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. 2016 Sep;127(9):3086-3092.
doi: 10.1016/j.clinph.2016.06.028. Epub 2016 Jul 9.

Late and progressive alterations of sleep dynamics following central thalamic deep brain stimulation (CT-DBS) in chronic minimally conscious state

Zoe M Adams  1 , Peter B Forgacs  2 , Mary M Conte  1 , Tanya J Nauvel  1 , Jonathan D Drover  1 , Nicholas D Schiff  3
Affiliations

Late and progressive alterations of sleep dynamics following central thalamic deep brain stimulation (CT-DBS) in chronic minimally conscious state

Zoe M Adams et al. Clin Neurophysiol. 2016 Sep.
No abstract available

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Conflict of interest statement

Conflict of interest statement: None of the authors have potential conflicts of interest to be disclosed.

Figures

Fig. 1
Fig. 1
Timeline of patient data collection. Study timeline and main findings. 10-s EEG segments are displayed for pre-CT-DBS and post-CT-DBS (TP 4) time points. Left: red arrow designates a “stage 2-like” sleep at the pre-CT-DBS time point, with slow and partially formed spindles. Blue arrow points to a “SWS-like” stage, with the intrusion of stage 2-like elements and slow spindles within slow wave activity. Right: red arrow highlights stage 2 sleep at TP 4 post-CT-DBS containing faster spindling activity. Blue arrow illustrates SWS at TP 4; segments contain increased low frequency activity and fewer stage 2-like elements. See Supplementary Fig. S3 to view power spectra at each time point as described in the blue and red boxes. (For interpretation of the references to colour in this figure legend, the reader is referred to the web version of this article.)
Fig. 2
Fig. 2
Stage 2 and SWS dynamics pre- and post-CT-DBS in the PS and HV. Examples of representative EEG responses from the PS in comparison with the HV. A: power spectra responses recorded from channels F3 and F4 at two time points (pre-CT-DBS and TP 4 post-CT-DBS) for both stage 2 (red) and SWS (blue) as compared to the HV. B: power spectra from stage 2 (red) and SWS segments (blue) obtained from pre-CT-DBS (light red or blue) and post-CT-DBS (TP 4) (dark red or blue) time points plotted on one axis. Double-headed arrow and brackets denote the lower (12 Hz) and upper (15 Hz) bounds of spindling activity observed in healthy sleep (Mölle et al., 2011). By TP 4, the spindle peak frequency is approaching the lower bound of this range. C: center spindle peak frequency in stage 2 sleep and the peak power in the spindle range in SWS for each study time point across channels F3, F4, FC5, FC6, C3, and C4. These values were determined after normalization using the method from Gottselig et al. (2002) (see Methods). (For interpretation of the references to colour in this figure legend, the reader is referred to the web version of this article.)
Fig. 3
Fig. 3
Time-varying spectrograms and hypnograms. Time-varying spectrograms and hypnograms were calculated from bipolar channel Fp1-F3 for pre- and post-CT-DBS implantation (TP 4) conditions, and for the HV. In the hypnograms, the x-axis indicates continuous time (10PM to 6AM), and the y-axis indexes sleep stages. A: HV spectrogram and accompanying hypnogram. B: spectrogram and hypnogram from the pre-CT-DBS time point. Red brackets in spectrogram indicate a mixing of stages, with low frequency (delta waves) co-occurring with higher frequency elements (spindle-like peaks). The sleep stage labels in B are denoted as “Stage 2-like” and “SWS-like” to emphasize that isolated stages of sleep were difficult to discern via standard visual scoring. C: At TP 4 post-CT-DBS, more defined stage 2 and SWS dominated the EEG record. However, there were still individual epochs that contained the mixing of sleep features. REM sleep emerged at TP 3 and remained present at TP 4 (Supplementary Fig. S2). (For interpretation of the references to colour in this figure legend, the reader is referred to the web version of this article.)
See this image and copyright information in PMC

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