Sleep Spindle Refractoriness Segregates Periods of Memory Reactivation

Efficacy and mechanisms of repeated closed-loop auditory exposure during slow-wave sleep for internet gaming disorder

Internet Gaming Disorder (IGD) is marked by impaired psychological and social functioning but remains without effective treatments. Cue exposure therapy (CET) is typically administered during wakefulness to help extinguish addictive memories. However, recent studies suggest that sleep may be an optimal state for memory modulation. This study aimed to assess the efficacy of repeated closed-loop exposure to game sounds during UP-state of slow-wave sleep (SWS) on IGD. 84 participants meeting DSM-5 criteria for IGD were randomly assigned to sleep intervention/control groups (SIG/SCG) or awake intervention/control groups (AIG/ACG) with two consecutive days of intervention. During SWS of two intervention nights, around 300 sounds were exposed at slow-wave UP-state. While the awake groups received similar auditory cue exposure during the awake state for two consecutive days. Cravings, playtime, and P300 amplitude in the cue reactivity task were recorded at baseline, post-intervention, and follow-up intervals (1, 2, 3, weeks, and 1 month). Results showed that the SIG significantly reduced cravings (p < 0.001), and playtime (p = 0.009) at post-intervention and follow-up, whereas awake CET showed no effect. The SIG exhibited higher low-frequency and early spindle power, along with lower late spindle power after sound exposure. Notably, the linear increase in sound-elicited late spindle power across the 20 intervention blocks over two experiment nights was positively correlated with reduced cravings post-intervention (r = 0.54, p = 0.015), especially among participants achieving a craving reduction greater than 30% after one month. Our findings suggest that closed-loop auditory exposure during SWS presents a promising, non-invasive intervention strategy for treating IGD, potentially exerting its effects by modulating late spindle power.

Impact of spindle-inspired transcranial alternating current stimulation during a nap on sleep-dependent motor memory consolidation in healthy older adults

With the increase in life expectancy and the rapid evolution of daily life technologies, older adults must constantly learn new skills to adapt to society. Sleep reinforces skills acquired during the day and is associated with the occurrence of specific oscillations such as spindles. However, with age, spindles deteriorate and thus likely contribute to memory impairments observed in older adults. The application of electric currents by means of transcranial alternating current stimulation (tACS) with spindle-like waveform, applied during the night, was found to enhance spindles and motor memory consolidation in young adults. Here, we tested whether tACS bursts inspired by spindles applied during daytime naps may (i) increase spindle density and (ii) foster motor memory consolidation in older adults. Twenty-six healthy older participants performed a force modulation task at 10:00, were retested at 16:30, and the day after the initial training. They had 90-minute opportunity to take a nap while verum or placebo spindle-inspired tACS bursts were applied with similar temporal parameters to those observed in young adults and independently of natural spindles, which are reduced in the elderly. We show that the density of natural spindles correlates with the magnitude of memory consolidation, thus confirming that spindles are promising physiological targets for enhancing memory consolidation in older adults. However, spindle-inspired tACS, as used in the present study, did not enhance either spindles or memory consolidation. We therefore suggest that applying tACS time-locked to natural spindles might be required to entrain them and improve their related functions.

Electrophysiological signatures underlying variability in human memory consolidation

We experience countless pieces of new information each day, but remembering them later depends on firmly instilling memory storage in the brain. Numerous studies have implicated non-rapid eye movement (NREM) sleep in consolidating memories via interactions between hippocampus and cortex. However, the temporal dynamics of this hippocampal-cortical communication and the concomitant neural oscillations during memory reactivations remains unclear. To address this issue, the present study used the procedure of targeted memory reactivation (TMR) following learning of object-location associations to selectively reactivate memories during human NREM sleep. Cortical pattern reactivation and hippocampal-cortical coupling were measured with intracranial EEG recordings in patients with epilepsy. We found that TMR produced variable amounts of memory enhancement across a set of object-location associations. Successful TMR increased hippocampal ripples and cortical spindles, apparent during two discrete sweeps of reactivation. The first reactivation sweep was accompanied by increased hippocampal-cortical communication and hippocampal ripple events coupled to local cortical activity (cortical ripples and high-frequency broadband activity). In contrast, hippocampal-cortical coupling decreased during the second sweep, while increased cortical spindle activity indicated continued cortical processing to achieve long-term storage. Taken together, our findings show how dynamic patterns of item-level reactivation and hippocampal-cortical communication support memory enhancement during NREM sleep.

Shaping the structural dynamics of motor learning through cueing during sleep

Enhancing the retention of recent memory traces through sleep reactivation is possible via Targeted memory reactivation (TMR), involving cueing learned material during posttraining sleep. Evidence indicates detectable short-term microstructural changes in the brain within an hour after motor sequence learning, and posttraining sleep is believed to contribute to the consolidation of these motor memories, potentially leading to enduring microstructural changes. In this study, we explored how TMR during posttraining sleep affects performance gains and delayed microstructural remodeling, using both standard diffusion tensor imaging and advanced neurite orientation dispersion and density imaging. Sixty healthy young adults participated in a 5 days protocol, undergoing five diffusion-weighted imaging sessions, pre- and post-two motor sequence training sessions, and after a posttraining night of either regular sleep (RS) or TMR. Results demonstrated rapid skill acquisition on day 1, followed by performance stabilization on day 2, and improvement on day 5, in both RS and TMR groups. (Re)training induced widespread microstructural changes in motor-related areas, initially involving the hippocampus, followed by a delayed engagement of the caudate nucleus. Mean Diffusivity changes were accompanied by increased neurite density index in the putamen, suggesting increased neurite density, while free water fraction reduction indicated glial reorganization. TMR-related structural differences emerged in the dorsolateral prefrontal cortex on day 2 and the right cuneus on day 5, suggesting unique sleep TMR-related neural reorganization patterns. Persistence of practice-related structural changes, although moderated over time, suggests a lasting neural network reorganization, partially mediated by sleep TMR.

Pulsed inhibition of corticospinal excitability by the thalamocortical sleep spindle

Thalamocortical sleep spindles, i.e., oscillatory bursts at ∼12-15 Hz of waxing and waning amplitude, are a hallmark feature of non-rapid eye movement (NREM) sleep and believed to play a key role in memory reactivation and consolidation. Generated in the thalamus and projecting to neocortex and hippocampus, they are phasically modulated by neocortical slow oscillations (<1 Hz) and in turn phasically modulate hippocampal sharp-wave ripples (>80 Hz). This hierarchical cross-frequency nesting, where slower oscillations group faster ones into certain excitability phases, may enable phase-dependent plasticity in the neocortex, and spindles have thus been considered windows of plasticity in the sleeping brain. However, the assumed phasic excitability modulation had not yet been demonstrated for spindles. Utilizing a recently developed real-time spindle detection algorithm, we applied spindle phase-triggered transcranial magnetic stimulation (TMS) to the primary motor cortex (M1) hand area to characterize the corticospinal excitability profile of spindles via motor evoked potentials (MEP). MEPs showed net suppression during spindles, driven by a "pulse of inhibition" during its falling flank with no inhibition or facilitation during its peak, rising flank, or trough. This unidirectional ("asymmetric") modulation occurred on top of the general sleep-related inhibition during spindle-free NREM sleep and did not extend into the refractory post-spindle periods. We conclude that spindles exert "asymmetric pulsed inhibition" on corticospinal excitability. These findings and the developed real-time spindle targeting methods enable future studies to investigate the causal role of spindles in phase-dependent synaptic plasticity and systems memory consolidation during sleep by repetitively targeting relevant spindle phases.

