Top-down control of arousal and sleep: Fundamentals and clinical implications.

Abstract:

:Mammalian sleep emerges from attenuated activity in the ascending reticular arousal system (ARAS), the main arousal network of the brain. This system originates in the brainstem and activates the thalamus and cortex during wakefulness via a well-characterized 'bottom-up' pathway. Recent studies propose that a less investigated cortico-thalamic 'top-down' pathway also regulates sleep. The present work integrates the current evidence on sleep regulation with a focus on the 'top-down' pathway and explores the potential to translate this information into clinically relevant interventions. Specifically, we elaborate the concept that arousal and sleep continuity in humans can be modulated by non-invasive brain stimulation (NIBS) techniques that increase or decrease cortical excitability. Based on preclinical studies, the modulatory effects of the stimulation are thought to extend to subcortical arousal networks. Further exploration of the 'top-down' regulation of sleep and its modulation through non-invasive brain stimulation techniques may contribute to the development of novel treatments for clinical conditions of disrupted arousal and sleep, which are among the major health problems worldwide.

journal_name

Sleep Med Rev

journal_title

Sleep medicine reviews

authors

Krone L,Frase L,Piosczyk H,Selhausen P,Zittel S,Jahn F,Kuhn M,Feige B,Mainberger F,Klöppel S,Riemann D,Spiegelhalder K,Baglioni C,Sterr A,Nissen C

doi

10.1016/j.smrv.2015.12.005

subject

Has Abstract

pub_date

2017-02-01 00:00:00

pages

17-24

eissn

1087-0792

issn

1532-2955

pii

S1087-0792(16)00002-2

journal_volume

31

pub_type

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