Sleep Characteristics And Brain VBM Study Of Comorbid Sleep Disorders In Epilepsy

ObjectiveEpilepsy is a common disease of the nervous system,most patients have a long course of disease,long epileptic seizures and the use of anti-epileptic drugs,patients are easy to be accompanied by other mental or physical comorbidities,the existence of comorbidities make the treatment of epilepsy more complex.Sleep disorder is one of the most common epilepsy comorbidities.The decrease of sleep quality easily leads to the decrease of daily life quality of patients and the increase of seizure frequency.This study evaluated the risk factors and sleep characteristics of comorbidities of epilepsy patients in a cross-sectional study of MRI negative epilepsy patients.Objective to investigate the changes of brain microstructure in patients with epilepsy comorbid sleep disorder.To further provide individualized treatment for patients with epileptic comorbid sleep disorder,and provide basis for the study of pathological mechanism of epileptic comorbid sleep disorder.MethodsA total of epilepsy patients admitted to the Department of Neurology of China-japan Friendship Hospital of Jilin University from March 2020 to December 2021 were selected,and the epilepsy patients with normal3.0T MRI results were screened.All patients completed the collection of MMSE,Anxiety and depression Scale,Pittsburgh sleep Scale and basic clinical data.Selected complained of sleep disorders and related scale assessment of patients with sleep disorders in further PSG examination,by two senior nerve internal medicine according to the history of specialized subject doctor,chief complaint and related inspection diagnosis of sleep disorders,in epilepsy were suffering from a sleep disorder group,the rest of the patients in normal epilepsy group and healthy control group selected at the same time to see a doctor in the hospital physical examination center of healthy people.Statistical analysis was conducted on the course of disease,age,medication and seizure type of patients in the sleep disorder group and the common epilepsy group.T-test/one-way ANOVA were performed respectively.Chi-square test was used for counting data,and P < 0.05 was considered as difference.The results with differences in single factor analysis were incorporated into the regression analysis for logistics regression analysis.P< 0.05 was considered to be statistically significant,and the influence of the above factors on sleep disorders in epilepsy co-morbidity was evaluated.PSG results of patients with comorbid sleep disorder were compared with normal values to analyze the sleep characteristics of patients with comorbid sleep disorder epilepsy.The imaging data of SPM12 processed brain structure images based on Metlab2013 b and the abnormal brain regions were extracted using SPM CAT12 kit.Further statistical analysis was conducted to explore the imaging changes of patients with sleep disorders in epilepsy and the frontal differences between them and ordinary epilepsy patients.ResultsA total of 60 epileptic patients with sleep disorders,48 epileptic patients and 30 healthy controls were included in this study.There was no significant difference in age,sex,onset age,course of disease,frequency of seizure and medication between the sleep disorder group and the epilepsy group.Anxiety and depression are risk factors of sleep disorder in epilepsy.The sleep characteristics of patients with epilepsy comorbidities were sleep structure disorder and prolonged N2 stage.In the epileptic comorbidities with sleep disorders,50% of patients presented with paradoxical insomnia and 50% with primary insomnia.The objective TST and subjective SOL of patients with contradictory insomnia were significantly shortened,the difference between subjective and objective sleep latency and the difference between subjective and objective sleep time were significantly increased,and N2 was prolonged and N3 was shortened.Atrophy of hippocampus,temporal lobe and other parts was found in epileptic patients,and atrophy of hippocampus,temporal lobe and thalamus was found in epileptic co-morbidities.Changes in thalamic structure may be associated with sleep disorders in epilepsy comorbidities.Conclution1.Anxiety and depression are risk factors of sleep disorder in epilepsy.2.PSG features of epileptic sleep disorders include sleep structure disorder and prolonged N2.Paradoxical insomnia accounts for 50% of sleep disorders in epilepsy patients.3.VBM can detect subtle structural changes in the brain that cannot be detected by conventional MRI,and structural changes in the thalamus may be associated with sleep disorders in epilepsy patients.