Functional brain alterations in acute sleep deprivation: An activation likelihood estimation meta-analysis

Stratification of orthognathic surgery patients for painful TMD and associated factors

OBJECTIVE

To identify clusters of patients with DFD based on variables related to TMD, psychological aspects, somatization, oral habits, and sleep.

METHOD

Ninety-two patients with DFD were evaluated before orthognathic surgery according to demographic data, facial profile, presence of painful TMD (DC/TMD), psychological aspects, oral habits, comorbidities, substance use, and sleep quality.

RESULTS

Eighty-six individuals comprised the final sample. The K-means cluster analysis identified two distinct but internally similar groups. One called "Vulnerable" with a higher prevalence of muscular TMD and associated factors with 43 (50%) participants, and another with 43 (50%) participants, called "Adaptive" with a lower prevalence of these variables (P<.01). The determining variables were signs and symptoms of anxiety and somatization, awake bruxism and self-reported sleep quality. The presence of arthralgia, comorbidities, or smoking did not influence the formation of the groups. The clusters were tested with gender, age, facial profile, maxillary excess, and deficiency. Only females were associated with the vulnerable group (P=.015). These results highlight the importance of multidimensional assessment of patients with DFD. The stratification of these individuals can help with personalized treatment, targeting specific strategies for each group, such as behavioral interventions and referrals to a multidisciplinary team.

Cortical excitability on sleep deprivation measured by transcranial magnetic stimulation: A systematic review and meta-analysis

Sleep deprivation is a common public problem, and researchers speculated its neurophysiological mechanisms related to cortical excitatory and inhibitory activity. Recently, transcranial magnetic stimulation combined with electromyography (TMS-EMG) and electroencephalography (TMS-EEG) have been used to assess cortical excitability in sleep-deprived individuals, but the results were inconsistent. Therefore, we conducted a meta-analysis to summarize relevant TMS-evoked indices of excitability and inhibition for exploring the cortical effects of sleep deprivation. In TMS-EMG studies, short-interval cortical inhibition (SICI) significantly decreased in sleep-deprived subjects; while the intracortical facilitation (ICF), resting motor threshold (RMT), and cortical silent period (CSP) were not significant compared to healthy controls. In TMS-EEG studies, the amplitude and slope of TMS-evoked potential (TEP) increased in sleep-deprived subjects. This study indicated that cortical inhibition decreased following sleep deprivation based on the TMS-EMG results and cortical excitability enhanced in the TMS-EEG results, supporting the disturbance of cortical excitability in sleep-deprived individuals.

Exploring the Effects of Sleep Deprivation on Physical Performance: An EEG Study in the Context of High-Intensity Endurance

BACKGROUND

While the effects of sleep deprivation on cognitive function are well-documented, its impact on high-intensity endurance performance and underlying neural mechanisms remains underexplored, especially in the context of search and rescue operations where both physical and mental performance are essential. This study examines the neurophysiological basis of sleep deprivation on high-intensity endurance using electroencephalography (EEG). In this crossover study, twenty firefighters were subjected to both sleep deprivation (SD) and normal sleep conditions, with each participant performing endurance treadmill exercise the following morning after each condition. EEG signals were recorded before and after high-intensity endurance exercise, and power spectrum analysis and functional connectivity analysis were performed on sleep related frequency bands rhythm: δ (0.5-4 Hz) and θ (4-8 Hz). The EEG power spectral and functional connectivity were measured by repeated measure analysis of variance.

RESULTS

The SD condition had an average sleep duration of 3.78 ± 0.69 h, while the duration for normal sleep was 7.63 ± 0.52 h. After high-intensity endurance exercise, the SD condition had a higher maximum heart rate (p < 0.05) and shorter exercise time (p < 0.05) than normal sleep. Compared with before exercise, the δ band in the left parietal lobe P7 channel increased significantly (p < 0.01), and the θ band in the central Cz channel and the left and right parietal lobe P7 and P8 channel increased significantly (p < 0.01 & p < 0 0.05) in SD and normal sleep conditions after exercise. After exercise, compared with normal sleep, the δ band power in occipital O1 and Oz channels and parietal P7 and TP7 channels in SD significantly decreased (p < 0.05 & p < 0.01); the power of the θ band decreased significantly in the occipital O1 channel, central CZ channel and the left and right parietal P7 and P8 channel (p < 0.05 & p < 0.01). Whole connectivity showed a significant increase (p = 0.001) in the δ band for the SD condition at post-exhaustion. Local connectivity analysis identified a localized network in the δ band with reduced (p < 0.001) post-exhaustion in the SD condition displaying inter-hemispheric differences in certain connections (FP1-CP4, T7-C4, T7-TP8, and O1-FT8) and intra-hemispheric (C3-CPz and Pz-P4) variations.

CONCLUSIONS

Sleep deprivation significantly reduced maximum endurance performance, indicating decreased neural activity in the central and parietal brain regions. Alterations in δ and θ frequency band power, along with disrupted connectivity, may highlight the neurophysiological basis underlying this decline.

Association of self-monitoring performance of cognitive performance with personal diurnal preference when sleep-deprived

In modern society, many workers struggle with sleep deprivation due to their work schedules and excessive workloads. Accurate self-awareness and self-monitoring abilities are crucial for workers to adopt risk-coping strategies and protective behaviors when fatigued. The current study examined the relationship between chronotypes and self-monitoring performance during 24 h of sleep deprivation. The study involved 26 male adults in a two-night experiment, and participants' diurnal preferences were evaluated using the Morningness-Eveningness Questionnaire (MEQ). Self-monitoring performance was calculated by comparing actual task performance with self-rated predicted or post-estimated performance in the psychomotor vigilance task (PVT) and Digit Symbol Substitution Task (DSST). The study found that task and self-monitoring performances in the PVT and DSST were maintained until around 4:00 h, after which they began to deteriorate. Individuals with a higher MEQ score, indicating a stronger tendency towards a morning type, showed inaccurate self-monitoring, particularly in the final quarter of the sleep deprivation experiment, due to overly optimistic predictions. However, only prediction accuracy and not post-estimation showed this correlation. This study highlights the importance of considering an individual's chronotype in workplace management, particularly in workplaces with irregular work timings, rotating shifts, and long working hours, to ensure better occupational safety.

Resting-State EEG Microstates Dynamics Associated with Interindividual Vulnerability to Sleep Deprivation

Purpose

Sleep deprivation can induce severe deficits in vigilant maintenance and alternation in large-scale networks. However, differences in the dynamic brain networks after sleep deprivation across individuals have rarely been investigated. In the present study, we used EEG microstate analysis to investigate the effects of sleep deprivation and how it differentially affects resting-state brain activity in different individuals.

Participants and Methods

A total of 44 healthy adults participated in a within-participant design study involving baseline sleep and 24-hour sleep deprivation, with resting-state EEG recorded during wakefulness. The psychomotor vigilance task (PVT) was used to measure vigilant attention. Participants were median split as vulnerable or resilient according to their changes in the number of lapses between the baseline sleep and sleep deprivation conditions.

Results

Sleep deprivation caused decreases in microstates A, B, and D, and increases in microstate C. We also found increased transition probabilities of microstates C and D between each other, lower transition probabilities from microstates C and D to microstate B, and higher transition probabilities from microstates A and B to microstate C. Sleep-deprived vulnerable individuals showed decreased occurrence of microstate B and transition probability from microstate C to B after sleep deprivation, but not in resilient individuals.

Conclusion

The findings suggest that sleep deprivation critically affects dynamic brain-state properties and the differences in time parameters of microstates might be the underlying neural basis of interindividual vulnerability to sleep deprivation.

