A local signature of LTP- and LTD-like plasticity in human NREM sleep

Neural oscillations and memory: unraveling the mechanisms of anesthesia-induced amnesia

General anesthesia is a widely used medical practice, affecting more than 300 million patients annually. Despite its ubiquity, the underlying mechanisms through which anesthetic agents induce amnesia remain poorly understood. This review explores the impact of general anesthetics on memory function, with a particular focus on the role of neural oscillations in anesthesia-induced memory suppression. Neural oscillations, such as theta, gamma, delta oscillations, slow oscillations (SO), spindles, and sharp wave ripples (SWR), are critical for memory formation and consolidation. Various anesthetics modulate these oscillations in ways that affect memory, even at subanesthetic concentrations. We highlight recent findings on the molecular and electrophysiological mechanisms by which general anesthetics influence memory-related neural oscillations, including the inhibition of synaptic plasticity, alterations in spike-timing-dependent plasticity (STDP), and disruption of cross-frequency couplings like theta-gamma and SO-spindle-SWR. Additionally, the review addresses the significance of age in anesthesia-related memory loss, with elderly patients being particularly vulnerable to long-term cognitive decline. Electrophysiological techniques, such as Electroencephalography (EEG); and advanced neuromodulation techniques, such as chemogenetics, and optogenetics, have provided insights into the neural dynamics underpinning anesthesia-induced amnesia, yet the causal relationship between EEG rhythms and memory impairment remains to be fully elucidated. This review underscores the importance of further research into the interaction between anesthesia, neural oscillations, and memory. Understanding these mechanisms will not only advance theoretical knowledge of general anesthesia but also aid in the development of safer anesthetic strategies to mitigate postoperative cognitive dysfunction, especially in high-risk populations.

Sleep and Learning: A Systematic Review

Introduction  Sleep deprivation has a great impact on the learning process in physicians in training. Therefore, inquiring on this phenomenon in the most recent investigations will facilitate the provision of evidence on the influence regarding the absence of sleep on the learning process in health personnel. Objectives  The aim of this systematic review is to review, analyze and discuss the current literature that shows the impact of sleep on the learning process on doctors in training. Data Synthesis  A systematic review was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. A search of the existing literature between the years of 2000 and 2022 was performed in the PubMed and Elsevier databases, taking into account the inclusion criteria of articles in English or Spanish and the established timeframe. As a result, 128 articles distributed in the databases were obtained and 23 articles that met the inclusion criteria were selected. Conclusion  Sleep is a fundamental factor for the consolidation, processing and functioning of memory and learning. Health professionals are a population at risk of sleep deprivation, thus it is important to take into account the effects it has on patients and health personnel.

Impact of single-trial avoidance learning on subsequent sleep

Both non-rapid eye movement (NonREM) sleep and rapid eye movement (REM) sleep, as well as sleep spindle and ripple oscillations, are important for memory formation. Through cortical EEG recordings of prefrontal cortex and hippocampus during and after an inhibitory avoidance task, we analysed the dynamic changes in the amounts of sleep, spindle and ripple oscillations related to memory formation. The total amount of NonREM sleep was reduced during the first hour after learning. Moreover, significant decrease of the total spindle and ripple counts was observed at the first hour after learning as well. In addition, foot shock alone, with no associated learning, produced little effect on the dynamics of sleep oscillations, indicating that the learning experience is necessary for these changes to occur.

Altered Sleep Oscillations as Neurophysiological Biomarkers of Schizophrenia

Sleep spindles and slow waves are the two main oscillatory activities occurring during nonrapid eye movement (NREM) sleep. Here, we will first describe the electrophysiological characteristics of these sleep oscillations along with the neurophysiological and molecular mechanisms underlying their generation and synchronization in the healthy brain. We will then review the extant evidence of deficits in sleep spindles and, to a lesser extent, slow waves, including in slow wave-spindle coupling, in patients with Schizophrenia (SCZ) across the course of the disorder, from at-risk to chronic stages. Next, we will discuss how these sleep oscillatory deficits point to defects in neuronal circuits within the thalamocortical network as well as to alterations in molecular neurotransmission implicating the GABAergic and glutamatergic systems in SCZ. Finally, after explaining how spindle and slow waves may represent neurophysiological biomarkers with predictive, diagnostic, and prognostic potential, we will present novel pharmacological and neuromodulatory interventions aimed at restoring sleep oscillatory deficits in SCZ, which in turn may serve as target engagement biomarkers to ameliorate the clinical symptoms and the quality of life of individuals affected by this devastating brain disorder.

Inferring Causality from Noninvasive Brain Stimulation in Cognitive Neuroscience

Noninvasive brain stimulation (NIBS) techniques, such as transcranial magnetic stimulation or transcranial direct and alternating current stimulation, are advocated as measures to enable causal inference in cognitive neuroscience experiments. Transcending the limitations of purely correlative neuroimaging measures and experimental sensory stimulation, they allow to experimentally manipulate brain activity and study its consequences for perception, cognition, and eventually, behavior. Although this is true in principle, particular caution is advised when interpreting brain stimulation experiments in a causal manner. Research hypotheses are often oversimplified, disregarding the underlying (implicitly assumed) complex chain of causation, namely, that the stimulation technique has to generate an electric field in the brain tissue, which then evokes or modulates neuronal activity both locally in the target region and in connected remote sites of the network, which in consequence affects the cognitive function of interest and eventually results in a change of the behavioral measure. Importantly, every link in this causal chain of effects can be confounded by several factors that have to be experimentally eliminated or controlled to attribute the observed results to their assumed cause. This is complicated by the fact that many of the mediating and confounding variables are not directly observable and dose-response relationships are often nonlinear. We will walk the reader through the chain of causation for a generic cognitive neuroscience NIBS study, discuss possible confounds, and advise appropriate control conditions. If crucial assumptions are explicitly tested (where possible) and confounds are experimentally well controlled, NIBS can indeed reveal cause-effect relationships in cognitive neuroscience studies.

