Selective rapid eye movement sleep deprivation affects cell size and number in kitten locus coeruleus

Cells in the locus coeruleus (LC) constitute the sole source of norepinephrine (NE) in the brain and change their discharge rates according to vigilance state. In addition to its well established role in vigilance, NE affects synaptic plasticity in the postnatal critical period (CP) of development. One form of CP synaptic plasticity affected by NE results from monocular occlusion, which leads to physiological and cytoarchitectural alterations in central visual areas. Selective suppression of rapid eye movement sleep (REMS) in the CP kitten enhances the central effects of monocular occlusion. The mechanisms responsible for heightened cortical plasticity following REMS deprivation (REMSD) remain undetermined. One possible mediator of an increase in plasticity is continuous NE outflow, which presumably persists during extended periods of REMSD. Tyrosine hydroxylase (TH) is the rate-limiting enzyme in the synthesis of NE and serves as a marker for NE-producing cells. We selectively suppressed REMS in kittens for 1 week during the CP. The number and size of LC cells expressing immunoreactivity to tyrosine hydroxylase (TH-ir) was assessed in age-matched REMS-deprived (RD)-, treatment–control (TXC)-, and home cage-reared (HCC) animals. Sleep amounts and slow wave activity (SWA) were also examined relative to baseline. Time spent in REMS during the study was lower in RD compared to TXC animals, and RD kittens increased SWA delta power in the latter half of the REMSD period. The estimated total number of TH-ir cells in LC was significantly lower in the RD than in the TXC kittens and numerically lower than in the HCC animals. The size of LC cells expressing TH-ir was greatest in the HCC group. HCC cells were significantly larger than TH-ir cells in the RD kittens. These data are consistent with presumed reduction in NE in forebrain areas, including visual cortex, caused by 1 week of REMSD.

Brain-derived neurotrophic factor (BDNF) reverses the effects of rapid eye movement sleep deprivation (REMSD) on developmentally regulated, long-term potentiation (LTP) in visual cortex slices

Work in this laboratory demonstrated a role for rapid eye movement sleep (REMS) in critical period (CP), postnatal days (P) 17-30, synaptic plasticity in visual cortex. Studies in adolescent rats showed that REMS deprivation (REMSD) reinitiates a developmentally regulated form of synaptic plasticity that otherwise is observed only in CP animals. Subsequent work added that REMSD affects inhibitory mechanisms that are thought to be involved in terminating the CP. Neurotrophins are implicated in the synaptic plasticity that underlies CP maturation and also final closure of the CP in visual cortex. Expression of brain-derived neurotrophic factor (BDNF) is dependent upon neuronal activity, and REMSD may block BDNF expression. We propose that REMS contributes to the maturation of visual cortex through regulation of BDNF expression and consequent, downstream increase in cortical inhibitory tone. In this study, osmotic minipumps delivered BDNF into visual cortex on one side of brain. The opposite hemisphere was not implanted and served as an internal control. We tested the hypothesis that BDNF is blocked by REMSD in late-adolescent rats and investigated whether replacing BDNF prevents induction of LTPWM-III by theta burst stimulation (TBS). We also assessed relative inhibitory tone in visual cortex with paired-pulse stimulation (PPS) in animals that were similarly REMSD- and BDNF-infused. After REMSD, both hemispheres were prepared in parallel for in vitro synaptic plasticity studies (LTPWM-III or PPS). In visual cortex of REMSD rats on the side receiving BDNF infusions (8 of 8 animals), TBS consistently failed to induce LTPWM-III. In contrast, LTPWM-III was obtained (5 of 5 animals) in the matched, non-infused hemisphere, as expected in rats of this age. REMSD animals that were unilaterally infused with saline produced LTPWM-III in both hemispheres. PPS studies in another group of REMSD animals that were unilaterally BDNF-infused displayed age-appropriate inhibition of the second response on the BDNF-infused side (5/5), whereas on the non-infused side facilitation was observed (3/3). Intracortical infusion of BDNF in REMSD adolescent rats appears to restore neurochemical processes necessary for termination of the CP for developmentally regulated synaptic plasticity in visual cortex. The results suggest that REMSD blocks BDNF expression and also maturation of inhibitory processes in adolescent visual cortex. These data support REMS' function in brain development.

Combined Insomnia and Poor CPAP Compliance

This report describes the case of Samuel, a Caucasian man in his early sixties who self-referred to a behavioral insomnia clinic at a university medical center. Samuel had recently been diagnosed with obstructive sleep apnea and had been prescribed continuous positive air pressure (CPAP) therapy for this condition. At the time he presented for treatment, he was non-compliant with his CPAP prescription and maintained that the physician who diagnosed obstructive sleep apnea was mistaken. His presenting complaint to the insomnia clinic was a 25-year history of difficulty initiating sleep, which he believed was the sole cause of his problem with daytime sleepiness. In addition to his obstructive sleep apnea, Samuel was diagnosed with obstructive sleep apnea and psychophysiological insomnia. The treatments selected were a motivational enhancement treatment for CPAP compliance and a cognitive-behavioral intervention for insomnia. Treatments were presented in a combined, sequential fashion. At treatment follow-up, Samuel reported increased CPAP compliance, decreased daytime sleepiness, and decreased insomnia severity.

Rapid eye movement sleep deprivation decreases long-term potentiation stability and affects some glutamatergic signaling proteins during hippocampal development

Development of the mammalian CNS requires formation and stabilization of neuronal circuits and synaptic connections. Sensory stimulation provided by the environment orchestrates neuronal circuit formation in the waking state. Endogenous sources of activation are also implicated in these processes. Accordingly we hypothesized that sleep, especially rapid eye movement sleep (REMS), the stage characterized by high neuronal activity that is more prominent in development than adulthood, provides endogenous stimulation, which, like sensory input, helps to stabilize and refine neuronal circuits during CNS development. Young (Y: postnatal day (PN) 16) and adolescent (A: PN44) rats were rapid eye movement sleep-deprived (REMSD) by gentle cage-shaking for only 4 h on 3 consecutive days (total 12 h). The effect of REMS deprivation in Y and A rats was tested 3-7 days after the last deprivation session (Y, PN21-25; A, PN49-53) and was compared with younger (immature, I, PN9-12) untreated, age-matched, treated and normal control groups. REMS deprivation negatively affected the stability of long-term potentiation (LTP) in Y but not A animals. LTP instability in Y-REMSD animals was similar to the instability in even the more immature, untreated animals. Utilizing immunoblots, we identified changes in molecular components of glutamatergic synapses known to participate in mechanisms of synaptic refinement and plasticity. Overall, N-methyl-d-aspartate receptor subunit 2B (NR2B), N-methyl-d-aspartate receptor subunit 2A, AMPA receptor subunit 1 (GluR1), postsynaptic density protein 95 (PSD-95), and calcium/calmodulin kinase II tended to be lower in Y REMSD animals (NR2B, GluR1 and PSD-95 were significantly lower) compared with controls, an effect not present in the A animals. Taken together, these data indicate that early-life REMS deprivation reduces stability of hippocampal neuronal circuits, possibly by hindering expression of mature glutamatergic synaptic components. The findings support a role for REMS in the maturation of hippocampal neuronal circuits.