Pupil size reveals arousal level fluctuations in human sleep

Recent animal research has revealed the intricate dynamics of arousal levels that are important for maintaining proper sleep resilience and memory consolidation. In humans, changes in arousal level are believed to be a determining characteristic of healthy and pathological sleep but tracking arousal level fluctuations has been methodologically challenging. Here we measured pupil size, an established indicator of arousal levels, by safely taping the right eye open during overnight sleep and tested whether pupil size affects cortical response to auditory stimulation. We show that pupil size dynamics change as a function of important sleep events across different temporal scales. In particular, our results show pupil size to be inversely related to the occurrence of sleep spindle clusters, a marker of sleep resilience. Additionally, we found pupil size prior to auditory stimulation to influence the evoked response, most notably in delta power, a marker of several restorative and regenerative functions of sleep. Recording pupil size dynamics provides insights into the interplay between arousal levels and sleep oscillations.

Anything but small: Microarousals stand at the crossroad between noradrenaline signaling and key sleep functions

Continuous sleep restores the brain and body, whereas fragmented sleep harms cognition and health. Microarousals (MAs), brief (3- to 15-s-long) wake intrusions into sleep, are clinical markers for various sleep disorders. Recent rodent studies show that MAs during healthy non-rapid eye movement (NREM) sleep are driven by infraslow fluctuations of noradrenaline (NA) in coordination with electrophysiological rhythms, vasomotor activity, cerebral blood volume, and glymphatic flow. MAs are hence part of healthy sleep dynamics, raising questions about their biological roles. We propose that MAs bolster NREM sleep's benefits associated with NA fluctuations, according to an inverted U-shaped curve. Weakened noradrenergic fluctuations, as may occur in neurodegenerative diseases or with sleep aids, reduce MAs, whereas exacerbated fluctuations caused by stress fragment NREM sleep and collapse NA signaling. We suggest that MAs are crucial for the restorative and plasticity-promoting functions of sleep and advance our insight into normal and pathological arousal dynamics from sleep.

The Effect of Targeted Memory Reactivation on Dogs' Visuospatial Memory

The role of sleep in memory consolidation is a widely discussed but still debated area of research. In light of the fact that memory consolidation during sleep is an evolutionary adaptive function, investigating the same phenomenon in nonhuman model species is highly relevant for its understanding. One such species, which has acquired human-analog sociocognitive skills through convergent evolution, is the domestic dog. Family dogs have surfaced as an outstanding animal model in sleep research, and their learning skills (in a social context) are subject to sleep-dependent memory consolidation. These results, however, are correlational, and the next challenge is to establish causality. In the present study, we aimed to adapt a TMR (targeted memory reactivation) paradigm in dogs and investigate its effect on sleep parameters. Dogs (N = 16) learned new commands associated with different locations and afterward took part in a sleep polysomnography recording when they were re-exposed to one of the previously learned commands. The results did not indicate a cueing benefit on choice performance. However, there was evidence for a decrease in choice latency after sleep, while the density (occurrence/minute) of fast sleep spindles was also notably higher during TMR recordings than adaptation recordings from the same animals and even compared with a larger reference sample from a previous work. Our study provides empirical evidence that TMR is feasible with family dogs, even during a daytime nap. Furthermore, the present study highlights several methodological and conceptual challenges for future research.

Auditory Rhythm Encoding during the Last Trimester of Human Gestation: From Tracking the Basic Beat to Tracking Hierarchical Nested Temporal Structures

Rhythm perception and synchronization to periodicity hold fundamental neurodevelopmental importance for language acquisition, musical behavior, and social communication. Rhythm is omnipresent in the fetal auditory world and newborns demonstrate sensitivity to auditory rhythmic cues. During the last trimester of gestation, the brain begins to respond to auditory stimulation and to code the auditory environment. When and how during this period do the neural capacities for rhythm processing develop? We conducted a cross-sectional study in 46 neonates (24 male) born between 27 and 35 weeks gestational age (wGA), measuring their neural responses to auditory rhythms with high-density electroencephalography during sleep. We developed measures to evaluate neural synchronization to nested rhythmic periodicities, including the fast isochronous beat and slower metrical (beat grouping) structures. We show that neural synchronization to beat and meter becomes stronger with increasing GA, converging on small phase differences between stimulus and neural responses near term, similar to those observed in adults. Dividing the cohort into subpopulations born before and after 33 wGA revealed that both younger and older groups showed neural synchronization to the fast periodicity related to the isochronous beat, whereas only the older group showed significant neural synchronization to the slower meter frequencies related to beat groupings, suggesting that encoding of nested periodicities arrives during late gestation. Together, our results shed light on the rapid evolution of neural coding of external hierarchical auditory rhythms during the third trimester of gestation, starting from the age when the thalamocortical axons establish the first synapses with the cortical plate.

Individualized temporal patterns drive human sleep spindle timing

Sleep spindles are cortical electrical oscillations considered critical for memory consolidation and sleep stability. The timing and pattern of sleep spindles are likely to be important in driving synaptic plasticity during sleep as well as preventing disruption of sleep by sensory and internal stimuli. However, the relative importance of factors such as sleep depth, cortical up/down-state, and temporal clustering in governing sleep spindle dynamics remains poorly understood. Here, we analyze sleep data from 1,025 participants, statistically modeling the simultaneous influences of multiple factors on moment-to-moment spindle production using a point process-generalized linear model framework. Results reveal fingerprint-like timing patterns, characterized by a refractory period followed by a period of increased spindle activity, which are highly individualized yet consistent night-to-night, with increased variability with age. Strikingly, short-term (<15 s) temporal patterns of past spindle history are the main determinant of spindle timing, accounting for over 70% of the statistical deviance-surpassing the contribution of factors such as cortical up/down-state (slow oscillation phase), sleep depth, and long-term history (15 to 90 s, including ~50 s infraslow activity). Short-term history has a statistically significant influence in over 98% of the population, suggesting it is a near-universal feature of spindle activity. Short-term history and slow oscillation phase exert independent effects on spindle timing. Our results establish a robust statistical framework to examine abnormalities in sleep spindle timing observed in neurological disorders and aging, as well as the relationship between individualized sleep spindle timing, cognition, and sleep stability.

Breathing orchestrates synchronization of sleep oscillations in the human hippocampus

Nested sleep oscillations, emerging from asynchronous states in coordinated bursts, are critical for memory consolidation. Whether these bursts emerge intrinsically or from an underlying rhythm is unknown. Here, we show a previously undescribed respiratory-driven oscillation in the human hippocampus that couples with cardinal sleep oscillations. Further, breathing promotes nesting of ripples in slow oscillations, together suggesting that respiration acts as an intrinsic rhythm to coordinate synchronization of sleep oscillations, providing a unique framework to characterize sleep-related respiratory and memory processes.

Targeted memory reactivation during sleep improves emotional memory modulation following imagery rescripting

Targeted Memory Reactivation (TMR) during sleep benefits memory integration and consolidation. In this pre-registered study, we investigated the effects of TMR applied during non-rapid eye movement (NREM) sleep following modulation and updating of aversive autobiographical memories using imagery rescripting (ImR). During 2-5 nights postImR, 80 healthy participants were repeatedly presented with either idiosyncratic words from an ImR updated memory during sleep (experimental group) or with no or neutral words (control groups) using a wearable EEG device (Mobile Health Systems Lab-Sleepband, MHSL-SB) [1] implementing a close-loop cueing procedure. Multivariate analysis were conducted to assess change score trajectories in five key emotional memory characteristics (positive and negative valence, emotional distress, arousal, and vividness) across assessments (timepoints, t) and between the study groups (TMR condition). While ImR showed significant effects on all memory characteristics (d = 0.76-1.66), there were significant additional improvements in the experimental group. Memories were significantly less vivid and afflicted with less emotional distress and arousal following ImR-words cueing. TMR during sleep in individuals' homes was feasible and further improved some ImR's adaptive memory effects. If replicated in clinical samples, TMR may be utilized to augment the effects of ImR and other clinical memory modulation procedures and create personalized treatment options. Such advances in emotional memory treatments are direly needed, as aversive memories are a salient feature across mental disorders, such as post-traumatic stress disorder (PTSD).

