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Blaskovich B, Bullón-Tarrasó E, Pöhlchen D, Manafis A, Neumayer H, Besedovsky L, Brückl T, Simor P, Binder FP, Spoormaker VI. The utility of wearable headband electroencephalography and pulse photoplethysmography to assess cortical and physiological arousal in individuals with stress-related mental disorders. J Sleep Res 2024; 33:e14123. [PMID: 38099396 DOI: 10.1111/jsr.14123] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Revised: 11/16/2023] [Accepted: 11/27/2023] [Indexed: 07/17/2024]
Abstract
Several stress-related mental disorders are characterised by disturbed sleep, but objective sleep biomarkers are not routinely examined in psychiatric patients. We examined the use of wearable-based sleep biomarkers in a psychiatric sample with headband electroencephalography (EEG) including pulse photoplethysmography (PPG), with an additional focus on microstructural elements as especially the shift from low to high frequencies appears relevant for several stress-related mental disorders. We analysed 371 nights of sufficient quality from 83 healthy participants and those with a confirmed stress-related mental disorder (anxiety-affective spectrum). The median value of macrostructural, microstructural (spectral slope fitting), and heart rate variables was calculated across nights and analysed at the individual level (N = 83). The headbands were accepted well by patients and the data quality was sufficient for most nights. The macrostructural analyses revealed trends for significance regarding sleep continuity but not sleep depth variables. The spectral analyses yielded no between-group differences except for a group × age interaction, with the normal age-related decline in the low versus high frequency power ratio flattening in the patient group. The PPG analyses showed that the mean heart rate was higher in the patient group in pre-sleep epochs, a difference that reduced during sleep and dissipated at wakefulness. Wearable devices that record EEG and/or PPG could be used over multiple nights to assess sleep fragmentation, spectral balance, and sympathetic drive throughout the sleep-wake cycle in patients with stress-related mental disorders and healthy controls, although macrostructural and spectral markers did not differ between the two groups.
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Affiliation(s)
- Borbala Blaskovich
- Department Genes and Environment, Max Planck Institute of Psychiatry, Munich, Germany
- Institute of Medical Psychology, Faculty of Medicine, LMU Munich, Munich, Germany
| | | | - Dorothee Pöhlchen
- Department Genes and Environment, Max Planck Institute of Psychiatry, Munich, Germany
| | - Alexandros Manafis
- Department Genes and Environment, Max Planck Institute of Psychiatry, Munich, Germany
| | - Hannah Neumayer
- Department Genes and Environment, Max Planck Institute of Psychiatry, Munich, Germany
| | - Luciana Besedovsky
- Institute of Medical Psychology, Faculty of Medicine, LMU Munich, Munich, Germany
| | - Tanja Brückl
- Department Genes and Environment, Max Planck Institute of Psychiatry, Munich, Germany
| | - Peter Simor
- Institute of Psychology, ELTE, Eötvös Loránd University, Budapest, Hungary
- Institute of Behavioral Sciences, Semmelweis University, Budapest, Hungary
| | - Florian P Binder
- Department Genes and Environment, Max Planck Institute of Psychiatry, Munich, Germany
| | - Victor I Spoormaker
- Department Genes and Environment, Max Planck Institute of Psychiatry, Munich, Germany
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Paquet C, Lenker KP, Calhoun SL, Bixler EO, Vgontzas AN, Fernandez-Mendoza J. Short-term stability and night-to-night variability of sleep parameters in nightmares comorbid with chronic insomnia Disorder across multiple nights of polysomnography. Sleep 2024; 47:zsae032. [PMID: 38300896 DOI: 10.1093/sleep/zsae032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Revised: 01/07/2024] [Indexed: 02/03/2024] Open
Abstract
STUDY OBJECTIVES The purpose of this study was to examine the degree of short-term stability of polysomnographic (PSG) measured sleep parameters and the overall differences between individuals with comorbid nightmares and insomnia compared to those with chronic insomnia disorder alone or good sleeping controls across four nights in the sleep lab. METHODS A total of 142 good sleeping controls, 126 chronic insomnia alone, and 24 comorbid insomnia/nightmare participants underwent four consecutive nights of 8-hour PSG recordings. Outcomes included sleep continuity, architecture, and REM-related parameters across nights one through four. Intraclass correlation coefficients with mixed-effect variances and repeated-measure analysis of covariance were used, respectively, to determine short-term stability as well as between-participants and time-by-group interaction effects. RESULTS Wake after sleep onset and stage 1 showed "poor stability" in the comorbid insomnia/nightmare group compared to "moderate stability" in the good sleeping controls and chronic insomnia alone group. Significant between-group effects (all ps < .05) showed that the comorbid insomnia/nightmare group took longer to fall asleep and had a greater first-night-effect in stage 1 compared to good sleeping controls and chronic insomnia alone group; in addition, the comorbid insomnia/nightmare and insomnia alone groups slept shorter, with fewer awakenings and REM periods, compared to the good sleeping controls. CONCLUSIONS Nightmares are associated with abnormal sleep above and beyond REM disruption, as sleep continuity was the primary aspect in which poor stability and group differences emerged. The greater inability to fall asleep and instability of sleep fragmentation in those with comorbid insomnia/nightmares compared to chronic insomnia alone may be attributed to the impact of presleep anticipatory anxiety and nightmare-related distress itself. CLINICAL TRIAL INFORMATION The data analyzed in this study does not come from any current or previous clinical trials. Therefore, there is no clinical trial information to report.
