Sleep deprivation alters functioning within the neural network underlying the covert orienting of attention

The Effect of Sleep Deprivation on Brain Fingerprint Stability: A Magnetoencephalography Validation Study

This study examined the stability of the functional connectome (FC) over time using fingerprint analysis in healthy subjects. Additionally, it investigated how a specific stressor, namely sleep deprivation, affects individuals' differentiation. To this aim, 23 healthy young adults underwent magnetoencephalography (MEG) recording at three equally spaced time points within 24 h: 9 a.m., 9 p.m., and 9 a.m. of the following day after a night of sleep deprivation. The findings indicate that the differentiation was stable from morning to evening in all frequency bands, except in the delta band. However, after a night of sleep deprivation, the stability of the FCs was reduced. Consistent with this observation, the reduced differentiation following sleep deprivation was found to be negatively correlated with the effort perceived by participants in completing the cognitive task during sleep deprivation. This correlation suggests that individuals with less stable connectomes following sleep deprivation experienced greater difficulty in performing cognitive tasks, reflecting increased effort.

Links between excessive daytime sleepiness and EEG power and activation in two subtypes of ADHD

OBJECTIVES

This study aimed to replicate previously reported EEG characteristics between typically developing (TD) children and two subtypes of Attention Deficit Hyperactivity Disorder (ADHD) using a frontal, single-channel, dry-sensor portable EEG device, and explore whether differences are moderated by excessive daytime sleepiness (EDS).

METHODS

Children with ADHD Inattentive (ADHD-I) and ADHD Combined presentation (ADHD-C) and typically-developing (TD) children (N = 34 in each group) had frontal EEG recorded during eyes-closed resting, eyes-open resting, and focus tasks. Participants also completed the Children's Self-Report Sleep Patterns - Sleepiness Scale as a measure of EDS.

RESULTS

Consistent with previous literature, there were increases in frontal delta and theta power in the ADHD-C compared to ADHD-I and TD groups, in all conditions. Novel power and activation effects in ADHD subtypes, as well as significant group and EDS interactions for alpha and beta power were also found.

CONCLUSIONS

These findings highlight the importance of considering ADHD subtypes and EDS when exploring EEG characteristics, and have important implications for the diagnosis and treatment of children with ADHD.

The Common Effects of Sleep Deprivation on Human Long-Term Memory and Cognitive Control Processes

Sleep deprivation is known to have adverse effects on various cognitive abilities. In particular, a lack of sleep has been reported to disrupt memory consolidation and cognitive control functions. Here, focusing on long-term memory and cognitive control processes, we review the consistency and reliability of the results of previous studies of sleep deprivation effects on behavioral performance with variations in the types of stimuli and tasks. Moreover, we examine neural response changes related to these behavioral changes induced by sleep deprivation based on human fMRI studies to determine the brain regions in which neural responses increase or decrease as a consequence of sleep deprivation. Additionally, we discuss about the possibility that light as an environmentally influential factor affects our sleep cycles and related cognitive processes.

Theta Activity During Encoding Interacts With NREM Sleep Oscillations to Predict Memory Generalization

Relatively little is known regarding the interaction between encoding-related neural activity and sleep-based memory consolidation. One suggestion is that a function of encoding-related theta power may be to “tag” memories for subsequent processing during sleep. This study aimed to extend previous work on the relationships between sleep spindles, slow oscillation-spindle coupling, and task-related theta activity with a combined Deese-Roediger-McDermott (DRM) and nap paradigm. This allowed us to examine the influence of task- and sleep-related oscillatory activity on the recognition of both encoded list words and associative theme words. Thirty-three participants (29 females, mean age = 23.2 years) learned and recognised DRM lists separated by either a 2 h wake or sleep period. Mixed-effects modelling revealed the sleep condition endorsed more associative theme words and fewer list words in comparison to the wake group. Encoding-related theta power was also found to influence sleep spindle density, and this interaction was predictive of memory outcomes. The influence of encoding-related theta was specific to sleep spindle density, and did not appear to influence the strength of slow oscillation-spindle coupling as it relates to memory outcomes. The finding of interactions between wakeful and sleep oscillatory-related activity in promoting memory and learning has important implications for theoretical models of sleep-based memory consolidation.

Circadian Rhythm Disorders and Corresponding Functional Brain Abnormalities in Young Female Nurses: A Preliminary Study

Objective: Shift work is associated with a decrease in melatonin level and perturbation of the circadian rhythm; however, it is unknown if these lead to functional brain changes. In this study, we investigated whether circadian rhythm disorders caused by shift work are related to changes in brain functional connectivity (FC) and regional homogeneity (ReHo) using whole-brain resting-state functional magnetic resonance imaging (fMRI).

Methods: This prospective case-control study included nine female night shift nurses and nine age-matched female day work nurses with normal sleep rhythms. To assess sleep quality and mood, participants were asked to complete questionnaires. Serum melatonin and cortisol levels were measured. ReHo of whole-brain resting-state function and seed-based FC of the bilateral hypothalamus were compared between groups. Variables that differed significantly between groups were used to examine the association between questionnaire scores and hormone levels and fMRI data.

