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ABSTRACT: BACKGROUND: Sleep-dependent performance improvements seem to be closely related to sleep spindles (12-15 Hz) and sleep slow-wave activity (SWA, 0.75-4.5 Hz). Pulse-modulated radiofrequency electromagnetic fields (RF EMF, carrier frequency 900 MHz) are capable to modulate these electroencephalographic (EEG) characteristics of sleep. OBJECTIVE: The aim of our study was to explore possible mechanisms how RF EMF affect cortical activity during sleep and to test whether such effects on cortical activity during sleep interact with sleep-dependent performance changes. METHODS: Sixteen male subjects underwent 2 experimental nights, one of them with all-night 0.25-0.8 Hz pulsed RF EMF exposure. All-night EEG was recorded. To investigate RF EMF induced changes in overnight performance improvement, subjects were trained for both nights on a motor task in the evening and the morning. RESULTS: We obtained good sleep quality in all subjects under both conditions (mean sleep efficiency > 90%). After pulsed RF EMF we found increased SWA during exposure to pulse-modulated RF EMF compared to sham exposure (P < 0.05) toward the end of the sleep period. Spindle activity was not affected. Moreover, subjects showed an increased RF EMF burst-related response in the SWA range, indicated by an increase in event-related EEG spectral power and phase changes in the SWA range. Notably, during exposure, sleep-dependent performance improvement in the motor sequence task was reduced compared to the sham condition (-20.1%, P = 0.03). CONCLUSION: The changes in the time course of SWA during the exposure night may reflect an interaction of RF EMF with the renormalization of cortical excitability during sleep, with a negative impact on sleep-dependent performance improvement.
Brain Stimulation 02/2013; · 3.76 Impact Factor
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ABSTRACT: Studies have repeatedly shown that electroencephalographic power during sleep is enhanced in the spindle frequency range following radio frequency electromagnetic field exposures pulse-modulated with fundamental frequency components of 2, 8, 14 or 217 Hz and combinations of these. However, signals used in previous studies also had significant harmonic components above 20 Hz. The current study aimed: (i) to determine if modulation components above 20 Hz, in combination with radio frequency, are necessary to alter the electroencephalogram; and (ii) to test the demodulation hypothesis, if the same effects occur after magnetic field exposure with the same pulse sequence used in the pulse-modulated radio frequency exposure. In a randomized double-blind crossover design, 25 young healthy men were exposed at weekly intervals to three different conditions for 30 min before sleep. Cognitive tasks were also performed during exposure. The conditions were a 2-Hz pulse-modulated radio frequency field, a 2-Hz pulsed magnetic field, and sham. Radio frequency exposure increased electroencephalogram power in the spindle frequency range. Furthermore, delta and theta activity (non-rapid eye movement sleep), and alpha and delta activity (rapid eye movement sleep) were affected following both exposure conditions. No effect on sleep architecture and no clear impact of exposure on cognition was observed. These results demonstrate that both pulse-modulated radio frequency and pulsed magnetic fields affect brain physiology, and the presence of significant frequency components above 20 Hz are not fundamental for these effects to occur. Because responses were not identical for all exposures, the study does not support the hypothesis that effects of radio frequency exposure are based on demodulation of the signal only.
