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Ben-Zion D, Gabitov E, Bitan T, Prior A. Impaired extraction and consolidation of morphological regularities in developmental dyslexia: A domain general deficit? Neuropsychologia 2023; 188:108652. [PMID: 37527734 DOI: 10.1016/j.neuropsychologia.2023.108652] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Revised: 06/11/2023] [Accepted: 07/24/2023] [Indexed: 08/03/2023]
Abstract
The current study examined whether adults with Developmental Dyslexia are impaired in learning linguistic regularities in a novel language, and whether this may be explained by a domain general deficit in the effect of sleep on consolidation. We compared online learning and offline consolidation of morphological regularities in individuals with Developmental Dyslexia (N = 40) and typical readers (N = 38). Participants learned to apply plural inflections to novel words based on morpho-phonological rules embedded in the input and learned to execute a finger motor sequence task. To test the effects of time and sleep on consolidation, participants were assigned into one of two sleep-schedule groups, trained in the evening or in the morning and tested 12 and 24 h later. Unlike typical readers, Dyslexic readers did not extract the morpho-phonological regularities during training and as a group they did not show offline gains in inflecting trained items 24 h after training, suggesting that the deficit in extraction of regularities during training may be related to the deficit in consolidation. The offline gains in dyslexic readers, were correlated with their prior phonological abilities, and were less affected by sleep than those of typical readers. Although no deficit was found in the consolidation of the motor task, dyslexic readers were again less successful in generating an abstract representation of the motor sequence, reflected in a difficulty to generalize the motor sequence knowledge acquired using one hand to the untrained hand. The results suggest that individuals with Developmental Dyslexia have a domain general deficit in extracting statistical regularities from an input. Within the language domain this deficit is reflected in reduced benefits of consolidation, particularly during sleep, perhaps due to reduced prior phonological abilities, which may impede the individual's ability to extract the linguistic regularities during and after training and thus constrain the consolidation process.
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Affiliation(s)
- Dafna Ben-Zion
- Department of Learning Disabilities, University of Haifa, Haifa, Israel; Edmond J. Safra Brain Research Center for the Study of Learning Disabilities, University of Haifa, Haifa, Israel; Institute of Information Processing and Decision Making, University of Haifa, Haifa, Israel; The Integrated Brain and Behavior Research Center (IBBRC), University of Haifa, Haifa, Israel.
| | - Ella Gabitov
- McConnell Brain Imaging Center, Montreal Neurological Institute, McGill University, Montreal, Quebec, H3A 2B4, Canada.
| | - Tali Bitan
- Institute of Information Processing and Decision Making, University of Haifa, Haifa, Israel; The Integrated Brain and Behavior Research Center (IBBRC), University of Haifa, Haifa, Israel; Department of Psychology, University of Haifa, Haifa, Israel; Department of Speech Language Pathology, University of Toronto, Toronto, ON, Canada.
| | - Anat Prior
- Department of Learning Disabilities, University of Haifa, Haifa, Israel; Edmond J. Safra Brain Research Center for the Study of Learning Disabilities, University of Haifa, Haifa, Israel.
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Cainelli E, Vedovelli L, Carretti B, Bisiacchi P. EEG correlates of developmental dyslexia: a systematic review. ANNALS OF DYSLEXIA 2023; 73:184-213. [PMID: 36417146 DOI: 10.1007/s11881-022-00273-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Accepted: 10/25/2022] [Indexed: 06/08/2023]
Abstract
Dyslexia is one of the most studied learning disorders. Despite this, its biological basis and main causes are still not fully understood. Electroencephalography (EEG) could be a powerful tool in identifying the underlying mechanisms, but knowledge of the EEG correlates of developmental dyslexia (DD) remains elusive. We aimed to systematically review the evidence on EEG correlates of DD and establish their quality. In July 2021, we carried out an online search of the PubMed and Scopus databases to identify published articles on EEG correlates in children with dyslexia aged 6 to 12 years without comorbidities. We follow the PRISMA guidelines and assess the quality using the Appraisal Tool questionnaire. Our final analysis included 49 studies (14% high quality, 63% medium, 20% low, and 2% very low). Studies differed greatly in methodology, making a summary of their results challenging. However, some points came to light. Even at rest, children with dyslexia and children in the control group exhibited differences in several EEG measures, particularly in theta and alpha frequencies; these frequencies appear to be associated with learning performance. During reading-related tasks, the differences between dyslexic and control children seem more localized in the left temporoparietal sites. The EEG activity of children with dyslexia and children in the control group differed in many aspects, both at rest and during reading-related tasks. Our data are compatible with neuroimaging studies in the same diagnostic group and expand the literature by offering new insights into functional significance.
