The mismatch negativity during natural sleep: intensity deviants.

Auditory event-related potentials (ERPs) were recorded from 7 subjects who slept for a single night in the laboratory. An 'oddball' sequence of brief tone pips, differing in intensity, was used. Frequently occurring 70 dB 'standards' were presented with infrequent 80 dB intensity increment deviants and 60 dB intensity decrement deviants. The probability of each deviant was 0.1. Stimuli were presented in a random sequence every 600 ms while subjects were awake but inattentive and during stages 2 and REM of sleep. During wakefulness, the intensity increments elicited a broad fronto-central negativity with two discernable peaks. The first, peaking at approximately 120 ms, showed a polarity inversion at the mastoid and likely represented a summation of the N1 wave and the mismatch negativity (MMN). The second, peaking at approximately 330 ms, may have reflected an enhanced N2b component. In REM sleep, the increment deviants elicited a small amplitude 100-200 ms negativity but its amplitude was not significantly larger than the baseline level. It was followed by a larger and significant 300-450 ms negativity but this was considered too delayed to represent the MMN. The decrement deviants elicited a small amplitude, but statistically non-significant, MMN-like wave during both wakefulness and in REM sleep. A MMN-like wave was absent in stage 2 sleep.

Event-related potentials to tones in the absence and presence of sleep spindles.

The present study focused on event-related potentials to tones in the presence and absence of sleep spindles. Six undergraduates were studied throughout an experimental night, following an adaptation session. The event-related potentials to tone stimuli were averaged for each subject. Separate averages were determined for trials on which no sleep spindle occurred 2 s before or after a tone and trials in which spindle activity was present. Both voltage distribution maps and multivariate analysis of the waveforms produced significant differences between these conditions, which could be seen as a higher initial positive component and sustained positively over the averaged epoch in the presence of spindles. Spectral analysis indicated that this result could not solely be ascribed to residual sigma activity in the spindle-present average. The results may provide insights into the functional role of sleep spindles in humans in addition to that suggested by a neurophysiological model of inhibition.

The effect of sleep onset on event related potentials with rapid rates of stimulus presentation.

Amplitude changes to the auditory P1-N1-P2-N2 event-related potential (ERP) complex were measured during sleep onset (SO). A rapid rate of stimulus presentation (every 600 ms) was employed. Eight young adults were tested during alert wakefulness, relaxed wakefulness, and during Stages 1, 2, 3 and 4 of sleep. Subjects were repeatedly awakened and the procedure replicated to ensure a sufficient number of trials were presented within each of the sub-intervals. A large fronto-central P1-N1-P2-N2 complex was observed in the Alert Wakefulness condition. A negative slow wave that overlapped the P1-N1-P2 complex became increasingly attenuated as the subject became more drowsy and finally entered sleep. N1 thus became increasingly attenuated and P1 and P2 increasingly augmented during sleep onset. This difference attained statistical significance during Stage 1 of sleep. N2 did not increase in amplitude at SO, as has been reported in other studies.

The mismatch negativity to frequency deviant stimuli during natural sleep.

Eight subjects spent a single night in the sleep laboratory. Event-related potentials (ERPs) were recorded during the presentation of two auditory "oddball' stimulus conditions in which tonal frequency was manipulated. In the first condition, 1000 Hz "standard' and 2000 Hz "deviant' tones were presented. In the second condition, the deviant tone was reduced to 1050 Hz. In both conditions, deviant probability was 0.2. Stimuli were presented every 600 ms during wakefulness and stages 2, 4, and REM of sleep. A distinctive N1 wave was visible in both stimulus conditions when the subject was awake. The deviant stimuli elicited a "mismatch negativity' (MMN) that inverted in polarity at the mastoid. In REM sleep, an N1 and a MMN were also elicited in both conditions. In the large deviance condition, the MMN had a slightly attenuated amplitude and was shorter in duration while in the small deviant condition, its peak latency was unusually early. Neither the N1 nor the MMN could be recorded in non-REM sleep.

Variations in period-analysed EEG asymmetry in REM and NREM sleep.