Difficulty in artificial word learning impacts targeted memory reactivation and its underlying neural signatures

Sleep associated memory consolidation and reactivation play an important role in language acquisition and learning of new words. However, it is unclear to what extent properties of word learning difficulty impact sleep associated memory reactivation. To address this gap, we investigated in 22 young healthy adults the effectiveness of auditory targeted memory reactivation (TMR) during non-rapid eye movement sleep of artificial words with easy and difficult to learn phonotactical properties. Here, we found that TMR of the easy words improved their overnight memory performance, whereas TMR of the difficult words had no effect. By comparing EEG activities after TMR presentations, we found an increase in slow wave density independent of word difficulty, whereas the spindle-band power nested during the slow wave up-states - as an assumed underlying activity of memory reactivation - was significantly higher in the easy/effective compared to the difficult/ineffective condition. Our findings indicate that word learning difficulty by phonotactics impacts the effectiveness of TMR and further emphasize the critical role of prior encoding depth in sleep associated memory reactivation.

Selective Modulation of Fear Memory in Non-Rapid Eye Movement Sleep

Sleep stabilizes memories for their consolidation, but how to modify specific fear memory during sleep remains unclear. Here, it is reported that using targeted memory reactivation (TMR) to reactivate prior fear learning experience in non-slow wave sleep (NS) inhibits fear memory consolidation, while TMR during slow wave sleep (SWS) enhances fear memory in mice. Replaying conditioned stimulus (CS) during sleep affects sleep spindle occurrence, leading to the reduction or enhancement of slow oscillation-spindle (SO-spindle) coupling in NS and SWS, respectively. Optogenetic inhibition of pyramidal neurons in the frontal association cortex (FrA) during TMR abolishes the behavioral effects of NS-TMR and SWS-TMR by modulating SO-spindle coupling. Notably, calcium imaging of the L2/3 pyramidal neurons in the FrA shows that CS during SWS selectively enhances the activity of neurons previously activated during fear conditioning (FC+ neurons), which significantly correlates with CS-elicited spindle power spectrum density. Intriguingly, these TMR-induced calcium activity changes of FC+ neurons further correlate with mice freezing behavior, suggesting their contributions to the consolidation of fear memories. The findings indicate that TMR can selectively weaken or strengthen fear memory, in correlation with modulating SO-spindle coupling and the reactivation of FC+ neurons during substages of non-rapid eye movement (NREM) sleep.

Auditory processing up to cortex is maintained during sleep spindles

Sleep spindles are transient 11-16 Hz brain oscillations generated by thalamocortical circuits. Their role in memory consolidation is well established, but how they play a role in sleep continuity and protection of memory consolidation against interference is unclear. One theory posits that spindles or a neural refractory period following their offset act as a gating mechanism, blocking sensory information en route to the cortex at the level of the thalamus. An alternative model posits that spindles do not participate in the suppression of neural responses to sound, although they can be produced in response to sound. We present evidence from three experiments using electroencephalography and magnetoencephalography in humans that examine different evoked responses in the presence of and following sleep spindles. The results provide convergent empirical evidence suggesting that auditory processing up to cortex is maintained during sleep spindles, and their refractory periods.

Coupling of Slow Oscillations in the Prefrontal and Motor Cortex Predicts Onset of Spindle Trains and Persistent Memory Reactivations

Sleep is known to drive the consolidation of motor memories. During nonrapid eye movement (NREM) sleep, the close temporal proximity between slow oscillations (SOs) and spindles ("nesting" of SO-spindles) is known to be essential for consolidation, likely because it is closely associated with the reactivation of awake task activity. Interestingly, recent work has found that spindles can occur in temporal clusters or "trains." However, it remains unclear how spindle trains are related to the nesting phenomenon. Here, we hypothesized that spindle trains are more likely when SOs co-occur in the prefrontal and motor cortex. We conducted simultaneous neural recordings in the medial prefrontal cortex (mPFC) and primary motor cortex (M1) of male rats training on the reach-to-grasp motor task. We found that intracortically recorded M1 spindles are organized into distinct temporal clusters. Notably, the occurrence of temporally precise SOs between mPFC and M1 was a strong predictor of spindle trains. Moreover, reactivation of awake task patterns is much more persistent during spindle trains in comparison with that during isolated spindles. Together, our work suggests that the precise coupling of SOs across mPFC and M1 may be a potential driver of spindle trains and persistent reactivation of motor memory during NREM sleep.

The timing of sleep spindles is modulated by the respiratory cycle in humans

OBJECTIVE

Coupling of sleep spindles with cortical slow waves and hippocampus sharp-waves ripples is crucial for sleep-related memory consolidation. Recent literature evidenced that nasal respiration modulates neural activity in large-scale brain networks. In rodents, this respiratory drive strongly varies according to vigilance states. Whether sleep oscillations are also respiration-modulated in humans remains open. In this work, we investigated the influence of breathing on sleep spindles during non-rapid-eye-movement sleep in humans.

METHODS

Full night polysomnography of twenty healthy participants were analysed. Spindles and slow waves were automatically detected during N2 and N3 stages. Spindle-related sigma power as well as spindle and slow wave events were analysed according to the respiratory phase.

RESULTS

We found a significant coupling between both slow and fast spindles and the respiration cycle, with enhanced sigma activity and occurrence probability of spindles during the middle part of the expiration phase. A different coupling was observed for slow waves negative peaks which were rather distributed around the two respiration phase transitions.

CONCLUSION

Our findings suggest that breathing cycle influences the dynamics of brain activity during non-rapid-eye-movement sleep.

SIGNIFICANCE

This coupling may enable sleep spindles to synchronize with other sleep oscillations and facilitate information transfer between distributed brain networks.

Sleep-dependent memory consolidation in young and aged brains

Young children and aged individuals are more prone to memory loss than young adults. One probable reason is insufficient sleep-dependent memory consolidation. Sleep timing and sleep-stage duration differ between children and aged individuals compared to adults. Frequent daytime napping and fragmented sleep architecture are common in children and older individuals. Moreover, sleep-dependent oscillations that play crucial roles in long-term memory storage differ among age groups. Notably, the frontal cortex, which is important for long-term memory storage undergoes major structural changes in children and aged subjects. The similarities in sleep dynamics between children and aged subjects suggest that a deficit in sleep-dependent consolidation contributes to memory loss in both age groups.

Oscillatory-Quality of sleep spindles links brain state with sleep regulation and function

Here, we characterized the dynamics of sleep spindles, focusing on their damping, which we estimated using a metric called oscillatory-Quality (o-Quality), derived by fitting an autoregressive model to electrophysiological signals, recorded from the cortex in mice. The o-Quality of sleep spindles correlates weakly with their amplitude, shows marked laminar differences and regional topography across cortical regions, reflects the level of synchrony within and between cortical networks, is strongly modulated by sleep-wake history, reflects the degree of sensory disconnection, and correlates with the strength of coupling between spindles and slow waves. As most spindle events are highly localized and not detectable with conventional low-density recording approaches, o-Quality thus emerges as a valuable metric that allows us to infer the spread and dynamics of spindle activity across the brain and directly links their spatiotemporal dynamics with local and global regulation of brain states, sleep regulation, and function.