Rapid eye movement sleep deprivation in post-critical period, adolescent rats alters the balance between inhibitory and excitatory mechanisms in visual cortex

Suppression of rapid eye movement sleep (REMS) in developing animals has both anatomical and physiological consequences. We have recently shown that initiating REMS deprivation (REMSD) prior to the end of the critical period in young rats delays termination of the critical period (CP) in visual cortex, and, consequently, the synaptic plasticity mechanisms that support a developmentally regulated form of long-term potentiation (LTP) are maintained in an immature state [J.P. Shaffery, C.M. Sinton, G. Bisset, H.P. Roffwarg, G.A. Marks, Rapid eye movement sleep deprivation modifies expression of long-term potentiation in visual cortex of immature rats, Neuroscience, 110 (2002) 431-443]. In CP animals, high-frequency, theta burst stimulation (TBS) directed at the white matter (WM) below visual cortex produces LTP in the post-synaptic cells in layer II/III (LTPWM-III). However, LTPWM-III can be induced in cortical tissue taken from REMS-deprived animals for up to a week beyond the usual end of the CP [J.P. Shaffery, C.M. Sinton, G. Bisset, H.P. Roffwarg, G.A. Marks, Rapid eye movement sleep deprivation modifies expression of long-term potentiation in visual cortex of immature rats, Neuroscience, 110 (2002) 431-443]. Further, in post-CP, adolescent animals (as late as postnatal day 60), REMSD appears to unmask synaptic plasticity mechanisms that allow for production of developmentally regulated LTPWM-III [J.P. Shaffery, J. Lopez, G. Bissette, H.P. Roffwarg, Rapid eye movement sleep deprivation revives a form of developmentally regulated synaptic plasticity in the visual cortex of post-critical period rats, Neurosci Lett., (2005), in press]. It has been proposed that REMSD's effects on production of LTPWM-III result from a reduction in efficiency of the inhibitory mechanisms thought to precipitate termination of the CP of brain development [J.P. Shaffery, J. Lopez, G. Bissette, H.P. Roffwarg, Rapid eye movement sleep deprivation revives a form of developmentally regulated synaptic plasticity in the visual cortex of post-critical period rats, Neurosci Lett., (2005), in press]. In this study we tested the hypothesis that low-frequency stimulation (LFS) of the fibers of the WM, which usually produces the related form of synaptic plasticity, long-term depression (LTD), will also reflect the reduction in inhibitory tone. We report here that LFS protocols, which in normally sleeping, adolescent rats usually produce either LTD or no change in response magnitude, in REMS-deprived, adolescent rats are more likely to produce LTP.

Rapid eye movement sleep deprivation revives a form of developmentally regulated synaptic plasticity in the visual cortex of post-critical period rats

The critical period for observing a developmentally regulated form of synaptic plasticity in the visual cortex of young rats normally ends at about postnatal day 30. This developmentally regulated form of in vitro long-term potentiation (LTP) can be reliably induced in layers II-III by aiming high frequency, theta burst stimulation (TBS) at the white matter situated directly below visual cortex (LTPWM-III). Previous work has demonstrated that suppression of sensory activation of visual cortex, achieved by rearing young rats in total darkness from birth, delays termination of the critical period for inducing LTPWM-III. Subsequent data also demonstrated that when rapid eye movement sleep (REMS) is suppressed, thereby reducing REMS cortical activation, just prior to the end of the critical period, termination of this developmental phase is delayed, and LTPWM-III can still be reliably produced in the usual post-critical period. Here, we report that for approximately 3 weeks immediately following the usual end of the critical period, suppression of REMS disrupts the maturational processes that close the critical period, and LTPWM-III is readily induced in brain slices taken from these somewhat older animals. Insofar as in vitro LTP is a model for the cellular and molecular changes that underlie developmental synaptic plasticity, these results suggest that mechanisms of synaptic plasticity, which participate in brain development and perhaps also in learning and memory processes, remain susceptible to the effects of REMS deprivation during the general period of adolescence in the rat.

Rapid eye-movement sleep deprivation does not 'rescue' developmentally regulated long-term potentiation in visual cortex of mature rats

The age at which it is possible to obtain a usually age-limited (developmental) form of long-term potentiation (LTP) in rat visual cortex slices can be extended by suppressing rapid eye movement (REM) sleep. In this study, we examined whether REM sleep deprivation can also 'rescue' this type of LTP in older rats. Rats, 42-59 days of age, were either REM sleep-deprived for 7-10 days (n=8), or not deprived of REM sleep (control group, n=8). Brain slices from visual cortex were tested for the developmental form- and a related, non-developmental form of LTP. Three of the eight REM sleep-deprived animals and four of the eight non-deprived animals met criteria for a valid attempt to induce the developmental form of LTP. Though the non-age-regulated form of LTP could be obtained in all seven of these animals, the developmental form could not be elicited in any, indicating that REM sleep deprivation does not uniformly affect all forms of LTP in adult rats. We conclude that extended periods of REM sleep deprivation do not facilitate induction of developmentally regulated LTP once the animal is beyond a certain age.