Monopolar EEG was recorded from lateral frontal and parietal sites with linked ear reference during sleep in 24 adults. Electrode placement followed the 10-20 International system. EEG was quantified using digital period analyses. The absolute difference in interhemispheric EEG parameters was compared for Stage 2, REM, and a slow wave sleep measure. The absolute difference measures reflect the degree of symmetry or asymmetry, regardless of the hemisphere of origin. Theta and delta activity in slow wave sleep was more asymmetrical than in either Stage 2 or REM. REM sleep was associated with the smallest asymmetries. These results do not support a right hemisphere REM, left hemisphere NREM relationship. Rather they suggest that REM sleep is associated with relative hemispheric symmetry whereas asymmetries are most prominent in slow wave sleep. Stage 2 sleep was significantly less asymmetrical than slow wave on a number of theta and delta measures. The significant differences between slow wave and Stage 2 sleep may denote functional differences within NREM sleep stages.

Topical aminocaproic acid significantly reduces the incidence of secondary hemorrhage in traumatic hyphema in the rabbit model.

Systemically administered aminocaproic acid has been shown to reduce the incidence of secondary hemorrhage after traumatic hyphema. To date, no topical treatment has been shown to be effective in reducing the incidence of rebleeding in a double-masked study. Experimentally induced traumatic hyphemas in the rabbit model were treated with topical placebo gel (4% carboxypolymethylene gel only) or carboxypolymethylene gel with amino-caproic acid (treated group) in a double-masked fashion and were compared with untreated controls (control group). In both the control and placebo groups, there was a 33% rebleed rate. The treated eyes had a 10% rebleed rate that is statistically significant. The topically applied aminocaproic acid gel appears to be well tolerated locally without evidence of systemic toxicity. This study indicates that topical aminocaproic acid may be an effective alternative to systemic treatment to reduce the incidence of secondary hemorrhage in traumatic hyphema.

Topically applied aminocaproic acid concentrates in the aqueous humor of the rabbit in therapeutic levels.

Systemically administered aminocaproic acid, used to reduce the incidence of secondary hemorrhage in traumatic hyphema, has been shown to accumulate in the aqueous humor of rabbits in a dose-dependent manner. Eight topical preparations of aminocaproic acid were studied to determine aqueous humor concentrations. The vehicles studied included the following: sodium chloride, 0.85 g/dL; polyvinyl alcohol, 1.4 g/dL; hydroxypropyl methylcellulose, 0.4 g/dL; benzalkonium chloride, 0.01 g/dL; ethylenediamine tetraacetic acid disodium, 0.01 g/dL; dimethyl sulfoxide, 11 and 39.6 g/dL; and carboxypolymethylene, 4 g/dL. All contained 735 g/L of aminocaproic acid except for dimethyl sulfoxide (39.6 g/dL) and carboxypolymethylene (4 g/dL), which contained 238 and 600 g/L of aminocaproic acid, respectively. Aqueous humor and plasma samples were assayed for aminocaproic acid content following topical administration. Aqueous humor concentrations of aminocaproic acid ranged from undetectable (less than 0.01 mg/dL) to 5.75 mg/dL. Plasma concentrations ranged from undetectable (less than 0.01 mg/dL) to 9.85 mg/dL. Polyvinyl alcohol (1.4 g/dL) and carboxy polymethylene (4 g/dL) provided the highest aqueous humor aminocaproic acid concentrations. The aqueous humor levels with topical aminocaproic acid administration were comparable with those achieved by systemic administration. Plasma drug levels with topical aminocaproic acid were between 5% and 33% of levels achieved by systemic aminocaproic acid. This study demonstrates that aminocaproic acid can be effectively delivered into the anterior chamber of rabbits by topical application.

Systemic aminocaproic acid reduces fibrinolysis in aqueous humor.

Systemically administered aminocaproic acid has been demonstrated to reduce the incidence of secondary hemorrhage in traumatic hyphema. To directly determine the concentration of aminocaproic acid in the aqueous humor, four groups of rabbits were studied following administration of four different regimens of intravenously administered aminocaproic acid. Plasma and aqueous humor samples were assayed for drug content and antifibrinolytic activity. Peak aqueous humor concentrations of aminocaproic acid ranged from 2.5 to 33 mg/dL and varied according to the systemic dose administered. The antifibrinolytic activity paralleled the aminocaproic acid content, with a peak range from 310 to 683 s. These findings indicate a direct relationship between antifibrinolytic activity and the concentration of aminocaproic acid in aqueous humor.