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Spindle density relates to cognitive outcomes in infantile epileptic spasms syndrome with unknown etiology: A retrospective cohort study.

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Title: Spindle density relates to cognitive outcomes in infantile epileptic spasms syndrome with unknown etiology: A retrospective cohort study.
Authors: Daida, Atsuro (AUTHOR), Matsuura, Ryuki (AUTHOR), Hamano, Shin‐ichiro (AUTHOR), Zhang, Yipeng (AUTHOR), Oba, Azusa (AUTHOR), Horita, Haruhito (AUTHOR), Hirata, Yuko (AUTHOR), Koichihara, Reiko (AUTHOR), Roychowdhury, Vwani (AUTHOR), Nariai, Hiroki (AUTHOR), Kikuchi, Kenjiro (AUTHOR)
Source: Epilepsia (Series 4). May2026, Vol. 67 Issue 5, p2533-2544. 12p.
Subjects: Sleep spindles, Cognitive ability, Treatment effectiveness, Infantile spasms, Intellectual disabilities, Thalamocortical system, Non-REM sleep, Cohort analysis
Abstract: Objective: Developmental arrest or regression that results in intellectual disability (ID) is a common neurological sequela of infantile epileptic spasms syndrome. Spindles are the hallmark of non‐rapid eye movement sleep, and their density correlates with cognitive performance. Recent evidence suggests that ictal and interictal epileptic activities hijack the thalamocortical network. Therefore, we aimed to investigate whether thalamocortical dysfunction, as represented by reduced spindle density, is related to cognitive outcomes. Methods: We retrospectively recruited patients diagnosed with infantile epileptic spasms syndrome who were treated at Saitama Children's Hospital. Specifically, we included patients with an unknown etiology to minimize the effects of preceding thalamocortical dysfunction induced by various etiologies before the onset of infantile epileptic spasms syndrome. These cohorts were separated into two groups based on the presence or absence of ID, defined as an intelligence quotient (IQ) or developmental quotient (DQ) of <70, during follow‐up. Information concerning patients' background characteristics, treatment response (defined as seizure cessation for at least 3 months), and cognitive performance was extracted. Pre‐ and posttreatment spindle features were derived from quantitative assessment of spindle features performed using automated algorithms, which were validated against expert human annotations. Additionally, logistic regression was used to validate the independent predictors of cognitive outcomes. Results: Overall, 45 patients were included (23 and 22 patients in the ID and non‐ID groups, respectively). Posttreatment spindle density was significantly higher in the non‐ID group than in the ID group. Moreover, spindle density was positively correlated with DQ/IQ values across the entire cohort. Finally, a logistic regression model revealed that spindle density and treatment response were independent predictors of cognitive outcomes. Significance: Reduced posttreatment spindle density was correlated with cognitive outcome in infantile epileptic spasms syndrome. The thalamocortical network may be a potential treatment target to achieve favorable cognitive outcomes. [ABSTRACT FROM AUTHOR]
Copyright of Epilepsia (Series 4) is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
Database: Psychology and Behavioral Sciences Collection
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  Label: Title
  Group: Ti
  Data: Spindle density relates to cognitive outcomes in infantile epileptic spasms syndrome with unknown etiology: A retrospective cohort study.
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  Data: &lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Daida%2C+Atsuro%22&quot;&gt;Daida, Atsuro&lt;/searchLink&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Matsuura%2C+Ryuki%22&quot;&gt;Matsuura, Ryuki&lt;/searchLink&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Hamano%2C+Shin‐ichiro%22&quot;&gt;Hamano, Shin‐ichiro&lt;/searchLink&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Zhang%2C+Yipeng%22&quot;&gt;Zhang, Yipeng&lt;/searchLink&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Oba%2C+Azusa%22&quot;&gt;Oba, Azusa&lt;/searchLink&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Horita%2C+Haruhito%22&quot;&gt;Horita, Haruhito&lt;/searchLink&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Hirata%2C+Yuko%22&quot;&gt;Hirata, Yuko&lt;/searchLink&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Koichihara%2C+Reiko%22&quot;&gt;Koichihara, Reiko&lt;/searchLink&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Roychowdhury%2C+Vwani%22&quot;&gt;Roychowdhury, Vwani&lt;/searchLink&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Nariai%2C+Hiroki%22&quot;&gt;Nariai, Hiroki&lt;/searchLink&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Kikuchi%2C+Kenjiro%22&quot;&gt;Kikuchi, Kenjiro&lt;/searchLink&gt; (AUTHOR)
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  Data: &lt;searchLink fieldCode=&quot;JN&quot; term=&quot;%22Epilepsia+%28Series+4%29%22&quot;&gt;Epilepsia (Series 4)&lt;/searchLink&gt;. May2026, Vol. 67 Issue 5, p2533-2544. 12p.