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Affiliation(s)
- Caitlin Paquet
- Department of Psychiatry and Behavioral Health, Sleep Research and Treatment Center, Penn State College of Medicine, Hershey, PA, USA
- Division of Sleep and Circadian Disorders, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Kristina P Lenker
- Department of Psychiatry and Behavioral Health, Sleep Research and Treatment Center, Penn State College of Medicine, Hershey, PA, USA
| | - Susan L Calhoun
- Department of Psychiatry and Behavioral Health, Sleep Research and Treatment Center, Penn State College of Medicine, Hershey, PA, USA
| | - Edward O Bixler
- Department of Psychiatry and Behavioral Health, Sleep Research and Treatment Center, Penn State College of Medicine, Hershey, PA, USA
| | - Alexandros N Vgontzas
- Department of Psychiatry and Behavioral Health, Sleep Research and Treatment Center, Penn State College of Medicine, Hershey, PA, USA
| | - Julio Fernandez-Mendoza
- Department of Psychiatry and Behavioral Health, Sleep Research and Treatment Center, Penn State College of Medicine, Hershey, PA, USA
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3
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Sayk C, Saftien S, Koch N, Ngo HVV, Junghanns K, Wilhelm I. Cortical hyperarousal in individuals with frequent nightmares. J Sleep Res 2024; 33:e14003. [PMID: 37688512 DOI: 10.1111/jsr.14003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Revised: 06/09/2023] [Accepted: 07/01/2023] [Indexed: 09/11/2023]
Abstract
Nightmares are common among the general population and psychiatric patients and have been associated with signs of nocturnal arousal such as increased heart rate or increased high-frequency electroencephalographic (EEG) activity. However, it is still unclear, whether these characteristics are more of a trait occurring in people with frequent nightmares or rather indicators of the nightmare state. We compared participants with frequent nightmares (NM group; n = 30) and healthy controls (controls; n = 27) who spent 4 nights in the sleep laboratory over the course of 8 weeks. The NM group received six sessions of imagery rehearsal therapy (IRT), the 'gold standard' of cognitive-behavioural therapy for nightmares, between the second and the third night. Sleep architecture and spectral power were compared between groups, and between nights of nightmare occurrence and nights without nightmare occurrence in the NM group. Additionally, changes before and after therapy were recorded. The NM group showed increased beta (16.25-31 Hz) and low gamma (31.25-35 Hz) power during the entire night compared to the controls, but not when comparing nights of nightmare occurrence to those without. Moreover, low gamma activity in rapid eye movement sleep was reduced after therapy in the NM group. Our findings indicate, cortical hyperarousal is more of a trait in people with frequent nightmares within a network of other symptoms, but also malleable by therapy. This is not only a new finding for IRT but could also lead to improved treatment options in the future that directly target high-frequency EEG activity.
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Affiliation(s)
- Clara Sayk
- Department of Psychiatry and Psychotherapy, Translational Psychiatry Unit, University of Lübeck, Lübeck, Germany
| | - Sophia Saftien
- Department of Psychiatry and Psychotherapy, Translational Psychiatry Unit, University of Lübeck, Lübeck, Germany
| | - Nicole Koch
- Department of Psychiatry and Psychotherapy, Translational Psychiatry Unit, University of Lübeck, Lübeck, Germany
| | - Hong-Viet V Ngo
- Department of Psychology, University of Lübeck, Lübeck, Germany
- Center for Brain, Behaviour and Metabolism, University of Lübeck, Lübeck, Germany
- Department of Psychology, University of Essex, Colchester, UK
| | - Klaus Junghanns
- Department of Psychiatry and Psychotherapy, Translational Psychiatry Unit, University of Lübeck, Lübeck, Germany
| | - Ines Wilhelm
- Department of Psychiatry and Psychotherapy, Translational Psychiatry Unit, University of Lübeck, Lübeck, Germany
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4
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Tomacsek V, Blaskovich B, Király A, Reichardt R, Simor P. Altered parasympathetic activity during sleep and emotionally arousing wakefulness in frequent nightmare recallers. Eur Arch Psychiatry Clin Neurosci 2024; 274:265-277. [PMID: 36862312 PMCID: PMC10914885 DOI: 10.1007/s00406-023-01573-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Accepted: 02/13/2023] [Indexed: 03/03/2023]
Abstract
Nightmare disorder is characterized by dysfunctional emotion regulation and poor subjective sleep quality reflected in pathophysiological features such as abnormal arousal processes and sympathetic influences. Dysfunctional parasympathetic regulation, especially before and during rapid eye movement (REM) phases, is assumed to alter heart rate (HR) and its variability (HRV) of frequent nightmare recallers (NM). We hypothesized that cardiac variability is attenuated in NMs as opposed to healthy controls (CTL) during sleep, pre-sleep wakefulness and under an emotion-evoking picture-rating task. Based on the polysomnographic recordings of 24 NM and 30 CTL participants, we examined HRV during pre-REM, REM, post-REM and slow wave sleep, separately. Additionally, electrocardiographic recordings of resting state before sleep onset and under an emotionally challenging picture-rating task were also analyzed. Applying repeated measures analysis of variance (rmANOVA), a significant difference was found in the HR of NMs and CTLs during nocturnal segments but not during resting wakefulness, suggesting autonomic dysregulation, specifically during sleep in NMs. As opposed to the HR, the HRV values were not significantly different in the rmANOVA in the two groups, implying that the extent of parasympathetic dysregulation on a trait level might depend on the severeness of dysphoric dreaming. Nonetheless, in the group comparisons, the NM group showed increased HR and reduced HRV during the emotion-evoking picture-rating task, which aimed to model the nightmare experience in the daytime, indicating disrupted emotion regulation in NMs under acute distress. In conclusion, trait-like autonomic changes during sleep and state-like autonomic responses to emotion-evoking pictures indicate parasympathetic dysregulation in NMs.
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Affiliation(s)
- Vivien Tomacsek
- Doctoral School of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary.
- Institute of Psychology, ELTE Eötvös Loránd University, 46 Izabella Street, Budapest, 1064, Hungary.
