alman sleep 2010 fina lmay
TRANSCRIPT
Click to Add Title
Click to Add Speaker Information
The Relationship between Absolute Beta Power and rCMRglc in Primary
Insomnia during REM sleep
Jennifer Alman1, David Cashmere2, Jean Miewald2, Eric Nofzinger, M.D.2, Daniel Buysse, M.D.2, and Anne Germain,
Ph.D.2
1Washington & Jefferson College
2Department of Psychiatry, University of Pittsburgh School of Medicine
Conflict of Interest DisclosuresSpeaker:
1. I do not have any potential conflicts of interest to disclose, OR
2. I wish to disclose the following potential conflicts of interest:
Financial support
Other
Speakers’ Bureaus
Consultant
Grant/Research Support
Details of Potential ConflictType of Potential Conflict
3. The material presented in this lecture has no relationship with any of these potential conflicts, OR
4. This talk presents material that is related to one or more of these potential conflicts, and the following objective references are provided as support for this lecture:
1.
2.
3.
X
Background• Increased beta power has been shown in
primary insomnia (PI) during NREM sleep.e.g., Merica and Gaillard, 1998
• PI is a disorder characterized by hyperarousal.
• REM sleep is a state of hyperarousal, especially in limbic regions.
• The neurobiological correlates of beta power in PI during REM sleep have not been investigated.
Study Aim
• Explore relationship between absolute beta power and rCMRglc during REM in PI.
• Hypothesis: Positive correlation between beta power and rCMRglc in:
– Occipital gyrus– Anterior cingulate cortex– Gyrus rectus and posterior medial
orbitofrontal cortex
Participants
• 10 PI subjects
• Mean age: 37.86 ± 9.38 years
• 7 women, 3 men• All subjects were free of medication,
comorbid psychiatric, other sleep and medical disorders.
Procedures• 3 nights spent in the lab.
– Night 1: Sleep apnea screening
– Night 2: Baseline
– Night 3: PET sleep study
• Whole-night REM sleep beta (16-32Hz) power estimates obtained from Night 2 from artifact-free 4-second epochs, averaged across all REM sleep periods.
EEGEMGEOG
saline
Lab Room
[radiotracer]
PET
PET Data Analysis
• Correlation analyses were conducted to determine the relationships between beta activity and rCMRglc during REM sleep.
• Reported results are corrected for multiple comparisons (p < .05).
Results
• No significant positive correlation between beta activity and rCMRglc.
• Trends observed for: – Gyrus rectus *– Middle temporal gyrus– Middle frontal gyrus– Dorsal/anterior cingulate gyrus *– Parieto-occipital sulcus
Results
• Significant negative correlations were found between beta activity and rCMRglc during REM sleep in 3 brain regions.
3034
10431
3219
K Corrected p-values
Coordinates
0.04-34, -44.-20
0.00152, -66, 14
0.03-10, 48, 10
Results: Region 1
• Significant Areas:
– Left cingulate gyrus
– Inferior and middle frontal gyri 9
876543210
Cingulate GyrusFrontal Gyri
Continuous Voxels: 3219
Coordinates: -10, 48, 10
Z=3.36, p=0.03
Results: Region 2
• Significant Areas:
– Right temporal gyri
– Parahippocampal gyrus and hippocampus
– Superior parietal lobule
9876543210
-14.
1,
-64.
3,
31.8
-16.
4, -
51.8
, 5.
2
-16.
4,
-51.
8,
5.2
Temporal GyriParrahippocampalGyrus/Hippocampus
Superior Parietal Lobule
Continuous Voxels: 10431
Coordinates: 52, -66, 14
Z=4.15, p<.001
Results: Region 3
• Significant Areas:– Left fusiform gyrus
– Temporal gyri
9876543210
-35.
2,
-57.
2,
-10.
4-3
5.2,
-57
.2, -
10.4
34,
-44.
-20
Continuous Voxels: 3034 Coordinates: -34, -44.-20
Z=4.38, p=.04
Fusiform gyrus
Temporal Gyri
Conclusions
• No areas reached statistical significance for positive correlations between beta activity and rCMRglc at corrected level of significance.
• PI decreased whole-night beta activity was associated with increased rCMRglc during REM sleep.
Limitations
• Whole-night absolute beta power used was from Night 2.– Repeat with beta activity during uptake period
• Beta power was the only measure used to indicate arousal. – Assess correlations with other measures of
arousal:• Peripheral arousal with heart rate variability • Cognitive/dream content• Indices of somatic arousal
» Perlis et al., 2001
Discussion
• No areas reached statistical significance for positive correlations between beta activity and rCMRglc at corrected level of significance.
• Differences across studies may result from a difference between NREM vs. REM sleep.
• The small sample sizes warrant caution when interpreting these preliminary results.
Discussion• We observed a negative correlation between beta activity
and rCMRglc during REM sleep.
• This pattern may not be specific to central arousal in PI during REM sleep:
– Frontal, parieto-occipital, and temporal regions are part of a perceptual/sensory integration and information processing network also involved dreaming.
– Maquet et al., 1996
– Beta activity orchestrates activity across these brain regions during wakefulness, and is decreased during REM sleep.
– Pérez-Garci et al., 2001
• The observed pattern may reflect disturbed REM sleep mentation in PI.
– Perlis et al., 2001
Future Directions
1. Replication in larger samples.
2. Focus on beta activity during FDG uptake period.
3. Exploration and comparison of the relationships between beta activity and rCMRglc during REM and NREM sleep.
4. Contrast these relationships across healthy sleepers, subjects with PI or insomnia comorbid with other disorders such as PTSD and depression.
5. Obtain dream reports from subjects undergoing sleep neuroimaging studies.
Acknowledgements
• Gina Pietrone• Research participants • N-CTRC staff
US Department of Defense (PT073961-W81XWH-07-PTSD-IIRA)
National Institutes of Health (MH053035; MH024652; MH66227; RR024153)