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Top-down control of arousal and sleep: Fundamentals and clinical implications
- Source :
- Sleep Medicine Reviews. 31:17-24
- Publication Year :
- 2017
- Publisher :
- Elsevier BV, 2017.
-
Abstract
- Mammalian sleep emerges from attenuated activity in the ascending reticular arousal system (ARAS), the main arousal network of the brain. This system originates in the brainstem and activates the thalamus and cortex during wakefulness via a well-characterized 'bottom-up' pathway. Recent studies propose that a less investigated cortico-thalamic 'top-down' pathway also regulates sleep. The present work integrates the current evidence on sleep regulation with a focus on the 'top-down' pathway and explores the potential to translate this information into clinically relevant interventions. Specifically, we elaborate the concept that arousal and sleep continuity in humans can be modulated by non-invasive brain stimulation (NIBS) techniques that increase or decrease cortical excitability. Based on preclinical studies, the modulatory effects of the stimulation are thought to extend to subcortical arousal networks. Further exploration of the 'top-down' regulation of sleep and its modulation through non-invasive brain stimulation techniques may contribute to the development of novel treatments for clinical conditions of disrupted arousal and sleep, which are among the major health problems worldwide.
- Subjects :
- 0301 basic medicine
Pulmonary and Respiratory Medicine
medicine.medical_treatment
Thalamus
Electroencephalography
Transcranial Direct Current Stimulation
Arousal
03 medical and health sciences
0302 clinical medicine
Physiology (medical)
medicine
Animals
Humans
Neuroscience of sleep
Cerebral Cortex
Transcranial direct-current stimulation
medicine.diagnostic_test
Brain
Sleep in non-human animals
030104 developmental biology
Neurology
Brain stimulation
Wakefulness
Neurology (clinical)
Sleep
Psychology
Neuroscience
030217 neurology & neurosurgery
Subjects
Details
- ISSN :
- 10870792
- Volume :
- 31
- Database :
- OpenAIRE
- Journal :
- Sleep Medicine Reviews
- Accession number :
- edsair.doi.dedup.....cd882ae8272058bc2ad99ac985a00289