Increased interictal spike activity associated with transient slow wave trains during non-rapid eye movement sleep

Non-rapid eye movement (NREM) sleep is characterized by recurring transient events (Cyclic Alternating Patterns, CAP), some of which consist of increased slow wave activity (A1 subtype). Such transient slow-wave events may play an important role in NREM sleep regulation and are known to facilitate epileptiform activity. In our study we investigated the relationship between interictal spike activity and Cyclic Alternating Patterns in three epileptic patients, using simultaneous scalp electroencephalogram (EEG) recording and intracranial electrocorticography. A significant increase of interictal activity was found during CAP A1 subtypes. A positive correlation between scalp EEG delta power and spike activity was found only in CAP A1 subtypes, but not during other events. These results show that transient (but not subcontinuous) delta activity has a facilitating effect on epileptoform activity, also suggesting a functional dissociation between morphologically similar delta activities.