Increased Use-Dependent Plasticity in Chronic Insomnia

Salas, Rachel E.; Galea, Joseph M.; Gamaldo, Alyssa A.; Gamaldo, Charlene E.; Allen, Richard P.; Smith, Michael T.; Cantarero, Gabriela; Lam, Barbara D.; Celnik, Pablo

doi:10.5665/sleep.3492

Cited by 17 publications

(14 citation statements)

References 90 publications

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“…Recently, neuroimaging has also suggested that insomnia patients have higher excitability in the bilateral dorsolateral prefrontal cortex (DLPFC) compared with healthy individuals (Nofzinger, ). Moreover, TMS measures showed cortical hyperexcitability in the restless legs syndrome, chronic insomnia, and sleep deprived healthy individuals, but cortical hypoexcitability in the obstructive sleep apnea syndrome (Lanza et al, ; Lanza, Cantone, et al, ; Lanza, Lanuzza, et al, ; Lin et al, ; Nardone et al, ; Salas et al, ). Combined with the inhibitory effect on cortical excitability by low‐frequency stimulation, we speculated that sequential bilateral low‐frequency magnetic stimulation over DLPFC may have a significant therapeutic effect on PI.…”

Section: Introductionmentioning

confidence: 99%

The Effect of sequential bilateral low‐frequency rTMS over dorsolateral prefrontal cortex on serum level of BDNF and GABA in patients with primary insomnia

Feng

Zhang

et al. 2019

Brain and Behavior

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Objective This study aimed to investigate the effect of sequential bilateral low‐frequency repetitive transcranial magnetic stimulation (rTMS) over dorsolateral prefrontal cortex (DLPFC) on patients with primary insomnia (PI). Methods A total of 32 eligible right‐handed participants diagnosed by PI according to International classification of sleep disorders (ICD‐3) were recruited into this study. Participants received 10 daily sessions of sequential bilateral 1 Hz rTMS over DLPFC. Before and after the whole procedure of rTMS, patients were assessed by Pittsburgh Sleep Quality Index (PSQI) for the severity of sleep disturbance. Meanwhile, serum concentration of brain‐derived neurotrophic factor (BDNF) and gamma‐aminobutyric acid (GABA) in patients was measured by ELISA and UPLC, respectively. Moreover, the amplitude of MEPs reflecting the right cortical excitability was examined. Finally, Pearson correlation analysis was performed to evaluate the correlation among the change of these variables. Results After rTMS treatment, the PSQI score was markedly decreased as compared to pre‐rTMS; the concentrations of serum BDNF and GABA were significantly higher; the amplitude of MEPs was markedly reduced. Pearson correlation analysis revealed that the change of PSQI score was negatively associated with the alteration of serum BDNF level and serum GABA level, and positively associated with the change of MEPs amplitude; the change of MEPs amplitude was negatively associated with fold change in the serum BDNF level and the serum GABA level; the increase in serum GABA level was positively associated with the serum BDNF level. Conclusions A sequential bilateral low‐frequency rTMS over DLPFC significantly improves primary insomnia probably by increasing the level of BDNF and GABA in the brain and reducing cortical excitability.

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Section: Introductionmentioning

confidence: 99%

The Effect of sequential bilateral low‐frequency rTMS over dorsolateral prefrontal cortex on serum level of BDNF and GABA in patients with primary insomnia

Feng

Zhang

et al. 2019

Brain and Behavior

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“…Moreover, recent evidence has suggested that insomnia might have an impact on both night and day brain functioning, with changes in brain plasticity, assessed via transcranial magnetic stimulation (TMS), reported in patients with PI [ 23 ]. Such a broad repercussion on central nervous system dynamics might also suggest an interaction between age-related brain plasticity mechanisms [ 24 ], length of exposure to sleep deprivation, and age of insomnia onset.…”

Section: Introductionmentioning

confidence: 99%

Age of Insomnia Onset Correlates with a Reversal of Default Mode Network and Supplementary Motor Cortex Connectivity

et al. 2018

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Insomnia might occur as result of increased cognitive and physiological arousal caused by acute or long acting stressors and associated cognitive rumination. This might lead to alterations in brain connectivity patterns as those captured by functional connectivity fMRI analysis, leading to potential insight about primary insomnia (PI) pathophysiology as well as the impact of long-term exposure to sleep deprivation. We investigated changes of voxel-wise connectivity patterns in a sample of 17 drug-naïve PI patients and 17 age-gender matched healthy controls, as well as the relationship between brain connectivity and age of onset, illness duration, and severity. Results showed a significant increase in resting-state functional connectivity of the bilateral visual cortex in PI patients, associated with decreased connectivity between the visual cortex and bilateral temporal pole. Regression with clinical scores originally unveiled a pattern of increased local connectivity as measured by intrinsic connectivity contrast (ICC), specifically resembling the default mode network (DMN). Additionally, age of onset was found to be correlated with the connectivity of supplementary motor area (SMA), and the strength of DMN←→SMA connectivity was significantly correlated with both age of onset (R2 = 41%) and disease duration (R2 = 21%). Chronic sleep deprivation, but most importantly early insomnia onset, seems to have a significant disruptive effect over the physiological negative correlation between DMN and SMA, a well-known fMRI marker of attention performance in humans. This suggests the need for more in-depth investigations on the prevention and treatment of connectivity changes and associated cognitive and psychological deficits in PI patients.

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“…The disruptions from psychosocial stressors may become stabilized in the brain through new neural pathways. 90 Thus, sleep difficulties stemming from the psychosocial experience prior to and throughout the adoption process may result in long-term sleep difficulties. Further, adopted children are at an increased risk for the development of psychopathology, which may also maintain sleep difficulties and create a vicious cycle of reinforcement.…”

Section: Discussionmentioning

confidence: 99%

“… 4 , 86 As these changes occur, the ability to regulate sleep decreases, and sleep difficulties become stabilized neural pathways. 90 Further, these neurobiological changes may increase physiological arousal at bedtime. 91 As a result, the brain is increasing wakefulness instead of inducing relaxation and rest.…”

Section: The Biology Of Sleep and Adoptionmentioning

confidence: 99%

Adopted youth and sleep difficulties

Radcliff

Baylor

Rybarczyk

2016

PHMT

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Sleep is a critical component of healthy development for youth, with cascading effects on youth’s biological growth, psychological well-being, and overall functioning. Increased sleep difficulties are one of many disruptions that adopted youth may face throughout the adoption process. Sleep difficulties have been frequently cited as a major concern by adoptive parents and hypothesized in the literature as a problem that may affect multiple areas of development and functioning in adopted youth. However, there is limited research exploring this relationship. Using a biopsychosocial framework, this paper reviews the extant literature to explore the development, maintenance, and impact of sleep difficulties in adopted youth. Finally, implications for future research and clinical interventions are outlined.

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Increased Use-Dependent Plasticity in Chronic Insomnia

Cited by 17 publications

References 90 publications

The Effect of sequential bilateral low‐frequency rTMS over dorsolateral prefrontal cortex on serum level of BDNF and GABA in patients with primary insomnia

The Effect of sequential bilateral low‐frequency rTMS over dorsolateral prefrontal cortex on serum level of BDNF and GABA in patients with primary insomnia

Age of Insomnia Onset Correlates with a Reversal of Default Mode Network and Supplementary Motor Cortex Connectivity

Adopted youth and sleep difficulties

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