A mechanism for learning with sleep spindles

Spindles are ubiquitous oscillations during non-rapid eye movement (NREM) sleep. A growing body of evidence points to a possible link with learning and memory, and the underlying mechanisms are now starting to be unveiled. Specifically, spindles are associated with increased dendritic activity and high intracellular calcium levels, a situation favourable to plasticity, as well as with control of spiking output by feed-forward inhibition. During spindles, thalamocortical networks become unresponsive to inputs, thus potentially preventing interference between memory-related internal information processing and extrinsic signals. At the system level, spindles are co-modulated with other major NREM oscillations, including hippocampal sharp wave-ripples (SWRs) and neocortical slow waves, both previously shown to be associated with learning and memory. The sequential occurrence of reactivation at the time of SWRs followed by neuronal plasticity-promoting spindles is a possible mechanism to explain NREM sleep-dependent consolidation of memories. This article is part of the Theo Murphy meeting issue 'Memory reactivation: replaying events past, present and future'.

Sleep Spindles: Mechanisms and Functions

Sleep spindles are burstlike signals in the electroencephalogram (EEG) of the sleeping mammalian brain and electrical surface correlates of neuronal oscillations in thalamus. As one of the most inheritable sleep EEG signatures, sleep spindles probably reflect the strength and malleability of thalamocortical circuits that underlie individual cognitive profiles. We review the characteristics, organization, regulation, and origins of sleep spindles and their implication in non-rapid-eye-movement sleep (NREMS) and its functions, focusing on human and rodent. Spatially, sleep spindle-related neuronal activity appears on scales ranging from small thalamic circuits to functional cortical areas, and generates a cortical state favoring intracortical plasticity while limiting cortical output. Temporally, sleep spindles are discrete events, part of a continuous power band, and elements grouped on an infraslow time scale over which NREMS alternates between continuity and fragility. We synthesize diverse and seemingly unlinked functions of sleep spindles for sleep architecture, sensory processing, synaptic plasticity, memory formation, and cognitive abilities into a unifying sleep spindle concept, according to which sleep spindles 1) generate neural conditions of large-scale functional connectivity and plasticity that outlast their appearance as discrete EEG events, 2) appear preferentially in thalamic circuits engaged in learning and attention-based experience during wakefulness, and 3) enable a selective reactivation and routing of wake-instated neuronal traces between brain areas such as hippocampus and cortex. Their fine spatiotemporal organization reflects NREMS as a physiological state coordinated over brain and body and may indicate, if not anticipate and ultimately differentiate, pathologies in sleep and neurodevelopmental, -degenerative, and -psychiatric conditions.

Thalamo-Cortical White Matter Underlies Motor Memory Consolidation via Modulation of Sleep Spindles in Young and Older Adults

Ample evidence suggests that consolidation of the memory trace associated with a newly acquired motor sequence is supported by thalamo-cortical spindle activity during subsequent sleep, as well as functional changes in a distributed cortico-striatal network. To date, however, no studies have investigated whether the structural white matter connections between these regions affect motor sequence memory consolidation in relation with sleep spindles. Here, we used diffusion weighted imaging (DWI) tractography to reconstruct the major fascicles of the cortico-striato-pallido-thalamo-cortical loop in both young and older participants who were trained on an explicit finger sequence learning task before and after a daytime nap. Thereby, this allowed us to examine whether post-learning sleep spindles measured using polysomnographic recordings interact with consolidation processes and this specific neural network. Our findings provide evidence corroborating the critical role of NREM2 thalamo-cortical sleep spindles in motor sequence memory consolidation, and show that the post-learning changes in these neurophysiological events relate specifically to white matter characteristics in thalamo-cortical fascicles. Moreover, we demonstrate that microstructure along this fascicle relates indirectly to offline gains in performance through an increase of spindle density over motor-related cortical areas. These results suggest that the integrity of thalamo-cortical projections, via their impact on sleep spindle generation, may represent one of the critical mechanisms modulating the expression of sleep-dependent offline gains following motor sequence learning in healthy adults.

Adult Gross Motor Learning and Sleep: Is There a Mutual Benefit?

Posttraining consolidation, also known as offline learning, refers to neuroplastic processes and systemic reorganization by which newly acquired skills are converted from an initially transient state into a more permanent state. An extensive amount of research on cognitive and fine motor tasks has shown that sleep is able to enhance these processes, resulting in more stable declarative and procedural memory traces. On the other hand, limited evidence exists concerning the relationship between sleep and learning of gross motor skills. We are particularly interested in this relationship with the learning of gross motor skills in adulthood, such as in the case of sports, performing arts, devised experimental tasks, and rehabilitation practice. Thus, the present review focuses on sleep and gross motor learning (GML) in adults. The literature on the impact of sleep on GML, the consequences of sleep deprivation, and the influence of GML on sleep architecture were evaluated for this review. While sleep has proven to be beneficial for most gross motor tasks, sleep deprivation in turn has not always resulted in performance decay. Furthermore, correlations between motor performance and sleep parameters have been found. These results are of potential importance for integrating sleep in physiotherapeutic interventions, especially for patients with impaired gross motor functions.