Targeted memory reactivation to augment treatment in post-traumatic stress disorder

Post-traumatic stress disorder (PTSD) is a psychiatric disorder with traumatic memories at its core. Post-treatment sleep may offer a unique time window to increase therapeutic efficacy through consolidation of therapeutically modified traumatic memories. Targeted memory reactivation (TMR) enhances memory consolidation by presenting reminder cues (e.g., sounds associated with a memory) during sleep. Here, we applied TMR in PTSD patients to strengthen therapeutic memories during sleep after one treatment session with eye movement desensitization and reprocessing (EMDR). PTSD patients received either slow oscillation (SO) phase-targeted TMR, using modeling-based closed-loop neurostimulation (M-CLNS) with EMDR clicks as a reactivation cue (n = 17), or sham stimulation (n = 16). Effects of TMR on sleep were assessed through high-density polysomnography. Effects on treatment outcome were assessed through subjective, autonomic, and fMRI responses to script-driven imagery (SDI) of the targeted traumatic memory and overall PTSD symptom level. Compared to sham stimulation, TMR led to stimulus-locked increases in SO and spindle dynamics, which correlated positively with PTSD symptom reduction in the TMR group. Given the role of SOs and spindles in memory consolidation, these findings suggest that TMR may have strengthened the consolidation of the EMDR-treatment memory. Clinically, TMR vs. sham stimulation resulted in a larger reduction of avoidance level during SDI. TMR did not disturb sleep or trigger nightmares. Together, these data provide first proof of principle that TMR may be a safe and viable future treatment augmentation strategy for PTSD. The required follow-up studies may implement multi-night TMR or TMR during REM sleep to further establish the clinical effect of TMR for traumatic memories.

Aversive memories can be weakened during human sleep via the reactivation of positive interfering memories

Recollecting painful or traumatic experiences can be deeply troubling. Sleep may offer an opportunity to reduce such suffering. We developed a procedure to weaken older aversive memories by reactivating newer positive memories during sleep. Participants viewed 48 nonsense words each paired with a unique aversive image, followed by an overnight sleep. In the next evening, participants learned associations between half of the words and additional positive images, creating interference. During the following non-rapid-eye-movement sleep, auditory memory cues were unobtrusively delivered. Upon waking, presenting cues associated with both aversive and positive images during sleep, as opposed to not presenting cues, weakened aversive memory recall while increasing positive memory intrusions. Substantiating these memory benefits, computational modeling revealed that cueing facilitated evidence accumulation toward positive affect judgments. Moreover, cue-elicited theta brain rhythms during sleep predominantly predicted the recall of positive memories. A noninvasive sleep intervention can thus modify aversive recollection and affective responses.

Modulating social learning-induced evaluation updating during human sleep

People often change their evaluations upon learning about their peers' evaluations, i.e., social learning. Given sleep's vital role in consolidating daytime experiences, sleep may facilitate social learning, thereby further changing people's evaluations. Combining a social learning task and the sleep-based targeted memory reactivation technique, we asked whether social learning-induced evaluation updating can be modulated during sleep. After participants had indicated their initial evaluation of snacks, they learned about their peers' evaluations while hearing the snacks' spoken names. During the post-learning non-rapid-eye-movement sleep, we re-played half of the snack names (i.e., cued snack) to reactivate the associated peers' evaluations. Upon waking up, we found that the social learning-induced evaluation updating further enlarged for both cued and uncued snacks. Examining sleep electroencephalogram (EEG) activity revealed that cue-elicited delta-theta EEG power and the overnight N2 sleep spindle density predicted post-sleep evaluation updating for cued but not for uncued snacks. These findings underscore the role of sleep-mediated memory reactivation and the associated neural activity in supporting social learning-induced evaluation updating.

Possible mechanisms to improve sleep spindles via closed loop stimulation during slow wave sleep: A computational study

Sleep spindles are one of the prominent EEG oscillatory rhythms of non-rapid eye movement sleep. In the memory consolidation, these oscillations have an important role in the processes of long-term potentiation and synaptic plasticity. Moreover, the activity (spindle density and/or sigma power) of spindles has a linear association with learning performance in different paradigms. According to the experimental observations, the sleep spindle activity can be improved by closed loop acoustic stimulations (CLAS) which eventually improve memory performance. To examine the effects of CLAS on spindles, we propose a biophysical thalamocortical model for slow oscillations (SOs) and sleep spindles. In addition, closed loop stimulation protocols are applied on a thalamic network. Our model results show that the power of spindles is increased when stimulation cues are applied at the commencing of an SO Down-to-Up-state transition, but that activity gradually decreases when cues are applied with an increased time delay from this SO phase. Conversely, stimulation is not effective when cues are applied during the transition of an Up-to-Down-state. Furthermore, our model suggests that a strong inhibitory input from the reticular (RE) layer to the thalamocortical (TC) layer in the thalamic network shifts leads to an emergence of spindle activity at the Up-to-Down-state transition (rather than at Down-to-Up-state transition), and the spindle frequency is also reduced (8-11 Hz) by thalamic inhibition.

Memory Reactivation during Sleep Does Not Act Holistically on Object Memory

Memory reactivation during sleep is thought to facilitate memory consolidation. Most sleep reactivation research has examined how reactivation of specific facts, objects, and associations benefits their overall retention. However, our memories are not unitary, and not all features of a memory persist in tandem over time. Instead, our memories are transformed, with some features strengthened and others weakened. Does sleep reactivation drive memory transformation? We leveraged the Targeted Memory Reactivation technique in an object category learning paradigm to examine this question. Participants (20 female, 14 male) learned three categories of novel objects, where each object had unique, distinguishing features as well as features shared with other members of its category. We used a real-time EEG protocol to cue the reactivation of these objects during sleep at moments optimized to generate reactivation events. We found that reactivation improved memory for distinguishing features while worsening memory for shared features, suggesting a differentiation process. The results indicate that sleep reactivation does not act holistically on object memories, instead supporting a transformation where some features are enhanced over others.

Delineating memory reactivation in sleep with verbal and non-verbal retrieval cues

Sleep supports memory consolidation via the reactivation of newly formed memory traces. One way to investigate memory reactivation in sleep is by exposing the sleeping brain to auditory retrieval cues; a paradigm known as targeted memory reactivation. To what extent the acoustic properties of memory cues influence the effectiveness of targeted memory reactivation, however, has received limited attention. We addressed this question by exploring how verbal and non-verbal memory cues affect oscillatory activity linked to memory reactivation in sleep. Fifty-one healthy male adults learned to associate visual stimuli with spoken words (verbal cues) and environmental sounds (non-verbal cues). Subsets of the verbal and non-verbal memory cues were then replayed during sleep. The voice of the verbal cues was either matched or mismatched to learning. Memory cues (relative to unheard control cues) prompted an increase in theta/alpha and spindle power, which have been heavily implicated in sleep-associated memory processing. Moreover, verbal memory cues were associated with a stronger increase in spindle power than non-verbal memory cues. There were no significant differences between the matched and mismatched verbal cues. Our findings suggest that verbal memory cues may be most effective for triggering memory reactivation in sleep, as indicated by an amplified spindle response.

