Effects of locus coeruleus lesions upon sleeping and waking in the rabbit

Importance of the locus coeruleus-norepinephrine system in sleep-wake regulation: implications for aging and Alzheimer’s disease

Five decades ago, seminal studies positioned the brainstem locus coeruleus (LC) norepinephrine (NE) system as a key substrate for the regulation of wakefulness and sleep, and this picture has recently been elaborated thanks to methodological advances in the precise investigation and experimental modulation of LC structure and functions. This review presents and discusses findings that support the major role of the LC-NE system at different levels of sleep-wake organization, ranging from its involvement in the overall architecture of the sleep-wake cycle to its associations with sleep microstructure, while accounting for the intricate neuroanatomy surrounding the LC. Given the particular position held by the LC-NE system by being at the intersection of sleep-wake dysregulation and initial pathophysiological processes of Alzheimer's disease (AD), we conclude by examining emerging opportunities to investigate LC-NE mediated relationships between sleep-wake alteration and AD in human aging. We further propose several research perspectives that could support the LC-NE system as a promising target for the identification of at-risk individuals in the preclinical stages of AD, and for the development of novel preventive interventions.

Locus Coeruleus Acid-Sensing Ion Channels Modulate Sleep-Wakefulness and State Transition from NREM to REM Sleep in the Rat

The locus coeruleus (LC) is one of the essential chemoregulatory and sleep-wake (S-W) modulating centers in the brain. LC neurons remain highly active during wakefulness, and some implicitly become silent during rapid eye movement (REM) sleep. LC neurons are also involved in CO₂-dependent modulation of the respiratory drive. Acid-sensing ion channels (ASICs) are highly expressed in some brainstem chemosensory breathing regulatory areas, but their localization and functions in the LC remain unknown. Mild hypercapnia increases the amount of non-REM (NREM) sleep and the number of REM sleep episodes, but whether ASICs in the LC modulate S-W is unclear. Here, we investigated the presence of ASICs in the LC and their role in S-W modulation and the state transition from NREM to REM sleep. Male Wistar rats were surgically prepared for chronic polysomnographic recordings and drug microinjections into the LC. The presence of ASIC-2 and ASIC-3 in the LC was immunohistochemically characterized. Microinjections of amiloride (an ASIC blocker) and APETx2 (a blocker of ASIC-2 and -3) into the LC significantly decreased wakefulness and REM sleep, but significantly increased NREM sleep. Mild hypercapnia increased the amount of NREM and the number of REM episodes. However, APETx2 microinjection inhibited this increase in REM frequency. These results suggest that the ASICs of LC neurons modulate S-W, indicating that ASICs could play an important role in vigilance-state transition. A mild increase in CO₂ level during NREM sleep sensed by ASICs could be one of the determinants of state transition from NREM to REM sleep.

Sleep-wake control and the thalamus

Sleep is an essential component of animal behavior, controlled by both circadian and homeostatic processes. Typical brain oscillations for sleep and wake states are distinctive and reflect recurrent activity amongst neural circuits spanning localized to global brain regions. Since the original discovery of hypothalamic centers controlling both sleep and wakefulness, current views now implicate networks of neuronal and non-neuronal cells distributed brain-wide. Yet the mechanisms of sleep-wake control remain unclear. In light of recent studies, here we review experimental evidence from lesional, correlational, pharmacological and genetics studies, which support a role for the thalamus in several aspects of sleep-wake states. How these thalamo-cortical network mechanisms contribute to other executive functions such as memory consolidation and cognition, remains an open question with direct implications for neuro-psychiatric diseases and stands as a future challenge for basic science and healthcare research.