Sleep bad, feel bad: Unpacking the role of exercise and socializing

This study investigates the daily associations between sleep disturbances and emotional well-being, focusing on exercise and social interaction as potential moderating factors. Using a longitudinal daily diary approach, we analyzed data from 455 participants (mean age = 41.98 years, 382 females) who reported daily diaries over 20 days. Multilevel modeling was employed to analyze both within- and between-person relations between sleep variables (duration, efficiency, difficulty falling asleep) and next day positive/negative affect. The analysis also explored the moderating roles of exercise and socializing, adjusting for age, sex, and COVID-related variables. Our findings indicate that at both within- and between-person levels, higher sleep efficiency predicted increased positive affect and reduced negative affect; conversely, difficulty falling asleep predicted diminished positive affect and heightened negative affect. Sleep duration had a nonlinear relationship with positive and negative affect, with both longer and shorter than usual sleep duration predicting less positive and more negative affect. Exercise and socializing showed different moderating roles in the relationship between sleep and negative affect. Exercise was found to mitigate the negative impact of poor sleep on negative affect, whereas extended socializing amplified the salutary impact of good sleep on reducing negative affect. Our findings underscore the importance of sleep health in daily emotional well-being, suggesting associations between sleep efficiency, difficulty falling asleep, and next-day affect at both within- and between-person levels. Furthermore, the distinct moderation patterns of exercise and socializing provide unique insights into the interplay of sleep, exercise, and social interaction, allowing more targeted interventions.

Impact of sleep deprivation on aperiodic activity: a resting-state EEG study

Sleep deprivation (SD) has been shown to have a negative impact on alertness, as evidenced by behavioral and electroencephalographic studies. Nevertheless, in prior studies utilizing conventional fixed-bandwidth spectral analysis the aperiodic and periodic components were often confused, and some important periodic parameters (i.e., center frequency, bandwidth) were ignored. Here, based on a large open-access dataset of SD, we employed a standardized process for multiple-electrode analysis and group inference. We found that, compared to the healthy sleep control state (SC), the aperiodic offset shifted overall after SD, primarily in the occipital region. This shift was associated with a reduction in subjective alertness. Regarding periodic components, we did not find any power change in the alpha rhythm, but there was an increase in bandwidth of alpha within different regions distributed in the occipital and temporal lobes. These findings highlight the potential significance and value of aperiodic parameters in behavioral and electrophysiological research.NEW & NOTEWORTHY Aperiodic and periodic components were separated in a large open-access EEG dataset of sleep deprivation. Aperiodic offsets increase after deprivation, particularly in the occipital region, reflecting a decline in self-reported vigilance. Parameterized alpha bandwidth, which was ignored in previous studies, is found to be relevant to sleep deprivation. Increase in bandwidth of alpha was focused in the occipital and temporal lobes.

Sleep and fundamental movement skills in primary schoolchildren: The REACT project

OBJECTIVE

Whether sleep is related to fundamental movement skills (FMS) in the pediatric population is largely unknown. The objective of this study was to examine the association between sleep characteristics (duration, efficiency, regularity) and FMS proficiency levels in school-aged children.

METHODS

This cross-sectional study included 996 children (mean age: 8.3 ± 1.2 years) from 25 of the 32 primary schools in Matosinhos, northern Portugal. Data collection occurred between January and June 2022. Sleep was assessed using an ActiGraph wGT3X-BT accelerometer worn on the wrist for 7 consecutive days. FMS proficiency levels were assessed in the schools with a new digital platform (Meu Educativo®) that evaluated five object control skills (dribble, kick, catch, throw, and underhand roll), with a total score ranging between 5 and 15. Multilevel ordinal logistic regression was used to test the associations between sleep characteristics and FMS proficiency levels. Covariates included age, sex, body mass index z-score, socioeconomic status, and moderate-to-vigorous physical activity.

RESULTS

The results showed that sleep characteristics (duration, efficiency, and regularity) were not related to FMS proficiency. Being a boy, older age, and higher moderate-to-vigorous physical activity levels were all significantly associated with better FMS proficiency levels. There were no significant sex-by-age interactions.

CONCLUSION

Sleep was not found to be related to FMS performance in children. This finding suggests that sleep is not a good correlate of FMS proficiency levels in school-aged children, and attention should be dedicated to other more important factors such as skill-learning-specific physical activity.

Alterations of sleep deprivation on brain function: A coordinate-based resting-state functional magnetic resonance imaging meta-analysis

BACKGROUND

Sleep deprivation is a prevalent issue that impacts cognitive function. Although numerous neuroimaging studies have explored the neural correlates of sleep loss, inconsistencies persist in the reported results, necessitating an investigation into the consistent brain functional changes resulting from sleep loss.

AIM

To establish the consistency of brain functional alterations associated with sleep deprivation through systematic searches of neuroimaging databases. Two meta-analytic methods, signed differential mapping (SDM) and activation likelihood estimation (ALE), were employed to analyze functional magnetic resonance imaging (fMRI) data.

METHODS

A systematic search performed according to PRISMA guidelines was conducted across multiple databases through July 29, 2023. Studies that met specific inclu-sion criteria, focused on healthy subjects with acute sleep deprivation and reported whole-brain functional data in English were considered. A total of 21 studies were selected for SDM and ALE meta-analyses.

RESULTS

Twenty-one studies, including 23 experiments and 498 subjects, were included. Compared to pre-sleep deprivation, post-sleep deprivation brain function was associated with increased gray matter in the right corpus callosum and decreased activity in the left medial frontal gyrus and left inferior parietal lobule. SDM revealed increased brain functional activity in the left striatum and right central posterior gyrus and decreased activity in the right cerebellar gyrus, left middle frontal gyrus, corpus callosum, and right cuneus.

CONCLUSION

This meta-analysis consistently identified brain regions affected by sleep deprivation, notably the left medial frontal gyrus and corpus callosum, shedding light on the neuropathology of sleep deprivation and offering insights into its neurological impact.

Altered Functional Connectivity in Working Memory Network After Acute Sleep Deprivation

Acute sleep deprivation (SD) has a detrimental effect on working memory (WM). However, prior functional magnetic resonance imaging (fMRI) studies have failed to reach consistent results on brain functions underlying WM decline after acute SD. Thus, we aimed to identify convergent patterns of abnormal brain functions due to WM decline after acute SD. A coordinate-based activation likelihood estimation (ALE) meta-analysis of task-state fMRI studies testing the effects of acute SD on WM was performed to construct WM network. Then 26 healthy subjects with regular sleep performed the n-back task and underwent resting-state fMRI scanning before and after 24 h of SD. The functional connectivity (FC) among these brain regions and correlations with WM performance were calculated. The ALE results displayed that SD subjects performing WM-related tasks had consistent hypoactivation in the occipital lobe, left middle occipital gyrus, parietal lobe, precuneus, inferior parietal lobule, right sub-gyral, right cuneus, right limbic lobe, and right posterior cingulate. Consistent hyperactivation was showed in the left cerebrum, including the lingual gyrus, posterior lobe, cuneus, temporal lobe, and fusiform gyrus. These identified brain regions as the seeds to construct WM network. The increased FC between the left declive and right sub-gyral, left cuneus and left lingual gyrus, and left cuneus and right post cingulate were found. Furthermore, the impaired WM performance negatively correlated with increased FC. Taken together, our findings highlight that the altered FC in WM network may be the underlying mechanisms of WM decline after acute SD.

Effect of homeostatic pressure on daytime vigilance performance: Evidence from behaviour and resting-state EEG

Vigilance is highly sensitive to the time-of-day effect and goes through the daytime trough during the period of the post-noon dip. A midday nap could maintain individuals' vigilance at an optimal level. Thus, homeostatic sleep pressure is one of the main reasons for the post-noon dip in daytime vigilance. The current study focussed on the role of homeostatic sleep pressure in the diurnal variation of vigilance performance with normal circadian rhythms and the corresponding neural basis. With 34 healthy adults, we recorded the resting-state electroencephalogram activities and the following vigilance performance measured by psychomotor vigilance test in the morning, the no-nap mid afternoon, and the nap mid afternoon. The circadian process was controlled by measuring vigilance and resting-state electroencephalogram activities at the same time point in the nap and no-nap conditions. Homeostatic sleep pressure accumulated from morning to mid afternoon induced the declined vigilance performance and a global increase in resting-state delta, theta, alpha, and beta1 bands power, and a local increase in beta2 band power in the central region. Furthermore, the more the spontaneous beta2 power increased, the less vigilance declined from morning to mid afternoon. The current findings suggest that homeostatic sleep pressure increased cortical excitability but decreased cortical communication efficiency from morning to mid afternoon. In addition, the activity of the high beta waves probably reflected the compensatory effort to counteract the negative impact of the low arousal state on the following vigilance task by performing more action preparation in the no-nap afternoon.

