1. Differential effects of bifrontal tDCS on arousal and sleep duration in insomnia patients and healthy controls
- Author
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Hannah Piosczyk, Michael A. Nitsche, Sulamith Tsodor, Annette Sterr, Marion Kuhn, Christoph Nissen, Stefan Klöppel, Dieter Riemann, Friederike Jahn, Bernd Feige, Jonathan G. Maier, Kai Spiegelhalder, Peter Selhausen, Lukas Frase, L B Krone, Florian Mainberger, and Chiara Baglioni
- Subjects
Adult ,Male ,medicine.medical_specialty ,Hyperarousal ,medicine.medical_treatment ,Biophysics ,Electroencephalography ,Audiology ,Transcranial Direct Current Stimulation ,Non-rapid eye movement sleep ,050105 experimental psychology ,lcsh:RC321-571 ,Arousal ,03 medical and health sciences ,0302 clinical medicine ,Sleep Initiation and Maintenance Disorders ,medicine ,Insomnia ,Humans ,0501 psychology and cognitive sciences ,Non-invasive ,EEG ,Wakefulness ,610 Medicine & health ,lcsh:Neurosciences. Biological psychiatry. Neuropsychiatry ,medicine.diagnostic_test ,Transcranial direct-current stimulation ,business.industry ,General Neuroscience ,05 social sciences ,Electrosleep ,Middle Aged ,Brain stimulation ,Case-Control Studies ,Female ,Neurology (clinical) ,Sleep onset ,medicine.symptom ,Sleep ,business ,030217 neurology & neurosurgery - Abstract
Background:Arousal and sleep represent basic domains of behavior, and alterations are of high clinical importance. Objective/hypothesis:The aim of this study was to further elucidate the neurobiology of insomnia disorder (ID) and the potential for new treatment developments, based on the modulation of cortical activity through the non-invasivebrain stimulationtechnique transcranial direct current stimulation (tDCS). Specifically, we tested the hypotheses that bi-frontal anodal tDCS shortens and cathodal tDCS prolongs total sleep time in patients with ID, compared to sham stimulation. Furthermore, we tested for differences in indices of arousal between ID patients and healthy controls and explored their potential impact on tDCS effects. Methods:Nineteen ID patients underwent a within-subject repeated-measures sleep laboratory study with adaptation, baseline and three experimental nights. Bifrontal anodal, cathodal and sham tDCS was delivered in a counterbalanced order immediately prior to sleep. WakeEEGwas recorded prior to and after tDCS as well as on the following morning. Subsequently, we compared patients with ID to a healthy control group from an earlier dataset. Results:Against our hypothesis, we did not observe any tDCS effects on sleep continuity or sleep architecture in patients with ID. Further analyses of nights without stimulation demonstrated significantly increased levels of arousal in ID patients compared to healthy controls, as indexed by subjective reports, reduced total sleep time, increased wake after sleep onset and increased high frequency EEG power during wakefulness andNREM sleep. Of note, indices of increased arousal predicted the lack of effect of tDCS in ID patients. Conclusions:Our study characterizes for the first time differential effects of tDCS on sleep in patients with ID and healthy controls, presumably related to persistent hyperarousal in ID. These findings suggest that adapted tDCS protocols need to be developed to modulate arousal and sleep dependent on baseline arousal levels.
- Published
- 2019