REM sleep-dependent short-term and long-term hourglass processes in the ultradian organization and recovery of REM sleep in the rat.

STUDY OBJECTIVES: To evaluate the contribution of long-term and short-term REM sleep homeostatic processes to REM sleep recovery and the ultradian organization of the sleep wake cycle. METHODS: Fifteen rats were sleep recorded under a 12:12 LD cycle. Animals were subjected during the rest phase to two protocols (2T2I or 2R2I) performed separately in non-consecutive experimental days. 2T2I consisted of 2 h of total sleep deprivation (TSD) followed immediately by 2 h of intermittent REM sleep deprivation (IRD). 2R2I consisted of 2 h of selective REM sleep deprivation (RSD) followed by 2 h of IRD. IRD was composed of four cycles of 20-min RSD intervals alternating with 10 min of sleep permission windows. RESULTS: REM sleep debt that accumulated during deprivation (9.0 and 10.8 min for RSD and TSD, respectively) was fully compensated regardless of cumulated NREM sleep or wakefulness during deprivation. Protocol 2T2I exhibited a delayed REM sleep rebound with respect to 2R2I due to a reduction of REM sleep transitions related to enhanced NREM sleep delta-EEG activity, without affecting REM sleep consolidation. Within IRD permission windows there was a transient and duration-dependent diminution of REM sleep transitions. CONCLUSIONS: REM sleep recovery in the rat seems to depend on a long-term hourglass process activated by REM sleep absence. Both REM sleep transition probability and REM sleep episode consolidation depend on the long-term REM sleep hourglass. REM sleep activates a short-term REM sleep refractory period that modulates the ultradian organization of sleep states.

Melatonin Relations With Respiratory Quotient Weaken on Acute Exposure to High Altitude.

High altitude (HA) exposure may affect human health and performance by involving the body timing system. Daily variations of melatonin may disrupt by HA exposure, thereby possibly affecting its relations with a metabolic parameter like the respiratory quotient (RQ). Sea level (SL) volunteers (7 women and 7 men, 21.0 ± 2.04 y) were examined for daily changes in salivary melatonin concentration (SMC). Sampling was successively done at SL (Antofagasta, Chile) and, on acute HA exposure, at nearby Caspana (3,270 m asl). Saliva was collected in special vials (Salimetrics Oral Swab, United Kingdom) at sunny noon (SMCD) and in the absence of blue light at midnight (SMCN). The samples were obtained after rinsing the mouth with tap water and were analyzed for SMC by immunoassay (ELISA kit; IBL International, Germany). RQ measurements (n = 12) were realized with a portable breath to breath metabolic system (OxiconTM Mobile, Germany), between 8:00 PM and 10:00 PM, once at either location. At SL, SMCD, and SMCN values (mean ± SD) were, respectively, 2.14 ± 1.30 and 11.6 ± 13.9 pg/ml (p < 0.05). Corresponding values at HA were 8.83 ± 12.6 and 13.7 ± 16.7 pg/ml (n.s.). RQ was 0.78 ± 0.07 and 0.89 ± 0.08, respectively, at SL and HA (p < 0.05). Differences between SMCN and SMCD (SMCN-SMCD) strongly correlate with the corresponding RQ values at SL (r = -0.74) and less tight at HA (r = -0.37). Similarly, mean daily SMC values (SMC) tightly correlate with RQ at SL (r = -0.79) and weaker at HA (r = -0.31). SMCN-SMCD, as well as, SMC values at SL, on the other hand, respectively, correlate with the corresponding values at HA (r = 0.71 and r = 0.85). Acute exposure to HA appears to loosen relations of SMC with RQ. A personal profile in daily SMC variation, on the other hand, tends to be conserved at HA.