Sleep disorders causally affect the brain cortical structure: A Mendelian randomization study

BACKGROUND

s: Previous studies have reported that patients with sleep disorders have altered brain cortical structures. However, the causality has not been determined. We performed a two-sample Mendelian randomization (MR) to reveal the causal effect of sleep disorders on brain cortical structure.

METHODS

We included as exposures 11 phenotypes of sleep disorders including subjective and objective sleep duration, insomnia symptom and poor sleep efficiency, daytime sleepiness (narcolepsy)/napping, morning/evening preference, and four sleep breathing related traits from nine European-descent genome-wide association studies (GWASs). Further, outcome variables were provided by ENIGMA Consortium GWAS for full brain and 34 region-specific cortical thickness (TH) and surface area (SA) of grey matter. Inverse-variance weighted (IVW) was used as the primary estimate whereas alternative MR methods were implemented as sensitivity analysis approaches to ensure results robustness.

RESULTS

At the global level, both self-reported or accelerometer-measured shorter sleep duration decreases the thickness of full brain both derived from self-reported data (βIVW = 0.03 mm, standard error (SE) = 0.02, P = 0.038; βIVW = 0.02 mm, SE = 0.01, P = 0.010). At the functional level, there were 66 associations of suggestive evidence of causality. Notably, one robust evidence after multiple testing correction (1518 tests) suggests the without global weighted SA of superior parietal lobule was influenced significantly by sleep efficiency (βIVW = -285.28 mm2, SE = 68.59, P = 3.2 × 10-5).

CONCLUSIONS

We found significant evidence that shorter sleep duration, as estimated by self-reported interview and accelerometer measurements, was causally associated with atrophy in the entire human brain.

Altered functional connectivity after acute sleep deprivation reveals potential locations for noninvasive brain stimulation techniques

BACKGROUNDS

Non-invasive brain stimulation (NIBS) techniques are emerging as efficacious treatments for sleep deprivation (SD). However, the stimulation location of NIBS (e.g. transcranial magnetic stimulation and transcranial direct current stimulation) on intervening acute SD is limited in previous studies. In this study, we aimed to investigate potentially effective targets of NIBS on intervening acute SD.

METHODS

We firstly performed a meta-analysis of 95 functional magnetic resonance imaging studies to find SD-related brain regions as regions of interest (ROI). Subsequently, we used resting-state functional connectivity analysis in 32 young individuals suffering from 24 h SD to identify brain surface regions associated with the ROIs. Finally, we applied 10-20 system coordinates to locate scalp sites for NIBS corresponding to the brain surface regions.

RESULTS

We identified the bilateral dorsolateral prefrontal cortex, bilateral inferior frontal gyrus, left supplementary motor area, precentral, right precuneus, bilateral inferior parietal gyrus, right middle temporal gyrus, and superior frontal gyrus as potential targets of NIBS for intervening SD. The 10-20 system coordinates corresponding to these brain surface regions were identified as potential sites for NIBS.

CONCLUSIONS

In conclusion, we identified several potential targets which could provide alternative stimulation locations for the use of NIBS on young patients suffering from acute SD.

The neurophysiologic landscape of the sleep onset: a systematic review

Background

The sleep onset process is an ill-defined complex process of transition from wakefulness to sleep, characterized by progressive modifications at the subjective, behavioural, cognitive, and physiological levels. To this date, there is no international consensus which could aid a principled characterisation of this process for clinical research purposes. The current review aims to systemise the current knowledge about the underlying mechanisms of the natural heterogeneity of this process.

Methods

In this systematic review, studies investigating the process of the sleep onset from 1970 to 2022 were identified using electronic database searches of PsychINFO, MEDLINE, and Embase.

Results

A total of 139 studies were included; 110 studies in healthy participants and 29 studies in participants with sleep disorders. Overall, there is a limited consensus across a body of research about what distinct biomarkers of the sleep onset constitute. Only sparse data exists on the physiology, neurophysiology and behavioural mechanisms of the sleep onset, with majority of studies concentrating on the non-rapid eye movement stage 2 (NREM 2) as a potentially better defined and a more reliable time point that separates sleep from the wake, on the sleep wake continuum.

Conclusions

The neurophysiologic landscape of sleep onset bears a complex pattern associated with a multitude of behavioural and physiological markers and remains poorly understood. The methodological variation and a heterogenous definition of the wake-sleep transition in various studies to date is understandable, given that sleep onset is a process that has fluctuating and ill-defined boundaries. Nonetheless, the principled characterisation of the sleep onset process is needed which will allow for a greater conceptualisation of the mechanisms underlying this process, further influencing the efficacy of current treatments for sleep disorders.

How the time-of-day affects the EEG signatures of vigilance fluctuation

Previous research suggested the homeostatic effect on the top-down control system as a major factor for daytime vigilance decrement, yet how it alters the cognitive processes of vigilance remains unclear. Using EEG, the current study measured the vigilance of 28 participants under three states: the morning, the midafternoon after napping and no-nap. The drift-diffusion model was applied to decompose vigilant reaction time into decision and non-decision components. From morning to midafternoon, vigilance declined during sustained wakefulness, but remained stable after midday napping. Increased sleep pressure negatively affected decision time and drift rate, but did not significantly alter the non-decision process. Frontocentral N2 amplitude decreased from morning to no-nap afternoon, associated with slowing decision time. In contrast, parietal P3 had no diurnal alterations during sustained wakefulness, but enhanced after napping. Pre-stimulus parietooccipital alpha power enhanced under high sleep pressure relative to low, accompanied by more lapses in no-nap vs. post-napping conditions. The homeostasis effect is a major contributor to daily vigilance fluctuation, specifically targeting top-down control processes during the pre-stimulus and decision-making stages. Under the influence of sleep homeostasis, the speed of decision-making declines with degradation in target monitoring from morning to afternoon, leading to post-noon vigilance decrement.

Reduced Resting-State EEG Power Spectra and Functional Connectivity after 24 and 36 Hours of Sleep Deprivation

Total sleep deprivation (TSD) leads to cognitive decline; however, the neurophysiological mechanisms underlying resting-state electroencephalogram (EEG) changes after TSD remain unclear. In this study, 42 healthy adult participants were subjected to 36 h of sleep deprivation (36 h TSD), and resting-state EEG data were recorded at baseline, after 24 h of sleep deprivation (24 h TSD), and after 36 h TSD. The analysis of resting-state EEG at baseline, after 24 h TSD, and after 36 h TSD using source localization analysis, power spectrum analysis, and functional connectivity analysis revealed a decrease in alpha-band power and a significant increase in delta-band power after TSD and impaired functional connectivity in the default mode network, precuneus, and inferior parietal lobule. The cortical activities of the precuneus, inferior parietal lobule, and superior parietal lobule were significantly reduced, but no difference was found between the 24 h and 36 h TSD groups. This may indicate that TSD caused some damage to the participants, but this damage temporarily slowed during the 24 h to 36 h TSD period.

The relationship between processing speed and remodeling spatial patterns of intrinsic brain activity in the elderly with different sleep duration

Objective

Brain neuroplasticity in which sleep affects the speed of information processing in the elderly population has not been reported. Therefore, this study was conducted to explore the effects of sleep on information processing speed and its central plasticity mechanism in the elderly.

Methods

A total of 50 individuals aged 60 and older were enrolled in this case control study. All subjects were divided into two groups according to the sleep time: short sleep duration (< 360 min) (6 men and 19 women; mean age: 66.96 ± 4.28 years old), and non-short sleep duration (> 360 min) (13 men and 12 women). Resting-state functional magnetic resonance imaging (rs-fMRI) data were collected, and the amplitude of low frequency fluctuation (ALFF), regional homogeneity (ReHo), and degree centrality (DC) were calculated for each participant. Two-sample t-tests were performed to compare the ALFF, ReHo, and DC maps between the two groups. Then, the relationships among clinical features, fMRI and cognitive function were analyzed using general linear model.

Results

Short sleep duration group showed significantly increased ALFF value in the bilateral middle frontal gyrus and right insula; significantly increased ReHo value in the left superior parietal gyrus, and decreased ReHo value in the right crebellum; significantly decreased DC value in the left inferior occipital gyrus, left superior parietal gyrus and right cerebellum (p < 0.05, AlphaSim correction). The ALFF value of right insula is significantly associated with symbol digit modalities test (SDMT) score (β = -0.363, p = 0.033).