The effects of aging on cortico-spinal excitability and motor memory consolidation

We investigated whether cortico-spinal excitability (CSE), a marker of synaptic plasticity, is associated with age-related differences in the consolidation of motor memory. Young and older participants practiced a visuomotor tracking task. Skill retention was assessed 8 and 24 hours after motor practice. Transcranial magnetic stimulation applied over the primary motor cortex at rest and during an isometric muscle contraction was used to assess absolute and normalized to baseline CSE at different points after practice. When skill performance was normalized to baseline level, both groups showed similar gains in acquisition, but the young group showed better retention 24 hours after practice. The young group also showed greater absolute CSE assessed during the isometric muscle contraction. Although young participants with greater absolute CSE showed better skill retention, it was the capacity to increase CSE after motor practice, and not absolute CSE, what was associated with skill retention in older participants. Older adults who have the capacity to increase CSE during motor memory consolidation show a better capacity to retain motor skills.

Slow-Wave Activity Enhancement to Improve Cognition

Slow-wave activity (SWA), and its coupling with other sleep features, reorganizes cortical circuitry, supporting cognition. This raises the question: can cognition be improved through SWA enhancement? SWA enhancement techniques range from behavioral interventions (such as exercise), which have high feasibility but low specificity, to laboratory-based techniques (such as transcranial stimulation), which have high specificity but are less feasible for widespread use. In this review we describe the pathways through which SWA is enhanced. Pathways encompass enhanced neural activity, increased energy metabolism, and endocrine signaling during wakefulness; also direct enhancement during sleep. We evaluate the robustness and practicality of SWA-enhancement techniques, discuss approaches for determining a causal role of SWA on cognition, and present questions to clarify the mechanisms of SWA-dependent cognitive improvements.

Does sleep facilitate the consolidation of allocentric or egocentric representations of implicitly learned visual-motor sequence learning?

Sleep facilitates the consolidation (i.e., enhancement) of simple, explicit (i.e., conscious) motor sequence learning (MSL). MSL can be dissociated into egocentric (i.e., motor) or allocentric (i.e., spatial) frames of reference. The consolidation of the allocentric memory representation is sleep-dependent, whereas the egocentric consolidation process is independent of sleep or wake for explicit MSL. However, it remains unclear the extent to which sleep contributes to the consolidation of implicit (i.e., unconscious) MSL, nor is it known what aspects of the memory representation (egocentric, allocentric) are consolidated by sleep. Here, we investigated the extent to which sleep is involved in consolidating implicit MSL, specifically, whether the egocentric or the allocentric cognitive representations of a learned sequence are enhanced by sleep, and whether these changes support the development of explicit sequence knowledge across sleep but not wake. Our results indicate that egocentric and allocentric representations can be behaviorally dissociated for implicit MSL. Neither representation was preferentially enhanced across sleep nor were developments of explicit awareness observed. However, after a 1-wk interval performance enhancement was observed in the egocentric representation. Taken together, these results suggest that like explicit MSL, implicit MSL has dissociable allocentric and egocentric representations, but unlike explicit sequence learning, implicit egocentric and allocentric memory consolidation is independent of sleep, and the time-course of consolidation differs significantly.

Sleep spindles: a physiological marker of age-related changes in gray matter in brain regions supporting motor skill memory consolidation

Sleep is necessary for the optimal consolidation of procedural learning, and in particular, for motor sequential skills. Motor sequence learning remains intact with age, but sleep-dependent consolidation is impaired, suggesting that memory deficits for procedural skills are specifically impacted by age-related changes in sleep. Age-related changes in spindles may be responsible for impaired motor sequence learning consolidation, but the morphological basis for this deficit is unknown. Here, we found that gray matter in the hippocampus and cerebellum was positively correlated with both sleep spindles and offline improvements in performance in young participants but not in older participants. These results suggest that age-related changes in gray matter in the hippocampus relate to spindles and may underlie age-related deficits in sleep-related motor sequence memory consolidation. In this way, spindles can serve as a biological marker for structural brain changes and the related memory deficits in older adults.

Insufficient chunk concatenation may underlie changes in sleep-dependent consolidation of motor sequence learning in older adults

Sleep enhances motor sequence learning (MSL) in young adults by concatenating subsequences (“chunks”) formed during skill acquisition. To examine whether this process is reduced in aging, we assessed performance changes on the MSL task following overnight sleep or daytime wake in healthy young and older adults. Young adult performance enhancement was correlated with nREM2 sleep, and facilitated by preferential improvement of slowest within-sequence transitions. This effect was markedly reduced in older adults, and accompanied by diminished sigma power density (12–15 Hz) during nREM2 sleep, suggesting that diminished chunk concatenation following sleep may underlie reduced consolidation of MSL in older adults.

Sleep Spindles as Facilitators of Memory Formation and Learning

Over the past decades important progress has been made in understanding the mechanisms of sleep spindle generation. At the same time a physiological role of sleep spindles is starting to be revealed. Behavioural studies in humans and animals have found significant correlations between the recall performance in different learning tasks and the amount of sleep spindles in the intervening sleep. Concomitant neurophysiological experiments showed a close relationship between sleep spindles and other sleep related EEG rhythms as well as a relationship between sleep spindles and synaptic plasticity. Together, there is growing evidence from several disciplines in neuroscience for a participation of sleep spindles in memory formation and learning.

