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Campillo-Ferrer T, Alcaraz-Sánchez A, Demšar E, Wu HP, Dresler M, Windt J, Blanke O. Out-of-body experiences in relation to lucid dreaming and sleep paralysis: A theoretical review and conceptual model. Neurosci Biobehav Rev 2024; 163:105770. [PMID: 38880408 DOI: 10.1016/j.neubiorev.2024.105770] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2024] [Revised: 05/31/2024] [Accepted: 06/11/2024] [Indexed: 06/18/2024]
Abstract
Out-of-body experiences (OBEs) are characterized by the subjective experience of being located outside the physical body. Little is known about the neurophysiology of spontaneous OBEs, which are often reported by healthy individuals as occurring during states of reduced vigilance, particularly in proximity to or during sleep (sleep-related OBEs). In this paper, we review the current state of research on sleep-related OBEs and hypothesize that maintaining consciousness during transitions from wakefulness to REM sleep (sleep-onset REM periods) may facilitate sleep-related OBEs. Based on this hypothesis, we propose a new conceptual model that potentially describes the relationship between OBEs and sleep states. The model sheds light on the phenomenological differences between sleep-related OBEs and similar states of consciousness, such as lucid dreaming (the realization of being in a dream state) and sleep paralysis (feeling paralyzed while falling asleep or waking up), and explores the potential polysomnographic features underlying sleep-related OBEs. Additionally, we apply the predictive coding framework and suggest a connecting link between sleep-related OBEs and OBEs reported during wakefulness.
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Affiliation(s)
- Teresa Campillo-Ferrer
- Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, the Netherlands; Department of Neuropsychology, Faculty of Psychology, Ruhr University Bochum, Bochum, Germany.
| | - Adriana Alcaraz-Sánchez
- Centre for Philosophical Psychology, Department of Philosophy, University of Antwerp, Antwerp, Belgium
| | - Ema Demšar
- Monash Centre for Consciousness and Contemplative Studies, Melbourne, Australia; Monash University, Department of Philosophy, Melbourne, Australia
| | - Hsin-Ping Wu
- Laboratory of Cognitive Neuroscience, Neuro-X Institute & Brain Mind Institute, Faculty of Life Sciences, Ecole Polytechnique Fédérale de Lausanne, Geneva, Switzerland; Department of Clinical Neuroscience, Geneva University Hospital, Geneva, Switzerland
| | - Martin Dresler
- Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Jennifer Windt
- Monash Centre for Consciousness and Contemplative Studies, Melbourne, Australia; Monash University, Department of Philosophy, Melbourne, Australia
| | - Olaf Blanke
- Laboratory of Cognitive Neuroscience, Neuro-X Institute & Brain Mind Institute, Faculty of Life Sciences, Ecole Polytechnique Fédérale de Lausanne, Geneva, Switzerland; Department of Clinical Neuroscience, Geneva University Hospital, Geneva, Switzerland
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2
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Tononi G, Boly M, Cirelli C. Consciousness and sleep. Neuron 2024; 112:1568-1594. [PMID: 38697113 PMCID: PMC11105109 DOI: 10.1016/j.neuron.2024.04.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2024] [Revised: 04/04/2024] [Accepted: 04/10/2024] [Indexed: 05/04/2024]
Abstract
Sleep is a universal, essential biological process. It is also an invaluable window on consciousness. It tells us that consciousness can be lost but also that it can be regained, in all its richness, when we are disconnected from the environment and unable to reflect. By considering the neurophysiological differences between dreaming and dreamless sleep, we can learn about the substrate of consciousness and understand why it vanishes. We also learn that the ongoing state of the substrate of consciousness determines the way each experience feels regardless of how it is triggered-endogenously or exogenously. Dreaming consciousness is also a window on sleep and its functions. Dreams tell us that the sleeping brain is remarkably lively, recombining intrinsic activation patterns from a vast repertoire, freed from the requirements of ongoing behavior and cognitive control.
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Affiliation(s)
- Giulio Tononi
- Department of Psychiatry, University of Wisconsin, Madison, WI 53719, USA.
| | - Melanie Boly
- Department of Neurology, University of Wisconsin, Madison, WI 53719, USA
| | - Chiara Cirelli
- Department of Psychiatry, University of Wisconsin, Madison, WI 53719, USA
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3
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Ruby P, Evangelista E, Bastuji H, Peter-Derex L. From physiological awakening to pathological sleep inertia: Neurophysiological and behavioural characteristics of the sleep-to-wake transition. Neurophysiol Clin 2024; 54:102934. [PMID: 38394921 DOI: 10.1016/j.neucli.2023.102934] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2023] [Revised: 12/07/2023] [Accepted: 12/08/2023] [Indexed: 02/25/2024] Open
Abstract
Sleep inertia refers to the transient physiological state of hypoarousal upon awakening, associated with various degrees of impaired neurobehavioral performance, confusion, a desire to return to sleep and often a negative emotional state. Scalp and intracranial electro-encephalography as well as functional imaging studies have provided evidence that the sleep inertia phenomenon is underpinned by an heterogenous cerebral state mixing local sleep and local wake patterns of activity, at the neuronal and network levels. Sleep inertia is modulated by homeostasis and circadian processes, sleep stage upon awakening, and individual factors; this translates into a huge variability in its intensity even under physiological conditions. In sleep disorders, especially in hypersomnolence disorders such as idiopathic hypersomnia, sleep inertia may be a daily, serious and long-lasting symptom leading to severe impairment. To date, few tools have been developed to assess sleep inertia in clinical practice. They include mainly questionnaires and behavioral tests such as the psychomotor vigilance task. Only one neurophysiological protocol has been evaluated in hypersomnia, the forced awakening test which is based on an event-related potentials paradigm upon awakening. This contrasts with the major functional consequences of sleep inertia and its potentially dangerous consequences in subjects required to perform safety-critical tasks soon after awakening. There is a great need to identify reproducible biomarkers correlated with sleep inertia-associated cognitive and behavioral impairment. These biomarkers will aim at better understanding and measuring sleep inertia in physiological and pathological conditions, as well as objectively evaluating wake-promoting treatments or non-pharmacological countermeasures to reduce this phenomenon.
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Affiliation(s)
- Perrine Ruby
- Lyon Neuroscience Research Centre, INSERM U1028, CNRS UMR 5292, Lyon, France
| | - Elisa Evangelista
- Sleep disorder Unit, Carémeau Hospital, Centre Hospitalo-universitaire de Nîmes, France; Institute for Neurosciences of Montpellier INM, Univ Montpellier, INSERM, Montpellier, France
| | - Hélène Bastuji
- Lyon Neuroscience Research Centre, INSERM U1028, CNRS UMR 5292, Lyon, France; Centre for Sleep Medicine and Respiratory Diseases, Croix-Rousse Hospital, Hospices Civils de Lyon, Lyon 1 University, Lyon, France
| | - Laure Peter-Derex
- Lyon Neuroscience Research Centre, INSERM U1028, CNRS UMR 5292, Lyon, France; Centre for Sleep Medicine and Respiratory Diseases, Croix-Rousse Hospital, Hospices Civils de Lyon, Lyon 1 University, Lyon, France.
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4
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Coenen A. Sensory gating and gaining in sleep: the balance between the protection of sleep and the safeness of life (a review). J Sleep Res 2024:e14152. [PMID: 38286435 DOI: 10.1111/jsr.14152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2023] [Revised: 11/28/2023] [Accepted: 01/10/2024] [Indexed: 01/31/2024]
Abstract
Sleep is a brain state characterised by a low vigilance level and diminished consciousness. Reaction to and processing of external stimuli is attenuated in sleep. During sleep, the reticular thalamic nucleus reduces the flow of sensory activity to the cerebral cortex through inhibition of the thalamus. This sensory gating process facilitates sleep. After reaching the afferent layers of primary cortex, the reduced sensory flow is adjusted, gained, and processed within various cortical layers before being transferred by the corticofugal system back to appropriate subdivisions of the thalamus as feedback. Thalamic subdivisions then dispatch this sensory information to related areas of the cerebral cortex, where it is (sub)consciously perceived. When necessary, a sleeping individual can be awakened by a wake-up call, either by stimuli indicating danger, or by personally meaningful stimuli. It is safe for a sleeping individual that it can be aroused when necessary. Evidently, there are two processes by which the brain adjusts the response to sensory stimuli before entering (sub)consciousness. Firstly 'sensory gating', a process favourable to the maintenance of sleep by reducing the sensory input to the brain through the reticular thalamic nucleus and secondly 'sensory gaining', a process implying that the gained preserved sensory input is continuously analysed by the corticofugal system to detect dangerous and relevant environmental elements, indispensable for safeness and well-being of the sleeper.
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Affiliation(s)
- Anton Coenen
- Department of Biological Psychology, Donders Centre for Cognition, Radboud University, Nijmegen, The Netherlands
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5
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Andrillon T, Oudiette D. What is sleep exactly? Global and local modulations of sleep oscillations all around the clock. Neurosci Biobehav Rev 2023; 155:105465. [PMID: 37972882 DOI: 10.1016/j.neubiorev.2023.105465] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Revised: 09/29/2023] [Accepted: 11/10/2023] [Indexed: 11/19/2023]
Abstract
Wakefulness, non-rapid eye-movement (NREM) and rapid eye-movement (REM) sleep differ from each other along three dimensions: behavioral, phenomenological, physiological. Although these dimensions often fluctuate in step, they can also dissociate. The current paradigm that views sleep as made of global NREM and REM states fail to account for these dissociations. This conundrum can be dissolved by stressing the existence and significance of the local regulation of sleep. We will review the evidence in animals and humans, healthy and pathological brains, showing different forms of local sleep and the consequences on behavior, cognition, and subjective experience. Altogether, we argue that the notion of local sleep provides a unified account for a host of phenomena: dreaming in REM and NREM sleep, NREM and REM parasomnias, intrasleep responsiveness, inattention and mind wandering in wakefulness. Yet, the physiological origins of local sleep or its putative functions remain unclear. Exploring further local sleep could provide a unique and novel perspective on how and why we sleep.
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Affiliation(s)
- Thomas Andrillon
- Paris Brain Institute, Sorbonne Université, Inserm-CNRS, Paris 75013, France; Monash Centre for Consciousness & Contemplative Studies, Monash University, Melbourne, VIC 3800, Australia.
| | - Delphine Oudiette
- Paris Brain Institute, Sorbonne Université, Inserm-CNRS, Paris 75013, France
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Postnov D, Semyachkina-Glushkovskaya O, Litvinenko E, Kurths J, Penzel T. Mechanisms of Activation of Brain's Drainage during Sleep: The Nightlife of Astrocytes. Cells 2023; 12:2667. [PMID: 37998402 PMCID: PMC10670149 DOI: 10.3390/cells12222667] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2023] [Revised: 11/09/2023] [Accepted: 11/15/2023] [Indexed: 11/25/2023] Open
Abstract
The study of functions, mechanisms of generation, and pathways of movement of cerebral fluids has a long history, but the last decade has been especially productive. The proposed glymphatic hypothesis, which suggests a mechanism of the brain waste removal system (BWRS), caused an active discussion on both the criticism of some of the perspectives and our intensive study of new experimental facts. It was especially found that the intensity of the metabolite clearance changes significantly during the transition between sleep and wakefulness. Interestingly, at the cellular level, a number of aspects of this problem have been focused on, such as astrocytes-glial cells, which, over the past two decades, have been recognized as equal partners of neurons and perform many important functions. In particular, an important role was assigned to astrocytes within the framework of the glymphatic hypothesis. In this review, we return to the "astrocytocentric" view of the BWRS function and the explanation of its activation during sleep from the viewpoint of new findings over the last decade. Our main conclusion is that the BWRS's action may be analyzed both at the systemic (whole-brain) and at the local (cellular) level. The local level means here that the neuro-glial-vascular unit can also be regarded as the smallest functional unit of sleep, and therefore, the smallest functional unit of the BWRS.
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Affiliation(s)
- Dmitry Postnov
- Department of Optics and Biophotonics, Saratov State University, Astrakhanskaya Str. 83, 410012 Saratov, Russia;
| | - Oxana Semyachkina-Glushkovskaya
- Department of Biology, Saratov State University, Astrakhanskaya Str. 83, 410012 Saratov, Russia; (O.S.-G.); (J.K.)
- Physics Department, Humboldt University, Newtonstrasse 15, 12489 Berlin, Germany
| | - Elena Litvinenko
- Department of Optics and Biophotonics, Saratov State University, Astrakhanskaya Str. 83, 410012 Saratov, Russia;
| | - Jürgen Kurths
- Department of Biology, Saratov State University, Astrakhanskaya Str. 83, 410012 Saratov, Russia; (O.S.-G.); (J.K.)
- Physics Department, Humboldt University, Newtonstrasse 15, 12489 Berlin, Germany
- Potsdam Institute for Climate Impact Research, Telegrafenberg A31, 14473 Potsdam, Germany
| | - Thomas Penzel
- Department of Biology, Saratov State University, Astrakhanskaya Str. 83, 410012 Saratov, Russia; (O.S.-G.); (J.K.)
- Charité — Universitätsmedizin Berlin, Charitéplatz 1, 10117 Berlin, Germany
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7
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Brazhe A, Verisokin A, Verveyko D, Postnov D. Astrocytes: new evidence, new models, new roles. Biophys Rev 2023; 15:1303-1333. [PMID: 37975000 PMCID: PMC10643736 DOI: 10.1007/s12551-023-01145-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Accepted: 09/08/2023] [Indexed: 11/19/2023] Open
Abstract
Astrocytes have been in the limelight of active research for about 3 decades now. Over this period, ideas about their function and role in the nervous system have evolved from simple assistance in energy supply and homeostasis maintenance to a complex informational and metabolic hub that integrates data on local neuronal activity, sensory and arousal context, and orchestrates many crucial processes in the brain. Rapid progress in experimental techniques and data analysis produces a growing body of data, which can be used as a foundation for formulation of new hypotheses, building new refined mathematical models, and ultimately should lead to a new level of understanding of the contribution of astrocytes to the cognitive tasks performed by the brain. Here, we highlight recent progress in astrocyte research, which we believe expands our understanding of how low-level signaling at a cellular level builds up to processes at the level of the whole brain and animal behavior. We start our review with revisiting data on the role of noradrenaline-mediated astrocytic signaling in locomotion, arousal, sensory integration, memory, and sleep. We then briefly review astrocyte contribution to the regulation of cerebral blood flow regulation, which is followed by a discussion of biophysical mechanisms underlying astrocyte effects on different brain processes. The experimental section is closed by an overview of recent experimental techniques available for modulation and visualization of astrocyte dynamics. We then evaluate how the new data can be potentially incorporated into the new mathematical models or where and how it already has been done. Finally, we discuss an interesting prospect that astrocytes may be key players in important processes such as the switching between sleep and wakefulness and the removal of toxic metabolites from the brain milieu.