Conclusion

Short sleep duration and processing speed are significantly associated with remodeling spatial patterns of intrinsic brain activity in the elderly.

Kullback-Leibler Divergence of Sleep-Wake Patterns Related with Depressive Severity in Patients with Epilepsy

(1) Objective: Whether abnormal sleep-wake rhythms were associated with depressive symptoms in patents with epilepsy had remained unclear. Our study aimed to establish relative entropy for the assessment of sleep-wake patterns and to explore the relationship between this index and the severity of depressive symptoms in patients with epilepsy. (2) Methods: We recorded long-term scalp electroencephalograms (EEGs) and Hamilton Depression Rating Scale-17 (HAMD-17) questionnaire scores from 64 patients with epilepsy. Patients with HAMD-17 scores of 0-7 points were defined as the non-depressive group, while patients with scores of 8 or higher were defined as the depression group. Sleep stages were firstly classified based on EEG data. We then quantified sleep-wake rhythm variations in brain activity using the Kullback-Leibler divergence (KLD) of daytime wakefulness and nighttime sleep. The KLD at different frequency bands in each brain region was analyzed between the depression and non-depression groups. (3) Results: Of the 64 patients with epilepsy included in our study, 32 had depressive symptoms. It was found that patients with depression had significantly decreased KLD for high-frequency oscillations in most brain areas, especially the frontal lobe. A detailed analysis was conducted in the right frontal region (F4) because of the significant difference in the high-frequency band. We found that the KLDs at the gamma bands were significantly decreased in the depression groups compared to the non-depression group (KLD_D = 0.35 ± 0.05, KLD_ND = 0.57 ± 0.05, p = 0.009). A negative correlation was displayed between the KLD of gamma band oscillation and HAMD-17 score (r = -0.29, p = 0.02). (4) Conclusions: Sleep-wake rhythms can be assessed using the KLD index calculated from long-term scalp EEGs. Moreover, the KLD of high-frequency bands had a negative correlation with HAMD-17 scores in patients with epilepsy, which indicates a close relationship between abnormal sleep-wake patterns and depressive symptoms in patients with epilepsy.

Associations between resting state brain activity and A1 adenosine receptor availability in the healthy brain: Effects of acute sleep deprivation

Introduction

Previous resting-state fMRI (Rs-fMRI) and positron emission tomography (PET) studies have shown that sleep deprivation (SD) affects both spontaneous brain activity and A1 adenosine receptor (A1AR) availability. Nevertheless, the hypothesis that the neuromodulatory adenosinergic system acts as regulator of the individual neuronal activity remains unexplored.

Methods

Therefore, fourteen young men underwent Rs-fMRI, A1AR PET scans, and neuropsychological tests after 52 h of SD and after 14 h of recovery sleep.

Results

Our findings suggested higher oscillations or regional homogeneity in multiple temporal and visual cortices, whereas decreased oscillations in cerebellum after sleep loss. At the same time, we found that connectivity strengths increased in sensorimotor areas and decreased in subcortical areas and cerebellum.

Discussion

Moreover, negative correlations between A1AR availability and rs-fMRI metrics of BOLD activity in the left superior/middle temporal gyrus and left postcentral gyrus of the human brain provide new insights into the molecular basis of neuronal responses induced by high homeostatic sleep pressure.

Altered vigilant maintenance and reorganization of rich-clubs in functional brain networks after total sleep deprivation

BACKGROUND

Sleep deprivation strongly deteriorates the stability of vigilant maintenance. In previous neuroimaging studies of large-scale networks, neural variations in the resting state after sleep deprivation have been well documented, highlighting that large-scale networks implement efficient cognitive functions and attention regulation in a spatially hierarchical organization. However, alterations of neural networks during cognitive tasks have rarely been investigated.

METHODS AND PURPOSES

The present study used a within-participant design of 35 healthy right-handed adults and used task-based functional magnetic resonance imaging to examine the neural mechanism of attentional decline after sleep deprivation from the perspective of rich-club architecture during a psychomotor vigilance task.

RESULTS

We found that a significant decline in the hub disruption index was related to impaired vigilance due to sleep loss. The hierarchical rich-club architectures were reconstructed after sleep deprivation, especially in the default mode network and sensorimotor network. Notably, the relatively fast alert response compensation was correlated with the feeder organizational hierarchy that connects core (rich-club) and peripheral nodes.

SIGNIFICANCES

Our findings provide novel insights into understanding the relationship of alterations in vigilance and the hierarchical architectures of the human brain after sleep deprivation, emphasizing the significance of optimal collaboration between different functional hierarchies for regular attention maintenance.

Chronotype, Longitudinal Volumetric Brain Variations Throughout Adolescence, and Depressive Symptom Development

OBJECTIVE

Adolescence is a critical period for circadian rhythm, with a strong shift toward eveningness around age 14. Also, eveningness in adolescence has been found to predict later onset of depressive symptoms. However, no previous study has investigated structural variations associated with chronotype in early adolescence and how this adds to the development of depressive symptoms.

METHOD

Assessment of 128 community-based adolescents (51% girls) at age 14 and 19 years was performed. Using whole-brain voxel-based morphometry, baseline (at age 14) regional gray matter volumes (GMVs), follow-up (at age 19) regional GMVs, and longitudinal changes (between 14 and 19) associated with Morningness/Eveningness Scale in Children score and sleep habits at baseline were measured. The association of GMV with depressive symptoms at 19 years was studied, and the role of potential clinical and genetic factors as mediators and moderators was assessed.

RESULTS

Higher eveningness was associated with larger GMV in the right medial prefrontal cortex at ages 14 and 19 in the whole sample. GMV in this region related to depressive symptoms at age 19 in catechol-O-methyltransferase (COMT) Val/Val, but not in Met COMT, carriers. Larger GMV also was observed in the right fusiform gyrus at age 14, which was explained by later wake-up time during weekends.

CONCLUSION

In adolescence, eveningness and its related sleep habits correlated with distinct developmental patterns. Eveningness was specifically associated with GMV changes in the medial prefrontal cortex; this could serve as a brain vulnerability factor for later self-reported depressive symptoms in COMT Val/Val carriers.

Activation likelihood estimation identifies brain regions activated during puncturing at Hegu in healthy volunteers: A meta-analysis

Background

Hegu is the most commonly used acupoints for pain relief. Recently, several functional neuroimaging studies have been performed on acupuncture at Hegu in healthy volunteers, but these studies have yielded diverse findings. Therefore, there is an urgent need to understand the brain response characteristics of acupuncture at Hegu.

Methods

Neuroimaging studies on acupuncture at Hegu published before October 2022 were collected from PubMed, Web of Science, Google Scholar, Embase, and CNKI (China National Knowledge Infrastructure) databases, and were screened by strict inclusion and exclusion criteria. The extraction of brain coordinates was performed by two independent researchers, and the results were analyzed using activation likelihood estimation (ALE) analysis based on quantitative coordinates.

Results

In total, 338 studies were searched, of which 19 studies were included in the final analysis after a rigorous double-blind screening review. Activation likelihood estimation showed that postcentral gyrus in the left brain were activated, whereas the anterior cingulate in the left brain and superior temporal gyrus in the right brain were deactivated.

Conclusion

Acupuncture at Hegu in healthy volunteers did not reveal specific brain regions. This finding implies that organismal status of the study subjects may have an important impact on the effect of acupoints.

Systematic review registration

[https://www.crd.york.ac.uk], identifier [CRD42020197296].

Dynamic hippocampal functional connectivity responses to varying working memory loads following total sleep deprivation

Sleep loss with work overload can impact human cognitive performance. However, the brain's response to an increased working memory load following total sleep deprivation (TSD) remains unclear. In the present study, we focussed on the dynamic response of the hippocampus to increased working memory load before and after total sleep deprivation of 36 h. A total of 16 male participants completed a verbal working memory task under functional magnetic resonance imaging. After whole-brain activation analysis and region of interest analysis of the hippocampus, the generalised form of context-dependent psychophysiological interactions (gPPI) was used to analyse the hippocampal functional connectivity with the whole brain. The results revealed that as the working memory load increased within a small range, from 0-back to 1-back task, the left hippocampal functional connectivity decreased with the left supplementary motor area, left pars opercularis, left rolandic operculum, right superior frontal gyrus, bilateral precentral gyrus, and left middle cingulate cortex following total sleep deprivation compared with that observed in resting wakefulness. When the working memory load further increased from 1-back to 2-back task, the connectivity increased between the left hippocampus and the left superior parietal lobule as well as between the left hippocampus and right lingual gyrus after total sleep deprivation compared with that observed in resting wakefulness. Moreover, the left hippocampus gPPI effect on the left middle cingulate cortex and left superior parietal lobule could predict the behavioural test accuracy in 1-back and 2-back task, respectively, following total sleep deprivation. These findings indicated that increased working memory load after total sleep deprivation disrupts working memory processes. The brain reacts to these disruptions in a dynamic and flexible manner, involving not only brain activation but also hippocampus-related functional network connections.