Brain Oscillations in Sport: Toward EEG Biomarkers of Performance

Brain dynamics is at the basis of top performance accomplishment in sports. The search for neural biomarkers of performance remains a challenge in movement science and sport psychology. The non-invasive nature of high-density electroencephalography (EEG) recording has made it a most promising avenue for providing quantitative feedback to practitioners and coaches. Here, we review the current relevance of the main types of EEG oscillations in order to trace a perspective for future practical applications of EEG and event-related potentials (ERP) in sport. In this context, the hypotheses of unified brain rhythms and continuity between wake and sleep states should provide a functional template for EEG biomarkers in sport. The oscillations in the thalamo-cortical and hippocampal circuitry including the physiology of the place cells and the grid cells provide a frame of reference for the analysis of delta, theta, beta, alpha (incl.mu), and gamma oscillations recorded in the space field of human performance. Based on recent neuronal models facilitating the distinction between the different dynamic regimes (selective gating and binding) in these different oscillations we suggest an integrated approach articulating together the classical biomechanical factors (3D movements and EMG) and the high-density EEG and ERP signals to allow finer mathematical analysis to optimize sport performance, such as microstates, coherency/directionality analysis and neural generators.

Modeling the effects of noninvasive transcranial brain stimulation at the biophysical, network, and cognitive level

Noninvasive transcranial brain stimulation (NTBS) is widely used to elucidate the contribution of different brain regions to various cognitive functions. Here we present three modeling approaches that are informed by functional or structural brain mapping or behavior profiling and discuss how these approaches advance the scientific potential of NTBS as an interventional tool in cognitive neuroscience. (i) Leveraging the anatomical information provided by structural imaging, the electric field distribution in the brain can be modeled and simulated. Biophysical modeling approaches generate testable predictions regarding the impact of interindividual variations in cortical anatomy on the injected electric fields or the influence of the orientation of current flow on the physiological stimulation effects. (ii) Functional brain mapping of the spatiotemporal neural dynamics during cognitive tasks can be used to construct causal network models. These models can identify spatiotemporal changes in effective connectivity during distinct cognitive states and allow for examining how effective connectivity is shaped by NTBS. (iii) Modeling the NTBS effects based on neuroimaging can be complemented by behavior-based cognitive models that exploit variations in task performance. For instance, NTBS-induced changes in response speed and accuracy can be explicitly modeled in a cognitive framework accounting for the speed-accuracy trade-off. This enables to dissociate between behavioral NTBS effects that emerge in the context of rapid automatic responses or in the context of slow deliberate responses. We argue that these complementary modeling approaches facilitate the use of NTBS as a means of dissecting the causal architecture of cognitive systems of the human brain.

Sleep and emotional functions

In this chapter, we review studies investigating the role of sleep in emotional functions. In particular, evidence has recently accumulated to show that brain regions involved in the processing of emotional and reward-related information are activated during sleep. We suggest that such activation of emotional and reward systems during sleep underlies the reprocessing and consolidation of memories with a high affective and motivational relevance for the organism. We also propose that these mechanisms occurring during sleep promote adapted cognitive and emotional responses in the waking state, including overnight performance improvement, creativity, and sexual functions. Activation across emotional-limbic circuits during sleep also appears to promote emotional maturation and the emergence of consciousness in the developing brain.

The nonspecific thalamus: A place in a wedding bed for making memories last?

We summarize anatomical, electrophysiological and behavioral evidence that the rostral intralaminar (ILN) and the reuniens and rhomboid (ReRh) nuclei that belong to the nonspecific thalamus, might be part of a hippocampo-cortico-thalamic network underlying consolidation of enduring declarative(-like) memories at systems level. The first part of this review describes the anatomical and functional organization of these thalamic nuclei. The second part presents the theoretical models supporting the active systems-level consolidation, a process that relies upon sleep specific field-potential oscillations occurring during both slow-wave sleep (SWS) and rapid eye movement (REM) sleep. The last part presents data in the rat showing that the lesion of the rostral ILN or of the ReRh specifically hinders the formation of remote spatial memories without affecting task acquisition or retrieval of a recent memory. These results showing a critical role of the ILN and ReRh nuclei in the transformation of a recent memory into a remote one are discussed in the context of their control of cortical arousal (ARAS) and of thalamo-cortico-thalamic synchronization.

Wakefulness delta waves increase after cortical plasticity induction

OBJECTIVE

Delta waves (DW) are present both during sleep and in wakefulness. In the first case, DW are considered effectors of synaptic plasticity, while in wakefulness, when they appear in the case of brain lesions, their functional meaning is not unanimously recognized. To throw light on the latter, we aimed to investigate the impact on DW exerted by the cortical plasticity-inducing protocol of intermittent theta burst stimulation (iTBS).

METHODS

Twenty healthy subjects underwent iTBS (11 real iTBS and nine sham iTBS) on the left primary motor cortex with the aim of inducing long-term potentiation (LTP)-like phenomena. Five-minute resting open-eye 32-channel EEG, right opponens pollicis motor-evoked potentials (MEPs), and alertness behavioral scales were collected before and up to 30 min after the iTBS. Power spectral density (PSD), interhemispheric coherence between homologous sensorimotor regions, and intrahemispheric coherence were calculated for the frequency bands ranging from delta to beta.

RESULTS

Real iTBS induced a significant increase of both MEP amplitude and DW PSD lasting up to 30 min after stimulation, while sham iTBS did not. The DW increase was evident over frontal areas ipsilateral and close to the stimulated cortex (electrode F3). Neither real nor sham iTBS induced significant modifications in the PSD of theta, alpha, and beta bands and in the interhemispheric coherence. Behavioral visuo-analogic scales score did not demonstrate changes in alertness after stimulations. No correlations were found between MEP amplitude and PSD changes in the delta band.

CONCLUSIONS

Our data showed that LTP induction in the motor cortex during wakefulness, by means of iTBS, is accompanied by a large and enduring increase of DW over the ipsilateral frontal cortex.

