Castelnovo, Anna Amacker, Julian Maiolo, Massimo Amato, Ninfa Pereno, Matteo Riccardi, Silvia Danani, Andrea Ulzega, Simone Manconi, Marco 2022 Confusional arousal is the milder expression of a family of disorders known as Disorders of Arousal (DOA) from non-REM sleep. These disorders are characterized by recurrent abnormal behaviors that occur in a state of reduced awareness for the external environment. Despite frequent amnesia for the nocturnal events, when actively probed, patients are able to report vivid hallucinatory/dream-like mental imagery. Traditional (low-density) scalp and stereo-electroencephalographic (EEG) recordings previously showed a pathological admixture of slow oscillations typical of NREM sleep and wake-like fast-mixed frequencies during these phenomena. However, our knowledge about the specific neural EEG dynamics over the entire brain is limited. We collected 2 consecutive in-laboratory sleep recordings using high-density (hd)-EEG (256 vertex-referenced geodesic system) coupled with standard video-polysomnography (v-PSG) from a 12-year-old drug-naıve and otherwise healthy child with a long-lasting history of sleepwalking. Source power topography and functional connectivity were computed during 20 selected confusional arousal episodes (from -6 to + 18 sec after motor onset), and during baseline slow wave sleep preceding each episode (from -3 to -2 min before onset). We found a widespread increase in slow wave activity (SWA) theta, alpha, beta, gamma power, associated with a parallel decrease in the sigma range during behavioral episodes compared to baseline sleep. Bilateral Broadman area 7 and right Broadman areas 39 and 40 were relatively spared by the massive increase in SWA power. Functional SWA connectivity analysis revealed a drastic increase in the number and complexity of connections from baseline sleep to full-blown episodes, that mainly involved an increased out-flow from bilateral frontomedial prefrontal cortex and left temporal lobe to other cortical regions. These effects could be appreciated in the 6 sec window preceding behavioral onset. Overall, our results support the idea that DOA are the expression of peculiar brain states, compatible with a partial re-emergence of consciousness. application/pdf https://localhost:5000/ark:/12658/srd1324957 https://susi.usi.ch/global/documents/324957 https://susi.usi.ch/documents/324957/files/Castelnovo_2022_Else_cortex.pdf eng info:eu-repo/semantics/altIdentifier/doi/10.1016/j.cortex.2022.05.021 info:eu-repo/semantics/altIdentifier/ark/12658/srd1324957 info:eu-repo/semantics/openAccess CC BY Cortex. - 2022, vol. 155, p. 62-74 Disorders of arousal NREM-sleep parasomnia Somnambulism Night terror Pavor nocturnus info:eu-repo/classification/udc/61 High-density EEG power topography and connectivity during confusional arousal http://purl.org/coar/resource_type/c_6501