Auditory Stimulation Effects on Sleep and Memory in Patients With Epilepsy

Study Overview
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Brief Summary
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This study will investigate the role of coordinated brain rhythms during sleep in memory consolidation and determine whether playing precisely timed brief bursts of noise can enhance these rhythms and improve memory in epilepsy inpatients with implanted hippocampal electrodes.

Detailed Description
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The investigators will test the hypotheses that coordinated brain rhythms during nonrapid eye movement sleep are associated with memory consolidation and can be enhanced with auditory stimulation (playing precisely timed brief bursts of quiet noise) to improve memory. The investigators will measure differences in sleep and memory performance in epilepsy inpatients with implanted hippocampal electrodes and continuous full scalp EEG monitoring under three overnight sleep conditions: a baseline night; a memory night during which sleep-dependent memory consolidation is assessed with the finger tapping motor sequence task (MST) with training prior to sleep and testing the next morning; and a stimulation night during which participants train on the MST, have precisely timed auditory stimulation during the sleep that follows, and are tested on the MST in the morning.

Official Title
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Effects of Auditory Stimulation on Coordinated Non-REM Sleep Oscillations and Memory in Epilepsy Inpatients With Implanted Hippocampal Electrodes

Conditions
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Epilepsy

Intervention / Treatment
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* Other: Baseline
* Other: Motor procedural memory task
* Other: Motor procedural memory task plus auditory stimulation


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Inpatients with epilepsy Aged 12-65 Undergoing clinically indicated continuous scalp and intracranial EEG monitoring with implanted hippocampal electrodes Fluent in English Able to give informed consent/assent (for minors aged 12-17 or adults with an appointed guardian) Exclusion Criteria: Intellectual disability impairing ability to perform task Motor problems that preclude finger tapping task Previous surgery anticipated to disrupt coordination of sleep oscillations in the circuitry of interest

Ages Eligible for Study
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Minimum Age: 12 Years
Maximum Age: 65 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Basic Science
Intervention Model: Single Group Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Epilepsy inpatients<br>Epilepsy inpatients with implanted hippocampal electrodes and continuous scalp EEG monitoring | Other: Baseline<br>* Hippocampal and scalp EEG monitoring during overnight sleep<br>Other: Motor procedural memory task<br>* Training on the finger tapping MST prior to monitored overnight sleep with MST testing the following morning<br>Other: Motor procedural memory task plus auditory stimulation<br>* Training on the finger tapping MST prior to monitored overnight sleep that includes auditory stimulation, with MST testing the following morning<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Changes in slow oscillation-spindle-hippocampal ripple coupling | Changes in the coupling of slow oscillations with spindles and hippocampal ripples during non-Rapid Eye Movement (NREM) sleep as measured by scalp and intracranial EEG between baseline, memory, and auditory stimulation nights. | Three nights of sleep within three weeks | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Changes in sleep-dependent consolidation of motor procedural memory | Changes in sleep-dependent improvement of motor procedural memory performance on the finger tapping motor sequence task (MST) between baseline, memory, and auditory stimulation nights. Different sequences are employed for the memory and auditory stimulation nights in a counter-balanced order. | Three nights of sleep within three weeks | 
| Changes in slow oscillations | Changes in slow oscillations during non-rapid eye movement (NREM) sleep as measured by EEG between the baseline, memory, and auditory stimulation nights | Three nights of sleep within three weeks | 
| Changes in sleep spindles | Changes in sleep spindles during non-rapid eye movement (NREM) sleep as measured by EEG between baseline, memory, and auditory stimulation nights | Three nights of sleep within three weeks | 
| Changes in hippocampal ripples | Changes in hippocampal ripples during non-rapid eye movement (NREM) sleep as measured by intracranial EEG between baseline, memory, and auditory stimulation nights | Three nights of sleep within three weeks | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Sleep, Memory, Auditory stimulation, Spindles, Intracranial monitoring, Hippocampal ripples, Slow oscillations