Results: The night shift nurses had significantly lower sleep quality and melatonin levels; lower ReHo activation in the bilateral cerebellar hemisphere and higher ReHo in the bilateral occipital lobe and left parietal lobe; and higher FC from the hypothalamus to the right cingulate gyrus, right putamen, and vermis than did the day shift nurses. Activation of the right cerebellar hemisphere left superior parietal gyrus, and the right superior occipital gyrus was correlated with sleep quality scores. Moreover, activation of the right cerebellar hemisphere (r = 0.583, P = 0.011) was correlated with melatonin levels, and higher sleepiness scores were associated with stronger FC between the hypothalamus and vermis (r = 0.501, P = 0.034).

Conclusions: Circadian rhythm disorder caused by night shift work can lead to a decrease in sleep quality and melatonin level, as well as a series of changes in brain FC and ReHo.

Impaired Coupling of the Brain's Default Network During Sleep Deprivation: A Resting-State EEG Study

INTRODUCTION

Sleep deprivation (SD) has a negative influence on mood and emotion processing, and previous studies have elucidated the impaired coupling within the default network (DN) after SD. However, the dynamic characteristic with high temporal precision was rarely investigated in the DN after SD.

METHODS

Here, the resting-state EEG after nocturnal sleep (NS) and SD was collected from 31 participants. The cortical electrical activities of the posterior cingulate cortex (PCC) and the anterior medial prefrontal cortex (aMPFC) were reconstructed applying the eLORETA, and the functional connectivity (FC) of PCC-aMPFC was calculated using the power envelope connectivity (PEC).

RESULTS

Compared with NS, the power spectrums of the PCC and the FC of PCC-aMPFC were significantly reduced in the α band after SD. Interestingly, the impaired PCC-aMPFC integration was positively correlated with the decreased positive affect, implying that the DN plays a critical role in the subjective mood state. Our moderation analysis further revealed that the intensity of the DN posterior-anterior interaction moderated sleep loss and positive affect.

DISCUSSION

Overall, the results reveal the strong relationship between the uncoupling of DN and the feeling down of mood. Our research may contribute towards a better understanding of the mood and cognition processing after sleep loss.

Individuals with insomnia misrecognize angry faces as fearful faces while missing the eyes: an eye-tracking study

Individuals with insomnia have been found to have disturbed perception of facial expressions. Through eye movement examinations, here we test the hypothesis that this effect is due to impaired visual attention functions for retrieving diagnostic features in facial expression judgments. Twenty-three individuals with insomnia symptoms and 23 controls without insomnia completed a task to categorize happy, sad, fearful, and angry facial expressions. The participants with insomnia were less accurate in recognizing angry faces and misidentified them as fearful faces more often than the controls. A hidden Markov modeling approach for eye movement data analysis revealed that when viewing facial expressions, more individuals with insomnia adopted a nose-mouth eye movement pattern focusing on the vertical face midline while more controls adopted an eyes-mouth pattern preferentially attending to lateral features, particularly the two eyes. As previous studies found that the primary diagnostic feature for recognizing angry faces is the eyes while the diagnostic features for other facial expressions involve the mouth region, missing the eye region may contribute to specific difficulties in recognizing angry facial expressions, consistent with our behavioral finding in participants with insomnia symptoms. Taken together, the findings suggest that impaired information selection through visual attention control may be related to the compromised emotion perception in individuals with insomnia.

No effect of cold pressor test-induced arousal on attentional benefits and costs in an endogenous spatial orienting paradigm

Previous studies have shown that arousal can influence hemispatial bias, suggesting that changes in arousal affect the neural networks involved in spatial attention control. The goal of the present study was to measure the effects of increased arousal on endogenous attentional orienting. We used a Spatial Orienting Paradigm to quantify attentional benefits and costs as measures of attentional orienting and re-orienting responses and exposed participants (N = 25; Experiment 1) to a bilateral feet Cold Pressor Test (CPT) to manipulate arousal. Increases in subjective distress ratings and blood pressure confirmed the effect of CPT on arousal. Although no overall effects of CPT on reaction times in the Spatial Orienting Paradigm were detected, an exploratory analysis of sex-specific effects revealed a left-lateralised decrease in benefits and increase in costs after CPT exposure in the male subsample (N = 11). To confirm these preliminary results, we repeated the experiment in a larger sample (N = 29, all male), but found no effect of CPT on orienting, with moderate to strong evidence in favour of a model excluding all (interaction) effects of CPT exposure (all BF_Incl < 0.3). Instead, our replicated results indicate that voluntary orienting is unaffected by CPT-induced increases of arousal. In the light of previous studies, and keeping in mind the interpretative challenges of null results, we discuss how and why our findings may be specific to endogenous as opposed to exogenous orienting and how arousal could possibly lead to the previously established effects on visuospatial bias without simultaneously affecting orienting and the underlying attention control networks.

Infection with Herpes Simplex virus type 1 (HSV-1) and sleep: The dog that did not bark

Persistent infection with Herpes Simplex viruses (HSV) and other brain infections is consistently associated with cognitive impairment. These infections can also affect sleep. Thus, sleep abnormalities could explain the cognitive dysfunction. We investigated the association between sleep variables and persistent HSV-1, HSV-2, cytomegalovirus (CMV) and Toxoplasma gondii (Tox) infections. Sleep data were collected from older adults with or without insomnia (N = 311, total); a subset completed polysomnographic and actigraphy studies (N = 145). No significant associations were found between the infections and insomnia or the remaining sleep variables following corrections for multiple comparisons. Sleep dysfunction is unlikely to explain the infection-related cognitive dysfunction.

