+1 (949) 670 0403Sawtooth Delta of the Thalamus: A Physiological Variant and the Intracranial Generator of Rapid-Eye Movement Sleep Sawtooth Waves
OBJECTIVE: To describe slow wave activity in the thalamic centro-median nucleus (CMN) region during rapid eye-movement (REM) sleep and its relation to the scalp EEG sawtooth waves.
METHODS: Five (5) patients undergoing stereo-electroencephalography were implanted in the CMN. Sleep was scored using the concurrent scalp EEG, eye-movement artifacts in Fp1, Fp2, F7, and F8, and chin EMG.
RESULTS: In the CMN region, blocks of successive delta waves assuming a sawtooth morphology were observed, presenting with high specificity for REM (p
CONCLUSIONS: SDT is a physiological variant, specific to REM sleep, manifesting with two morphologically distinct subtypes, one of them generating REM sawtooth waves on scalp.
SIGNIFICANCE: Discriminating between this physiological variant and actual ictal neurophysiological signatures is imperative for efficient therapeutic CMN neurostimulation.