Jaramillo, ValeriaValeriaJaramilloJendoubi, Jasmine LéaJasmine LéaJendoubiMaric, AngelinaAngelinaMaricMensen, ArmandArmandMensenHeyse, Natalie CNatalie CHeyseEberhard-Moscicka, Aleksandra KatarzynaAleksandra KatarzynaEberhard-Moscicka0000-0001-5325-5152Wiest, Roland Gerhard RudiRoland Gerhard RudiWiestBassetti, Claudio L.A.Claudio L.A.BassettiHuber, RetoRetoHuber2024-09-022024-09-022021-11https://boris-portal.unibe.ch/handle/20.500.12422/43751OBJECTIVE Slow waves are thought to mediate an overall reduction in synaptic strength during sleep. The specific contribution of the thalamus to this so-called synaptic renormalization is unknown. Thalamic stroke is associated with daytime sleepiness, along with changes to sleep electroencephalography and cognition making it a unique "experiment of nature" to assess the relationship between sleep rhythms, synaptic renormalization, and daytime functions. METHODS Sleep was studied by polysomnography and high-density electroencephalography over 17 nights in patients with thalamic (n = 12) and 15 nights in patients with extra-thalamic (n = 11) stroke. Sleep electroencephalography overnight slow wave slope changes, and their relationship with subjective daytime sleepiness, cognition, and other functional tests were assessed. RESULTS Thalamic and extra-thalamic patients did not differ in terms of age, sleep duration or apnea-hypopnea index. Conversely, overnight slope changes were reduced in a large cluster of electrodes in thalamic compared to extra-thalamic stroke patients. This reduction was related to increased daytime sleepiness. No significant differences were found in other functional tests between the two groups. INTERPRETATION In patients with thalamic stroke a reduction in overnight slow wave slope change and increased daytime sleepiness was found. Sleep- and wake-centered mechanisms for this relationship are discussed. Overall, this study suggests a central role of the thalamus in synaptic renormalization. This article is protected by copyright. All rights reserved.enHigh-density Electroencephalography (EEG) Restorative Function of Sleep Thalamic Stroke600 - Technology::610 - Medicine & healtharticle10.48350/1593843451600210.1002/ana.26217