Revisión de trastornos psiquiátricos en enfermedad de Parkinson (EP): a propósito de un caso / Review of psychiatric disorders in Parkinson's disease (PD): about a case

La Enfermedad de Parkinson se inicia generalmente en las personas entre los 50 y 60 años, La mayoría de los pacientes de Parkinson se encuentran en situación de doble vulnerabilidad: vejez y discapacidad. El objetivo del tratamiento es reducir la velocidad de progresión de la enfermedad, controlar los síntomas y los efectos secundarios derivados de los fármacos que se usan para tratarla. La presentación de las alteraciones psiquiátricas se caracteriza por episodios de alucinaciones, trastornos confusionales, trastornos del control de los impulsos, hipersexualidad o Parasomnias, siendo de presentación habitualmente vespertina. Estos pueden evolucionar llegando a cuadros de psicosis, estados confusionales crónicos, ideas delirantes en forma permanente, con alto contenido paranoide, existiendo un gran riesgo de intentos suicidas.

Parkinson's disease usually begins in people between the ages of 50 and 60. Most Parkinson's patients are in a situation of double vulnerability: old age and disability. The goal of treatment is to reduce the rate of progression of the disease, control of the symptoms and side effects derived from the drugs used to treat it. The presentation of the psychiatric alterations is characterized by episodes of hallucinations, confusional disorders, disorders of the control of the impulses, hypersexuality or Parasomnias, being usually of evening presentation. These can evolve into psychosis, chronic confusional states, persistent delusional ideas, with high paranoid content, and there is a high risk of suicide attempts.

Envelope analysis links oscillatory and arrhythmic EEG activities to two types of neuronal synchronization.

Traditionally, EEG is understood as originating from the synchronous activation of neuronal populations that generate rhythmic oscillations in specific frequency bands. Recently, new neuronal dynamics regimes have been identified (e.g. neuronal avalanches) characterized by irregular or arrhythmic activity. In addition, it is starting to be acknowledged that broadband properties of EEG spectrum (following a 1/f law) are tightly linked to brain function. Nevertheless, there is still no theoretical framework accommodating the coexistence of these two EEG phenomenologies: rhythmic/narrowband and arrhythmic/broadband. To address this problem, we present a new framework for EEG analysis based on the relation between the Gaussianity and the envelope of a given signal. EEG Gaussianity is a relevant assessment because if EEG emerges from the superposition of uncorrelated sources, it should exhibit properties of a Gaussian process, otherwise, as in the case of neural synchronization, deviations from Gaussianity should be observed. We use analytical results demonstrating that the coefficient of variation of the envelope (CVE) of Gaussian noise (or any of its filtered sub-bands) is the constant 4π-1≈0.523, thus enabling CVE to be a useful metric to assess EEG Gaussianity. Furthermore, a new and highly informative analysis space (envelope characterization space) is generated by combining the CVE and the envelope average amplitude. We use this space to analyze rat EEG recordings during sleep-wake cycles. Our results show that delta, theta and sigma bands approach Gaussianity at the lowest EEG amplitudes while exhibiting significant deviations at high EEG amplitudes. Deviations to low-CVE appeared prominently during REM sleep, associated with theta rhythm, a regime consistent with the dynamics shown by the synchronization of weakly coupled oscillators. On the other hand, deviations to high-CVE, appearing mostly during NREM sleep associated with EEG phasic activity and high-amplitude Gaussian waves, can be interpreted as the arrhythmic superposition of transient neural synchronization events. These two different manifestations of neural synchrony (low-CVE/high-CVE) explain the well-known spectral differences between REM and NREM sleep, while also illuminating the origin of the EEG 1/f spectrum.

Post-Learning Sleep Transiently Boosts Context Specific Operant Extinction Memory.

Operant extinction is learning to supress a previously rewarded behavior. It is known to be strongly associated with the specific context in which it was acquired, which limits the therapeutic use of operant extinction in behavioral treatments, e.g., of addiction. We examined whether sleep influences contextual memory of operant extinction over time, using two different recall tests (Recent and Remote). Rats were trained in an operant conditioning task (lever press) in context A, then underwent extinction training in context B, followed by a 3-h retention period that contained either spontaneous morning sleep, morning sleep deprivation, or spontaneous evening wakefulness. A recall test was performed either immediately after the 3-h experimental retention period (Recent recall) or after 48 h (Remote), in the extinction context B and in a novel context C. The two main findings were: (i) at the Recent recall test, sleep in comparison with sleep deprivation and spontaneous wakefulness enhanced extinction memory but, only in the extinction context B; (ii) at the Remote recall, extinction performance after sleep was enhanced in both contexts B and C to an extent comparable to levels at Recent recall in context B. Interestingly, extinction performance at Remote recall was also improved in the sleep deprivation groups in both contexts, with no difference to performance in the sleep group. Our results suggest that 3 h of post-learning sleep transiently facilitate the context specificity of operant extinction at a Recent recall. However, the improvement and contextual generalization of operant extinction memory observed in the long-term, i.e., after 48 h, does not require immediate post-learning sleep.