Journal of Sleep Research 06/2012; · 3.16 Impact Factor
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ABSTRACT: The sleep electroencephalogram (EEG) undergoes many changes during adolescence. We assessed whether sleep homeostasis is altered across adolescent development using two measures: the dissipation of slow-wave activity (SWA, 0.6-4.6Hz) across the night and the rate of build-up of SWA in the first non-rapid eye movement (NREM) sleep episode. Furthermore, we examined the association between homeostatic and circadian measures, by correlating the build-up of SWA in the first non-rapid eye movement (NREM) sleep episode with circadian phase. Finally, we compared the dissipation of SWA in individuals with (PH+) and without (PH-) a parental history of alcohol abuse/dependence. Twenty children (8 PH+) and 25 teens (10 PH+) underwent two consecutive polysomnographic recordings at ages 9/10 and 15/16 years and again 1.5-3 years later. Thirteen young adults (ages 20-23 years; no PH+) were assessed one time. The decay of Process S was modeled for each individual at each assessment using data from both recordings. Four parameters of Process S were derived for EEG derivation C3/A2: time constant of the decay, lower asymptote (LA), the level of S at sleep onset (S(SO)), and S(SO) minus LA. We found no change in these parameters between assessments for the children and teen cohorts. Between-subject analysis of the follow-up assessment for children (ages 11-13 years) and the initial assessment for teens (ages 15/16 years) showed no difference in these parameters, nor did follow-up assessment of teens (ages 17-19 years) compared to the single assessment of young adults (ages 20-23 years). Similarly, we observed no developmental changes in the rate of the build-up of SWA in the first NREM sleep episode for our within- and between-subject analyses, or a correlation between this measure and circadian phase for either cohort. With regard to parental alcohol history, we found no difference in the dissipation of sleep pressure between PH+ and PH- children and teens. These results indicate that the dissipation of sleep pressure does not change across adolescent development, is not correlated with circadian phase, and does not differ between PH+ and PH- children and teens.
Neuroscience 04/2012; 216:167-77. · 3.38 Impact Factor
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ABSTRACT: In patients with cirrhosis, hyperammonemia and hepatic encephalopathy are common after gastrointestinal bleeding and can be simulated by an amino acid challenge (AAC), or the administration of a mixture of amino acids mimicking the composition of hemoglobin. The aim of this study was to investigate the clinical, psychometric, and wake-/sleep-electroencephalogram (EEG) correlates of induced hyperammonemia. Ten patients with cirrhosis and 10 matched healthy volunteers underwent: (1) 8-day sleep quality/timing monitoring; (2) neuropsychiatric assessment at baseline/after AAC; (3) hourly ammonia/subjective sleepiness assessment for 8 hours after AAC; (4) sleep EEG recordings (nap opportunity: 17:00-19:00) at baseline/after AAC. Neuropsychiatric performance was scored according to age-/education-adjusted Italian norms. Sleep stages were scored visually for 20-second epochs; power density spectra were calculated for consecutive 20-second epochs and average spectra determined for consolidated episodes of non-rapid eye movement (non-REM) sleep of minimal common length. The AAC resulted in: (i) an increase in ammonia concentrations/subjective sleepiness in both patients and healthy volunteers; (ii) a worsening of neuropsychiatric performance (wake EEG slowing) in two (20%) patients and none of the healthy volunteers; (iii) an increase in the length of non-REM sleep in healthy volunteers [49.3 (26.6) versus 30.4 (15.6) min; P = 0.08]; (iv) a decrease in the sleep EEG beta power (fast activity) in the healthy volunteers; (v) a decrease in the sleep EEG delta power in patients. CONCLUSION: AAC led to a significant increase in daytime subjective sleepiness and changes in the EEG architecture of a subsequent sleep episode in patients with cirrhosis, pointing to a reduced ability to produce restorative sleep.
Hepatology 03/2012; 55(3):869-78. · 11.66 Impact Factor
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ABSTRACT: A novel exposure system for double-blind human electromagnetic provocation studies has been developed that satisfies the precision, control of fields and potential artifacts, and provides the flexibility to investigate the response of hypotheses-driven electromagnetic field exposure schemes on brain function, ranging from extremely low frequency (ELF) to radio frequency (RF) fields. The system can provide the same exposure of the lateral cerebral cortex at two different RF frequencies (900 and 2140 MHz) but with different exposure levels at subcortical structures, and also allows uniform ELF magnetic field exposure of the brain. The RF modulation and ELF signal are obtained by a freely programmable arbitrary signal generator allowing a wide range of worst-case exposure scenarios to be simulated, including those caused by wireless devices. The maximum achievable RF exposure is larger than 60 W/kg peak spatial specific absorption rate averaged over 10 g of tissue. The maximum ELF magnetic field exposure of the brain is 800 A/m at 50 Hz with a deviation from uniformity of 8% (SD).