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Affiliation(s)
- Alexey Brazhe
- Department of Biophysics, Biological Faculty, Lomonosov Moscow State University, Leninskie Gory, 1/24, Moscow, 119234 Russia
- Department of Molecular Neurobiology, Institute of Bioorganic Chemistry RAS, GSP-7, Miklukho-Maklay Str., 16/10, Moscow, 117997 Russia
| | - Andrey Verisokin
- Department of Theoretical Physics, Kursk State University, Radishcheva st., 33, Kursk, 305000 Russia
| | - Darya Verveyko
- Department of Theoretical Physics, Kursk State University, Radishcheva st., 33, Kursk, 305000 Russia
| | - Dmitry Postnov
- Department of Optics and Biophotonics, Saratov State University, Astrakhanskaya st., 83, Saratov, 410012 Russia
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8
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Huijben IAM, Hermans LWA, Rossi AC, Overeem S, van Gilst MM, van Sloun RJG. Interpretation and further development of the hypnodensity representation of sleep structure. Physiol Meas 2023; 44. [PMID: 36595329 DOI: 10.1088/1361-6579/aca641] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Accepted: 11/25/2022] [Indexed: 11/27/2022]
Abstract
Objective.The recently-introduced hypnodensity graph provides a probability distribution over sleep stages per data window (i.e. an epoch). This work explored whether this representation reveals continuities that can only be attributed to intra- and inter-rater disagreement of expert scorings, or also to co-occurrence of sleep stage-dependent features within one epoch.Approach.We proposed a simplified model for time series like the ones measured during sleep, and a second model to describe the annotation process by an expert. Generating data according to these models, enabled controlled experiments to investigate the interpretation of the hypnodensity graph. Moreover, the influence of both the supervised training strategy, and the used softmax non-linearity were investigated. Polysomnography recordings of 96 healthy sleepers (of which 11 were used as independent test set), were subsequently used to transfer conclusions to real data.Main results.A hypnodensity graph, predicted by a supervised neural classifier, represents the probability with which the sleep expert(s) assigned a label to an epoch. It thus reflects annotator behavior, and is thereby only indirectly linked to the ratio of sleep stage-dependent features in the epoch. Unsupervised training was shown to result in hypnodensity graph that were slightly less dependent on this annotation process, resulting in, on average, higher-entropy distributions over sleep stages (Hunsupervised= 0.41 versusHsupervised= 0.29). Moreover, pre-softmax predictions were, for both training strategies, found to better reflect the ratio of sleep stage-dependent characteristics in an epoch, as compared to the post-softmax counterparts (i.e. the hypnodensity graph). In real data, this was observed from the linear relation between pre-softmax N3 predictions and the amount of delta power.Significance.This study provides insights in, and proposes new, representations of sleep that may enhance our comprehension about sleep and sleep disorders.
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Affiliation(s)
- Iris A M Huijben
- Dept. of Electrical Engineering, Eindhoven University of Technology, 5612 AP Eindhoven, The Netherlands.,Onera Health, 5617 BD Eindhoven, The Netherlands
| | - Lieke W A Hermans
- Dept. of Electrical Engineering, Eindhoven University of Technology, 5612 AP Eindhoven, The Netherlands
| | | | - Sebastiaan Overeem
- Dept. of Electrical Engineering, Eindhoven University of Technology, 5612 AP Eindhoven, The Netherlands.,Sleep Medicine Center Kempenhaeghe, 5591 VE Heeze, The Netherlands
| | - Merel M van Gilst
- Dept. of Electrical Engineering, Eindhoven University of Technology, 5612 AP Eindhoven, The Netherlands.,Sleep Medicine Center Kempenhaeghe, 5591 VE Heeze, The Netherlands
| | - Ruud J G van Sloun
- Dept. of Electrical Engineering, Eindhoven University of Technology, 5612 AP Eindhoven, The Netherlands
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9
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Pinggal E, Dockree PM, O'Connell RG, Bellgrove MA, Andrillon T. Pharmacological Manipulations of Physiological Arousal and Sleep-Like Slow Waves Modulate Sustained Attention. J Neurosci 2022; 42:8113-8124. [PMID: 36109167 PMCID: PMC9637000 DOI: 10.1523/jneurosci.0836-22.2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2022] [Revised: 08/25/2022] [Accepted: 08/29/2022] [Indexed: 11/21/2022] Open
Abstract
Sustained attention describes our ability to keep a constant focus on a given task. This ability is modulated by our physiological state of arousal. Although lapses of sustained attention have been linked with dysregulations of arousal, the underlying physiological mechanisms remain unclear. An emerging body of work proposes that the intrusion during wakefulness of sleep-like slow waves, a marker of the transition toward sleep, could mechanistically account for attentional lapses. This study aimed to expose, via pharmacological manipulations of the monoamine system, the relationship between the occurrence of sleep-like slow waves and the behavioral consequences of sustained attention failures. In a double-blind, randomized-control trial, 32 healthy human male participants received methylphenidate, atomoxetine, citalopram or placebo during four separate experimental sessions. During each session, electroencephalography (EEG) was used to measure neural activity while participants completed a visual task requiring sustained attention. Methylphenidate, which increases wake-promoting dopamine and noradrenaline across cortical and subcortical areas, improved behavioral performance whereas atomoxetine, which increases dopamine and noradrenaline predominantly over frontal cortices, led to more impulsive responses. Additionally, citalopram, which increases sleep-promoting serotonin, led to more missed trials. Based on EEG recording, citalopram was also associated with an increase in sleep-like slow waves. Importantly, compared with a classical marker of arousal such as α power, only slow waves differentially predicted both misses and faster responses in a region-specific fashion. These results suggest that a decrease in arousal can lead to local sleep intrusions during wakefulness which could be mechanistically linked to impulsivity and sluggishness.SIGNIFICANCE STATEMENT We investigated whether the modulation of attention and arousal could not only share the same neuromodulatory pathways but also rely on similar neuronal mechanisms; for example, the intrusion of sleep-like activity within wakefulness. To do so, we pharmacologically manipulated noradrenaline, dopamine, and serotonin in a four-arm, randomized, placebo-controlled trial and examined the consequences on behavioral and electroencephalography (EEG) indices of attention and arousal. We showed that sleep-like slow waves can predict opposite behavioral signatures: impulsivity and sluggishness. Slow waves may be a candidate mechanism for the occurrence of attentional lapses since the relationship between slow-wave occurrence and performance is region-specific and the consequences of these local sleep intrusions are in line with the cognitive functions carried by the underlying brain regions.
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Affiliation(s)
- Elaine Pinggal
- School of Psychological Sciences, Turner Institute for Brain and Mental Health, Monash University, Melbourne, Victoria 3168, Australia
| | - Paul M Dockree
- Trinity College Institute of Neuroscience and School of Psychology, Trinity College Dublin, Dublin D02 PN40, Ireland
| | - Redmond G O'Connell
- Trinity College Institute of Neuroscience and School of Psychology, Trinity College Dublin, Dublin D02 PN40, Ireland
| | - Mark A Bellgrove
- School of Psychological Sciences, Turner Institute for Brain and Mental Health, Monash University, Melbourne, Victoria 3168, Australia
| | - Thomas Andrillon
- School of Philosophical, Historical, and International Studies, Centre for Consciousness and Contemplative Studies, Monash University, Melbourne, Victoria 3168, Australia
- Paris Brain Institute, Sorbonne Université, Institut National de la Santé et de la Recherche Médicale-Centre National de la Recherche Scientifique, Paris 75013, France
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10
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Szabó JP, Fabó D, Pető N, Sákovics A, Bódizs R. Role of anterior thalamic circuitry during sleep. Epilepsy Res 2022; 186:106999. [DOI: 10.1016/j.eplepsyres.2022.106999] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Revised: 07/22/2022] [Accepted: 08/10/2022] [Indexed: 12/01/2022]
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11
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Mainieri G, Loddo G, Castelnovo A, Balella G, Cilea R, Mondini S, Manconi M, Provini F. EEG Activation Does Not Differ in Simple and Complex Episodes of Disorders of Arousal: A Spectral Analysis Study. Nat Sci Sleep 2022; 14:1097-1111. [PMID: 35698590 PMCID: PMC9188335 DOI: 10.2147/nss.s360120] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Accepted: 05/24/2022] [Indexed: 11/23/2022] Open
Abstract
Purpose Disorders of arousal (DoA) are characterized by incomplete awakening from NREM sleep, with the admixture of both deep sleep and wake EEG activity. Previous observations suggested that changes in EEG activity could be detected in the seconds preceding DoA episodes. The aims of this work were to characterize the topography of EEG spectral changes prior to DoA episodes and to investigate whether or not behavioral complexity could be predicted by changes in EEG immediately preceding behavioral onsets. Patients and Methods We collected 103 consecutive video-polysomnographic recordings of 53 DoA adult patients and classified all episodes as simple, rising and complex arousal movements. For each episode, a 5-second window preceding its motor onset ("pre-event") and a 60-second window from 2 to 3 minutes before the episodes ("baseline") were compared. Subsequently, a between-group comparison was performed for the pre-event of simpler versus the more complex episodes. Results Spectral analysis over 325 DoA episodes showed an absolute significant increase prior to DoA episodes in all frequency bands excluding sigma, which displayed the opposite effect. In normalized maps, the increase was relatively higher over the central/anterior areas for both slow and fast frequency bands. No significant differences emerged from the comparison between simpler and more complex episodes. Conclusion Taken together, these results show that deep sleep and wake-like EEG rhythms coexist over overlapping areas before DoA episodes, suggesting an alteration of local sleep mechanisms. Episodes of different complexity are preceded by a similar EEG activation, implying that they possibly share a similar pathophysiology.
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Affiliation(s)
- Greta Mainieri
- Department of Biomedical and NeuroMotor Sciences, University of Bologna, Bologna, Italy
| | - Giuseppe Loddo
- Department of Primary Care, Azienda AUSL di Bologna, Bologna, Italy
| | - Anna Castelnovo
- Sleep Medicine Unit, Neurocenter of Southern Switzerland, Lugano, Switzerland
- Faculty of Biomedical Sciences, Università della Svizzera Italiana, Lugano, Switzerland
- University Hospital of Psychiatry, University of Bern, Bern, Switzerland
| | - Giulia Balella
- Department of Biomedical and NeuroMotor Sciences, University of Bologna, Bologna, Italy
| | - Rosalia Cilea
- Neurology Unit, “Morgagni-Pierantoni” Hospital, AUSL Romagna, Forlì, Italy
| | - Susanna Mondini
- IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italia
| | - Mauro Manconi
- Sleep Medicine Unit, Neurocenter of Southern Switzerland, Lugano, Switzerland
- Faculty of Biomedical Sciences, Università della Svizzera Italiana, Lugano, Switzerland
- Department of Neurology, University Hospital, Inselspital, Bern, Switzerland
| | - Federica Provini
- Department of Biomedical and NeuroMotor Sciences, University of Bologna, Bologna, Italy
- IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italia
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12
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Fitzroy AB, Kainec KA, Spencer RMC. Ageing-related changes in nap neuroscillatory activity are mediated and moderated by grey matter volume. Eur J Neurosci 2021; 54:7332-7354. [PMID: 34541728 PMCID: PMC8809479 DOI: 10.1111/ejn.15468] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Revised: 08/14/2021] [Accepted: 09/10/2021] [Indexed: 12/03/2022]
Abstract
Ageing‐related changes in grey matter result in changes in the intensity and topography of sleep neural activity. However, it is unclear whether these findings can be explained by ageing‐related differences in sleep pressure or circadian influence. The current study used high‐density electroencephalography to assess how grey matter volume differences between young and older adults mediate and moderate neuroscillatory activity differences during a midday nap following a motor sequencing task. Delta, theta, and sigma amplitude were reduced in older relative to young adults, especially over frontocentral scalp, leading to increases in relative delta frontality and relative sigma lateral centroposteriority. Delta reductions in older adults were mediated by grey matter loss in frontal medial cortex, primary motor cortex, thalamus, caudate, putamen, and pallidum, and were moderated by putamen grey matter volume. Theta reductions were mediated by grey matter loss in primary motor cortex, thalamus, and caudate, and were moderated by putamen and pallidum grey matter volume. Sigma changes were moderated by putamen and pallidum grey matter volume. Moderation results suggested that across frequencies, young adults with more grey matter had increased activity, whereas older adults with more grey matter had unchanged or decreased activity. These results provide a critical extension of previous findings from overnight sleep in a midday nap, indicating that they are not driven by sleep pressure or circadian confounds. Moreover, these results suggest brain regions associated with motor sequence learning contribute to sleep neural activity following a motor sequencing task.
