Dual control of the brainstem on the spindle oscillation in humans

Spectral pattern analysis of propofol induced spindle oscillations in the presence of auditory stimulations

This study’s primary objective is to analyze human EEG spindle oscillations during propofol-induced anesthesia and to address possible activation sources. Such an analysis also has a secondary role of investigating the short- term spectral patterns and their functional role.

Artifact-free epochs of spindle activations were selected from the electroencephalograms of patients undergoing propofol anesthesia. Power spectral analysis and source localization using standardized low-resolution-brain-electromagnetic-tomography (sLORETA) were performed. Additionally, spectrograms were obtained by means of using the Complex Morlet-based algorithm. In order to highlight the functional properties, auditory stimulations were conducted during the propofol administration. The loss of consciousness was reached at a level of 0.8-1.2 µg/mL, which also provided distinct spindle oscillations in the continuous EEG. The un-evoked (spontaneous) and evoked (auditory) conditions were examined across non-medicated and medicated conditions (propofol). The propofol administration resulted in appearance of 12-14 Hz spindle activity mostly localized in BA6, BA9, BA10, BA21, BA24 and BA37 areas. The presence of auditory stimulations slightly shifted these maximum activities to different locations. Between the medicated and non-medicated conditions, there was a significant reduction of spindle activity, which was pinpointed to BA7 (precuneus area). The findings indicate that spindle oscillations may have a dual nature. That is, spindle oscillations may be activity dependent and disruptive for large-scale information processing networks in the brain. Hence, the study of spindle oscillation may provide a basis for understanding the short-term spectral patterns of human EEG.

Sleep spindles: an overview

Sleep spindles are a distinctive EEG phasic feature of NREM sleep and are prevalent during stage 2 as compared to slow wave sleep. While the neurophysiological mechanisms of spindle generation, that involves thalamic and corticothalamic networks, have been recently delineated and are briefly reviewed, their definitive functional meaning still remains to be elucidated. This review summarizes the present knowledge on visually scored and automatically detected spindles, as well as the literature on EEG power in the sigma band. Among the factors known to affect sleep spindles and sigma activity, their intra-cycle temporal dynamics, their time-course across sleep cycles, the reciprocal relationship with delta activity, the effects of sleep deprivation, of circadian factors and of ageing, and their role in information processing have been discussed. Moreover, specific attention has been paid to the existence of functionally and topographically distinct slow- and fast-spindles, also taking into account the presence of large inter-individual differences. Nevertheless, several fundamental issues remain to be elucidated: the physiological mechanisms controlling age-related changes in spindle parameters; the role of melatonin as a spindle-promoting agent; the relationships between plastic mechanisms (after stroke, or as a consequence of learning) and modifications in spindle activity; the possibility of using some spindle parameters as an index of the severity of developmental disorders in abnormal maturational processes.

Widespread activation of the brainstem preceding the recruiting rhythm in human epilepsies

The excitability change of the brainstem was investigated before and during the conspicuous epileptic discharge in six patients with generalized convulsive seizures. The discharge consisted of a short duration of recruiting rhythm, which was considered equivalent to the seizure discharge on electroencephalogram. The excitability of the brainstem was measured with the parameters (amplitude and area) of component waves (wave-III and -V) of brainstem auditory evoked potentials. The theoretical background of the analysis is that brainstem auditory evoked potentials are 'far-field' potentials, by which they convey the information on the activity change of the brainstem even during the paroxysmal discharge within the cortex. The excitability of both the ventral (parameters of wave-III) and the dorsal brainstem (parameters of wave-V) exhibited a synchronized change (activation-inactivation). They were enhanced from -2.4+/-0.4 s, reaching the maxima before the onset of the seizure discharge, and decayed corresponding to the emergence of the recruiting rhythm. The results suggest the possibility that the widespread (ventral and dorsal) and synchronized activation of the brainstem triggers the seizure discharge in human generalized epilepsy. During the widespread activation of the brainstem, both the thalamus and the cortex probably undergo a suppressed inhibitory state through the cholinergic activation, precipitating the seizure discharge.

Ictogenesis: the origin of seizures in humans. A new look at an old theory

Seizure (ictal) behavior in humans has been observed and recorded since ancient times. A satisfactory solution to this vexing problem continues to elude medical science. Antiepileptic drug (AED) therapy fails to control seizures in 20% of patients with primary generalized epilepsy and 35% of patients with partial epilepsy and has many side effects, including death. This paper cites evidence from the current literature that supports a plausible hypothesis of seizure genesis that was published in 1942, but somehow escaped recognition. It presents a concept that challenges contemporary thinking and may provide the basis for a much needed paradigm shift in the understanding of the nature of seizures and an approach to their management. The theory views a seizure as a natural reflex defense response to a lethal threat to the brain. Although capable of inflicting bodily injury due to falls, drowning, etc., the seizure is not considered inherently harmful to the brain and may be associated with beneficial circulatory changes. Efforts to control and prevent seizures should be directed away from pharma-chemical suppression towards developing methods and bioactive agents that promote neuroplasticity, neurogenesis, and an optimized physiological milieu within the brain.

Brainstem activates paroxysmal discharge in human generalized epilepsy

In nine patients with generalized epilepsy of convulsive seizures, the excitability change of the brainstem was evaluated over the course of the interictal paroxysmal discharge (poly spike-and-wave complex, poly SWC). The evaluation was carried out by a sequential analysis of brainstem auditory evoked potentials (BAEPs) before and during one sequence of poly SWC. The characteristics of BAEPs, i.e. far-field evoked potentials, allowed the evaluation of the excitability change in the brainstem, which was not influenced by the cortical activity. The excitability in the ventral brainstem, measured with the parameters of wave-III, showed a biphasic fluctuation (deceleration--acceleration) before the onset of poly SWC (minima at -0.7+/-0.4 s). On the other hand, the excitability in the dorsal brainstem, measured with the parameters of wave-V, showed no significant difference over the course of poly SWC. The results suggest that the biphasic excitability change in the ventral brainstem is conveyed to the cortex through the ascending activating system. The excitability acceleration preceded by deceleration in the ventral brainstem probably synchronizes the cortical activity profoundly enough to produce poly SWC through the activation of intralaminar thalamic neurons.