Shared local brain dynamics in pediatric and adult NREM parasomnias
AI Summary
DoA show a reproducible age invariant cortical signature: increases in delta and beta before onset, frontal delta persistence, posterior delta suppression, bilateral beta enhancement.
Compared with physiological arousals, DoA arise from a sleepier baseline with higher delta, lower beta, and greater beta coexisting with persistent frontal delta.
DoA reflect spatially organised arousal integration failure: posterior sensorimotor and awareness circuits reactivate, anterior executive regions remain sleep like; hd-EEG source analysis aids translation.
Sleep. 2026 May 8:zsag123. doi: 10.1093/sleep/zsag123. Online ahead of print.
ABSTRACT
STUDY OBJECTIVES: To characterize source-level cortical oscillatory dynamics before and during disorders of arousal (DoA) compared with physiological motor arousals in children and adults.
MATERIALS AND METHODS: Nineteen children (10.9 ± 3.0 years) and 22 adults (30.3 ± 5.2 years) with DoA underwent 256-channel high-density EEG with video-polysomnography. Source-space spectral analysis in delta (0.5-4 Hz) and beta (18-30 Hz) bands was computed during stable slow-wave-sleep (-3 to -2 minutes before movement onset) and from -5 seconds to +15 seconds around movement onset for 84 DoA episodes and 146 physiological motor arousals. Linear mixed-effects models with permutation-based cluster correction were applied.
RESULTS: Four reproducible cortical hallmarks emerged across age groups: (i) a widespread pre-onset increase in beta and delta relative to slow-wave-sleep; (ii) sustained frontal delta enhancement over anterior cingulate, dorsomedial and ventromedial prefrontal, frontopolar, and orbitofrontal cortices; (iii) concurrent centro-parietal delta suppression spanning posterior cingulate, precuneus, superior parietal, sensorimotor, and supplementary motor regions; and (iv) persistent bilateral beta enhancement. Compared with physiological arousals, DoA arose from a “sleepier” background (higher delta, lower beta) and displayed greater beta coexisting with frontal delta persistence. Children showed broader pre-onset delta effects and more diffuse post-onset persistence, whereas adults exhibited a more anteriorly confined pattern.
CONCLUSION: DoA display a reproducible, age-invariant cortical signature, consistent with a spatially organized failure of arousal integration: posterior sensorimotor and awareness circuits partially reactivate, while anterior executive and emotion-regulatory regions remain sleep-like. These spatiotemporal fingerprints position hd-EEG source analysis as a translational tool for mechanistically informed diagnostic and therapeutic development.
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