Erin D. Berja

TL;DR: A database of sleep electroencephalograms from 772 developmentally normal children is curated to characterize spindles from birth through 18 years and demonstrates that sleep spindle features follow distinct age-specific patterns in distribution, rate, duration, frequency, estimated refractory period, and inter-hemispheric spindle lag.

TL;DR: In this article , the functional and structural connectivity between the inferior Rolandic cortex and the ventrolateral (VL) nucleus of the thalamus and ventroposterolateral (VPL) nucleus in children with active, resolved and non-active Rolandic epilepsy was investigated.

TL;DR: Impaired sleep-dependent memory consolidation in children with Rolandic epilepsy is predicted by reduced sleep spindles in the centrotemporal cortex.

Abstract: OBJECTIVE Early identification of infants at risk of cerebral palsy (CP) enables interventions to optimize outcomes. Central sleep spindles reflect thalamocortical sensorimotor circuit function. We hypothesized that abnormal infant central spindle activity would predict later contralateral CP. METHODS We trained and validated an automated detector to measure spindle rate, duration, and percentage from central electroencephalogram (EEG) channels in high-risk infants (n = 35) and age-matched controls (n = 42). Neonatal magnetic resonance imaging (MRI) findings, infant motor exam, and CP outcomes were obtained from chart review. Using univariable and multivariable logistic regression models, we examined whether spindle activity, MRI abnormalities, and/or motor exam predicted future contralateral CP. RESULTS The detector had excellent performance (F1 = 0.50). Spindle rate (p = 0.005, p = 0.0004), duration (p < 0.001, p < 0.001), and percentage (p < 0.001, p < 0.001) were decreased in hemispheres corresponding to future CP compared to those without. In this cohort, PLIC abnormality (p = 0.004) and any MRI abnormality (p = 0.004) also predicted subsequent CP. After controlling for MRI findings, spindle features remained significant predictors and improved model fit (p < 0.001, all tests). Using both spindle duration and MRI findings had highest accuracy to classify hemispheres corresponding to future CP (F1 = 0.98, AUC 0.999). CONCLUSION Decreased central spindle activity improves the prediction of future CP in high-risk infants beyond early MRI or clinical exam alone. SIGNIFICANCE Decreased central spindle activity provides an early biomarker for CP.