Local cerebral glucose utilization in non-rapid eye movement sleep

Functional consequences of sustained sleep deprivation in the rat

Sleep deprivation disrupts vital biological processes that are necessary for cognitive ability and physical health, but the physiological changes that underlie these outward effects are largely unknown. The purpose of the present studies in the laboratory rat is to prolong sleep deprivation to delineate the pathophysiology and to determine its mediation. In the rat, the course of prolonged sleep deprivation has a syndromic nature and eventuates in a life-threatening state. An early and central symptom of sleep deprivation is a progressive increase in peripheral energy expenditure to nearly double normal levels. An attempt to alleviate this negative energy balance by feeding rats a balanced diet that is high in its efficiency of utilization prolongs survival and attenuates or delays development of malnutrition-like symptoms, indicating that several symptoms can be manipulated to some extent by energy and nutrient consumption. Most changes in neuroendocrine parameters appear to be responses to metabolic demands, such as increased plasma catecholamines indicating sympathetic activation. Plasma total thyroid hormones, however, decline to severely low levels; a metabolic complication that is associated with other sleep deprivation-induced symptoms, such as a decline in body temperature to hypothermic levels despite increased energy expenditure. Metabolic mapping of the brain revealed a dissociation between the energy metabolism of the brain and that of the body. Sleep deprivation's effects on cerebral structures are heterogeneous and unidirectional toward decreased functional activity. The hypometabolic brain structures are concentrated in the hypothalamus, thalamus and limbic systems, whereas few regions in the rest of the brain and none in the medulla, are affected. Correspondence can be found between some of the affected cerebral structures and several of the peripheral symptoms, such as hyperphagia and possible heat retention problems. The factor predisposing to mortality is a decreased resistance to infection. Lethal opportunistic organisms are permitted to infect the bloodstream, which presumably results in a cascade of toxic-like reactions. Host defense is thus the first system to fail. There is neither fever nor marked tissue inflammatory reactions typical of infectious disease states, suggesting that sleep deprivation is immunosuppressive. Each of the four abnormalities identified--(1) a deep negative energy balance and associated malnutrition; (2) heterogeneous decreases in cerebral function; (3) low thyroid hormone concentrations; and (4) decrease resistance to infection--can be viewed as having an early origin during the sleep deprivation process to signify the foremost pathogenic situation to which the other abnormalities might be secondarily related.(ABSTRACT TRUNCATED AT 400 WORDS)

Landau-Kleffner syndrome with continuous spikes and waves during slow-wave sleep

The Landau-Kleffner syndrome is sometimes associated with continuous spike-waves during slow-wave sleep. The clinical significance of this association is unclear. In order to investigate differences in glucose metabolic patterns between awake and sleep states in two children with Landau-Kleffner syndrome and continuous spike-waves during slow-wave sleep, fluorodeoxyglucose positron-emission tomographic (PET) studies were performed in each state. In the first patient, the awake interictal PET study revealed moderate hypometabolism in the thalamus and frontal and temporal cortex and mild hypometabolism in the parietal and anterior cingulate cortex bilaterally. Occipital cortex was severely hypometabolic bilaterally. In a repeat PET study performed during sleep in which continuous spike-waves during slow-wave sleep were present, the only difference noted compared to the awake study was a marked bilateral increase in temporal cortex metabolism. The awake interictal PET in the second child was normal, except for mildly increased relative glucose metabolism in the left inferior temporal cortex. The sleep PET study with continuous spike-waves during slow-wave sleep in this child showed hypermetabolism in both temporal lobes; however, this was more pronounced, with a wider distribution in the left temporal cortex. In normal subjects, PET studies performed during awake and sleep states have not revealed such differences. Whether the temporal lobes are involved in the generation of continuous spike-waves during slow-wave sleep remains to be confirmed in a larger group of patients. The first child was treated surgically with multiple subpial transection, following which continuous spike-waves during slow-wave sleep disappeared and language function improved.(ABSTRACT TRUNCATED AT 250 WORDS)

[Contribution of positron emission tomography in the study of wakefulness and sleep. Status of the question]

Positron emission tomography (PET) allows the exploration of cerebral physiological and biochemical processes in vivo in man. Sleep studies using this technique first demonstrated that cerebral metabolic rates for glucose decrease during slow wave sleep in comparison with wakefulness whereas, during paradoxical sleep, the cerebral glucose metabolism is as high as during wakefulness. At present, several laboratories are currently exploring the regional modifications of cerebral blood flow during sleep. The results are partial and preliminary but seem to show a relative decrease in frontal cortex blood flow during slow sleep. This short review also considers some PET studies of sleep deprivation and sleep related pathologies.

Dynamic features of hemodynamic and metabolic changes in the human brain during all-night sleep as revealed by near-infrared spectroscopy

By the use of near-infrared spectroscopy, hemodynamic and metabolic changes were monitored continuously in the human brain during all-night sleep in a similar time dimension as closely monitored by electroencephalography. Measurements were started in the awake state, the values of which were taken as the control. Contrary to what many have predicted, the cerebral oxygen metabolic rate (CMRO2) increased during the transition from wakefulness to sleep. Cerebral blood flow (CBF) decreased during non-rapid eye movement (non-REM) sleep, in which a dissociation between changes in CBF and those in CMRO2 was observed. The CBF returned to the control level even in response to the only 20-s appearance of alpha activity on the electroencephalogram. During REM sleep both CBF and CMRO2 were practically the same as the control level, whereas during the transition from REM sleep to arousal a disproportionate increase in CBF compared with CMRO2 was observed. Thus, it is suggested that the flow-metabolic coupling mechanism is reset to a new level during sleep.