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Affiliation(s)
- Elisa Cainelli
- Department of General Psychology, University of Padova, Via Venezia, 8, 35133, Padua, Italy.
| | - Luca Vedovelli
- Unit of Biostatistics, Epidemiology, and Public Health, Department of Cardiac, Thoracic, Vascular Sciences, and Public Health, University of Padova, Padua, Italy
| | - Barbara Carretti
- Department of General Psychology, University of Padova, Via Venezia, 8, 35133, Padua, Italy
| | - Patrizia Bisiacchi
- Department of General Psychology, University of Padova, Via Venezia, 8, 35133, Padua, Italy
- Padova Neuroscience Centre, PNC, Padua, Italy
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Evidence of a maturational disruption in non-rapid eye movement sleep slow wave activity in youth with attention-deficit/hyperactivity, learning and internalizing disorders. Sleep Med 2022; 90:230-237. [PMID: 35217303 PMCID: PMC8923949 DOI: 10.1016/j.sleep.2022.01.026] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Revised: 01/13/2022] [Accepted: 01/31/2022] [Indexed: 11/23/2022]
Abstract
BACKGROUND Sleep slow wave activity (SWA) peaks during childhood and declines in the transition to adolescence during typical development (TD). It remains unknown whether this trajectory differs in youth with neuropsychiatric disorders. METHODS We analyzed sleep EEGs of 664 subjects 6 to 21 y (449 TD, 123 unmedicated, 92 medicated) and 114 subjects 7-12 y (median 10.5 y) followed-up at 18-22 y (median 19 y). SWA (0.4-4 Hz) power was calculated during non-rapid eye movement sleep. RESULTS TD and unmedicated youth showed cubic central and frontal SWA trajectories from 6 to 21 y (p-cubic<0.05), with TD youth showing peaks in central SWA at 6.8 y and frontal at 8.2 y. Unmedicated attention-deficit/hyperactivity (ADHD) and/or learning disorders (LD) showed peak central SWA 2 y later (at 9.6 y, coinciding with peak frontal SWA) than TD, followed by a 67% steeper slope by 19 y. Frontal SWA peak and slope in unmedicated ADHD/LD, and that of central and frontal in internalizing disorders (ID), were similar to TD. Unmedicated ADHD/LD did not differ in the longitudinal SWA percent change by 18-22 y; unmedicated ID showed a lower longitudinal change in frontal SWA than TD. Medicated youth showed a linear decline in central and frontal SWA from 6 to 21 y (p-linear<0.05). CONCLUSIONS ADHD/LD youth show a maturational delay and potential topographical disruption in SWA during childhood and steeper decline throughout adolescence, suggesting faster synaptic pruning. Youth with ID experience less changes in frontal SWA by late adolescence. Psychotropic medications may impact the maturational trajectory of SWA, but not the magnitude of developmental decline by late adolescence.
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Williams LC, Earle FS. Overnight consolidation of speech sounds predicts decoding ability in skilled adult readers. SCIENTIFIC STUDIES OF READING : THE OFFICIAL JOURNAL OF THE SOCIETY FOR THE SCIENTIFIC STUDY OF READING 2021; 26:79-88. [PMID: 35095261 PMCID: PMC8797985 DOI: 10.1080/10888438.2021.1904936] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
PURPOSE Phonological representations are important for reading. In the current work, we examine the relationship between speech-perceptual memory encoding and consolidation to reading ability in skilled adult readers. METHOD Seventy-three young adults (age 18-24) were first tested in their word and nonword reading ability, and then trained in the late evening to identify an unfamiliar speech sound contrast (Hindi retroflex-dental). Participants were assessed in their ability to perceive the target contrast immediately before training, after training, and 12 hours later. RESULTS While perceptual performance on the target at any time point was unassociated with reading ability, overnight changes to the post-training perceptual ability over the 12-hour delay was significantly associated with nonword reading (i.e. decoding) ability, but not real-word reading. CONCLUSION These results provide preliminary support for the hypothesis that individual differences in memory processes that update phonological representations following acoustic-phonetic exposure relate to decoding performance, including in adulthood.