Locus coeruleus syndrome as a complication of tectal surgery

We describe a case of a 48-year-old woman who underwent a resection of a tectal pilocytic astrocytoma complicated by a sequence of fluctuating consciousness, psychosis with complex hallucinations and lasting sleeping disturbances in which she vividly acts out her dreams. Based on the clinical and anatomical evidence of this case, we propose the term locus coeruleus syndrome to describe this association of iatrogenic symptoms. Along with those of the locus coeruleus, lesions of the dorsal raphe nucleus, ventral tegmentum, substantia nigra pars compacta, the superior colliculus and other peduncular lesions (such as peduncular hallucinosis) are involved in the regulation of sleep-wake/arousal, behaviour, sleeping disorders and rapid eye movement atonia. However, iatrogenic lesion of the locus coeruleus could explain the complications on all levels in our patient.

Activation of inactivation process initiates rapid eye movement sleep

Interactions among REM-ON and REM-OFF neurons form the basic scaffold for rapid eye movement sleep (REMS) regulation; however, precise mechanism of their activation and cessation, respectively, was unclear. Locus coeruleus (LC) noradrenalin (NA)-ergic neurons are REM-OFF type and receive GABA-ergic inputs among others. GABA acts postsynaptically on the NA-ergic REM-OFF neurons in the LC and presynaptically on the latter's projection terminals and modulates NA-release on the REM-ON neurons. Normally during wakefulness and non-REMS continuous release of NA from the REM-OFF neurons, which however, is reduced during the latter phase, inhibits the REM-ON neurons and prevents REMS. At this stage GABA from substantia nigra pars reticulate acting presynaptically on NA-ergic terminals on REM-ON neurons withdraws NA-release causing the REM-ON neurons to escape inhibition and being active, may be even momentarily. A working-model showing neurochemical-map explaining activation of inactivation process, showing contribution of GABA-ergic presynaptic inhibition in withdrawing NA-release and dis-inhibition induced activation of REM-ON neurons, which in turn activates other GABA-ergic neurons and shutting-off REM-OFF neurons for the initiation of REMS-generation has been explained. Our model satisfactorily explains yet unexplained puzzles (i) why normally REMS does not appear during waking, rather, appears following non-REMS; (ii) why cessation of LC-NA-ergic-REM-OFF neurons is essential for REMS-generation; (iii) factor(s) which does not allow cessation of REM-OFF neurons causes REMS-loss; (iv) the association of changes in levels of GABA and NA in the brain during REMS and its deprivation and associated symptoms; v) why often dreams are associated with REMS.

Role of norepinephrine in the regulation of rapid eye movement sleep

Sleep and wakefulness are instinctive behaviours that are present across the animal species. Rapid eye movement (REM) sleep is a unique biological phenomenon expressed during sleep. It evolved about 300 million years ago and is noticed in the more evolved animal species. Although it has been objectively identified in its present characteristic form about half a century ago, the mechanics of how REM is generated, and what happens upon its loss are not known. Nevertheless, extensive research has shown that norepinephrine plays a crucial role in its regulation. The present knowledge that has been reviewed in this manuscript suggests that neurons in the brain stem are responsible for controlling this state and presence of excess norepinephrine in the brain does not allow its generation. Furthermore, REM sleep loss increases levels of norepinephrine in the brain that affects several factors including an increase in Na-K ATPase activity. It has been argued that such increased norepinephrine is ultimately responsible for REM sleep deprivation, associated disturbances in at least some of the physiological conditions leading to alteration in behavioural expression and settling into pathological conditions.

Effects of locus coeruleus lesions on vigilance and attentive behaviour in cat

Previous data have suggested that in the cat, expectancy behaviour (waiting for a target to appear) and associated electrocortical, focal, synchronized activity ('mu' rhythms) are modulated by a noradrenergic system possibly originating from the locus coeruleus (LC). To test the latter hypothesis, we have examined the behavioural and ECoG changes induced after bilateral LC lesions. Our results demonstrated that destruction of the anterior 3/4th of the LC (A6 noradrenergic cell group) resulted in a considerable increase of mu rhythms and expectancy behaviour, without episodes of drowsiness that normally occur. Destruction of the posterior fourth of LC (A4 noradrenergic group) only increased the duration of slow sleep. Extending the A6 lesion to include the dorsal ascending noradrenergic bundle also increased the expectancy behaviour and mu rhythms. Finally, when the nucleus subcoeruleus was also involved, the duration of slow sleep and the frequency of paradoxical sleep episodes increased. These findings indicate that the LC exerts an inhibitory effect on structures involved in the induction and persistence of expectancy behaviour with accompanying mu rhythms.

