Abnormal Thalamic Functional Connectivity During Light Non-Rapid Eye Movement Sleep in Children With Primary Nocturnal Enuresis

Abstract Objective The present work investigated abnormalities of thalamocortical and intrathalamic functional connectivity (FC) in children with primary nocturnal enuresis (PNE) during light non-rapid eye movement (NREM) sleep using a simultaneous electroencephalography-functional magnetic resonance imaging (EEG-fMRI) method. Method Polysomnographic and EEG-MRI data were obtained during sleep from 61 children with PNE (10.2 ± 1.7 years, 59% male participants) and 61 age-matched controls (10.1 ± 1.4 years, 54% male participants). All subjects first participated in one overnight video-polysomnographic study. Total sleep time (TST), percentage of TST (%TST) in each sleep stage, arousal index (A index) and awakening index (AA index) were calculated. Simultaneous EEG-fMRI studies were then performed using a 3T MRI system with a 32-channel MRI-compatible EEG system. Visual scoring of EEG data permitted sleep staging. Thalamocortical and intrathalamic FCs in the waking state and at different stages of light sleep were calculated and compared. Results Children with PNE had a higher %TST in light sleep and a higher A index compared with controls. Abnormal thalamocortical FCs were detected in the lateral prefrontal cortex, medial prefrontal cortex and inferior parietal lobule during light NREM sleep. Abnormal intrathalamic FCs were also detected during light NREM sleep among the motor, occipital, prefrontal and temporal subdivisions of the thalamus. Conclusion Abnormal prefrontal and parietal thalamocortical FCs, accompanied by abnormal intrathalamic FCs among the motor, occipital, prefrontal and temporal subdivision of thalamus during light NREM sleep, may be related to abnormal sleep and enuresis in children with PNE.