Emotion regulation mediates the effects of sleep on stress and aggression

It is well established that poor sleep directly increases stress and aggression, but potential mediators of this relationship remain poorly understood. The present study provided the first direct test of whether capacity for emotion regulation mediated the relationship between sleep with stress. It also aimed to extend current understanding of whether emotion regulation might mediate the association between sleep and aggression, by assessing four distinct subcomponents of aggression (anger, hostility, verbal aggression, and physical aggression). In service of these goals, 740 participants completed validated measures of sleep, stress, aggression, and emotion regulation. Results showed that emotion regulation partially mediated the relationship between sleep quality with stress, anger, hostility, and verbal aggression, and fully mediated the relationship between sleep with physical aggression. These data provide novel evidence that emotion regulation abilities may serve as a protective factor against the negative consequences of sleep disturbances.

Vigilant Attention, Cerebral Blood Flow and Grey Matter Volume Change after 36 h of Acute Sleep Deprivation in Healthy Male Adults: A Pilot Study

It is commonly believed that alertness and attention decrease after sleep deprivation (SD). However, there are not enough studies on the changes in psychomotor vigilance testing (PVT) during SD and the corresponding changes in brain function and brain structure after SD. Therefore, we recruited 30 healthy adult men to perform a 36 h acute SD experiment, including the measurement of five indicators of PVT every 2 h, and analysis of cerebral blood flow (CBF) and grey matter volume (GMV) changes, before and after SD by magnetic resonance imaging (MRI). The PVT measurement found that the mean reaction time (RT), fastest 10% RT, minor lapses, and false starts all increased progressively within 20 h of SD, except for major lapses. Subsequently, all indexes showed a significant lengthening or increasing trend, and the peak value was in the range of 24 h-32 h and decreased at 36 h, in which the number of major lapses returned to normal. MRI showed that CBF decreased in the left orbital part of the superior frontal gyrus, the left of the rolandic operculum, the left triangular part, and the right opercular part of the inferior frontal gyrus, and CBF increased in the left lingual gyrus and the right superior gyrus after 36 h SD. The left lingual gyrus was negatively correlated with the major lapses, and both the inferior frontal gyrus and the superior frontal gyrus were positively correlated with the false starts. Still, there was no significant change in GMV. Therefore, we believe that 36 h of acute SD causes alterations in brain function and reduces alert attention, whereas short-term acute SD does not cause changes in brain structure.

Extreme conditions affect neuronal oscillations of cerebral cortices in humans in the China Space Station and on Earth

Rhythmical oscillations of neural populations can reflect working memory performance. However, whether neuronal oscillations of the cerebral cortex change in extreme environments, especially in a space station, remains unclear. Here, we recorded electroencephalography (EEG) signals when volunteers and astronauts were executing a memory task in extreme working conditions. Our experiments showed that two extreme conditions affect neuronal oscillations of the cerebral cortex and manifest in different ways. Lengthy periods of mental work impairs the gating mechanism formed by theta-gamma phase-amplitude coupling of two cortical areas, and sleep deprivation disrupts synaptic homeostasis, as reflected by the substantial increase in theta wave activity in the cortical frontal-central area. In addition, we excluded the possibility that nutritional supply or psychological situations caused decoupled theta-gamma phase-amplitude coupling or an imbalance in theta wave activity increase. Therefore, we speculate that the decoupled theta-gamma phase-amplitude coupling detected in astronauts results from their lengthy periods of mental work in the China Space Station. Furthermore, comparing preflight and inflight experiments, we find that long-term spaceflight and other hazards in the space station could worsen this decoupling evolution. This particular neuronal oscillation mechanism in the cerebral cortex could guide countermeasures for the inadaptability of humans working in spaceflight.

Impairment of executive functions due to sleep alterations: An integrative review on the use of P300

Objective

Cognitive impairment due to sleep deprivation (SD) is an important global health concern as part of the growing rates of sleep disorders and sleep deprivation worldwide. Amongst the affected cognitive processes, the effects of SD on the executive functions (EFs) show diverse methods and inconclusive or contradictory results, highlighting the importance of further research in this field. Considering this scenario, we evaluate one of the most used methods for objectively evaluating EFs on SD: the event-related potential (ERP) P300.

Methods

Our study provides a comprehensive review on the use of P300 for evaluating executive functions in sleep alterations on subjects of all ages, as well as an analysis on the efficiency of P300 as an assessment method for executive functions compared to traditional neurocognitive batteries. We review the benefits of P300 application for multiple sleep/wake alterations, whether evoked in laboratory or as part of pre-existing sleep disorders.

Results

We assess the diverse protocols used to elicit and complement P300, the most identified alterations in amplitude and latency, and suggest new lines of study that could benefit from P300 within the field.

Conclusion

We conclude that P300 is a valuable asset for evaluating executive dysfunction under sleep deprivation both as a standalone protocol and in conjunction with subjective methods, with consistently significant results in assessing executive dysfunction in a diversity of subjects and etiologies.

Protective actions of nuclear factor erythroid 2-related factor 2 (NRF2) and downstream pathways against environmental stressors

Environmental risk factors, including noise, air pollution, chemical agents, ultraviolet radiation (UVR) and mental stress have a considerable impact on human health. Oxidative stress and inflammation are key players in molecular pathomechanisms of environmental pollution and risk factors. In this review, we delineate the impact of environmental risk factors and the protective actions of the nuclear factor erythroid 2-related factor 2 (NRF2) in connection to oxidative stress and inflammation. We focus on well-established studies that demonstrate the protective actions of NRF2 and its downstream pathways against different environmental stressors. State-of-the-art mechanistic considerations on NRF2 signaling are discussed in detail, e.g. classical concepts like KEAP1 oxidation/electrophilic modification, NRF2 ubiquitination and degradation. Specific focus is also laid on NRF2-dependent heme oxygenase-1 induction with detailed presentation of the protective down-stream pathways of heme oxygenase-1, including interaction with BACH1 system. The significant impact of all environmental stressors on the circadian rhythm and the interactions of NRF2 with the circadian clock will also be considered here. A broad range of NRF2 activators is discussed in relation to environmental stressor-induced health side effects, thereby suggesting promising new mitigation strategies (e.g. by nutraceuticals) to fight the negative effects of the environment on our health.

Sleep, stress and aggression: Meta-analyses investigating associations and causality

Prior research suggests that sleep is associated with increased subjective stress and aggression, but important questions remain about the typical magnitude of these relationships, as well as their potential moderators. We therefore conducted the first meta-analysis of this literature. Across 340 associational and experimental studies, significant associations were identified between sleep with both subjective stress (r = 0.307, p < .001) and aggression (r = 0.258, p < .001) in individuals from the general population, as well as between sleep with subjective stress (r = 0.425, p < .001) in individuals with sleep disorders. Experimental sleep restriction also led to increased subjective stress (g = 0.403, p = .017) and aggression (g = 0.330, p = .042). These findings suggest that poorer sleep is associated with - and leads to - heightened levels of subjective stress and aggression. These findings, and their implications, are discussed in relation to neurobiological literature, which highlights the complex interplay between metabolic activity in the brain, hormonal changes, and behavior.