SIGNIFICANCE

The present results are strongly in favor of a prominent role of DW in the neural plasticity processes taking place during the awake state.

fMRI and sleep correlates of the age-related impairment in motor memory consolidation

Behavioral studies indicate that older adults exhibit normal motor sequence learning (MSL), but paradoxically, show impaired consolidation of the new memory trace. However, the neural and physiological mechanisms underlying this impairment are entirely unknown. Here, we sought to identify, through functional magnetic resonance imaging during MSL and electroencephalographic (EEG) recordings during daytime sleep, the functional correlates and physiological characteristics of this age-related motor memory deficit. As predicted, older subjects did not exhibit sleep-dependent gains in performance (i.e., behavioral changes that reflect consolidation) and had reduced sleep spindles compared with young subjects. Brain imaging analyses also revealed that changes in activity across the retention interval in the putamen and related brain regions were associated with sleep spindles. This change in striatal activity was increased in young subjects, but reduced by comparison in older subjects. These findings suggest that the deficit in sleep-dependent motor memory consolidation in elderly individuals is related to a reduction in sleep spindle oscillations and to an associated decrease of activity in the cortico-striatal network.

Sleep and dreaming are for important matters

Recent studies in sleep and dreaming have described an activation of emotional and reward systems, as well as the processing of internal information during these states. Specifically, increased activity in the amygdala and across mesolimbic dopaminergic regions during REM sleep is likely to promote the consolidation of memory traces with high emotional/motivational value. Moreover, coordinated hippocampal-striatal replay during NREM sleep may contribute to the selective strengthening of memories for important events. In this review, we suggest that, via the activation of emotional/motivational circuits, sleep and dreaming may offer a neurobehavioral substrate for the offline reprocessing of emotions, associative learning, and exploratory behaviors, resulting in improved memory organization, waking emotion regulation, social skills, and creativity. Dysregulation of such motivational/emotional processes due to sleep disturbances (e.g., insomnia, sleep deprivation) would predispose to reward-related disorders, such as mood disorders, increased risk-taking and compulsive behaviors, and may have major health implications, especially in vulnerable populations.

Is sleep essential for neural plasticity in humans, and how does it affect motor and cognitive recovery?

There is a general consensus that sleep is strictly linked to memory, learning, and, in general, to the mechanisms of neural plasticity, and that this link may directly affect recovery processes. In fact, a coherent pattern of empirical findings points to beneficial effect of sleep on learning and plastic processes, and changes in synaptic plasticity during wakefulness induce coherent modifications in EEG slow wave cortical topography during subsequent sleep. However, the specific nature of the relation between sleep and synaptic plasticity is not clear yet. We reported findings in line with two models conflicting with respect to the underlying mechanisms, that is, the “synaptic homeostasis hypothesis” and the “consolidation” hypothesis, and some recent results that may reconcile them. Independently from the specific mechanisms involved, sleep loss is associated with detrimental effects on plastic processes at a molecular and electrophysiological level. Finally, we reviewed growing evidence supporting the notion that plasticity-dependent recovery could be improved managing sleep quality, while monitoring EEG during sleep may help to explain how specific rehabilitative paradigms work. We conclude that a better understanding of the sleep-plasticity link could be crucial from a rehabilitative point of view.

About sleep's role in memory

Over more than a century of research has established the fact that sleep benefits the retention of memory. In this review we aim to comprehensively cover the field of "sleep and memory" research by providing a historical perspective on concepts and a discussion of more recent key findings. Whereas initial theories posed a passive role for sleep enhancing memories by protecting them from interfering stimuli, current theories highlight an active role for sleep in which memories undergo a process of system consolidation during sleep. Whereas older research concentrated on the role of rapid-eye-movement (REM) sleep, recent work has revealed the importance of slow-wave sleep (SWS) for memory consolidation and also enlightened some of the underlying electrophysiological, neurochemical, and genetic mechanisms, as well as developmental aspects in these processes. Specifically, newer findings characterize sleep as a brain state optimizing memory consolidation, in opposition to the waking brain being optimized for encoding of memories. Consolidation originates from reactivation of recently encoded neuronal memory representations, which occur during SWS and transform respective representations for integration into long-term memory. Ensuing REM sleep may stabilize transformed memories. While elaborated with respect to hippocampus-dependent memories, the concept of an active redistribution of memory representations from networks serving as temporary store into long-term stores might hold also for non-hippocampus-dependent memory, and even for nonneuronal, i.e., immunological memories, giving rise to the idea that the offline consolidation of memory during sleep represents a principle of long-term memory formation established in quite different physiological systems.

Common mechanisms of human perceptual and motor learning

The adult mammalian brain has a remarkable capacity to learn in both the perceptual and motor domains through the formation and consolidation of memories. Such practice-enabled procedural learning results in perceptual and motor skill improvements. Here, we examine evidence supporting the notion that perceptual and motor learning in humans exhibit analogous properties, including similarities in temporal dynamics and the interactions between primary cortical and higher-order brain areas. These similarities may point to the existence of a common general mechanism for learning in humans.

High density electroencephalography in sleep research: potential, problems, future perspective

High density EEG (hdEEG) during sleep combines the superior temporal resolution of EEG recordings with high spatial resolution. Thus, this method allows a topographical analysis of sleep EEG activity and thereby fosters the shift from a global view of sleep to a local one. HdEEG allowed to investigate sleep rhythms in terms of their characteristic behavior (e.g., the traveling of slow waves) and in terms of their relationship to cortical functioning (e.g., consciousness and cognitive abilities). Moreover, recent studies successfully demonstrated that hdEEG can be used to study brain functioning in neurological and neuro-developmental disorders, and to evaluate therapeutic approaches. This review highlights the potential, the problems, and future perspective of hdEEG in sleep research.