Immediate-early genes in spontaneous wakefulness and sleep: expression of c-fos and NGFI-A mRNA and protein

We have recently shown that the expression of two immediate-early genes, c-fos and NGFI-A, is strongly affected by sleep deprivation, In this work, we investigated c-fos and NGFI-A expression after periods of spontaneous wakefulness or sleep. We used in situ hybridization and immunocytochemistry to detect the corresponding mRNA and protein levels, respectively. A first group of rats (S-L) was sacrificed during the light hours at the end of a long period of sleep. A second group (W-L) was sacrificed under similar conditions, except that during the last half hour the animals had been spontaneously awake. A third group (W-D) was sacrificed during the dark hours after a long period of continuous wakefulness. We found that c-fos and NGFI-A expression in several brain areas was increased in W-L and W-D rats with respect to S-L rats. Some of these areas, including the cerebral cortex, basal ganglia, and colliculi, may have been activated by the increased sensory and motor activity associated with waking. The activation of other areas, such as the medial preoptic area of the hypothalamus and some brainstem nuclei, may be more directly related to sleep regulation. These results indicate that many regions showing an increased expression of immediate early genes after wakefulness induced by sleep deprivation are also activated by periods of spontaneous wakefulness.

Diminished brain glucose metabolism is a significant determinant for falling rates of systemic glucose utilization during sleep in normal humans

Systemic glucose utilization declines during sleep in man. We tested the hypothesis that this decline in utilization is largely accounted for by reduced brain glucose metabolism. 10 normal subjects underwent internal jugular and radial artery cannulation to determine cerebral blood flow by N2O equilibrium technique and to quantitate cross-brain glucose and oxygen differences before and every 3 h during sleep. Sleep stage was graded by continuous electroencephalogram, and systemic glucose turnover was estimated by isotope dilution. Brain glucose metabolism fell from 33.6 +/- 2.2 mumol/100 g per min (mean +/- SE) before sleep (2300 h) to a mean nadir of 24.3 +/- 1.1 mumol/100 g per min at 0300 h during sleep (P = 0.001). Corresponding rates of systemic glucose utilization fell from 13.2 +/- 0.8 to 11.0 +/- 0.5 mumol/kg per min (P = 0.003). Diminished brain glucose metabolism was the product of a reduced arteriovenous glucose difference, 0.643 +/- 0.024 to 0.546 +/- 0.020 mmol/liter (P = 0.002), and cerebral blood flow, 50.3 +/- 2.8 to 44.6 +/- 1.4 cc/100 g per min (P = 0.021). Brain oxygen metabolism fell commensurately from 153.4 +/- 11.8 to 128.0 +/- 8.4 mumol/100 g per min (P = 0.045). The observed reduction in brain metabolism occurred independent of stage of central nervous system electrical activity (electroencephalographic data), and was more closely linked to duration of sleep. We conclude that a decline in brain glucose metabolism is a significant determinant of falling rates of systemic glucose utilization during sleep.

The locus coeruleus and immediate-early genes in spontaneous and forced wakefulness

In this study, we mapped the expression of two immediate-early genes to examine the functional activation of the locus coeruleus and other regions of the rat brain after periods of spontaneous wakefulness or sleep and after sleep deprivation. c-fos and NGFI-A are two immediate-early genes that are rapidly induced by physiological stimuli and can be used as molecular markers of neural activation. We used immunocytochemical detection of Fos and NGFI-A proteins associated with double labeling for tyrosine hydroxylase to identify activated noradrenergic cells. We found that the expression of Fos and NGFI-A was markedly increased in the locus coeruleus and other brain areas both after spontaneous wakefulness and after short periods (3-24 h) of sleep deprivation. Several Fos-positive cells and most NGFI-A positive cells found in the locus coeruleus after periods of spontaneous wakefulness were shown to be noradrenergic. This study demonstrates that wakefulness per se, whether spontaneous or induced by total sleep deprivation, results in the functional activation of identified noradrenergic locus coeruleus cells.

Average blood flow and oxygen uptake in the human brain during resting wakefulness: a critical appraisal of the Kety-Schmidt technique

The Kety-Schmidt technique can be regarded as the reference method for measurement of global average cerebral blood flow (average CBF) and global average cerebral metabolic rate of oxygen (average CMRO2). However, in the practical application of the method, diffusion equilibrium for inert gas tracer between the brain and its venous blood is not reached. As a consequence, normal values for CBF and CMRO2 of 54 ml 100 g-1 min-1 and 3.5 ml 100 g-1 min-1 obtained with the Kety-Schmidt technique are an overestimation of the true values. Using the Kety-Schmidt technique we have performed 57 measurements of CBF and CMRO2 during EEG-verified wakeful rest in young normal adults. In order to estimate the equilibrium values for CBF and CMRO2, a simple computer-based simulation model was employed to quantitate the systematic overestimation caused by incomplete tracer equilibrium. When correcting the measured data, we find that the true average values for CBF and CMRO2 in the healthy young adult are approximately 46 ml 100 g-1 min-1 and approximately 3.0 ml 100 g-1 min-1. Previous studies have suggested that some of the variation in CMRO2 values could be ascribed to differences in cerebral venous anatomy. However in the present study, no correlation between CMRO2 and cerebral venous anatomy as imaged by magnetic resonance angiography could be established. Our data show that the interindividual variation of CMRO2 is 11% (coefficient of variation).