CNS arousal systems: possible role in delirium

Delirium is often considered a global and nonspecific alteration in cerebral function. However, the recent clinical evidence for heterogeneity within the syndrome of delirium suggests that different systems of the brain may be important in different kinds of delirium. Some forms of delirium, such as anticholinergic toxicity and hepatic encephalopathy, may be caused by drugs or toxins acting on specific brain neurochemical systems. The neurophysiological bases of the control of normal arousal and attention are still relatively poorly understood. However, the recent appreciation of the existence of neurotransmitter-specific projections from the hypothalamus and brain stem directly to the cerebral cortex has spurred new research. Some of these projections may be important in particular kinds of delirium; for instance, evidence from a number of different lines of research implicates GABA systems in the brain as being important in the delirium of hepatic encephalopathy. Cholinergic neurons in the basal forebrain and pons innervate the cerebral cortex. Both of these neurons, but particularly the pontine group, may be important in the delirium of anticholinergic toxicity. Thus, more research on the physiology of these systems in normal sleep and arousal, as well as in pathophysiological states, is indicated. Little is known about changes in these systems with aging. The well-known degeneration in cholinergic systems in Alzheimer's disease, and the sensitivity of individuals with Alzheimer's disease to anticholinergic toxicity, suggest a role of central cholinergic systems in anticholinergic delirium in demented patients. Further research into the involvement of the other systems in aging and delirium apparently would be fruitful.

Variations in nuchal muscle tonus following paradoxical sleep deprivation in the rabbit

Although tonic inhibition of nuchal or facial musculature is considered an intrinsic component of paradoxical sleep (PS) in mammals, this inhibition is either absent or greatly attenuated in the rabbit. To further explore the characteristics of this phenomenon in this species, variations in quantified nuchal muscle activity were examined before, during and following 24 h of PS deprivation. It was postulated that if the substrate for PS-associated tonic electromyogram (EMG) inhibition is present, this procedure--which is known to affect both tonic and phasic components of PS--might enhance such inhibition. For these investigations chronically implanted rabbits (electroencephalographic, eye movement and nuchal muscle placements) were recorded continuously for 5 consecutive days (two day baseline, one day deprivation, two day recovery). Muscle activity was quantified by resetting integration techniques and comparisons made of activity levels before, during and after PS episodes across conditions. The deprivation procedure significantly reduced the amount of PS relative to baseline values, and a significant PS increase (rebound) occurred during postdeprivation recordings. Across-condition EMG-related effects included the corroboration of previous reports of an absence of nuchal atonia during PS, a significant diurnal variation in EMG activity--with greater activity occurring during the dark portion of the light-dark cycle, and enhanced activity immediately following PS episodes relative to either pre-PS or PS levels. Deprivation-related changes in quantified EMG activity included a pre-PS decrease during both the last 12 h of deprivation and the initial 12 h of recovery sleep, and an enhancement of EMG activity during PS.(ABSTRACT TRUNCATED AT 250 WORDS)

Unilateral lesions in locus coeruleus area enhance paradoxical sleep

To clarify the effect of locus coeruleus (LC) lesions in sleep mechanisms, modifications in the amount of wakefulness (W), drowsiness (D), slow sleep (SS) and paradoxical sleep (PS) were examined in 9 cats with unilateral lesions in the dorso-lateral pontine tegmentum and in 3 sham-operated controls. In 4 animals the LC area was unilaterally destroyed--affecting structures that have previously been proposed as PGO-off elements--while the remaining 5 cats had lesions situated close to but sparing the LC area. Analysis of variance among baseline values of all cats, 'postlesion' values of the sham-operated controls and the postlesion values of the 2 groups of operated animals, indicated that the variations of W, D and SS among the different groups were not statistically significant. Only variations in the time spent in PS reached statistically significant values. Individual comparisons between PS values of the 4 groups showed that only an increase of PS in the animals with lesions in the LC area was statistically significant, in comparison with the PS values of the remaining groups. These results indicate that the dorso-lateral pontine area, which is considered to exert a tonic inhibitory influence in the generation of the phasic activity during PS, also mediates in the sleep-wakefulness cycle as an inhibitory region for controlling proportions of PS.