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Luongo A, Lukowski A, Protho T, Van Vorce H, Pisani L, Edgin J. Sleep's role in memory consolidation: What can we learn from atypical development? ADVANCES IN CHILD DEVELOPMENT AND BEHAVIOR 2021; 60:229-260. [PMID: 33641795 DOI: 10.1016/bs.acdb.2020.08.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Research conducted over the last century has suggested a role for sleep in the processes guiding healthy cognition and development, including memory consolidation. Children with intellectual and developmental disabilities (IDDs) tend to have higher rates of sleep disturbances, which could relate to behavior issues, developmental delays, and learning difficulties. While several studies examine whether sleep exacerbates daytime difficulties and attention deficits in children with IDDs, this chapter focuses on the current state of knowledge regarding sleep and memory consolidation in typically developing (TD) groups and those at risk for learning difficulties. In particular, this chapter summarizes the current literature on sleep-dependent learning across developmental disabilities, including Down syndrome, Williams syndrome, Autism Spectrum Disorder, and Learning Disabilities (Attention-Deficit/Hyperactivity Disorder and Dyslexia). We also highlight the gaps in the current literature and identify challenges in studying sleep-dependent memory in children with different IDDs. This burgeoning new field highlights the importance of considering the role of sleep in memory retention across long delays when evaluating children's memory processes. Further, an understanding of typical and atypical development can mutually inform recent theories of sleep's role in memory.
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Affiliation(s)
- A Luongo
- Department of Psychology, University of Arizona, Tucson, AZ, Unites States
| | - A Lukowski
- Department of Psychological Sciences, University of California Irvine, Irvine, CA, United States
| | - T Protho
- Department of Psychology, University of Arizona, Tucson, AZ, Unites States
| | - H Van Vorce
- Department of Psychology, University of Arizona, Tucson, AZ, Unites States
| | - L Pisani
- Department of Psychology, University of Arizona, Tucson, AZ, Unites States
| | - J Edgin
- Department of Psychology, University of Arizona, Tucson, AZ, Unites States; University of Arizona Sonoran UCEDD, Tucson, AZ, United States.
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Reda F, Gorgoni M, D’Atri A, Scarpelli S, Carpi M, Di Cola E, Menghini D, Vicari S, Stella G, De Gennaro L. Sleep-Related Declarative Memory Consolidation in Children and Adolescents with Developmental Dyslexia. Brain Sci 2021; 11:73. [PMID: 33429959 PMCID: PMC7826880 DOI: 10.3390/brainsci11010073] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Revised: 12/31/2020] [Accepted: 01/04/2021] [Indexed: 02/05/2023] Open
Abstract
Sleep has a crucial role in memory processes, and maturational changes in sleep electrophysiology are involved in cognitive development. Albeit both sleep and memory alterations have been observed in Developmental Dyslexia (DD), their relation in this population has been scarcely investigated, particularly concerning topographical aspects. The study aimed to compare sleep topography and associated sleep-related declarative memory consolidation in participants with DD and normal readers (NR). Eleven participants with DD and 18 NR (9-14 years old) underwent a whole-night polysomnography. They were administered a word pair task before and after sleep to assess for declarative memory consolidation. Memory performance and sleep features (macro and microstructural) were compared between the groups, and the intercorrelations between consolidation rate and sleep measures were assessed. DD showed a deeper worsening in memory after sleep compared to NR and reduced slow spindles in occipito-parietal and left fronto-central areas. Our results suggest specific alterations in local sleep EEG (i.e., sleep spindles) and in sleep-dependent memory consolidation processes in DD. We highlight the importance of a topographical approach, which might shed light on potential alteration in regional cortical oscillation dynamics in DD. The latter might represent a target for therapeutic interventions aimed at enhancing cognitive functioning in DD.
