Physiological and pathological high-frequency oscillations have distinct sleep-homeostatic properties.
The stage of sleep is a known modulator of high-frequency oscillations (HFOs). For instance, high amplitude slow waves during NREM sleep and the subtypes of REM sleep were shown to contribute to a better separation between physiological and pathological HFOs. This study investigated rates and spatial spread of the different HFO types (physiological and pathological ripples in the 80-250 Hz frequency band, and fast ripples above 250 Hz) depending on time spent in sleep across the different sleep cycles.



Fifteen patients with focal pharmaco-resistant epilepsy underwent one night of video-polysomnography during chronic intracranial EEG recording for presurgical epilepsy evaluation. The HFO rate and spread across the different sleep cycles were determined with an automatic HFO detector. We built models to explain the observed rate and spread based on time in sleep and other variables i.e. sleep stage, delta band and sigma band activity, and slow wave amplitude. Statistical significance of the different variables was determined by a model comparison using the Akaike information criterion.



The rate of HFOs depends significantly on the accumulated time of sleep. As the night advanced, the rate of pathological ripples and fast ripples decreased during NREM sleep (up to 15% per hour spent in the respective sleep stages), while the rate of physiological ripples increased during REM sleep (8% per hour spent in REM sleep). Interestingly, the stage of sleep but not the sleep cycle determined the extent of spread of HFOs, showing a larger field during NREM sleep and a more restricted field during REM sleep.



The different dependence with sleep time for physiological and pathological ripples is in keeping with their distinct underlying generating mechanisms. From a practical point of view, the first sleep cycle seems to be best suitable for studying HFOs in epilepsy, given that the contrast between physiological and pathological ripple rates is largest during this time.
Montreal Neurological Institute and Hospital, McGill University, 3801 University Street, Montreal H3A 2B4, Québec, Canada.
Nicolás
N
von Ellenrieder
Montreal Neurological Institute and Hospital, McGill University, 3801 University Street, Montreal H3A 2B4, Québec, Canada.
François
F
Dubeau
Montreal Neurological Institute and Hospital, McGill University, 3801 University Street, Montreal H3A 2B4, Québec, Canada.
Jean
J
Gotman
Montreal Neurological Institute and Hospital, McGill University, 3801 University Street, Montreal H3A 2B4, Québec, Canada; Department of Medicine and Center for Neuroscience Studies, Queen's University, 18 Stuart Street, Kingston K7L3N6, Ontario, Canada.
Birgit
B
Frauscher
D058256:Brain Waves / Q000502:physiology*; D000069279:Drug Resistant Epilepsy / Q000150:complications* / Q000000981:diagnostic imaging; D004569:Electroencephalography; D005260:Female; D006706:Homeostasis / Q000502:physiology*; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008279:Magnetic Resonance Imaging; D008297:Male; D008962:Models, Theoretical; D017286:Polysomnography; D012189:Retrospective Studies; D012894:Sleep Stages / Q000502:physiology*; D012893:Sleep Wake Disorders / Q000000981:diagnostic imaging / Q000209:etiology*; D014741:Video Recording
Epilepsy; High frequency oscillations; Intracerebral EEG; Polysomnography; Sleep