Rapid eye movement sleep deprivation modifies expression of long-term potentiation in visual cortex of immature rats

During rapid eye movement (REM) sleep, activity of non-retinal origin is propagated into central visual-system pathways in a manner similar, in pattern and intensity, to central visual-system activity that is exogenously generated in waking. It has been hypothesized that REM sleep, which is more abundantly represented early in life than later, functions to provide adjunct 'afferent' input for shaping synaptic connectivity during brain maturation. Here we present data that support this proposal. Recent studies have described a developmentally regulated form of in vitro long-term potentiation (LTP) in the visual cortex that is experience- and age-dependent. In immature rats, suppression of retinal activation of the visual system by removal of visual experience (dark rearing) extends the age when the developmentally regulated form of LTP can be produced. This study tests whether suppression of REM-state activation of the visual system also lengthens the developmental period in which this specific form of LTP can be elicited. Young rats were deprived of REM sleep by the multiple-small-platforms-over-water method during the typically latest week for induction of such LTP in slices of visual cortex. After this week, we could still induce LTP in slices from nearly all the REM-sleep-deprived rats (8/9) but not from age-matched rats that had not lost REM sleep (0/5). The control rats had been housed on large platforms that allow the animals to obtain REM sleep. Only body weights and the concentration of thyrotrophin-releasing hormone in the hypothalamus distinguished home-caged, normal-sleeping controls from both groups of platform animals. On all measures, stress levels were not dissimilar in the two platforms groups. After 7 days of behavioral suppression of REM sleep in immature rats, and consequent reduction of the intense, extra-retinal activity endogenously generated during this sleep state, we found that the period was extended in which developmentally regulated synaptic plasticity (LTP) could be elicited in slices of visual neocortex. These studies support the role of REM sleep and its associated neuronal activity in brain maturation.

The effects of 1 week of REM sleep deprivation on parvalbumin and calbindin immunoreactive neurons in central visual pathways of kittens

Many maturational processes in the brain are at high levels prenatally as well as neonatally before eye-opening, when extrinsic sensory stimulation is limited. During these periods of rapid brain development, a large percentage of time is spent in rapid eye movement (REM) sleep, a state characterized by high levels of endogenously produced brain activity. The abundance of REM sleep in early life and its ensuing decline to lower levels in adulthood strongly suggest that REM sleep constitutes an integral part of the activity-dependent processes that enable normal physiological and structural brain development. We examined the effect of REM sleep deprivation during the critical period for visual development on the development of two calcium-binding proteins that are associated with developmental synaptic plasticity and are found in the lateral geniculate nucleus (LGN) and visual cortex. In this study, REM sleep deprivation was carried out utilizing a computer-controlled, cage-shaking apparatus that successfully suppressed REM sleep. Body weight data suggested that this method of REM sleep deprivation produced less stress than the classical multiple-platform-over-water method. In REM sleep-deprived animals with normal binocular vision, the number of parvalbumin-immunoreactive (PV) neurons in LGN was found to be lower compared with control animals but was not affected in visual cortex. The pattern of calbindin-immunoreactivity (CaB) was unchanged at either site after REM sleep deprivation. Parvalbumin-immunoreactivity develops later than calbindin-immunoreactivity in the LGN, and the REM sleep deprivation that we applied from postnatal day 42-49 delayed this essential step in the development of the kitten's visual system. These data suggest that in early postnatal brain development, REM sleep facilitates the usual time course of the expression of PV-immunoreactivity in LGN neurons.

Effects of fluoxetine on the polysomnogram in outpatients with major depression

This study investigated the effects of open-label fluoxetine (20 mg/d) on the polysomnogram (PSG) in depressed outpatients (n = 58) who were treated for 5 weeks, after which dose escalation was available (< or = 40 mg/d), based on clinical judgment. Thirty-six patients completed all 10 weeks of acute phase treatment and responded (HRS-D < or = 10). PSG assessments were conducted and subjective sleep evaluations were gathered at baseline and at weeks 1, 5, and 10. Of the 36 subjects who completed the acute phase, 17 were reevaluated after 30 weeks on continuation phase treatment and 13 after approximately 7 weeks (range 6-8 weeks) following medication discontinuation. Acute phase treatment in responders was associated with significant increases in REM latency, Stage 1 sleep, and REM density, as well as significant decreases in sleep efficiency, total REM sleep, and Stage 2 sleep. Conversely, subjective measures of sleep indicated a steady improvement during acute phase treatment. After fluoxetine was discontinued, total REM sleep and sleep efficiency were found to be increased as compared to baseline.

Ponto-geniculo-occipital-wave suppression amplifies lateral geniculate nucleus cell-size changes in monocularly deprived kittens

We have previously shown that during the post-natal critical period of development of the cat visual system, 1 week of instrumental rapid eye movement (REM) sleep deprivation (IRSD) during 2 weeks of monocular deprivation (MD) results in significant amplification of the effects of solely the 2-week MD on cell-size in the binocular segment of the lateral geniculate nucleus (LGN) [36,40]. In this study, we examined whether elimination of ponto-geniculo-occipital (PGO)-wave phasic activity in the LGN during REM sleep (REMS), rather than suppression of all REMS state-related activity, would similarly yield enhanced plasticity effects on cell-size in LGN. PGO-activity was eliminated in LGN by bilateral pontomesencephalic lesions [8,32]. This method of removing phasic activation at the level of the LGN preserved sleep and wake proportions as well as the tonic activities (low voltage, fast frequency ECoG and low amplitude EMG) that characterize REM sleep. The lesions were performed in kittens on post-natal day 42, at the end of the first week of the 2-week period of MD, the same age when IRSD was started in the earlier study. LGN interlaminar cell-size disparity increased in the PGO-wave-suppressed animals as it had in behaviorally REM sleep-deprived animals. Smaller A1/A-interlaminar ratios reflect the increased disparity effect in both the REM sleep- and PGO-suppressed groups compared to animals subjected to MD-alone. With IRSD, the effect was achieved because the occluded eye-related, LGN A1-lamina cells tended to be smaller relative to their size after MD-alone, whereas after PGO-suppressing lesions, the A1-lamina cells retained their size and the non-occluded eye-related, A-lamina cells tended to be larger than after MD-alone. Despite this difference, for which several possible explanations are offered, these A1/A-interlaminar ratio data indicate that in conjunction either with suppression of the whole of the REMS state or selective removal of REM sleep phasic activity at the LGN, altered visual input evokes more LGN cell plasticity during the developmental period than it would otherwise. These data further support involvement of the REM sleep state in reducing susceptibility to plasticity changes and undesirable variability in the course of normative CNS growth and maturation.

Neuronal activity in the lateral geniculate nucleus associated with ponto-geniculo-occipital waves lacks lamina specificity

Ponto-geniculo-occipital (PGO) waves are spontaneously occurring field potentials recorded in the dorsal lateral geniculate nucleus (LGN) just prior to and during rapid eye movement (REM) sleep. Facilitated discharge rates of LGN neurons are associated with PGO waves. In kittens during the critical period of visual system development, both visual experience and PGO waves appear capable of influencing the course of development through activity-dependent mechanisms. Retinal innervation of LGN segregates into eye-specific laminae and is critical to supporting the role of binocular visual experience in development. We sought to determine whether neuronal activity associated with PGO waves also exhibits lamina specificity. PGO wave-related discharges were examined in LGN neurons identified as to lamina location in adult cats administered urethane anesthesia and the reserpine-like compound, RO4-1284. Spontaneous activity of LGN neurons was related to the occurrence of PGO-like waves in all cells studied. No factors could be found that differentiated lamina location and PGO wave-related discharges. We conclude that the PGO wave influence on neuronal activity in the visual system is fundamentally different from that derived from visual experience. The implications of this difference for the role of the two sources of activation in the control of neural activity in development are discussed.