Age-related arrhythmogenesis on ascent and descent: "autonomic conflicts" on hypoxia/reoxygenation at high altitude?

PURPOSE: To discern whether arrhythmogenesis at high-altitude (HA) may differ depending on ascent or descent, as well as on age. METHODS: Male subjects (37.9±12.0 SD y, n=33) were separated into a young (Y) group (29.6±5.73 SD y, n=18) and an older (O) one (47.9±9.83 SD y, n=15). All subjects were monitored by Holter electrocardiography while successively ascending (41.2±7.51 SD min) and descending (38.7±6.68 SD min) between 2950 and 5050 m as car passengers on a 25 km road in Northern Chile. Arrhythmic events (AE) ensued when the difference between two consecutive RR intervals exceeded 0.16 sec. RESULTS: From 311 AE registered, 29% occurred on ascent and 71% on descent, the sinusal type predominating in both age groups. AE incidence, RR interval duration, and heart rate variability (HRV) in the time domain (RMSSD) increased during descent, as compared to ascent, in the Y group (p<0.05), but not in the O one. Independently of age, AE incidence along descent associates with the time previously spent at 5050 m (p<0.001). CONCLUSIONS: Rapid transitions at HA favor arrhythmogenesis, the latter becoming evident particularly in the Y group on descent. Age-dependent changes of autonomic activity appear to be involved in arrhythmogenesis on transitions at HA.

Envelope analysis of the airflow signal to improve polysomnographic assessment of sleep disordered breathing.

STUDY OBJECTIVES: Given the detailed respiratory waveform signal provided by the nasal cannula in polysomnographic (PSG) studies, to quantify sleep breathing disturbances by extracting a continuous variable based on the coefficient of variation of the envelope of that signal. DESIGN: Application of an algorithm for envelope analysis to standard nasal cannula signal from actual polysomnographic studies. SETTING: PSG recordings from a sleep disorders center were analyzed by an algorithm developed on the Igor scientific data analysis software. PATIENTS OR PARTICIPANTS: Recordings representative of different degrees of sleep disordered breathing (SDB) severity or illustrative of the covariation between breathing and particularly relevant factors and variables. INTERVENTIONS: The method calculated the coefficient of variation of the envelope for each 30-second epoch. The normalized version of that coefficient was defined as the respiratory disturbance variable (RDV). The method outcome was the all-night set of RDV values represented as a time series. MEASUREMENTS AND RESULTS: RDV quantitatively reflected departure from normal sinusoidal breathing at each epoch, providing an intensity scale for disordered breathing. RDV dynamics configured itself in recognizable patterns for the airflow limitation (e.g., in UARS) and the apnea/hypopnea regimes. RDV reliably highlighted clinically meaningful associations with staging, body position, oximetry, or CPAP titration. CONCLUSIONS: Respiratory disturbance variable can assess sleep breathing disturbances as a gradual phenomenon while providing a comprehensible and detailed representation of its dynamics. It may thus improve clinical diagnosis and provide a revealing descriptive tool for mechanistic sleep disordered breathing modeling. Respiratory disturbance variable may contribute to attaining simplified screening methodologies, novel diagnostic criteria, and insightful research tools.

Visualization and clustering of sleep states in a frequency domain feature space.

Sleep studies assess the recurrent manifestation of stereotype configurations of relevant biosignals. These configurations are known as states (Wake, REM sleep and NonREM sleep) and stages (N1-N3 within NREM sleep). These two fundamental descriptive domains, time course and variable configuration, can be readily rendered available through improved visualization techniques. Time course is summarized by EEG spectrograms, instantaneous frequency analysis of cardio-respiratory signals and other sleep dependent variables. State and stage configurations can be further evidenced as clusters in 2D or 3D spaces whose axis are sleep-relevant extracted variables. The latter techniques also allows for visualization of transition process as pathways from one cluster to another.