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Affiliation(s)
- Ahren B Fitzroy
- Neuroscience and Behavior Program, University of Massachusetts Amherst, Amherst, MA, USA.,Department of Psychological and Brain Sciences, University of Massachusetts Amherst, Amherst, MA, USA
| | - Kyle A Kainec
- Neuroscience and Behavior Program, University of Massachusetts Amherst, Amherst, MA, USA.,Department of Psychological and Brain Sciences, University of Massachusetts Amherst, Amherst, MA, USA
| | - Rebecca M C Spencer
- Neuroscience and Behavior Program, University of Massachusetts Amherst, Amherst, MA, USA.,Department of Psychological and Brain Sciences, University of Massachusetts Amherst, Amherst, MA, USA.,Institute for Applied Life Sciences, University of Massachusetts Amherst, Amherst, MA, USA
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13
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Ochab JK, Szwed J, Oleś K, Bereś A, Chialvo DR, Domagalik A, Fąfrowicz M, Ogińska H, Gudowska-Nowak E, Marek T, Nowak MA. Observing changes in human functioning during induced sleep deficiency and recovery periods. PLoS One 2021; 16:e0255771. [PMID: 34469434 PMCID: PMC8409667 DOI: 10.1371/journal.pone.0255771] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Accepted: 07/25/2021] [Indexed: 11/18/2022] Open
Abstract
Prolonged periods of sleep restriction seem to be common in the contemporary world. Sleep loss causes perturbations of circadian rhythmicity and degradation of waking alertness as reflected in attention, cognitive efficiency and memory. Understanding whether and how the human brain recovers from chronic sleep loss is important not only from a scientific but also from a public health perspective. In this work we report on behavioral, motor, and neurophysiological correlates of sleep loss in healthy adults in an unprecedented study conducted in natural conditions and comprising 21 consecutive days divided into periods of 4 days of regular life (a baseline), 10 days of chronic partial sleep restriction (30% reduction relative to individual sleep need) and 7 days of recovery. Throughout the whole experiment we continuously measured the spontaneous locomotor activity by means of actigraphy with 1-minute resolution. On a daily basis the subjects were undergoing EEG measurements (64-electrodes with 500 Hz sampling frequency): resting state with eyes open and closed (8 minutes long each) followed by Stroop task lasting 22 minutes. Altogether we analyzed actigraphy (distributions of rest and activity durations), behavioral measures (reaction times and accuracy from Stroop task) and EEG (amplitudes, latencies and scalp maps of event-related potentials from Stroop task and power spectra from resting states). We observed unanimous deterioration in all the measures during sleep restriction. Further results indicate that a week of recovery subsequent to prolonged periods of sleep restriction is insufficient to recover fully. Only one measure (mean reaction time in Stroop task) reverted to baseline values, while the others did not.
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Affiliation(s)
- Jeremi K. Ochab
- Institute of Theoretical Physics, Jagiellonian University, Kraków, Poland
- M. Kac Complex Systems Research Center, Jagiellonian University, Kraków, Poland
| | - Jerzy Szwed
- Institute of Theoretical Physics, Jagiellonian University, Kraków, Poland
- M. Kac Complex Systems Research Center, Jagiellonian University, Kraków, Poland
| | - Katarzyna Oleś
- Institute of Theoretical Physics, Jagiellonian University, Kraków, Poland
| | - Anna Bereś
- Department of Cognitive Neuroscience and Neuroergonomics, Jagiellonian University, Kraków, Poland
| | - Dante R. Chialvo
- Center for Complex Systems & Brain Sciences (CEMSC3), Universidad Nacional de San Martín, Buenos Aires, Argentina
- Consejo Nacional de Investigaciones Científicas y Tecnológicas (CONICET), Buenos Aires, Argentina
| | - Aleksandra Domagalik
- Department of Cognitive Neuroscience and Neuroergonomics, Jagiellonian University, Kraków, Poland
| | - Magdalena Fąfrowicz
- Department of Cognitive Neuroscience and Neuroergonomics, Jagiellonian University, Kraków, Poland
| | - Halszka Ogińska
- Department of Cognitive Neuroscience and Neuroergonomics, Jagiellonian University, Kraków, Poland
| | - Ewa Gudowska-Nowak
- Institute of Theoretical Physics, Jagiellonian University, Kraków, Poland
- Małopolska Center of Biotechnology, Jagiellonian University, Kraków, Poland
| | - Tadeusz Marek
- Department of Cognitive Neuroscience and Neuroergonomics, Jagiellonian University, Kraków, Poland
- Małopolska Center of Biotechnology, Jagiellonian University, Kraków, Poland
| | - Maciej A. Nowak
- Institute of Theoretical Physics, Jagiellonian University, Kraków, Poland
- M. Kac Complex Systems Research Center, Jagiellonian University, Kraków, Poland
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14
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Abstract
Electroencephalogram (EEG) recording is essential in the evaluation of complex movement and behaviors during sleep, but in particular for differentiating epileptic versus nonepileptic events. In general, epileptiform discharges occur with greater density in the first few nonerapid eye movement cycles, and approximately 12% to 20% of seizures occur exclusively at night. This review examines the epilepsy types and syndromes whose presentation is strongly influenced by the sleep state, with an appraisal about the role that sleep plays in facilitating seizures, while deleaneatign EEG findings and clinical manifestation. The review will summarize the typical semiology of sleep-related hypermotor seizures and contrasted with those occurring during none/rapid eye movement parasomnias and sleep-related movement disorders.
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Affiliation(s)
- Ting Wu
- Ronald Reagan Medical Center, David Geffen School of Medicine at UCLA, 710 Westwood Plaza, Room 1-240, Los Angeles, CA 90095, USA
| | - Alon Y Avidan
- UCLA Sleep Disorders Center, UCLA Department of Neurology, David Geffen School of Medicine at UCLA, 710 Westwood Boulevard, RNRC, C153, Mail Code 176919, Los Angeles, CA, USA.
| | - Jerome Engel
- UCLA Seizure Disorder Center, Brain Research Institute, David Geffen School of Medicine at UCLA, 10833 Le Conte Avenue, Los Angeles, CA 90095, USA
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15
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Peter-Derex L. Beyond the waves: what does the EEG still hold a century after H. Berger ? Sleep 2021; 44:6316215. [PMID: 34228798 DOI: 10.1093/sleep/zsab165] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Affiliation(s)
- Laure Peter-Derex
- Center for Sleep Medicine and Respiratory Diseases, Lyon University Hospital, Lyon 1 University, Lyon, France.,Lyon Neuroscience Research Center, CNRS UMR 5292, INSERM U1028 - PAM team, Lyon, France
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16
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Geiser T, Hertenstein E, Fehér K, Maier JG, Schneider CL, Züst MA, Wunderlin M, Mikutta C, Klöppel S, Nissen C. Targeting Arousal and Sleep through Noninvasive Brain Stimulation to Improve Mental Health. Neuropsychobiology 2021; 79:284-292. [PMID: 32408296 DOI: 10.1159/000507372] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2020] [Accepted: 03/14/2020] [Indexed: 01/29/2023]
Abstract
Arousal and sleep represent fundamental physiological domains, and alterations in the form of insomnia (difficulty falling or staying asleep) or hypersomnia (increased propensity for falling asleep or increased sleep duration) are prevalent clinical problems. Current first-line treatments include psychotherapy and pharmacotherapy. Despite significant success, a number of patients do not benefit sufficiently. Progress is limited by an incomplete understanding of the -neurobiology of insomnia and hypersomnia. This work summarizes current concepts of the regulation of arousal and sleep and its modulation through noninvasive brain stimulation (NIBS), including transcranial magnetic, current, and auditory stimulation. Particularly, we suggest: (1) characterization of patients with sleep problems - across diagnostic entities of mental disorders - based on specific alterations of sleep, including alterations of sleep slow waves, sleep spindles, cross-frequency coupling of brain oscillations, local sleep-wake regulation, and REM sleep and (2) targeting these with specific NIBS techniques. While evidence is accumulating that the modulation of specific alterations of sleep through NIBS is feasible, it remains to be tested whether this translates to clinically relevant effects and new treatment developments.
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Affiliation(s)
- Tim Geiser
- University Hospital of Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Elisabeth Hertenstein
- University Hospital of Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Kristoffer Fehér
- University Hospital of Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Jonathan G Maier
- University Hospital of Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Carlotta L Schneider
- University Hospital of Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Marc A Züst
- University Hospital of Old Age Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Marina Wunderlin
- University Hospital of Old Age Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Christian Mikutta
- University Hospital of Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland.,Privatklinik Meiringen, Meiringen, Switzerland
| | - Stefan Klöppel
- University Hospital of Old Age Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Christoph Nissen
- University Hospital of Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland,
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17
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Russo S, Pigorini A, Mikulan E, Sarasso S, Rubino A, Zauli FM, Parmigiani S, d'Orio P, Cattani A, Francione S, Tassi L, Bassetti CLA, Lo Russo G, Nobili L, Sartori I, Massimini M. Focal lesions induce large-scale percolation of sleep-like intracerebral activity in awake humans. Neuroimage 2021; 234:117964. [PMID: 33771696 DOI: 10.1016/j.neuroimage.2021.117964] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Revised: 02/15/2021] [Accepted: 03/08/2021] [Indexed: 11/26/2022] Open
Abstract
Focal cortical lesions are known to result in large-scale functional alterations involving distant areas; however, little is known about the electrophysiological mechanisms underlying these network effects. Here, we addressed this issue by analysing the short and long distance intracranial effects of controlled structural lesions in humans. The changes in Stereo-Electroencephalographic (SEEG) activity after Radiofrequency-Thermocoagulation (RFTC) recorded in 21 epileptic subjects were assessed with respect to baseline resting wakefulness and sleep activity. In addition, Cortico-Cortical Evoked Potentials (CCEPs) recorded before the lesion were employed to interpret these changes with respect to individual long-range connectivity patterns. We found that small structural ablations lead to the generation and large-scale propagation of sleep-like slow waves within the awake brain. These slow waves match those recorded in the same subjects during sleep, are prevalent in perilesional areas, but can percolate up to distances of 60 mm through specific long-range connections, as predicted by CCEPs. Given the known impact of slow waves on information processing and cortical plasticity, demonstrating their intrusion and percolation within the awake brain add key elements to our understanding of network dysfunction after cortical injuries.
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Affiliation(s)
- S Russo
- Department of Biomedical and Clinical Sciences "L. Sacco", University of Milan, Milan, Italy
| | - A Pigorini
- Department of Biomedical and Clinical Sciences "L. Sacco", University of Milan, Milan, Italy
| | - E Mikulan
- Department of Biomedical and Clinical Sciences "L. Sacco", University of Milan, Milan, Italy
| | - S Sarasso
- Department of Biomedical and Clinical Sciences "L. Sacco", University of Milan, Milan, Italy
| | - A Rubino
- "C. Munari" Epilepsy Surgery Centre, Department of Neuroscience, Niguarda Hospital, Milan 20162, Italy
| | - F M Zauli
- Department of Biomedical and Clinical Sciences "L. Sacco", University of Milan, Milan, Italy
| | - S Parmigiani
- Department of Biomedical and Clinical Sciences "L. Sacco", University of Milan, Milan, Italy
| | - P d'Orio
- "C. Munari" Epilepsy Surgery Centre, Department of Neuroscience, Niguarda Hospital, Milan 20162, Italy; Institute of Neuroscience, CNR, via Volturno 39E, 43125 Parma, Italy
| | - A Cattani
- Department of Biomedical and Clinical Sciences "L. Sacco", University of Milan, Milan, Italy; Department of Psychiatry, University of Wisconsin-Madison, Madison, WI, 53719, USA
| | - S Francione
- "C. Munari" Epilepsy Surgery Centre, Department of Neuroscience, Niguarda Hospital, Milan 20162, Italy
| | - L Tassi
- "C. Munari" Epilepsy Surgery Centre, Department of Neuroscience, Niguarda Hospital, Milan 20162, Italy
| | - C L A Bassetti
- Department of Neurology, Inselspital, University of Bern, Switzerland
| | - G Lo Russo
- "C. Munari" Epilepsy Surgery Centre, Department of Neuroscience, Niguarda Hospital, Milan 20162, Italy
| | - L Nobili
- Child Neuropsychiatry, IRCCS Istituto G. Gaslini, Genova 16147, Italy; Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DiNOGMI), University of Genoa, Genoa, Italy
| | - I Sartori
- "C. Munari" Epilepsy Surgery Centre, Department of Neuroscience, Niguarda Hospital, Milan 20162, Italy
| | - M Massimini
- Department of Biomedical and Clinical Sciences "L. Sacco", University of Milan, Milan, Italy; IRCCS, Fondazione Don Carlo Gnocchi, Milan 20148, Italy; Azrieli Program in Brain, Mind and Consciousness, Canadian Institute for Advanced Research, Toronto, Canada.
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18
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Wood C, Bianchi MT, Yun CH, Shin C, Thomas RJ. Multicomponent Analysis of Sleep Using Electrocortical, Respiratory, Autonomic and Hemodynamic Signals Reveals Distinct Features of Stable and Unstable NREM and REM Sleep. Front Physiol 2020; 11:592978. [PMID: 33343390 PMCID: PMC7744633 DOI: 10.3389/fphys.2020.592978] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2020] [Accepted: 11/13/2020] [Indexed: 12/05/2022] Open
Abstract
A new concept of non-rapid eye movement (NREM) and rapid eye movement (REM) sleep is proposed, that of multi-component integrative states that define stable and unstable sleep, respectively, NREMS, NREMUS REMS, and REMUS. Three complementary data sets are used: obstructive sleep apnea (20), healthy subjects (11), and high loop gain sleep apnea (50). We use polysomnography (PSG) with beat-to-beat blood pressure monitoring, and electrocardiogram (ECG)-derived cardiopulmonary coupling (CPC) analysis to demonstrate a bimodal, rather than graded, characteristic of NREM sleep. Stable NREM (NREMS) is characterized by high probability of occurrence of the <1 Hz slow oscillation, high delta power, stable breathing, blood pressure dipping, strong sinus arrhythmia and vagal dominance, and high frequency CPC. Conversely, unstable NREM (NREMUS) has the opposite features: a fragmented and discontinuous <1 Hz slow oscillation, non-dipping of blood pressure, unstable respiration, cyclic variation in heart rate, and low frequency CPC. The dimension of NREM stability raises the possibility of a comprehensive integrated multicomponent network model of NREM sleep which captures sleep onset (e.g., ventrolateral preoptic area-based sleep switch) processes, synaptic homeostatic delta power kinetics, and the interaction of global and local sleep processes as reflected in the spatiotemporal evolution of cortical “UP” and “DOWN” states, while incorporating the complex dynamics of autonomic-respiratory-hemodynamic systems during sleep. Bimodality of REM sleep is harder to discern in health. However, individuals with combined obstructive and central sleep apnea allows ready recognition of REMS and REMUS (stable and unstable REM sleep, respectively), especially when there is a discordance of respiratory patterns in relation to conventional stage of sleep.
