Brain, Vol 120, Issue 7 1173-1197, Copyright © 1997 by Oxford University Press
AR Braun, TJ Balkin, NJ Wesenten, RE Carson, M Varga, P Baldwin, S Selbie, G Belenky and P Herscovitch
To assess dynamic changes in brain function throughout the sleep-wake
cycle, CBF was measured with H2(15)O and PET in 37 normal male volunteers:
(i) while awake prior to sleep onset; (ii) during Stage 3-4 sleep, i.e.
slow wave sleep (SWS); (iii) during rapid eye movement (REM) sleep; and
(iv) upon waking following recovery sleep. Subjects were monitored
polysomnographically and PET images were acquired throughout the course of
a single night. Stage-specific contrasts were performed using statistical
parametric mapping. Data were analysed in repeated measures fashion,
examining within-subject differences between stages [pre-sleep
wakefulness-SWS (n = 20 subjects); SWS-post-sleep wakefulness (n = 14);
SWS-REM sleep (n = 7); pre-sleep wakefulness-REM sleep (n = 8); REM
sleep-post-sleep wakefulness (n = 7); pre-sleep wakefulness-post-sleep
wakefulness (n = 20)]. State dependent changes in the activity of
centrencephalic regions, including the brainstem, thalamus and basal
forebrain (profound deactivations during SWS and reactivations during REM
sleep) are consistent with the idea that these areas are constituents of
brain systems which mediate arousal. Shifts in the level of activity of the
striatum suggested that the basal ganglia might be more integrally involved
in the orchestration of the sleep-wake cycle than previously thought.
State-dependent changes in the activity of limbic and paralimbic areas,
including the insula, cingulate and mesial temporal cortices, paralleled
those observed in centrencephalic structures during both REM sleep and SWS.
A functional dissociation between activity in higher order, heteromodal
association cortices in the frontal and parietal lobes and unimodal sensory
areas of the occipital and temporal lobes appeared to be characteristic of
both SWS and REM sleep. SWS was associated with selective deactivation of
the heteromodal association areas, while activity in primary and secondary
sensory cortices was preserved. SWS may not, as previously thought,
represent a generalized decrease in neuronal activity. On the other hand,
REM sleep was characterized by selective activation of certain
post-rolandic sensory cortices, while activity in the frontoparietal
association cortices remained depressed. REM sleep may be characterized by
activation of widespread areas of the brain, including the centrencephalic,
paralimbic and unimodal sensory regions, with the specific exclusion of
areas which normally participate in the highest order analysis and
integration of neural information. Deactivation of the heteromodal
association areas (the orbital, dorsolateral prefrontal and inferior
parietal cortices) constitutes the single feature common to both non-REM
and REM sleep states, and may be a defining characteristic of sleep itself.
The stages of sleep could also be distinguished by characteristic
differences in the relationships between the basal ganglia, thalamic nuclei
and neocortical regions of interest.
ARTICLES
Regional cerebral blood flow throughout the sleep-wake cycle. An H2(15)O PET study
Language Section, National Institute on Deafness and Other Communication Disorders, National Institutes of Health, Bethesda, MD 20892, USA.
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