Bioelectromagnetics 02/2012; 33(6):527-33. · 1.84 Impact Factor
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ABSTRACT: EEG sleep spindle activity (SpA) during non-rapid eye movement (NREM) sleep has been reported to be associated with measures of intelligence and overnight performance improvements. The reticular nucleus of the thalamus is generating sleep spindles in interaction with thalamocortical connections. The same system enables efficient encoding and processing during wakefulness. Thus, we examined if the triangular relationship between SpA, measures of intelligence and declarative learning reflect the efficiency of the thalamocortical system. As expected, SpA was associated with general cognitive ability, e.g. information processing speed. SpA was also associated with learning efficiency, however, not with overnight performance improvement in a declarative memory task. SpA might therefore reflect the efficiency of the thalamocortical network and can be seen as a marker for learning during encoding in wakefulness, i.e. learning efficiency.
PLoS ONE 01/2012; 7(11):e49561. · 4.09 Impact Factor
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ABSTRACT: The aim of the study was to investigate the relationship between regional aspects of the children's sleep electroencephalogram (EEG) (high-density EEG recordings) and their intellectual ability. The spectral power in the α, σ, and β frequency ranges of 109 EEG derivations was correlated with the scores of full-scale intelligence quotient, fluid intelligence quotient, and working memory (14 participants, mean age: 10.5±1.0 years; six girls). The previously reported relationship (derivation C3/A2) between spectral band power and intellectual ability could further be refined, particular spatial patterns over central and parietal areas with positive correlations were found. Thus, neurobiological correlates of intelligence during sleep may exhibit brain region-specific patterns.
Neuroreport 12/2011; 23(2):93-7. · 1.66 Impact Factor
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ABSTRACT: Sleep homeostasis refers to the increase of sleep pressure during waking and the decrease of sleep intensity during sleep. Electroencephalography (EEG) slow-wave activity (SWA; EEG power in the 0.75-4.5 Hz range) is a marker of non-rapid eye movement (NREM) sleep intensity and can be used to model sleep homeostasis (Process S). SWA shows a frontal predominance, and its increase after sleep deprivation is most pronounced in frontal areas. The question arises whether the dynamics of the homeostatic Process S also show regional specificity. Furthermore, the spatial distribution of SWA is characteristic for an individual and may reflect traits of functional anatomy. The aim of the current study was to quantify inter-individual variation in the parameters of Process S and investigate their spatial distribution. Polysomnographic recordings obtained with 27 EEG derivations of a baseline night of sleep and a recovery night of sleep after 40 h of sustained wakefulness were analyzed. Eight healthy young subjects participated in this study. Process S was modeled by a saturating exponential function during wakefulness and an exponential decline during sleep. Empirical mean SWA per NREM sleep episode at episode midpoint served for parameter estimation at each derivation. Time constants were restricted to a physiologically meaningful range.
For both, the buildup and decline of Process S, significant topographic differences were observed: The decline and buildup of Process S were slowest in fronto-central areas while the fastest dynamics were observed in parieto-occipital (decrease) and frontal (buildup) areas. Each individual showed distinct spatial patterns in the parameters of Process S and the parameters differed significantly between individuals.
For the first time, topographical aspects of the buildup of Process S were quantified. Our data provide an additional indication of regional differences in sleep homeostasis and support the notion of local aspects of sleep regulation.
BMC Neuroscience 08/2011; 12:84. · 3.04 Impact Factor
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ABSTRACT: Waking and sleep data in adults show high heritability and trait-like characteristics in EEG spectra. This phenomenon has not been examined in children and adolescents where brain development influences the EEG. The present study examines whether a trait-like sleep EEG pattern is detectable across adolescent development. Two consecutive nights of standard sleep recordings were performed in 19 9-10-year-old children and 26 15-16-year-old teens, and were repeated 1.5-3 years later. EEG spectra averaged across the night for non-rapid eye movement and rapid eye movement sleep separately were classified using hierarchical cluster analysis, which showed that all 4 nights of a participant clustered together for a majority of participants. Intraclass correlation coefficients were also very high (>0.7) across nights separated by several years, indicating a trait-like feature of the sleep EEG. In summary, our results, using two measures of stability, indicate that a "trait-like" aspect can be detected in the sleep EEG across adolescent development despite considerable neurodevelopmental changes. This finding indicates that the brain oscillators responsible for generating the sleep EEG signal remain relatively stable across adolescent development.
