical mantle. However, reports of MEG spindles occurring without EEG spindles, and vice versa, are inconsistent with synchronous distributed generation. We objectively determined the frequency of MEG-only, EEG-only, and combined MEG-EEG spindles in high density recordings of natural sleep in humans. About 50% of MEG spindles occur without EEG spindles, but the converse is rare (∼15%). Compared to spindles that occur in MEG only, those that occur in both MEG and EEG have ∼1% more MEG coherence and ∼15% more MEG power, insufficient to account for the ∼55% increase in EEG power. However, these combined spindles involve ∼66% more MEG channels, especially over frontocentral cortex. Furthermore, when both MEG and EEG are involved in a given spindle, the MEG spindle begins ∼150 ms before the EEG spindle and ends ∼250 ms after. Our findings suggest that spindles begin in focal cortical locations which are better recorded with MEG gradiometers than referential EEG due to the biophysics of their propagation. For some spindles, only these regions remain active. For other spindles, these locations may recruit other areas over the next 200 ms, until a critical mass is achieved, including especially frontal cortex, resulting in activation of a diffuse and/or multifocal generator that is best recorded by referential EEG derivations due to their larger leadfields.

Topographical frequency dynamics within EEG and MEG sleep spindles

OBJECTIVE

Spindles are rhythmic bursts of 10-16 Hz activity, lasting ∼1 s, occur during normal stage 2 sleep. Spindles are slower in frontal EEG and possibly MEG. The posterior-fast EEG pattern may predominate early in the spindle, and the anterior-slow pattern late. We aimed to determine the proportion of spindles showing this spatio-spectro-temporal interaction for EEG, and whether it occurs in MEG.

METHODS

We recorded high density EEG and MEG from seven healthy subjects during normal stage 2 sleep. High vs. low frequency (12 vs. 14 Hz) power was measured early vs. late (25th-45th vs. 55th-75th duration percentile) in 183 spindle discharges.

RESULTS

The predicted spatio-spectro-temporal interaction was shown by 48% of EEG and 34% of MEG spindles (chance=25%). Topographically, high frequency EEG power was greatest at midline central contacts, and low frequency power at midline frontal. This frequency-specific topography was fixed over the course of the spindle.

CONCLUSIONS

An evolution from posterior-fast to anterior-slow generators commonly occurs during spindles, and this is visible with EEG and to a lesser extent, MEG.

SIGNIFICANCE

The spatio-spectral-temporal evolution of spindles may reflect their possible involvement in coordinating cortical activity during consolidation.

Divergent cortical generators of MEG and EEG during human sleep spindles suggested by distributed source modeling

Background

Sleep spindles are ∼1-second bursts of 10–15 Hz activity, occurring during normal stage 2 sleep. In animals, sleep spindles can be synchronous across multiple cortical and thalamic locations, suggesting a distributed stable phase-locked generating system. The high synchrony of spindles across scalp EEG sites suggests that this may also be true in humans. However, prior MEG studies suggest multiple and varying generators.

Methodology/Principal Findings

We recorded 306 channels of MEG simultaneously with 60 channels of EEG during naturally occurring spindles of stage 2 sleep in 7 healthy subjects. High-resolution structural MRI was obtained in each subject, to define the shells for a boundary element forward solution and to reconstruct the cortex providing the solution space for a noise-normalized minimum norm source estimation procedure. Integrated across the entire duration of all spindles, sources estimated from EEG and MEG are similar, diffuse and widespread, including all lobes from both hemispheres. However, the locations, phase and amplitude of sources simultaneously estimated from MEG versus EEG are highly distinct during the same spindles. Specifically, the sources estimated from EEG are highly synchronous across the cortex, whereas those from MEG rapidly shift in phase, hemisphere, and the location within the hemisphere.

Conclusions/Significance

The heterogeneity of MEG sources implies that multiple generators are active during human sleep spindles. If the source modeling is correct, then EEG spindles are generated by a different, diffusely synchronous system. Animal studies have identified two thalamo-cortical systems, core and matrix, that produce focal or diffuse activation and thus could underlie MEG and EEG spindles, respectively. Alternatively, EEG spindles could reflect overlap at the sensors of the same sources as are seen from the MEG. Although our results generally match human intracranial recordings, additional improvements are possible and simultaneous intra- and extra-cranial measures are needed to test their accuracy.

