Sleep-wake disturbances in sporadic Creutzfeldt-Jakob disease

BACKGROUND: The prevalence and characteristics of sleep-wake disturbances in sporadic Creutzfeldt-Jakob disease (sCJD) are poorly understood. METHODS: Seven consecutive patients with definite sCJD underwent a systematic assessment of sleep-wake disturbances, including clinical history, video-polysomnography, and actigraphy. Extent and distribution of neurodegeneration was estimated by brain autopsy in six patients. Western blot analyses enabling classification and quantification of the protease-resistant isoform of the prion protein, PrPSc, in thalamus and occipital cortex was available in four patients. RESULTS: Sleep-wake symptoms were observed in all patients, and were prominent in four of them. All patients had severe sleep EEG abnormalities with loss of sleep spindles, very low sleep efficiency, and virtual absence of REM sleep. The correlation between different methods to assess sleep-wake functions (history, polysomnography, actigraphy, videography) was generally poor. Brain autopsy revealed prominent changes in cortical areas, but only mild changes in the thalamus. No mutation of the PRNP gene was found. CONCLUSIONS: This study demonstrates in sporadic Creutzfeldt-Jakob disease, first, the existence of sleep-wake disturbances similar to those reported in fatal familial insomnia in the absence of prominent and isolated thalamic neuronal loss, and second, the need of a multimodal approach for the unambiguous assessment of sleep-wake functions in these patients.

Sleep-wake habits and disorders in a series of 100 adult epilepsy patients--a prospective study

The aim of the study was to assess sleep-wake habits and disorders and excessive daytime sleepiness (EDS) in an unselected outpatient epilepsy population. Sleep-wake habits and presence of sleep disorders were assessed by means of a clinical interview and a standard questionnaire in 100 consecutive patients with epilepsy and 90 controls. The questionnaire includes three validated instruments: the Epworth Sleepiness Scale (ESS) for EDS, SA-SDQ for sleep apnea (SA), and the Ullanlinna Narcolepsy Scale (UNS) for narcolepsy. Sleep complaints were reported by 30% of epilepsy patients compared to 10% of controls (p=0.001). The average total sleep time was similar in both groups. Insufficient sleep times were suspected in 24% of patients and 33% of controls. Sleep maintenance insomnia was more frequent in epilepsy patients (52% vs. 38%, p=0.06), whereas nightmares (6% vs. 16%, p=0.04) and bruxism (10% vs. 19%, p=0.07) were more frequent in controls. Sleep onset insomnia (34% vs. 28%), EDS (ESS >or=10, 19% vs. 14%), SA (9% vs. 3%), restless legs symptoms (RL-symptoms, 18% vs. 12%) and most parasomnias were similarly frequent in both groups. In a stepwise logistic regression model loud snoring and RL-symptoms were found to be the only independent predictors of EDS in epilepsy patients. In conclusion, sleep-wake habits and the frequency of most sleep disorders are similar in non-selected epilepsy patients as compared to controls. In epilepsy patients, EDS was predicted by a history of loud snoring and RL-symptoms but not by SA or epilepsy-related variables (including type of epilepsy, frequency of seizures, and number of antiepileptic drugs).

Proton entry into the near-lunar plasma wake for magnetic field aligned flow

We report the first observation of protons in the near-lunar (100-200 km from the surface) and deeper (near anti-subsolar point) plasma wake when the interplanetary magnetic field (IMF) and solar wind velocity (vsw) are parallel (aligned flow; angle between IMF and vsw≤10°). More than 98% of the observations during aligned flow condition showed the presence of protons in the wake. These observations are obtained by the Solar Wind Monitor sensor of the Sub-keV Atom Reflecting Analyser experiment on Chandrayaan-1. The observation cannot be explained by the conventional fluid models for aligned flow. Back tracing of the observed protons suggests that their source is the solar wind. The larger gyroradii of the wake protons compared to that of solar wind suggest that they were part of the tail of the solar wind velocity distribution function. Such protons could enter the wake due to their large gyroradii even when the flow is aligned to IMF. However, the wake boundary electric field may also play a role in the entry of the protons into the wake.

Low-Income Developing Countries and WTO Litigation: Why Wake Up the Sleeping Dog?

The World Trade Organization (WTO) is one of the most judicialized dispute settlement systems in international politics. While a general appreciation has developed that the system has worked quite well, research has not paid sufficient attention to the weakest actors in the system. This paper addresses the puzzle of missing cases of least-developed countries initiating WTO disputes settlement procedures. It challenges the existing literature on developing countries in WTO dispute settlement which predominantly focuses on legal capacity and economic interests. The paper provides an argument that the small universe of ‘actionable cases’, the option of free riding and the assessment of the perceived opportunity costs related to other foreign policy priorities better explain the absence of cases. In addition (and somewhat counterintuitively), we argue that the absence of cases is not necessarily bad news and shows how the weakest actors can use the dispute settlement system in a ‘lighter version’ or in indirect ways. The argument is empirically assessed by conducting a case study on four West African cotton-producing countries (C4) and their involvement in dispute settlement.

Wake up. Back to Bed – Zugang zum nächtlichen Training?