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Affiliation(s)
- Christopher Wood
- Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA, United States
| | - Matt Travis Bianchi
- Division of Sleep Medicine, Department of Neurology, Massachusetts General Hospital, Boston, MA, United States
| | - Chang-Ho Yun
- Department of Neurology, Bundang Clinical Neuroscience Center, Seoul National University Bundang Hospital, Seongnam, South Korea
| | - Chol Shin
- Division of Pulmonary, Sleep and Critical Care Medicine, Department of Internal Medicine, Korea University Ansan Hospital, Ansan, South Korea
| | - Robert Joseph Thomas
- Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA, United States
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19
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Sarasso S, Zubler F, Pigorini A, Sartori I, Castana L, Nobili L. Thalamic and neocortical differences in the relationship between the time course of delta and sigma power during NREM sleep in humans. J Sleep Res 2020; 30:e13166. [PMID: 32830381 DOI: 10.1111/jsr.13166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2020] [Revised: 06/14/2020] [Accepted: 07/22/2020] [Indexed: 11/28/2022]
Abstract
Sleep spindles and slow waves are the hallmarks of non-rapid eye movement (NREM) sleep and are produced by the dynamic interplay between thalamic and cortical regions. Several studies in both human and animal models have focused their attention on the relationship between electroencephalographic (EEG) spindles and slow waves during NREM, using the power in the sigma and delta bands as a surrogate for the production of spindles and slow waves. A typical report is an overall inverse relationship between the time course of sigma and delta power as measured by a single correlation coefficient both within and across NREM episodes. Here we analysed stereotactically implanted intracerebral electrode (Stereo-EEG [SEEG]) recordings during NREM simultaneously acquired from thalamic and from several neocortical sites in six neurosurgical patients. We investigated the relationship between the time course of delta and sigma power and found that, although at the cortical level it shows the expected inverse relationship, these two frequency bands follow a parallel time course at the thalamic level. Both these observations were consistent across patients and across different cortical as well as thalamic regions. These different temporal dynamics at the neocortical and thalamic level are discussed, considering classical as well as more recent interpretations of the neurophysiological determinants of sleep spindles and slow waves. These findings may also help understanding the regulatory mechanisms of these fundamental sleep EEG graphoelements across different brain compartments.
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Affiliation(s)
- Simone Sarasso
- Dipartimento di Scienze Biomediche e Cliniche ''L. Sacco'', Università degli Studi di Milano, Milan, Italy
| | - Frederic Zubler
- Sleep-Wake-Epilepsy Center, Department of Neurology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Andrea Pigorini
- Dipartimento di Scienze Biomediche e Cliniche ''L. Sacco'', Università degli Studi di Milano, Milan, Italy
| | - Ivana Sartori
- Claudio Munari" Centre for Epilepsy Surgery, Niguarda Hospital, Milan, Italy
| | - Laura Castana
- Claudio Munari" Centre for Epilepsy Surgery, Niguarda Hospital, Milan, Italy
| | - Lino Nobili
- Department of Neuroscience (DINOGMI), University of Genoa, Genoa, Italy.,Child Neuropsychiatry Unit, IRCCS Giannina Gaslini Institute, Genoa, Italy
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20
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Comanducci A, Boly M, Claassen J, De Lucia M, Gibson RM, Juan E, Laureys S, Naccache L, Owen AM, Rosanova M, Rossetti AO, Schnakers C, Sitt JD, Schiff ND, Massimini M. Clinical and advanced neurophysiology in the prognostic and diagnostic evaluation of disorders of consciousness: review of an IFCN-endorsed expert group. Clin Neurophysiol 2020; 131:2736-2765. [PMID: 32917521 DOI: 10.1016/j.clinph.2020.07.015] [Citation(s) in RCA: 96] [Impact Index Per Article: 24.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2019] [Revised: 07/06/2020] [Accepted: 07/26/2020] [Indexed: 12/13/2022]
Abstract
The analysis of spontaneous EEG activity and evoked potentialsis a cornerstone of the instrumental evaluation of patients with disorders of consciousness (DoC). Thepast few years have witnessed an unprecedented surge in EEG-related research applied to the prediction and detection of recovery of consciousness after severe brain injury,opening up the prospect that new concepts and tools may be available at the bedside. This paper provides a comprehensive, critical overview of bothconsolidated and investigational electrophysiological techniquesfor the prognostic and diagnostic assessment of DoC.We describe conventional clinical EEG approaches, then focus on evoked and event-related potentials, and finally we analyze the potential of novel research findings. In doing so, we (i) draw a distinction between acute, prolonged and chronic phases of DoC, (ii) attempt to relate both clinical and research findings to the underlying neuronal processes and (iii) discuss technical and conceptual caveats.The primary aim of this narrative review is to bridge the gap between standard and emerging electrophysiological measures for the detection and prediction of recovery of consciousness. The ultimate scope is to provide a reference and common ground for academic researchers active in the field of neurophysiology and clinicians engaged in intensive care unit and rehabilitation.
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Affiliation(s)
- A Comanducci
- IRCCS Fondazione Don Carlo Gnocchi, Milan, Italy
| | - M Boly
- Department of Neurology and Department of Psychiatry, University of Wisconsin, Madison, USA; Wisconsin Institute for Sleep and Consciousness, Department of Psychiatry, University of Wisconsin-Madison, Madison, USA
| | - J Claassen
- Department of Neurology, Columbia University Medical Center, New York Presbyterian Hospital, New York, NY, USA
| | - M De Lucia
- Laboratoire de Recherche en Neuroimagerie, Department of Clinical Neurosciences, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - R M Gibson
- The Brain and Mind Institute and the Department of Physiology and Pharmacology, Western Interdisciplinary Research Building, N6A 5B7 University of Western Ontario, London, Ontario, Canada
| | - E Juan
- Wisconsin Institute for Sleep and Consciousness, Department of Psychiatry, University of Wisconsin-Madison, Madison, USA; Amsterdam Brain and Cognition, Department of Psychology, University of Amsterdam, Amsterdam, the Netherlands
| | - S Laureys
- Coma Science Group, Centre du Cerveau, GIGA-Consciousness, University and University Hospital of Liège, 4000 Liège, Belgium; Fondazione Europea per la Ricerca Biomedica Onlus, Milan 20063, Italy
| | - L Naccache
- Inserm U 1127, CNRS UMR 7225, Institut du Cerveau et de la Moelle épinière, ICM, Paris, France; Sorbonne Université, UPMC Université Paris 06, Faculté de Médecine Pitié-Salpêtrière, Paris, France
| | - A M Owen
- The Brain and Mind Institute and the Department of Physiology and Pharmacology, Western Interdisciplinary Research Building, N6A 5B7 University of Western Ontario, London, Ontario, Canada
| | - M Rosanova
- Department of Biomedical and Clinical Sciences "L. Sacco", University of Milan, Milan, Italy; Fondazione Europea per la Ricerca Biomedica Onlus, Milan 20063, Italy
| | - A O Rossetti
- Neurology Service, Department of Clinical Neurosciences, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - C Schnakers
- Research Institute, Casa Colina Hospital and Centers for Healthcare, Pomona, CA, USA
| | - J D Sitt
- Inserm U 1127, CNRS UMR 7225, Institut du Cerveau et de la Moelle épinière, ICM, Paris, France
| | - N D Schiff
- Feil Family Brain and Mind Research Institute, Weill Cornell Medical College, 1300 York Avenue, New York, NY 10065, USA
| | - M Massimini
- IRCCS Fondazione Don Carlo Gnocchi, Milan, Italy; Department of Biomedical and Clinical Sciences "L. Sacco", University of Milan, Milan, Italy
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21
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Rapid fast-delta decay following prolonged wakefulness marks a phase of wake-inertia in NREM sleep. Nat Commun 2020; 11:3130. [PMID: 32561733 PMCID: PMC7305232 DOI: 10.1038/s41467-020-16915-0] [Citation(s) in RCA: 42] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2019] [Accepted: 05/30/2020] [Indexed: 11/25/2022] Open
Abstract
Sleep-wake driven changes in non-rapid-eye-movement sleep (NREM) sleep (NREMS) EEG delta (δ-)power are widely used as proxy for a sleep homeostatic process. Here, we noted frequency increases in δ-waves in sleep-deprived mice, prompting us to re-evaluate how slow-wave characteristics relate to prior sleep-wake history. We identified two classes of δ-waves; one responding to sleep deprivation with high initial power and fast, discontinuous decay during recovery sleep (δ2) and another unrelated to time-spent-awake with slow, linear decay (δ1). Reanalysis of previously published datasets demonstrates that δ-band heterogeneity after sleep deprivation is also present in human subjects. Similar to sleep deprivation, silencing of centromedial thalamus neurons boosted subsequent δ2-waves, specifically. δ2-dynamics paralleled that of temperature, muscle tone, heart rate, and neuronal ON-/OFF-state lengths, all reverting to characteristic NREMS levels within the first recovery hour. Thus, prolonged waking seems to necessitate a physiological recalibration before typical NREMS can be reinstated. Changes in EEG delta-activity are widely used as proxy of sleep propensity. Here the authors demonstrate in mice and humans the presence of two types of delta-waves, only one of which reports on prior sleep-wake history with dynamics denoting a wake-inertia process accompanying deepest non-rapid-eye-movement sleep (NREM) sleep.
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22
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Andrillon T, Kouider S. The vigilant sleeper: neural mechanisms of sensory (de)coupling during sleep. CURRENT OPINION IN PHYSIOLOGY 2020. [DOI: 10.1016/j.cophys.2019.12.002] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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23
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Petrovic J, Radovanovic L, Saponjic J. Diversity of simultaneous sleep in the motor cortex and hippocampus in rats. J Sleep Res 2020; 30:e13090. [PMID: 32472657 DOI: 10.1111/jsr.13090] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Revised: 04/28/2020] [Accepted: 04/30/2020] [Indexed: 11/26/2022]
Abstract
We investigated the homogeneity/heterogeneity of spontaneous sleep, simultaneously recorded in the motor cortex and the hippocampus of control rats, and particularly analysed simultaneous and non-simultaneous motor cortical and hippocampal non-rapid eye movement (NREM)/rapid eye movement (REM) sleep. We demonstrate that the sleep architectures of the motor cortex and hippocampus are different in control rats. There was an increase of NREM duration and a decrease of REM duration in the hippocampus versus the motor cortex. In terms of duration, NREM state is the most heterogeneous in the hippocampus, whereas the REM state is the most heterogeneous in the motor cortex. Whereas the hippocampal NREM duration was increased due to the prolongation of NREM episodes, the hippocampal REM duration decreased due to the decreased number of REM episodes. The heterogeneity of sleep in the motor cortex and hippocampus in control rats was particularly expressed through the inverse alteration of sigma amplitude during NREM sleep and beta/gamma amplitudes during REM sleep in the hippocampus, along with the delta, sigma, beta and gamma amplitudes only during non-simultaneous NREM/REM sleep in the hippocampus. We demonstrated the brain structure-related and NREM/REM state-related heterogeneity of the motor cortical and hippocampal local sleep in control rats. The distinctly altered local NREM/REM states, alongside their episode dynamics and electroencephalographic (EEG) microstructures, suggest the importance of both the local neuronal network substrate and the NREM/REM neurochemical substrate in the control mechanisms of sleep.
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Affiliation(s)
- Jelena Petrovic
- Department of Neurobiology, Institute for Biological Research "Sinisa Stankovic" - National Institute of Republic of Serbia, University of Belgrade, Belgrade, Serbia
| | - Ljiljana Radovanovic
- Department of Neurobiology, Institute for Biological Research "Sinisa Stankovic" - National Institute of Republic of Serbia, University of Belgrade, Belgrade, Serbia
| | - Jasna Saponjic
- Department of Neurobiology, Institute for Biological Research "Sinisa Stankovic" - National Institute of Republic of Serbia, University of Belgrade, Belgrade, Serbia
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24
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Zakharov AV, Poverennova IE, Kalinin VA, Khivintseva EV. Parasomnias Associated with Disordered Arousal from Slow-Wave Sleep: Mechanism of Occurrence and Neurophysiological Characteristics. ACTA ACUST UNITED AC 2020. [DOI: 10.1007/s11055-020-00897-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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25
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Adamantidis AR, Gutierrez Herrera C, Gent TC. Oscillating circuitries in the sleeping brain. Nat Rev Neurosci 2019; 20:746-762. [DOI: 10.1038/s41583-019-0223-4] [Citation(s) in RCA: 76] [Impact Index Per Article: 15.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/04/2019] [Indexed: 12/20/2022]
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Andrillon T, Windt J, Silk T, Drummond SPA, Bellgrove MA, Tsuchiya N. Does the Mind Wander When the Brain Takes a Break? Local Sleep in Wakefulness, Attentional Lapses and Mind-Wandering. Front Neurosci 2019; 13:949. [PMID: 31572112 PMCID: PMC6753166 DOI: 10.3389/fnins.2019.00949] [Citation(s) in RCA: 47] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2019] [Accepted: 08/22/2019] [Indexed: 01/18/2023] Open
Abstract
Sleep has been classically described as an all-or-nothing global phenomenon. However, recent research strongly suggests that this view requires tempering. Invasive and non-invasive recordings in animals and humans show that neural activity typically associated with sleep can locally occur during wakefulness. Although local sleep is defined neuronally, it has been associated with impaired performance during cognitive tasks. Comparatively, the phenomenology of local sleep (i.e., what it feels like when your brain is partially asleep) has been less explored. Taking into account the literature on the neuronal and behavioral profile of local sleep intrusions in wakefulness, we propose that occurrences of local sleep could represent the neural mechanism underlying many attentional lapses. In particular, we argue that a unique physiological event such as local sleep could account for a diversity of behavioral outcomes from sluggish to impulsive responses. We further propose that local sleep intrusions could impact individuals' subjective experience. Specifically, we propose that the timing and anatomical sources of local sleep intrusions could be responsible for both the behavioral consequences and subjective content of attentional lapses and may underlie the difference between subjective experiences such as mind wandering and mind blanking. Our framework aims to build a parallel between spontaneous experiences in sleep and wakefulness by integrating evidence across neuronal, behavioral and experiential levels. We use the example of attention deficit hyperactivity disorder (ADHD) to illustrate how local sleep could explain complex cognitive profiles which include inattention, impulsivity, mind-wandering and mind-blanking.