The time course of the probability of transition into and out of REM sleep.

STUDY OBJECTIVES: A model of rapid eye movement (REM) sleep expression is proposed that assumes underlying regulatory mechanisms operating as inhomogenous Poisson processes, the overt results of which are the transitions into and out of REM sleep. DESIGN: Based on spontaneously occurring REM sleep episodes ("Episode") and intervals without REM sleep ("Interval"), 3 variables are defined and evaluated over discrete 15-second epochs using a nonlinear logistic regression method: "Propensity" is the instantaneous rate of into-REM transition occurrence throughout an Interval, "Volatility" is the instantaneous rate of out-of-REM transition occurrence throughout an Episode, and "Opportunity" is the probability of being in non-REM (NREM) sleep at a given time throughout an Interval, a requisite for transition. SETTING: 12:12 light:dark cycle, isolated boxes. PARTICIPANTS: Sixteen male Sprague-Dawley rats. INTERVENTIONS: None. Spontaneous sleep cycles. MEASUREMENTS AND RESULTS: The highest levels of volatility and propensity occur, respectively, at the very beginning of Episodes and Intervals. The new condition stabilizes rapidly, and variables reach nadirs at minute 1.25 and 2.50, respectively. Afterward, volatility increases markedly, reaching values close to the initial level. Propensity increases moderately, the increment being stronger through NREM sleep bouts occurring at the end of long Intervals. Short-term homeostasis is evidenced by longer REM sleep episodes lowering propensity in the following Interval. CONCLUSIONS: The stabilization after transitions into Episodes or Intervals and the destabilization after remaining for some time in either condition may be described as resulting from continuous processes building up during Episodes and intervals. These processes underlie the overt occurrence of transitions.

On-line analysis of biosignals for the automation of total and specific sleep deprivation in the rat

A computer-based system that automates sleep studies, including sleep deprivation paradigms, is described. The system allows for total or REM-specific sleep deprivation and is based on a reliable, fast-responding, on-line state detection algorithm linked to a dependable intervention device. Behavioral state detection is achieved by dimension reduction of short-term EEG power spectrum. Interventions are made by serial outputs to servomotors that move a cage with different patterns and variable intensity. The system can adapt itself to individual characteristics and to changes in recording conditions. Customized protocols can be designed by defining the states or stages to be deprived, including scheduling temporal patterns. A detailed analysis of the relevant signals during and after deprivation is readily available. Data is presented from two experimental designs in rats. One consisted of specific REM-sleep short-term deprivation and the other of 10-hour total sleep deprivation. An outline of conceptual and practical considerations involved in the automation of laboratory set-ups oriented to biosignal analysis is provided. Careful monitoring of sleep EEG variables during sleep deprivation suggests peculiarities of brain functioning in that condition. A corollary is that sleep deprivation should not be considered to be merely a forced prolonged wakefulness.

On-line analysis of biosignals for the automation of total and specific sleep deprivation in the rat.

A computer-based system that automates sleep studies, including sleep deprivation paradigms, is described. The system allows for total or REM-specific sleep deprivation and is based on a reliable, fast-responding, on-line state detection algorithm linked to a dependable intervention device. Behavioral state detection is achieved by dimension reduction of short-term EEG power spectrum. Interventions are made by serial outputs to servomotors that move a cage with different patterns and variable intensity. The system can adapt itself to individual characteristics and to changes in recording conditions. Customized protocols can be designed by defining the states or stages to be deprived, including scheduling temporal patterns. A detailed analysis of the relevant signals during and after deprivation is readily available. Data is presented from two experimental designs in rats. One consisted of specific REM-sleep short-term deprivation and the other of 10-hour total sleep deprivation. An outline of conceptual and practical considerations involved in the automation of laboratory set-ups oriented to biosignal analysis is provided. Careful monitoring of sleep EEG variables during sleep deprivation suggests peculiarities of brain functioning in that condition. A corollary is that sleep deprivation should not be considered to be merely a forced prolonged wakefulness.