The wake maintenance zone shows task dependent changes in cognitive function following one night without sleep

Study Objectives

The interaction between homeostatic sleep pressure and circadian timing modulates the impact of sleep deprivation on cognition. We aimed to investigate how this interaction affects different cognitive functions.

Methods

Twenty-three healthy volunteers (18 males; mean age = 25.4 ± 5.7 years) underwent 40 hours of sleep deprivation under constant routine conditions. Performance on the Psychomotor Vigilance Test and a cognitive battery assessing vigilant attention, complex attention, recognition memory, and working memory was assessed in the morning (27 hours awake) and evening (37 hours awake) during sleep deprivation and compared to well-rested performance 24 hours earlier. Circadian phase assessments confirmed evening tests occurred in the wake maintenance zone (WMZ).

Results

Increased time awake significantly impacted performance on all measures except recognition memory. Post hoc analyses found performance on all measures was significantly impaired in the morning following 27 hours of sleep deprivation compared to well-rested performance 24 hours earlier. In contrast, complex attention and working memory were preserved in the WMZ after 37 hours awake compared to 24 hours earlier, while vigilant attention and PVT performance were significantly impaired. During sleep deprivation, composite scores of speed and accuracy were both impaired in the morning, while only speed was impaired during the WMZ.

Conclusions

We observed task- and time-dependent effects of sleep deprivation, such that vigilant attention was significantly impaired after both 27 hours and 37 hours awake (compared to when well-rested at the same circadian clock time). In contrast, complex attention and working memory were impaired at 27 hours awake, but preserved in the WMZ despite increased homeostatic sleep pressure (37 hours awake).

RT Slowing to Valid Cues on a Reflexive Attention Task in Children and Young Adults

Peripheral cueing tasks can be used to measure reflexive (automatic) attention. In these tasks, increases in response time or RT (costs) typically follow contralateral (invalid) cues as attention must move from the location of the cue to the target. Reductions in RT (benefits) to a target typically follow ipsilateral (valid) cues because the cue draws attention to where the target will appear. Two exceptions to RT benefits are inhibition of return (IOR) and masking. IOR is the tendency to respond slower to targets that appear in locations attended within the last 200–2000 ms. Masking occurs when the visibility of a target is blocked by another stimulus (e.g., the cue). Herein, we describe two experiments, both using a modified Posner task with “earth rockets” as cues and “alien spaceships” as targets. Cues were equally likely to appear on the left or right side of a display following targets. Participants were instructed to press a left or right key corresponding to a left or right target. In Experiment 1, we obtained data from 203 children (10.58–16.55 years old). We discovered unexpected costs following cues that typically provide RT benefits. In Experiment 2, we explored IOR, masking, and age differences in the occurrence of these costs. We manipulated the cue-target temporal distance (“stimulus onset asynchrony” or SOA) to explore IOR and the cue-target spatial distance to explore masking. We also considered a wider age range. Sixty-three children and 41 young adults participated. Experiment 2 revealed a three-way interaction between SOA, spatial distance, and age. At the shorter SOA (100 ms) and moderate spatial distance, unexpected costs followed valid cues for younger children (7.07–10.15 years old). These costs also occurred in young adults (18.00–23.02 years old) following far distance cues at this SOA. At the longer SOA (200 ms), these costs followed moderate and far cues for younger children and near cues for young adults. Older children (10.31–14.92 years) did not have unexpected costs. We explain the findings in terms of masking, IOR, and possible developmental mechanisms.

Neuropeptide S overcomes short term memory deficit induced by sleep restriction by increasing prefrontal cortex activity

Sleep restriction (SR) impairs short term memory (STM) that might be related to different processes. Neuropeptide S (NPS), an endogenous neuropeptide that improves short term memory, activates arousal and decreases anxiety is likely to counteract the SR-induced impairment of STM. The objective of the present study was to find common cerebral pathways in sleep restriction and NPS action in order to ultimately antagonize SR effect on memory. The STM was assessed using a spontaneous spatial alternation task in a T-maze. C57-Bl/6J male mice were distributed in 4 groups according to treatment (0.1nmol of NPS or vehicle intracerebroventricular injection) and to 20h-SR. Immediately after behavioural testing, regional c-fos immunohistochemistry was performed and used as a neural activation marker for spatial short term memory (prefrontal cortex, dorsal hippocampus) and emotional reactivity (basolateral amygdala and ventral hippocampus). Anxiety-like behaviour was assessed using elevated-plus maze task. Results showed that SR impaired short term memory performance and decreased neuronal activation in cingular cortex.NPS injection overcame SR-induced STM deficits and increased neuronal activation in infralimbic cortex. SR spared anxiety-like behavior in the elevated-plus maze. Neural activation in basolateral nucleus of amygdala and ventral hippocampus were not changed after SR.In conclusion, the present study shows that NPS overcomes SR-induced STM deficits by increasing prefrontal cortex activation independently of anxiety-like behaviour.