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Affiliation(s)
- Thomas Andrillon
- School of Psychological Sciences, Turner Institute for Brain and Mental Health, Monash University, Melbourne, VIC, Australia
| | - Jennifer Windt
- School of Philosophical, Historical and International Studies, Monash University, Melbourne, VIC, Australia
| | - Tim Silk
- School of Psychology, Deakin University, Melbourne, VIC, Australia
- Murdoch Children’s Research Institute, Melbourne, VIC, Australia
- Department of Paediatrics, University of Melbourne, Melbourne, VIC, Australia
| | - Sean P. A. Drummond
- School of Psychological Sciences, Turner Institute for Brain and Mental Health, Monash University, Melbourne, VIC, Australia
| | - Mark A. Bellgrove
- School of Psychological Sciences, Turner Institute for Brain and Mental Health, Monash University, Melbourne, VIC, Australia
| | - Naotsugu Tsuchiya
- School of Psychological Sciences, Turner Institute for Brain and Mental Health, Monash University, Melbourne, VIC, Australia
- Center for Information and Neural Networks (CiNet), National Institute of Information and Communications Technology (NICT), Osaka, Japan
- Advanced Telecommunications Research Computational Neuroscience Laboratories, Kyoto, Japan
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Castelnovo A, Lopez R, Proserpio P, Nobili L, Dauvilliers Y. NREM sleep parasomnias as disorders of sleep-state dissociation. Nat Rev Neurol 2019; 14:470-481. [PMID: 29959394 DOI: 10.1038/s41582-018-0030-y] [Citation(s) in RCA: 100] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Non-rapid eye movement (NREM) sleep parasomnias (or NREM parasomnias) are fascinating disorders with mysterious neurobiological substrates. These conditions are common and often severe, with social, personal and forensic implications. The NREM parasomnias include sleepwalking, sleep terrors and confusional arousals - collectively termed disorders of arousal (DOAs) - as well as less well-known entities such as sleep-related sexual behaviours and eating disorders. Affected patients can exhibit waking behaviours arising abruptly out of NREM sleep. Although the individual remains largely unresponsive to the external environment, their EEG shows both typical sleep-like and wake-like features, and they occasionally report dreaming afterwards. Therefore, these disorders offer a unique natural model to explore the abnormal coexistence of local sleep and wake brain activity and the dissociation between behaviour and various aspects of consciousness. In this article, we critically review major findings and updates on DOAs, focusing on neurophysiological studies, and offer an overview of new clinical frontiers and promising future research areas. We advocate a joint effort to inform clinicians and the general public about the management and follow-up of these conditions. We also strongly encourage collaborative multicentre studies to add more objective polysomnographic criteria to the current official diagnostic definitions and to develop clinical practice guidelines, multidisciplinary research approaches and evidence-based medical care.
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Affiliation(s)
- Anna Castelnovo
- Center for Sleep and Consciousness, Department of Psychiatry, University of Wisconsin-Madison, Madison, WI, USA.,Sleep and Epilepsy Center, Neurocenter of Southern Switzerland, Civic Hospital of Lugano, Lugano, Switzerland
| | - Régis Lopez
- Reference National Center for Narcolepsy-Hypersomnia, Sleep Unit, Department of Neurology, Gui-de-Chauliac Hospital, CHU Montpellier, Montpellier, France
| | - Paola Proserpio
- Claudio Munari Center for Epilepsy Surgery, Niguarda Hospital, Milan, Italy
| | - Lino Nobili
- Claudio Munari Center for Epilepsy Surgery, Niguarda Hospital, Milan, Italy. .,Department of Neuroscience, DINOGMI, University of Genoa, Genoa, Italy.
| | - Yves Dauvilliers
- Reference National Center for Narcolepsy-Hypersomnia, Sleep Unit, Department of Neurology, Gui-de-Chauliac Hospital, CHU Montpellier, Montpellier, France.
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Miano S, Amato N, Foderaro G, Pezzoli V, Ramelli GP, Toffolet L, Manconi M. Sleep phenotypes in attention deficit hyperactivity disorder. Sleep Med 2019; 60:123-131. [PMID: 30377038 DOI: 10.1016/j.sleep.2018.08.026] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2018] [Revised: 07/27/2018] [Accepted: 08/06/2018] [Indexed: 01/17/2023]
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Miano S, Amato N, Garbazza C, Abbafati M, Foderaro G, Pezzoli V, Ramelli GP, Manconi M. Shooting a high-density electroencephalographic picture on sleep in children with attention-deficit/hyperactivity disorder. Sleep 2019; 42:5540162. [DOI: 10.1093/sleep/zsz167] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2018] [Revised: 05/28/2019] [Indexed: 02/04/2023] Open
Abstract
Abstract
Study Objectives
Sleep-related slow-wave activity (SWA) has been recognized as a marker of synaptic plasticity. In children affected by attention deficit hyperactivity disorder (ADHD), SWA is mainly located in the central rather than frontal regions, reflecting a maturational delay. A detailed subjective and objective sleep investigation, including a full night video-polysomnography (PSG-HD-EEG), was performed on 30 consecutive drug naïve outpatients with a diagnosis of ADHD. They received a diagnosis of sleep disorders in 29/30 cases, and most of them had a past history of sleep problems. They had a higher apnea–hypopnea index at PSG, and slept less than 9 hr at actigraphy. We aimed to describe the SWA behavior in the same group of children with ADHD.
Materials and Methods
The full-night PSG-HD EEG of children with ADHD was compared with the one of the 25 healthy controls. The scalp SWA mapping, the decrease of SWA during the night, and the EEG source of SWA were analyzed.
Results
At scalp topography, the focus of SWA was observed over the centro–parietal–occipital regions in participants with ADHD (p < 0.01), which remained significant in the subgroups divided between subgroups according to the sleep diagnosis (p < 0.01). The physiological decrease in SWA was more evident in control participants. The source analysis revealed a greater delta power over the posterior cingulate in participants with ADHD (p < 0.01).
Conclusions
Our results confirm static and dynamic changes in SWA behavior in children with ADHD, which may reflect a maturational delay occurring at a vulnerable age, as a consequence of chronic sleep deprivation.
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Affiliation(s)
- Silvia Miano
- Sleep Center, Neurocenter of Southern Switzerland, Civic Hospital of Lugano (EOC), Lugano, Switzerland
| | - Ninfa Amato
- Sleep Center, Neurocenter of Southern Switzerland, Civic Hospital of Lugano (EOC), Lugano, Switzerland
| | - Corrado Garbazza
- Sleep Center, Neurocenter of Southern Switzerland, Civic Hospital of Lugano (EOC), Lugano, Switzerland
| | - Manuel Abbafati
- Sleep Center, Neurocenter of Southern Switzerland, Civic Hospital of Lugano (EOC), Lugano, Switzerland
| | - Giuseppe Foderaro
- Department of Pediatrics, Civic Hospital of Lugano, Lugano, Switzerland
| | - Valdo Pezzoli
- Department of Pediatrics, Civic Hospital of Lugano, Lugano, Switzerland
| | - Gian Paolo Ramelli
- Department of Pediatrics, San Giovanni Hospital, Bellinzona, Switzerland
| | - Mauro Manconi
- Sleep Center, Neurocenter of Southern Switzerland, Civic Hospital of Lugano (EOC), Lugano, Switzerland
- Department of Neurology, University Hospital, Inselspital, Bern, Switzerland
- Faculty of Biomedical Sciences, University of Southern Switzerland, Lugano, Switzerland
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Hertig-Godeschalk A, Skorucak J, Malafeev A, Achermann P, Mathis J, Schreier DR. Microsleep episodes in the borderland between wakefulness and sleep. Sleep 2019; 43:5536744. [DOI: 10.1093/sleep/zsz163] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2018] [Revised: 05/16/2019] [Indexed: 11/14/2022] Open
Abstract
AbstractStudy objectivesThe wake-sleep transition zone represents a poorly defined borderland, containing, for example, microsleep episodes (MSEs), which are of potential relevance for diagnosis and may have consequences while driving. Yet, the scoring guidelines of the American Academy of Sleep Medicine (AASM) completely neglect it. We aimed to explore the borderland between wakefulness and sleep by developing the Bern continuous and high-resolution wake-sleep (BERN) criteria for visual scoring, focusing on MSEs visible in the electroencephalography (EEG), as opposed to purely behavior- or performance-defined MSEs.MethodsMaintenance of Wakefulness Test (MWT) trials of 76 randomly selected patients were retrospectively scored according to both the AASM and the newly developed BERN scoring criteria. The visual scoring was compared with spectral analysis of the EEG. The quantitative EEG analysis enabled a reliable objectification of the visually scored MSEs. For less distinct episodes within the borderland, either ambiguous or no quantitative patterns were found.ResultsAs expected, the latency to the first MSE was significantly shorter in comparison to the sleep latency, defined according to the AASM criteria. In certain cases, a large difference between the two latencies was observed and a substantial number of MSEs occurred between the first MSE and sleep. Series of MSEs were more frequent in patients with shorter sleep latencies, while isolated MSEs were more frequent in patients who did not reach sleep.ConclusionThe BERN criteria extend the AASM criteria and represent a valuable tool for in-depth analysis of the wake-sleep transition zone, particularly important in the MWT.
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Affiliation(s)
- Anneke Hertig-Godeschalk
- Department of Neurology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
- Graduate School for Health Sciences, University of Bern, Bern, Switzerland
| | - Jelena Skorucak
- Institute of Pharmacology and Toxicology, University of Zurich, Zurich, Switzerland
- Neuroscience Center Zurich, University of Zurich and ETH Zurich, Zurich, Switzerland
- Sleep and Health Zurich, University of Zurich, Zurich, Switzerland
| | - Alexander Malafeev
- Institute of Pharmacology and Toxicology, University of Zurich, Zurich, Switzerland
- Neuroscience Center Zurich, University of Zurich and ETH Zurich, Zurich, Switzerland
| | - Peter Achermann
- Institute of Pharmacology and Toxicology, University of Zurich, Zurich, Switzerland
- Neuroscience Center Zurich, University of Zurich and ETH Zurich, Zurich, Switzerland
- Sleep and Health Zurich, University of Zurich, Zurich, Switzerland
- KEY Institute for Brain Mind Research, Department of Psychiatry, Psychotherapy and Psychosomatics, University Hospital of Psychiatry, Zurich, Switzerland
| | - Johannes Mathis
- Department of Neurology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - David R Schreier
- Department of Neurology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
- Graduate School for Health Sciences, University of Bern, Bern, Switzerland
- Department of Medicine, Spital STS AG Thun, Thun, Switzerland
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Desjardins MÈ, Baril AA, Soucy JP, Dang-Vu TT, Desautels A, Petit D, Montplaisir J, Zadra A. Altered brain perfusion patterns in wakefulness and slow-wave sleep in sleepwalkers. Sleep 2019. [PMID: 29514303 DOI: 10.1093/sleep/zsy039] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Study Objectives The present study assessed brain perfusion patterns with single-photon emission computed tomography (SPECT) during sleepwalkers' post-sleep deprivation slow-wave sleep (SWS) and resting-state wakefulness. Methods Following a 24 hr period of sleep deprivation, 10 sleepwalkers and 10 sex- and age-matched controls were scanned with a high-resolution SPECT scanner. Participants were injected with 99mTc-ethylene cysteinate dimer after 2 min of stable SWS within their first sleep cycle as well as during resting-state wakefulness, both after a subsequent 24 hr period of sleep deprivation. Results When compared with controls' brain perfusion patterns during both SWS and resting-state wakefulness, sleepwalkers showed reduced regional cerebral perfusion in several bilateral frontal regions, including the superior frontal, middle frontal, and medial frontal gyri. Moreover, reduced regional cerebral perfusion was also found in sleepwalkers' left postcentral gyrus, insula, and superior temporal gyrus during SWS compared with controls. During resting-state wakefulness compared with controls, reduced cerebral perfusion was also found in parietal and temporal regions of sleepwalkers' left hemisphere, whereas the right parahippocampal gyrus showed increased regional cerebral perfusion. Conclusions Our results reveal patterns of reduced regional cerebral perfusion in sleepwalkers' frontal and parietal areas when compared with controls, regions previously associated with SWS generation and episode occurrence. Additionally, reduced perfusion in the dorsolateral prefrontal cortex and insula during recovery SWS is consistent with the clinical features of somnambulistic episodes, including impaired awareness and reduced pain perception. Altered regional cerebral perfusion patterns during sleepwalkers' resting-state wakefulness may be related to daytime functional anomalies in this population.
