{"title":"rTMS通过增加睡眠纺锤波改善睡眠中癫痫持续电状态伴有中央颞叶尖峰的自限性癫痫患者的认知","authors":"Yixian Han, Jing Gao, Yongkang Zhou, Jiahui Deng, Huajun Yang, Xiongfei Wang, Jing Wang, Yujiao Yang, Jie Ren, Lingling Chen, Minghui Wang, Qinqin Deng, Haidan Wang, Mengyang Wang, Tianfu Li","doi":"10.1111/cns.70501","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Background</h3>\n \n <p>Patients with self-limited epilepsy with centrotemporal spikes (SeLECTS) and electrical status epilepticus in sleep (ESES) lead to cognitive impairment. However, therapeutic options are limited.</p>\n </section>\n \n <section>\n \n <h3> Objectives</h3>\n \n <p>The <b>s</b>leep spindle is a biomarker of cognitive dysfunction in patients with SeLECTS. This study aimed to explore whether the sleep spindle is linked to the outcome of repetitive transcranial magnetic stimulation (rTMS) in patients with SeLECTS with ESES.</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>Nine patients with SeLECTS with ESES underwent low-frequency rTMS (≤ 1 Hz) or continuous theta burst stimulation (cTBS) for 10 days. To assess the clinical efficacy and alteration in the sleep spindle, EEG recordings were performed both before and after rTMS. A machine learning algorithm YASA was used to calculate the coupling of the sleep spindle and slow waves.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>75% of patients remained seizure-free for 6 months after rTMS. The spike–wave index (SWI) decreased significantly after rTMS compared with the baseline. The sleep spindle significantly increased in all patients at 3 months and 6 months after rTMS (<i>p</i> = 0.002). Both IQ and MQ improved significantly at 6 months after rTMS. Improvement of IQ and increase of the sleep spindle was significantly positively correlated (<i>p</i> = 0.035). The mean probability of the sleep spindle coupling in the slow wave “up” state increased from 28% to 55%.</p>\n </section>\n \n <section>\n \n <h3> Conclusion(s)</h3>\n \n <p>Increase of the sleep spindle and the mean probability of the sleep spindle coupling in the slow wave “up” state might be a potential mechanism for cognition improvement in patients with SeLECTS with ESES.</p>\n </section>\n </div>","PeriodicalId":154,"journal":{"name":"CNS Neuroscience & Therapeutics","volume":"31 7","pages":""},"PeriodicalIF":5.0000,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/cns.70501","citationCount":"0","resultStr":"{\"title\":\"rTMS Improves Cognition in Patients With Self-Limited Epilepsy With Centrotemporal Spikes With Electrical Status Epilepticus in Sleep via Increase of the Sleep Spindle\",\"authors\":\"Yixian Han, Jing Gao, Yongkang Zhou, Jiahui Deng, Huajun Yang, Xiongfei Wang, Jing Wang, Yujiao Yang, Jie Ren, Lingling Chen, Minghui Wang, Qinqin Deng, Haidan Wang, Mengyang Wang, Tianfu Li\",\"doi\":\"10.1111/cns.70501\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div>\\n \\n \\n <section>\\n \\n <h3> Background</h3>\\n \\n <p>Patients with self-limited epilepsy with centrotemporal spikes (SeLECTS) and electrical status epilepticus in sleep (ESES) lead to cognitive impairment. However, therapeutic options are limited.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Objectives</h3>\\n \\n <p>The <b>s</b>leep spindle is a biomarker of cognitive dysfunction in patients with SeLECTS. This study aimed to explore whether the sleep spindle is linked to the outcome of repetitive transcranial magnetic stimulation (rTMS) in patients with SeLECTS with ESES.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Methods</h3>\\n \\n <p>Nine patients with SeLECTS with ESES underwent low-frequency rTMS (≤ 1 Hz) or continuous theta burst stimulation (cTBS) for 10 days. To assess the clinical efficacy and alteration in the sleep spindle, EEG recordings were performed both before and after rTMS. A machine learning algorithm YASA was used to calculate the coupling of the sleep spindle and slow waves.