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Brain oscillatory activity during sleep shows unknown dysfunctions in early encephalopathy

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Abstract

Electroencephalographic recordings in cirrhotic patients without overt hepatic encephalopathy (HE) have mainly been performed during wakefulness. Our aim was to quantify their alterations in nocturnal sleep electroencephalogram (EEG). In 20 patients and 20 healthy volunteers, we recorded a nocturnal digital polysomnography. Different sleep parameters were measured. Besides, we performed quantitative analysis of EEG (qEEG) as follows: spectral power in the different sleep stages was calculated in the frequency bands low δ, δ, θ, α, and σ. Also, the mean dominant frequency and Sleep Indexes were obtained. In comparison with controls, the group of patients showed (1) different alterations in both the microstructure and the macrostructure of sleep; (2) an increase in, both, θ band power and the average mean dominant frequency during rapid eye movement (REM); (3) in all sleep stages, a decrease of sleep electroencephalogram spectral power in low δ band and an increase in δ band: and (4) in stages N3 and REM, significant increases in the minimum of mean dominant frequency and in the respective sleep indexes. Therefore, in cirrhotic patients without overt HE, and likely having minimal hepatic encephalopathy, we found different alterations in both the microstructure and the macrostructure of nocturnal sleep. Also, sleep qEEG showed a brain dysfunction in slow oscillatory mechanisms intrinsic of sleep stages, with an increase in the frequency of its maximal electroencephalogram synchronization, from low δ to δ band. These alterations may reflect the onset of encephalopathy; sleep qEEG may, thus, be an adequate tool for its brain functional evaluation and follow-up.

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Acknowledgments

This work was supported by FIS 00/0457 and FIS G03/155 to JMG. MEM was a recipient of a post-doctoral fellowship (FIS G03/155). The authors wish to thank Dr. Angel Núñez for his valuable comments and Verónica García-Vázquez for her suggestions on data analysis.

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Authors and Affiliations

  1. Neurología Experimental, Hospital Universitario Ramón y Cajal, Instituto Ramón y Cajal de Investigación Sanitaria, Madrid, Spain

    María Elena Martino, José Fernández-Lorente, María Romero-Vives & José María Gaztelu

  2. Unidad de Medicina y Cirugía Experimental, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón, Dr. Esquerdo, 46, 28007, Madrid, Spain

    María Elena Martino

  3. Servicio de Neurofisiología Clínica, Hospital General Universitario Gregorio Marañón, Madrid, Spain

    José Fernández-Lorente

  4. Servicio de Gastroenterología, Hospital Universitario Ramón y Cajal, Madrid, Spain

    Rafael Bárcena

  5. Universidad Alcalá de Henares, Madrid, Spain

    Rafael Bárcena

  6. Centro de Tecnología Biomédica, Universidad Politécnica de Madrid, Madrid, Spain

    José María Gaztelu

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  1. María Elena Martino
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  2. José Fernández-Lorente
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  3. María Romero-Vives
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  4. Rafael Bárcena
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  5. José María Gaztelu
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Correspondence to María Elena Martino.

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Martino, M.E., Fernández-Lorente, J., Romero-Vives, M. et al. Brain oscillatory activity during sleep shows unknown dysfunctions in early encephalopathy. J Physiol Biochem 70, 821–835 (2014). https://doi.org/10.1007/s13105-014-0351-2

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  • DOI: https://doi.org/10.1007/s13105-014-0351-2

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