EpilepsyNCT00071370
Activating Effects of Sleep Deprivation on Synchronized MEG-EEG Recordings of Epilepsy Patients With Non-Diagnostic EEG
An observational study of Epilepsy, run by National Institute of Neurological Disorders and Stroke (NINDS) at 1 site in United States.
Trial summary
This study will evaluate how the state of being completely deprived of sleep has an effect on recordings of magnetoencephalography (MEG) and electroencephalography (EEG), in relation to how alert someone is and how sleepy someone perceives himself or herself to be. Read more about this study
- Who is it for?
- Any age
- Conditions the study is for
- Epilepsy
- How many people
- 25 participants
- Where
- 1 siteUnited States
- Study dates
- Oct 2003to Nov 2005
- Phase
- Observational
- Are there results?
- None posted in the registry
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages Any age
- All sexes
- No healthy volunteers
- Child, Adult, Older adult
Who may be able to join
- Patients 18 years or older
- Patients of both sexes and of any race or ethnicity who have a diagnosis of epilepsy routine EEG on the day of a baseline MEG-EEG without IEDs.
Who cannot join
- Patients younger than 18 years
- Patients with progressive neurological disorders
- Patients who are unable to lie still or cooperate adequately with MRI or MEG/EEG
- Patients who are unable to sustain the required degree of sleep deprivation.
- Patients who have had brain surgery.
- Patients unable to sign and understand the study consent
- Patients with IEDs on a routine EEG
- Patients with IEDs on the baseline MEG-EEG
Trial locations and contacts
1 site in 1 country.
United States1 site
National Institute of Neurological Disorders and Stroke (NINDS)
Bethesda, Maryland, 20892
About this study
Official title: Activating Effects of Sleep Deprivation On Synchronized MEG-EEG Recordings Of Epilepsy Patients With Non-Diagnostic EEG
This study will evaluate how the state of being completely deprived of sleep has an effect on recordings of magnetoencephalography (MEG) and electroencephalography (EEG), in relation to how alert someone is and how sleepy someone perceives himself or herself to be. EEG measures electronic potential differences on the scalp. On the other hand, MEG is a non-invasive technique for recording the activity of neurons in the brain, through recording of magnetic fields caused by synchronized neural currents. It has the ability to detect seizures. Because magnetic signals of the brain vary, this technique must balance two key problems: weakness of the signal and strength of the noise. The EEG is sensitive to extra-cellular volume currents, whereas the MEG primarily registers intra-cellular currents. Because electrical fields are quite dependent on the conductive properties of the tissues, and magnetic fields are significantly less distorted by tissue, the MEG has better spatial resolution. There is a great deal of evidence that EEG and MEG provide complementary data about underlying currents of ions.
The complex relationship of sleep and epilepsy is well known. Sleep has been used for many years as a powerful EEG activator. Many researchers have supported the hypothesis that there is a specific activating effect of sleep deprivation on epileptic discharges. Sleep deprivation is defined as a sleepless state of longer than 24 hours. The increased use of MEG in diagnosis could improve the procedure for evaluating patients before surgery for epilepsy, by making invasive studies less necessary.
Read more
Patients 18 years of age or older, with a diagnosis of epilepsy and with a documented last routine EEG (at least 2 weeks earlier) and routine EEG on the day of a baseline MEG-EEG without interictal epileptiform discharges (IEDs) may be eligible for this study.
Participants will be rated according to the Epworth, Stanford, and Karolinska Sleepiness Scales, to determine their subjective sleepiness. They will be randomly assigned to stay awake all night or sleep in the hospital overnight. That is, a sleep deprivation and non-sleep deprivation synchronized MEG-EEG recording will be performed in random order. Then the sequence of sleep deprivation and non-sleep deprivation will be reversed within 14 to 21 days. During the recordings, the patient will either sit or lie with his or her head in a helmet covering the entire head, with openings for the eyes and ears. Brain magnetic fields will be recorded with a 275-channel OMEGA system. Throughout the session, visual and two-way audio communication will be maintained with the patient. Recording sessions will last 90 to 180 minutes, with the patient allowed to take breaks after at least 10 minutes in a scanner. Attempts will be made to encourage patients to stay awake and sleep for about the same amount of time during each recording, to acquire comparable amounts of sleep and awake recordings.