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Affiliation(s)
- Marie-Ève Desjardins
- Center for Advanced Research in Sleep Medicine, Hôpital du Sacré-Cœur de Montréal, Montreal, Canada.,Department of Psychology, Université de Montréal, Montreal, Canada
| | - Andrée-Ann Baril
- Center for Advanced Research in Sleep Medicine, Hôpital du Sacré-Cœur de Montréal, Montreal, Canada.,Faculty of Medicine, Université de Montréal, Montreal, Canada
| | - Jean-Paul Soucy
- PERFORM Centre, Concordia University, Montreal, Canada.,McConnell Brain Imaging Centre, Montreal Neurological Institute, McGill University, Montreal, Canada
| | - Thien Thanh Dang-Vu
- PERFORM Centre, Concordia University, Montreal, Canada.,Center for Studies in Behavioral Neurobiology, Concordia University, Montreal, Canada.,Centre de Recherche de l'Institut Universitaire de Gériatrie de Montréal and Department of Neurosciences, Université de Montréal, Montreal, Canada
| | - Alex Desautels
- Center for Advanced Research in Sleep Medicine, Hôpital du Sacré-Cœur de Montréal, Montreal, Canada.,Faculty of Medicine, Université de Montréal, Montreal, Canada
| | - Dominique Petit
- Center for Advanced Research in Sleep Medicine, Hôpital du Sacré-Cœur de Montréal, Montreal, Canada.,Faculty of Medicine, Université de Montréal, Montreal, Canada
| | - Jacques Montplaisir
- Center for Advanced Research in Sleep Medicine, Hôpital du Sacré-Cœur de Montréal, Montreal, Canada.,Faculty of Medicine, Université de Montréal, Montreal, Canada
| | - Antonio Zadra
- Center for Advanced Research in Sleep Medicine, Hôpital du Sacré-Cœur de Montréal, Montreal, Canada.,Department of Psychology, Université de Montréal, Montreal, Canada
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Gorlova S, Ichiba T, Nishimaru H, Takamura Y, Matsumoto J, Hori E, Nagashima Y, Tatsuse T, Ono T, Nishijo H. Non-restorative Sleep Caused by Autonomic and Electroencephalography Parameter Dysfunction Leads to Subjective Fatigue at Wake Time in Shift Workers. Front Neurol 2019; 10:66. [PMID: 30804882 PMCID: PMC6370690 DOI: 10.3389/fneur.2019.00066] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2018] [Accepted: 01/17/2019] [Indexed: 01/06/2023] Open
Abstract
Sleep is a physiological state that plays important role in the recovery of fatigue. However, the relationship between the physiological status of sleep and subjective fatigue remains unknown. In the present study, we hypothesized that the non-recovery of fatigue at wake time due to non-restorative sleep might be ascribed to changes in specific parameters of electroencephalography (EEG) and heart rate variability (HRV) in poor sleepers. Twenty healthy female shift-working nurses participated in the study. Subjective fatigue was assessed using the visual analog scale (VAS) at bedtime and wake time. During sleep on the night between 2 consecutive day shifts, the EEG powers at the frontal pole, HRV based on electrocardiograms, and distal-proximal gradient of skin temperature were recorded and analyzed. The results indicated that the subjects with high fatigue on the VAS at wake time exhibited (1) a decrease in deep non-rapid eye movement (NREM) (stageN3) sleep duration in the first sleep cycle; (2) a decrease in REM latency; (3) a decrease in ultra-slow and delta EEG powers, particularly from 30 to 65 min after sleep onset; (4) a decrease in the total power of HRV, particularly from 0 to 30 min after sleep onset; (5) an increase in the very low frequency component of HRV; and (6) a smaller increase in the distal-proximal gradient of skin temperature, than those of the subjects with low fatigue levels. The correlational and structural equation modeling analyses of these parameters suggested that an initial decrease in the total power of HRV from 0 to 30 min after sleep onset might inhibit the recovery from fatigue during sleep (i.e., increase the VAS score at wake time) via its effects on the ultra-slow and delta powers from 30 to 65 min after sleep onset, stageN3 duration in the first sleep cycle, REM latency, and distal-proximal gradient of skin temperature. These findings suggest an important role of these physiological factors in recovery from fatigue during sleep, and that interventions to modify these physiological factors might ameliorate fatigue at wake time.
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Affiliation(s)
- Sofya Gorlova
- System Emotional Science, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, Toyama, Japan
| | | | - Hiroshi Nishimaru
- System Emotional Science, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, Toyama, Japan
| | - Yusaku Takamura
- System Emotional Science, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, Toyama, Japan
| | - Jumpei Matsumoto
- System Emotional Science, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, Toyama, Japan
| | - Etsuro Hori
- System Emotional Science, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, Toyama, Japan
| | | | - Tsuyoshi Tatsuse
- Department of Epidemiology and Health Policy, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, Toyama, Japan
| | - Taketoshi Ono
- System Emotional Science, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, Toyama, Japan
| | - Hisao Nishijo
- System Emotional Science, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, Toyama, Japan
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Züst MA, Ruch S, Wiest R, Henke K. Implicit Vocabulary Learning during Sleep Is Bound to Slow-Wave Peaks. Curr Biol 2019; 29:541-553.e7. [DOI: 10.1016/j.cub.2018.12.038] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2018] [Revised: 09/25/2018] [Accepted: 12/20/2018] [Indexed: 01/13/2023]
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Choi H, Jeong J, Kim H, Shin C, Yoon IY. Implication of Fast Activities of Spectral Analysis in Subjective Sleep Complaints of Elderly Women. J Geriatr Psychiatry Neurol 2019; 32:24-30. [PMID: 30477382 DOI: 10.1177/0891988718813711] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE In elderly patients, women have better qualities of sleep than men in objective parameters; however, women subjectively complain more about sleep disturbances than men. We performed visual scoring and spectral analysis of sleep electroencephalograms to explain these gender differences in the degree of arousal, the most representative marker in insomnia. METHODS A total of 354 participants (≥60 years old) were recruited from a Korean community underwent nocturnal polysomnography (NPSG). A Fast Fourier transform was used for the spectral analysis of the NPSG data. Relative power was calculated as absolute power of each band divided by total absolute power. Difference in total sleep time (D_TST) is obtained by subtracting the total sleep time reported in Pittsburgh Sleep Quality Index (PSQI) from the TST measured by the NPSG. RESULTS A total of 75 participants (women, 51) were finally analyzed. Women had higher PSQI, longer sleep latencies, sleep inefficiencies, and daytime dysfunctions compared to men. The percentage of stage 1 sleep was higher in men versus in women, whereas percentage of stage 3 sleep was higher in women than in men ( P = .001; P = .001). Women had higher relative alpha and beta powers than men during nonrapid eye movement (NREM) sleep ( P = .017; P = .015). During NREM sleep, beta power was negatively correlated with D_TST ( R = -0.250, P = .033), and relative alpha power in stage 3 sleep was positively correlated with sleep latency in PSQI ( R = 0.267, P = .022). CONCLUSION Spectral analysis showed that women had more disturbed sleep than men. The result from the spectral analysis may explain hyperarousal in elderly women.
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Affiliation(s)
- Hayun Choi
- 1 Department of Psychiatry, Veteran Health Service Medical Center, Seoul, Republic of Korea
| | - Jahyun Jeong
- 2 Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam-si, Gyeonggi-do, Republic of Korea
| | - Heejun Kim
- 2 Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam-si, Gyeonggi-do, Republic of Korea
| | - Chuljin Shin
- 3 Department of Neuropsychiatry, Chungbuk National University School of Medicine, Cheongju, Chungbuk, Republic of Korea
| | - In-Young Yoon
- 2 Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam-si, Gyeonggi-do, Republic of Korea.,4 Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea
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Kokkinos V, Vulliémoz S, Koupparis AM, Koutroumanidis M, Kostopoulos GK, Lemieux L, Garganis K. A hemodynamic network involving the insula, the cingulate, and the basal forebrain correlates with EEG synchronization phases of sleep instability. Sleep 2018; 42:5253667. [DOI: 10.1093/sleep/zsy259] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2018] [Revised: 11/27/2018] [Indexed: 01/25/2023] Open
Affiliation(s)
- Vasileios Kokkinos
- Department of Neurological Surgery, School of Medicine, University of Pittsburgh, PA
- Epilepsy Center of Thessaloniki, St. Luke’s Hospital, Thessaloniki, Greece
- Neurophysiology Unit, Department of Physiology, Medical School, University of Patras, Greece
| | - Serge Vulliémoz
- Department of Clinical and Experimental Epilepsy, UCL Institute of Neurology, Queen Square, London, UK
- MRI Unit, Epilepsy Society, Chalfont St. Peter, UK
- EEG and Epilepsy Unit, Neurology, University Hospital and Faculty of Medicine, Geneva, Switzerland
| | - Andreas M Koupparis
- Neurophysiology Unit, Department of Physiology, Medical School, University of Patras, Greece
- Montreal Neurological Institute, McGill University, Montreal, Canada
| | - Michalis Koutroumanidis
- Department of Clinical Neurophysiology and Epilepsies, Guy’s, St. Thomas’ and Evelina Hospital for Children, NHS Foundation Trust, London, UK
- Department of Neuroscience, Institute of Psychiatry, Kings College London, UK
| | - George K Kostopoulos
- Neurophysiology Unit, Department of Physiology, Medical School, University of Patras, Greece
| | - Louis Lemieux
- Department of Clinical and Experimental Epilepsy, UCL Institute of Neurology, Queen Square, London, UK
- MRI Unit, Epilepsy Society, Chalfont St. Peter, UK
| | - Kyriakos Garganis
- Epilepsy Center of Thessaloniki, St. Luke’s Hospital, Thessaloniki, Greece
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36
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Olcese U, Oude Lohuis MN, Pennartz CMA. Sensory Processing Across Conscious and Nonconscious Brain States: From Single Neurons to Distributed Networks for Inferential Representation. Front Syst Neurosci 2018; 12:49. [PMID: 30364373 PMCID: PMC6193318 DOI: 10.3389/fnsys.2018.00049] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2018] [Accepted: 09/25/2018] [Indexed: 11/29/2022] Open
Abstract
Neuronal activity is markedly different across brain states: it varies from desynchronized activity during wakefulness to the synchronous alternation between active and silent states characteristic of deep sleep. Surprisingly, limited attention has been paid to investigating how brain states affect sensory processing. While it was long assumed that the brain was mostly disconnected from external stimuli during sleep, an increasing number of studies indicates that sensory stimuli continue to be processed across all brain states-albeit differently. In this review article, we first discuss what constitutes a brain state. We argue that-next to global, behavioral states such as wakefulness and sleep-there is a concomitant need to distinguish bouts of oscillatory dynamics with specific global/local activity patterns and lasting for a few hundreds of milliseconds, as these can lead to the same sensory stimulus being either perceived or not. We define these short-lasting bouts as micro-states. We proceed to characterize how sensory-evoked neural responses vary between conscious and nonconscious states. We focus on two complementary aspects: neuronal ensembles and inter-areal communication. First, we review which features of ensemble activity are conducive to perception, and how these features vary across brain states. Properties such as heterogeneity, sparsity and synchronicity in neuronal ensembles will especially be considered as essential correlates of conscious processing. Second, we discuss how inter-areal communication varies across brain states and how this may affect brain operations and sensory processing. Finally, we discuss predictive coding (PC) and the concept of multi-level representations as a key framework for understanding conscious sensory processing. In this framework the brain implements conscious representations as inferences about world states across multiple representational levels. In this representational hierarchy, low-level inference may be carried out nonconsciously, whereas high levels integrate across different sensory modalities and larger spatial scales, correlating with conscious processing. This inferential framework is used to interpret several cellular and population-level findings in the context of brain states, and we briefly compare its implications to two other theories of consciousness. In conclusion, this review article, provides foundations to guide future studies aiming to uncover the mechanisms of sensory processing and perception across brain states.
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Affiliation(s)
- Umberto Olcese
- Cognitive and Systems Neuroscience Group, Swammerdam Institute for Life Sciences, Faculty of Science, University of Amsterdam, Amsterdam, Netherlands
- Research Priority Area Brain and Cognition, University of Amsterdam, Amsterdam, Netherlands
| | - Matthijs N. Oude Lohuis
- Cognitive and Systems Neuroscience Group, Swammerdam Institute for Life Sciences, Faculty of Science, University of Amsterdam, Amsterdam, Netherlands
- Research Priority Area Brain and Cognition, University of Amsterdam, Amsterdam, Netherlands
| | - Cyriel M. A. Pennartz
- Cognitive and Systems Neuroscience Group, Swammerdam Institute for Life Sciences, Faculty of Science, University of Amsterdam, Amsterdam, Netherlands
- Research Priority Area Brain and Cognition, University of Amsterdam, Amsterdam, Netherlands
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37
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Gent TC, Bassetti CLA, Adamantidis AR. Sleep-wake control and the thalamus. Curr Opin Neurobiol 2018; 52:188-197. [PMID: 30144746 DOI: 10.1016/j.conb.2018.08.002] [Citation(s) in RCA: 80] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2018] [Accepted: 08/02/2018] [Indexed: 01/23/2023]
Abstract
Sleep is an essential component of animal behavior, controlled by both circadian and homeostatic processes. Typical brain oscillations for sleep and wake states are distinctive and reflect recurrent activity amongst neural circuits spanning localized to global brain regions. Since the original discovery of hypothalamic centers controlling both sleep and wakefulness, current views now implicate networks of neuronal and non-neuronal cells distributed brain-wide. Yet the mechanisms of sleep-wake control remain unclear. In light of recent studies, here we review experimental evidence from lesional, correlational, pharmacological and genetics studies, which support a role for the thalamus in several aspects of sleep-wake states. How these thalamo-cortical network mechanisms contribute to other executive functions such as memory consolidation and cognition, remains an open question with direct implications for neuro-psychiatric diseases and stands as a future challenge for basic science and healthcare research.
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Affiliation(s)
- Thomas C Gent
- Centre for Experimental Neurology, Department of Neurology, Inselspital University Hospital Bern, University of Bern, Bern, Switzerland
| | - Claudio LA Bassetti
- Centre for Experimental Neurology, Department of Neurology, Inselspital University Hospital Bern, University of Bern, Bern, Switzerland; Department of Biomedical Research, Inselspital University Hospital Bern, University of Bern, Bern, Switzerland
| | - Antoine R Adamantidis
- Centre for Experimental Neurology, Department of Neurology, Inselspital University Hospital Bern, University of Bern, Bern, Switzerland; Department of Biomedical Research, Inselspital University Hospital Bern, University of Bern, Bern, Switzerland.
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Absent sleep EEG spindle activity in GluA1 (Gria1) knockout mice: relevance to neuropsychiatric disorders. Transl Psychiatry 2018; 8:154. [PMID: 30108203 PMCID: PMC6092338 DOI: 10.1038/s41398-018-0199-2] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2017] [Revised: 06/03/2018] [Accepted: 06/11/2018] [Indexed: 12/31/2022] Open
Abstract
Sleep EEG spindles have been implicated in attention, sensory processing, synaptic plasticity and memory consolidation. In humans, deficits in sleep spindles have been reported in a wide range of neurological and psychiatric disorders, including schizophrenia. Genome-wide association studies have suggested a link between schizophrenia and genes associated with synaptic plasticity, including the Gria1 gene which codes for the GluA1 subunit of α-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid (AMPA) receptor. Gria1-/- mice exhibit a phenotype relevant for neuropsychiatric disorders, including reduced synaptic plasticity and, at the behavioural level, attentional deficits leading to aberrant salience. In this study we report a striking reduction of EEG power density including the spindle-frequency range (10-15 Hz) during sleep in Gria1-/- mice. The reduction of spindle-activity in Gria1-/- mice was accompanied by longer REM sleep episodes, increased EEG slow-wave activity in the occipital derivation during baseline sleep, and a reduced rate of decline of EEG slow wave activity (0.5-4 Hz) during NREM sleep after sleep deprivation. These data provide a novel link between glutamatergic dysfunction and sleep abnormalities in a schizophrenia-relevant mouse model.
