Analysis of polysomnographic findings in Agrypnia Excitata

ARTURO GARAY ; SUSANA BLANCO

Paris

Congreso; 21 Congress of the Sleep Research Society; 2012

Sleep Research Society

“Agrypnia Excitata” is a term coined originally by Lugaresi and Provini (Sleep Medicine Reviews 2001) to describe a syndrome caused by a dysfunction in thalamolimbic circuits producing severe insomnia, mental confusion, dream enactment, motor and autonomic activation. Of conceptual importance for the understanding of the neurophysiopathology of mechanisms of wakefulness and sleep, this syndrome is observed in fatal familial insomnia (FFI), delirium tremens, limbic autoimmune encephalopaties (LAE) and the Mulvihill-Smith syndrome. We analized polysomnographic findings of a proven case of LAE associated with VGKC antibodies (LAE-VGKG) antibodies and performed its comparisons with findings previously reported in our case of FFI (Garay A. et al., Neurology 1996). We analized polisomnograms (PSGs) of LAE-VGKC (PSGs, n=3) using digital video-polysomnographic recordings. Sleep-wake patterns were scored in 30 seconds epochs and in 5 seconds epochs by time-frequency analysis thorough continuous wavelet transform (CWT). For the analysis of our results we performed simulations using a mathematical model of sleep and wake of Rempe et al. (J. Math. Biol. 2010). LAE-VGKC showed during epochs analysis of the motor segmental overactivity a cyclic alternating pattern (CAP) with cycles of rest and activity of 60-90 sec. (p< 0.05, Kruskall-Wallis NP Test, Dunn´s NC Test). Previous data of IFF showed CAP during “intra-atypical REM sleep” fragmentation near to 60-90 sec. Using a multirresolution wavelet filter we split the band under 5 second activity. We then perform the Fourier spectrum of this extracted activity, detecting oscillations below < 1Hz. During modeling, modifications of circadian and homeostatic variables were able to produce a cyclic behaviour like LAE-VGKC and IFF.