Read the detailed description
Objective:
We would like to evaluate the activating effects of complete sleep deprivation (SD) on synchronized MEG-EEG recordings, and on each of the components singly, in relation to the degree of alertness during recording (awake vs. sleep) and the subjective degree of sleepiness as assessed by standardized scales. We postulate that acute SD will increase the diagnostic yield of synchronized MEG-EEG and activate both modalities (MEG, EEG) to the same degree. The increased diagnostic utility of MEG could improve the epilepsy surgery evaluation procedure for many patients by rendering invasive studies less necessary. The medical and economic utilization of such expensive resources as MEG could thus be rationalized.
Population:
Participants of this study will be epilepsy patients whose last routine interictal EEG (performed at least two weeks earlier), subsequent pre-screening EEG and screening MEG-EEG show no interictal epileptiform discharges (IEDs), and are therefore considered non-diagnostic.
Study Design/Methods:
We will use a 275-channel Whole-head MEG System (CTF Systems 2001 Inc.). Patients will have a screening, non-SD and SD MEG-EEG after their degree of sleepiness is assessed using the Epworth, Stanford and Karnolinska sleepiness scales. Starting one day after the MEG-EEG, SD and non-SDMEG-EEG will be performed in random order within 14-21 days of each other. This will ensure an equal amount of sampling effect in SD and non-SD data sets. The MEG-EEG session will last 90 to 180 minutes. Patients may take a break after at least 10 minutes in a scanner. We will attempt to record a comparable amount of awake and sleep data. At least thirty minutes of artifact-free baseline, non-SD and SD MEG-EEG will be analyzed. For the purpose of blinding, each modality will be read independently by two readers, each of whom will be blinded to the relationship of the MEG-EEG data to sleep deprivation, results obtained by the other modality and subjective degree of sleepiness. Only interpretations of each modality agreed upon by both readers will be accepted. When there is no agreement, a third independent reader will resolve the disagreement.
Outcomes:
The primary outcome measure will be the proportion of seizure foci detected and delineated after SD on synchronized MEG-EEG recordings. Comparisons will also be made for each recording modality and between them, according to the state of alertness during recording and subjective feeling of sleepiness before each recording.
- Conditions
- Epilepsy
- Keywords
- Magnetoencephalography, Electroencephalogram (EEG), Interictal Epileptiform Discharges, Epilepsy, Sleep Deprivation, Seizure
- Medical subject headings
- Epilepsy, Sleep Deprivation, Seizures
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted20 Oct 2003 (estimated)
- Study startOct 2003
- Study completionNov 2005
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (3)Papers the sponsor has linked to this study.
- Other trials for EpilepsyStudies of the same condition, open and under way.
- More trials run by National Institute of Neurological Disorders and Stroke (NINDS)The sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Observational
- Enrolment
- 25 participants
Sponsor and investigators
- Sponsor type
- US National Institutes of Health
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT00071370
- Sponsor's protocol ID
- 040015
- Other IDs
- 04-N-0015
- Status last verified
- Nov 2005
- First submitted
- 20 Oct 2003
- Last updated
- 4 Mar 2008
- Results posted
- No
Publications
Dinner DS. Effect of sleep on epilepsy. J Clin Neurophysiol. 2002 Dec;19(6):504-13. doi: 10.1097/00004691-200212000-00003.
PubMed 12488781Brockhaus A, Lehnertz K, Wienbruch C, Kowalik A, Burr W, Elbert T, Hoke M, Elger CE. Possibilities and limitations of magnetic source imaging of methohexital-induced epileptiform patterns in temporal lobe epilepsy patients. Electroencephalogr Clin Neurophysiol. 1997 May;102(5):423-36. doi: 10.1016/s0921-884x(97)96625-x.