Targeted Memory Reactivation during Nonrapid Eye Movement Sleep Enhances Neutral, But Not Negative, Components of Memory

Emotionally salient components of memory are preferentially remembered at the expense of accompanying neutral information. This emotional memory trade-off is enhanced over time, and possibly sleep, through a process of memory consolidation. Sleep is believed to benefit memory through a process of reactivation during nonrapid eye movement sleep (NREM). Here, targeted memory reactivation (TMR) was used to manipulate the reactivation of negative and neutral memories during NREM sleep. Thirty-one male and female participants encoded composite scenes containing either a negative or neutral object superimposed on an always neutral background. During NREM sleep, sounds associated with the scene object were replayed, and memory for object and background components was tested the following morning. We found that TMR during NREM sleep improved memory for neutral, but not negative scene objects. This effect was associated with sleep spindle activity, with a larger spindle response following TMR cues predicting TMR effectiveness for neutral items only. These findings therefore do not suggest a role of NREM memory reactivation in enhancing the emotional memory trade-off across a 12 h period but do align with growing evidence of spindle-mediated memory reactivation in service of neutral declarative memory.

Recurring memory reactivation: The offline component of learning

One can be aware of the effort needed to memorize a new fact or to recall the name of a new acquaintance. Because of experiences like this, learning can seem to have only two components, encoding information and, after some delay, retrieving information. To the contrary, learning entails additional, intervening steps that sometimes are hidden from the learner. For firmly acquiring fact and event knowledge in particular, learners are generally not cognizant of the necessity of offline consolidation. The memories that persist to be available reliably at a later time, according to the present conceptualization, are the ones we repeatedly rehearse and integrate with other knowledge, whether we do this intentionally or unknowingly, awake or asleep. This article examines the notion that learning is not a function of waking brain activity alone. What happens in the brain while we sleep also impacts memory storage, and consequently is a critical component of learning. The idea that memories can change over time and become enduring has long been present in memory research and is foundational for the concept of memory consolidation. Nevertheless, the notion that memory consolidation happens during sleep faced much resistance before eventually being firmly established. Research is still needed to elucidate the operation and repercussions of repeated reactivation during sleep. Comprehensively understanding how offline memory reactivation contributes to learning is vital for both theoretical and practical considerations.

An update on recent advances in targeted memory reactivation during sleep

Targeted Memory Reactivation (TMR) is a noninvasive tool to manipulate memory consolidation during sleep. TMR builds on the brain's natural processes of memory reactivation during sleep and aims to facilitate or bias these processes in a certain direction. The basis of this technique is the association of learning content with sensory cues, such as odors or sounds, that are presented during subsequent sleep to promote memory reactivation. Research on TMR has drastically increased over the last decade with rapid developments. The aim of the present review is to highlight the most recent advances of this research. We focus on effects of TMR on the strengthening of memories in the declarative, procedural and emotional memory domain as well as on ways in which TMR can be used to promote forgetting. We then discuss advanced technical approaches to determine the optimal timing of TMR within the ongoing oscillatory activity of the sleeping brain as well as the specificity of TMR for certain memory contents. We further highlight the specific effects of TMR during REM sleep and in influencing dream content. Finally, we discuss recent evidence for potential applications of TMR for mental health, educational purposes and in the home setting. In conclusion, the last years of research have provided substantial advances in TMR that can guide future endeavors in research and application.

No Benefit in Memory Performance after Nocturnal Memory Reactivation Coupled with Theta-tACS

Targeted memory reactivation (TMR) is an effective technique to enhance sleep-associated memory consolidation. The successful reactivation of memories by external reminder cues is typically accompanied by an event-related increase in theta oscillations, preceding better memory recall after sleep. However, it remains unclear whether the increase in theta oscillations is a causal factor or an epiphenomenon of successful TMR. Here, we used transcranial alternating current stimulation (tACS) to examine the causal role of theta oscillations for TMR during non-rapid eye movement (non-REM) sleep. Thirty-seven healthy participants learned Dutch-German word pairs before sleep. During non-REM sleep, we applied either theta-tACS or control-tACS (23 Hz) in blocks (9 min) in a randomised order, according to a within-subject design. One group of participants received tACS coupled with TMR time-locked two seconds after the reminder cue (time-locked group). Another group received tACS in a continuous manner while TMR cues were presented (continuous group). Contrary to our predictions, we observed no frequency-specific benefit of theta-tACS coupled with TMR during sleep on memory performance, neither for continuous nor time-locked stimulation. In fact, both stimulation protocols blocked the TMR-induced memory benefits during sleep, resulting in no memory enhancement by TMR in both the theta and control conditions. No frequency-specific effect was found on the power analyses of the electroencephalogram. We conclude that tACS might have an unspecific blocking effect on memory benefits typically observed after TMR during non-REM sleep.

Age-associated sleep spindle characteristics in Duchenne muscular dystrophy

Brain oscillations of non-rapid eye movement sleep, including slow oscillations (SO, 0.5-1.5 Hz) and spindles (10-16 Hz), mirror underlying brain maturation across development and are associated with cognition. Hence, age-associated emergence and changes in the electrophysiological properties of these rhythms can lend insight into cortical development, specifically in comparisons between pediatric populations and typically developing peers. We previously evaluated age-associated changes in SOs in male patients with Duchenne muscular dystrophy (DMD), finding a significant age-related decline between 4 and 18 years. While primarily a muscle disorder, male patients with DMD can also have sleep, cognitive, and cortical abnormalities, thought to be driven by altered dystrophin expression in the brain. In this follow-up study, we characterized the age-associated changes in sleep spindles. We found that age-dependent spindle characteristics in patients with DMD, including density, frequency, amplitude, and duration, were consistent with age-associated trends reported in the literature for typically developing controls. Combined with our prior finding of age-associated decline in SOs, our results suggest that SOs, but not spindles, are a candidate intervention target to enhance sleep in patients with DMD.

Individualized temporal patterns dominate cortical upstate and sleep depth in driving human sleep spindle timing

Sleep spindles are critical for memory consolidation and strongly linked to neurological disease and aging. Despite their significance, the relative influences of factors like sleep depth, cortical up/down states, and spindle temporal patterns on individual spindle production remain poorly understood. Moreover, spindle temporal patterns are typically ignored in favor of an average spindle rate. Here, we analyze spindle dynamics in 1008 participants from the Multi-Ethnic Study of Atherosclerosis using a point process framework. Results reveal fingerprint-like temporal patterns, characterized by a refractory period followed by a period of increased spindle activity, which are highly individualized yet consistent night-to-night. We observe increased timing variability with age and distinct gender/age differences. Strikingly, and in contrast to the prevailing notion, individualized spindle patterns are the dominant determinant of spindle timing, accounting for over 70% of the statistical deviance explained by all of the factors we assessed, surpassing the contribution of slow oscillation (SO) phase (~14%) and sleep depth (~16%). Furthermore, we show spindle/SO coupling dynamics with sleep depth are preserved across age, with a global negative shift towards the SO rising slope. These findings offer novel mechanistic insights into spindle dynamics with direct experimental implications and applications to individualized electroencephalography biomarker identification.

Odor cueing of declarative memories during sleep enhances coordinated spindles and slow oscillations

Long-term memories are formed by repeated reactivation of newly encoded information during sleep. This process can be enhanced by using memory-associated reminder cues like sounds and odors. While auditory cueing has been researched extensively, few electrophysiological studies have exploited the various benefits of olfactory cueing. We used high-density electroencephalography in an odor-cueing paradigm that was designed to isolate the neural responses specific to the cueing of declarative memories. We show widespread cueing-induced increases in the duration and rate of sleep spindles. Higher spindle rates were most prominent over centro-parietal areas and largely overlapping with a concurrent increase in the amplitude of slow oscillations (SOs). Interestingly, greater SO amplitudes were linked to a higher likelihood of coupling a spindle and coupled spindles expressed during cueing were more numerous in particular around SO up states. We thus identify temporally and spatially coordinated enhancements of sleep spindles and slow oscillations as a candidate mechanism behind cueing-induced memory processing. Our results further demonstrate the feasibility of studying neural activity patterns linked to such processing using olfactory cueing during sleep.