REM sleep deprivation in monocularly occluded kittens reduces the size of cells in LGN monocular segment

STUDY OBJECTIVES

In this study, we test the hypothesis that when REM-state activation (which impinges upon all lateral geniculate nucleus laminae irrespective of stimulating eye) is deprived, the monocular segment (MS) that is cut off from visual input and also deprived of REM-state activation will exhibit smaller cells, owing to the loss of extrinsic as well as intrinsic activation.

DESIGN

We carried out a study comparing soma sizes in the MSs of kittens subjected to monocular deprivation (MD) + REM deprivation (RD) to two age-matched nonRD groups, MD ONLYs and MD MOMS (MD kittens living in their home cages).

MEASUREMENTS AND RESULTS

Perikaryal outlines of 100 cells in each of the bilateral MSs were measured. As predicted, mean cell size in the MS connected to the patched eye of MD + RD kittens, but in neither of the control groups, was significantly smaller than in the MS afferented by the nonpatched eye. One-way ANOVAs comparing MS cell-size means from the same sides across groups were also significant, but the two MSs showed different results on post hoc tests. The ordering of MS cell-size means correlated significantly with a measure that aggregates the sources of activation reaching a particular MS and their durations.

CONCLUSIONS

These results reveal that removal of REM-state activation during CNS development amplifies the plasticity processes generated when normal visual afferentation to central visual areas is interrupted. Our findings in the MS of the LGN indicate that during the usual operation of REM sleep, central visual-sensory sites receive intrinsic activation that, in the visual system, is additive and complementary to the stimulation obtained from extrinsic sources. In the course of early development, normative symmetrical activation of central visual areas during REM sleep may counterbalance plasticity changes caused either by absent or aberrant sensory stimulation.

Controlled comparison of electrophysiological sleep in families of probands with unipolar depression

OBJECTIVE

This study presents polysomnographic data and psychiatric history for parents and siblings of probands with unipolar depression and short REM latency, probands with unipolar depression and normal REM latency, and normal comparison probands.

METHOD

Parents and adult siblings (N = 252) of probands (N = 64) were evaluated for lifetime history of psychiatric disorders and were studied in the sleep laboratory for 3 nights.

RESULTS

REM latency predicted lifetime history of major depression. Short REM latency was also associated with slow wave sleep deficits. Rate of short REM latency in relatives of depressed probands with short REM latency quadrupled the rate in relatives of both depressed probands with normal REM latency and normal probands. Lifetime risk of depression was almost twice as high in relatives of depressed probands with short REM latency as in relatives of depressed probands with normal REM latency.

CONCLUSIONS

Short REM latency and slow wave sleep deficits are familial. Short REM latency is associated with increased risk of major depression beyond the familial risk associated with a depressed proband. Polysomnographic abnormalities also occurred in unaffected relatives. Although the data can be considered only suggestive, these findings indicate that polysomnographic abnormalities may precede the clinical expression of depression and may be useful in identifying those at highest risk for the illness.

Dexamethasone response, thyrotropin-releasing hormone stimulation, rapid eye movement latency, and subtypes of depression

Most prior studies of mood disorders have used a single laboratory test to assist in differential diagnosis, prediction of treatment response, and prediction of relapse. This study compared three laboratory measures in a combined in- and outpatient sample of depressed patients. Dexamethasone suppression test (DST) nonsuppression occurred in 46% of patients with endogenous major depression, in 15% with nonendogenous major depression, and in 56% with bipolar, depressed phase disorder. A blunted thyrotropin-releasing hormone stimulation test (TRH-ST) occurred in 25% of patients with endogenous, 10% with nonendogenous, and 44% with bipolar, depressed phase disorder. Reduced REM latency was found in 65% of endogenous major depressions, in 34% of nonendogenous major depressions, and in 53% of bipolar, depressed phase disorders. Fifty-one percent of those with reduced REM latency also evidenced DST nonsuppression. When the endogenous major depression and bipolar, depressed phase groups were combined, 28% had no laboratory abnormality, whereas 8% evidenced all three. These findings suggest that 1) endogenous/nonendogenous unipolar groups are distinguished by all three laboratory tests; 2) most patients with a blunted TRH-ST also evidence DST nonsuppression; and 3) one half of patients with reduced REM latency evidence DST nonsuppression. Sensitivity is greatest and specificity is lowest for REM latency, followed by the DST and then the TRH-ST.

Rapid eye movement sleep deprivation in kittens amplifies LGN cell-size disparity induced by monocular deprivation

The abundance of rapid eye movement (REM) sleep in the neonatal mammal and its subsequent decline in the course of development, as well as the dramatic and widespread enhancement of CNS activity during REM sleep, led us to propose that this state plays a functional role in the normative physiological and structural maturation of the brain [54]. When, after 1 week of monocular deprivation (MD), a second week of MD was coupled with behavioral deprivation of REM sleep, the structural alteration in the visual system provoked by MD alone (interlaminar relay cell-size disparity in the lateral geniculate nucleus (LGN) was amplified. With the addition of REM deprivation during MD, the LGN cells connected to the surgically patched eye, which are smaller than normal after MD, became even smaller, whereas the LGN cells receiving input from the seeing eye, which display compensatory hypertrophy after MD, grew even larger. We believe that the interlaminar disparity effect widened because during REM deprivation, the already vision-compromised LGN cells associated with the patched eye also lose the ascending brainstem activation reaching them during the REM state. Loss of the two main sources of 'afference' by these LGN cells permits their seeing-eye LGN counterparts to gain even greater advantage in the competition for synaptic connections in cortex, which is reflected in the relative soma sizes of the LGN relay cells. It is likely that the relatively abundant REM state in early maturation provides symmetric stimulation to all LGN relay cells, irrespective of eye of innervation. The symmetric activation propagated from brainstem to LGN acts to 'buffer' abnormal, asymmetric visual input and, thereby diminishes the extreme, asymmetric structural alteration that results from MD in the absence of REM sleep. We conclude that REM sleep-generated CNS discharge in development has the effect of 'protecting' the CNS against excessive plasticity changes. This is consistent with the possibility that REM sleep plays a role in the genetically programmed processes that direct normative brain development.