Einleitung Ein Klartraum ist definiert als ein Traum, in dem der Träumende weiß, dass er träumt. In der Fachliteratur finden sich verschiedene Induktionstechniken, um die Klartraum-häufigkeit zu steigern (z.B. Stumbrys, Erlacher, Schädlich & Schredl, 2012). Zudem wurde in einer Pilotstudie gezeigt, dass ein Training im Klartraum zu Verbesserungen in einer Zielwurfaufgabe am nächsten Morgen führt (Erlacher & Schredl, 2010). Um ein regelmäßiges Training im Traum zu ermöglichen, besteht für die Sportpraxis das Problem, Klarträume gezielt zu induzieren. In dieser Studie wurde im Schlaflabor die so genannte Memnotische Induktion von luziden Träumen (MILT) – eine Autosugges-tionstechnik in der die Intention, einen Klartraum zu erleben, an Traumhinweise ge-koppelt wird – im Morgenschlaf überprüft. Methoden Insgesamt wurden 52 Versuchsteilnehmer (32 männlich und 20 weiblich) im Alter von 24 Jahren (± 2.2) im Schlaflabor untersucht. Die Personen waren in 4 Gruppen aufge-teilt. Alle Personen schliefen zunächst für ca. 6 Stunden, wurden dann aus einer REM-Phase geweckt und sollten einen Traum berichten. Im Anschluss blieben die Teilnehmer 30 bzw. 60 Minuten wach und praktizierten entweder MILT oder beschäf-tigten sich mit einer kognitiven oder motorischen Kontrollaufgabe. Im Anschluss durf-ten alle Teilnehmer für max. 4 weitere Stunden schlafen. Das Auftreten eines Klartraums in der morgendlichen Schlafphase diente als abhängige Variable. Ergebnisse und Diskussion Die Ergebnisse zeigen, dass MILT zu einer gesteigerten Klartraumhäufigkeit (33-70%) im Vergleich zur Kontrollbedingung (9-14%) führt. Ein Unterschied zwischen 30 Minuten (50%) zu 60 Minuten MILT (70%) ist marginal. Das Auftreten von Klarträumen kann durch MILT im Morgenschlaf signifikant gestei-gert werden. Die Erfolgsquote schwankt jedoch mit Blick auf die genaue Definition ei-nes Klartraums. Es konnten bei nicht klartraumerfahrenen Versuchsteilnehmerinnen mehr Klarträume induziert werden. Für die Sportpraxis könnten solche Induktions-techniken dem Sportler ermöglichen, im Traum zu trainieren. In weiteren Studien wäre zu untersuchen, ob Athleten ebenfalls Klarträume induziert werden können. Ebenso sollte die Auswirkung eines regelmäßigen Klartraumtrainings in der Sportpraxis wei-ter untersucht werden. Literatur Stumbrys, T., Erlacher, D., Schädlich, M. & Schredl, M. (2012). Induction of lucid dreams: a systematic review of evidence. Consciousness and Cognition, 21(3), 1456-1475. Erlacher, D. & Schredl, M. (2010). Practicing a motor task in a lucid dream enhances subsequent performance: A pilot study. The Sport Psychologist, 24(2), 157-167.

Sleep-Wake Cycle Dysfunction in the TgCRND8 Mouse Model of Alzheimer's Disease: From Early to Advanced Pathological Stages.

In addition to cognitive decline, individuals affected by Alzheimer's disease (AD) can experience important neuropsychiatric symptoms including sleep disturbances. We characterized the sleep-wake cycle in the TgCRND8 mouse model of AD, which overexpresses a mutant human form of amyloid precursor protein resulting in high levels of β-amyloid and plaque formation by 3 months of age. Polysomnographic recordings in freely-moving mice were conducted to study sleep-wake cycle architecture at 3, 7 and 11 months of age and corresponding levels of β-amyloid in brain regions regulating sleep-wake states were measured. At all ages, TgCRND8 mice showed increased wakefulness and reduced non-rapid eye movement (NREM) sleep during the resting and active phases. Increased wakefulness in TgCRND8 mice was accompanied by a shift in the waking power spectrum towards fast frequency oscillations in the beta (14-20 Hz) and low gamma range (20-50 Hz). Given the phenotype of hyperarousal observed in TgCRND8 mice, the role of noradrenergic transmission in the promotion of arousal, and previous work reporting an early disruption of the noradrenergic system in TgCRND8, we tested the effects of the alpha-1-adrenoreceptor antagonist, prazosin, on sleep-wake patterns in TgCRND8 and non-transgenic (NTg) mice. We found that a lower dose (2 mg/kg) of prazosin increased NREM sleep in NTg but not in TgCRND8 mice, whereas a higher dose (5 mg/kg) increased NREM sleep in both genotypes, suggesting altered sensitivity to noradrenergic blockade in TgCRND8 mice. Collectively our results demonstrate that amyloidosis in TgCRND8 mice is associated with sleep-wake cycle dysfunction, characterized by hyperarousal, validating this model as a tool towards understanding the relationship between β-amyloid overproduction and disrupted sleep-wake patterns in AD.