The sleep-deprived human brain

How does a lack of sleep affect our brains? In contrast to the benefits of sleep, frameworks exploring the impact of sleep loss are relatively lacking. Importantly, the effects of sleep deprivation (SD) do not simply reflect the absence of sleep and the benefits attributed to it; rather, they reflect the consequences of several additional factors, including extended wakefulness. With a focus on neuroimaging studies, we review the consequences of SD on attention and working memory, positive and negative emotion, and hippocampal learning. We explore how this evidence informs our mechanistic understanding of the known changes in cognition and emotion associated with SD, and the insights it provides regarding clinical conditions associated with sleep disruption.

Mindful Reading: Mindfulness Meditation Helps Keep Readers with Dyslexia and ADHD on the Lexical Track

This study explored the effects of a Mindfulness-Based Stress Reduction (MBSR) intervention on reading, attention, and psychological well-being among people with developmental dyslexia and/or attention deficits. Various types of dyslexia exist, characterized by different error types. We examined a question that has not been tested so far: which types of errors (and dyslexias) are affected by MBSR training. To do so, we tested, using an extensive battery of reading tests, whether each participant had dyslexia, and which errors types s/he makes, and then compared the rate of each error type before and after the MBSR workshop. We used a similar approach to attention disorders: we evaluated the participants’ sustained, selective, executive, and orienting of attention to assess whether they had attention-disorders, and if so, which functions were impaired. We then evaluated the effect of MBSR on each of the attention functions. Psychological measures including mindfulness, stress, reflection and rumination, lifesatisfaction, depression, anxiety, and sleep-disturbances were also evaluated. Nineteen Hebrew-readers completed a 2-month mindfulness workshop. The results showed that whereas reading errors of letter-migrations within and between words and vowelletter errors did not decrease following the workshop, most participants made fewer reading errors in general following the workshop, with a significant reduction of 19% from their original number of errors. This decrease mainly resulted from a decrease in errors that occur due to reading via the sublexical rather than the lexical route. It seems, therefore, that mindfulness helped reading by keeping the readers on the lexical route. This improvement in reading probably resulted from improved sustained attention: the reduction in sublexical reading was significant for the dyslexic participants who also had attention deficits, and there were significant correlations between reduced reading errors and decreases in impulsivity. Following the meditation workshop, the rate of commission errors decreased, indicating decreased impulsivity, and the variation in RTs in the CPT task decreased, indicating improved sustained attention. Significant improvements were obtained in participants’ mindfulness, perceived-stress, rumination, depression, state-anxiety, and sleep-disturbances. Correlations were also obtained between reading improvement and increased mindfulness following the workshop. Thus, whereas mindfulness training did not affect specific types of errors and did not improve dyslexia, it did affect the reading of adults with developmental dyslexia and ADHD, by helping them to stay on the straight path of the lexical route while reading. Thus, the reading improvement induced by mindfulness sheds light on the intricate relation between attention and reading. Mindfulness reduced impulsivity and improved sustained attention, and this, in turn, improved reading of adults with developmental dyslexia and ADHD, by helping them to read via the straight path of the lexical route.

How acute total sleep loss affects the attending brain: a meta-analysis of neuroimaging studies

STUDY OBJECTIVES

Attention is a cognitive domain that can be severely affected by sleep deprivation. Previous neuroimaging studies have used different attention paradigms and reported both increased and reduced brain activation after sleep deprivation. However, due to large variability in sleep deprivation protocols, task paradigms, experimental designs, characteristics of subject populations, and imaging techniques, there is no consensus regarding the effects of sleep loss on the attending brain. The aim of this meta-analysis was to identify brain activations that are commonly altered by acute total sleep deprivation across different attention tasks.

DESIGN

Coordinate-based meta-analysis of neuroimaging studies of performance on attention tasks during experimental sleep deprivation.

METHODS

The current version of the activation likelihood estimation (ALE) approach was used for meta-analysis. The authors searched published articles and identified 11 sleep deprivation neuroimaging studies using different attention tasks with a total of 185 participants, equaling 81 foci for ALE analysis.

RESULTS

The meta-analysis revealed significantly reduced brain activation in multiple regions following sleep deprivation compared to rested wakefulness, including bilateral intraparietal sulcus, bilateral insula, right prefrontal cortex, medial frontal cortex, and right parahippocampal gyrus. Increased activation was found only in bilateral thalamus after sleep deprivation compared to rested wakefulness.

CONCLUSION

Acute total sleep deprivation decreases brain activation in the fronto-parietal attention network (prefrontal cortex and intraparietal sulcus) and in the salience network (insula and medial frontal cortex). Increased thalamic activation after sleep deprivation may reflect a complex interaction between the de-arousing effects of sleep loss and the arousing effects of task performance on thalamic activity.

Treatment of allergic rhinitis is associated with improved attention performance in children: the Allergic Rhinitis Cohort Study for Kids (ARCO-Kids)

Background

It has been well known that pediatric allergic rhinitis was associated with poor performance at school due to attention deficit. However, there were no cohort studies for the effect of treatment of allergic rhinitis on attention performance in pediatric population. Thus, the aim of this study was to investigate whether attention performance was improved after treatment in children with allergic rhinitis.

