Sleep-dependent memory consolidation in the epilepsy monitoring unit: A pilot study

Objective: We sought to examine whether patients with focal epilepsy exhibit sleep dependent memory consolidation, whether memory retention rates correlated with particular aspects of sleep physiology, and how the process was affected by seizures. Methods: We prospectively recruited patients with focal epilepsy and assessed declarative memory using a task consisting of 15 pairs of colored pictures on a 5 x 6 grid. Patients were tested 12 h after training, once after 12 h of wakefulness and once after 12 h that included sleep. EMG chin electrodes were placed to enable sleep scoring. The number and density of sleep spindles were assessed using a wavelet-based algorithm. Results: Eleven patients were analyzed age 21-56 years. The percentage memory retention over 12 h of wakefulness was 62.7% and over 12 h which included sleep 83.6% (p = 0.04). Performance on overnight testing correlated with the duration of slow wave sleep (SWS) (r = +0.63, p < 0.05). Three patients had seizures during the day, and 3 had nocturnal seizures. Day-time seizures did not affect retention rates, while those patients who had night time seizures had a drop in retention from an average of 92% to 60.5%. Conclusions: There is evidence of sleep dependent memory consolidation in patients with epilepsy which mostly correlates with the amount of SWS. Our preliminary findings suggest that nocturnal seizures likely disrupt sleep dependent memory consolidation. Significance: Findings highlight the importance of SWS in sleep dependent memory consolidation and the adverse impact of nocturnal seizures on this process. (C) 2016 International Federation of Clinical Neurophysiology. Published by Elsevier Ireland Ltd. All rights reserved.