Meta-Analysis of the Antidepressant Effects of Acute Sleep Deprivation.

OBJECTIVE: To provide a quantitative meta-analysis of the antidepressant effects of sleep deprivation to complement qualitative reviews addressing response rates. DATA SOURCES: English-language studies from 1974 to 2016 using the keywords sleep deprivation and depression searched through PubMed and PsycINFO databases. STUDY SELECTION: A total of 66 independent studies met criteria for inclusion: conducted experimental sleep deprivation, reported the percentage of the sample that responded to sleep deprivation, provided a priori definition of antidepressant response, and did not seamlessly combine sleep deprivation with other therapies (eg, chronotherapeutics, repetitive transcranial magnetic stimulation). DATA EXTRACTION: Data extracted included percentage of responders, type of sample (eg, bipolar, unipolar), type of sleep deprivation (eg, total, partial), demographics, medication use, type of outcome measure used, and definition of response (eg, 30% reduction in depression ratings). Data were analyzed with meta-analysis of proportions and a Poisson mixed-effects regression model. RESULTS: The overall response rate to sleep deprivation was 45% among studies that utilized a randomized control group and 50% among studies that did not. The response to sleep deprivation was not affected significantly by the type of sleep deprivation performed, the nature of the clinical sample, medication status, the definition of response used, or age and gender of the sample. CONCLUSIONS: These findings support a significant effect of sleep deprivation and suggest the need for future studies on the phenotypic nature of the antidepressant response to sleep deprivation, on the neurobiological mechanisms of action, and on moderators of the sleep deprivation treatment response in depression.

How acute total sleep loss affects the attending brain: a meta-analysis of neuroimaging studies.

STUDY OBJECTIVES: Attention is a cognitive domain that can be severely affected by sleep deprivation. Previous neuroimaging studies have used different attention paradigms and reported both increased and reduced brain activation after sleep deprivation. However, due to large variability in sleep deprivation protocols, task paradigms, experimental designs, characteristics of subject populations, and imaging techniques, there is no consensus regarding the effects of sleep loss on the attending brain. The aim of this meta-analysis was to identify brain activations that are commonly altered by acute total sleep deprivation across different attention tasks. DESIGN: Coordinate-based meta-analysis of neuroimaging studies of performance on attention tasks during experimental sleep deprivation. METHODS: The current version of the activation likelihood estimation (ALE) approach was used for meta-analysis. The authors searched published articles and identified 11 sleep deprivation neuroimaging studies using different attention tasks with a total of 185 participants, equaling 81 foci for ALE analysis. RESULTS: The meta-analysis revealed significantly reduced brain activation in multiple regions following sleep deprivation compared to rested wakefulness, including bilateral intraparietal sulcus, bilateral insula, right prefrontal cortex, medial frontal cortex, and right parahippocampal gyrus. Increased activation was found only in bilateral thalamus after sleep deprivation compared to rested wakefulness. CONCLUSION: Acute total sleep deprivation decreases brain activation in the fronto-parietal attention network (prefrontal cortex and intraparietal sulcus) and in the salience network (insula and medial frontal cortex). Increased thalamic activation after sleep deprivation may reflect a complex interaction between the de-arousing effects of sleep loss and the arousing effects of task performance on thalamic activity.

Extreme cognitive interviewing: a blueprint for false memories through imagination inflation.

This article examines a 3-decades-old unsolved homicide, where the victim's 4-year-and-9-month-old daughter was deemed the only eyewitness (State of Nebraska v. Donald J. Sykora, 2008). The authors critique the investigative methods employed over 33 years, with particular emphasis on the final "extreme" cognitive interview of the daughter, which persisted for days and incorporated various imaginative techniques. Adverse circumstances pervade the case: (a) the young age of the presumed witness when the murder occurred; (b) the vulnerability of memory to suggestion and revision over time; (c) the possible earlier use of hypnosis to refresh recall; and (d) implementing a poorly documented, 31-hour cognitive interview that encouraged repetition and fantasy. In this case, the prolonged cognitive interview is perilously hypnotic-like, yielding evidence that must be regarded as a product of imagination inflation--defective for sustaining veridical testimony.

Behavioral persistence in carrying out a posthypnotic suggestion beyond the hypnotic context: a consideration of the role of perceived demand characteristics.