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Quercia A, Zappasodi F, Committeri G, Ferrara M. Local Use-Dependent Sleep in Wakefulness Links Performance Errors to Learning. Front Hum Neurosci 2018; 12:122. [PMID: 29666574 PMCID: PMC5891895 DOI: 10.3389/fnhum.2018.00122] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2017] [Accepted: 03/12/2018] [Indexed: 01/10/2023] Open
Abstract
Sleep and wakefulness are no longer to be considered as discrete states. During wakefulness brain regions can enter a sleep-like state (off-periods) in response to a prolonged period of activity (local use-dependent sleep). Similarly, during nonREM sleep the slow-wave activity, the hallmark of sleep plasticity, increases locally in brain regions previously involved in a learning task. Recent studies have demonstrated that behavioral performance may be impaired by off-periods in wake in task-related regions. However, the relation between off-periods in wake, related performance errors and learning is still untested in humans. Here, by employing high density electroencephalographic (hd-EEG) recordings, we investigated local use-dependent sleep in wake, asking participants to repeat continuously two intensive spatial navigation tasks. Critically, one task relied on previous map learning (Wayfinding) while the other did not (Control). Behaviorally awake participants, who were not sleep deprived, showed progressive increments of delta activity only during the learning-based spatial navigation task. As shown by source localization, delta activity was mainly localized in the left parietal and bilateral frontal cortices, all regions known to be engaged in spatial navigation tasks. Moreover, during the Wayfinding task, these increments of delta power were specifically associated with errors, whose probability of occurrence was significantly higher compared to the Control task. Unlike the Wayfinding task, during the Control task neither delta activity nor the number of errors increased progressively. Furthermore, during the Wayfinding task, both the number and the amplitude of individual delta waves, as indexes of neuronal silence in wake (off-periods), were significantly higher during errors than hits. Finally, a path analysis linked the use of the spatial navigation circuits undergone to learning plasticity to off periods in wake. In conclusion, local sleep regulation in wakefulness, associated with performance failures, could be functionally linked to learning-related cortical plasticity.
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Affiliation(s)
- Angelica Quercia
- Department of Neuroscience, Imaging and Clinical Sciences, G. d'Annunzio University of Chieti-Pescara, Chieti, Italy
| | - Filippo Zappasodi
- Department of Neuroscience, Imaging and Clinical Sciences, G. d'Annunzio University of Chieti-Pescara, Chieti, Italy.,Institute for Advanced Biomedical Technologies (ITAB), G. d'Annunzio University of Chieti-Pescara, Chieti, Italy
| | - Giorgia Committeri
- Department of Neuroscience, Imaging and Clinical Sciences, G. d'Annunzio University of Chieti-Pescara, Chieti, Italy.,Institute for Advanced Biomedical Technologies (ITAB), G. d'Annunzio University of Chieti-Pescara, Chieti, Italy
| | - Michele Ferrara
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, Coppito, Italy
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40
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Desjardins MÈ, Carrier J, Lina JM, Fortin M, Gosselin N, Montplaisir J, Zadra A. EEG Functional Connectivity Prior to Sleepwalking: Evidence of Interplay Between Sleep and Wakefulness. Sleep 2017; 40:2991628. [PMID: 28204773 DOI: 10.1093/sleep/zsx024] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Study Objectives Although sleepwalking (somnambulism) affects up to 4% of adults, its pathophysiology remains poorly understood. Sleepwalking can be preceded by fluctuations in slow-wave sleep EEG signals, but the significance of these pre-episode changes remains unknown and methods based on EEG functional connectivity have yet to be used to better comprehend the disorder. Methods We investigated the sleep EEG of 27 adult sleepwalkers (mean age: 29 ± 7.6 years) who experienced a somnambulistic episode during slow-wave sleep. The 20-second segment of sleep EEG immediately preceding each patient's episode was compared with the 20-second segment occurring 2 minutes prior to episode onset. Results Results from spectral analyses revealed increased delta and theta spectral power in the 20 seconds preceding the episodes' onset as compared to the 20 seconds occurring 2 minutes before the episodes. The imaginary part of the coherence immediately prior to episode onset revealed (1) decreased delta EEG functional connectivity in parietal and occipital regions, (2) increased alpha connectivity over a fronto-parietal network, and (3) increased beta connectivity involving symmetric inter-hemispheric networks implicating frontotemporal, parietal and occipital areas. Conclusions Taken together, these modifications in EEG functional connectivity suggest that somnambulistic episodes are preceded by brain processes characterized by the co-existence of arousal and deep sleep.
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Affiliation(s)
- Marie-Ève Desjardins
- Center for Advanced Research in Sleep Medicine, Hôpital du Sacré-Cœur de Montréal, Montréal, Canada.,Department of Psychology, Université de Montréal, Montréal, Canada
| | - Julie Carrier
- Center for Advanced Research in Sleep Medicine, Hôpital du Sacré-Cœur de Montréal, Montréal, Canada.,Department of Psychology, Université de Montréal, Montréal, Canada
| | - Jean-Marc Lina
- Center for Advanced Research in Sleep Medicine, Hôpital du Sacré-Cœur de Montréal, Montréal, Canada.,École de technologie supérieure, Department of Electrical Engineering, Montréal, Canada
| | - Maxime Fortin
- Center for Advanced Research in Sleep Medicine, Hôpital du Sacré-Cœur de Montréal, Montréal, Canada.,Department of Psychology, Université du Québec à Montréal, Montréal, Canada
| | - Nadia Gosselin
- Center for Advanced Research in Sleep Medicine, Hôpital du Sacré-Cœur de Montréal, Montréal, Canada.,Department of Psychology, Université de Montréal, Montréal, Canada
| | - Jacques Montplaisir
- Center for Advanced Research in Sleep Medicine, Hôpital du Sacré-Cœur de Montréal, Montréal, Canada.,Department of Psychiatry, Université de Montréal, Montréal, Canada
| | - Antonio Zadra
- Center for Advanced Research in Sleep Medicine, Hôpital du Sacré-Cœur de Montréal, Montréal, Canada.,Department of Psychology, Université de Montréal, Montréal, Canada
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41
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Lambert I, Roehri N, Giusiano B, Carron R, Wendling F, Benar C, Bartolomei F. Brain regions and epileptogenicity influence epileptic interictal spike production and propagation during NREM sleep in comparison with wakefulness. Epilepsia 2017; 59:235-243. [PMID: 29205292 DOI: 10.1111/epi.13958] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/25/2017] [Indexed: 01/08/2023]
Abstract
OBJECTIVE Non-rapid eye movement (NREM) sleep is known to be a brain state associated with an activation of interictal epileptic activity. The goal of this work was to quantify topographic changes occurring during NREM sleep in comparison with wakefulness. METHOD We studied intracerebral recordings of 20 patients who underwent stereo-electroencephalography (SEEG) during presurgical evaluation for pharmacoresistant focal epilepsy. We measured the number of interictal spikes (IS) and quantified the co-occurrence of IS between brain regions during 1 hour of NREM sleep and 1 hour of wakefulness. Co-occurrence is a method to estimate IS networks based on a temporal concordance between IS of different brain regions. Each studied region was labeled as "seizure-onset zone" (SOZ), "propagation zone" (PZ), or "not involved region" (NIR). RESULTS During NREM sleep, the number of interictal spikes significantly increased in all regions (mean of 68%). This increase was higher in medial temporal regions than in other regions, whether involved in the SOZ. Spike co-occurrence increased significantly in all regions during NREM sleep in comparison with wakefulness but was greater in neocortical regions. Spike co-occurrence in medial temporal regions was not higher than in other regions, suggesting that the increase of the number of spikes in this region was in great part a local effect. SIGNIFICANCE This study demonstrated that medial temporal regions show a greater propensity to spike production or propagation during NREM sleep compared to other brain regions, even when the medial temporal lobe is not involved in the SOZ.
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Affiliation(s)
- Isabelle Lambert
- Inserm, INS, Institute of Neurosciences of Systems, Aix Marseille Univ, Marseille, France.,Clinical Neurophysiology, Timone Hospital, APHM, Marseille, France
| | - Nicolas Roehri
- Inserm, INS, Institute of Neurosciences of Systems, Aix Marseille Univ, Marseille, France
| | - Bernard Giusiano
- Inserm, INS, Institute of Neurosciences of Systems, Aix Marseille Univ, Marseille, France
| | - Romain Carron
- Functional and Stereotactic Neurosurgery, Timone Hospital, APHM, Marseille, France
| | | | - Christian Benar
- Inserm, INS, Institute of Neurosciences of Systems, Aix Marseille Univ, Marseille, France
| | - Fabrice Bartolomei
- Inserm, INS, Institute of Neurosciences of Systems, Aix Marseille Univ, Marseille, France.,Clinical Neurophysiology, Timone Hospital, APHM, Marseille, France
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42
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D'Atri A, Romano C, Gorgoni M, Scarpelli S, Alfonsi V, Ferrara M, Ferlazzo F, Rossini PM, De Gennaro L. Bilateral 5 Hz transcranial alternating current stimulation on fronto-temporal areas modulates resting-state EEG. Sci Rep 2017; 7:15672. [PMID: 29142322 PMCID: PMC5688177 DOI: 10.1038/s41598-017-16003-2] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2017] [Accepted: 11/03/2017] [Indexed: 02/08/2023] Open
Abstract
Rhythmic non-invasive brain stimulations are promising tools to modulate brain activity by entraining neural oscillations in specific cortical networks. The aim of the study was to assess the possibility to influence the neural circuits of the wake-sleep transition in awake subjects via a bilateral transcranial alternating current stimulation at 5 Hz (θ-tACS) on fronto-temporal areas. 25 healthy volunteers participated in two within-subject sessions (θ-tACS and sham), one week apart and in counterbalanced order. We assessed the stimulation effects on cortical EEG activity (28 derivations) and self-reported sleepiness (Karolinska Sleepiness Scale). θ-tACS induced significant increases of the theta activity in temporo-parieto-occipital areas and centro-frontal increases in the alpha activity compared to sham but failed to induce any online effect on sleepiness. Since the total energy delivered in the sham condition was much less than in the active θ-tACS, the current data are unable to isolate the specific effect of entrained theta oscillatory activity per se on sleepiness scores. On this basis, we concluded that θ-tACS modulated theta and alpha EEG activity with a topography consistent with high sleep pressure conditions. However, no causal relation can be traced on the basis of the current results between these rhythms and changes on sleepiness.
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Affiliation(s)
- Aurora D'Atri
- Department of Psychology, University of Rome "Sapienza", Via dei Marsi 78, 00185, Rome, Italy
- IRCCS San Raffaele Pisana, Via della Pisana 235, 00163, Rome, Italy
| | - Claudia Romano
- Department of Psychology, University of Rome "Sapienza", Via dei Marsi 78, 00185, Rome, Italy
| | - Maurizio Gorgoni
- Department of Psychology, University of Rome "Sapienza", Via dei Marsi 78, 00185, Rome, Italy
| | - Serena Scarpelli
- Department of Psychology, University of Rome "Sapienza", Via dei Marsi 78, 00185, Rome, Italy
| | - Valentina Alfonsi
- Department of Psychology, University of Rome "Sapienza", Via dei Marsi 78, 00185, Rome, Italy
| | - Michele Ferrara
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, Via Vetoio (Coppito 2), 67100 Coppito, L'Aquila, Italy
| | - Fabio Ferlazzo
- Department of Psychology, University of Rome "Sapienza", Via dei Marsi 78, 00185, Rome, Italy
| | - Paolo Maria Rossini
- IRCCS San Raffaele Pisana, Via della Pisana 235, 00163, Rome, Italy
- Institute of Neurology, Catholic University of The Sacred Heart, Largo Agostino Gemelli 8, 00168, Rome, Italy
| | - Luigi De Gennaro
- Department of Psychology, University of Rome "Sapienza", Via dei Marsi 78, 00185, Rome, Italy.
- IRCCS San Raffaele Pisana, Via della Pisana 235, 00163, Rome, Italy.
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Fattinger S, Kurth S, Ringli M, Jenni OG, Huber R. Theta waves in children's waking electroencephalogram resemble local aspects of sleep during wakefulness. Sci Rep 2017; 7:11187. [PMID: 28894254 PMCID: PMC5593855 DOI: 10.1038/s41598-017-11577-3] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2017] [Accepted: 08/25/2017] [Indexed: 02/04/2023] Open
Abstract
Vyazovskiy and colleagues found in rats’ multi-unit recordings brief periods of silence (off-states) in local populations of cortical neurons during wakefulness which closely resembled the characteristic off-states during sleep. These off-states became more global and frequent with increasing sleep pressure and were associated with the well-known increase of theta activity under sleep deprivation in the surface EEG. Moreover, the occurrence of such off-states was related to impaired performance. While these animal experiments were based on intracranial recordings, we aimed to explore whether the human surface EEG may also provide evidence for such a local sleep-like intrusion during wakefulness. Thus, we analysed high-density wake EEG recordings during an auditory attention task in the morning and evening in 12 children. We found that, theta waves became more widespread in the evening and the occurrence of widespread theta waves was associated with slower reaction times in the attention task. These results indicate that widespread theta events measured on the scalp might be markers of local sleep in humans. Moreover, such markers of local sleep, seem to be related to the well described performance decline under high sleep pressure.