Methods

In this ARCO-Kids (Allergic Rhinitis Cohort Study for Kids), consecutive pediatric patients with rhinitis symptoms underwent a skin prick test and computerized comprehensive attention test. According to the skin prick test results, the children were diagnosed as allergic rhinitis or non- allergic rhinitis. All of the patients were regularly followed up and treated with oral medication or intranasal corticosteroid sprays. The comprehensive attention tests consisted of sustained and divided attention tasks. Each of the tasks was assessed by the attention score which was calculated by the number of omission and commission errors. The comprehension attention test was repeated after 1 year.

Results

A total of 797 children with allergic rhinitis and 239 children with non-allergic rhinitis were included. Initially, the attention scores of omission and commission errors on divided attention task were significantly lower in children with allergic rhinitis than in children with non-allergic rhinitis. After 1 year of treatment, children with allergic rhinitis showed improvement in attention: commission error of sustained (95.6±17.0 vs 97.0±16.6) and divided attention task (99.1±15.8 vs 91.8±23.5). Meanwhile, there was no significant difference of attention scores in children with non-allergic rhinitis.

Conclusions

Our study showed that management of allergic rhinitis might be associated with improvement of attention.

Night shifts, sleep deprivation, and attention performance in medical students

OBJECTIVE

To determine attention performance of medical students after sleep deprivation due to night shift work.

METHODS

Prospective cohort design. All seventh, eighth and ninth semester students were invited to participate (n= 209). The effectiveness and concentration indices (d2 Test for attention, dependent variable) from 180 students at 3 evaluations during the semester were compared. Eighth and ninth semester students underwent their second evaluation after a night shift. The independent variables were nocturnal sleep measurements.

RESULTS

No differences in nocturnal sleep hours during the previous week (p=0.966), sleep deprivation (p=0.703) or effectiveness in the d2 Test (p=0.428) were found between the groups at the beginning of the semester. At the beginning and the end of the semester, the d2 Test results were not different between groups (p=0.410, p=0.394) respectively. The second evaluation showed greater sleep deprivation in students with night shift work (p=0.001). The sleep deprived students had lower concentration indices (p=0.001).The differences were associated with the magnitude of sleep deprivation (p=0.008). Multivariate regression analysis showed that attention performance was explained by sleep deprivation due to night shift work, adjusting for age and gender. Students with sleep deprivation had worse concentration than those without.

CONCLUSIONS

Sleep deprivation due to night shift work in medical students had a negative impact on their attention performance. Medical educators should address these potential negative learning and patient care consequences of sleep deprivation in medical students due to night shifts.

The effects of total sleep deprivation on semantic priming: event-related potential evidence for automatic and controlled processing strategies

There is general consensus that performance on a number of cognitive tasks deteriorates following total sleep deprivation. At times, however, subjects manage to maintain performance. This may be because of an ability to switch cognitive strategies including the exertion of compensatory effort. The present study examines the effects of total sleep deprivation on a semantic word priming task. Word priming is unique because it can be carried out using different strategies involving either automatic, effortless or controlled, effortful processing. Twelve subjects were presented with word pairs, a prime and a target, that were either highly semantically associated (cat…dog), weakly associated (cow…barn) or unassociated (apple…road). In order to increase the probability of the use of controlled processing following normal sleep, the subject's task was to determine if the target word was semantically related to the prime. Furthermore, the time between the offset of the prime and the onset of the target was relatively long, permitting the use of an effortful, expectancy-predictive strategy. Event-related potentials (ERPs) were recorded from 64 electrode sites. After normal sleep, RTs were faster and accuracy higher to highly associated targets; this performance advantage was also maintained following sleep deprivation. A large negative deflection, the N400, was larger to weakly associated and unassociated targets in both sleep-deprived and normal conditions. The overall N400 was however larger in the normal sleep condition. Moreover, a long-lasting negative slow wave developed between the offset of the prime and the onset of the target. These physiological measures are consistent with the use of an effortful, predictive strategy following normal sleep but an automatic, effortless strategy following total sleep deprivation. A picture priming task was also run. This task benefits less from the use of a predictive strategy. Accordingly, in this task, ERPs following the target did not differ as a function of the amount of sleep.

Okonkwo O, den Hollander JA, Martin RC, Belue K, Copeland JN, Harrell LE, Brockington JC, Clark DG, Marson DC. MRI volume of the medial frontal cortex predicts financial capacity in patients with mild Alzheimer's disease

Persons with mild Alzheimer's disease (AD) have significant deficits in financial abilities. This study examined the relationship between brain structure volumes, cognition, and financial capacity in patients with mild AD. Sixteen mild AD patients and 16 older adult comparisons completed the Financial Capacity Instrument (FCI), a psychometric measure of financial abilities, and also underwent magnetic resonance imaging (MRI) to obtain volumes of the bilateral hippocampi, angular gyri, precunei, and medial and dorsolateral frontal cortices. Mild AD patients performed significantly below comparisons on the FCI and had significantly smaller hippocampi. Among mild AD patients, FCI performance was moderately correlated with frontal (medial and dorsolateral frontal cortex) and posterior (angular gyri and precunei) cortical volumes. Stepwise regression demonstrated that medial frontal cortex volume predicted FCI score. The relationship between medial frontal cortex volume and overall FCI score was partially mediated by two measures of simple attention (DRS Attention, DRS Construction). The findings suggest that medial frontal cortex atrophy and associated declines in simple attention play an increasingly important role in declining financial skills in patients with mild AD.