Journal of Neuroscience 04/2011; 31(17):6371-8. · 7.11 Impact Factor
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ABSTRACT: Previous studies have observed increases in electroencephalographic power during sleep in the spindle frequency range (approximately 11-15 Hz) after exposure to mobile phone-like radio frequency electromagnetic fields (RF EMF). Results also suggest that pulse modulation of the signal is crucial to induce these effects. Nevertheless, it remains unclear which specific elements of the field are responsible for the observed changes. We investigated whether pulse-modulation frequency components in the range of sleep spindles may be involved in mediating these effects. Thirty young healthy men were exposed, at weekly intervals, to three different conditions for 30 min directly prior to an 8-h sleep period. Exposure consisted of a 900-MHz RF EMF, pulse modulated at 14 Hz or 217 Hz, and a sham control condition. Both active conditions had a peak spatial specific absorption rate of 2 W kg(-1) . During exposure subjects performed three different cognitive tasks (measuring attention, reaction speed and working memory), which were presented in a fixed order. Electroencephalographic power in the spindle frequency range was increased during non-rapid eye movement sleep (2nd episode) following the 14-Hz pulse-modulated condition. A similar but non-significant increase was also observed following the 217-Hz pulse-modulated condition. Importantly, this exposure-induced effect showed considerable individual variability. Regarding cognitive performance, no clear exposure-related effects were seen. Consistent with previous findings, our results provide further evidence that pulse-modulated RF EMF alter brain physiology, although the time-course of the effect remains variable across studies. Additionally, we demonstrated that modulation frequency components within a physiological range may be sufficient to induce these effects.
Journal of Sleep Research 04/2011; 21(1):50-8. · 3.16 Impact Factor
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ABSTRACT: The steady increase of mobile phone usage has led to a rising concern about possible adverse health effects of radio frequency electromagnetic field (RF EMF) exposure at intensities even below the existing safety limits. Accumulating evidence suggests that pulse-modulated RF EMF may alter brain physiology. Yet, whereas effects on the human electroencephalogram in waking and sleep have repeatedly been shown in recent years, results on cognitive performance are inconsistent.
This review compares 41 provocation studies regarding the effects of RF EMF exposure similar to mobile telephones on cognitive performance measures in humans. The studies were identified via systematic searches of the databases Pub Med and ISI Web of Science and were published in peer-reviewed journals between 1998 and the end of 2009.
Based on a critical discussion within the scope of methodological standards it is concluded that state-of-the-art-methods in bio-electromagnetic research on RF EMF effects and cognition have neither been specified nor fully implemented over the last 10-11 years. The lack of a validated tool, which reliably assesses changes in cognitive performance caused by RF EMF exposure, may contribute to the current inconsistencies in outcomes. The high variety of findings may also be due to methodological issues such as differences in sample size and the composition of study groups, experimental design, exposure setup as well as the exposure conditions, and emphasizes the need for a standardized protocol in bioelectromagnetic research.
At present, no underlying biological mechanism has been identified which mediates the effects on brain functioning as observed in electroencephalographic (EEG) studies. A future aim must be to identify this mechanism as well as a reliable exposure protocol in order to gain more insights into possible behavioral and related health consequences of high-frequency EMF exposure.
Environmental Health 01/2011; 10(1):10. · 2.65 Impact Factor
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ABSTRACT: To investigate the within-subject stability in the sleep EEG and the association between the sleep EEG and intellectual abilities in 9- to 12-year-old children.