Magnetoencephalography demonstrates multiple asynchronous generators during human sleep spindles

Sleep spindles are approximately 1 s bursts of 10-16 Hz activity that occur during stage 2 sleep. Spindles are highly synchronous across the cortex and thalamus in animals, and across the scalp in humans, implying correspondingly widespread and synchronized cortical generators. However, prior studies have noted occasional dissociations of the magnetoencephalogram (MEG) from the EEG during spindles, although detailed studies of this phenomenon have been lacking. We systematically compared high-density MEG and EEG recordings during naturally occurring spindles in healthy humans. As expected, EEG was highly coherent across the scalp, with consistent topography across spindles. In contrast, the simultaneously recorded MEG was not synchronous, but varied strongly in amplitude and phase across locations and spindles. Overall, average coherence between pairs of EEG sensors was approximately 0.7, whereas MEG coherence was approximately 0.3 during spindles. Whereas 2 principle components explained approximately 50% of EEG spindle variance, >15 were required for MEG. Each PCA component for MEG typically involved several widely distributed locations, which were relatively coherent with each other. These results show that, in contrast to current models based on animal experiments, multiple asynchronous neural generators are active during normal human sleep spindles and are visible to MEG. It is possible that these multiple sources may overlap sufficiently in different EEG sensors to appear synchronous. Alternatively, EEG recordings may reflect diffusely distributed synchronous generators that are less visible to MEG. An intriguing possibility is that MEG preferentially records from the focal core thalamocortical system during spindles, and EEG from the distributed matrix system.

Thalamic deactivation at sleep onset precedes that of the cerebral cortex in humans

Thalamic and cortical activities are assumed to be time-locked throughout all vigilance states. Using simultaneous intracortical and intrathalamic recordings, we demonstrate here that the thalamic deactivation occurring at sleep onset most often precedes that of the cortex by several minutes, whereas reactivation of both structures during awakening is synchronized. Delays between thalamus and cortex deactivations can vary from one subject to another when a similar cortical region is considered. In addition, heterogeneity in activity levels throughout the cortical mantle is larger than previously thought during the descent into sleep. Thus, asynchronous thalamo-cortical deactivation while falling asleep probably explains the production of hypnagogic hallucinations by a still-activated cortex and the common self-overestimation of the time needed to fall asleep.

In-vivo animation of midazolam-induced electrocorticographic changes in humans

Previous human studies have demonstrated that midazolam-induced signal changes on scalp EEG recording include widespread augmentation of sigma-oscillations and that the amplitude of such oscillations is correlated to the severity of midazolam-induced amnesia. Still unanswered questions include whether midazolam-induced sigma-augmentation also involves the medial temporal region, which plays a role in memory encoding. Taking advantage of rare and unique opportunities to monitor neuronal activities using intracranial electrocorticography (ECoG) recording, we determined how intravenous administration of midazolam elicited spectral frequency changes in the human cerebral cortex, including the medial temporal region. We studied three children with focal epilepsy who underwent subdural electrode placement and extraoperative ECoG recording for subsequent resection of the seizure focus; an intravenous bolus of midazolam was given to abort an ongoing simple partial seizure or to provide sedation prior to induction of general anesthesia. 'Midazolam-induced ECoG frequency alteration' in sites distant from the seizure focus was sequentially animated on their individual three-dimensional MR images. The common ECoG changes induced by midazolam included gradual augmentation of sigma-oscillations (12-16 Hz) in the widespread non-epileptic regions, including the medial temporal region. The spatial and temporal alteration of ECoG spectral frequency pattern can be appreciated via animation movies. Midazolam-induced sigma-augmentation was observed in the medial temporal region in our relatively small cohort of human subjects. In-vivo animation of ECoG spectral measures provided a unique situation to study the effect of midazolam on neuronal processing in the deep brain regions.

Effect of sleep on interictal spikes and distribution of sleep spindles on electrocorticography in children with focal epilepsy

OBJECTIVE

To determine how sleep with central spindles alters the spatial distribution of interictal spike frequency in children with intractable focal seizures, and whether such children have spindles arising from the medial temporal region in addition to the frontal-central region.

METHODS

Seventeen children (age: 7 months-17 years) were studied using extraoperative electrocorticography (ECoG).

RESULTS

Overall spike frequency across the subdural electrodes was greater during sleep with central spindles compared to wakefulness. In 13 children showing at least 1 spike/min in an electrode, the spatial distribution of spike frequency was similar during wakefulness and sleep; in addition, the spike frequency was greater in the seizure onset zones compared to the non-onset areas, regardless of wakefulness or sleep. Spindles were identified in the medial temporal region during sleep with central spindles in all 17 children.

CONCLUSION

Overall spike frequency may be increased by sleep with spindles, but the spatial distribution of spike frequency appears similar during wakefulness and sleep in children with intractable focal seizures.

SIGNIFICANCE

Both awake and sleep ECoG may be useful to predict seizure onset zones in children with intractable focal epilepsy. Medial temporal spindles are present in some children with focal epilepsy.