Depression spectrum disease with and without depression in first-degree relatives

Family history was assessed in 211 outpatients with unipolar major depression and diagnoses were rendered according to Winokur et al. (Winokur et al. (1978) J. Nerv. Ment. Dis. 166, 764-768) family history typology. The subclassification of Depression Spectrum Disease with Alcoholism and Depression (DSDA + D) was applied to those patients reporting at least one first-degree relative suffering from alcoholism and another first-degree relative suffering from depression (n = 103), while Depression Spectrum Disease with Alcoholism (DSDA) was applied to those patients with at least one first-degree relative suffering from alcoholism, but none suffering from depression (n = 108). These two groups were compared on demographic, clinical and biological characteristics. They were also compared with 162 patients who reported the presence of depression and absence of alcoholism in first-degree relatives, designated as Familial Pure Depressive Disease (FPDD) by the Winokur et al. (1978) classification. Results revealed that the DSDA + D group was younger, had an earlier age at onset of depression and experienced more episodes of depression than did the DSDA group. No differences were found between the two groups on biological measures. The FPDD group was more similar to the DSDA + D group than the DSDA group in terms of age at onset and number of depressives episodes. However, the FPDD group had a longer length of illness than either of the DSD groups. These data suggest that the DSD group should be more narrowly defined (excluding those with a positive family history of depression) in future clinical research studies.

A functional role for REM sleep in brain maturation

The biological function of REM sleep is defined in terms of the functions of neural processes that selectively operate during the REM sleep state. The high amounts of REM sleep expressed by the young during a period of central nervous system plasticity suggest that one function of REM sleep is in development. The phenomenon of activity-dependent development has been clearly shown to be one mechanism by which early sensory experience can affect the course of neural development. Activity-dependent development may be a ubiquitous process in brain maturation by which activity in one brain region can influence the developmental course of other regions. We hypothesize an ontogenetic function of REM sleep; namely, the widespread control of neuronal activity exerted by specific REM sleep processes help to direct brain maturation through activity-dependent developmental mechanisms. Preliminary tests of the hypothesis have been conducted in the developing feline visual system, which has long been known to incorporate information derived from visual experience in establishing neuronal connectivity. We find that suppression of REM sleep processes by an instrumental REM deprivation procedure results in a significant enhancement of the effects of altered visual experience by monocular occlusion. Bilateral brainstem lesions that selectively block the occurrence of ponto-geniculo-occipital (PGO) waves are sufficient to produce similar results. These data indicate that the propagation of phasic influences during REM sleep interacts with other processes subserving neural development. This source of influence appears not to derive from the environment but rather stems from an intrinsic source of genetic origin. Examination of the neural activity associated with PGO waves in the lateral geniculate nucleus reveals a distribution of facilitatory influence markedly different from that induced by visual experience. We conclude that REM sleep directs the course of brain maturation in early life through the control of neural activity.

Sleep EEG features of adolescents with major depression

A substantial body of research in adults has established that certain sleep polysomnographic abnormalities are commonly found in depressed patients, including sleep continuity disturbances, reduced slow-wave sleep, shortened rapid eye movement (REM) latency and increased REM density. To date the findings in depressed adolescents are equivocal. Three consecutive nights of polysomnographic recordings were obtained in 31 hospitalized depressed adolescents and 17 age-matched normal controls. The depressed adolescents had a shorter REM latency, shorter sleep latency, more REM sleep, and less stage 3 nonREM (NREM) sleep. There was a trend for melancholic and suicidal patients to have a shorter REM latency.

Latency to rapid eye movement sleep as a predictor of treatment response to fluoxetine and placebo in nonpsychotic depressed outpatients

Fluoxetine and placebo were compared in 89 outpatients with major depression with (n = 45) or without (n = 44) a reduced or shortened rapid eye movement latency (SREML) (< or = 65 minutes) to determine whether rapid eye movement latency (REML) predicted placebo and/or antidepressant response. Men and women were stratified based on polysomnographic recordings and then randomly assigned to receive double-blind fluoxetine (20 mg/day) or placebo for 8 weeks after a 2-week, single-blind, placebo lead-in period. Fluoxetine-treated patients demonstrated a significantly greater reduction in the Hamilton Rating Scale for Depression total score and a significantly greater response rate than placebo-treated patients in both the SREML and the combined strata. Treatment differences in the non-SREML stratum were not statistically significant. Results supported REML as a predictor of placebo nonresponse but did not predict a differential fluoxetine response in patients with SREML compared with patients without SREML.

The effects of nefazodone on sleep architecture in depression

A polysomnographic study was conducted on 10 outpatients with major depression at baseline and during 4 to 8 weeks of open-trial treatment with nefazodone (400 to 600 mg/day). All 10 patients were treatment responders as evidenced by at least 50% reduction from baseline scores on the Hamilton Depression Rating Scale. Nefazodone was associated with significantly decreased wake and movement time and increased minutes and percentage of stage 2 sleep at the expense of light stage 1 sleep. Nefazodone did not increase rapid-eye-movement (REM) latency and it did not suppress REM sleep. In fact, a trend toward increased REM in the second REM period was observed, although decreased REM in the third REM period was also noted. In summary, nefazodone, an effective antidepressant, decreases arousals and wakefulness during sleep and reduces light non-REM sleep. This agent does not appear to suppress REM sleep or prolong REM latency in patients who respond to treatment.

The effects of fluoxetine on the polysomnogram of depressed outpatients: a pilot study

The effects of fluoxetine (FLU) and its active metabolite, norfluoxetine (NFLU), on the polysomnogram (PSG) of nine depressed outpatients (eight with major depression; one with bipolar II, depressed phase disorder) were investigated by contrasting PSG values prior to treatment and during administration of FLU. The PSG changes were correlated with daily dose, cumulative dosage, single serum concentrations, and the total area under the serum concentration curve (AUC) of both FLU and NFLU. Fluoxetine clearly increased both stage 1 sleep time and rapid-eye-movement (REM) latency and decreased both percent REM and REM density. With a few exceptions, the cumulative dosage of FLU and the AUC of FLU and NFLU were better predictors of the changes in awake and movement time in the PSG than single-sample concentrations of FLU and NFLU taken at the time of PSG assessment.