| | - Borbála Blaskovich
- Institute of Medical Psychology, Faculty of Medicine, Ludwig Maximilian University of Munich, Munich, Germany
| | - Anna Király
- National Institute of Locomotor Diseases and Disabilities, Budapest, Hungary
| | - Richárd Reichardt
- Institute of Education and Psychology at Szombathely, ELTE Eötvös Loránd University, Budapest, Hungary
| | - Péter Simor
- Institute of Psychology, ELTE Eötvös Loránd University, 46 Izabella Street, Budapest, 1064, Hungary
- UR2NF, Neuropsychology and Functional Neuroimaging Research Unit at CRCN-Center for Research in Cognition and Neurosciences and UNI-ULB Neurosciences Institute, Université Libre de Bruxelles (ULB), Brussels, Belgium
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5
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Ollila HM, Sinnott-Armstrong N, Kantojärvi K, Broberg M, Palviainen T, Jones S, Ripatti V, Pandit A, Rong R, Kristiansson K, Sandman N, Valli K, Hublin C, Ripatti S, Widen E, Kaprio J, Saxena R, Paunio T. Nightmares share genetic risk factors with sleep and psychiatric traits. Transl Psychiatry 2024; 14:123. [PMID: 38413574 PMCID: PMC10899618 DOI: 10.1038/s41398-023-02637-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Revised: 08/08/2023] [Accepted: 10/23/2023] [Indexed: 02/29/2024] Open
Abstract
Nightmares are vivid, extended, and emotionally negative or negative dreams that awaken the dreamer. While sporadic nightmares and bad dreams are common and generally harmless, frequent nightmares often reflect underlying pathologies of emotional regulation. Indeed, insomnia, depression, anxiety, or alcohol use have been associated with nightmares in epidemiological and clinical studies. However, the connection between nightmares and their comorbidities are poorly understood. Our goal was to examine the genetic risk factors for nightmares and estimate correlation or causality between nightmares and comorbidities. We performed a genome-wide association study (GWAS) in 45,255 individuals using a questionnaire-based assessment on the frequency of nightmares during the past month and genome-wide genotyping data. While the GWAS did not reveal individual risk variants, heritability was estimated at 5%. In addition, the genetic correlation analysis showed a robust correlation (rg > 0.4) of nightmares with anxiety (rg = 0.671, p = 7.507e-06), depressive (rg = 0.562, p = 1.282e-07) and posttraumatic stress disorders (rg = 0.4083, p = 0.0152), and personality trait neuroticism (rg = 0.667, p = 4.516e-07). Furthermore, Mendelian randomization suggested causality from insomnia to nightmares (beta = 0.027, p = 0.0002). Our findings suggest that nightmares share genetic background with psychiatric traits and that insomnia may increase an individual's liability to experience frequent nightmares. Given the significant correlations with psychiatric and psychological traits, it is essential to grow awareness of how nightmares affect health and disease and systematically collect information about nightmares, especially from clinical samples and larger cohorts.
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Affiliation(s)
- Hanna M Ollila
- Institute for Molecular Medicine Finland (FIMM), University of Helsinki, Helsinki, Finland
- Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, USA
- Program in Medical and Population Genetics, Broad Institute, Cambridge, MA, USA
- Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | | | - Katri Kantojärvi
- Population Health, Finnish Institute for Health and Welfare, Helsinki, Finland
- Department of Psychiatry and SleepWell Research Program, Faculty of Medicine, University of Helsinki and Helsinki University Central Hospital, Helsinki, Finland
| | - Martin Broberg
- Institute for Molecular Medicine Finland (FIMM), University of Helsinki, Helsinki, Finland
| | - Teemu Palviainen
- Institute for Molecular Medicine Finland (FIMM), University of Helsinki, Helsinki, Finland
| | - Samuel Jones
- Institute for Molecular Medicine Finland (FIMM), University of Helsinki, Helsinki, Finland
| | - Vili Ripatti
- Institute for Molecular Medicine Finland (FIMM), University of Helsinki, Helsinki, Finland
| | - Anita Pandit
- Department of Biostatistics, School of Public Health, University of Michigan, Ann Arbor, MI, 48109, USA
| | - Robin Rong
- Department of Biostatistics, School of Public Health, University of Michigan, Ann Arbor, MI, 48109, USA
| | - Kati Kristiansson
- Population Health, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Nils Sandman
- Department of Psychology and Speech-Language Pathology, and Turku Brain and Mind Center, University of Turku, Turku, Finland
| | - Katja Valli
- Department of Psychology and Speech-Language Pathology, and Turku Brain and Mind Center, University of Turku, Turku, Finland
- Department of Cognitive Neuroscience and Philosophy, University of Skövde, Skövde, Sweden
| | | | - Samuli Ripatti
- Institute for Molecular Medicine Finland (FIMM), University of Helsinki, Helsinki, Finland
- Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, USA
- Program in Medical and Population Genetics, Broad Institute, Cambridge, MA, USA
| | - Elisabeth Widen
- Institute for Molecular Medicine Finland (FIMM), University of Helsinki, Helsinki, Finland
| | - Jaakko Kaprio
- Institute for Molecular Medicine Finland (FIMM), University of Helsinki, Helsinki, Finland
| | - Richa Saxena
- Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, USA.
- Program in Medical and Population Genetics, Broad Institute, Cambridge, MA, USA.
- Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.
- Division of Sleep and Circadian Disorders, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA.
| | - Tiina Paunio
- Population Health, Finnish Institute for Health and Welfare, Helsinki, Finland.
- Department of Psychiatry and SleepWell Research Program, Faculty of Medicine, University of Helsinki and Helsinki University Central Hospital, Helsinki, Finland.
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6
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Černý F, Piorecká V, Kliková M, Kopřivová J, Bušková J, Piorecký M. All-night spectral and microstate EEG analysis in patients with recurrent isolated sleep paralysis. Front Neurosci 2024; 18:1321001. [PMID: 38389790 PMCID: PMC10882627 DOI: 10.3389/fnins.2024.1321001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Accepted: 01/25/2024] [Indexed: 02/24/2024] Open
Abstract
The pathophysiology of recurrent isolated sleep paralysis (RISP) has yet to be fully clarified. Very little research has been performed on electroencephalographic (EEG) signatures outside RISP episodes. This study aimed to investigate whether sleep is disturbed even without the occurrence of a RISP episode and in a stage different than conventional REM sleep. 17 RISP patients and 17 control subjects underwent two consecutive full-night video-polysomnography recordings. Spectral analysis was performed on all sleep stages in the delta, theta, and alpha band. EEG microstate (MS) analysis was performed on the NREM 3 phase due to the overall high correlation of subject template maps with canonical templates. Spectral analysis showed a significantly higher power of theta band activity in REM and NREM 2 sleep stages in RISP patients. The observed rise was also apparent in other sleep stages. Conversely, alpha power showed a downward trend in RISP patients' deep sleep. MS maps similar to canonical topographies were obtained indicating the preservation of prototypical EEG generators in RISP patients. RISP patients showed significant differences in the temporal dynamics of MS, expressed by different transitions between MS C and D and between MS A and B. Both spectral analysis and MS characteristics showed abnormalities in the sleep of non-episodic RISP subjects. Our findings suggest that in order to understand the neurobiological background of RISP, there is a need to extend the analyzes beyond REM-related processes and highlight the value of EEG microstate dynamics as promising functional biomarkers of RISP.
