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

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 and Nissen, C (2016) Top-down control of arousal and sleep: Fundamentals and clinical implications. Sleep medicine reviews.

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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.

Item Type: Article
Subjects : Psychology
Authors :
AuthorsEmailORCID
Krone, LUNSPECIFIEDUNSPECIFIED
Frase, LUNSPECIFIEDUNSPECIFIED
Piosczyk, HUNSPECIFIEDUNSPECIFIED
Selhausen, PUNSPECIFIEDUNSPECIFIED
Zittel, SUNSPECIFIEDUNSPECIFIED
Jahn, FUNSPECIFIEDUNSPECIFIED
Kuhn, MUNSPECIFIEDUNSPECIFIED
Feige, BUNSPECIFIEDUNSPECIFIED
Mainberger, FUNSPECIFIEDUNSPECIFIED
Klöppel, SUNSPECIFIEDUNSPECIFIED
Riemann, DUNSPECIFIEDUNSPECIFIED
Spiegelhalder, KUNSPECIFIEDUNSPECIFIED
Baglioni, CUNSPECIFIEDUNSPECIFIED
Sterr, AUNSPECIFIEDUNSPECIFIED
Nissen, CUNSPECIFIEDUNSPECIFIED
Date : 14 January 2016
Identification Number : 10.1016/j.smrv.2015.12.005
Copyright Disclaimer : © 2016. This manuscript version is made available under the CC-BY-NC-ND 4.0 license http://creativecommons.org/licenses/by-nc-nd/4.0/
Uncontrolled Keywords : Sleep; Arousal; Brain stimulation; Thalamus; Cortex; Transcranial direct current stimulation; Cortico-thalamic feedback; Sleep continuity
Depositing User : Symplectic Elements
Date Deposited : 06 Jul 2016 09:41
Last Modified : 06 Jul 2016 09:41
URI: http://epubs.surrey.ac.uk/id/eprint/811120

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