Intellectual ability (WISC-IV, full scale, fluid, and verbal IQ, working memory, speed of processing) were examined and all-night polysomnography was performed (2 nights per subject).
Sleep laboratory.
Fourteen healthy children (mean age 10.5 ± 1.0 years; 6 girls).
Spectral analysis was performed on artifact-free NREM sleep epochs (C3/A2). To determine intra-individual stability and inter-individual variability of the sleep EEG, power spectra were used as feature vectors for the estimation of Euclidean distances, and intraclass correlation coefficients (ICC) were calculated for the 2 nights. Sleep spindle peaks were identified for each individual and individual sigma band power was determined. Trait-like aspects of the sleep EEG were observed for sleep stage variables and spectral power. Within-subject distances were smaller than between-subject distances and ICC values ranged from 0.72 to 0.96. Correlations between spectral power in individual frequency bins and intelligence scores revealed clusters of positive associations in the alpha, sigma, and beta range for full scale IQ, fluid IQ, and working memory. Similar to adults, sigma power correlated with full scale (r = 0.67) and fluid IQ (r = 0.65), but not with verbal IQ. Spindle peak frequency was negatively related to full scale IQ (r = -0.56).
The sleep EEG during childhood shows high within-subject stability and may be a marker for intellectual ability.
Sleep 01/2011; 34(2):181-9. · 5.05 Impact Factor
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ABSTRACT: Due to the greatly non-uniform field distribution induced in brain tissues by radio frequency electromagnetic sources, the exposure of anatomical and functional regions of the brain may be a key issue in interpreting laboratory findings and epidemiological studies concerning endpoints related to the central nervous system. This paper introduces the Talairach atlas in characterization of the electromagnetic exposure of the brain. A hierarchical labeling scheme is mapped onto high-resolution human models. This procedure is fully automatic and allows identification of over a thousand different sites all over the brain. The electromagnetic absorption can then be extracted and interpreted in every region or combination of regions in the brain, depending on the characterization goals. The application examples show how this methodology enhances the dosimetry assessment of the brain based on results obtained by either finite difference time domain simulations or measurements delivered by test compliance dosimetry systems. Applications include, among others, the detailed dosimetric analysis of the exposure of the brain during cell phone use, improved design of exposure setups for human studies or medical diagnostic and therapeutic devices using electromagnetic fields or ultrasound.
Physics in Medicine and Biology 01/2011; 56(2):383-96. · 2.83 Impact Factor
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ABSTRACT: We examined the association between sleep behavior and cognitive functioning in 60 healthy children between 7 and 11 years of age under nonexperimental conditions. Intellectual abilities were assessed by the Wechsler Intelligence Scale for Children (4th edition) and sleep variables by questionnaires, actigraphy, and sleep diaries. Correlation analysis revealed a negative association between sleep duration on weekends and measures of intelligence (full-scale IQ, r = -.29; fluid IQ, r = -.36). The regression coefficient for sleep duration on weekends was -6.11 (SE = 2.09), indicating an increase of 6.11 points on fluid IQ scores for each hour of shorter sleep duration. Attention measures did not correlate with cognitive or sleep variables. Daytime sleepiness as a potential moderator of the relationship between sleep duration and cognitive performance was not related to cognitive or sleep variables. We conclude that children with higher daytime cognitive efficiency (reflected by higher intelligence scores) show increased nighttime efficiency (reflected by shorter sleep duration). In the light of the neural efficiency hypothesis, the current results argue for an extension of the original theory-referring not only to daytime but also to nighttime behavior.
Developmental Psychology 07/2010; 46(4):949-54. · 3.21 Impact Factor
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ABSTRACT: The two-process model posits that sleep is regulated by 2 independent processes, a circadian Process C and a homeostatic Process S. EEG slow-wave activity (SWA) is a marker of NREM sleep intensity and is used as an indicator of sleep homeostasis. So far, parameters of the two-process model have been derived mainly from average data. Our aim was to quantify inter-individual differences.
Polysomnographic recordings (analysis of existing data).