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Affiliation(s)
- Filip Černý
- Faculty of Biomedical Engineering, Czech Technical University, Prague, Czechia
- Sleep and Chronobiology Research Center, National Institute of Mental Health, Klecany, Czechia
| | - Václava Piorecká
- Faculty of Biomedical Engineering, Czech Technical University, Prague, Czechia
- Sleep and Chronobiology Research Center, National Institute of Mental Health, Klecany, Czechia
| | - Monika Kliková
- Sleep and Chronobiology Research Center, National Institute of Mental Health, Klecany, Czechia
| | - Jana Kopřivová
- Sleep and Chronobiology Research Center, National Institute of Mental Health, Klecany, Czechia
- Third Faculty of Medicine, Charles University, Prague, Czechia
| | - Jitka Bušková
- Sleep and Chronobiology Research Center, National Institute of Mental Health, Klecany, Czechia
- Third Faculty of Medicine, Charles University, Prague, Czechia
| | - Marek Piorecký
- Faculty of Biomedical Engineering, Czech Technical University, Prague, Czechia
- Sleep and Chronobiology Research Center, National Institute of Mental Health, Klecany, Czechia
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7
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Poli A, Cappellini F, Sala J, Miccoli M. The integrative process promoted by EMDR in dissociative disorders: neurobiological mechanisms, psychometric tools, and intervention efficacy on the psychological impact of the COVID-19 pandemic. Front Psychol 2023; 14:1164527. [PMID: 37727746 PMCID: PMC10505816 DOI: 10.3389/fpsyg.2023.1164527] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2023] [Accepted: 08/07/2023] [Indexed: 09/21/2023] Open
Abstract
Dissociative disorders (DDs) are characterized by a discontinuity in the normal integration of consciousness, memory, identity, emotion, perception, bodily representation, motor control, and action. The life-threatening coronavirus disease 2019 (COVID-19) pandemic has been identified as a potentially traumatic event and may produce a wide range of mental health problems, such as depression, anxiety disorders, sleep disorders, and DD, stemming from pandemic-related events, such as sickness, isolation, losing loved ones, and fear for one's life. In our conceptual analysis, we introduce the contribution of the structural dissociation of personality (SDP) theory and polyvagal theory to the conceptualization of the COVID-19 pandemic-triggered DD and the importance of assessing perceived safety in DD through neurophysiologically informed psychometric tools. In addition, we analyzed the contribution of eye movement desensitization and reprocessing (EMDR) to the treatment of the COVID-19 pandemic-triggered DD and suggest possible neurobiological mechanisms of action of the EMDR. In particular, we propose that, through slow eye movements, the EMDR may promote an initial non-rapid-eye-movement sleep stage 1-like activity, a subsequent access to a slow-wave sleep activity, and an oxytocinergic neurotransmission that, in turn, may foster the functional coupling between paraventricular nucleus and both sympathetic and parasympathetic cardioinhibitory nuclei. Neurophysiologically informed psychometric tools for safety evaluation in DDs are discussed. Furthermore, clinical and public health implications are considered, combining the EMDR, SDP theory, and polyvagal conceptualizations in light of the potential dissociative symptomatology triggered by the COVID-19 pandemic.
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8
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Peter-Derex L, von Ellenrieder N, van Rosmalen F, Hall J, Dubeau F, Gotman J, Frauscher B. Regional variability in intracerebral properties of NREM to REM sleep transitions in humans. Proc Natl Acad Sci U S A 2023; 120:e2300387120. [PMID: 37339200 PMCID: PMC10293806 DOI: 10.1073/pnas.2300387120] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Accepted: 05/12/2023] [Indexed: 06/22/2023] Open
Abstract
Transitions between wake and sleep states show a progressive pattern underpinned by local sleep regulation. In contrast, little evidence is available on non-rapid eye movement (NREM) to rapid eye movement (REM) sleep boundaries, considered as mainly reflecting subcortical regulation. Using polysomnography (PSG) combined with stereoelectroencephalography (SEEG) in humans undergoing epilepsy presurgical evaluation, we explored the dynamics of NREM-to-REM transitions. PSG was used to visually score transitions and identify REM sleep features. SEEG-based local transitions were determined automatically with a machine learning algorithm using features validated for automatic intra-cranial sleep scoring (10.5281/zenodo.7410501). We analyzed 2988 channel-transitions from 29 patients. The average transition time from all intracerebral channels to the first visually marked REM sleep epoch was 8 s ± 1 min 58 s, with a great heterogeneity between brain areas. Transitions were observed first in the lateral occipital cortex, preceding scalp transition by 1 min 57 s ± 2 min 14 s (d = -0.83), and close to the first sawtooth wave marker. Regions with late transitions were the inferior frontal and orbital gyri (1 min 1 s ± 2 min 1 s, d = 0.43, and 1 min 1 s ± 2 min 5 s, d = 0.43, after scalp transition). Intracranial transitions were earlier than scalp transitions as the night advanced (last sleep cycle, d = -0.81). We show a reproducible gradual pattern of REM sleep initiation, suggesting the involvement of cortical mechanisms of regulation. This provides clues for understanding oneiric experiences occurring at the NREM/REM boundary.
