Abstract
BackgroundDespite its high prevalence, relatively little is known about the pathophysiology of somnambulism. Increasing evidence indicates that somnambulism is associated with functional abnormalities during wakefulness and that sleep deprivation constitutes an important drive that facilitates sleepwalking in predisposed patients. Here, we studied the neural mechanisms associated with somnambulism using Single Photon Emission Computed Tomography (SPECT) with 99mTc-Ethylene Cysteinate Dimer (ECD), during wakefulness and after sleep deprivation.MethodsTen adult sleepwalkers and twelve controls with normal sleep were scanned using 99mTc-ECD SPECT in morning wakefulness after a full night of sleep. Eight of the sleepwalkers and nine of the controls were also scanned during wakefulness after a night of total sleep deprivation. Between-group comparisons of regional cerebral blood flow (rCBF) were performed to characterize brain activity patterns during wakefulness in sleepwalkers.ResultsDuring wakefulness following a night of total sleep deprivation, rCBF was decreased bilaterally in the inferior temporal gyrus in sleepwalkers compared to controls.ConclusionsFunctional neural abnormalities can be observed during wakefulness in somnambulism, particularly after sleep deprivation and in the inferior temporal cortex. Sleep deprivation thus not only facilitates the occurrence of sleepwalking episodes, but also uncovers patterns of neural dysfunction that characterize sleepwalkers during wakefulness.
Highlights
Sleepwalking, or somnambulism, is defined by complex behaviors arising primarily during slow-wave sleep (SWS), with the subject displaying altered consciousness, impaired judgment, mental confusion, and decreased responsiveness to environmental stimulation [1, 2]
During wakefulness following a night of total sleep deprivation, regional cerebral blood flow (rCBF) was decreased bilaterally in the inferior temporal gyrus in sleepwalkers compared to controls
Functional neural abnormalities can be observed during wakefulness in somnambulism, after sleep deprivation and in the inferior temporal cortex
Summary
Sleepwalking, or somnambulism, is defined by complex behaviors arising primarily during slow-wave sleep (SWS), with the subject displaying altered consciousness, impaired judgment, mental confusion, and decreased responsiveness to environmental stimulation [1, 2]. These behaviors may be as simple as moving objects or walking in the room, or can involve elaborate actions such as preparing food or getting ready for work in the middle of the night. Most studies of somnambulism have investigated either the episodes themselves or the sleep period immediately preceding episode onset [6, 7] This contrasts with the paucity of reports focusing on daytime function abnormalities in sleepwalkers. We studied the neural mechanisms associated with somnambulism using Single Photon Emission Computed Tomography (SPECT) with 99mTc-Ethylene Cysteinate Dimer (ECD), during wakefulness and after sleep deprivation
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