Closed-loop modulation of sleep in children undergoing intracranial recordings

Cell Reports Medicine 2026 Open access

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Authors: Simeon M. Wong, Vicki Li, Karim Mithani, Nebras M. Warsi, Hrishikesh Suresh, Sebastian C. Coleman, Olivia N. Arski, Colin Massicotte, Rohit Sharma, Alexander G. Weil, Aristides Hadjinicolaou, H Otsubo
+9 more Puneet Jain, Ayako Ochi, James T. Rutka, Elizabeth N. Kerr, Mary Lou Smith, Lauren Sham, Shelly Weiss, Elizabeth Donner, George M. Ibrahim
DOI: 10.1016/j.xcrm.2025.102538
Cited by: 2
References: 162

Abstract

Children with epilepsy suffer a vicious cycle in which disturbed sleep heightens seizure susceptibility, while seizures further disrupt sleep quality, particularly impairing the slow-wave sleep (SWS) critical for cognitive, immune, and metabolic function. We present a phase-targeted auditory stimulation (PTAS) system that delivers stimuli timed to endogenous slow oscillations. In 27 children undergoing epilepsy monitoring with simultaneous scalp, intracranial, and thalamic recordings, PTAS significantly enhances SWS power, with maximal effects on thalamic, frontal, and auditory regions in a randomized cross-over protocol. Stimulation also suppresses interictal epileptiform discharges (from 0.4 to

Fields of Study & Subjects

Sleep and Wakefulness Research Epilepsy research and treatment EEG and Brain-Computer Interfaces

Publication details

Journal / source
Cell Reports Medicine
Publisher
Elsevier BV
Volume
7
Issue
1
Pages
102538–102538
Publication date
1 January 2026
Language
EN