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Affiliation(s)
- Laure Peter-Derex
- Center for Sleep Medicine and Respiratory Diseases, Croix-Rousse Hospital, University Hospital of Lyon, Lyon 1 University, 69004Lyon, France
- Lyon Neuroscience Research Center, CNRS UMR5292/INSERM U1028, Lyon69000, France
| | - Nicolás von Ellenrieder
- Montreal Neurological Institute and Hospital, McGill University, Montreal, QCH3A 2B4, Canada
| | - Frank van Rosmalen
- Montreal Neurological Institute and Hospital, McGill University, Montreal, QCH3A 2B4, Canada
| | - Jeffery Hall
- Montreal Neurological Institute and Hospital, McGill University, Montreal, QCH3A 2B4, Canada
| | - François Dubeau
- Montreal Neurological Institute and Hospital, McGill University, Montreal, QCH3A 2B4, Canada
| | - Jean Gotman
- Montreal Neurological Institute and Hospital, McGill University, Montreal, QCH3A 2B4, Canada
| | - Birgit Frauscher
- Montreal Neurological Institute and Hospital, McGill University, Montreal, QCH3A 2B4, Canada
- Analytical Neurophysiology Lab, Montreal Neurological Institute and Hospital, McGill University, Montreal, QCH3A 2B4, Canada
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9
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Simor P, Bogdány T, Sifuentes-Ortega R, Rovai A, Peigneux P. Lateralized tactile stimulation during NREM sleep globally increases both slow and fast frequency activities. Psychophysiology 2023; 60:e14191. [PMID: 36153813 PMCID: PMC10078489 DOI: 10.1111/psyp.14191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Revised: 07/06/2022] [Accepted: 09/06/2022] [Indexed: 01/25/2023]
Abstract
Slow frequency activity during non-rapid eye movement (NREM) sleep emerges from synchronized activity of widely distributed thalamo-cortical and cortico-cortical networks, reflecting homeostatic and restorative properties of sleep. Slow frequency activity exhibits a reactive nature, and can be increased by acoustic stimulation. Although non-invasive brain stimulation is a promising technique in basic and clinical sleep research, sensory stimulation studies focusing on modalities other than the acoustic are scarce. We explored here the potential of lateralized vibro-tactile stimulation (VTS) of the finger to locally modify electroencephalographic activity during nocturnal NREM sleep. Eight seconds-long sequences of vibro-tactile pulses were delivered at a rate of 1 Hz either to the left or to the right index finger, in addition to a sham condition, in fourteen healthy participants. VTS markedly increased slow frequency activity that peaked between 1-4 Hz but extended to higher (~13 Hz) frequencies, with fronto-central dominance. Enhanced slow frequency activity was accompanied by increased (14-22 Hz) fast frequency power peaking over central and posterior locations. VTS increased the amplitude of slow waves, especially during the first 3-4 s of stimulation. Noticeably, we did not observe local-hemispheric effects, that is, VTS resulted in a global cortical response regardless of stimulation laterality. VTS moderately increased slow and fast frequency activities in resting wakefulness, to a much lower extent compared to NREM sleep. The concomitant increase in slow and fast frequency activities in response to VTS indicates an instant homeostatic response coupled with wake-like, high-frequency activity potentially reflecting transient periods of increased environmental processing.
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Affiliation(s)
- Péter Simor
- Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary.,UR2NF, Neuropsychology and Functional Neuroimaging Research Unit at CRCN-Center for Research in Cognition and Neurosciences, Brussels, Belgium.,UNI-ULB Neurosciences Institute, Université Libre de Bruxelles (ULB), Brussels, Belgium
| | - Tamás Bogdány
- Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary.,UR2NF, Neuropsychology and Functional Neuroimaging Research Unit at CRCN-Center for Research in Cognition and Neurosciences, Brussels, Belgium.,Doctoral School of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary
| | - Rebeca Sifuentes-Ortega
- UR2NF, Neuropsychology and Functional Neuroimaging Research Unit at CRCN-Center for Research in Cognition and Neurosciences, Brussels, Belgium.,UNI-ULB Neurosciences Institute, Université Libre de Bruxelles (ULB), Brussels, Belgium
| | - Antonin Rovai
- UNI-ULB Neurosciences Institute, Université Libre de Bruxelles (ULB), Brussels, Belgium.,Laboratoire de Cartographie fonctionnelle du Cerveau (LCFC), ULB Neuroscience Institute (UNI), CUB-Hôpital Erasme, Université libre de Bruxelles (ULB), Brussels, Belgium.,Department of Functional Neuroimaging, Service of Nuclear Medicine, CUB-Hôpital Erasme, Université libre de Bruxelles (ULB), Brussels, Belgium
| | - Philippe Peigneux
- UR2NF, Neuropsychology and Functional Neuroimaging Research Unit at CRCN-Center for Research in Cognition and Neurosciences, Brussels, Belgium.,UNI-ULB Neurosciences Institute, Université Libre de Bruxelles (ULB), Brussels, Belgium
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Mäder T, Oliver KI, Daffre C, Kim S, Orr SP, Lasko NB, Seo J, Kleim B, Pace-Schott EF. Autonomic activity, posttraumatic and nontraumatic nightmares, and PTSD after trauma exposure. Psychol Med 2023; 53:731-740. [PMID: 34127168 PMCID: PMC9121310 DOI: 10.1017/s0033291721002075] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
BACKGROUND Nightmares are a hallmark symptom of posttraumatic stress disorder (PTSD). This strong association may reflect a shared pathophysiology in the form of altered autonomic activity and increased reactivity. Using an acoustic startle paradigm, we investigated the interrelationships of psychophysiological measures during wakefulness and PTSD diagnosis, posttraumatic nightmares, and nontraumatic nightmares. METHODS A community sample of 122 trauma survivors were presented with a series of brief loud tones, while heart rate (HRR), skin conductance (SCR), and orbicularis oculi electromyogram (EMGR) responses were measured. Prior to the tone presentations, resting heart rate variability (HRV) was assessed. Nightmares were measured using nightmare logs. Three dichotomous groupings of participants were compared: (1) current PTSD diagnosis (n = 59), no PTSD diagnosis (n = 63), (2) those with (n = 26) or without (n = 96) frequent posttraumatic nightmares, and (3) those with (n = 22) or without (n = 100) frequent nontraumatic nightmares. RESULTS PTSD diagnosis was associated with posttraumatic but not with nontraumatic nightmares. Both PTSD and posttraumatic nightmares were associated with a larger mean HRR to loud tones, whereas nontraumatic nightmare frequency was associated with a larger SCR. EMGR and resting HRV were not associated with PTSD diagnosis or nightmares. CONCLUSIONS Our findings suggest a shared pathophysiology between PTSD and posttraumatic nightmares in the form of increased HR reactivity to startling tones, which might reflect reduced parasympathetic tone. This shared pathophysiology could explain why PTSD is more strongly related to posttraumatic than nontraumatic nightmares, which could have important clinical implications.