Cerebral glucose utilization during stage 2 sleep in man

Using [18F]fluorodeoxyglucose method and positron emission tomography, we performed paired determinations of the cerebral glucose utilization at one week intervals during sleep and wakefulness, in 12 young normal subjects. During 6 of 28 sleep runs, a stable stage 2 SWS was observed that fulfilled the steady-state conditions of the model. The cerebral glucose utilization during stage 2 SWS was lower than during wakefulness, but the variation did not significantly differ from zero (mean variation: -11.5 +/- 25.57%, P = 0.28). The analysis of 89 regions of interest showed that glucose metabolism differed significantly from that observed at wake in 6 brain regions, among them both thalamic nuclei. We conclude that the brain energy metabolism is not homogeneous throughout all the stages of non-REMS but decreases from stage 2 SWS to deep SWS; we suggest that a low thalamic glucose metabolism is a metabolic feature common to both stage 2 and deep SWS, reflecting the inhibitory processes observed in the thalamus during these stages of sleep. Stage 2 SWS might protect the stability of sleep by insulating the subject from the environment and might be a prerequisite to the full development of other phases of sleep, especially deep SWS.

Cerebral oxygen metabolism and cerebral blood flow in man during light sleep (stage 2)

We measured cerebral blood flow (CBF) and cerebral metabolic rate of oxygen (CMRO2) during light sleep (stage 2) in 8 young healthy volunteers using the Kety-Schmidt technique with 133Xe as the inert gas. Measurements were performed during wakefulness and light sleep as verified by standard polysomnography. Unlike our previous study in man showing a highly significant 25% decrease in CMRO2 during deep sleep (stage 3-4) we found a modest but statistically significant decrease of 5% in CMRO2 during stage 2 sleep. Deep and light sleep are both characterized by an almost complete lack of mental activity. They differ in respect of arousal threshold as a stronger stimulus is required to awaken a subject from deep sleep as compared to light sleep. Our results suggest that during non-rapid eye movement sleep cerebral metabolism and thereby cerebral synaptic activity is correlated to cerebral readiness rather than to mental activity.

REM sleep-associated hemoglobin oxygenation in the monkey forebrain studied using near-infrared spectrophotometry

The oxygenation state of hemoglobin (Hb) in the monkey forebrain was monitored continuously throughout nocturnal sleep using a near-infrared spectrophotometric technique. During rapid eye movement (REM) sleep, an increase in oxygenated Hb occurred concomitantly with a decrease in deoxygenated Hb, while no significant changes in Hb oxygenation were observed during slow wave sleep (SWS). A gradual increase in total Hb content was also observed to occur during each REM sleep episode but not during SWS.

Cerebral glucose utilization during sleep in Landau-Kleffner syndrome: a PET study

Three right-handed male children (aged 5, 6, and 11 years) with signs, symptoms and/or history of the syndrome of acquired aphasia-epilepsy (Landau-Kleffner syndrome) were studied during drug-induced, electroencephalographically (EEG)-monitored sleep by positron-emission tomography (PET) and the [18F]fluorodeoxyglucose (FDG) method. Our data demonstrate that in Landau-Kleffner syndrome, cerebral glucose utilization is not normal during sleep. The metabolic pattern varied between the children but the metabolic disturbances always predominated over the temporal lobes. They were right-sided, left-sided, or bilateral. In the two first patients, EEG recordings showed continuous spike-and-wave discharges during sleep and a right-greater-than-left asymmetry was observed in temporal areas. In patient 1, the asymmetry was associated with a relative increase of glucose utilization of the right posterior temporal region. In patient 2, the glucose utilization was relatively decreased in the left anterotemporal and left perisylvian regions. In patient 3, the sleep EEG showed no discharge and no significant asymmetry was observed; however, glucose utilization of both temporal lobes was decreased. Lower metabolic rates in subcortical structures than in cortex were also noted in the three children. This metabolic pattern may be related to the maturation of the central nervous system (CNS).

Rates of cerebral protein synthesis are linked to slow wave sleep in the rat

Using L-[1-14C]leucine autoradiography, rates of cerebral and local cerebral protein synthesis were studied during wakefulness, slow wave sleep (SWS) and REM sleep in the rat. In the cerebrum as a whole, the rate at which labelled leucine was incorporated into tissues was positively correlated with the occurrence of slow wave sleep. We failed to observe a significant correlation of protein synthesis rate with either wakefulness or REM sleep. As in the cerebrum as a whole, most discrete brain regions showed moderate positive correlations between the occurrence of SWS and rates of protein synthesis. There were no brain regions in which rates of protein synthesis showed striking correlations with sleep-wake states. Thus, the occurrence of SWS is associated with higher rates of protein synthesis throughout the brain. These data suggest that SWS sleep favors the restoration of cerebral proteins.

Cerebral glucose utilization during sleep-wake cycle in man determined by positron emission tomography and [18F]2-fluoro-2-deoxy-D-glucose method

Using the [18F]fluorodeoxyglucose method and positron emission tomography, we studied cerebral glucose utilization during sleep and wakefulness in 11 young normal subjects. Each of them was studied at least thrice: during wakefulness, slow wave sleep (SWS) and rapid eye movement sleep (REMS), at 1 week intervals. Four stage 3-4 SWS and 4 REMS fulfilled the steady state conditions of the model. The control population consisted of 9 normal age-matched subjects studied twice during wakefulness at, at least, 1 week intervals. Under these conditions, the average difference between the first and the second cerebral glucose metabolic rates (CMRGlu was: -7.91 +/- 15.46%, which does not differ significantly from zero (P = 0.13). During SWS, a significant decrease in CMRGlu was observed as compared to wakefulness (mean difference: -43.80 +/- 14.10%, P less than 0.01). All brain regions were equally affected but thalamic nuclei had significantly lower glucose utilization than the average cortex. During REMS, the CMRGlu were as high as during wakefulness (mean difference: 4.30 +/- 7.40%, P = 0.35). The metabolic pattern during REMS appeared more heterogeneous than at wake. An activation of left temporal and occipital areas is suggested. It is hypothetized that energy requirements for maintaining membrane polarity are reduced during SWS because of a decreased rate of synaptic events. During REMS, cerebral glucose utilization is similar to that of wakefulness, presumably because of reactivated neurotransmission and increased need for ion gradients maintenance.