The neurophysiology of closed-loop auditory stimulation in sleep: A magnetoencephalography study

Closed-loop auditory stimulation (CLAS) is a brain modulation technique in which sounds are timed to enhance or disrupt endogenous neurophysiological events. CLAS of slow oscillation up-states in sleep is becoming a popular tool to study and enhance sleep's functions, as it increases slow oscillations, evokes sleep spindles and enhances memory consolidation of certain tasks. However, few studies have examined the specific neurophysiological mechanisms involved in CLAS, in part because of practical limitations to available tools. To evaluate evidence for possible models of how sound stimulation during brain up-states alters brain activity, we simultaneously recorded electro- and magnetoencephalography in human participants who received auditory stimulation across sleep stages. We conducted a series of analyses that test different models of pathways through which CLAS of slow oscillations may affect widespread neural activity that have been suggested in literature, using spatial information, timing and phase relationships in the source-localized magnetoencephalography data. The results suggest that auditory information reaches ventral frontal lobe areas via non-lemniscal pathways. From there, a slow oscillation is created and propagated. We demonstrate that while the state of excitability of tissue in auditory cortex and frontal ventral regions shows some synchrony with the electroencephalography (EEG)-recorded up-states that are commonly used for CLAS, it is the state of ventral frontal regions that is most critical for slow oscillation generation. Our findings advance models of how CLAS leads to enhancement of slow oscillations, sleep spindles and associated cognitive benefits and offer insight into how the effectiveness of brain stimulation techniques can be improved.

Single closed-loop acoustic stimulation targeting memory consolidation suppressed hippocampal ripple and thalamo-cortical spindle activity in mice

Brain rhythms of sleep reflect neuronal activity underlying sleep-associated memory consolidation. The modulation of brain rhythms, such as the sleep slow oscillation (SO), is used both to investigate neurophysiological mechanisms as well as to measure the impact of sleep on presumed functional correlates. Previously, closed-loop acoustic stimulation in humans targeted to the SO Up-state successfully enhanced the slow oscillation rhythm and phase-dependent spindle activity, although effects on memory retention have varied. Here, we aim to disclose relations between stimulation-induced hippocampo-thalamo-cortical activity and retention performance on a hippocampus-dependent object-place recognition task in mice by applying acoustic stimulation at four estimated SO phases compared to sham condition. Across the 3-h retention interval at the beginning of the light phase closed-loop stimulation failed to improve retention significantly over sham. However, retention during SO Up-state stimulation was significantly higher than for another SO phase. At all SO phases, acoustic stimulation was accompanied by a sharp increase in ripple activity followed by about a second-long suppression of hippocampal sharp wave ripple and longer maintained suppression of thalamo-cortical spindle activity. Importantly, dynamics of SO-coupled hippocampal ripple activity distinguished SOUp-state stimulation. Non-rapid eye movement (NREM) sleep was not impacted by stimulation, yet preREM sleep duration was effected. Results reveal the complex effect of stimulation on the brain dynamics and support the use of closed-loop acoustic stimulation in mice to investigate the inter-regional mechanisms underlying memory consolidation.

Automatic sleep spindles identification and classification with multitapers and convolution

Sleep spindles are isolated transient surges of oscillatory neural activity present during sleep stages 2 and 3 in the nonrapid eye movement (NREM). They can indicate the mechanisms of memory consolidation and plasticity in the brain. Spindles can be identified across cortical areas and classified as either slow or fast. There are spindle transients across different frequencies and power, yet most of their functions remain a mystery. Using several electroencephalogram (EEG) databases, this study presents a new method, called the "spindles across multiple channels" (SAMC) method, for identifying and categorizing sleep spindles in EEGs during the NREM sleep. The SAMC method uses a multitapers and convolution (MT&C) approach to extract the spectral estimation of different frequencies present in sleep EEGs and graphically identify spindles across multiple channels. The characteristics of spindles, such as duration, power, and event areas, are also extracted by the SAMC method. Comparison with other state-of-the-art spindle identification methods demonstrated the superiority of the proposed method with an agreement rate, average positive predictive value, and sensitivity of over 90% for spindle classification across the three databases used in this paper. The computing cost was found to be, on average, 0.004 seconds per epoch. The proposed method can potentially improve the understanding of the behavior of spindles across the scalp and accurately identify and categories sleep spindles.

Temporal cluster-based organization of sleep spindles underlies motor memory consolidation

Sleep benefits motor memory consolidation, which is mediated by sleep spindle activity and associated memory reactivations during non-rapid eye movement (NREM) sleep. However, the particular role of NREM2 and NREM3 sleep spindles and the mechanisms triggering this memory consolidation process remain unclear. Here, simultaneous electroencephalographic and functional magnetic resonance imaging (EEG-fMRI) recordings were collected during night-time sleep following the learning of a motor sequence task. Adopting a time-based clustering approach, we provide evidence that spindles iteratively occur within clustered and temporally organized patterns during both NREM2 and NREM3 sleep. However, the clustering of spindles in trains is related to motor memory consolidation during NREM2 sleep only. Altogether, our findings suggest that spindles' clustering and rhythmic occurrence during NREM2 sleep may serve as an intrinsic rhythmic sleep mechanism for the timed reactivation and subsequent consolidation of motor memories, through synchronized oscillatory activity within a subcortical-cortical network involved during learning.

Neural reactivation during human sleep

Sleep promotes memory consolidation: the process by which newly acquired memories are stabilised, strengthened, and integrated into long-term storage. Pioneering research in rodents has revealed that memory reactivation in sleep is a primary mechanism underpinning sleep's beneficial effect on memory. In this review, we consider evidence for memory reactivation processes occurring in human sleep. Converging lines of research support the view that memory reactivation occurs during human sleep, and is functionally relevant for consolidation. Electrophysiology studies have shown that memory reactivation is tightly coupled to the cardinal neural oscillations of non-rapid eye movement sleep, namely slow oscillation-spindle events. In addition, functional imaging studies have found that brain regions recruited during learning become reactivated during post-learning sleep. In sum, the current evidence paints a strong case for a mechanistic role of neural reactivation in promoting memory consolidation during human sleep.

Disturbed laterality of non-rapid eye movement sleep oscillations in post-stroke human sleep: a pilot study

Sleep is known to promote recovery post-stroke. However, there is a paucity of data profiling sleep oscillations in the post-stroke human brain. Recent rodent work showed that resurgence of physiologic spindles coupled to sleep slow oscillations (SOs) and concomitant decrease in pathological delta (δ) waves is associated with sustained motor performance gains during stroke recovery. The goal of this study was to evaluate bilaterality of non-rapid eye movement (NREM) sleep-oscillations (namely SOs, δ-waves, spindles, and their nesting) in post-stroke patients vs. healthy control subjects. We analyzed NREM-marked electroencephalography (EEG) data in hospitalized stroke-patients (n = 5) and healthy subjects (n = 3). We used a laterality index to evaluate symmetry of NREM oscillations across hemispheres. We found that stroke subjects had pronounced asymmetry in the oscillations, with a predominance of SOs, δ-waves, spindles, and nested spindles in affected hemisphere, when compared to the healthy subjects. Recent preclinical work classified SO-nested spindles as restorative post-stroke and δ-wave-nested spindles as pathological. We found that the ratio of SO-nested spindles laterality index to δ-wave-nested spindles laterality index was lower in stroke subjects. Using linear mixed models (which included random effects of concurrent pharmacologic drugs), we found large and medium effect size for δ-wave nested spindle and SO-nested spindle, respectively. Our results in this pilot study indicate that considering laterality index of NREM oscillations might be a useful metric for assessing recovery post-stroke and that factoring in pharmacologic drugs may be important when targeting sleep modulation for neurorehabilitation post-stroke.