Activation of CNR1/PI3K/AKT Pathway by Tanshinone IIA Protects Hippocampal Neurons and Ameliorates Sleep Deprivation-Induced Cognitive Dysfunction in Rats

Sleep deprivation is commonplace in modern society, Short periods of continuous sleep deprivation (SD) may negatively affect brain and behavioral function and may lead to vehicle accidents and medical errors. Tanshinone IIA (Tan IIA) is an important lipid-soluble component of Salvia miltiorrhiza, which could exert neuroprotective effects. The aim of this study was to investigate the mechanism of neuroprotective effect of Tan IIA on acute sleep deprivation-induced cognitive dysfunction in rats. Tan IIA ameliorated behavioral abnormalities in sleep deprived rats, enhanced behavioral performance in WMW and NOR experiments, increased hippocampal dendritic spine density, and attenuated atrophic loss of hippocampal neurons. Tan IIA enhanced the expression of CB1, PI3K, AKT, STAT3 in rat hippocampus and down-regulated the expression ratio of Bax to Bcl-2. These effects were inhibited by cannabinoid receptor 1 antagonist (AM251). In conclusion, Tan IIA can play a neuroprotective role by activating the CNR1/PI3K/AKT signaling pathway to antagonize apoptosis in the hippocampus and improve sleep deprivation-induced spatial recognition and learning memory dysfunction in rats. Our study suggests that Tan IIA may be a candidate for the prevention of sleep deprivation-induced dysfunction in spatial recognition and learning memory.

ENIGMA-Sleep: Challenges, opportunities, and the road map

Neuroimaging and genetics studies have advanced our understanding of the neurobiology of sleep and its disorders. However, individual studies usually have limitations to identifying consistent and reproducible effects, including modest sample sizes, heterogeneous clinical characteristics and varied methodologies. These issues call for a large-scale multi-centre effort in sleep research, in order to increase the number of samples, and harmonize the methods of data collection, preprocessing and analysis using pre-registered well-established protocols. The Enhancing NeuroImaging Genetics through Meta-Analysis (ENIGMA) consortium provides a powerful collaborative framework for combining datasets across individual sites. Recently, we have launched the ENIGMA-Sleep working group with the collaboration of several institutes from 15 countries to perform large-scale worldwide neuroimaging and genetics studies for better understanding the neurobiology of impaired sleep quality in population-based healthy individuals, the neural consequences of sleep deprivation, pathophysiology of sleep disorders, as well as neural correlates of sleep disturbances across various neuropsychiatric disorders. In this introductory review, we describe the details of our currently available datasets and our ongoing projects in the ENIGMA-Sleep group, and discuss both the potential challenges and opportunities of a collaborative initiative in sleep medicine.

Sleep Patterns of Resident Physicians and the Effect of Heartfulness Meditation

Background:

Medical residents are vulnerable to poor sleep quality due to intense work shifts and academic load. Studies objectively quantified with sleep quantity and quality among resident physicians are limited. Meditation techniques have been shown to improve sleep but are rarely studied in this population. The aim of the present study is to evaluate sleep patterns of internal medicine residents and the effect of a structured Heartfulness meditation program to improve sleep quality.

Methods:

A total of 36 residents participated in a pre–post cohort study from January 2019 through April 2019. Sleep was monitored during a one-week outpatient rotation with two validated assessment tools, namely consensus sleep diary and actigraphy. After four intervening weeks, when the residents returned to the same rotation, Heartfulness meditation was practiced and the same parameters were measured. At the end of the study period, an anonymous qualitative feedback survey was collected to assess the feasibility of the intervention.

Results:

All 36 residents participated in the study (mean age 31.09 years, SD 4.87); 34 residents (94.4%) had complete pre–post data. Consensus sleep diary data showed decreased sleep onset time from 21.03 to 14.84 min (P = .01); sleep quality and restfulness scores increased from 3.32 to 3.89 and 3.08 to 3.54, respectively (P < .001 for both). Actigraphy showed a change in sleep onset time from 20.9 min to 14.5 min (P = .003). Sleep efficiency improved from 83.5% to 85.6% (P = .019). Wakefulness after initial sleep onset changed from 38.8 to 39.9 min (P = .682). Sleep fragmentation index and the number of awakenings decreased from 6.16 to 5.46 (P = .004) and 41.71 to 36.37 (P = .013), respectively.

Conclusions:

Residents obtained nearly 7 h of sleep during outpatient rotation. Findings suggest a structured Heartfulness meditation practice to be a feasible program to improve subjective sleep onset time and several objective measures among resident physicians.

Neural mechanisms that promote food consumption following sleep loss and social stress: An fMRI study in adolescent girls with overweight/obesity

STUDY OBJECTIVES

Insufficient sleep and social stress are associated with weight gain and obesity development in adolescent girls. Functional magnetic resonance imaging (fMRI) research suggests that altered engagement of emotion-related neural networks may explain overeating when under stress. The purpose of this study is to explore the effects of acute sleep restriction on female adolescents' neural responding during social evaluative stress and their subsequent eating behavior.

METHODS

Forty-two adolescent females (ages 15-18 years) with overweight or obesity completed a social stress induction task in which they were told they would be rated by peers based on their photograph and profile. Participants were randomly assigned to one night of sleep deprivation or 9 hours of sleep the night before undergoing fMRI while receiving positive and negative evaluations from their peers. After which, subjects participated in an ad libitum buffet.

RESULTS

Sleep deprived, relative to non-deprived girls had distinct patterns of neural engagement to positive and negative evaluation in anterior, mid, and posterior aspects of midline brain structures. Moreover, a sleep deprivation-by-evaluation valence-by-caloric intake interaction emerged in bilateral dorsal anterior cingulate. Among sleep deprived girls, greater engagement during negative, but not positive, feedback was associated with lower caloric intake. This was not observed for non-sleep deprived girls.

CONCLUSIONS

Results suggest an interaction between acute sleep loss and social evaluation that predicts emotion-related neural activation and caloric intake in adolescents. This research helps to elucidate the relationship between sleep loss, social stress, and weight status using a novel health neuroscience model.

Expert Opinion: Managing sleep disturbances in people with epilepsy

Poor sleep and daytime sleepiness are common in people with epilepsy. Sleep disorders can disrupt seizure control and in turn sleep and vigilance problems can be exacerbated by seizures and by antiepileptic treatments. Nevertheless, these aspects are frequently overlooked in clinical practice and a clear agreement on the evidence-based guidelines for managing common sleep disorders in people with epilepsy is lacking. Recently, recommendations to standardize the diagnostic pathway for evaluating patients with sleep-related epilepsies and comorbid sleep disorders have been presented. To build on these, we adopted the Delphi method to establish a consensus within a group of experts and we provide practical recommendations for identifying and managing poor night-time sleep and daytime sleepiness in people with epilepsy. We recommend that a comprehensive clinical history of sleep habits and sleep hygiene should be always obtained from all people with epilepsy and their bed partners. A psychoeducational approach to inform patients about habits or practices that may negatively influence their sleep or their vigilance levels should be used, and strategies for avoiding these should be applied. In case of a suspected comorbid sleep disorder an appropriate diagnostic investigation should be performed. Moreover, the possible presence of sleep fragmentation induced by sleep-related seizures should be ruled out. Finally, the dose and timing of antiepileptic medications and other co-medications should be optimized to improve nocturnal sleep and avoid daytime sedation.

Observing changes in human functioning during induced sleep deficiency and recovery periods

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.

Sleep deprivation alters task-related changes in functional connectivity of the frontal cortex: A near-infrared spectroscopy study

Sleep deprivation (SD) is known to be associated with decreased cognitive performance; however, the underlying mechanisms are poorly understood. As interactions between distinct brain regions depend on mental state, functional brain networks established by these connections typically show a reorganization during task. Hence, analysis of functional connectivity (FC) could reveal the task-related change in the examined frontal brain networks. Our objective was to assess the impact of SD on static FC in the prefrontal and motor cortices and find whether changes in FC correlate with changes in neuropsychological scores. Healthy young male individuals (n = 10, 27.6 ± 3.7 years of age) participated in the study. A battery of tests from the Cambridge Neuropsychological Test Automated Battery (CANTAB) and 48 channel functional near-infrared spectroscopy (fNIRS) measurements were performed before and after 24 hr of SD. Network metrics were obtained by graph theoretical analysis using the fNIRS records in resting state and during finger-tapping sessions. During task, SD resulted in a significantly smaller decrease in the number and strength of functional connections (characterizing FC) in the frontal cortex. Changes in the global connection strengths correlated with decreased performance in the paired association learning test. These results indicate a global impact of SD on functional brain networks in the frontal lobes.