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Affiliation(s)
- Flaminia Reda
- Department of Psychology, Sapienza University of Rome, 00185 Rome, Italy; (F.R.); (M.G.); (M.C.); (E.D.C.)
| | - Maurizio Gorgoni
- Department of Psychology, Sapienza University of Rome, 00185 Rome, Italy; (F.R.); (M.G.); (M.C.); (E.D.C.)
| | - Aurora D’Atri
- Department of Biotechnological and Applied Clinical Sciences, University of L’Aquila, 67100 L’Aquila, Italy;
| | | | - Matteo Carpi
- Department of Psychology, Sapienza University of Rome, 00185 Rome, Italy; (F.R.); (M.G.); (M.C.); (E.D.C.)
| | - Erica Di Cola
- Department of Psychology, Sapienza University of Rome, 00185 Rome, Italy; (F.R.); (M.G.); (M.C.); (E.D.C.)
| | - Deny Menghini
- Child and Adolescent Psychiatry Unit, IRCCS Bambino Gesù Children’s Hospital, 00165 Rome, Italy; (D.M.); (S.V.)
| | - Stefano Vicari
- Child and Adolescent Psychiatry Unit, IRCCS Bambino Gesù Children’s Hospital, 00165 Rome, Italy; (D.M.); (S.V.)
- Department of Life Science and Public Health, Catholic University of the Sacred Heart, 00153 Rome, Italy
| | - Giacomo Stella
- Department of Education and Human Sciences, University of Modena and Reggio Emilia, 42121 Reggio Emilia, Italy;
| | - Luigi De Gennaro
- Department of Psychology, Sapienza University of Rome, 00185 Rome, Italy; (F.R.); (M.G.); (M.C.); (E.D.C.)
- IRCCS Fondazione Santa Lucia, 00179 Rome, Italy;
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DelRosso LM, Hartmann S, Baumert M, Bruni O, Ruth C, Ferri R. Non-REM sleep instability in children with restless sleep disorder. Sleep Med 2020; 75:276-281. [DOI: 10.1016/j.sleep.2020.07.033] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2020] [Revised: 07/10/2020] [Accepted: 07/18/2020] [Indexed: 11/26/2022]
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Gorgoni M, Scarpelli S, Reda F, De Gennaro L. Sleep EEG oscillations in neurodevelopmental disorders without intellectual disabilities. Sleep Med Rev 2020; 49:101224. [PMID: 31731102 DOI: 10.1016/j.smrv.2019.101224] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2019] [Revised: 08/29/2019] [Accepted: 10/15/2019] [Indexed: 02/08/2023]
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Cyclic alternating pattern in infants with congenital hypothyroidism. Brain Dev 2019; 41:66-71. [PMID: 30037585 DOI: 10.1016/j.braindev.2018.07.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2018] [Revised: 07/04/2018] [Accepted: 07/05/2018] [Indexed: 11/22/2022]
Abstract
Congenital hypothyroidism is defined as thyroid hormone deficiency present at birth which is crucial for brain development. Recently, the cyclic alternating pattern, a rhythm present in electroencephalography recordings in non-Rapid eye movement sleep, has been related to brain development and cognition in different pediatric conditions. Therefore, we evaluated the cyclic alternating pattern rate in infants with congenital hypothyroidism, thyroxine supplementation, and healthy controls. The parameters of the cyclic alternating pattern were evaluated in 19 healthy infants (10 female, mean age 25.5 ± 15.5 months) and 21 infants diagnosed with congenital hypothyroidism (19 female, mean age 24.3 ± 19.0 months). We considered the transient electro-cortical activations (phase A of the cycle) in non-Rapid eye movement sleep and the subdivisions of the A phase in: A1, A2 and A3, based on their frequency content. All subjects were subjected to polysomnography recording in a standard laboratory setting. Sleep data were stored computer following the International 10-20 System. Data showed that congenital hypothyroidism infants exhibited higher frequency of central apnea, hypopnea, and arousals in comparison to controls. Particularly, central apnea index decreased with age in the control group but not in congenital hypothyroidism group. Regarding to cyclic alternating pattern measurements, congenital hypothyroidism infants exhibit a higher frequency in the percentage of A3 subtype (electroencephalographic desynchrony) and conversely a lower percentage of A1 subtype (electroencephalographic synchrony), than healthy infants. An important finding of this study is the positive correlation between A1 mean duration and age, which is bigger in control group than in congenital hypothyroidism group (time duration in control group (0.52 s/month) versus congenital hypothyroidism group (0.1 s/month). Infants with congenital hypothyroidism showed an increase of A3 subtype, of central apnea, and of arousals. The reduction of percentage and mean duration of A1 subtype could be a valuable indicator of sleep development in patients with congenital hypothyroidism and healthy infants.