Thinking and hallucinating: Reciprocal changes in sleep

Internal deliberations (focused thoughts) and endogenous percepts (hallucinations) vary in a reciprocal manner across the states of waking and sleep, paralleling changes in regional brain activation. As subjects go from waking through sleep onset to NREM sleep and then to REM sleep, they report progressively more hallucinoid imagery and progressively less thinking. We have investigated whether this reciprocity in cognition between NREM and REM is maintained throughout the night. To do so, we analyzed 229 REM and 165 NREM reports collected with the Nightcap sleep monitoring system from 16 participants in their homes over 14 nights. The reports were scored for the presence of hallucinations and directed thinking by external judges. As predicted, hallucinations were more frequent in REM than in NREM for each segment of the night, and directed thinking was more frequent in NREM in the first 5 h of the night. Late in the night, directed thinking was equally infrequent in NREM and REM. At the same time, hallucinations increased within both NREM and REM as the night progressed, whereas directed thinking decreased in NREM and remained at a stable, low level in REM. These findings suggest that a reciprocal shift in focused thinking and hallucinating is a general property of cognitive activity across the wake-sleep cycle. Biological evidence supports the hypothesis that these cognitive changes are governed by specific state regulatory and neurocognitive processes at several levels of the brain.

Sleep spindles in human prefrontal cortex: an electrocorticographic study

To investigate the sleep spindle activity of the human prefrontal cortex (PFC), we simultaneously recorded whole nights of polysomnographic and electrocorticographic (ECoG) activities during the natural sleep of epileptic patients. Subjects were nine patients with intractable epilepsy who had subdural electrodes surgically attached to the orbital (seven cases), medial (three cases), or dorsolateral (two cases) PFC, and in one case to the frontal pole. To examine spindle frequencies, fast Fourier transformation (FFT) and auto-correlation analyses were performed on the PFC ECoG and Cz EEG data, primarily on epochs of stage 2 sleep. Lower sigma band ECoG oscillations of about 12 Hz were widely distributed across all prefrontal cortical areas including the frontal limbic regions, but none of the PFC sigma frequency peaks coincided with the faster (about 14 Hz) Cz EEG sleep spindles. Combining our results with anatomical and electrophysiological facts, it is suggested that the thalamofrontal circuit involving the rostral reticular and the mediodorsal nucleus of the thalamus is responsible for the generation of 12 Hz frontal spindles in humans.

Correlation between electroencephalography and heart rate variability during sleep

It is known that autonomic nervous activities change in correspondence with sleep stages. However, the characteristics of continuous fluctuations in nocturnal autonomic nerve tone have not been clarified in detail. The study aimed to determine the possible correlation between the electroencephalogram (EEG) and autonomic nervous activities, and to clarify in detail the nocturnal fluctuations in autonomic nerve activities. Overnight EEGs and electrocardiograms of seven healthy males were obtained. These EEGs were analyzed by fast Fourier transformation algorithm to extract delta, sigma and beta power. Heart rate and heart rate variability (HRV) were calculated in consecutive 5-min epochs. The HRV indices of low frequency (LF), high frequency (HF) and LF/HF ratio were calculated from the spectral analysis of R-R intervals. The sleep stages were manually scored according to Rechtschaffen and Kales' criteria. Low frequency and LF/HF were significantly lower during non-rapid eye movement (NREM) than REM, and were lower in stages 3 and 4 than in stages 1 and 2. Furthermore, delta EEG showed inverse correlations with LF (r = - 0.44, P < 0.001) and LF/HF (r = - 0.41, P < 0.001). In contrast, HF differed neither between REM and NREM nor among NREM sleep stages. Detailed analysis revealed that correlation was evident from the first to third NREM, but not in the fourth and fifth NREM. Delta EEG power showed negative correlations with LF and LF/HF, suggesting that sympathetic nervous activities continuously fluctuate in accordance with sleep deepening and lightening.

Cortical oscillations in human medial temporal lobe during wakefulness and all-night sleep

We have recorded human medial temporal lobe electrocorticogram during wakefulness and natural sleep in epileptic patients with subdural electrodes. From these recordings, we have found gamma (30-150 Hz) [Neuroscience 90 (1999) 1149] and beta-1 (10-20 Hz) [NeuroReport 10 (1999) 3055] activities during wakefulness in human medial temporal lobe. In this paper, we will report changes of these frequencies across wake and natural sleep. Electrocorticograms during wake, slow wave sleep and rapid eye movement (REM) sleep were subjected to fast Fourier transformation analysis. During wake two spectral enhancements, beta-1 and gamma, were consistently observed across subjects. In the raw signal, beta-1 was observed as a regular rhythmic oscillation. In slow wave sleep, the beta-1 peak disappeared but gamma remained, although slightly reduced in power. During REM sleep, beta-1 appeared again, but the peak frequency was significantly lower than during wake (mean frequency: wake=16.6, REM=12.8 Hz). The gamma peak was also present in REM sleep. It has been known that the rhythmic slow activity (RSA) or theta is observed in some animals. However, it is unclear whether the human hippocampus displays similar activity. Since human beta-1 appears during wake and REM sleep when RSA is observed in other species, and since beta-1 is also a regular rhythmic oscillation, we propose that beta-1 may be the functional equivalent of hippocampal RSA (theta) observed in some animals. Functional significances of the gamma activity should be further investigated.