Three-dimensional distribution of 3H-naloxone binding to opiate receptors in the human fetal and infant brainstem

Despite the putative role of opioids in disorders of the developing human brainstem, little is known about the distribution and ontogeny of opioid-specific perikarya, fibers, terminals, and/or receptors in human fetuses and infants. This study provides baseline information about the quantitative distribution of opiate receptors in the human fetal and infant brainstem. Brainstem sections were analyzed from three fetuses, 19-21 weeks gestation, and seven infants, 45-68 postconceptional weeks, in whom the postmortem interval was less than or equal to 12 hours. Opiate receptors were localized by autoradiographic methods with the radiolabelled antagonist 3H-naloxone. Computer-based methods permitted quantitation of 3H-naloxone binding in specific nuclei, as well as three-dimensional reconstructions of binding patterns. High 3H-naloxone binding corresponds primarily to sensory and limbic nuclei, and to nuclei whose functions are known to be influenced by opioids, e.g., trigeminal nucleus (pain), nucleus tractus solitarii and nucleus parabrachialis medialis (cardio-respiration), and locus coeruleus (arousal). The regional distribution of opiate receptors as determined by 3H-naloxone binding is similar in human infants to that reported in human adults and animals and corresponds most closely to that of mu receptors. We found, however, that opiate receptor binding is high in the fetal and infant inferior olive, in comparison to low binding reported in this site in adult humans, primates, and rodents. In addition, opiate receptors are sparse in the fetal and infant substantia nigra, as in reports of the adult human substantia nigra, compared to moderate densities reported in primates and rodents. By midgestation, the regional distribution of 3H-naloxone binding in human fetuses is similar, but not identical, to that in infants. Highest 3H-naloxone binding occurs in the inferior olive in fetuses at midgestation, compared to the interpeduncular nucleus in infants. Tritiated naloxone binding quantitatively decreases in virtually all nuclei sampled over the last trimester, but not to the same degree. The most substantial binding decrease (two- to fourfold) occurs in the inferior olive and may reflect programmed regressive events, e.g., neuronal loss, during its development. Definitive developmental trends in 3H-naloxone binding are not observed in the postnatal period studied. The heterogeneous distribution of opiate binding in individual brainstem nuclei underscores the need for volumetric sampling in quantitative studies.

Cerebral blood flow and metabolism in sleep

A review is presented of the electrical activity of the brain and its global and regional blood flow and metabolism in the different stages of sleep and in wakefulness in animals and humans. During slow-wave sleep (SWS), the blood flow and metabolism of the brain decrease slightly below the level of wakefulness. During rapid eye movement the activity of the brain increases above that of SWS and sometimes above that of wakefulness. Some studies suggest that both at sleep onset and at arousal the brain stem-cerebellar complex (BSC) may be activated before the cortex and the right hemisphere before the left. Variation of hemispheric dominance seems to be a phenomenon of both wakefulness and sleep.

Gammahydroxybutyrate: an endogenous regulator of energy metabolism

Gammahydroxybutyrate is a naturally occurring metabolite of many mammalian tissues. Although its administration produces a wide range of pharmacological effects, its normal function has never been clearly defined. GHB can induce NREM and REM sleep, anaesthesia, hypothermia, and a trance-like state which has been considered a model for petit mal epilepsy. It markedly increases brain dopamine levels. It has been touted as a central neurotransmitter or neuromodulator, and high affinity brain receptors, as well as central mechanisms for its synthesis, uptake and release have been demonstrated in support of this. But GHB is also found in many peripheral tissues and in some of these in higher concentrations than in the brain. No explanation has been offered for its presence in these tissues. A number of studies indicate that GHB can reduce energy substrate consumption in both brain and peripheral tissues, and that it can protect these tissues from the damaging effects of anoxia or excessive metabolic demand. Indeed there is some evidence to suggest that endogenous GHB levels rise under these circumstances. GHB appears to act through the endogenous opioid system, since in the brain, at least, GHB raises dynorphin levels and its metabolic and pharmacological effects can be blocked by naloxone. These, and other observations detailed in this review, suggest that GHB may function naturally in the induction and maintenance of physiological states, like sleep and hibernation, in which energy utilization is depressed. GHB may also function naturally as an endogenous protective agent when tissue energy supplies are limited.