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Affiliation(s)
- Thomas Mäder
- Department of Psychology, University of Zurich, Zurich, Switzerland
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland
| | - Katelyn I. Oliver
- Department of Psychiatry, Massachusetts General Hospital, Charlestown, MA, USA
- Athinoula A. Martinos Center for Biomedical Imaging, Charlestown, MA, USA
| | - Carolina Daffre
- Department of Psychiatry, Massachusetts General Hospital, Charlestown, MA, USA
- Athinoula A. Martinos Center for Biomedical Imaging, Charlestown, MA, USA
| | - Sophie Kim
- Department of Psychiatry, Massachusetts General Hospital, Charlestown, MA, USA
- Athinoula A. Martinos Center for Biomedical Imaging, Charlestown, MA, USA
| | - Scott P. Orr
- Department of Psychiatry, Massachusetts General Hospital, Charlestown, MA, USA
- Athinoula A. Martinos Center for Biomedical Imaging, Charlestown, MA, USA
- Department of Psychiatry, Harvard Medical School, Charlestown, MA, USA
| | - Natasha B. Lasko
- Department of Psychiatry, Massachusetts General Hospital, Charlestown, MA, USA
- Athinoula A. Martinos Center for Biomedical Imaging, Charlestown, MA, USA
- Department of Psychiatry, Harvard Medical School, Charlestown, MA, USA
| | - Jeehye Seo
- Department of Psychiatry, Massachusetts General Hospital, Charlestown, MA, USA
- Athinoula A. Martinos Center for Biomedical Imaging, Charlestown, MA, USA
- Department of Psychiatry, Harvard Medical School, Charlestown, MA, USA
- Department of Psychological & Brain Sciences, University of Massachusetts, Amherst, MA, USA
| | - Birgit Kleim
- Department of Psychology, University of Zurich, Zurich, Switzerland
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland
- Neuroscience Centre Zurich, University of Zurich, Zurich, Switzerland
| | - Edward Franz Pace-Schott
- Department of Psychiatry, Massachusetts General Hospital, Charlestown, MA, USA
- Athinoula A. Martinos Center for Biomedical Imaging, Charlestown, MA, USA
- Department of Psychiatry, Harvard Medical School, Charlestown, MA, USA
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11
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Sleep spindles, stress and PTSD: The state of the science and future directions. Neurobiol Stress 2023; 23:100516. [PMID: 36861030 PMCID: PMC9969071 DOI: 10.1016/j.ynstr.2023.100516] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2022] [Revised: 01/16/2023] [Accepted: 01/17/2023] [Indexed: 01/27/2023] Open
Abstract
Sleep spindles are a signature feature of non-REM (NREM) sleep, with demonstrated relationships to sleep maintenance and learning and memory. Because PTSD is characterized by disturbances in sleep maintenance and in stress learning and memory, there is now a growing interest in examining the role of sleep spindles in the neurobiology of PTSD. This review provides an overview of methods for measuring and detecting sleep spindles as they pertain to human PTSD and stress research, presents a critical review of early findings examining sleep spindles in PTSD and stress neurobiology, and proposes several directions for future research. In doing so, this review underscores the extensive heterogeneity in sleep spindle measurement and detection methods, the wide range of spindle features that may be and have been examined, the many persisting unknowns about the clinical and functional relevance of those features, and the problems considering PTSD as a homogeneous group in between-group comparisons. This review also highlights the progress that has been made in this field and underscores the strong rationale for ongoing work in this area.
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12
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Predictive coding, multisensory integration, and attentional control: A multicomponent framework for lucid dreaming. Proc Natl Acad Sci U S A 2022; 119:e2123418119. [PMID: 36279459 PMCID: PMC9636904 DOI: 10.1073/pnas.2123418119] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
Lucid dreaming (LD) is a mental state in which we realize not being awake but are dreaming while asleep. It often involves vivid, perceptually intense dream images as well as peculiar kinesthetic sensations, such as flying, levitating, or out-of-body experiences. LD is in the cross-spotlight of cognitive neuroscience and sleep research as a particular case to study consciousness, cognition, and the neural background of dream experiences. Here, we present a multicomponent framework for the study and understanding of neurocognitive mechanisms and phenomenological aspects of LD. We propose that LD is associated with prediction error signals arising during sleep and occurring at higher or lower levels of the processing hierarchy. Prediction errors are resolved by generating a superordinate self-model able to integrate ambiguous stimuli arriving from sensory periphery and higher-order cortical regions. While multisensory integration enables lucidity maintenance and contributes to peculiar kinesthetic experiences, attentional control facilitates multisensory integration by dynamically regulating the balance between the influence of top-down mental models and the precision weighting of bottom-up sensory inputs. Our novel framework aims to link neural correlates of LD with current concepts of sleep and arousal regulation and provide testable predictions on interindividual differences in LD as well as neurocognitive mechanisms inducing lucid dreams.
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Response to the Commentary on the paper "The heartbeat evoked potential is a questionable biomarker in nightmare disorder: A replication study. By Bogdany, T., Perakakis, P., Bodizs, R., Simor, P., 2021. NeuroImage Clin. 33, 102933". Neuroimage Clin 2022; 36:103197. [PMID: 36152562 PMCID: PMC9508493 DOI: 10.1016/j.nicl.2022.103197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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Bogdány T, Perakakis P, Bódizs R, Simor P. The heartbeat evoked potential is a questionable biomarker in nightmare disorder: A replication study. Neuroimage Clin 2022; 33:102933. [PMID: 34990964 PMCID: PMC8743245 DOI: 10.1016/j.nicl.2021.102933] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Revised: 12/12/2021] [Accepted: 12/30/2021] [Indexed: 11/30/2022]
Abstract
Perogamvros et al. (2013) examined heart beat evoked potential (HEP) in nightmare sufferers. Increased HEP was proposed to be a robust biomarker in nightmare disorder. We aimed to replicate the original study in two separate and larger databases. We did not confirm the original finding showing differential HEP in REM sleep. Our data cast doubts on the utility of HEP as a biomarker in nightmare disorder.
Frequent nightmares are highly prevalent and constitute a risk factor for a wide range of psychopathological conditions. Despite its prevalence and clinical relevance however, the pathophysiological mechanisms of nightmares are poorly understood. A recent study (Perogamvros et, al 2019) examined the heart beat evoked potential (HEP) in a small group of nightmare sufferers (N = 11) and matched healthy controls (N = 11) and observed markedly different (Hedges’ g = 1.42 [0.62–2.22]) HEP response across the groups during Rapid Eye Movement (REM) sleep. Moreover, the HEP correlated with depression scores in the nightmare group only. The authors concluded that the HEP in REM sleep could be used as a trait-like biomarker reflecting pathological emotional-and sleep regulation in nightmare disorder. To replicate the above study, we performed the same analyses of HEPs in two separate, and larger databases comprising the polysomnographic recordings of nightmare sufferers and matched controls (NStudy 1 = 39 ; NStudy 2 = 41). In contrast to the original findings, we did not observe significant differences in HEP across the two groups in either of the two databases. Moreover, we found no associations between depression scores and HEP amplitudes in the relevant spatiotemporal cluster. Our data cast doubts on the utility of HEP as a biomarker in the diagnostic and treatment procedures of nightmare disorder and suggests that the interpretation of HEP as a marker of impaired arousal and emotional processing during REM sleep is premature and requires further validation.
