High-Density Electroencephalographic Recordings During Sleep in Children and Adolescents With Acquired Brain Injury.
BACKGROUND
Acquired brain injuries (ABI) such as traumatic brain injury (TBI) or stroke can result in motor, language, or cognitive impairments. Although a considerable number of studies have investigated functional recovery, underlying brain reorganization remains poorly understood. Accumulating evidence indicates that plastic processes in the brain are linked to changes in electroencephalographic (EEG) slow wave activity (SWA) during deep sleep (EEG spectral power 1-4.5 Hz).


OBJECTIVE
We investigated sleep SWA in children and adolescents with ABI.


METHODS
We used high-density EEG (128 electrodes) to record sleep in 22 young patients with ABI (age range = 4-16 years). We compared patients to 52 previously measured typically developing children and adolescents (age range = 4-16 years).


RESULTS
The pattern of alterations in SWA differed between particular patient groups. In patients with bilateral stroke, SWA was globally reduced across the entire scalp. Patients with unilateral stroke showed a local reduction in SWA over lesion areas and an increase over perilesional and contralateral brain areas. In patients with severe TBI, we found a reduction in SWA over the midline and an increase over lateral brain areas. We found no consistent pattern in patients with mild to moderate TBI.


CONCLUSIONS
Sleep SWA seems to be a sensitive measure to assess individual alterations in neural activity after ABI. Deviations from age norms might indirectly indicate plastic processes that have occurred since injury. Improving our understanding of neural activity after ABI could optimize clinical prognosis and guide the development of novel therapeutic interventions.
1 Child Development Center and Pediatric Sleep Disorders Center, University Children's Hospital Zurich, Switzerland.|2 Rehabilitation Center Affoltern am Albis, University Children's Hospital Zurich, Switzerland.|3 Children's Research Center, University Children's Hospital Zurich, Switzerland.
Anne-Laure
AL
Mouthon
2 Rehabilitation Center Affoltern am Albis, University Children's Hospital Zurich, Switzerland.|3 Children's Research Center, University Children's Hospital Zurich, Switzerland.
Andreas
A
Meyer-Heim
1 Child Development Center and Pediatric Sleep Disorders Center, University Children's Hospital Zurich, Switzerland.|3 Children's Research Center, University Children's Hospital Zurich, Switzerland.|5 Department of Integrative Physiology, University of Colorado Boulder, Boulder, CO, USA.
Salome
S
Kurth
1 Child Development Center and Pediatric Sleep Disorders Center, University Children's Hospital Zurich, Switzerland.|3 Children's Research Center, University Children's Hospital Zurich, Switzerland.
Maya
M
Ringli
1 Child Development Center and Pediatric Sleep Disorders Center, University Children's Hospital Zurich, Switzerland.|3 Children's Research Center, University Children's Hospital Zurich, Switzerland.
Fiona
F
Pugin
2 Rehabilitation Center Affoltern am Albis, University Children's Hospital Zurich, Switzerland.|3 Children's Research Center, University Children's Hospital Zurich, Switzerland.
Hubertus J A
HJA
van Hedel
1 Child Development Center and Pediatric Sleep Disorders Center, University Children's Hospital Zurich, Switzerland.|3 Children's Research Center, University Children's Hospital Zurich, Switzerland.|4 Department of Child and Adolescent Psychiatry and Psychotherapy, Psychiatric Hospital, University of Zurich, Switzerland.
Reto
R
Huber
D000293:Adolescent; D000367:Age Factors; D001930:Brain Injuries / Q000503:physiopathology*; D001931:Brain Mapping; D058256:Brain Waves / Q000502:physiology*; D002648:Child; D002675:Child, Preschool; D004569:Electroencephalography; D005260:Female; D006801:Humans; D008297:Male; D012372:ROC Curve; D012720:Severity of Illness Index; D012890:Sleep / Q000502:physiology*; D013057:Spectrum Analysis
EEG; acquired brain injury; sleep; slow wave activity