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Affiliation(s)
- Sara Fattinger
- Child Development Center, University Children's Hospital Zurich, Zurich, Switzerland.,Children's Research Center, University Children's Hospital Zurich, Zurich, Switzerland.,Neuroscience Center Zurich, Zurich, Switzerland
| | - Salome Kurth
- Children's Research Center, University Children's Hospital Zurich, Zurich, Switzerland.,Neuroscience Center Zurich, Zurich, Switzerland.,Pulmonary Clinic, Division of Pulmonology, University Hospital Zurich, Zurich, Switzerland
| | - Maya Ringli
- Child Development Center, University Children's Hospital Zurich, Zurich, Switzerland.,Children's Research Center, University Children's Hospital Zurich, Zurich, Switzerland.,Neuroscience Center Zurich, Zurich, Switzerland
| | - Oskar G Jenni
- Child Development Center, University Children's Hospital Zurich, Zurich, Switzerland.,Children's Research Center, University Children's Hospital Zurich, Zurich, Switzerland.,Neuroscience Center Zurich, Zurich, Switzerland
| | - Reto Huber
- Child Development Center, University Children's Hospital Zurich, Zurich, Switzerland. .,Neuroscience Center Zurich, Zurich, Switzerland. .,Department of Child and Adolescent Psychiatry and Psychotherapy, Psychiatric Hospital, University of Zurich, Zurich, Switzerland.
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Formation and suppression of acoustic memories during human sleep. Nat Commun 2017; 8:179. [PMID: 28790302 PMCID: PMC5548898 DOI: 10.1038/s41467-017-00071-z] [Citation(s) in RCA: 47] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2016] [Accepted: 05/30/2017] [Indexed: 11/09/2022] Open
Abstract
Sleep and memory are deeply related, but the nature of the neuroplastic processes induced by sleep remains unclear. Here, we report that memory traces can be both formed or suppressed during sleep, depending on sleep phase. We played samples of acoustic noise to sleeping human listeners. Repeated exposure to a novel noise during Rapid Eye Movements (REM) or light non-REM (NREM) sleep leads to improvements in behavioral performance upon awakening. Strikingly, the same exposure during deep NREM sleep leads to impaired performance upon awakening. Electroencephalographic markers of learning extracted during sleep confirm a dissociation between sleep facilitating memory formation (light NREM and REM sleep) and sleep suppressing learning (deep NREM sleep). We can trace these neural changes back to transient sleep events, such as spindles for memory facilitation and slow waves for suppression. Thus, highly selective memory processes are active during human sleep, with intertwined episodes of facilitative and suppressive plasticity.Though memory and sleep are related, it is still unclear whether new memories can be formed during sleep. Here, authors show that people could learn new sounds during REM or light non-REM sleep, but that learning was suppressed when sounds were played during deep NREM sleep.
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45
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Neural Markers of Responsiveness to the Environment in Human Sleep. J Neurosci 2017; 36:6583-96. [PMID: 27307244 DOI: 10.1523/jneurosci.0902-16.2016] [Citation(s) in RCA: 71] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2016] [Accepted: 05/14/2016] [Indexed: 11/21/2022] Open
Abstract
UNLABELLED Sleep is characterized by a loss of behavioral responsiveness. However, recent research has shown that the sleeping brain is not completely disconnected from its environment. How neural activity constrains the ability to process sensory information while asleep is yet unclear. Here, we instructed human volunteers to classify words with lateralized hand responses while falling asleep. Using an electroencephalographic (EEG) marker of motor preparation, we show how responsiveness is modulated across sleep. These modulations are tracked using classic event-related potential analyses complemented by Lempel-Ziv complexity (LZc), a measure shown to track arousal in sleep and anesthesia. Neural activity related to the semantic content of stimuli was conserved in light non-rapid eye movement (NREM) sleep. However, these processes were suppressed in deep NREM sleep and, importantly, also in REM sleep, despite the recovery of wake-like neural activity in the latter. In NREM sleep, sensory activations were counterbalanced by evoked down states, which, when present, blocked further processing of external information. In addition, responsiveness markers correlated positively with baseline complexity, which could be related to modulation in sleep depth. In REM sleep, however, this relationship was reversed. We therefore propose that, in REM sleep, endogenously generated processes compete with the processing of external input. Sleep can thus be seen as a self-regulated process in which external information can be processed in lighter stages but suppressed in deeper stages. Last, our results suggest drastically different gating mechanisms in NREM and REM sleep. SIGNIFICANCE STATEMENT Previous research has tempered the notion that sleepers are isolated from their environment. Here, we pushed this idea forward and examined, across all sleep stages, the brain's ability to flexibly process sensory information, up to the decision level. We extracted an EEG marker of motor preparation to determine the completion of the sensory processing chain and explored how it is constrained by baseline and evoked neural activity. In NREM sleep, slow waves elicited by stimuli appeared to block response preparation. We also used a novel analytic approach (Lempel-Ziv complexity) and showed that the ability to process external information correlates with neural complexity. A reversal of the correlation between complexity and motor indices in REM sleep suggests drastically different gating mechanisms across sleep stages.
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46
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Kremen V, Duque JJ, Brinkmann BH, Berry BM, Kucewicz MT, Khadjevand F, Van Gompel J, Stead M, St Louis EK, Worrell GA. Behavioral state classification in epileptic brain using intracranial electrophysiology. J Neural Eng 2017; 14:026001. [PMID: 28050973 PMCID: PMC5460075 DOI: 10.1088/1741-2552/aa5688] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
OBJECTIVE Automated behavioral state classification can benefit next generation implantable epilepsy devices. In this study we explored the feasibility of automated awake (AW) and slow wave sleep (SWS) classification using wide bandwidth intracranial EEG (iEEG) in patients undergoing evaluation for epilepsy surgery. APPROACH Data from seven patients (age [Formula: see text], 4 women) who underwent intracranial depth electrode implantation for iEEG monitoring were included. Spectral power features (0.1-600 Hz) spanning several frequency bands from a single electrode were used to train and test a support vector machine classifier. MAIN RESULTS Classification accuracy of 97.8 ± 0.3% (normal tissue) and 89.4 ± 0.8% (epileptic tissue) across seven subjects using multiple spectral power features from a single electrode was achieved. Spectral power features from electrodes placed in normal temporal neocortex were found to be more useful (accuracy 90.8 ± 0.8%) for sleep-wake state classification than electrodes located in normal hippocampus (87.1 ± 1.6%). Spectral power in high frequency band features (Ripple (80-250 Hz), Fast Ripple (250-600 Hz)) showed comparable performance for AW and SWS classification as the best performing Berger bands (Alpha, Beta, low Gamma) with accuracy ⩾90% using a single electrode contact and single spectral feature. SIGNIFICANCE Automated classification of wake and SWS should prove useful for future implantable epilepsy devices with limited computational power, memory, and number of electrodes. Applications include quantifying patient sleep patterns and behavioral state dependent detection, prediction, and electrical stimulation therapies.
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Affiliation(s)
- Vaclav Kremen
- Department of Neurology, Mayo Systems Electrophysiology Laboratory, Mayo Clinic, 200 First St SW, Rochester, MN 55905, USA. Czech Institute of Informatics, Robotics and Cybernetics, Czech Technical University in Prague, Zikova street 1903/4, 166 36 Prague 6, Czech Republic. Department of Physiology and Biomedical Engineering, Mayo Clinic, 200 First St SW, Rochester, MN 55905, USA
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Comparison of t -test ranking with PCA and SEPCOR feature selection for wake and stage 1 sleep pattern recognition in multichannel electroencephalograms. Biomed Signal Process Control 2017. [DOI: 10.1016/j.bspc.2016.09.016] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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48
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Spatiotemporal characteristics of sleep spindles depend on cortical location. Neuroimage 2016; 146:236-245. [PMID: 27840241 DOI: 10.1016/j.neuroimage.2016.11.010] [Citation(s) in RCA: 56] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2016] [Revised: 10/09/2016] [Accepted: 11/05/2016] [Indexed: 12/31/2022] Open
Abstract
Since their discovery almost one century ago, sleep spindles, 0.5-2s long bursts of oscillatory activity at 9-16Hz during NREM sleep, have been thought to be global and relatively uniform throughout the cortex. Recent work, however, has brought this concept into question but it remains unclear to what degree spindles are global or local and if their properties are uniform or location-dependent. We addressed this question by recording sleep in eight patients undergoing evaluation for epilepsy with intracranial electrocorticography, which combines high spatial resolution with extensive cortical coverage. We find that spindle characteristics are not uniform but are strongly influenced by the underlying cortical regions, particularly for spindle density and fundamental frequency. We observe both highly isolated and spatially distributed spindles, but in highly skewed proportions: while most spindles are restricted to one or very few recording channels at any given time, there are spindles that occur over widespread areas, often involving lateral prefrontal cortices and superior temporal gyri. Their co-occurrence is affected by a subtle but significant propagation of spindles from the superior prefrontal regions and the temporal cortices towards the orbitofrontal cortex. This work provides a brain-wide characterization of sleep spindles as mostly local graphoelements with heterogeneous characteristics that depend on the underlying cortical area. We propose that the combination of local characteristics and global organization reflects the dual properties of the thalamo-cortical generators and provides a flexible framework to support the many functions ascribed to sleep in general and spindles specifically.
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Miano S, Esposito M, Foderaro G, Ramelli GP, Pezzoli V, Manconi M. Sleep-Related Disorders in Children with Attention-Deficit Hyperactivity Disorder: Preliminary Results of a Full Sleep Assessment Study. CNS Neurosci Ther 2016; 22:906-914. [PMID: 27255788 DOI: 10.1111/cns.12573] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2016] [Revised: 04/10/2016] [Accepted: 05/05/2016] [Indexed: 01/29/2023] Open
Abstract
BACKGROUND AND METHODS We present the preliminary results of a prospective case-control sleep study in children with a diagnosis of attention-deficit hyperactivity disorder (ADHD). A deep sleep assessment including sleep questionnaires, sleep habits, a video-polysomnographic recording with full high-density electroencephalography (EEG) and cardiorespiratory polygraphy, multiple sleep latency test, and 1-week actigraphic recording were performed to verify whether children with ADHD may be classified into one of the following five phenotypes: (1) hypoarousal state, resembling narcolepsy, which may be considered a "primary" form of ADHD; (2) delayed sleep onset insomnia; (3) sleep-disordered breathing; (4) restless legs syndrome and/or periodic limb movements; and (5) sleep epilepsy and/or EEG interictal epileptiform discharges. RESULTS Fifteen consecutive outpatients with ADHD were recruited (two female, mean age 10.6 ± 2.2, age range 8-13.7 years) over 6 months. The narcolepsy-like sleep phenotype was observed in three children, the sleep onset insomnia phenotype was observed in one child, mild obstructive sleep apnea was observed in three children, sleep hyperkinesia and/or PLMs were observed in five children, while IEDs and or nocturnal epilepsy were observed in three children. Depending on the sleep phenotype, children received melatonin, iron supplementation, antiepileptic drugs, or stimulants. CONCLUSIONS Our study further highlights the need to design an efficient sleep diagnostic algorithm for children with ADHD, thereby more accurately identifying cases in which a full sleep assessment is indicated.
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Affiliation(s)
- Silvia Miano
- Sleep and Epilepsy Center, Neurocenter of Southern Switzerland, Civic Hospital of Lugano, Lugano, Switzerland.
| | - Maria Esposito
- Clinic of Child and Adolescent Neuropsychiatry, Department of Mental Health, Physical and Preventive Medicine, Second University of Naples, Naples, Italy
| | - Giuseppe Foderaro
- Department of Pediatrics, Civic Hospital of Lugano, Lugano, Switzerland
| | - Gian Paolo Ramelli
- Department of Pediatrics, San Giovanni Hospital, Bellinzona, Switzerland
| | - Valdo Pezzoli
- Department of Pediatrics, Civic Hospital of Lugano, Lugano, Switzerland
| | - Mauro Manconi
- Sleep and Epilepsy Center, Neurocenter of Southern Switzerland, Civic Hospital of Lugano, Lugano, Switzerland
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50
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Younes M, Younes M, Giannouli E. Accuracy of Automatic Polysomnography Scoring Using Frontal Electrodes. J Clin Sleep Med 2016; 12:735-46. [PMID: 26951417 PMCID: PMC4865561 DOI: 10.5664/jcsm.5808] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2015] [Accepted: 01/13/2016] [Indexed: 01/04/2023]
Abstract
STUDY OBJECTIVES The economic cost of performing sleep monitoring at home is a major deterrent to adding sleep data during home studies for investigation of sleep apnea and to investigating non-respiratory sleep complaints. Michele Sleep Scoring System (MSS) is a validated automatic system that utilizes central electroencephalography (EEG) derivations and requires minimal editing. We wished to determine if MSS' accuracy is maintained if frontal derivations are used instead. If confirmed, home sleep monitoring would not require home setup or lengthy manual scoring by technologists. METHODS One hundred two polysomnograms (PSGs) previously recorded from patients with assorted sleep disorders were scored using MSS once with central and once with frontal derivations. Total sleep time, sleep/stage R sleep onset latencies, awake time, time in different sleep stages, arousal/awakening index and apnea-hypopnea index were compared. In addition, odds ratio product (ORP), a continuous index of sleep depth/quality (Sleep 2015;38:641-54), was generated for every 30-sec epoch in each PSG and epoch-by-epoch comparison of ORP was performed. RESULTS Intraclass correlation coefficients (ICCs) ranged from 0.89 to 1.0 for the various sleep variables (0.96 ± 0.03). For epoch-by-epoch comparisons of ORP, ICC was > 0.85 in 96 PSGs. Lower values in the other six PSGs were related to signal artifacts in either derivation. ICC for whole-record average ORP was 0.98. CONCLUSIONS MSS is as accurate with frontal as with central EEG derivations. The use of frontal electrodes along with MSS should make it possible to obtain high-quality sleep data without requiring home setup or lengthy scoring time by expert technologists.
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Affiliation(s)
- Magdy Younes
- Sleep Disorders Centre, University of Manitoba, Winnipeg, Manitoba, Canada
- YRT Ltd, Winnipeg, Canada
| | | | - Eleni Giannouli
- Sleep Disorders Centre, University of Manitoba, Winnipeg, Manitoba, Canada
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