Top-down control of arousal and sleep: Fundamentals and clinical implications

详细信息    查看全文

• 作者：Lukas Krone^a ; ^b ; Lukas Frase^a ; ^b ; Hannah Piosczyk^a ; ^b ; Peter Selhausen^a ; ^b ; Sulamith Zittel^a ; ^b ; Friederike Jahn^a ; ^b ; Marion Kuhn^a ; ^b ; Bernd Feige^b ; Florian Mainberger^a ; Stefan Kl&ouml ; ppel^a ; Dieter Riemann^b ; Kai Spiegelhalder^b ; Chiara Baglioni^b ; Annette Sterr^c ; Christoph Nissen^a ; ^b ; ^{christoph.nissen@uniklinik-freiburg.de}
• 关键词：Sleep ; Arousal ; Brain stimulation ; Thalamus ; Cortex ; Transcranial direct current stimulation ; Cortico-thalamic feedback ; Sleep continuity
• 刊名：Sleep Medicine Reviews
• 出版年：2017
• 出版时间：February 2017
• 年：2017
• 卷：31
• 期：Complete
• 页码：17-24
• 全文大小：545 K
• 卷排序：31

文摘

Mammalian sleep emerges from attenuated activity in the ascending reticular arousal system (ARAS), the main arousal network of the brain. This system originates in the brainstem and activates the thalamus and cortex during wakefulness via a well-characterized ‘bottom-up’ pathway. Recent studies propose that a less investigated cortico-thalamic ‘top-down’ pathway also regulates sleep. The present work integrates the current evidence on sleep regulation with a focus on the ‘top-down’ pathway and explores the potential to translate this information into clinically relevant interventions. Specifically, we elaborate the concept that arousal and sleep continuity in humans can be modulated by non-invasive brain stimulation (NIBS) techniques that increase or decrease cortical excitability. Based on preclinical studies, the modulatory effects of the stimulation are thought to extend to subcortical arousal networks. Further exploration of the ‘top-down’ regulation of sleep and its modulation through non-invasive brain stimulation techniques may contribute to the development of novel treatments for clinical conditions of disrupted arousal and sleep, which are among the major health problems worldwide.