Circadian rhythms, sleep deprivation, and human performance

Much of the current science on, and mathematical modeling of, dynamic changes in human performance within and between days is dominated by the two-process model of sleep-wake regulation, which posits a neurobiological drive for sleep that varies homeostatically (increasing as a saturating exponential during wakefulness and decreasing in a like manner during sleep), and a circadian process that neurobiologically modulates both the homeostatic drive for sleep and waking alertness and performance. Endogenous circadian rhythms in neurobehavioral functions, including physiological alertness and cognitive performance, have been demonstrated using special laboratory protocols that reveal the interaction of the biological clock with the sleep homeostatic drive. Individual differences in circadian rhythms and genetic and other components underlying such differences also influence waking neurobehavioral functions. Both acute total sleep deprivation and chronic sleep restriction increase homeostatic sleep drive and degrade waking neurobehavioral functions as reflected in sleepiness, attention, cognitive speed, and memory. Recent evidence indicating a high degree of stability in neurobehavioral responses to sleep loss suggests that these trait-like individual differences are phenotypic and likely involve genetic components, including circadian genes. Recent experiments have revealed both sleep homeostatic and circadian effects on brain metabolism and neural activation. Investigation of the neural and genetic mechanisms underlying the dynamically complex interaction between sleep homeostasis and circadian systems is beginning. A key goal of this work is to identify biomarkers that accurately predict human performance in situations in which the circadian and sleep homeostatic systems are perturbed.

Age-related decline in controlled retrieval: the role of the PFC and sleep

Age-related cognitive impairments often include difficulty retrieving memories, particularly those that rely on executive control. In this paper we discuss the influence of the prefrontal cortex on memory retrieval, and the specific memory processes associated with the prefrontal cortex that decline in late adulthood. We conclude that preretrieval processes associated with preparation to make a memory judgment are impaired, leading to greater reliance on postretrieval processes. This is consistent with the view that impairments in executive control significantly contribute to deficits in controlled retrieval. Finally, we discuss age-related changes in sleep as a potential mechanism that contributes to deficiencies in executive control that are important for efficient retrieval. The sleep literature points to the importance of slow-wave sleep in restoration of prefrontal cortex function. Given that slow-wave sleep significantly declines with age, we hypothesize that age-related changes in slow-wave sleep could mediate age-related decline in executive control, manifesting a robust deficit in controlled memory retrieval processes. Interventions, like physical activity, that improve sleep could be effective methods to enhance controlled memory processes in late life.

Working throughout the night: beyond 'sleepiness'--impairments to critical decision making

By the end of the first night on a 12h night-shift, wakefulness may have lasted up to 24h since the previous sleep. Although most work situations requiring critical decisions are foreseen and effectively resolved by well trained staff, such wakefulness can produce impairments in dealing with unexpected challenging situations involving uncertainty, change, distractions and capacity to evaluate risks. Also compromised can be the ability to engage in and keep abreast of protracted negotiations undertaken throughout the night. These effects, which are not just 'sleepiness', seem due to deteriorations with 'supervisory executive functions' of the prefrontal cortex; a region that appears particularly vulnerable to prolonged wakefulness. Recent research findings are presented to support this case, and some evidence-based recommendations made about practical countermeasures.

Statistical evaluation of recurrence quantification analysis applied on single trial evoked potential studies

OBJECTIVE

We evaluated the potential of recurrence quantification analysis (RQA) to improve the analysis of trial-by-trial-variability in event-related potentials (ERPs) experiments.

METHODS

We use an acoustic oddball paradigm to compare the efficiency of RQA with a linear amplitude based analysis of single trial ERPs with regard to the power to distinguish responses to different tone types. We further probed the robustness of both analyses towards structured noise induced by parallel magnetic resonance imaging (MRI).

RESULTS

RQA provided robust discrimination of responses to different tone types, even when EEG data were contaminated by structured noise. Yet, its power to discriminate responses to different tone types was not significantly superior to a linear amplitude analysis. RQA measures were only moderately correlated with EEG amplitudes, suggesting that RQA may extract additional information from single trial responses not detected by amplitude evaluation.

CONCLUSIONS

RQA allows quantifying signal characteristics of single trial ERPs measured with and without noise induced by parallel MRI. RQA power to discriminate responses to different tone types was similar to linear amplitude based analysis.

SIGNIFICANCE

RQA has the potential to detect differences of signal features in response to a standard oddball paradigm and provide additional trial-by-trial information compared to classical amplitude based analysis.