Sound attenuated sleep laboratory.
Eight healthy young males.
40-h sustained wakefulness.
Process S was modeled by a saturating exponential function during wakefulness and an exponential decline during sleep. Empirical mean SWA (derivation C3A2) per NREM sleep episode at episode midpoint were used for parameter estimation. Parameters were estimated simultaneously by minimizing the mean square error between data and simulations of Process S. This approach was satisfactory for average data and most individual data. We further improved our methodological approach by limiting the time constants to a physiologically meaningful range. This allowed a satisfactory fit also for the one individual whose parameters were beyond a physiological range. The time constants of the buildup of Process S ranged from 14.1 h to 26.4 h and those of the decline from 1.2 h to 2.9 h with similar inter-individual variability of the buildup and decline of Process S.
We established a robust method for parameter estimation of Process S on an individual basis.
Sleep 04/2010; 33(4):491-8. · 5.05 Impact Factor
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ABSTRACT: This article addresses associations between sleep, cognition and intelligence in a developmental context and clarifies the terminology. Research must differentiate between aspects related to general underlying traits and those aspects that are characterized by state-dependent fluctuations.
Progress in brain research 01/2010; 185:167-79. · 3.04 Impact Factor
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ABSTRACT: Slow oscillations (< 1 Hz) in the non-rapid eye movement (NREM) sleep electroencephalogram (EEG) result from slow membrane potential fluctuations of cortical neurones, alternating between a depolarized up-state and a hyperpolarized down-state. They are thought to underlie the restorative function of sleep. We investigated the behaviour of slow oscillations in humans under increased sleep pressure to assess their contribution to sleep homeostasis. EEG recordings (C3A2) of baseline and recovery sleep after sleep deprivation (eight healthy males, mean age 23 years; 40 h of prolonged wakefulness) were analysed. Half-waves were defined as positive or negative deflections between consecutive zero crossings in the 0.5-2 Hz range of the band-pass filtered EEG. Increased sleep pressure resulted in a redistribution of half-waves between 0.5 and 2 Hz: the number of half-waves per minute was reduced below 0.9 Hz while it was increased above 1.2 Hz. EEG power was increased above 1 Hz. The increase in frequency was accompanied by increased slope of the half-waves and decreased number of multi-peak waves. In both baseline and recovery sleep, amplitude and slope were correlated highly over a broad frequency range and positive half-waves were characterized by a lower frequency than the negative ones, pointing to a longer duration of up- than down-states. We hypothesize that the higher frequency of slow oscillatory activity after prolonged wakefulness may relate to faster alternations between up- and down-states at the cellular level under increased sleep pressure. This study does not question slow-wave activity as a marker of sleep homeostasis, as the observed changes occurred within the same frequency range.
Journal of Sleep Research 10/2009; 19(1 Pt 2):228-37. · 3.16 Impact Factor
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ABSTRACT: We recently proposed insufficient non-rapid eye movement sleep (NREMS) intensity to contribute to disturbed nocturnal sleep in patients with narcolepsy-cataplexy (NC). To test this hypothesis, we investigated the effect of physiologically intensified NREMS in recovery sleep following sleep deprivation.
Nocturnal baseline and recovery sleep architecture, and the sleep electroencephalogram (EEG) before and after 40 hours of sustained wakefulness were compared between 6 drug-free patients with NC (age range: 19-37 years) and 6 individually matched, healthy control subjects (18-43 years).
Sleep and sleep EEG power spectra (C3A2 derivation). The dynamics of the homeostatic Process S were estimated from the time course of slow-wave activity (SWA, spectral power within 0.75-4.5 Hz) across consecutive NREMS episodes.
Sleep research laboratory.