PubMed 9191586el-Ad B, Neufeld MY, Korczyn AD. Should sleep EEG record always be performed after sleep deprivation? Electroencephalogr Clin Neurophysiol. 1994 Apr;90(4):313-5. doi: 10.1016/0013-4694(94)90150-3.
PubMed 7512913
Study at a glance
From the registry record, last updated by the sponsor on 4 Mar 2008. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Activating Effects of Sleep Deprivation On Synchronized MEG-EEG Recordings Of Epilepsy Patients With Non-Diagnostic EEG
- ClinicalTrials.gov ID
- NCT00071370
- Acronym / sponsor ID
- 040015
- Conditions
- Epilepsy
- Keywords
- Magnetoencephalography, Electroencephalogram (EEG), Interictal Epileptiform Discharges, Epilepsy, Sleep Deprivation, Seizure
- Study type
- Observational
- Recruitment status
- Completed
- Enrolment
- 25 participants
- Lead sponsor
- National Institute of Neurological Disorders and Stroke (NINDS)US National Institutes of Health
- Study start
- Oct 2003
- Study completion
- Nov 2005
- First posted
- 20 Oct 2003 (estimated)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
This study will evaluate how the state of being completely deprived of sleep has an effect on recordings of magnetoencephalography (MEG) and electroencephalography (EEG), in relation to how alert someone is and how sleepy someone perceives himself or herself to be. EEG measures electronic potential differences on the scalp. On the other hand, MEG is a non-invasive technique for recording the activity of neurons in the brain, through recording of magnetic fields caused by synchronized neural currents. It has the ability to detect seizures. Because magnetic signals of the brain vary, this technique must balance two key problems: weakness of the signal and strength of the noise. The EEG is sensitive to extra-cellular volume currents, whereas the MEG primarily registers intra-cellular currents. Because electrical fields are quite dependent on the conductive properties of the tissues, and magnetic fields are significantly less distorted by tissue, the MEG has better spatial resolution. There is a great deal of evidence that EEG and MEG provide complementary data about underlying currents of ions.
The complex relationship of sleep and epilepsy is well known. Sleep has been used for many years as a powerful EEG activator. Many researchers have supported the hypothesis that there is a specific activating effect of sleep deprivation on epileptic discharges. Sleep deprivation is defined as a sleepless state of longer than 24 hours. The increased use of MEG in diagnosis could improve the procedure for evaluating patients before surgery for epilepsy, by making invasive studies less necessary.
Patients 18 years of age or older, with a diagnosis of epilepsy and with a documented last routine EEG (at least 2 weeks earlier) and routine EEG on the day of a baseline MEG-EEG without interictal epileptiform discharges (IEDs) may be eligible for this study.
Participants will be rated according to the Epworth, Stanford, and Karolinska Sleepiness Scales, to determine their subjective sleepiness. They will be randomly assigned to stay awake all night or sleep in the hospital overnight. That is, a sleep deprivation and non-sleep deprivation synchronized MEG-EEG recording will be performed in random order. Then the sequence of sleep deprivation and non-sleep deprivation will be reversed within 14 to 21 days. During the recordings, the patient will either sit or lie with his or her head in a helmet covering the entire head, with openings for the eyes and ears. Brain magnetic fields will be recorded with a 275-channel OMEGA system. Throughout the session, visual and two-way audio communication will be maintained with the patient. Recording sessions will last 90 to 180 minutes, with the patient allowed to take breaks after at least 10 minutes in a scanner. Attempts will be made to encourage patients to stay awake and sleep for about the same amount of time during each recording, to acquire comparable amounts of sleep and awake recordings.