Global reduction in cerebral blood flow and metabolism elicited from intrinsic neurons of fastigial nucleus

We sought to determine whether the global increase in regional cerebral blood flow (rCBF) produced by electrical stimulation of the rostral cerebellar fastigial nucleus (FN) is a consequence of excitation of intrinsic neurons of the FN or of axons of fibers passing through or projecting into it. Studies were conducted in rats anesthetized with chloralose, paralyzed and ventilated. rCBF was measured with [14C]iodoantipyrine as tracer and regional cerebral glucose utilization (rCGU) by [14C]2-deoxyglucose in homogenates of 11 brain regions. Neuronal perikarya in FN were excited chemically by local microinjection of the glutamate analogue kainic acid (KA) (5 nmol in 100 nl). KA elicited a transient and significant fall of arterial pressure and heart rate, the fastigial depressor response (FDR). Associated was a significant and symmetrical reduction in rCBF, to 44% of control in all regions except medulla. The response was site- and agent-specific and unrelated to the hypotension. KA also significantly and proportionally reduced, to 52% of control, rCGU in the same 10 areas of brain. In all regions the magnitudes of the reductions in rCBF and rCGU elicited by KA were linearly related. Intrinsic neurons of FN were chronically destroyed by local microinjection of the excitotoxin ibotenic acid (IBO) (10 micrograms/microliters in 0.4 microliter). Destruction of intrinsic FN neurons had no effect on resting rCBF nor on the global cerebrovascular vasodilation elicited by electrical stimulation of the FN. We conclude that: (a) excitation of intrinsic neurons of FN elicits a widespread reduction of cerebral metabolism and, secondarily, blood flow; (b) FN neurons do not exert a long-term tonic influence on brain blood flow nor metabolism; (c) the global increase in rCBF elicited by electrical stimulation of the FN is a consequence of excitation of axons projecting into or through the nucleus.

Local cerebral glucose utilization in the postictal phase of amygdaloid kindled rats

Local cerebral glucose utilization was measured by means of the quantitative autoradiographic 2-[14C]deoxyglucose method during the postictal phase of various seizure stages of amygdaloid kindling in conscious rats. The partially kindled animals exhibited a partial seizure such as chewing and/or head nodding, and the fully kindled animals, a generalized tonic-clonic convulsion. The control animals were implanted with an electrode, but not electrically stimulated. Cerebral glucose utilization of the fully kindled animals was deeply depressed in the postictal phase as compared to the control, and that of the partially kindled animals was moderately decreased. The side-to-side differences of cerebral glucose utilization were observed only in the partially kindled group in which glucose utilization was more depressed on the side of stimulation. Among the structures with depressed glucose utilization, only one structure, the interpeduncular nucleus, showed a relative increase in glucose utilization during the postictal phase of the kindled groups. As the postictal phase has been considered as a period of inhibition, these results may indicate that the neural networks linking the interpeduncular nucleus play an active role in the mechanisms of termination of a seizure and postictal refractoriness.

Measuring cholinergic sensitivity: II. Arecoline effects on metabolic activity in pontine regions of rat brain

Brain imaging studies may help to localize areas particularly sensitive to cholinergic agonists. A study in rats using the 2-deoxyglucose method for studying changes in brain metabolic activity was performed. Among regions in the pons/medulla, arecoline, 0.05 mg/kg ip, increased glucose utilization in the dorsal raphe, median raphe, and basilar pontine nuclei without producing behavioral or cardiovascular effects. These brain areas, along with the hippocampus, may be pertinent to studies of muscarinic supersensitivity in humans.

Regional cerebral glucose metabolic rate in human sleep assessed by positron emission tomography

The cerebral metabolic rate of glucose was measured during nighttime sleep in 36 normal volunteers using positron emission tomography and fluorine-18-labeled 2-deoxyglucose (FDG). In comparison to waking controls, subjects given FDG during non-rapid eye movement (NREM) sleep (primarily stages 2 and 3) showed about a 23% reduction in metabolic rate across the entire brain. This decrease was greater for the frontal than temporal or occipital lobes, and greater for basal ganglia and thalamus than cortex. Subjects in rapid eye movement (REM) sleep tended to have higher cortical metabolic rates than waking subjects. The cingulate gyrus was the only cortical structure to show a significant increase in glucose metabolic rate in REM sleep in comparison to waking. The basal ganglia were relatively more active on the right in REM sleep and symmetrical in NREM sleep.

Antiepileptic drugs and cerebral glucose metabolism

Using PET with [18-F]-2-deoxyglucose (FDG), we studied the effects of antiepileptic drugs on cerebral glucose metabolism. Serial scans were performed before and after the test drug was added to or removed from the patient's regimen. At least 3 weeks elapsed after achieving steady-state plasma levels when drugs were added, or after plasma levels were undetectable when drugs were tapered, before repeat scans were obtained. Only a single drug was changed between scans. In the phenobarbital (PB) study, the "on-drug" scan was performed first in each case. In this instance, a mean of 14 weeks elapsed between the time blood levels were undetectable and repeat scanning in order to avoid the possibility of withdrawal effects. Scanning in each group was performed 30 min after injection of 5 mCi of FDG, with EEG monitoring to exclude ictal activity. Regional glucose metabolic rates were calculated in 8 to 20 regions of interest. PB reduced LCMRglu in seven of eight regions studied, with a mean reduction over all regions of 37 +/- 3%. Phenytoin (PHT) reduced LCMRglu in only two of 10 regions (mean = 13%). We studied the effect of PHT on cerebellar metabolism in 42 patients using unpaired scans. Cerebellar LCMRglu was lower when patients were taking PHT at the time of scan, as well as in those who were taking PHT for 5 years or more, but the differences were not significant. There was a weak inverse correlation between PHT serum level and cerebellar LCMRglu in patients taking the drug at the time of scan (r = -0.36; 0.05 less than p less than 0.1).(ABSTRACT TRUNCATED AT 250 WORDS)

Increase of multiple unit activity during slow wave sleep in the cat preoptic area

Multiple unit activities (MUA) in 307 brainstem sites were recorded by chronically implanted electrodes in cats, using a polygraph with 4 channel MUA recording units. During transition from waking to slow wave sleep, at 15 sites including the medial preoptic area (11), the diagonal band of Broca (2) and medial anterior hypothalamic area (2), consistently earlier increase of MUA in discharge rate was observed, while MUA in other areas decreased. Also, at 13 sites in these areas, a decrease in discharge rate was demonstrated during paradoxical sleep. These findings suggest a close relationship between the preoptic area and sleep mechanisms, supporting a notion that an active site for induction of slow wave sleep may reside in the preoptic area.