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Smith FRH, Gaskell MG, Weighall AR, Warmington M, Reid AM, Henderson LM. Consolidation of vocabulary is associated with sleep in typically developing children, but not in children with dyslexia. Dev Sci 2017; 21:e12639. [PMID: 29226513 DOI: 10.1111/desc.12639] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2016] [Accepted: 10/13/2017] [Indexed: 11/27/2022]
Abstract
Sleep is known to play an active role in consolidating new vocabulary in adults; however, the mechanisms by which sleep promotes vocabulary consolidation in childhood are less well understood. Furthermore, there has been no investigation into whether previously reported differences in sleep architecture might account for variability in vocabulary consolidation in children with dyslexia. Twenty-three children with dyslexia and 29 age-matched typically developing peers were exposed to 16 novel spoken words. Typically developing children showed overnight improvements in novel word recall; the size of the improvement correlated positively with slow wave activity, similar to previous findings with adults. Children with dyslexia showed poorer recall of the novel words overall, but nevertheless showed overnight improvements similar to age-matched peers. However, comparisons with younger children matched on initial levels of novel word recall pointed to reduced consolidation in dyslexics after 1 week. Crucially, there were no significant correlations between overnight consolidation and sleep parameters in the dyslexic group. This suggests a reduced role of sleep in vocabulary consolidation in dyslexia, possibly as a consequence of lower levels of learning prior to sleep, and highlights how models of sleep-associated memory consolidation can be usefully informed by data from typical and atypical development.
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Affiliation(s)
- Faye R H Smith
- School of Education, Communication and Language Sciences, Newcastle University, Newcastle-upon-Tyne, UK
| | | | - Anna R Weighall
- Institute of Psychological Sciences, University of Leeds, Leeds, UK
| | - Meesha Warmington
- Department of Human Communication Sciences, University of Sheffield, Sheffield, UK
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Wilkinson M, Kane T, Wang R, Takahashi E. Migration Pathways of Thalamic Neurons and Development of Thalamocortical Connections in Humans Revealed by Diffusion MR Tractography. Cereb Cortex 2017; 27:5683-5695. [PMID: 27913428 PMCID: PMC6075593 DOI: 10.1093/cercor/bhw339] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2016] [Revised: 09/28/2016] [Accepted: 10/19/2016] [Indexed: 11/13/2022] Open
Abstract
The thalamus plays an important role in signal relays in the brain, with thalamocortical (TC) neuronal pathways linked to various sensory/cognitive functions. In this study, we aimed to see fetal and postnatal development of the thalamus including neuronal migration to the thalamus and the emergence/maturation of the TC pathways. Pathways from/to the thalami of human postmortem fetuses and in vivo subjects ranging from newborns to adults with no neurological histories were studied using high angular resolution diffusion MR imaging (HARDI) tractography. Pathways likely linked to neuronal migration from the ventricular zone and ganglionic eminence (GE) to the thalami were both successfully detected. Between the ventricular zone and thalami, more tractography pathways were found in anterior compared with posterior regions, which was well in agreement with postnatal observations that the anterior TC segment had more tract count and volume than the posterior segment. Three different pathways likely linked to neuronal migration from the GE to the thalami were detected. No hemispheric asymmetry of the TC pathways was quantitatively observed during development. These results suggest that HARDI tractography is useful to identify multiple differential neuronal migration pathways in human brains, and regional differences in brain development in fetal ages persisted in postnatal development.