Altered insula-prefrontal functional connectivity correlates to decreased vigilant attention after total sleep deprivation

BACKGROUND

Sleep deprivation can robustly affect vigilant attention. The insula is a key hub of the salience network that mediates shifting attention between endogenous and exogenous states. However, little is known regarding the involvement of insular functional connectivity in impaired vigilant attention after total sleep deprivation (TSD). The purpose of this study is to explore the alterations in insular functional connectivity and its association with vigilant attention performance following TSD.

METHODS

Twenty-six adult men were enrolled in the study. Participants underwent two counterbalanced resting-state functional magnetic resonance imaging (rs-fMRI) scans, once in rested wakefulness (RW) and once after 36 h of TSD. Seed-based functional connectivity analysis was performed using rs-fMRI data for the left and right insula. The vigilant attention was measured using a psychomotor vigilance test (PVT). Furthermore, Pearson correlation analysis was conducted to investigate the relationship between altered insular functional connectivity and PVT performance.

RESULTS

Compared to RW, enhanced functional connectivity was observed between the insula and prefrontal cortex and anterior cingulate cortex, while reduced functional connectivity was observed between the insula and temporal, parietal, and occipital regions following TSD. Moreover, altered insular functional connectivity with the prefrontal cortex, ie superior frontal gyrus and middle frontal gyrus, and inferior temporal gyrus was correlated with PVT performance after TSD.

CONCLUSION

Our results suggest that insular coupling with the prefrontal cortex and inferior temporal gyrus may act as neural indicators for vigilant attention impairment, which further reveals the critical role of the salience network in cognitive decline following TSD.

Sleep deprivation and compensatory cognitive effort on a visual information processing task

STUDY OBJECTIVES

Total sleep deprivation (TSD) is often associated with worse performance on tasks of attention and working memory, but some studies show no performance changes. One possibility is that greater compensatory cognitive effort is put forth to achieve similar results after TSD. We aimed to better understand the relationship between TSD, cognitive engagement, and performance outcomes following TSD.

METHODS

Twenty healthy adults completed cognitive testing following a night of normal sleep and again after ~55 hours of TSD. Participants detected target letters in low (3-item) and high (10-item) load visual letter displays on the span of apprehension task with concurrent pupillometry, a measure of cognitive effort.

RESULTS

We found significantly poorer detection accuracy and marginally longer response times following TSD across both arrays. In both arrays, significantly greater preparatory pupillary responses were found just prior to array onset. There was also a significant session by array interaction for pupillary responses, such that significantly greater dilation was found for the 3-letter array after TSD, while a nonsignificant decline in dilation was found following the 10-letter array after TSD.

CONCLUSIONS

These results suggest a complex relationship between attentional control and cognitive resource allocation following TSD. Sleep-deprived individuals may allocate more compensatory cognitive effort to easier tasks but choose to disengage from more challenging cognitive tasks that have little perceived reward or probability of success to preserve diminishing cognitive resources. More work is needed to better delineate the underlying neurological systems involved in these processing load-dependent attentional control mechanisms after TSD.

Altered functional connectivity between the nucleus basalis of Meynert and anterior cingulate cortex is associated with declined attentional performance after total sleep deprivation

BACKGROUND

Sleep deprivation can markedly influence vigilant attention. The nucleus basalis of Meynert (NBM), the main source of cholinergic projections to the cortex, plays an important role in wakefulness maintenance and attention control. However, the involvement of NBM in attentional impairments after total sleep deprivation (TSD) has yet to be established. The purpose of this study is to investigate the alterations in NBM functional connectivity and its association with the attentional performance following TSD.

METHODS

Thirty healthy adult males were recruited in the study. Participants underwent two resting-state functional magnetic resonance imaging (rs-fMRI) scans, once in rested wakefulness (RW) and once after 36 h of TSD. Seed-based functional connectivity analysis was performed using rs-fMRI data for the left and right NBM. The vigilant attention was measured using a psychomotor vigilance test (PVT). Furthermore, Pearson correlation analysis was conducted to investigate the relationship between altered NBM functional connectivity and changed PVT performance after TSD.

RESULTS

Compared to RW, enhanced functional connectivity was observed between right NBM and bilateral thalamus and cingulate cortex, while reduced functional connectivity was observed between left NBM and right superior parietal lobule following TSD. Moreover, altered NBM functional connectivity with the left anterior cingulate cortex was negatively correlated with PVT performance after TSD.

CONCLUSION

Our results suggest that the disrupted NBM-related cholinergic circuit highlights an important role in attentional performance after TSD. The enhanced NBM functional connectivity with the anterior cingulate cortex may act as neural signatures for attentional deficits induced by sleep deprivation.

Altered frontal connectivity after sleep deprivation predicts sustained attentional impairment: A resting-state functional magnetic resonance imaging study

A series of studies have shown that sleep loss impairs one's capability for sustained attention. However, the underlying neurobiological mechanism linking sleep loss with sustained attention has not been elucidated. The present study aimed to investigate the effect of sleep deprivation on the resting-state brain and explored whether the magnitude of vigilance impairment after acute sleep deprivation can be predicted by measures of spontaneous fluctuations and functional connectivity. We implemented resting-state functional magnetic resonance imaging with 42 participants under both normal sleep and 24-hr sleep-deprivation conditions. The amplitude of low-frequency fluctuations (ALFF) and functional connectivity was used to investigate the neurobiological change caused by sleep deprivation, and the psychomotor vigilance task (PVT) was used to measure sustained attention in each state. Correlation analysis was used to investigate the relationship between the change in ALFF/functional connectivity and vigilance performance. Sleep deprivation induced significant reductions in ALFF in default mode network nodes and frontal-parietal network nodes, while inducing significant increments of ALFF in the bilateral thalamus, motor cortex, and visual cortex. The increased ALFF in the visual cortex was correlated with increased PVT lapses. Critically, decreased frontal-thalamus connectivity was correlated with increased PVT lapses, while increased frontal-visual connectivity was correlated with increased PVT lapses. The findings indicated that acute sleep deprivation induced a robust alteration in the resting brain, and sustained attentional impairment after sleep deprivation could be predicted by altered frontal connectivity with crucial neural nodes of stimulus input, such as the thalamus and visual cortex.

Regional brain metabolism differentiates narcolepsy type 1 and idiopathic hypersomnia

STUDY OBJECTIVES

Daytime sleepiness is a manifestation of multiple sleep and neurologic disorders. Few studies have assessed patterns of regional brain metabolism across different disorders of excessive daytime sleepiness. One such disorder, idiopathic hypersomnia (IH), is particularly understudied.

METHODS

People with IH, narcolepsy (NT1), and non-sleepy controls underwent [ 18F]-fluorodeoxyglucose (FDG) positron emission tomography (PET) with electroencephalography (EEG). Participants were instructed to resist sleep and were awoken if sleep occurred. Voxel-wise parametric analysis identified clusters that significantly differed between each pair of groups, with a minimum cluster size of 100 voxels at a cluster detection threshold of p < 0.005. Correlations between glucose metabolism and sleep characteristics were evaluated.

RESULTS

Participants (77% women) had IH (n = 16), NT1 (n = 14), or were non-sleepy controls (n = 9), whose average age was 33.8 (+/-10.7) years. Compared to controls, NT1 participants demonstrated hypermetabolism in fusiform gyrus, middle occipital gyrus, superior and middle temporal gyri, insula, cuneus, precuneus, pre- and post-central gyri, and culmen. Compared to controls, IH participants also demonstrated hypermetabolism in precuneus, inferior parietal lobule, superior and middle temporal gyri, and culmen. Additionally, IH participants demonstrated altered metabolism of the posterior cingulate. Most participants fell asleep. Minutes of N1 during uptake was significantly negatively correlated with metabolism of the middle temporal gyrus.

CONCLUSION

NT1 and IH demonstrate somewhat overlapping, but distinct, patterns of regional metabolism.

Relation of Decreased Functional Connectivity Between Left Thalamus and Left Inferior Frontal Gyrus to Emotion Changes Following Acute Sleep Deprivation

Objective: The thalamus is a key node for sleep-wake pathway gate switching during acute sleep deprivation (ASD), and studies have shown that it plays a certain role in emotion changes. However, there are no studies on the association between the thalamus and emotion changes in ASD. In this study, we used resting-state functional magnetic resonance imaging (R-fMRI) to explore whether changes in the functional connections between the thalamus and other brain regions are related to emotion changes and further explored the function of the thalamus under total ASD conditions.

