Header

UZH-Logo

Maintenance Infos

Disparate effects of hormones and vigabatrin on sleep slow waves in patients with West syndrome – An indication of their mode of action?


Heinrich, Bianka; Schmitt, Bernhard; Bölsterli, Bigna K; Critelli, Hanne; Huber, Reto; Fattinger, Sara (2021). Disparate effects of hormones and vigabatrin on sleep slow waves in patients with West syndrome – An indication of their mode of action? Journal of Sleep Research, 30(3):Epub ahead of print.

Abstract

Synaptic downscaling during sleep, a physiological process to restore synaptic homeostasis and maintain learning efficiency and healthy brain development, has been related to a reduction of the slope of sleep slow waves (SSW). However, such synaptic downscaling seems not to be reflected in high-amplitude SSW. Recently we have shown reduced SSW slopes during hormonal treatment (adrenocorticotrophic hormone, prednisolone) in patients with West syndrome (WS). Yet, whether this reduction was related to successful treatment or reflects a specific effect of hormone therapy is unknown. Thus, we retrospectively analysed nap electroencephalograms of 61 patients with WS successfully treated with hormones, vigabatrin (VGB), or both. The slope of SSW during treatment (T1) and 2-7 months later (T2) when hormonal treatment was tapered off were compared between the treatment groups and healthy, age-matched controls. At T1 hormone treatment reduced the slope of low-amplitude SSW, whereas VGB increased the slope of high-amplitude SSW (linear mixed effect model: FGroup = 7.04, p < 0.001; FAmplitude = 1,646.68, p < 0.001; FGroup*Amplitude = 3.38, p < 0.001). At T2, untreated patients did not differ anymore from healthy controls, whereas those still under VGB showed the same alterations as those with VGB at T1. This result indicates a disparate effect of VGB and hormone on the SSW slope. In particular, hormones seem to reduce the slope of cortical generated low-amplitude SSW, similar to the physiological synaptic downscaling during sleep. Thus, a loss of functional neuronal connectivity might be an alternative explanation of the antiepileptic effect of hormonal treatment.

Abstract

Synaptic downscaling during sleep, a physiological process to restore synaptic homeostasis and maintain learning efficiency and healthy brain development, has been related to a reduction of the slope of sleep slow waves (SSW). However, such synaptic downscaling seems not to be reflected in high-amplitude SSW. Recently we have shown reduced SSW slopes during hormonal treatment (adrenocorticotrophic hormone, prednisolone) in patients with West syndrome (WS). Yet, whether this reduction was related to successful treatment or reflects a specific effect of hormone therapy is unknown. Thus, we retrospectively analysed nap electroencephalograms of 61 patients with WS successfully treated with hormones, vigabatrin (VGB), or both. The slope of SSW during treatment (T1) and 2-7 months later (T2) when hormonal treatment was tapered off were compared between the treatment groups and healthy, age-matched controls. At T1 hormone treatment reduced the slope of low-amplitude SSW, whereas VGB increased the slope of high-amplitude SSW (linear mixed effect model: FGroup = 7.04, p < 0.001; FAmplitude = 1,646.68, p < 0.001; FGroup*Amplitude = 3.38, p < 0.001). At T2, untreated patients did not differ anymore from healthy controls, whereas those still under VGB showed the same alterations as those with VGB at T1. This result indicates a disparate effect of VGB and hormone on the SSW slope. In particular, hormones seem to reduce the slope of cortical generated low-amplitude SSW, similar to the physiological synaptic downscaling during sleep. Thus, a loss of functional neuronal connectivity might be an alternative explanation of the antiepileptic effect of hormonal treatment.

Statistics

Citations

Dimensions.ai Metrics

Altmetrics

Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > University Children's Hospital Zurich > Medical Clinic
04 Faculty of Medicine > Psychiatric University Hospital Zurich > Department of Child and Adolescent Psychiatry
Dewey Decimal Classification:610 Medicine & health
Scopus Subject Areas:Life Sciences > Cognitive Neuroscience
Life Sciences > Behavioral Neuroscience
Uncontrolled Keywords:Cognitive Neuroscience, Behavioral Neuroscience, General Medicine, ACTH; EEG; West syndrome; prednisolone; sleep slow waves; vigabatrin.
Language:English
Date:1 June 2021
Deposited On:18 Dec 2020 15:26
Last Modified:28 May 2021 01:04
Publisher:Wiley-Blackwell Publishing, Inc.
ISSN:0962-1105
OA Status:Closed
Free access at:Publisher DOI. An embargo period may apply.
Publisher DOI:https://doi.org/10.1111/jsr.13137
PubMed ID:32657499
Project Information:
  • : FunderSNSF
  • : Grant ID320030_179443
  • : Project TitleManipulating cortical synchronization by means of closed-loop acoustic stimulation during sleep - method optimization and proof of concept study in childhood epilepsy

Download

Full text not available from this repository.
View at publisher

Get full-text in a library