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  Data: &lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Sleep+spindles%22&quot;&gt;Sleep spindles&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Cognitive+ability%22&quot;&gt;Cognitive ability&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Treatment+effectiveness%22&quot;&gt;Treatment effectiveness&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Infantile+spasms%22&quot;&gt;Infantile spasms&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Intellectual+disabilities%22&quot;&gt;Intellectual disabilities&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Thalamocortical+system%22&quot;&gt;Thalamocortical system&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Non-REM+sleep%22&quot;&gt;Non-REM sleep&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Cohort+analysis%22&quot;&gt;Cohort analysis&lt;/searchLink&gt;
– Name: Abstract
  Label: Abstract
  Group: Ab
  Data: Objective: Developmental arrest or regression that results in intellectual disability (ID) is a common neurological sequela of infantile epileptic spasms syndrome. Spindles are the hallmark of non‐rapid eye movement sleep, and their density correlates with cognitive performance. Recent evidence suggests that ictal and interictal epileptic activities hijack the thalamocortical network. Therefore, we aimed to investigate whether thalamocortical dysfunction, as represented by reduced spindle density, is related to cognitive outcomes. Methods: We retrospectively recruited patients diagnosed with infantile epileptic spasms syndrome who were treated at Saitama Children&#39;s Hospital. Specifically, we included patients with an unknown etiology to minimize the effects of preceding thalamocortical dysfunction induced by various etiologies before the onset of infantile epileptic spasms syndrome. These cohorts were separated into two groups based on the presence or absence of ID, defined as an intelligence quotient (IQ) or developmental quotient (DQ) of &lt;70, during follow‐up. Information concerning patients&#39; background characteristics, treatment response (defined as seizure cessation for at least 3 months), and cognitive performance was extracted. Pre‐ and posttreatment spindle features were derived from quantitative assessment of spindle features performed using automated algorithms, which were validated against expert human annotations. Additionally, logistic regression was used to validate the independent predictors of cognitive outcomes. Results: Overall, 45 patients were included (23 and 22 patients in the ID and non‐ID groups, respectively). Posttreatment spindle density was significantly higher in the non‐ID group than in the ID group. Moreover, spindle density was positively correlated with DQ/IQ values across the entire cohort. Finally, a logistic regression model revealed that spindle density and treatment response were independent predictors of cognitive outcomes. Significance: Reduced posttreatment spindle density was correlated with cognitive outcome in infantile epileptic spasms syndrome. The thalamocortical network may be a potential treatment target to achieve favorable cognitive outcomes. [ABSTRACT FROM AUTHOR]
– Name: AbstractSuppliedCopyright
  Label:
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  Data: &lt;i&gt;Copyright of Epilepsia (Series 4) is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder&#39;s express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.&lt;/i&gt; (Copyright applies to all Abstracts.)
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    Identifiers:
      – Type: doi
        Value: 10.1002/epi.70130
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      – Code: eng
        Text: English
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      Pagination:
        PageCount: 12
        StartPage: 2533
    Subjects:
      – SubjectFull: Sleep spindles
        Type: general
      – SubjectFull: Cognitive ability
        Type: general
      – SubjectFull: Treatment effectiveness
        Type: general
      – SubjectFull: Infantile spasms
        Type: general
      – SubjectFull: Intellectual disabilities
        Type: general
      – SubjectFull: Thalamocortical system
        Type: general
      – SubjectFull: Non-REM sleep
        Type: general
      – SubjectFull: Cohort analysis
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      – TitleFull: Spindle density relates to cognitive outcomes in infantile epileptic spasms syndrome with unknown etiology: A retrospective cohort study.
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              Text: May2026
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              Y: 2026
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