Local cerebral glucose utilization non-selectively elevated in rapid eye movement sleep of the fetus

The [14C]deoxyglucose method for measuring local cerebral glucose utilization was employed in an effort to identify regions of the brain which participate in the increased neuronal activity of rapid eye movement (REM) sleep. The study was conducted in near term fetal sheep in which REM periods are of sufficient duration to obtain reliable data with this method. Neither the postulated executive centers of REM sleep nor those structures in the brainstem known to participate in the electrical activity peculiar to this sleep phase were found to have selectively elevated rates of glucose utilization. Rather, these regions shared equally with virtually all other structures in having rates higher than those which accompany non-REM sleep.

Differential distributions of oxidative enzymes within subnuclei of the interpeduncular nucleus in rats

Previous research has shown that neuropeptides, biogenic amines, and transmitter-related enzymes are differentially distributed between the subnuclei of the interpeduncular nucleus (IPN). The present study provides evidence that oxidative enzymes also are differentially distributed across IPN subnuclei. Histochemical staining for glucose-6-phosphate dehydrogenase (G6PDH) is most intense in the dorsal-medial subnucleus, followed in order of diminishing intensity by the rostral, rostral-lateral, dorsal-lateral, lateral, central, intermediate, and apical subnuclei. Succinate dehydrogenase (SDH) reaction product is most intense in the central and intermediate subnuclei, followed in order of diminishing intensity by the rostral, rostral-lateral, lateral, dorsal-medial, and apical subnuclei. Since few cell bodies contain reaction product, these enzymes probably are localized predominantly within dendrites and/or axon terminals in the neuropil of the IPN. The present findings suggest that the individual IPN subnuclei have their own distinctive endogenous level of oxidative and general metabolic activity.

The effect of diazepam sedation on cerebral glucose metabolism in Alzheimer's disease as measured using positron emission tomography

The effect of sedation induced by intravenous diazepam on cerebral glucose metabolic activity was examined with [18F]2-fluoro-2-deoxy-D-glucose (FDG) and positron emission tomography (PET) in five patients with probable Alzheimer's disease. Each subject was studied on 2 separate days: on one occasion at rest with eyes patched and ears open, and on the second when sedated with intravenous diazepam titrated to maintain stage II sleep by clinical and EEG criteria. Similar patterns of glucose uptake were observed in both the presence and the absence of sedation, but overall glucose utilization was depressed an average of 20% and was closely correlated with the amount of diazepam administered prior to the injection of FDG. The predominant temporoparietal hypometabolism and relative sparing of frontal metabolism observed in this disease are therefore not explained by differences in anxiety or activity level in this patient group. Utilization of diazepam sedation for PET study appears to be safe and may permit the study of patients otherwise unable to cooperate with FDG-PET procedures.

Afferent projections to the interpeduncular nucleus in the rat, as studied by retrograde and anterograde transport of wheat germ agglutinin conjugated to horseradish peroxidase

We examined the afferent projections to the subnuclei of the interpeduncular nucleus (IPN) in the rat by means of retrograde and anterograde transport of wheat germ agglutinin conjugated to horseradish peroxidase (WGA-HRP). We observed locations of retrogradely labeled cells following injections of WGA-HRP into the IPN, and distributions of anterogradely labeled fibers and terminals within the IPN following injections into the areas that contain cells of origin of afferents. Results of the retrograde and anterograde experiments have clarified the detailed organization of the IPN afferents. A part of the nucleus incertus, located dorsomedial to the dorsal tegmental nucleus, projects to the contralateral half of the rostral subnucleus of the IPN; the pars caudalis of the dorsal tegmental nucleus projects sparsely to the rostral lateral, dorsal lateral, lateral, caudal, and apical subnuclei predominantly contralaterally; the laterodorsal tegmental nucleus, to most of the subnuclei predominantly contralaterally; the ventromedial central gray rostral to the dorsal tegmental nucleus and lateral to the dorsal raphe nucleus projects to the rostral lateral and dorsal lateral subnuclei predominantly contralaterally; the median raphe nucleus, substantially to all subnuclei; the medial habenular nucleus, in a topographic manner, to the rostral, central, and intermediate subnuclei, to the rostral lateral and lateral subnuclei predominantly ipsilaterally, and to the dorsal lateral subnucleus predominantly contralaterally; the supramammillary nucleus and areas around the origin of the mammillothalamic tract and near the third ventricle project sparsely to the ventral part of the rostral subnucleus and to the central, lateral, caudal and apical subnuclei; the nucleus of the diagonal band, sparsely to the rostral, central, dorsal lateral, caudal, and apical subnuclei. These differential projections of the afferents to the subnuclei of the IPN may reflect its complex functions within the limbic midbrain circuit.

