Effect of Auditory Stimulation on Spike Waves in Sleep

Effect of Closed-loop Auditory Stimulation on Spike Waves During Slow Wave Sleep, an Open Label Pilot Study

Background: Close relationship exists between sleep slow wave (SSW) and the generation of spike wave in NREM-sleep. SSW are cortically generated oscillations alternating between excitatory depolarization ("Up-phase" of the SSW) and inhibitory hyperpolarization ("Down-phase" of the SSW). It has been shown experimentally that with increasing synchrony of slow neuronal oscillations SSW turn into spike waves. Acoustic pulses applied in correspondence to the SSW "Up-phase" enhance the amplitude of the subsequent SSW. Conversely, tones delivered at the SSW "Downphase" have a disruptive effect on the following SSW.

Participants: Patients with epilepsy and spike waves in NREM-sleep.

Objective: Modification of spike wave frequency, amplitude and spreading during NREM sleep by acoustic pulses applied at the "Up-" or "Down-phase" of SSW.

Inclusion Criteria:

• Participants with Rolandic epilepsy/BECTS
• Participants with ESES/CSWS
• Participants with generalized spike waves in sleep
• EEG within 6 months before study night consistent with the diagnosis

Exclusion Criteria:

• Clinically significant concomitant acute or chronic disease
• Seizure frequency >1/week, history of convulsive status epilepticus or seizures provoked by sleep deprivation
• Severe sleep problems
• Treatment with corticosteroids, immunosuppressive or vagus nerve stimulation