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Affiliation(s)
- Tamás Bogdány
- Doctoral School of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary; Institute of Psychology, ELTE, Eötvös Loránd University, Budapest, Hungary
| | - Pandelis Perakakis
- Department of Social, Work, and Differential Psychology, Complutense University of Madrid, Spain
| | - Róbert Bódizs
- Institute of Behavioural Sciences, Semmelweis University, Budapest, Hungary; National Institute of Clinical Neurosciences, Budapest, Hungary
| | - Péter Simor
- Institute of Psychology, ELTE, Eötvös Loránd University, Budapest, Hungary; UR2NF, Neuropsychology and Functional Neuroimaging Research Unit at CRCN - Center for Research in Cognition and Neurosciences and UNI - ULB Neurosciences Institute, Université Libre de Bruxelles (ULB), Brussels, Belgium.
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15
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Simor P, Bogdány T, Bódizs R, Perakakis P. Cortical monitoring of cardiac activity during rapid eye movement sleep: the heartbeat evoked potential in phasic and tonic rapid-eye-movement microstates. Sleep 2021; 44:zsab100. [PMID: 33870427 PMCID: PMC8633618 DOI: 10.1093/sleep/zsab100] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Revised: 04/04/2021] [Indexed: 11/13/2022] Open
Abstract
Sleep is a fundamental physiological state that facilitates neural recovery during periods of attenuated sensory processing. On the other hand, mammalian sleep is also characterized by the interplay between periods of increased sleep depth and environmental alertness. Whereas the heterogeneity of microstates during non-rapid-eye-movement (NREM) sleep was extensively studied in the last decades, transient microstates during rapid-eye-movement (REM) sleep received less attention. REM sleep features two distinct microstates: phasic and tonic. Previous studies indicate that sensory processing is largely diminished during phasic REM periods, whereas environmental alertness is partially reinstated when the brain switches into tonic REM sleep. Here, we investigated interoceptive processing as quantified by the heartbeat evoked potential (HEP) during REM microstates. We contrasted the HEPs of phasic and tonic REM periods using two separate databases that included the nighttime polysomnographic recordings of healthy young individuals (N = 20 and N = 19). We find a differential HEP modulation of a late HEP component (after 500 ms post-R-peak) between tonic and phasic REM. Moreover, the late tonic HEP component resembled the HEP found in resting wakefulness. Our results indicate that interoception with respect to cardiac signals is not uniform across REM microstates, and suggest that interoceptive processing is partially reinstated during tonic REM periods. The analyses of the HEP during REM sleep may shed new light on the organization and putative function of REM microstates.
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Affiliation(s)
- Péter Simor
- Institute of Psychology, ELTE, Eötvös Loránd University, Budapest, Hungary
- Institute of Behavioural Sciences, Semmelweis University, Budapest, Hungary
- UR2NF, Neuropsychology and Functional Neuroimaging Research Unit at CRCN – Center for Research in Cognition and Neurosciences and UNI – ULB Neurosciences Institute, Université Libre de Bruxelles (ULB), Brussels, Belgium
| | - Tamás Bogdány
- Institute of Psychology, ELTE, Eötvös Loránd University, Budapest, Hungary
- Doctoral School of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary
| | - Róbert Bódizs
- Institute of Behavioural Sciences, Semmelweis University, Budapest, Hungary
- National Institute of Clinical Neurosciences, Budapest, Hungary
| | - Pandelis Perakakis
- Department of Social, Organisational, and Differential Psychology, Complutense University of Madrid, Madrid, Spain
- Brain, Mind, & Behavior Research Center, University of Granada, Granada, Spain
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16
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Marquis LP, Julien SH, Daneault V, Blanchette-Carrière C, Paquette T, Carr M, Soucy JP, Montplaisir J, Nielsen T. Local Neuronal Synchronization in Frequent Nightmare Recallers and Healthy Controls: A Resting-State Functional Magnetic Resonance Imaging Study. Front Neurosci 2021; 15:645255. [PMID: 33815047 PMCID: PMC8012764 DOI: 10.3389/fnins.2021.645255] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Accepted: 02/25/2021] [Indexed: 11/25/2022] Open
Abstract
Nightmares are highly dysphoric dreams that are well-remembered upon awakening. Frequent nightmares have been associated with psychopathology and emotional dysregulation, yet their neural mechanisms remain largely unknown. Our neurocognitive model posits that nightmares reflect dysfunction in a limbic-prefrontal circuit comprising medial prefrontal and anterior cingulate cortices, hippocampus, and amygdala. However, there is a paucity of studies that used brain imaging to directly test the neural correlates of nightmares. One such study compared the regional homogeneity (ReHo) of resting-state functional magnetic resonance imaging blood-oxygen level-dependent signals between frequent nightmare recallers and controls. The main results were greater regional homogeneity in the left anterior cingulate cortex and right inferior parietal lobule for the nightmare recallers than for the controls. In the present study, we aimed to document the ReHo correlates of frequent nightmares using several nightmare severity measures. We acquired resting-state functional magnetic resonance imaging data from 18 frequent nightmare recallers aged 18-35 (3 males and 15 females) and 18 age- and sex-matched controls, as well as retrospective and prospective disturbed dreaming frequency estimates and scores on the Nightmare Distress Questionnaire. While there were inconsistent results for our different analyses (group comparisons, correlational analyses for frequency estimates/Nightmare Distress scores), our results suggest that nightmares are associated with altered ReHo in frontal (medial prefrontal and inferior frontal), parietal, temporal and occipital regions, as well as some subcortical regions (thalamus). We also found a positive correlation between retrospective disturbed dreaming frequency estimates and ReHo values in the hippocampus. These findings are mostly in line with a recent SPECT study from our laboratory. Our results point to the possibility that a variety of regions, including but not limited to the limbic-prefrontal circuit of our neurocognitive model, contribute to nightmare formation.
