Dante Picchioni

Decoupling of the brain's default mode network during deep sleep

The recent discovery of a circuit of brain regions that is highly active in the absence of overt behavior has led to a quest for revealing the possible function of this so-called default-mode network (DMN). A very recent study, finding similarities in awake humans and anesthetized primates, has suggested that DMN activity might not simply reflect ongoing conscious mentation but rather a more general form of network dynamics typical of complex systems. Here, by performing functional MRI in humans, it is shown that a natural, sleep-induced reduction of consciousness is reflected in altered correlation between DMN network components, most notably a reduced involvement of frontal cortex. This suggests that DMN may play an important role in the sustenance of conscious awareness.

Insomnia as predictor versus outcome of PTSD and depression among Iraq combat veterans.

OBJECTIVES The study conducted a longitudinal assessment of insomnia as an antecedent versus consequence of posttraumatic stress disorder (PTSD) and depression symptoms among combat veterans. DESIGN Two postdeployment time points were used in combination with structural equation modeling to examine the relative strength of two possible directions of prediction: insomnia as a predictor of psychological symptoms, and psychological symptoms as a predictor of insomnia. Participants were active duty soldiers (N = 659) in a brigade combat team who were assessed 4 months after their return from a 12-month deployment to Iraq, and then again eight months later. RESULTS Although both insomnia and psychological symptoms were associated at both time periods and across time periods, insomnia at 4 months postdeployment was a significant predictor of change in depression and PTSD symptoms at 12 months postdeployment, whereas depression and PTSD symptoms at 4 months postdeployment were not significant predictors of change in insomnia at 12 months postdeployment. CONCLUSIONS Results support the role of insomnia in the development of additional psychological problems and highlight the clinical implications for combat veterans, to include the importance of longitudinal assessment and monitoring of sleep disturbances, and the need for early intervention.

Sleep loss and sleepiness: current issues.

Awareness of the consequences of sleep loss and its implications for public health and safety is increasing. Sleep loss has been shown to generally impair the entire spectrum of mental abilities, ranging from simple psychomotor performance to executive mental functions. Sleep loss may also impact metabolism in a manner that contributes to obesity and its attendant health consequences. Although objective measures of alertness and performance remain degraded, individuals subjectively habituate to chronic partial sleep loss (eg, sleep restriction), and recovery from this type of sleep loss is slow, factors that may help to explain the observation that many individuals in the general population are chronically sleep restricted. Individual differences in habitual sleep duration appear to be a trait-like characteristic that is determined by several factors, including genetic polymorphisms.

Sleep Loss and Sleepiness

Awareness of the consequences of sleep loss and its implications for public health and safety is increasing. Sleep loss has been shown to generally impair the entire spectrum of mental abilities, ranging from simple psychomotor performance to executive mental functions. Sleep loss may also impact metabolism in a manner that contributes to obesity and its attendant health consequences. Although objective measures of alertness and performance remain degraded, individuals subjectively habituate to chronic partial sleep loss (eg, sleep restriction), and recovery from this type of sleep loss is slow, factors that may help to explain the observation that many individuals in the general population are chronically sleep restricted. Individual differences in habitual sleep duration appear to be a trait-like characteristic that is determined by several factors, including genetic polymorphisms.

Rhythmic alternating patterns of brain activity distinguish rapid eye movement sleep from other states of consciousness

Rapid eye movement (REM) sleep constitutes a distinct “third state” of consciousness, during which levels of brain activity are commensurate with wakefulness, but conscious awareness is radically transformed. To characterize the temporal and spatial features of this paradoxical state, we examined functional interactions between brain regions using fMRI resting-state connectivity methods. Supporting the view that the functional integrity of the default mode network (DMN) reflects “level of consciousness,” we observed functional uncoupling of the DMN during deep sleep and recoupling during REM sleep (similar to wakefulness). However, unlike either deep sleep or wakefulness, REM was characterized by a more widespread, temporally dynamic interaction between two major brain systems: unimodal sensorimotor areas and the higher-order association cortices (including the DMN), which normally regulate their activity. During REM, these two systems become anticorrelated and fluctuate rhythmically, in reciprocally alternating multisecond epochs with a frequency ranging from 0.1 to 0.01 Hz. This unique spatiotemporal pattern suggests a model for REM sleep that may be consistent with its role in dream formation and memory consolidation.