Compliance with a posthypnotic suggestion (PHS) to carry out a specific behavior in a subsequent nonhypnotic setting was investigated in high and medium hypnotizable participants. The target behavior--solicited by either a PHS given during hypnosis, a waking social request, or both--was to be performed daily for an unspecified period of time. Findings indicated that the waking request alone yielded a high level of compliance, particularly among medium hypnotizable participants. In contrast, highly hypnotizable participants who received the PHS coupled with instructions for posthypnotic amnesia exhibited considerable variation in responding, whereas high hypnotizables, who received either a waking request, or a combination of PHS and waking request, performed similarly to medium hypnotizables. Postexperimental interview data suggest that perceived demand characteristics may contribute to variation in the persistence of posthypnotic behavior outside the hypnotic context.

Circadian rhythm profiles in women with night eating syndrome.

Night eating syndrome (NES) is characterized by evening hyperphagia and frequent awakenings accompanied by food intake. Patients with NES display a delayed circadian pattern of food intake but retain a normal sleep-wake cycle. These characteristics initiated the current study, in which the phase and amplitude of behavioral and neuroendocrine circadian rhythms in patients with NES were evaluated. Fifteen women with NES (mean age +/- SD, 40.8 +/- 8.7 y) and 14 control subjects (38.6 +/- 9.5 y) were studied in the laboratory for 3 nights, with food intake measured daily. Blood also was collected for 25 h (every 2 h from 0800 to 2000 h, and then hourly from 2100 to 0900 h) and assayed for glucose and 7 hormones (insulin, ghrelin, leptin, melatonin, cortisol, thyroid-stimulating hormone [TSH] and prolactin). Statistical analyses utilized linear mixed-effects cosinor analysis. Control subjects displayed normal phases and amplitudes for all circadian rhythms. In contrast, patients with NES showed a phase delay in the timing of meals, and delayed circadian rhythms for total caloric, fat, and carbohydrate intake. In addition, phase delays of 1.0 to 2.8 h were found in 2 food-regulatory rhythms-leptin and insulin-and in the circadian melatonin rhythm (with a trend for a delay in the circadian cortisol rhythm). In contrast, circulating levels of ghrelin, the primary hormone that stimulates food intake, were phase advanced by 5.2 h. The glucose rhythm showed an inverted circadian pattern. Patients with NES also showed reduced amplitudes in the circadian rhythms of food intake, cortisol, ghrelin, and insulin, but increased TSH amplitude. Thus, patients with NES demonstrated significant changes in the timing and amplitude of various behavioral and physiological circadian markers involved in appetite and neuroendocrine regulation. As such, NES may result from dissociations between central (suprachiasmatic nucleus) timing mechanisms and putative oscillators elsewhere in the central nervous system or periphery, such as the stomach or liver. Considering these results, chronobiologic treatments for NES such as bright light therapy may be useful. Indeed, bright light therapy has shown efficacy in reducing night eating in case studies and should be evaluated in controlled clinical trials.

Functional imaging of working memory following normal sleep and after 24 and 35 h of sleep deprivation: Correlations of fronto-parietal activation with performance.

Working memory was evaluated after normal sleep, and at 24 and 35 h of sleep deprivation (SD) in 26 healthy young adults to examine the neural correlates of inter-individual differences in performance. The extent of performance decline was not significantly different between the two SD test periods although there was greater variability in performance at SD35. In both SD sessions, there was reduced task-related activation (relative to normal sleep) in both superior parietal regions and the left thalamus. Activation of the left parietal and left frontal regions after normal sleep was negatively correlated with performance accuracy decline from normal sleep to SD24 thus differentiating persons who maintained working memory performance following SD from those who were vulnerable to its effects.

The cognitive interview: does it successfully avoid the dangers of forensic hypnosis?

Seventy-two undergraduates viewed a videotape of a bank robbery that culminated in the shooting of a young boy. Several days later, participants were interviewed about their recollection of events in the film through baseline oral and written narrative accounts followed by random assignment to a hypnosis (HYP) condition, the cognitive interview (CI), or a motivated, repeated recall (MRR) control interview. Participants also completed a forced interrogatory recall test, which indexed potential report criterion differences between the interview conditions. In terms of information provided for the first time during treatment interviews, HYP led to greater productivity than the CI or the MRR interview, which did not differ significantly from each other. Evidence that these differences in recall resulted primarily from report criterion differences rather than differences in accessible memory was obtained from the forced interrogatory recall test. In this test, no differences were observed between the three interview conditions. Finally, the data revealed that participants' hypnotic ability was associated with the recall of erroneous and confabulatory material for those tested in the HYP and CI conditions but not those in the MRR condition. This suggests that some CI mnemonics may invoke hypnotic-like processes in hypnotizable people.