Cerebral and local cerebral metabolism in the cat during slow wave and REM sleep

[14C]2-deoxyglucose autoradiography was used to show cerebral and regional cerebral metabolism during slow-wave sleep (SWS) and rapid-eye-movement sleep (REM) in the cat. Lower levels of mean cerebral metabolism, reflecting cerebral energy conservation, were associated with SWS. A clear link between REM and mean cerebral metabolism was not observed. At the regional level, SWS was associated with markedly low metabolism in thalamic sensory relays and in cortex. REM was associated with relatively low metabolism in the cerebellum, but with relatively high metabolism in the hippocampus, and in some 'motor' regions including the trigeminal and red nuclei. Thus, SWS was linked to cerebral energy conservation and to particularly low levels of functional activity in cortical and sub-cortical sensory regions. REM was unlike SWS in that: REM did not appear to be strongly linked to cerebral energy conservation; REM was linked to metabolism in fewer brain regions than was SWS; and most REM-linked regions exhibited relatively high levels of metabolism. In addition, while SWS was most clearly associated with functional activity in sensory regions, REM was linked to functional activity in a small number of limbic and motor regions. In sum, SWS and REM are associated with distinctive cerebral metabolic and functional states.

Local cerebral glucose utilization in the free moving mouse: a comparison during two stages of the activity-rest cycle

The 2-deoxy-D[1-14C]glucose ([14C]DG) technique has been applied to the free moving mouse for the quantitative determination of local cerebral glucose utilization (LCGU). Reproducible values for LCGU were obtained indicating that the [14C]DG method had a sufficient resolution power to allow visualization and quantification of very small structures provided that glucose and [14C]DG plasma concentrations were measured on microsamples, autoradiographs prepared from proper tissue sections and suitable techniques used for analysis of the maps thus obtained. LCGU was measured in free moving mice during two stages of the light-dark cycle, one corresponding to a period of rest and the other to a period of high motor activity. In the two groups of animals LCGU was heterogeneous in the grey matter, the highest values being found in the auditory regions, the cerebellar and vestibular nuclei. LCGU was found to be lower in drowsy animals during the day than in active animals during the night and the difference was significant in the 8 following structures: the sensorimotor cortex, the septal nuclei, the nucleus of the olfactory tract, the basal amygdaloid nucleus, the ventral nucleus of the thalamus, the lateral geniculate body, the medial geniculate body and the auditory cortex. On the contrary, the suprachiasmatic nucleus was very active during the day and relatively inactive during the night as previously reported in the rat.

Widespread reductions in cerebral blood flow and metabolism elicited by electrical stimulation of the parabrachial nucleus in rat

We have studied the effect of electrical stimulation of the parabrachial nucleus (PBN) and adjacent areas of dorsal pons on regional cerebral blood flow (rCBF) and glucose utilization (rCGU) in anesthetized (chloralose), paralyzed (tubocurarine) rats. rCBF and rCGU were measured in dissected tissue samples of 9 brain regions by the [14C]iodoantipyrine and [14C]2-deoxyglucose method, respectively. Electrical stimulation restricted to the medial parabrachial nucleus (PBNm, n = 5) elicited significant (P less than 0.05) reductions in rCBF in 7 out of 9 brain regions. Reductions were greatest in cerebral cortex (up to 35% in occipital cortex) and least in the white matter of the corpus callosum (23%). The effect on rCBF persisted after transection of the cervical sympathetic trunk (n = 5). In contrast, stimulation of the lateral portion of PBN (n = 5), periventricular gray (n = 5) and interestingly, the nucleus locus coeruleus (n = 5) failed to elicit similar changes in rCBF. PBNm stimulation also elicited decreases in rCGU (n = 4) in 5 out of 9 brain areas, most notably regions of cerebral cortex. The decreases in rCGU (delta rCGU) were linearly related to the decreases in rCBF (delta rCBF) according to the equation delta rCBF = 2.37 delta rCGU + 2.1 (r = 0.72; P less than 0.001). We conclude that excitation of neural pathways originating in, or passing through, PBNm elicits a widespread reduction in cerebral metabolism and secondarily in blood flow (secondary vasoconstriction). Since projections of the PBNm do not involve the entire cortex, it seems likely that the effect is mediated via inhibition of diffuse cortical projections through a subcortical site.

Regional cerebral blood flow (rCBF) in man during perception of radiant warmth and heat pain

The present study concerns the effects of experimental pain (radiant warmth and heat pain) on regional cerebral blood flow (rCBF) in pretrained subjects. The radiant warmth caused a general rCBF increase. However, if anxiety was avoided, heat pain caused the general rCBF level to return towards the level at rest. Thus, pain sensation per se may not cause a larger rCBF (and metabolic) response than that of the localized tactile stimulation, provided that the element of psychic apprehension and anxiety is eliminated or controlled.

Regional cerebral glucose metabolism in man during wakefulness, sleep, and dreaming

Regional cerebral glucose metabolism was measured by positron emission tomography in 4 healthy male volunteers, both during wakefulness and sleep, using the 2-deoxy-D-[2-18F]glucose method. While 3 of the subjects did not report dreaming and, during sleep stages I-IV of variable duration, exhibited a non-selective decrease in metabolic rates averaging 12.6 +/- 4.73% (mean +/- S.D.) for the entire brain, the fourth volunteer who experienced an extended nightmare during his sleep examination showed a generalized increase in cerebral glucose utilization ranging from 2.1% in lentiform nucleus to 30.0% in the superior frontal cortex, with a weighted whole brain average of 16.4%. These findings suggest that energy metabolism in the human brain is generally depressed during slow-wave sleep as opposed to a--possibly differential--activation during dreaming.