Selective modulations of attentional asymmetries after sleep deprivation

Pseudoneglect is a slight but consistent misplacement of attention toward the left visual field, commonly observed in young healthy subjects. This leftward attentional bias is thought to result from a right hemispheric dominance in visuospatial processing. Changes in endogenous levels of alertness may modulate attentional asymmetries and pseudoneglect in particular. In line with this hypothesis, it has been shown that sleep deprived shift-workers present a reversal of their attentional bias in a landmark (LDM) task (Manly, T., Dobler, V. B., Dodds, C. M., & George, M. A. (2005). Rightward shift in spatial awareness with declining alertness. Neuropsychologia, 43(12), 1721-1728). However, circadian disturbances and fatigue effects at the end of a shift work may have contributed to this reversal effect. In a first experiment, we show that sleep deprivation (SD) under controlled conditions does not markedly change the leftward bias, observable both at 21:00 and at 07:00 after SD. In a second experiment, we tested the hypothesis that a drastic reduction or inversion in the attentional bias would be present only when both the circadian drive for sleep propensity is maximal (i.e. around 05:00) and homeostatic sleep pressure is high. Thus participants were tested at 21:00 and under SD conditions at 05:00 and 09:00. Additionally, we used the greyscales (GS) task well-known to evidence a leftward bias in luminance judgments. Although results evidenced a consistent leftward bias both in the LDM and GS, we found a suppression of the leftward bias at the circadian nadir of alertness (05:00) after SD only for the GS, but not for the LDM. Noticeably, the leftward bias in the GS vanished at 05:00 after SD but reappeared at 09:00 despite continued SD, suggesting a predominant circadian influence on attentional asymmetries in the GS. Additionally, inter-sessions correlations evidenced a reproducible, consistent bias both in the LDM and GS, with no consistent relationship between the two tasks, suggesting independence of the neural networks subtending performance in LDM and GS. Overall, our results suggest that SD per se does not impede the leftward bias both in LDM and GS, whereas circadian-related variations in vigilance may impact attentional asymmetries in luminance judgments.

Effects of sleep deprivation on cortical activation during directed attention in the absence and presence of visual stimuli

Sleep deprivation (SD) can give rise to faltering attention but the mechanics underlying this remain uncertain. Using a covert attention task that required attention to a peripheral target location, we compared the effects of attention and SD on baseline activity prior to visual stimulation as well as on stimulus-evoked activity. Volunteers were studied after a night of normal sleep (RW) and a night of SD. Baseline signal elevations evoked by preparatory attention in the absence of visual stimulation were attenuated within rFEF, rIPS (sparing SEF) and all retinotopically mapped visual areas during SD, indicative of impaired endogenous attention. In response to visual stimuli, attention modulated activation in higher cortical areas and extrastriate cortex (hV4, ventral occipital areas) after RW. SD attenuated rFEF, rIPS, V3a and VO stimulus-evoked activation regardless of whether stimuli were attended. Notably, the modulation of stimulus-evoked activation by attention was not affected by SD unlike for the preparatory period, suggesting a reduced number, but still functional circuits during SD. Deficits in endogenous attention in SD dominate in the preparatory period, whereas changes in stimulus-related activation arise from an interaction between compromised fronto-parietal top-down control of attention and reduced sensitivity of extrastriate visual cortex to top-down or bottom-up inputs.

Reduced visual processing capacity in sleep deprived persons

Multiple experiments have found sleep deprivation to lower task-related parietal and extrastriate visual activation, suggesting a reduction of visual processing capacity in this state. The perceptual load theory of attention (Lavie, 1995) predicts that our capacity to process unattended distractors will be reduced by increasing perceptual difficulty of task-relevant stimuli. Here, we evaluated the effects of sleep deprivation and perceptual load on visual processing capacity by measuring neural repetition-suppression to unattended scenes while healthy volunteers attended to faces embedded in face-scene pictures. Perceptual load did not affect repetition suppression after a normal night of sleep. Sleep deprivation reduced repetition suppression in the parahippocampal place area (PPA) in the high but not low perceptual load condition. Additionally, the extent to which task-related fusiform face area (FFA) activation was reduced after sleep deprivation correlated with behavioral performance and lowered repetition suppression in the PPA. The findings concerning correct responses indicate that a portion of stimulus related activation following a normal night of sleep contributes to potentially useful visual processing capacity that is attenuated following sleep deprivation. Finally, when unattended stimuli are not highly intrusive, sleep deprivation does not appear to increase distractibility.

Long-term sleep disturbances in children: a cause of neuronal loss

Short-term sleep loss is known to cause temporary difficulties in cognition, behaviour and health but the effects of persistent sleep deprivation on brain development have received little or no attention. Yet, severe sleep disorders that last for years are common in children especially when they have neurodevelopmental disabilities. There is increasing evidence that chronic sleep loss can lead to neuronal and cognitive loss in children although this is generally unrecognized by the medical profession and the public. Without the restorative functions of sleep due to total sleep deprivation, death is inevitable within a few weeks. Chronic sleep disturbances at any age deprive children of healthy environmental exposure which is a prerequisite for cognitive growth more so during critical developmental periods. Sleep loss adversely effects pineal melatonin production which causes disturbance of circadian physiology of cells, organs, neurochemicals, neuroprotective and other metabolic functions. Through various mechanisms sleep loss causes widespread deterioration of neuronal functions, memory and learning, gene expression, neurogenesis and numerous other changes which cause decline in cognition, behaviour and health. When these changes are long-standing, excessive cellular stress develops which may result in widespread neuronal loss. In this review, for the first time, recent research advances obtained from various fields of sleep medicine are integrated in order to show that untreated chronic sleep disorders may lead to impaired brain development, neuronal damage and permanent loss of developmental potentials. Further research is urgently needed because these findings have major implications for the treatment of sleep disorders.

Sleep deprivation impairs object-selective attention: a view from the ventral visual cortex

Background

Most prior studies on selective attention in the setting of total sleep deprivation (SD) have focused on behavior or activation within fronto-parietal cognitive control areas. Here, we evaluated the effects of SD on the top-down biasing of activation of ventral visual cortex and on functional connectivity between cognitive control and other brain regions.