Spontaneous activity in the thalamic reticular nucleus during the sleep/wake cycle of the freely-moving rat

Neurons of the somatosensory thalamic reticular nucleus (TRN) were studied by extracellular recordings through the sleep/wake cycle in the unanesthetized, freely-moving rat. All electrophysiologically-identified TRN neurons expressed rhythmic patterns of discharge that altered with shifts in sleep/wake state. During slow wave (SW) sleep, neurons displayed spike-burst discharges in long trains followed by pauses. high-frequency oscillations in auto-correlograms in the spindle-frequency range (approximately 10 Hz) reflected the rhythm of interburst intervals within the trains whereas low-frequency oscillations (0.3-0.2 Hz) displayed the rhythm of intertrain intervals. During rapid eye movement (REM) sleep, a more continuous pattern of spike-burst discharges was prominent, resulting in absence of a detectable, low-frequency rhythm but persistence of spindle-frequency firing. At the transitions between SW and REM sleep, cell discharge was more tonic than during either sleep state and lacked a dominant rhythm. During the wake (AW) state, neurons fired in a single-spike mode that also lacked rhythmicity. Unlike their pattern of discharge, TRN neurons' mean rate of discharge did not distinguish sleep/wake state. The mean discharge rates were: SW, 18.4 +/- 1.3; REM, 17.4 +/- 1.2; AW, 22.3 +/- 2.1 (Hz +/- S.E.M.). Mean discharge rate during transitions from SW to REM sleep (28.6 +/- 2.1) was significantly higher, however, than during any sleep/wake state. Compelling evidence was lacking for segregation of TRN neurons into discrete populations according to absolute discharge rate. Neurons recorded simultaneously from the same electrode discharged synchronous trains of spike-bursts and pauses during SW sleep. This phenomenon may be related to generation of EEG slow waves.(ABSTRACT TRUNCATED AT 250 WORDS)

Cholinergic responsiveness of neurons in the ventroposterior thalamus of the anesthetized rat

Acetylcholine has been implicated as an important neurotransmitter in the mechanisms of thalamic activation. Cholinergic mechanisms are thought to directly underlie the high level of excitability observed in thalamic relay neurons during waking and rapid eye movement sleep. We sought to determine if the cholinergic responsiveness of neurons in the ventroposterior nuclei of the thalamus in rat is consistent with this view. Neurons in the chloral hydrate-anesthetized rat were studied with extracellular recording and microiontophoretic application of cholinergic agents. In most cases (63% of 63 cells), the ejection of the agonist, carbachol, had no observable effect on spontaneous activity. Facilitation (25%), inhibition (8%) and inhibition followed by facilitation (3%) were also observed. Carbachol ejections that by themselves were ineffective in altering spontaneous activity proved capable, in 93% of 28 cells, of antagonizing the uniformly facilitatory responses produced by glutamate ejection. The putative M1-selective, cholinergic agonist, McN-A-343, was also ineffective alone in altering spontaneous activity in the majority of cases (74% of 27 cells) and produced only inhibitory responses in the remaining seven neurons studied. Interacting applications of McN-A-343 and glutamate resulted, in all cases, in antagonism of glutamate facilitation (N = 12). The various responses to applied cholinergic agonists were all capable of being antagonized by muscarinic receptor-blocking agents. Both the high proportion of inhibitory responses and the antagonism of glutamate facilitatory responses suggest that ventroposterior neurons in the rat differ from other thalamocortical relay neurons in the rat and cat with regard to cholinergic responsiveness. Additionally, the lack of predominantly facilitatory responding renders it unlikely that cholinergic mechanisms directly underlie increases in excitability of ventroposterior neurons observed during waking and rapid eye movement sleep.

Digital period analysis of EEG in depression: periodicity, coherence, and interhemispheric relationships during sleep

1. Interhemispheric EEG differences were compared between 12 symptomatic depressed outpatients, 12 asymptomatic patients and 12 normal controls during two consecutive nights in the Sleep Study Unit. 2. EEG was quantified using digital period analysis (DPA), a time-domain analysis of successive polarity changes (zero-cross) and instances of zero slope (first derivative), yielding percent-time in each frequency band. 3. The degree of hemispheric asymmetry (L-R) was computed for delta, beta and theta percentages from REM, Stage 2 and Slow-Wave (SW) sleep. 4. Normals showed small asymmetries throughout sleep with largest differences in SW, with no consistent relationship between right and left activity and sleep stage. 5. Both depressed groups showed largest asymmetries in REM sleep, with significantly more beta, theta and delta in the right hemisphere consistently. None of the 24 depressed patients showed greater left hemisphere activity throughout sleep.

Prospective assessment of electroencephalographic sleep in remitted major depression

We studied 29 patients with major depression before treatment and then followed these patients prospectively with monthly electroencephalographic (EEG) sleep assessments after successful treatment. Most EEG sleep measures demonstrated no change from the episode throughout a prolonged period of clinical remission. When there was evidence of a change in EEG sleep measures, the effect was modest and due to only a small subset of patients. These findings contribute to the accumulating evidence that selected EEG sleep measures appear to be trait-like and may be useful in identifying individuals at risk for major depression.

Distribution of period-analyzed delta activity during sleep

The distribution of delta EEG activity was evaluated during sleep in eight healthy adults. Digital period analysis, including an amplitude measurement, was used to quantify delta activity. The average percentages of delta half- and full-wave zero-crosses, mean delta power, and mean total power were computed for each nonrapid eye movement (NREM) period. The distribution of these delta measures was examined across NREM periods (NREMPs). No significant linear trends were evident in the zero-cross or power measures. Four subjects showed the highest delta power and greatest incidence of delta in the second rather than first NREMP. Regression analyses of individual delta incidence data revealed that only 62.5% of recording nights could be described with an exponential equation. Exponential regressions described 81% of delta amplitude cases. Further, delta activity in some subjects could be described by either linear or exponential regression. The findings suggest that the temporal changes of delta activity may not be entirely systematic across NREMPs and are variable across subjects.

Digital period analysis of sleep EEG in depression

The period-analyzed sleep electroencephalogram (EEG) was compared in a group of 9 depressed outpatients and 9 age-matched normal controls. Both groups showed rhythms in beta, delta, and theta activity with an approximately 90-min period. The phase and coherence between fast and slow frequency EEG measures, however, differed significantly in the two groups. Beta and delta rhythms were less coherent in the depressed outpatient sample. The control group showed higher coherence and a strong coupling of beta and delta activity. These preliminary data suggest that depression may be associated with some degree of ultradian rhythm disturbances though periodicity is unaffected.