Method: Thirty healthy, right-handed adult men underwent emotional assessment according to the Profile of Mood States Scale and R-fMRI scans before and after ASD. The correlations between changes in functional connectivity between the thalamus and other brain regions and emotion changes were then studied.

Results: Positive emotions and psychomotor performance were reduced, and negative emotions were increased following ASD. The functional connections between the left thalamus and left middle temporal gyrus, left inferior frontal gyrus, right thalamus, right inferior temporal gyrus, left middle temporal pole gyrus, right calcarine, left cuneus, left rectus and left medial superior frontal gyrus were significantly altered. Decreased functional connectivity between left thalamus and left inferior frontal gyrus related to emotion changes following ASD.

Conclusion: This study finds that functional changes in the thalamus are associated with emotion changes during ASD, suggesting that the left thalamus probably plays an essential role in emotion changes under ASD conditions.

Neuronal activation and performance changes in working memory induced by chronic sleep restriction in adolescents

Most adolescents get less than the recommended 8-10 hr of sleep per night. Functional deficits from lack of sleep include disruption of working memory. Adult neuroimaging studies of sleep deprivation suggest diminished responses in task-related brain networks if performance degrades, but compensatory increased responses with maintained performance. This study utilized functional magnetic resonance imaging to examine compensatory and diminished brain responses in adolescents during working memory performance, comparing chronic sleep restriction and healthy sleep duration. Thirty-six healthy adolescents, 14-17 years old, experienced a 3-week protocol: (a) sleep phase stabilization; (b) sleep restriction (~6.5 hr nightly); and (c) healthy sleep duration (~9 hr nightly). After each sleep manipulation, we acquired functional magnetic resonance imaging with an NBack working memory task with four difficulty levels (0 to 3-back). NBack performance degraded with higher task difficulty, but without a detectable effect of sleep duration. ANOVA revealed main effects of both NBack difficulty and sleep in widespread brain networks. Planned contrasts showed that, compared with healthy sleep, sleep restriction resulted in greater medial prefrontal activation and weaker activation in the precuneus for the most difficult task condition. During sleep restriction, we found compensatory functional responses in brain regions that process sensory input and vigilance. However, adolescents also showed impaired performance and diminished brain responses during the hardest task level under a week of chronic sleep restriction. Chronic sleep restriction during adolescence is common. Understanding the impact of ongoing functional compensation and performance breakdown during this developmental period can have important implications for learning and educational strategies.

Methodological issues of systematic reviews and meta-analyses in the field of sleep medicine: A meta-epidemiological study

An increasing number of systematic reviews and meta-analyses (SRMAs) have been published in the field of sleep medicine. We evaluated the methodological issues of these SRMAs. A protocol was developed in advance. Three databases were searched from inception to October 2019 for SRMAs published in major academic journals of sleep medicine that assessed healthcare interventions. The AMSTAR 2.0 instrument was used to evaluate the methodological issues and a multivariable regression analysis was conducted to investigate potential measures associated with methodological validity. We identified 163 SRMAs. The median number of missing safeguards of these SRMAs was 7 out of 16 (Interquartile range, IQR: 6-9), and on average, two of these missing safeguards were critical weaknesses. Our regression analysis suggested that SRMAs published in recent years (β = 0.16; 95%CI: 0.08, 0.24; p = 0.002), with the first author from Europe (β = 0.08; 95%CI: 0.02, 0.14; p = 0.013) tend to have higher relative methodological ranks. In conclusion, the methodological validity for current SRMAs in sleep medicine was poor. Further efforts to improve the methodological validity are needed.

Sleep and COVID-19: considerations about immunity, pathophysiology, and treatment

The fear and uncertainty caused by the coronavirus disease 2019 (COVID-19) pandemic, threats to survival are one of the main problems of everyday life; however, mental health care must also be considered a priority. During social isolation also called self-quarantine, the restricted mobility and social contact, concern about financial resources and availability of supplies, fear of infection, questions about the duration of self-quarantine, cause anxiety, depression, stress, insomnia and reduced the quality and quantity of sleep, that may present a greater risk to the health of the general population. Sleep disorders are increasingly becoming a major health issue in modern society, and are influenced by retinal stimulation by electronic devices, as well extended and/or night shift-work, which may aggravate the systemic and lung inflammation during viral infections. Sleep disorders can induce pro-inflammatory states and be harmful during the COVID-19 pandemic. The possible interactions between many drugs used to treat COVID-19, and those used to treat sleep disorders are unknown, mostly due to the lack of a standard protocol to treat these patients. Insufficient sleep or irregular sleep-wake cycles may impair health, immune system, induce pro-inflammation state, and may lead to increased vulnerability to viral infections, involving inflammatory and oxidative/antioxidant imbalance. In this sense, obstructive sleep apnea has been associated with recognized COVID-19 risk comorbidities and considered a risk factor for COVID-19. During the COVID-19 pandemic, health care cannot stop, and telemedicine has presented itself as an alternative method of delivering services. When a face-to-face visit is mandatory, or in locations with minimal community transmission where sleep centers have resumed activities, it is important that the sleep center facilities are properly prepared to receive the patients during the COVID-19 pandemic, and follow all relevant safety rules. In this work we gathered a group of researchers, specialists in aspects related to chronobiology, sleep, sleep disorders, and the immune system. Thus, we conducted a narrative review in order to address the relationship between COVID-19 and sleep, as well as its immunological aspects and strategies that may be applied in order to mitigate the harmful effects on health that affects everyone during the pandemic.

Shift-work-related sleep disruption and the risk of decline in cognitive function: The CRUISE Study

Acute total sleep deprivation and partial sleep deprivation have negative impacts on cognitive performance. Studies in subjects who regularly experience sleep loss, however, are rare and often restricted to examination of internal sleeping disorders. To address this issue, we set up a pilot study to explore the effects of a week characterized by sleep disruption on cognitive functioning, using a case–control setting in a maritime pilot group with chronic exposure to intermittent extrinsic, work‐related sleep disruption. Twenty maritime pilots (aged 30–50 years) were compared to sex‐ and education‐matched controls with normal sleep behaviour, from the same age range. We assessed subjective and objective cognitive function, including attention, psychomotor speed, memory and executive function using the Cambridge Neuropsychological Test Automated Battery (CANTAB). Although we were able to confirm poorer sleep in maritime pilots and subjective complaints in some cognitive domains, we did not find objective cognitive deficits in the maritime pilot group compared to controls without sleep disruption. This could suggest that in this group of healthy, young maritime pilots, exposure to sleep disruption resulted in some subjective cognitive complaints, but objective deficits of cognitive function were not detected in comparison with a non‐pilot control group. However, given the small sample size, the absence of an effect does not exclude the possibility that sleep disruption could result in cognitive deficits in general. Therefore, our findings have to be confirmed in future prospective studies with a larger sample size and matched controls, regarding age, education and work history.

Ellagic acid protects mice against sleep deprivation-induced memory impairment and anxiety by inhibiting TLR4 and activating Nrf2

Sleep disorder has become a prevalent issue in current society and is connected with the deterioration of neurobehaviors such as mood, cognition and memory. Ellagic acid (EA) is a phenolic phytoconstituent extracted from grains and fruits that has potent neuroprotective properties. This research aimed to study the alleviative effect and mechanism of EA on memory impairment and anxiety caused by sleep deprivation (SD). EA ameliorated behavioral abnormalities in SD mice, associated with increased dendritic spine density, and reduced shrinkage and loss of hippocampal neurons. EA reduced the inflammatory response and oxidative stress injury caused by SD, which may be related to activation of the Nrf2/HO-1 pathway and mitigation of the TLR4-induced inflammatory response. In addition, EA significantly reduced the mortality and ROS levels in glutamate (Glu)-induced hippocampal neuron injury, and these effects of EA were enhanced in TLR4 siRNA-transfected neurons. However, knockdown of Nrf2 dramatically restrained the protective impact of EA on Glu-induced toxicity. Taken together, EA alleviated memory impairment and anxiety in sleep-deprived mice potentially by inhibiting TLR4 and activating Nrf2. Our findings suggested that EA may be a promising nutraceutical ingredient to prevent cognitive impairment and anxiety caused by sleep loss.