Sleep and the functional connectome

Sleep and the functional connectome are research areas with considerable overlap. Neuroimaging studies of sleep based on EEG-PET and EEG-fMRI are revealing the brain networks that support sleep, as well as networks that may support the roles and processes attributed to sleep. For example, phenomena such as arousal and consciousness are substantially modulated during sleep, and one would expect this modulation to be reflected in altered network activity. In addition, recent work suggests that sleep also has a number of adaptive functions that support waking activity. Thus the study of sleep may elucidate the circuits and processes that support waking function and complement information obtained from fMRI during waking conditions. In this review, we will discuss examples of this for memory, arousal, and consciousness after providing a brief background on sleep and on studying it with fMRI.

Infraslow EEG oscillations organize large-scale cortical–subcortical interactions during sleep: A combined EEG/fMRI study

Infraslow (<0.1 Hz) oscillations of brain activity, measured by EEG and other methods, have become a subject of increasing interest. While their prominence during sleep has been established, the functional significance of these oscillations for sleep physiology is unknown. To clarify this role, we examined correlations between infraslow EEG oscillations and BOLD fMRI during the course of natural sleep in healthy volunteers. Infraslow EEG oscillations appear to organize a broad dissociation of activity in cortical and subcortical regions: in general, correlations between power in the infraslow EEG band and BOLD were positive in subcortical regions and negative in the cortex. Robust negative correlations were found principally in paramedian heteromodal cortices whereas positive correlations were seen in cerebellum, thalamus, basal ganglia, lateral neocortices and hippocampus. This pattern of correlations suggests a mechanism by which infraslow oscillations may organize sleep-dependent neuroplastic processes including consolidation of episodic memory.

Sleep symptoms as a partial mediator between combat stressors and other mental health symptoms in Iraq war veterans.

Sleep symptoms are a prominent feature of mental health disorders like PTSD and depression. However, it is unknown whether sleep symptoms mediate the relationship between combat stress and these disorders. We examined the mediating role of sleep symptoms on the relationship between combat stress and PTSD; and the relationship between combat stress and depression using data from 576 Army veterans of the Iraq War surveyed in 2004. Correlational analyses revealed that when insomnia was included in the model, the correlation between combat stressors and other depression symptoms decreased by 65%; and when nightmares were included in the model, the correlation between combat stressors and other PTSD symptoms decreased by 69%. We replicated these analyses using individual items assessing PTSD and depression and found that the insomnia and nightmare items had the largest and second largest mediation effect between combat stressors and PTSD and depression symptoms. Our result support the theory that sleep symptoms contribute to the development and/or maintenance of other mental health symptoms and that early treatment of sleep symptoms may mitigate the other mental health consequences of combat stress.

fMRI differences between early and late stage-1 sleep

This study sought to test for differences in regional brain activity between stage-1 sleep immediately following wake and immediately preceding stage-2 sleep. Data were collected during daytime fMRI sessions with simultaneous EEG acquisition. A stage-1 interval was defined as follows: > or =30s of wake, immediately followed by > or =60s of continuous stage 1, immediately followed by > or =30s of stage 2. We compared brain activity between the first 30s of stage 1 (early stage 1), the last 30s of stage 1 (late stage 1), and isolated wake. A conjunction analysis sorted each voxel into one of a series of mutually exclusive categories that represented the various possible combinations of a significant increase, decrease, or no difference among these three states. The initial dataset consisted of 14 healthy volunteers. A total of 22 sessions in these participants yielded six stage-1 intervals (from four participants) that met criteria for inclusion in the analysis. There were multiple clusters of significant voxels. Examples include changes in default-mode network areas where activity increased compared to wake only in early stage 1 and a bilateral change in the hippocampus where activity increased compared to wake only in late stage 1. These results suggest that activity in anatomically identifiable, volumetric brain regions exhibit differences during stage-1 sleep that would not have been detected with the EEG. These differences may also have specific relevance to understanding the process of sleep onset as well as the neural mechanisms of performance lapses during sleep deprivation.

Caffeine Gum Minimizes Sleep Inertia

Naps are an effective strategy for maintaining alertness and cognitive performance; however, upon abrupt wakening from naps, sleep inertia (temporary performance degradation) may ensue. In the present study, attenuation of post-nap sleep inertia was attempted by administration of caffeine gum. Using a double-blind, placebo-controlled crossover design, 15 healthy, non-smoking adults were awakened at 1 hr. and again at 6 hr. after lights out (0100 and 0600, respectively) and were immediately administered a gum pellet containing 100 mg of caffeine or placebo. A 5-min. psychomotor vigilance task was administered at 0 min., 6 min., 12 min., and 18 min. post-awakening. At 0100, response speed with caffeine was significantly better at 12 min. and 18 min. post-awakening compared to placebo; at 0600, caffeines effects were evident at 18 min. post-awakening. Caffeinated gum is a viable means of rapidly attenuating sleep inertia, suggesting that the adenosine receptor system is involved in sleep maintenance.