Comparison of the delta EEG in the first and second non-REM periods in depressed adults and normal controls

The distribution of period-analyzed delta activity in the first and second non-rapid eye movement (NREM) periods was compared in nine symptomatic depressed outpatients and nine normal controls. The groups did not differ in ratios of delta zero-cross or delta power in the first to the second NREM periods. Further, neither group showed a systematic change in delta count or delta power across the first two NREM periods. Our findings suggest that ratios of delta activity in the first two NREM periods may not systematically differentiate depressed adults from normal subjects.

Electroencephalographic sleep abnormalities in depressed children: a hypothesis

Although most studies on sleep in child and adolescent depression have indicated that sleep is relatively unaffected, abnormalities have been found. We hypothesized that discrepancies occur because family history of depression and sleep abnormalities in a parent have not been taken into account. In a group of parents and offspring with a family history of depression, 57% of parents had evidence of abnormal sleep. Sleep continuity and sleep architecture were correlated, and the magnitude of these correlations increased between parents with abnormal sleep and their offspring. Abnormal sleep may be expressed at a younger age when there is familial evidence for depression and abnormal sleep in a parent.

Cholinergic modulation of responses to glutamate in the thalamic reticular nucleus of the anesthetized rat

Neurons in the thalamic reticular nucleus (TRN) of the chloral hydrate-anesthetized rat were studied with extracellular recording and microiontophoretic application of cholinergic agents. In most cases (63%), the ejection of the agonist, carbachol, had no observable effect on spontaneous activity, and in an additional 33% of cases was observed to inhibit discharge rate. Carbachol ejections with identical current and duration parameters proved capable of antagonizing the uniformly facilitatory responses produced by glutamate ejection in these same cells. The muscarinic nature of cholinergic effects was documented by scopolamine's specific antagonism of the responses. The muscarinic antagonists, pirenzepine and AF-DX-116, both diminished the effects of carbachol. Application of muscarinic agonists, such as McN-A-343 and oxotremorine-M, yielded qualitatively the same results as carbachol, though, with current as a criterion, oxotremorine-M was slightly more and McN-A-343 much less potent than carbachol. The functional implications of cholinergic modulation of the facilitatory inputs to TRN are discussed, with particular emphasis on the role of acetylcholine and the TRN in the sleep/wake-related activity of thalamic neurons.

A sensitive air pressure-measuring transducer for indirect middle ear muscle recording in humans

In the past, the recording of middle ear muscle activity (MEMA) during sleep was accomplished with the use of the acoustic impedance bridge (AIB). However, two major concerns with this technique are: 1. augmentation of MEMA (and possible impairment of the auditory apparatus), as a consequence of the 85-95 dB probe tone, which is necessary for acoustic tympanometry; 2. the AIB recording method is susceptible to snoring artifact so that determination of true MEMA events is difficult. By utilizing a highly sensitive air-pressure measuring transducer (AMPT), we were able to record MEMA accurately without artifactual stimulation of this endogenously occurring REM sleep phasic activity. Possible damage to inner ear structures is precluded because no sound input is required with the AMPT.

A cross-sectional study of the effects of depression on REM latency

In a cross-sectional design to address the effects of the course of depression on rapid-eye-movement (REM) latency, we have matched patients in their first-episode with (1) age-matched patients with recurrent depression, (2) onset-matched patients with recurrent depression, and (3) age-matched normal control subjects. Patients were also matched for sex and treatment site (inpatient or outpatient). No differences were found in REM latency for the three depressed groups, and all had lower REM latency than normals. This finding is taken as support for stable REM latency throughout the course of depression.

Does the pretreatment polysomnogram predict response to cognitive therapy in depressed outpatients? A preliminary report

Although several studies reveal that cognitive therapy effectively remediates depressive symptoms in many unipolar nonpsychotic depressed outpatients, the question as to which depressions respond to cognitive therapy remains unanswered. We hypothesized that patients with reduced rapid eye movement (REM) latency (less than or equal to 65.0 min) before treatment would be less likely than those with nonreduced REM latency (greater than 65.0 min) to respond to cognitive therapy. The rationale for this prediction was that endogenous depressions are more likely to exhibit this abnormality and also tend to respond to tricyclic antidepressant medication. Thus, we queried whether these depressions might also respond less to a psychosocial intervention. To date, 39 outpatients with nonpsychotic, unipolar major depression (by the Schedule for Affective Disorders and Schizophrenia-Lifetime Version and Research Diagnostic Criteria) who score at least 14 on the 17-item Hamilton Rating Scale for Depression have completed this project, which is still in process. Preliminary findings do not suggest a systematic relationship between pretreatment REM latency and response to cognitive therapy. Further, these results suggest that at least some patients with biological dysregulation, as indicated by reduced REM latency, show a favorable response to an acute trial of cognitive therapy. Study limitations include a small sample of patients who exhibit extremely reduced REM latencies (less than or equal to 51.0 min) and a small number of endogenous depressions. Data collection continues.

Age-adjusted threshold values for reduced REM latency in unipolar depression using ROC analysis

To determine an age-adjusted, clinically meaningful depressive diathesis, we have implemented Receiver Operator Characteristic (ROC) analysis for mean rapid eye movement (REM) latency in patients with unipolar depression. Depressed patients were compared with age-matched normal control subjects. Sensitivity and specificity estimates were calculated for selected threshold values on the ROC curves as well as for the Research Diagnostic Criteria endogenous/nonendogenous subtype. The mean REM latency value of 65.0-66.0 min was most sensitive and specific for depressed patients aged 35-72. The threshold value of 70.0 min appeared optimally sensitive and specific for depressed patients aged 20-34. There was no effect of age on REM latency in the normal control sample. Among depressed patients there was an effect of age but this was clearly observable only in nonendogenous depressed patients.

Children with major depression show reduced rapid eye movement latencies

A substantial body of research in adults has established that certain sleep polysomnographic abnormalities are commonly found in depressed patients, including sleep continuity disturbances, reduced slow-wave sleep, shortened rapid eye movement (REM) latency, and increased REM density. To date, these abnormalities have not been documented in depressed children compared with age-matched controls. Three consecutive nights of polysomnographic recordings were obtained in 25 hospitalized depressed children and 20 age-matched healthy controls. The depressed patients had reduced REM latencies. The shortest single-night REM latency of each individual was the most sensitive discriminating value between depressed subjects and controls. The influence of different scoring criteria in distinguishing depressed children from healthy children is discussed. In addition, depressed children had an increased sleep latency and increased REM time but did not have stage 4 differences.