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Affiliation(s)
- Louis-Philippe Marquis
- Department of Psychology, Université de Montréal, Montreal, QC, Canada
- Center for Advanced Research in Sleep Medicine, CIUSSS-NÎM – Hôpital du Sacré-Coeur de Montréal, Montreal, QC, Canada
| | - Sarah-Hélène Julien
- Department of Psychology, Université de Montréal, Montreal, QC, Canada
- Center for Advanced Research in Sleep Medicine, CIUSSS-NÎM – Hôpital du Sacré-Coeur de Montréal, Montreal, QC, Canada
| | - Véronique Daneault
- Department of Psychology, Université de Montréal, Montreal, QC, Canada
- Center for Advanced Research in Sleep Medicine, CIUSSS-NÎM – Hôpital du Sacré-Coeur de Montréal, Montreal, QC, Canada
| | - Cloé Blanchette-Carrière
- Department of Psychology, Université de Montréal, Montreal, QC, Canada
- Center for Advanced Research in Sleep Medicine, CIUSSS-NÎM – Hôpital du Sacré-Coeur de Montréal, Montreal, QC, Canada
| | - Tyna Paquette
- Center for Advanced Research in Sleep Medicine, CIUSSS-NÎM – Hôpital du Sacré-Coeur de Montréal, Montreal, QC, Canada
| | - Michelle Carr
- Department of Psychiatry, Sleep & Neurophysiology Research Laboratory, University of Rochester Medical Center, Rochester, NY, United States
| | | | - Jacques Montplaisir
- Center for Advanced Research in Sleep Medicine, CIUSSS-NÎM – Hôpital du Sacré-Coeur de Montréal, Montreal, QC, Canada
- Department of Psychiatry, Université de Montréal, Montreal, QC, Canada
| | - Tore Nielsen
- Center for Advanced Research in Sleep Medicine, CIUSSS-NÎM – Hôpital du Sacré-Coeur de Montréal, Montreal, QC, Canada
- Department of Psychiatry, Université de Montréal, Montreal, QC, Canada
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Unaltered EEG spectral power and functional connectivity in REM microstates in frequent nightmare recallers: are nightmares really a REM parasomnia? Sleep Med 2020; 75:192-200. [PMID: 32858360 DOI: 10.1016/j.sleep.2020.07.014] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2020] [Revised: 06/23/2020] [Accepted: 07/10/2020] [Indexed: 11/22/2022]
Abstract
BACKGROUND Frequent nightmares show signs of hyperarousal in NREM sleep. Nevertheless, idiopathic nightmare disorder is considered a REM parasomnia, but the pathophysiology of REM sleep in relation to frequent nightmares is controversial. Cortical oscillatory activity in REM sleep is largely modulated by phasic and tonic REM periods and seems to be linked to different functions and dysfunctions of REM sleep. Here, we examined cortical activity and functional synchronization in frequent nightmare recallers and healthy controls, during phasic and tonic REM. METHODS Frequent nightmare recallers (N = 22) and healthy controls (N = 22) matched for high dream recall spent two nights in the laboratory. Phasic and tonic REM periods from the second nights' recordings were selected to examine differences in EEG spectral power and weighted phase lag index (WPLI) across groups and REM states. RESULTS Phasic REM showed increased power and synchronization in delta and gamma frequency bands, whereas tonic REM featured increased power and synchronization in the alpha and beta bands. In the theta band, power was higher during tonic, and synchronization was higher during phasic REM sleep. No differences across nightmare and control participants or patterns representing interactions between the groups and REM microstates emerged. CONCLUSIONS Our findings do not support the idea that abnormal REM sleep power and synchronization play a role in the pathophysiology of frequent nightmares. Altered REM sleep in nightmare disorder could have been confounded with comorbid pathologies and increased dream recall, or might be linked to more specific state factors (nightmare episodes).
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Scarpelli S, D’Atri A, Bartolacci C, Gorgoni M, Mangiaruga A, Ferrara M, De Gennaro L. Dream Recall upon Awakening from Non-Rapid Eye Movement Sleep in Older Adults: Electrophysiological Pattern and Qualitative Features. Brain Sci 2020; 10:E343. [PMID: 32503215 PMCID: PMC7349242 DOI: 10.3390/brainsci10060343] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Revised: 05/29/2020] [Accepted: 06/01/2020] [Indexed: 02/05/2023] Open
Abstract
Several findings support the activation hypothesis, positing that cortical arousal promotes dream recall (DR). However, most studies have been carried out on young participants, while the electrophysiological (EEG) correlates of DR in older people are still mostly unknown. We aimed to test the activation hypothesis on 20 elders, focusing on the Non-Rapid Eye Movement (NREM) sleep stage. All the subjects underwent polysomnography, and a dream report was collected upon their awakening from NREM sleep. Nine subjects were recallers (RECs) and 11 were non-RECs (NRECs). The delta and beta EEG activity of the last 5 min and the total NREM sleep was calculated by Fast Fourier Transform. Statistical comparisons (RECs vs. NRECs) revealed no differences in the last 5 min of sleep. Significant differences were found in the total NREM sleep: the RECs showed lower delta power over the parietal areas than the NRECs. Consistently, statistical comparisons on the activation index (delta/beta power) revealed that RECs showed a higher level of arousal in the fronto-temporal and parieto-occipital regions than NRECs. Both visual vividness and dream length are positively related to the level of activation. Overall, our results are consistent with the view that dreaming and the storage of oneiric contents depend on the level of arousal during sleep, highlighting a crucial role of the temporo-parietal-occipital zone.
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Affiliation(s)
- Serena Scarpelli
- IRCCS Fondazione Santa Lucia, 00179 Rome, Italy;
- Department of Psychology, Sapienza University of Rome, 00185 Rome, Italy; (A.D.); (C.B.); (M.G.); (A.M.)
| | - Aurora D’Atri
- Department of Psychology, Sapienza University of Rome, 00185 Rome, Italy; (A.D.); (C.B.); (M.G.); (A.M.)
| | - Chiara Bartolacci
- Department of Psychology, Sapienza University of Rome, 00185 Rome, Italy; (A.D.); (C.B.); (M.G.); (A.M.)
| | - Maurizio Gorgoni
- Department of Psychology, Sapienza University of Rome, 00185 Rome, Italy; (A.D.); (C.B.); (M.G.); (A.M.)
| | - Anastasia Mangiaruga
- Department of Psychology, Sapienza University of Rome, 00185 Rome, Italy; (A.D.); (C.B.); (M.G.); (A.M.)
- Department of Medical and Surgical Sciences (DIMEC), University of Bologna, 40126 Bologna, Italy
| | - Michele Ferrara
- Department of Biotechnological and Applied Clinical Sciences, University of L’Aquila, Via Vetoio (Coppito 2), 67100 Coppito (L’Aquila), Italy;
| | - Luigi De Gennaro
- IRCCS Fondazione Santa Lucia, 00179 Rome, Italy;
- Department of Psychology, Sapienza University of Rome, 00185 Rome, Italy; (A.D.); (C.B.); (M.G.); (A.M.)
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