Detailed description
Objective:
We would like to evaluate the activating effects of complete sleep deprivation (SD) on synchronized MEG-EEG recordings, and on each of the components singly, in relation to the degree of alertness during recording (awake vs. sleep) and the subjective degree of sleepiness as assessed by standardized scales. We postulate that acute SD will increase the diagnostic yield of synchronized MEG-EEG and activate both modalities (MEG, EEG) to the same degree. The increased diagnostic utility of MEG could improve the epilepsy surgery evaluation procedure for many patients by rendering invasive studies less necessary. The medical and economic utilization of such expensive resources as MEG could thus be rationalized.
Population:
Participants of this study will be epilepsy patients whose last routine interictal EEG (performed at least two weeks earlier), subsequent pre-screening EEG and screening MEG-EEG show no interictal epileptiform discharges (IEDs), and are therefore considered non-diagnostic.
Study Design/Methods:
We will use a 275-channel Whole-head MEG System (CTF Systems 2001 Inc.). Patients will have a screening, non-SD and SD MEG-EEG after their degree of sleepiness is assessed using the Epworth, Stanford and Karnolinska sleepiness scales. Starting one day after the MEG-EEG, SD and non-SDMEG-EEG will be performed in random order within 14-21 days of each other. This will ensure an equal amount of sampling effect in SD and non-SD data sets. The MEG-EEG session will last 90 to 180 minutes. Patients may take a break after at least 10 minutes in a scanner. We will attempt to record a comparable amount of awake and sleep data. At least thirty minutes of artifact-free baseline, non-SD and SD MEG-EEG will be analyzed. For the purpose of blinding, each modality will be read independently by two readers, each of whom will be blinded to the relationship of the MEG-EEG data to sleep deprivation, results obtained by the other modality and subjective degree of sleepiness. Only interpretations of each modality agreed upon by both readers will be accepted. When there is no agreement, a third independent reader will resolve the disagreement.
Outcomes:
The primary outcome measure will be the proportion of seizure foci detected and delineated after SD on synchronized MEG-EEG recordings. Comparisons will also be made for each recording modality and between them, according to the state of alertness during recording and subjective feeling of sleepiness before each recording.
Study design
Who may qualify
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Child, Adult, Older adult
Key inclusion criteria (2 listed)
- Patients 18 years or older
- Patients of both sexes and of any race or ethnicity who have a diagnosis of epilepsy routine EEG on the day of a baseline MEG-EEG without IEDs.
Key exclusion criteria (8 listed)
- Patients younger than 18 years
- Patients with progressive neurological disorders
- Patients who are unable to lie still or cooperate adequately with MRI or MEG/EEG
- Patients who are unable to sustain the required degree of sleep deprivation.
- Patients who have had brain surgery.
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Primary outcome
Not reported in the source record.
Results and safety
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 4 Mar 2008.
- Background: PubMed 12488781Dinner DS. Effect of sleep on epilepsy. J Clin Neurophysiol. 2002 Dec;19(6):504-13. doi: 10.1097/00004691-200212000-00003.
- Background: PubMed 9191586Brockhaus A, Lehnertz K, Wienbruch C, Kowalik A, Burr W, Elbert T, Hoke M, Elger CE. Possibilities and limitations of magnetic source imaging of methohexital-induced epileptiform patterns in temporal lobe epilepsy patients. Electroencephalogr Clin Neurophysiol. 1997 May;102(5):423-36. doi: 10.1016/s0921-884x(97)96625-x.
- Background: PubMed 7512913el-Ad B, Neufeld MY, Korczyn AD. Should sleep EEG record always be performed after sleep deprivation? Electroencephalogr Clin Neurophysiol. 1994 Apr;90(4):313-5. doi: 10.1016/0013-4694(94)90150-3.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
The record lists no contact. Use the official record to reach the sponsor.
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
An observational study of Epilepsy, run by National Institute of Neurological Disorders and Stroke (NINDS) at 1 site in United States.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 2 inclusion and 8 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: finished, as of the sponsor's last update on 4 Mar 2008. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in United States. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT00071370, which also lists 3 linked publications.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 4 Mar 2008.