Item-specific neural representations during human sleep support long-term memory

Understanding how individual memories are reactivated during sleep is essential in theorizing memory consolidation. Here, we employed the targeted memory reactivation (TMR) paradigm to unobtrusively replaying auditory memory cues during human participants' slow-wave sleep (SWS). Using representational similarity analysis (RSA) on cue-elicited electroencephalogram (EEG), we found temporally segregated and functionally distinct item-specific neural representations: the early post-cue EEG activity (within 0 to 2,000 ms) contained comparable item-specific representations for memory cues and control cues, signifying effective processing of auditory cues. Critically, the later EEG activity (2,500 to 2,960 ms) showed greater item-specific representations for post-sleep remembered items than for forgotten and control cues, indicating memory reprocessing. Moreover, these later item-specific neural representations were supported by concurrently increased spindles, particularly for items that had not been tested prior to sleep. These findings elucidated how external memory cues triggered item-specific neural representations during SWS and how such representations were linked to successful long-term memory. These results will benefit future research aiming to perturb specific memory episodes during sleep.

The effects of closed-loop auditory stimulation on sleep oscillatory dynamics in relation to motor procedural memory consolidation

STUDY OBJECTIVES

Healthy aging and many disorders show reduced sleep-dependent memory consolidation and corresponding alterations in non-rapid eye movement sleep oscillations. Yet sleep physiology remains a relatively neglected target for improving memory. We evaluated the effects of closed-loop auditory stimulation during sleep (CLASS) on slow oscillations (SOs), sleep spindles, and their coupling, all in relation to motor procedural memory consolidation.

METHODS

Twenty healthy young adults had two afternoon naps: one with auditory stimulation during SO upstates and another with no stimulation. Twelve returned for a third nap with stimulation at variable times in relation to SO upstates. In all sessions, participants trained on the motor sequence task prior to napping and were tested afterward.

RESULTS

Relative to epochs with no stimulation, upstate stimuli disrupted sleep and evoked SOs, spindles, and SO-coupled spindles. Stimuli that successfully evoked oscillations were delivered closer to the peak of the SO upstate and when spindle power was lower than stimuli that failed to evoke oscillations. Across conditions, participants showed similar significant post-nap performance improvement that correlated with the density of SO-coupled spindles.

CONCLUSIONS

Despite its strong effects on sleep physiology, CLASS failed to enhance motor procedural memory. Our findings suggest methods to overcome this failure, including better sound calibration to preserve sleep continuity and the use of real-time predictive algorithms to more precisely target SO upstates and to avoid disrupting endogenous SO-coupled spindles and their mnemonic function. They motivate continued development of CLASS as an intervention to manipulate sleep oscillatory dynamics and improve memory.

Spindle-dependent memory consolidation in healthy adults: A meta-analysis

Accumulating evidence suggests a central role for sleep spindles in the consolidation of new memories. However, no meta-analysis of the association between sleep spindles and memory performance has been conducted so far. Here, we report meta-analytical evidence for spindle-memory associations and investigate how multiple factors, including memory type, spindle type, spindle characteristics, and EEG topography affect this relationship. The literature search yielded 53 studies reporting 1427 effect sizes, resulting in a small to moderate effect for the average association. We further found that spindle-memory associations were significantly stronger for procedural memory than for declarative memory. Neither spindle types nor EEG scalp topography had an impact on the strength of the spindle-memory relation, but we observed a distinct functional role of global and fast sleep spindles, especially for procedural memory. We also found a moderation effect of spindle characteristics, with power showing the largest effect sizes. Collectively, our findings suggest that sleep spindles are involved in learning, thereby representing a general physiological mechanism for memory consolidation.

Closed-loop auditory stimulation of sleep slow oscillations: Basic principles and best practices

Sleep is essential for our physical and mental well-being. During sleep, despite the paucity of overt behavior, our brain remains active and exhibits a wide range of coupled brain oscillations. In particular slow oscillations are characteristic for sleep, however whether they are directly involved in the functions of sleep, or are mere epiphenomena, is not yet fully understood. To disentangle the causality of these relationships, experiments utilizing techniques to detect and manipulate sleep oscillations in real-time are essential. In this review, we first overview the theoretical principles of closed-loop auditory stimulation (CLAS) as a method to study the role of slow oscillations in the functions of sleep. We then describe technical guidelines and best practices to perform CLAS and analyze results from such experiments. We further provide an overview of how CLAS has been used to investigate the causal role of slow oscillations in various sleep functions. We close by discussing important caveats, open questions, and potential topics for future research.

Neural oscillations after acute large artery atherosclerotic cerebral infarction during resting state and sleep spindles

Electroencephalogram-microstate analysis was conducted using low-resolution electromagnetic tomography (LORETA)-KEY to evaluate dynamic brain network changes in patients with acute large artery atherosclerotic cerebral infarction (LAACI) during the rest and sleep stages. This study included 35 age- and sex-matched healthy controls and 34 patients with acute LAACI. Each participant performed a 3-h, 19-channel video electroencephalogram test. Subsequently, 20 epochs of 2-s sleep spindles during stage N2 sleep and five epochs of 10-s electroencephalogram data in the resting state for each participant were obtained. In both the resting state and sleep spindles, patients with LAACI displayed altered neural oscillations. The parameters of microstate A (coverage, occurrence, and duration) increased during the resting state in the patients with LAACI compared with healthy controls. The coverage and occurrence of microstate B and D were reduced in the LAACI group compared with the healthy controls (p < 0.05). Moreover, during sleep spindles, the duration of microstate A and the transition probability from microstate A and B to C decreased, but the coverage of microstate B and the transition rate from microstate B to D increased (p < 0.05) in the LAACI group compared with the healthy controls. These results enable better understanding of how neural oscillations are modified in patients with LAACI during the resting state and sleep spindles. Following LAACI, the dynamic brain network undergoes changes during sleep spindles and the resting state. Continued long-term investigations are required to determine how well these changes in brain dynamics reflect the clinical characteristics of patients with LAACI.

A system based on machine learning for improving sleep

Closed-loop auditory stimulation is one of the well-known and emerging sensory stimulation techniques, which achieves the purpose of sleep regulation by driving the EEG slow oscillation (SO, <1 Hz) through auditory stimulation. The main challenge is to accurately identify the stimulation timing and provide feedback in real-time, which has high requirements on the response time and recognition accuracy of the closed-loop auditory stimulation system. To reduce the impact of systematic errors on the regulation results, most traditional closed-loop auditory stimulation systems try to identify a single feature to determine the timing of stimulus delivery and reduce the system feedback delay by simplifying the calculation. Unlike existing closed-loop regulation systems that identify specific brain features, this paper proposes a closed-loop auditory stimulation sleep regulation system deploying machine learning. The process is: through online sleep real-time automatic staging, tracking the sleep stage to provide feedback quickly, and continuously offering external auditory stimulation at a specific SO phase. This paper uses this system to conduct sleep auditory stimulation regulation experiments on ten subjects. The experimental results show that the sleep closed-loop regulation system proposed in this paper can achieve consistency (effective for almost all subjects in the experiment) and immediate (taking effect immediately after stimulation) modulation effects on SOs. More importantly, the proposed method is superior to existing advanced methods. Therefore, the system designed in this paper has great potential to be more reliable and flexible in sleep regulation.