EEG-guided transcranial magnetic stimulation reveals rapid shifts in motor cortical excitability during the human sleep slow oscillation

Evoked cortical responses do not follow a rigid input-output function but are dynamically shaped by intrinsic neural properties at the time of stimulation. Recent research has emphasized the role of oscillatory activity in determining cortical excitability. Here we employed EEG-guided transcranial magnetic stimulation (TMS) during non-rapid eye movement sleep to examine whether the spontaneous <1 Hz neocortical slow oscillation (SO) is associated with corresponding fluctuations of evoked responses. Whereas the SO's alternating phases of global depolarization (up-state) and hyperpolarization (down-state) are clearly associated with fluctuations in spontaneous neuronal excitation, less is known about state-dependent shifts in neocortical excitability. In 12 human volunteers, single-pulse TMS of the primary motor cortical hand area (M1(HAND)) was triggered online by automatic detection of SO up-states and down-states in the EEG. State-dependent changes in cortical excitability were traced by simultaneously recording motor-evoked potentials (MEPs) and TMS-evoked EEG potentials (TEPs). Compared to wakefulness and regardless of SO state, sleep MEPs were smaller and delayed whereas sleep TEPs were fundamentally altered, closely resembling a spontaneous SO. However, both MEPs and TEPs were consistently larger when evoked during SO up-states than during down-states, and amplitudes within each SO state depended on the actual EEG potential at the time and site of stimulation. These results provide first-time evidence for a rapid state-dependent shift in neocortical excitability during a neuronal oscillation in the human brain. We further demonstrate that EEG-guided temporal neuronavigation is a powerful tool to investigate the phase-dependent effects of neuronal oscillations on perception, cognition, and motor control.

Activity of cortical and thalamic neurons during the slow (<1 Hz) rhythm in the mouse in vivo

During NREM sleep and under certain types of anaesthesia, the mammalian brain exhibits a distinctive slow (<1 Hz) rhythm. At the cellular level, this rhythm correlates with so-called UP and DOWN membrane potential states. In the neocortex, these UP and DOWN states correspond to periods of intense network activity and widespread neuronal silence, respectively, whereas in thalamocortical (TC) neurons, UP/DOWN states take on a more stereotypical oscillatory form, with UP states commencing with a low-threshold Ca²⁺ potential (LTCP). Whilst these properties are now well recognised for neurons in cats and rats, whether or not they are also shared by neurons in the mouse is not fully known. To address this issue, we obtained intracellular recordings from neocortical and TC neurons during the slow (<1 Hz) rhythm in anaesthetised mice. We show that UP/DOWN states in this species are broadly similar to those observed in cats and rats, with UP states in neocortical neurons being characterised by a combination of action potential output and intense synaptic activity, whereas UP states in TC neurons always commence with an LTCP. In some neocortical and TC neurons, we observed ‘spikelets’ during UP states, supporting the possible presence of electrical coupling. Lastly, we show that, upon tonic depolarisation, UP/DOWN states in TC neurons are replaced by rhythmic high-threshold bursting at ~5 Hz, as predicted by in vitro studies. Thus, UP/DOWN state generation appears to be an elemental and conserved process in mammals that underlies the slow (<1 Hz) rhythm in several species, including humans.

Slow wave activity during sleep: functional and therapeutic implications

Electroencephalographic slow-wave activity (EEG SWA) is an electrophysiological signature of slow (0.5 to 4.0 Hz), synchronized, oscillatory neocortical activity. In healthy individuals, EEG SWA is maximally expressed during non-rapid-eye-movement (non-REM) sleep, and intensifies as a function of prior wake duration. Many of the cellular and network mechanisms generating EEG SWA have been identified, but a number of questions remain unanswered. For example, although EEG SWA is a marker of sleep need, its precise relationship with sleep homeostasis and its roles in the brain are unknown. In this review, the authors discuss their current understanding of the neural mechanisms and possible functions of EEG SWA.

Enhancing plasticity through repeated rTMS sessions: the benefits of a night of sleep

OBJECTIVE

Previous work has demonstrated that corticospinal facilitation from 20Hz repetitive transcranial magnetic stimulation (rTMS) was greater during a second rTMS session 24h after the first. We sought to determine whether such metaplasticity is dependent on a particular phase of the normal sleep-wake/circadian cycle.

METHODS

Twenty healthy participants received two sessions of 20Hz rTMS over the hand motor cortex (M1) spaced 12h apart, either over-day or overnight.

RESULTS

Baseline corticospinal excitability did not differ by group or session. The time-of-day of Session 1 did not influence the relative increase in excitability following rTMS. However, the increase in excitability from the second rTMS session was 2-fold greater in the overnight group.

CONCLUSIONS

When a night with sleep follows rTMS to M1, the capacity to induce subsequent plasticity in M1 is enhanced, suggesting sleep-wake and/or circadian-dependent modulation of processes of metaplasticity.

SIGNIFICANCE

TMS treatment of neuropsychiatric disorders entails repeated sessions of rTMS. Our findings suggest that the timing of sessions relative to the sleep-wake/circadian cycle may be a critical factor in the cumulative effect of treatment. Future studies using this paradigm may provide mechanistic insights into human metaplasticity, leading to refined strategies to enhance non-invasive stimulation therapies.

