title: Sleep deprivation increases cortical excitability in epilepsy: syndrome-specific effects.
abstract: OBJECTIVE
  To use transcranial magnetic stimulation (TMS) to investigate the hypothesis that sleep deprivation increases cortical excitability in people with epilepsy.
  
  
  METHODS
  We performed paired pulse TMS stimulation, using a number of interstimulus intervals (ISIs) on each hemisphere of 30 patients with untreated newly diagnosed epilepsy (15 idiopathic generalized epilepsy [IGE] and 15 focal epilepsy) and on the dominant hemisphere of 13 healthy control subjects, before and after sleep deprivation.
  
  
  RESULTS
  Both hemispheres in patients with IGE and the hemisphere ipsilateral to the EEG seizure focus in those with focal epilepsy showed an increase in cortical excitability following sleep deprivation at a number of ISIs. This change in excitability was most prominent in the patients with IGE. Although there were minor changes after sleep deprivation in control subjects and the contralateral hemisphere in the focal epilepsy group seen at the 250-millisecond ISI, it was less than in the other groups.
  
  
  CONCLUSIONS
  Sleep deprivation increases cortical excitability in epilepsy; the pattern of change is syndrome dependent.
authors.affiliation: Department of Neurology, Austin Health, Studley Road, Heidelberg, Victoria 3084, Australia.
authors.forename: R A B
authors.initials: RA
authors.lastname: Badawy
authors.forename: J M
authors.initials: JM
authors.lastname: Curatolo
authors.forename: M
authors.initials: M
authors.lastname: Newton
authors.forename: S F
authors.initials: SF
authors.lastname: Berkovic
authors.forename: R A L
authors.initials: RA
authors.lastname: Macdonell
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002540:Cerebral Cortex / Q000503:physiopathology*; D004569:Electroencephalography / Q000379:methods; D004827:Epilepsy / Q000503:physiopathology*; D005260:Female; D007839:Functional Laterality; D006801:Humans; D008297:Male; D008875:Middle Aged; D016192:Resting Phase, Cell Cycle / Q000502:physiology; D012892:Sleep Deprivation / Q000503:physiopathology*; D013997:Time Factors; D050781:Transcranial Magnetic Stimulation / Q000379:methods