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Results</h3>\\n \\n <p>75% of patients remained seizure-free for 6 months after rTMS. The spike–wave index (SWI) decreased significantly after rTMS compared with the baseline. The sleep spindle significantly increased in all patients at 3 months and 6 months after rTMS (<i>p</i> = 0.002). Both IQ and MQ improved significantly at 6 months after rTMS. Improvement of IQ and increase of the sleep spindle was significantly positively correlated (<i>p</i> = 0.035). The mean probability of the sleep spindle coupling in the slow wave “up” state increased from 28% to 55%.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Conclusion(s)</h3>\\n \\n <p>Increase of the sleep spindle and the mean probability of the sleep spindle coupling in the slow wave “up” state might be a potential mechanism for cognition improvement in patients with SeLECTS with ESES.</p>\\n </section>\\n </div>\",\"PeriodicalId\":154,\"journal\":{\"name\":\"CNS Neuroscience & Therapeutics\",\"volume\":\"31 7\",\"pages\":\"\"},\"PeriodicalIF\":5.0000,\"publicationDate\":\"2025-07-07\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://onlinelibrary.wiley.com/doi/epdf/10.1111/cns.70501\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"CNS Neuroscience & Therapeutics\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://onlinelibrary.wiley.com/doi/10.1111/cns.70501\",\"RegionNum\":1,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"NEUROSCIENCES\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"CNS Neuroscience & Therapeutics","FirstCategoryId":"3","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1111/cns.70501","RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"NEUROSCIENCES","Score":null,"Total":0}
rTMS Improves Cognition in Patients With Self-Limited Epilepsy With Centrotemporal Spikes With Electrical Status Epilepticus in Sleep via Increase of the Sleep Spindle
Background
Patients with self-limited epilepsy with centrotemporal spikes (SeLECTS) and electrical status epilepticus in sleep (ESES) lead to cognitive impairment. However, therapeutic options are limited.
Objectives
The sleep spindle is a biomarker of cognitive dysfunction in patients with SeLECTS. This study aimed to explore whether the sleep spindle is linked to the outcome of repetitive transcranial magnetic stimulation (rTMS) in patients with SeLECTS with ESES.
Methods
Nine patients with SeLECTS with ESES underwent low-frequency rTMS (≤ 1 Hz) or continuous theta burst stimulation (cTBS) for 10 days. To assess the clinical efficacy and alteration in the sleep spindle, EEG recordings were performed both before and after rTMS. A machine learning algorithm YASA was used to calculate the coupling of the sleep spindle and slow waves.
Results
75% of patients remained seizure-free for 6 months after rTMS. The spike–wave index (SWI) decreased significantly after rTMS compared with the baseline. The sleep spindle significantly increased in all patients at 3 months and 6 months after rTMS (p = 0.002). Both IQ and MQ improved significantly at 6 months after rTMS. Improvement of IQ and increase of the sleep spindle was significantly positively correlated (p = 0.035). The mean probability of the sleep spindle coupling in the slow wave “up” state increased from 28% to 55%.
Conclusion(s)
Increase of the sleep spindle and the mean probability of the sleep spindle coupling in the slow wave “up” state might be a potential mechanism for cognition improvement in patients with SeLECTS with ESES.
期刊介绍：
CNS Neuroscience & Therapeutics provides a medium for rapid publication of original clinical, experimental, and translational research papers, timely reviews and reports of novel findings of therapeutic relevance to the central nervous system, as well as papers related to clinical pharmacology, drug development and novel methodologies for drug evaluation. The journal focuses on neurological and psychiatric diseases such as stroke, Parkinson’s disease, Alzheimer’s disease, depression, schizophrenia, epilepsy, and drug abuse.
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