Short-term homeostasis of REM sleep throughout a 12:12 light:dark schedule in the rat.

STUDY OBJECTIVES: Intervals extending from the end of a rapid eye movement (REM) sleep episode until the triggering of the next tend to be longer when they follow a longer REM sleep episode. A short-term REM sleep homeostatic process has been hypothesized to explain this effect. The present study assessed and modeled the REM sleep episode-interval relationship and compared its expression at different phases of a 12:12 light: dark schedule. DESIGN: Chronically implanted rats were continuously recorded for 3 consecutive days. Automated state scoring in 15-second epochs determined lengths of REM sleep episodes and intervals and non-rapid eye movement sleep and wakefulness content of intervals. SETTING: Individual sound-attenuated temperature-regulated boxes. PARTICIPANTS: 16 Sprague-Dawley rats. INTERVENTIONS: Scheduled 12:12 light:dark cycle. MEASUREMENTS AND RESULTS: The effect of REM sleep episode length is evidenced by a rising trend in the means and robust means of intervals and non-rapid eye movement content that follow REM sleep episodes of a given length. The relationship of robust means of intervals and REM sleep episode length was best fitted by a Gompertz sigmoid function. The parameters of the Gompertz equation were modulated throughout the 24 hours, presenting the highest amplitude and earliest rise in hours 1 to 4 after lights on and the lowest amplitude at the start of lights off. The modulation was also evident when only intervals with less than 3 minutes of wakefulness were considered. CONCLUSIONS: Short-term REM sleep homeostasis is modulated throughout the 24 hours under a 12:12 light:dark regime. Its assessment may provide a useful measure of REM sleep propensity, regulation, and recurrence.

Short-term homeostasis of REM sleep assessed in an intermittent REM sleep deprivation protocol in the rat.

An intermittent rapid eye movement (REM) sleep deprivation protocol was applied to determine whether an increase in REM sleep propensity occurs throughout an interval without REM sleep comparable with the spontaneous sleep cycle of the rat. Seven chronically implanted rats under a 12 : 12 light-dark schedule were subjected to an intermittent REM sleep deprivation protocol that started at hour 6 after lights-on and lasted for 3 h. It consisted of six instances of a 10-min REM sleep permission window alternating with a 20-min REM sleep deprivation window. REM sleep increased throughout the protocol, so that total REM sleep in the two REM sleep permission windows of the third hour became comparable with that expected in the corresponding baseline hour. Attempted REM sleep transitions were already increased in the second deprivation window. Attempted transitions to REM sleep were more frequent in the second than in the first half of any 20-min deprivation window. From one deprivation window to the next, transitions to REM sleep changed in correspondence to the amount of REM sleep in the permission window in-between. Our results suggest that: (i) REM sleep pressure increases throughout a time segment similar in duration to a spontaneous interval without REM sleep; (ii) it diminishes during REM sleep occurrence; and (iii) that drop is proportional to the intervening amount of REM sleep. These results are consistent with a homeostatic REM sleep regulatory mechanism that operates in the time scale of spontaneous sleep cycle.

Prevalencia de bacteriuria en presscolares / Prevalence of bacteriuria in preschool children

En 320 preescolares divididos en dos grupos según edad (2 y 3 años, 4 y 5 años), se practicó - en dos muestras seriadas de orina - recuento total y de bacterias Gram negativas, como parte de un programa tendiente a medir la prevalencia de bacteriuria y la influencia de la edad, sexo y condición socioecocncómica sobre ella. En el grupo de 4 y 5 años, la prevalencia de bacteriuria fue similar a la encontrada en niñas de 6 a 15 años. Los recuentos bacterianos > ou = 10**5 fueron más frecuentes en el sexo femenino, no observándose influencia de la condición socioeconómica. Contrariamente, en las niñas de 2 y 3 años y de situación socioeconómica baja, se presentó mayor prevalencia de bacteriuria verdadera. Estos últimos resultados se contraponen con los obtenidos en estudios epidemiológicos anteriores