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Affiliation(s)
- Molly Wilkinson
- Department of Behavioral Neuroscience, Northeastern University, Boston, MA 02115, USA
| | - Tara Kane
- Department of Behavioral Neuroscience, Northeastern University, Boston, MA 02115, USA
- Division of Newborn Medicine, Department of Medicine, Boston Children's Hospital, Harvard Medical School, 300 Longwood Avenue, Boston, MA 02115, USA
| | - Rongpin Wang
- Division of Newborn Medicine, Department of Medicine, Boston Children's Hospital, Harvard Medical School, 300 Longwood Avenue, Boston, MA 02115, USA
- Department of Radiology, Guizhou Provincial People's Hospital, 83 Zhong Shan Dong Lu, Guiyang, Guizhou Province550002, P.R. China
| | - Emi Takahashi
- Division of Newborn Medicine, Department of Medicine, Boston Children's Hospital, Harvard Medical School, 300 Longwood Avenue, Boston, MA 02115, USA
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA 02219, USA
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Esposito M, Carotenuto M. Intellectual disabilities and power spectra analysis during sleep: a new perspective on borderline intellectual functioning. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2014; 58:421-429. [PMID: 23517422 DOI: 10.1111/jir.12036] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 02/18/2013] [Indexed: 06/01/2023]
Abstract
BACKGROUND The role of sleep in cognitive processes has been confirmed by a growing number of reports for all ages of life. Analysing sleep electroencephalogram (EEG) spectra may be useful to study cortical organisation in individuals with Borderline Intellectual Functioning (BIF), as seen in other disturbances even if it is not considered a disease. The aim of this study was to determine if the sleep EEG power spectra in children with BIF could be different from typically developing children. METHODS Eighteen BIF (12 males) (mean age 11.04; SD ± 1.07) and 24 typical developing children (14 men) (mean age 10.98; SD ± 1.76; P = 0.899) underwent an overnight polysomnography (PSG) recording in the Sleep Laboratory of the Clinic of Child and Adolescent Neuropsychiatry, after one adaptation night. Sleep was subdivided into 30-s epochs and sleep stages were scored according to the standard criteria and the power spectra were calculated for the Cz-A2 channel using the sleep analysis software Hypnolab 1.2 (SWS Soft, Italy) by means of the Fast Fourier Transform and the power spectrum was calculated for frequencies between 0.5 and 60 Hz with a frequency step of 1 Hz and then averaged across the following bands delta (0.5-4 Hz), theta (5-7 Hz), alpha (8-11 Hz), sigma (11-15 Hz), and beta (16-30 Hz), gamma (30-60 Hz) for S2, SWS and REM (Rapid Eye Movement) sleep stages. RESULTS BIF have a reduced sleep duration (total sleep time; P < 0.001), and an increased rate of stage shifts (P < 0.001) and awakenings (P < 0.001) and WASO (wakefulness after sleep onset) % (P < 0.001); the stage 2% (P < 0.001), and REM% (P < 0.001) were lower and slow-wave sleep percentage was slightly higher (P < 0.001). All children with BIF had an AHI (apnoea-hypopnea index) less than 1 (mean AHI = 0.691 ± 0.236) with a mean oxygen saturation of 97.6% and a periodic leg movement index (PLMI) less than 5 (mean PLMI = 2.94 ± 1.56). All sleep stages had a significant reduction in gamma frequency (30-60 Hz) (P < 0.001) and an increased delta frequency (0.5-4.0 Hz) (P < 0.001) power in BIF subjects compared with typically developing children. CONCLUSION Our findings shed light on the importance of sleep for cognition processes particularly in cognitive borderline dysfunction and the role of EEG spectral power analysis to recognize sleep characteristics in BIF children.
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Affiliation(s)
- M Esposito
- Sleep Clinic for Developmental Age, Clinic of Child and Adolescent Neuropsychiatry, Second University of Naples, Naples, Italy
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13
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Ferini-Strambi L, Galbiati A, Marelli S. Sleep microstructure and memory function. Front Neurol 2013; 4:159. [PMID: 24130550 PMCID: PMC3795358 DOI: 10.3389/fneur.2013.00159] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2013] [Accepted: 09/26/2013] [Indexed: 11/13/2022] Open
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Urbain C, Galer S, Van Bogaert P, Peigneux P. Pathophysiology of sleep-dependent memory consolidation processes in children. Int J Psychophysiol 2013; 89:273-83. [DOI: 10.1016/j.ijpsycho.2013.06.022] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2013] [Revised: 06/13/2013] [Accepted: 06/17/2013] [Indexed: 11/30/2022]
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15
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Novelli L, Ferri R, Bruni O. Sleep cyclic alternating pattern and cognition in children: a review. Int J Psychophysiol 2013; 89:246-51. [PMID: 23911606 DOI: 10.1016/j.ijpsycho.2013.07.009] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2013] [Revised: 07/20/2013] [Accepted: 07/22/2013] [Indexed: 10/26/2022]
Abstract
Several studies have been recently focused on the relationship between sleep cyclic alternating pattern (CAP) and daytime cognitive performance, supporting the idea that the CAP slow components may play a role in sleep-related cognitive processes. Based on the results of these reports, it can be hypothesized that the analysis of CAP might be helpful in characterizing sleep microstructure patterns of different phenotypes of intellectual disability and a series of studies has been carried out that are reviewed in this paper. First the studies exploring the correlations between CAP and cognitive performance in normal adults and children are described; then, those analyzing the correlation between CAP and cognitive patterns of several developmental conditions with neurocognitive dysfunction (with or without mental retardation) are reported in detail in order to achieve a unitary view of the role of CAP in these conditions that allows to detect a particular "sleep microstructure phenotype" of children with neurologic/neuropsychiatric disorders.