Cortical abnormalities in Alzheimer's disease

Regional cerebral glucose metabolism, an index of neuronal activity, was compared in 20 patients with Alzheimer's disease and 8 age-matched normal volunteers by positron emission tomography following [18F]2-fluoro-2-deoxy-D-glucose administration. Overall cortical glucose utilization in the Alzheimer's group was 10 to 49% below that of control individuals. The posterior parietal cortex and contiguous portions of posterior temporal and anterior occipital lobes were most severely affected; frontal cortex was relatively spared. This pattern of cortical involvement is consistent with the major clinical features of Alzheimer's disease. Comparison of patients with early and more advanced dementia suggested that a substantial decline in glucose metabolism occurs before cognitive impairment becomes evident; once the patient is symptomatic, however, small additional metabolic decrements are associated with a marked deterioration in intellectual function.

Log amplitude is a linear function of log frequency in NREM sleep eeg of young and elderly normal subjects

The log of the amplitude of EEG waves during NREM sleep is a linear function of the log of their frequency. The slope of this function is reliable within individuals, is significantly less steep in elderly than in young subjects and, in both groups, becomes flatter across successive NREM periods. We interpret these results as consistent with the hypothesis that the function of NREM sleep is to reverse the effects of waking on the brain. According to this model the decreased steepness of slope in the elderly and in later NREM periods reflects the diminishing intensity of these processes. Whatever the correct interpretation, the within-subject consistency of slope values permits their empirical study as a function of experimental manipulations. In addition, the quantitative F-A function established here (A = c/Fb) sets constraints that may prove useful for physiologic models of EEG waves during sleep.

Local changes in cerebral 2-deoxyglucose uptake during alphaxalone anaesthesia with special reference to the habenulo-interpeduncular system

The effects of the steroid anaesthetic Althesin (alphaxalone plus alphadolone acetate) on regional cerebral metabolism was studied in female rats. [14C]2-Deoxyglucose (2-DG) uptake was measured in 19 discrete anatomical areas by quantitative autoradiography. Under Althesin anaesthesia metabolic activity, relative to the corpus callosum ( rma ), was significantly (24-46%) increased in the locus coeruleus, medial (but not lateral) habenula (Hb) and interpeduncular nucleus (IPN). The Hb-IPN tract, not discernible in autoradiograms from conscious rats, became readily apparent in films from anaesthetized rats. However, the increased metabolic activity of this pathway was not associated with a significant change in the tissue concentrations of substance P in either the Hb or IPN. In sensorimotor and visual cortex, caudate nucleus, thalamic nuclei and the medial geniculate body rma was significantly (26-38%) depressed. Metabolic activity in the other 8 areas measured was unaffected by Althesin. Destruction of the stria medullaris input to the habenulae prevented the Althesin-induced increase in 2-DG uptake by the MHb and LHb.

Physiological characteristics of pressure immobility. Effects of morphine, naloxone and pain

This study is an attempt to detect the most important modifications of physiological parameters occurring during pressure immobility in rabbits and to compare them with those recorded during animal hypnosis. Like the latter, pressure immobility is characterized by the development of high voltage slow waves in the EEG, reduction in frequency and amount of rhythmic slow activity in the hippocampus (RSA) and depression of spinal polysynaptic reflexes. Systolic and diastolic blood pressures are not modified. Duration of two types of immobility is positively correlated within individuals. Treatment by a single dose of morphine (1 mg/kg) potentiates the duration and this effect is antagonized by naloxone (1 mg/kg). Repeated morphine injection up to tolerance reduces duration. Pressure immobility may also be produced under persistent nociceptive stimulation and is characterized by the development of high voltage slow waves in the EEG, as is typical in the absence of pain. Naloxone, (5 mg/kg) injected in a condition of persistent noxious stimulation, reduces immobility duration. In contrast to animal hypnosis, the duration of pressure immobility is neither potentiated by pain nor reduced by naloxone (1,5 or 20 mg/kg). It is suggested that the two immobilities are controlled by several mechanisms, some similar, some different.

Hypnogenic center theory of sleep: no support from metabolic mapping in monkeys

By comparing rates of glucose utilization in brains of monkeys in non-REM sleep and two types of awake controls, we attempted to reveal cerebral hypnogenic centers that drive organisms to sleep through increases in their neural activity. Instead we found that metabolic activity is reduced in all the putative hypnogenic centers during sleep as compared to wakefulness. The results thus offer no support for the notion of an active center that either maintains or triggers sleep.

Organization of the mouse cerebral cortex: a histochemical study using glycogen phosphorylase

The postmortem phosphorylase a activity in cryostat sections taken from the brains of mice killed without any prior period of maintained anaesthesia ('unanaesthetized' mice) was compared histochemically with the activity in sections taken from mice anaesthetized with pentobarbitone prior to decapitation ('anaesthetized' mice). This study provides evidence for the existence of two separate overlapping modular subdivisions of the somatosensory cortex. The modules observed in the 'unanaesthetized' mice were restricted to layer IV and corresponded to the hollows of the whisker barrels where the thalamic afferents terminate. In contrast, the modules observed in the 'anaesthetized' mice extended from layer I to layer V, and formed a mosaic of cylinders that was out of register with the whisker barrels. These cylinders may correspond to the terminal fields of corticocortical afferents. In a few of the 'unanaesthetized' mice bands of high phosphorylase a activity are evident in the visual areas 17 and 18. This suggests that in the mouse, as in higher mammals, the thalamic input to the visual cortex gives rise to a columnar organization. In the 'anaesthetized' mice the mosaic of modules observed in the somatosensory cortex is also present in the auditory and motor areas. The modules in both groups of mice have similar diameters of between 200 and 350 microns.