Contribution of sleep to memory consolidation

The contribution of sleep to memory processing is being characterized at increasingly detailed levels. At a behavioral level, better performance at retrieval is usually observed after sleep, relative to a period of wakefulness. At a brainsystems level, functional neuroimaging techniques have demonstrated that the distribution of regional brain activity is influenced by previous waking experience. At present, the selective effects of sleep components, such as slow waves or spindles are being characterized. These effects are framed in terms of neural firing patterns and also in terms of the molecular mechanisms underpinning the effects of sleep on brain plasticity. Collectively, the available data indicate a positive influence of sleep on memory consolidation.

The effects of morning training on night sleep: a behavioral and EEG study

The consolidation of memories in a variety of learning processes benefits from post-training sleep, and recent work has suggested a role for sleep slow wave activity (SWA). Previous studies using a visuomotor learning task showed a local increase in sleep SWA in right parietal cortex, which was correlated with post-sleep performance enhancement. In these as in most similar studies, learning took place in the evening, shortly before sleep. Thus, it is currently unknown whether learning a task in the morning, followed by the usual daily activities, would also result in a local increase in sleep SWA during the night, and in a correlated enhancement in performance the next day. To answer this question, a group of subjects performed a visuomotor learning task in the morning and was retested the following morning. Whole night sleep was recorded with high-density EEG. We found an increase of SWA over the right posterior parietal areas that was most evident during the second sleep cycle. Performance improved significantly the following morning, and the improvement was positively correlated with the SWA increase in the second sleep cycle. These results suggest that training-induced changes in sleep SWA and post-sleep improvements do not depend upon the time interval between original training and sleep.

The memory function of sleep

Sleep has been identified as a state that optimizes the consolidation of newly acquired information in memory, depending on the specific conditions of learning and the timing of sleep. Consolidation during sleep promotes both quantitative and qualitative changes of memory representations. Through specific patterns of neuromodulatory activity and electric field potential oscillations, slow-wave sleep (SWS) and rapid eye movement (REM) sleep support system consolidation and synaptic consolidation, respectively. During SWS, slow oscillations, spindles and ripples - at minimum cholinergic activity - coordinate the re-activation and redistribution of hippocampus-dependent memories to neocortical sites, whereas during REM sleep, local increases in plasticity-related immediate-early gene activity - at high cholinergic and theta activity - might favour the subsequent synaptic consolidation of memories in the cortex.

Sleep spindle activity is correlated with reading abilities in developmental dyslexia

STUDY OBJECTIVES

To analyze sleep architecture of children with dyslexia, by means of conventional parameters and EEG spectral analysis and to correlate sleep parameters and EEG spectra with neuropsychological measures.

DESIGN

Cross-sectional study involving validated sleep questionnaires, neuropsychological scales, and polysomnographic recordings.

SETTING

Sleep laboratory in academic center.

PARTICIPANTS

Sixteen subjects with developmental dyslexia (mean age 10.8 years) and 11 normally reading children (mean age 10.1 years). All the subjects underwent overnight polysomnographic recording; EEG power spectra were computed from the Cz derivation and spindle density was calculated during sleep stages N2.

INTERVENTION

N/A.

MEASUREMENTS AND RESULTS

Dyslexic children showed an increase in power of frequency bands between 0.5-3 Hz and 11-12 Hz in stage N2 and between 0.5-1 Hz in stage N3; they also showed significantly increased spindle density during N2. The power of the sigma band in N2 was positively correlated with the Word reading and MT reading tests; similarly, spindle density was significantly correlated with the Word reading test. The increased spindle activity and EEG sigma power in dyslexic subjects were found to be correlated with the degree of dyslexic impairment.

CONCLUSIONS

The correlation found between sleep spindle activity and reading abilities in developmental dyslexia supports the hypothesis of a role for NREM sleep and spindles in sleep-related neurocognitive processing.

Inducing Homeostatic-Like Plasticity in Human Motor Cortex Through Converging Corticocortical Inputs

Transcranial stimulation techniques have revealed homeostatic-like metaplasticity in the hand area of the human primary motor cortex (M1HAND) that controls stimulation-induced changes in corticospinal excitability. Here we combined two interventional protocols that induce long-term depression (LTD)–like or long-term potentiation (LTP)–like plasticity in left M1HAND through different afferents. We hypothesized that the left M1HAND would integrate LTP- and LTD-like plasticity in a homeostatic fashion. In ten healthy volunteers, low-intensity repetitive transcranial magnetic stimulation (rTMS) of the left dorsal premotor cortex (PMD) was first applied to produce an LTP-like increase (5 Hz rTMS) or LTD-like decrease (1 Hz rTMS) in corticospinal excitability in left M1HAND via premotor-to-motor inputs. Following PMD rTMS, paired-associative stimulation (PAS) was applied to the right median nerve and left M1HAND to induce spike-time–dependent plasticity in sensory-to-motor inputs to left M1HAND. We adjusted the interstimulus interval to the N20 latency of the median nerve somatosensory-evoked cortical potential to produce an LTP-like increase (PASN20+2ms) or an LTD-like decrease (PASN20−5ms) in corticospinal excitability. The amplitude of motor-evoked potentials was recorded from intrinsic hand muscles to assess stimulation-induced changes in corticospinal excitability. Premotor-to-motor preconditioning triggered a homeostatic response to subsequent sensory-to-motor PAS. After facilitatory 5 Hz rTMS, “facilitatory” PASN20+2ms suppressed corticospinal excitability. Likewise, “inhibitory” PASN20−5ms facilitated corticospinal excitability after “inhibitory” 1 Hz rTMS. There was a negative linear relationship between the excitability changes induced by PMD rTMS and those elicited by subsequent PAS. Excitability changes were not paralleled by changes in performance during a finger-tapping task. These results provide evidence for a homeostatic response pattern in the human M1HAND that integrates acute plastic changes evoked through different “input channels.”