Sleep disturbance produced by electrical stimulation of the locus coeruleus in a human subject

A 25-year-old man with a chronically implanted stimulating electrode placed in the region of the locus coeruleus (LC) was monitored for 5 nights in a sleep laboratory to study the role of the LC in sleep. Sleep patterns were compared between the 2 nights in which the stimulation was applied periodically every 90 min and the 2 nights in which no stimulation was applied. In contrast to the normal sleep patterns that occurred during the 2 nonstimulation nights, electrical stimulation of the LC produced a profound disruption of sleep and significant reductions in the total amounts of NREM sleep, REM sleep, REM sleep as a percent of total sleep (NREM + REM sleep), and total sleep. Results suggest that the LC has a role in maintaining normal sleep patterns.

Sleep-wakefulness rhythms in the rabbit

The characteristics and stability of sleep-wakefulness patterns across consecutive 24-h periods were examined in adult male rabbits implanted for chronic recording of electroencephalographic, eye movement, and nuchal muscle activities. Criteria for stage scoring along with associated scoring reliability are presented. Rabbits slept an average of 11.4 h per day, 25.9% of which was drowsy, 64.5% slow wave sleep, and 9.6% paradoxical sleep. Diurnal differences in amount and type of sleep, consisting of increased wakefulness and decreased paradoxical sleep during the dark phase of the light-dark cycle, were observed. The results are integrated with those of previous sleep studies in this species and phylogenetic implications of variations in the distribution and characteristics of sleep in the rabbit are discussed.

A study of EEG activities during sleep-wakefulness states in rabbits by autocorrelation and power spectrum analyses

A polysomnography was performed on nine rabbits with electrodes chronically implanted at the sensorimotor and visual corticies and hippocampus. The physiological sleep of the rabbits was divided into three stages: awake (W), slow wave sleep (SWS) and REM sleep (REM). For autocorrelation and power spectrum analyses, a transitional zone (T) from W to SWS was added to the fundamental three stages. No essential differences between the mean frequencies of the cortical and hippocampal EEGs were seen. The mean frequencies of hippocampal EEG were as follows: 6.4 in W, 5.4 and 2.4 in T, 2.2 in SWS and 7.3 Hz in REM. The mean peak frequency of hippocampal EEG during REM was significantly higher than that during W.

Effects of brainstem lesions on tonic immobility in the rabbit (Oryctolagus cuniculus)

Lesions were placed in discrete brainstem areas implicated in the generation of both tonic immobility (T1) and paradoxical sleep (PS) to examine postulated state and event correspondences between these states in the rabbit. Lesions were concentrated in the region of the nucleus locus coeruleus (LC)-an area implicated in the mediation of muscular atonia during PS-but also included other reticular (pontine gigantocellular tegmental field: FTG), and nonreticular (vestibular, cerebellar, central grey, collicular) areas. Polygraphic recordings of EEG, EMG and EOG activities were taken during sleep-waking states and measures of the TI response were obtained before (1 day prior) and after (5 and 14 days) lesions were made. None of the lesions was followed by a sustained, significant variation in either frequency of induction or duration of TI. Following LC lesions, and to a lesser extent after FTG lesions, sleep patterns were fragmented, with a reduction or absence of PS and the occurrence of phasic motor activation at times when PS periods might be expected to occur. The absence of PS and persistence of TI following specific brainstem lesions indicate a fundamental difference in mechanisms underlying these states. It is suggested that a major determinant of these results is the activation of phasic activity during PS but not TI, and that the possibility remains that both states may share a common mechanism of tonic motor control.