Rolandic Epilepsy, Sleep, and Learning

Rolandic epilepsy (also called self-limited epilepsy with centrotemporal spikes, SeLECTS; childhood epilepsy with centrotemporal spikes, CECTS; benign epilepsy with centrotemporal spikes, BECTS) is the most common childhood epilepsy syndrome, accounting for 20% of all childhood epilepsy, and characterized by a transient period of seizures and cognitive difficultes of varying severity and duration in school-age children. Rolandic epilepsy thus provides a natural model to study biomarkers and mechanisms of epileptogenicity and cognitive comorbidities in epilepsy. Through this work, we have introduced and validated novel biomarkers for (1) epileptogenicity (spike ripples), (2) memory dysfunction (sleep spindles), and (3) made the pathophysiological discovery that Rolandic epilepsy is a focal thalamocortical circuit disorder in which focal sleep-activated epileptiform spikes. spike ripples, disrupt regional sleep spindles. In our ongoing studies, we use multimodal imaging and experimental tasks to understand the cause of seizures and cognitive symptoms in Rolandic epilepsy. Our long term goal is to identify new targets and approaches to treat seizures and cognitive deficits in Rolandic epilepsy and related epileptic encephalopathies.

Findings to date:

We have identified abnormal communications between the thalamus–a deep brain nucleus responsible for organizing cortical brain rhythms during sleep, and the cortex–the outer layer of the brain responsible for learning and cognition in children with Rolandic epilepsy.
[Thorn et al, 2020] [Hunki et al, 2022]

We have found that disruptions to rhythms during sleep predict several of the learning difficulties experienced by some children with Rolandic epilepsy. Specifically, children with Rolandic epilepsy have decreased sleep spindles, brain oscillations generated in the thalamus during sleep that support sleep-dependent memory consolidation. In both children with and without epilepsy, the rate of sleep spindles predicts several measures of cognitive performance.
[Kramer et al, 2021] [Spencer et al, 2022] [Li et al, 2021]

We have found that abnormal fast oscillations coinciding with epileptiform spikes better predict the risk of future seizures in children with Rolandic epilepsy.
[Kramer et al, 2019] [Nadalin et al, 2021] [Chu et al, 2017]

Other findings in Rolandic epilepsy and related epileptic encephalopathies: [Ross et al, 2020]; [Qiang et al, 2021]; [Song et al, 2019]; [Xie et al, 2018]; [Stoyell et al, 2021]

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