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Affiliation(s)
- Luana Novelli
- Centre for Pediatric Sleep Disorders, Department of Social and Developmental Psychology, Sapienza University, Rome, Italy
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Bruni O, Kohler M, Novelli L, Kennedy D, Lushington K, Martin J, Ferri R. The role of NREM sleep instability in child cognitive performance. Sleep 2012; 35:649-56. [PMID: 22547891 PMCID: PMC3321424 DOI: 10.5665/sleep.1824] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
STUDY OBJECTIVES Based on recent reports of the involvement of cyclic alternating pattern (CAP) in cognitive functioning in adults, we investigated the association between CAP parameters and cognitive performance in healthy children. DESIGN Polysomnographic assessment and standardized neurocognitive testing in healthy children. SETTINGS Sleep laboratory. PARTICIPANTS Forty-two children aged 7.6 ± 2.7 years, with an even distribution of body mass percentile (58.5 ± 25.5) and SES reflective of national norms. MEASUREMENTS Analysis of sleep macrostructure following the R&K criteria and of cyclic alternating pattern (CAP). The neurocognitive tests were the Stanford Binet Intelligence Scale (5(th) edition) and a Neuropsychological Developmental Assessment (NEPSY) RESULTS: Fluid reasoning ability was positively associated with CAP rate, particularly during SWS and with A1 total index and A1 index in SWS. Regression analysis, controlling for age and SES, showed that CAP rate in SWS and A1 index in SWS were significant predictors of nonverbal fluid reasoning, explaining 24% and 22% of the variance in test scores, respectively. CONCLUSION This study shows that CAP analysis provides important insights on the role of EEG slow oscillations (CAP A1) in cognitive performance. Children with higher cognitive efficiency showed an increase of phase A1 in total sleep and in SWS.
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Affiliation(s)
- Oliviero Bruni
- Centre for Paediatric Sleep Disorders, Department of Developmental Neurology and Psychiatry, Sapienza University, Rome, Italy.
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Verrillo E, Bizzarri C, Bruni O, Ferri R, Pavone M, Cappa M, Cutrera R. Effects of replacement therapy on sleep architecture in children with growth hormone deficiency. Sleep Med 2012; 13:496-502. [PMID: 22437138 DOI: 10.1016/j.sleep.2011.09.018] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2011] [Revised: 08/20/2011] [Accepted: 09/07/2011] [Indexed: 11/17/2022]
Abstract
OBJECTIVE Children with GH deficiency (GHD) show a general decrease in electroencephalographic (EEG) arousability represented by a significant global decrease in Cyclic Alternating Pattern (CAP). The aim of the present study was to evaluate if sleep structure is influenced by GH substitutive therapy by analyzing the classical sleep architecture parameters and sleep microstructure by means of CAP. SUBJECTS AND METHODS Laboratory polysomnographic sleep recordings were obtained from five children affected by GHD (two girls and three boys; mean age: 4.6 ± 3.1 years), at baseline and after GH therapy, and from 10 normal healthy children (four girls and six boys, mean age: 5.6 ± 2.2 years). RESULTS Compared to controls, GHD subjects showed a reduced total sleep time with increased wakefulness and a consequent decrease in sleep efficiency; GH therapy was associated with an increase of the awakenings/hour and a large effect size was evident for sleep latency, sleep efficiency, and stage N3, which were decreased, and for stage W, which was increased. CAP appeared to be globally reduced and all phase A subtypes and CAP cycle showed a longer duration in GHD children vs. controls. GH substitutive treatment was followed by an increase in CAP rate (total, in N2, and in N3); additionally, A1 index was also significantly increased, especially during stage N3, with a very large effect size. On the other hand, A2 and A3 index and CAP cycle mean duration were reduced. CONCLUSION Sleep stage architecture seems to be influenced by the GH status, but the analysis of sleep microstructure by means of CAP reveals an enhancement of EEG slow oscillations in GHD patients (demonstrated by an increase in CAP rate and A1 index during N3) after the start of GH replacement therapy. These findings deserve to be verified in a larger trial.