Clinical value of cortical bursting in preterm infants with intraventricular haemorrhage

BACKGROUND

In healthy preterm infants, cortical burst rate and temporal dynamics predict important measures such as brain growth. We hypothesised that in preterm infants with germinal matrix-intraventricular haemorrhage (GM-IVH), cortical bursting could provide prognostic information.

AIMS

We determined how cortical bursting was influenced by the injury, and whether this was related to developmental outcome.

STUDY DESIGN

Single-centre retrospective cohort study at University College London Hospitals, UK.

SUBJECTS

33 infants with GM-IVH ≥ grade II (median gestational age: 25 weeks).

OUTCOME MEASURES

We identified 47 EEGs acquired between 24 and 40 weeks corrected gestational age as part of routine clinical care. In a subset of 33 EEGs from 25 infants with asymmetric injury, we used the least-affected hemisphere as an internal comparison. We tested whether cortical burst rate predicted survival without severe impairment (median 2 years follow-up).

RESULTS

In asymmetric injury, cortical burst rate was lower over the worst- than least-affected hemisphere, and bursts over the worst-affected hemisphere were less likely to immediately follow bursts over the least-affected hemisphere than vice versa. Overall, burst rate was lower in cases of GM-IVH with parenchymal involvement, relative to milder structural injury grades. Higher burst rate modestly predicted survival without severe language (AUC 0.673) or motor impairment (AUC 0.667), which was partly mediated by structural injury grade.

CONCLUSIONS

Cortical bursting can index the functional injury after GM-IVH: perturbed burst initiation (rate) and propagation (inter-hemispheric dynamics) likely reflect associated grey matter and white matter damage. Higher cortical burst rate is reassuring for a positive outcome.

The influence of encoding strategy on associative memory consolidation across wake and sleep

Sleep benefits memory consolidation. However, factors present at initial encoding may moderate this effect. Here, we examined the role that encoding strategy plays in subsequent memory consolidation during sleep. Eighty-nine participants encoded pairs of words using two different strategies. Each participant encoded half of the word pairs using an integrative visualization technique, where the two items were imagined in an integrated scene. The other half were encoded nonintegratively, with each word pair item visualized separately. Memory was tested before and after a period of nocturnal sleep (N = 47) or daytime wake (N = 42) via cued recall tests. Immediate memory performance was significantly better for word pairs encoded using the integrative strategy compared with the nonintegrative strategy (P < 0.001). When looking at the change in recall across the delay, there was significantly less forgetting of integrated word pairs across a night of sleep compared with a day spent awake (P < 0.001), with no significant difference in the nonintegrated pairs (P = 0.19). This finding was driven by more forgetting of integrated compared with not-integrated pairs across the wake delay (P < 0.001), whereas forgetting was equivalent across the sleep delay (P = 0.26). Together, these results show that the strategy engaged in during encoding impacts both the immediate retention of memories and their subsequent consolidation across sleep and wake intervals.

Targeted memory reactivation during slow-wave sleep vs. sleep stage N2: no significant differences in a vocabulary task

Sleep supports memory consolidation, and slow-wave sleep (SWS) in particular is assumed to benefit the consolidation of verbal learning material. Re-exposure to previously learned words during SWS with a technique known as targeted memory reactivation (TMR) consistently benefits memory. However, TMR has also been successfully applied during sleep stage N2, though a direct comparison between words selectively reactivated during SWS versus N2 is still missing. Here, we directly compared the effects of N2 TMR and SWS TMR on memory performance in a vocabulary learning task in a within-subject design. Thirty-four healthy young participants (21 in the main sample and 13 in an additional sample) learned 120 Dutch-German word pairs before sleep. Participants in the main sample slept for ∼8 h during the night, while participants in the additional sample slept ∼3 h. We reactivated the Dutch words selectively during N2 and SWS in one single night. Forty words were not cued. Participants in the main sample recalled the German translations of the Dutch words after sleep in the morning, while those in the additional sample did so at 2:00 a.m. As expected, we observed no differences in recall performance between words reactivated during N2 and SWS. However, we failed to find an overall memory benefit of reactivated over nonreactivated words. Detailed time-frequency analyses showed that words played during N2 elicited stronger characteristic oscillatory responses in several frequency bands, including spindle and theta frequencies, compared with SWS. These oscillatory responses did not vary with the memory strengths of individual words. Our results question the robustness and replicability of the TMR benefit on memory using our Dutch vocabulary learning task. We discuss potential boundary conditions for vocabulary reactivation paradigms and, most importantly, see the need for further replication studies, ideally including multiple laboratories and larger sample sizes.

Sleep-related motor skill consolidation and generalizability after physical practice, motor imagery, and action observation

Sleep benefits the consolidation of motor skills learned by physical practice, mainly through periodic thalamocortical sleep spindle activity. However, motor skills can be learned without overt movement through motor imagery or action observation. Here, we investigated whether sleep spindle activity also supports the consolidation of non-physically learned movements. Forty-five electroencephalographic sleep recordings were collected during a daytime nap after motor sequence learning by physical practice, motor imagery, or action observation. Our findings reveal that a temporal cluster-based organization of sleep spindles underlies motor memory consolidation in all groups, albeit with distinct behavioral outcomes. A daytime nap offers an early sleep window promoting the retention of motor skills learned by physical practice and motor imagery, and its generalizability toward the inter-manual transfer of skill after action observation. Findings may further have practical impacts with the development of non-physical rehabilitation interventions for patients having to remaster skills following peripherical or brain injury.

Reap while you sleep: Consolidation of memories differs by how they were sown

Newly formed memories are spontaneously reactivated during sleep, leading to their strengthening. This reactivation process can be manipulated by reinstating learning-related stimuli during sleep, a technique termed targeted memory reactivation. Numerous studies have found that delivering cues during sleep improves memory for simple associations, in which one cue reactivates one tested memory. However, real-life memories often live in rich, complex networks of associations. In this review, we will examine recent forays into investigating how targeted sleep reactivation affects memories within complex paradigms, in which one cue can reactivate multiple tested memories. A common theme across studies is that reactivation consequences do not merely depend on whether memories reside in complex arrangements, but on how memories interact with one another during acquisition. We therefore emphasize how intricate study design details that alter the nature of learning and/or participant intentions impact the outcomes of sleep reactivation. In some cases, complex networks of memories interact harmoniously to bring about mutual memory benefits; in other cases, memories interact antagonistically and produce selective impairments in retrieval. Ultimately, although this burgeoning area of research has yet to be systematically explored, results suggest that the fate of reactivated stimuli within complex arrangements depends on how they were learned.

Modulation of sleep using noninvasive stimulations during sleep

Among the various sleep modulation methods for improving sleep, three methods using noninvasive stimulation during sleep have been reviewed and summarized. The first method involves noninvasive direct brain stimulation to induce a current directly in the brain cortex. Electrically or magnetically applied stimulations trigger electrical events such as slow oscillations or sleep spindles, which can also be recorded by an electroencephalogram. The second method involves sensory stimulation during sleep, which provides stimulation through the sensory pathway to invoke equivalent brain activity like direct brain stimulation. Olfactory, vestibular, and auditory stimulation methods have been used, resulting in several sleep-modulating effects, which are characteristic and depend on the experimental paradigm. The third method is to modulate sleep by shifting the autonomic balance affecting sleep homeostasis. To strengthen parasympathetic dominance, stimulation was applied to decrease heart rate by synchronizing the heart rhythm. These noninvasive stimulation methods can strengthen slow-wave sleep, consolidate declarative or procedural memory, and modify sleep macrostructure. These stimulation methods provide evidence and possibility for sleep modulation in our daily life as an alternative method for the treatment of disturbed sleep and enhancing sleep quality and performance beyond the average level.