In baseline, SWA decreased across consecutive NREMS episodes in patients with NC and control subjects. The build-up of SWA, however, was attenuated in NC in the second episode (P = 0.01) due to a higher number of short wake periods (P = 0.02). Prolonged wakefulness increased initial SWA in both groups (P = 0.003) and normalized the baseline differences between patients and control subjects in the time course of SWA in NREMS. The changed dynamics of SWA in the patients in recovery sleep when compared with baseline were associated with reduced numbers of intermittent wake periods in the first (P = 0.01) and second (P = 0.04) NREMS episodes. All patients, but no control subjects, showed a sleep-onset rapid eye movement period (SOREMP) in both baseline and recovery sleep. Sleep deprivation increased SOREMP duration (P = 0.03).
Increased SWA after sleep deprivation indicates that sleep homeostasis is functional in NC. Increased NREMS intensity in recovery sleep postpones sleep fragmentation, supporting our concept that sleep fragmentation is directly related to insufficient NREMS intensity in NC. The persistence of SOREMP despite enhanced NREMS pressure suggests an abnormal interaction between NREMS and REMS regulatory processes.
Sleep 07/2008; 31(6):859-67. · 5.05 Impact Factor
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ABSTRACT: The aim of this study was to provide the information necessary to enable the comparison of exposure conditions in different human volunteer studies published by the research groups at the Universities of Turku, Swinburne, and Zurich. The latter applied a setup optimized for human volunteer studies in the context of risk assessment while the first two applied a modified commercial mobile phone for which detailed dosimetric data were lacking. While the Zurich Setup exposed the entire cortex of the target hemisphere, the other two setups resulted in only very localized exposure of the upper cheek, and concentrated on a limited area of the middle temporal gyrus just above the ear. The resulting peak spatial SAR averaged over 1 g of the cortex was 0.19 W/kg of the Swinburne Setup, and 0.31 W/kg for the Turku Setup, compared to 1 W/kg for the Zurich Setup. The average exposure of the thalamus was 5% and 9% of the Zurich Setup results for the Swinburne and Turku Setups, respectively. In general, the phone-based setup results in only reasonably defined exposures in a very limited area around the maximum exposure; the exposure of the rest of the cortex was low, and may vary greatly as a function of the setup, position, and local anatomy. The analysis confirms the need for a carefully designed exposure setup that exposes the relevant brain areas to a well-defined level in human volunteer studies, and shows that studies can only be properly compared and replicated if sufficiently detailed dosimetric information is available.
Bioelectromagnetics 02/2008; 29(1):11-9. · 1.84 Impact Factor
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ABSTRACT: The clinical features and natural course of paramedian thalamic stroke is poorly known. The aim of this study was to characterize the evolution of neurological, neuropsychological, and sleep-wake deficits after paramedian thalamic stroke.
Forty-six consecutive patients, aged 48.4+/-16.6 years, were studied. Fourteen had bilateral, 16 left-sided, and 16 right-sided lesions. Assessment included neurological examinations, estimation of sleep needs, formal neuropsychological tests (n=27), and polysomnographies (n=31). Functional outcome was followed up over 1 year in 31 patients with the modified Rankin Scale and Barthel index.
Oculomotor palsy (76% of patients), mild gait ataxia (67%), deficits of attention (63%), fluency and error control (59%), learning and memory (67%), and behavior (67%) were common in the acute stroke phase. Outcome was excellent with right-sided infarcts but mostly incomplete with bilateral and left-sided lesions. This was mainly related to persistent frontal lobe-related and cognitive deficits found in 100% bilateral and 90% left-sided, but only 33% right-sided strokes. Initially, hypersomnia was present in all patients associated with increased stage 1 sleep, reduced stage 2 sleep, and reduced sleep spindles. Sleep needs improved in patients with bilateral and almost disappeared with unilateral lesions after 1 year. Sleep architecture remained abnormal with the exception of sleep spindles that increased.
Whereas neurological deficits and hypersomnia recover to large extent in patients with paramedian thalamic stroke, the frontal lobe-related and cognitive deficits, which are mainly linked with bilateral and left-sided lesions, often persist. As such, stroke outcome is better in right-sided than bilateral or left-sided infarcts.
Stroke 02/2008; 39(1):62-8. · 5.73 Impact Factor