Memory processes during sleep: beyond the standard consolidation theory

Two-step theories of memory formation suggest that an initial encoding stage, during which transient neural assemblies are formed in the hippocampus, is followed by a second step called consolidation, which involves re-processing of activity patterns and is associated with an increasing involvement of the neocortex. Several studies in human subjects as well as in animals suggest that memory consolidation occurs predominantly during sleep (standard consolidation model). Alternatively, it has been suggested that consolidation may occur during waking state as well and that the role of sleep is rather to restore encoding capabilities of synaptic connections (synaptic downscaling theory). Here, we review the experimental evidence favoring and challenging these two views and suggest an integrative model of memory consolidation.

Slow waves, synaptic plasticity and information processing: insights from transcranial magnetic stimulation and high-density EEG experiments

Sleep slow waves are the main phenomenon underlying NREM sleep. They are homeostatically regulated, they are thought to be linked to learning and plasticity processes and, at the same time, they are associated with marked changes in cortical information processing. Using transcranial magnetic stimulation (TMS) and high-density (hd) EEG we can measure slow waves, induce and measure plastic changes in the cerebral cortex and directly assess corticocortical information transmission. In this manuscript we review the results of recent experiments in which TMS with hd-EEG is used to demonstrate (i) a causal link between cortical plastic changes and sleep slow waves and (ii) a causal link between slow waves and the decreased ability of thalamocortical circuits to integrate information and to generate conscious experience during NREM sleep. The data presented here suggest a unifying mechanism linking slow waves, plasticity and cortical information integration; moreover, they suggest that TMS can be used as a nonpharmacological means to controllably induce slow waves in the human cerebral cortex.

Consensus paper: combining transcranial stimulation with neuroimaging

In the last decade, combined transcranial magnetic stimulation (TMS)-neuroimaging studies have greatly stimulated research in the field of TMS and neuroimaging. Here, we review how TMS can be combined with various neuroimaging techniques to investigate human brain function. When applied during neuroimaging (online approach), TMS can be used to test how focal cortex stimulation acutely modifies the activity and connectivity in the stimulated neuronal circuits. TMS and neuroimaging can also be separated in time (offline approach). A conditioning session of repetitive TMS (rTMS) may be used to induce rapid reorganization in functional brain networks. The temporospatial patterns of TMS-induced reorganization can be subsequently mapped by using neuroimaging methods. Alternatively, neuroimaging may be performed first to localize brain areas that are involved in a given task. The temporospatial information obtained by neuroimaging can be used to define the optimal site and time point of stimulation in a subsequent experiment in which TMS is used to probe the functional contribution of the stimulated area to a specific task. In this review, we first address some general methodologic issues that need to be taken into account when using TMS in the context of neuroimaging. We then discuss the use of specific brain mapping techniques in conjunction with TMS. We emphasize that the various neuroimaging techniques offer complementary information and have different methodologic strengths and weaknesses.

Consensus: Motor cortex plasticity protocols

Noninvasive transcranial stimulation is being increasingly used by clinicians and neuroscientists to alter deliberately the status of the human brain. Important applications are the induction of virtual lesions (for example, transient dysfunction) to identify the importance of the stimulated brain network for a certain sensorimotor or cognitive task, and the induction of changes in neuronal excitability, synaptic plasticity or behavioral function outlasting the stimulation, for example, for therapeutic purposes. The aim of this article is to review critically the properties of the different currently used stimulation protocols, including a focus on their particular strengths and weaknesses, to facilitate their appropriate and conscientious application.

Cortical plasticity induced by transcranial magnetic stimulation during wakefulness affects electroencephalogram activity during sleep

BACKGROUND

Sleep electroencephalogram (EEG) brain oscillations in the low-frequency range show local signs of homeostatic regulation after learning. Such increases and decreases of slow wave activity are limited to the cortical regions involved in specific task performance during wakefulness. Here, we test the hypothesis that reorganization of motor cortex produced by long-term potentiation (LTP) affects EEG activity of this brain area during subsequent sleep.

METHODOLOGY/PRINCIPAL FINDINGS

By pairing median nerve stimulation with transcranial magnetic stimulation over the contralateral motor cortex, one can potentiate the motor output, which is presumed to reflect plasticity of the neural circuitry. This paired associative stimulation increases M1 cortical excitability at interstimulus intervals of 25 ms. We compared the scalp distribution of sleep EEG power following paired associative stimulation at 25 ms to that following a control paradigm with 50 ms intervals. It is shown that the experimental manipulation by paired associative stimulation at 25 ms induces a 48% increase in amplitude of motor evoked potentials. This LTP-like potentiation, induced during waking, affects delta and theta EEG power in both REM and non-REM sleep, measured during the following night. Slow-wave activity increases in some frontal and prefrontal derivations and decreases at sites neighboring and contralateral to the stimulated motor cortex. The magnitude of increased amplitudes of motor evoked potentials by the paired associative stimulation at 25 ms predicts enhancements of slow-wave activity in prefrontal regions.

CONCLUSIONS/SIGNIFICANCE

An LTP-like paradigm, presumably inducing increased synaptic strength, leads to changes in local sleep regulation, as indexed by EEG slow-wave activity. Enhancement and depression of slow-wave activity are interpreted in terms of a simultaneous activation of both excitatory and inhibitory circuits consequent to the paired associative stimulation at 25 ms.