The cholinergic influence upon rat dorsal lateral geniculate nucleus is dependent on state of arousal

Several lines of evidence suggest a role for acetylcholine (ACh) in mediating the effects of state of arousal on transfer of visual information through the lateral geniculate nucleus (LGN). Local application of cholinergic agonists to geniculate relay cells in anesthetized cats and rats produces predominantly facilitatory effects. This indicates that presynaptic release of ACh may be responsible for the increased excitability of LGN relay cells that is observed during waking and REM sleep. In this study in rats we have examined the influence of cholinergic agonists applied during the 3 natural states of arousal: waking, slow-wave (SW) sleep and rapid eye movement (REM) sleep. Pharmacological agents were iontophoretically administered to identified, single cells in head-restrained, unanesthetized rats free to sleep and wake. Application of cholinergic agonist produced state-dependent differences in response in all geniculate relay-cells studied. During both waking and REM sleep, a facilitatory response was always observed, whereas in SW sleep responses were of three types: no effect (62%), inhibition (24%), and biphasic inhibition followed by facilitation (14%). All response types were antagonized by scopolamine. In contrast to the qualitatively different state-dependent effects of cholinergic agonists, response to application of glutamate, with quantitative variations, was uniformly facilitatory in all states, though responses in SW sleep tended to be lower in magnitude. The effects of gamma-aminobutyric acid (GABA), glycine, and serotonin were inhibitory in all states. These data are consistent with the suggested role of ACh in mediation of increased relay-cell excitability during REM sleep and waking. Our findings, however, also indicate that in the transition from SW sleep to REM or waking, local release of ACh is not solely responsible for alterations in cell excitability.

Reduced REM latency predicts response to tricyclic medication in depressed outpatients

Forty-two outpatients with major depressive disorder entered a double-blind, randomized trial of either desipramine or amitriptyline for a minimum of 6 weeks. Pretreatment polysomnographic and clinical measures were used to predict response. Response was defined as a 17-item Hamilton Rating Scale for Depression score less than or equal to 9 at the end of treatment. There was a 61.1% response rate for patients treated with amitriptyline and a 66.7% response rate for patients treated with desipramine. Reduced REM latency (2-night mean less than or equal to 65.0 min) predicted a positive response to these tricyclic antidepressants. REM latency did not differentiate between desipramine or amitriptyline responders. More patients with reduced REM latency (80%) responded to treatment compared with patients with nonreduced REM latency (50%). The 80% response rate in reduced REM latency depressed patients confirms our previous findings in a mixed inpatient and outpatient sample. Contrary to our hypothesis, in this sample, endogenous depression was not associated with a good response to tricyclic medication.

Polysomnographic parameters in first-degree relatives of unipolar probands

We present polysomnographic data for psychiatrically asymptomatic first-degree relatives of unipolar depressed probands. Relatives were classified by proband rapid eye movement (REM) latency (reduced/nonreduced) and by personal REM latency (reduced/nonreduced). Reduced REM latency relatives, whether defined by the proband or by their own REM latency, had polysomnographic alterations consistent with those found in depressed patients, although none of these relatives was depressed at assessment. Reduced REM latency relatives with a history of unipolar depression were compared to reduced REM latency relatives with no history of depression. Virtually no polysomnographic differences were found. Polysomnographic alterations may be stable antecedents of the onset of depression.

Sleep state-specific neuronal activity in rat dorsal lateral geniculate nucleus is not altered by local serotonin and norepinephrine depletion

The relay cells in dorsal lateral geniculate nucleus (dLGN) represent one among many populations of neurons throughout the neuraxis that display systematic alteration of spontaneous rate and pattern of discharge concurrent with change in state of arousal. Both noradrenergic (NE) and serotonergic (5-HT) systems innervate dLGN and are implicated in sleep-wake control mechanisms. Our study was designed to test the influence of these systems upon sleep state-related multiple unit activity in the dLGN. Two monoamine neurotoxins, 5,7-dihydroxytryptamine and 6-hydroxydopamine, were injected locally into dLGN to destroy NE and 5HT afferents individually and in combination. In three separate treatment groups, mean monoamine concentrations in dLGN were reduced in relation to the contralateral, vehicle-injected, control dLGN to: 1) NE-17%, 5HT-14%; 2) NE-46%, 5HT-28%, and 3) NE-6%, 5HT-77%. In no case was chronic sleep state-related cell activity in dLGN significantly altered. We conclude that afferent monoaminergic inputs are not critically related to the mechanisms underlying normative shifts in sleep state-related neuronal activity in dLGN.

Secular trend in unipolar depression: a hypothesis

To address the observation of a secular trend in the incidence of major depression, we have evaluated prevalence of unipolar depression in first-degree relatives of unipolar depressed probands, all of whom were studied in the sleep laboratory. A threshold value of reduced (less than or equal to 65.0 min) or non-reduced (greater than 65.0 min) REM latency was used to define groups for both parents and siblings. Unipolar depression occurred at the same rate in both reduced REM latency siblings (57.1%) and parents (66.7%). Siblings with non-reduced REM latency had a higher rate of depression (36.8%) than non-reduced REM latency parents (0.0%). Implications for biological and environmental factors associated with liability for unipolar depression are discussed.

PGO waves and insomnia in PCPA-treated rats

The serotonin-depleting drug, parachlorophenylalanine (PCPA), in a dosage of 300 mg/kg, was administered to rats in an effort to test the hypothesis that altered distribution of PGO waves following drug treatment may be responsible for the sleep disruption and consequent sleep loss that accompany decreased serotonin levels. Consistent with the hypothesis, we found that the greater the proportion of PGO waves that precede spontaneous arousals, the greater the reduction in slow wave sleep. However, inconsistent with the hypothesis, we found that the decrease in sleep did not result from an increase in the number of arousals. Further, though an increase in the proportion of waking waves always accompanied a rise in wake time, the two variables were negatively correlated. These data do not support a PGO wave/arousal hypothesis to account for the decrease in sleep following PCPA treatment in the rat. Rather, the findings tend to implicate an alteration in the mechanisms of arousal linked to serotonin depletion.

Risk factors in families of unipolar depression. I. Psychiatric illness and reduced REM latency

In this report, we present data documenting the incidence of reduced REM latency and the lifetime prevalence of psychiatric illness in the parents and siblings of early onset unipolar depressed probands. The prevalence of psychiatric illness (49.3%), especially affective disorders (34.3%), was very high among these relatives. Reduced REM latency in the family members of reduced REM latency probands showed a concordance rate of 70.6% regardless of psychiatric history. The relative risk for unipolar depression among relatives with reduced REM latency was almost three times greater than for relatives with nonreduced REM latency.