RESUMEN
OBJECTIVE: Slow waves are thought to mediate an overall reduction in synaptic strength during sleep. The specific contribution of the thalamus to this so-called synaptic renormalization is unknown. Thalamic stroke is associated with daytime sleepiness, along with changes to sleep electroencephalography and cognition, making it a unique "experiment of nature" to assess the relationship between sleep rhythms, synaptic renormalization, and daytime functions. METHODS: Sleep was studied by polysomnography and high-density electroencephalography over 17 nights in patients with thalamic (n = 12) and 15 nights in patients with extrathalamic (n = 11) stroke. Sleep electroencephalographic overnight slow wave slope changes and their relationship with subjective daytime sleepiness, cognition, and other functional tests were assessed. RESULTS: Thalamic and extrathalamic patients did not differ in terms of age, sleep duration, or apnea-hypopnea index. Conversely, overnight slope changes were reduced in a large cluster of electrodes in thalamic compared to extrathalamic stroke patients. This reduction was related to increased daytime sleepiness. No significant differences were found in other functional tests between the 2 groups. INTERPRETATION: In patients with thalamic stroke, a reduction in overnight slow wave slope change and increased daytime sleepiness was found. Sleep- and wake-centered mechanisms for this relationship are discussed. Overall, this study suggests a central role of the thalamus in synaptic renormalization. ANN NEUROL 2021;90:821-833.
Asunto(s)
Trastornos de Somnolencia Excesiva/fisiopatología , Sueño/fisiología , Accidente Cerebrovascular/fisiopatología , Tálamo/fisiopatología , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Cognición/fisiología , Electroencefalografía/métodos , Humanos , Masculino , Persona de Mediana Edad , Polisomnografía/métodos , Adulto JovenRESUMEN
The neurobiological basis of near-death experiences (NDEs) is unknown, but a few studies attempted to investigate it by reproducing in laboratory settings phenomenological experiences that seem to closely resemble NDEs. So far, no study has induced NDE-like features via hypnotic modulation while simultaneously measuring changes in brain activity using high-density EEG. Five volunteers who previously had experienced a pleasant NDE were invited to re-experience the NDE memory and another pleasant autobiographical memory (dating to the same time period), in normal consciousness and with hypnosis. We compared the hypnosis-induced subjective experience with the one of the genuine experience memory. Continuous high-density EEG was recorded throughout. At a phenomenological level, we succeeded in recreating NDE-like features without any adverse effects. Absorption and dissociation levels were reported as higher during all hypnosis conditions as compared to normal consciousness conditions, suggesting that our hypnosis-based protocol increased the felt subjective experience in the recall of both memories. The recall of a NDE phenomenology was related to an increase of alpha activity in frontal and posterior regions. This study provides a proof-of-concept methodology for studying the phenomenon, enabling to prospectively explore the NDE-like features and associated EEG changes in controlled settings.
Asunto(s)
Encéfalo/fisiología , Muerte , Hipnosis , Recuerdo Mental/fisiología , Adulto , Electroencefalografía , Femenino , Humanos , Masculino , Memoria Episódica , Persona de Mediana EdadRESUMEN
We often engage in two concurrent but unrelated activities, such as driving on a quiet road while listening to the radio. When we do so, does our brain split into functionally distinct entities? To address this question, we imaged brain activity with fMRI in experienced drivers engaged in a driving simulator while listening either to global positioning system instructions (integrated task) or to a radio show (split task). We found that, compared with the integrated task, the split task was characterized by reduced multivariate functional connectivity between the driving and listening networks. Furthermore, the integrated information content of the two networks, predicting their joint dynamics above and beyond their independent dynamics, was high in the integrated task and zero in the split task. Finally, individual subjects' ability to switch between high and low information integration predicted their driving performance across integrated and split tasks. This study raises the possibility that under certain conditions of daily life, a single brain may support two independent functional streams, a "functional split brain" similar to what is observed in patients with an anatomical split.