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Affiliation(s)
- Elisabetta Verrillo
- Respiratory Unit, Bambino Gesù Children's Hospital and Research Institute, Rome, Italy
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Parrino L, Ferri R, Bruni O, Terzano MG. Cyclic alternating pattern (CAP): the marker of sleep instability. Sleep Med Rev 2011; 16:27-45. [PMID: 21616693 DOI: 10.1016/j.smrv.2011.02.003] [Citation(s) in RCA: 239] [Impact Index Per Article: 18.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2010] [Revised: 02/21/2011] [Accepted: 02/21/2011] [Indexed: 11/16/2022]
Abstract
Cyclic alternating pattern CAP is the EEG marker of unstable sleep, a concept which is poorly appreciated among the metrics of sleep physiology. Besides, duration, depth and continuity, sleep restorative properties depend on the capacity of the brain to create periods of sustained stable sleep. This issue is not confined only to the EEG activities but reverberates upon the ongoing autonomic activity and behavioral functions, which are mutually entrained in a synchronized oscillation. CAP can be identified both in adult and children sleep and therefore represents a sensitive tool for the investigation of sleep disorders across the lifespan. The present review illustrates the story of CAP in the last 25 years, the standardized scoring criteria, the basic physiological properties and how the dimension of sleep instability has provided new insight into pathophysiolology and management of sleep disorders.
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Affiliation(s)
- Liborio Parrino
- Sleep Disorders Center, Department of Neurosciences, University of Parma, Italy
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19
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Ferri R, Drago V, Aricò D, Bruni O, Remington RW, Stamatakis K, Punjabi NM. Response to “The evidence that cyclic alternating pattern subtypes affect cognitive functioning is very weak”. Sleep Med 2010. [DOI: 10.1016/j.sleep.2010.05.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Bruni O, Novelli L, Miano S, Parrino L, Terzano MG, Ferri R. Cyclic alternating pattern: A window into pediatric sleep. Sleep Med 2010; 11:628-36. [PMID: 20427233 DOI: 10.1016/j.sleep.2009.10.003] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2009] [Revised: 10/12/2009] [Accepted: 10/16/2009] [Indexed: 10/19/2022]
Abstract
Cyclic alternating pattern (CAP) has now been studied in different age groups of normal infants and children, and it is clear that it shows dramatic changes with age. In this review we first focus on the important age-related changes of CAP from birth to peripubertal age and, subsequently, we describe the numerous studies on CAP in developmental clinical conditions such as pediatric sleep disordered breathing, disorders of arousal (sleep walking and sleep terror), pediatric narcolepsy, learning disabilities with mental retardation (fragile-X syndrome, Down syndrome, autistic spectrum disorder, Prader-Willi syndrome) or without (dyslexia, Asperger syndrome, attention-deficit/hyperactivity disorder). CAP rate is almost always decreased in these conditions with the exception of the disorders of arousal and some cases of sleep apnea. Another constant result is the reduction of A1 subtypes, probably in relationship with the degree of cognitive impairment. The analysis of CAP in pediatric sleep allows a better understanding of the underlying neurophysiological mechanisms of sleep disturbance. CAP can be considered as a window into pediatric sleep, allowing a new vision on how the sleeping brain is influenced by a specific pathology or how sleep protecting mechanisms try to counteract internal or external disturbing events.
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Affiliation(s)
- Oliviero Bruni
- Department of Developmental Neurology and Psychiatry, Centre for Pediatric Sleep Disorders, Sapienza University, Rome, Italy.
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