Methodology/Principal Findings

Twenty-three healthy young adult volunteers underwent fMRI after a normal night of sleep (RW) and after sleep deprivation in a counterbalanced manner while performing a selective attention task. During this task, pictures of houses or faces were randomly interleaved among scrambled images. Across different blocks, volunteers responded to house but not face pictures, face but not house pictures, or passively viewed pictures without responding. The appearance of task-relevant pictures was unpredictable in this paradigm. SD resulted in less accurate detection of target pictures without affecting the mean false alarm rate or response time. In addition to a reduction of fronto-parietal activation, attending to houses strongly modulated parahippocampal place area (PPA) activation during RW, but this attention-driven biasing of PPA activation was abolished following SD. Additionally, SD resulted in a significant decrement in functional connectivity between the PPA and two cognitive control areas, the left intraparietal sulcus and the left inferior frontal lobe.

Conclusions/Significance

SD impairs selective attention as evidenced by reduced selectivity in PPA activation. Further, reduction in fronto-parietal and ventral visual task-related activation suggests that it also affects sustained attention. Reductions in functional connectivity may be an important additional imaging parameter to consider in characterizing the effects of sleep deprivation on cognition.

An ERP examination of the different effects of sleep deprivation on exogenously cued and endogenously cued attention

BACKGROUND

Behavior and neuroimaging studies have shown selective attention to be negatively impacted by sleep deprivation. Two unresolved questions are (1) whether sleep deprivation impairs attention modulation of early visual processing or of a later stage of cognition and (2) how sleep deprivation affects exogenously versus endogenously driven selective attention.

STUDY OBJECTIVES

To investigate the time course and different effects of sleep deprivation on exogenously and endogenously cued selective attention.

DESIGN

Participants performed modified Attention Network Tests (ANTs) using exogenously and endogenously cued targets to index brain networks underlying selective attention. Target-locked event-related potentials (ERPs) were recorded as participants performed the Attention Network Tests on 2 days separated by 24 hours of total sleeplessness.

PARTICIPANTS

Fourteen US Military Academy cadets and 12 US Army soldiers from the Ironhorse Brigade, Ft. Hood, Texas.

MEASUREMENT AND RESULTS

For both Attention Network Tests, sleep deprivation led to slowed response times, decreased accuracy rates, a diminished positive P3 (450- to 550-ms) ERP component, and an enhanced P2 (312- to 434-ms) ERP component. In contrast, the parietal N1 (157- to 227-ms) ERP response was reduced with sleep deprivation for endogenously, but not exogenously, cued targets. These sleep deprivation-related effects occurred in the context of typical behavior and ERP patterns expected in a cued spatial-attention task.

CONCLUSIONS

These findings suggest that as little as 24 hours of sleep deprivation affects both early and late stages of attention selection but affects endogenously driven selective attention to a greater degree than it does exogenously driven selective attention.

Sleep deprivation and its effects on object-selective attention

Sleep deprivation (SD) affects attention but it is an open question as to whether all subtypes of attention are similarly affected. We investigated the effects of 24 h of total SD on object-selective attention. 26 healthy, young adults viewed quartets of alternating faces or place scenes and performed selective judgments on faces only, scenes only or both faces and scenes. Volunteers underwent fMRI following a normal night of sleep and again following approximately 24 h of total sleep deprivation in a counterbalanced fashion. Sleep deprivation resulted in slower and less accurate picture classification as well as poorer recognition memory for scenes. Attention strongly modulated activation in the Parahippocampal Place Area (PPA). Task-related activation in the fronto-parietal cortex and PPA was reduced in SD, but the relative modulation of PPA activation by attention was preserved. Psychophysiological interaction between the left intra-parietal sulcus and the PPA that was clearly present after a normal night of sleep was reduced below threshold following SD suggesting that PPI may be a more sensitive method of detecting change in selective attention. Sleep deprivation may affect object-selective attention in addition to exerting a task-independent deficit in attention.

Neurocognitive consequences of sleep deprivation

Sleep deprivation is associated with considerable social, financial, and health-related costs, in large measure because it produces impaired cognitive performance due to increasing sleep propensity and instability of waking neurobehavioral functions. Cognitive functions particularly affected by sleep loss include psychomotor and cognitive speed, vigilant and executive attention, working memory, and higher cognitive abilities. Chronic sleep-restriction experiments--which model the kind of sleep loss experienced by many individuals with sleep fragmentation and premature sleep curtailment due to disorders and lifestyle--demonstrate that cognitive deficits accumulate to severe levels over time without full awareness by the affected individual. Functional neuroimaging has revealed that frequent and progressively longer cognitive lapses, which are a hallmark of sleep deprivation, involve distributed changes in brain regions including frontal and parietal control areas, secondary sensory processing areas, and thalamic areas. There are robust differences among individuals in the degree of their cognitive vulnerability to sleep loss that may involve differences in prefrontal and parietal cortices, and that may have a basis in genes regulating sleep homeostasis and circadian rhythms. Thus, cognitive deficits believed to be a function of the severity of clinical sleep disturbance may be a product of genetic alleles associated with differential cognitive vulnerability to sleep loss.