Differential effects of bifrontal tDCS on arousal and sleep duration in insomnia patients and healthy controls

<p><strong>Background:</strong>&nbsp;Arousal and sleep represent basic domains of behavior, and alterations are of high clinical importance.</p> <p><strong>Objective/hypothesis:</strong>&nbsp;The aim of this study was to further elucidate the neurobi...

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Main Authors: Frase, L, Selhausen, P, Krone, L, Tsodor, S, Jahn, F, Feige, B, Maier, JG, Mainberger, F, Piosczyk, H, Kuhn, M, Klöppel, S, Sterr, A, Baglioni, C, Spiegelhalder, K, Riemann, D, Nitsche, MA, Nissen, C
Format: Journal article
Language:English
Published: Elsevier 2019
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author Frase, L
Selhausen, P
Krone, L
Tsodor, S
Jahn, F
Feige, B
Maier, JG
Mainberger, F
Piosczyk, H
Kuhn, M
Klöppel, S
Sterr, A
Baglioni, C
Spiegelhalder, K
Riemann, D
Nitsche, MA
Nissen, C
author_facet Frase, L
Selhausen, P
Krone, L
Tsodor, S
Jahn, F
Feige, B
Maier, JG
Mainberger, F
Piosczyk, H
Kuhn, M
Klöppel, S
Sterr, A
Baglioni, C
Spiegelhalder, K
Riemann, D
Nitsche, MA
Nissen, C
author_sort Frase, L
collection OXFORD
description <p><strong>Background:</strong>&nbsp;Arousal and sleep represent basic domains of behavior, and alterations are of high clinical importance.</p> <p><strong>Objective/hypothesis:</strong>&nbsp;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-invasive&nbsp;brain stimulation&nbsp;technique 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.</p> <p><strong>Methods:</strong>&nbsp;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. Wake&nbsp;EEG&nbsp;was 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.</p> <p><strong>Results:</strong>&nbsp;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 and&nbsp;NREM sleep. Of note, indices of increased arousal predicted the lack of effect of tDCS in ID patients.</p> <p><strong>Conclusions:</strong>&nbsp;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.</p>
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spelling oxford-uuid:8836994f-2633-410a-92d3-b34ddc9e237b2022-03-26T22:15:41ZDifferential effects of bifrontal tDCS on arousal and sleep duration in insomnia patients and healthy controlsJournal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:8836994f-2633-410a-92d3-b34ddc9e237bEnglishSymplectic ElementsElsevier2019Frase, LSelhausen, PKrone, LTsodor, SJahn, FFeige, BMaier, JGMainberger, FPiosczyk, HKuhn, MKlöppel, SSterr, ABaglioni, CSpiegelhalder, KRiemann, DNitsche, MANissen, C<p><strong>Background:</strong>&nbsp;Arousal and sleep represent basic domains of behavior, and alterations are of high clinical importance.</p> <p><strong>Objective/hypothesis:</strong>&nbsp;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-invasive&nbsp;brain stimulation&nbsp;technique 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.</p> <p><strong>Methods:</strong>&nbsp;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. Wake&nbsp;EEG&nbsp;was 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.</p> <p><strong>Results:</strong>&nbsp;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 and&nbsp;NREM sleep. Of note, indices of increased arousal predicted the lack of effect of tDCS in ID patients.</p> <p><strong>Conclusions:</strong>&nbsp;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.</p>
spellingShingle Frase, L
Selhausen, P
Krone, L
Tsodor, S
Jahn, F
Feige, B
Maier, JG
Mainberger, F
Piosczyk, H
Kuhn, M
Klöppel, S
Sterr, A
Baglioni, C
Spiegelhalder, K
Riemann, D
Nitsche, MA
Nissen, C
Differential effects of bifrontal tDCS on arousal and sleep duration in insomnia patients and healthy controls
title Differential effects of bifrontal tDCS on arousal and sleep duration in insomnia patients and healthy controls
title_full Differential effects of bifrontal tDCS on arousal and sleep duration in insomnia patients and healthy controls
title_fullStr Differential effects of bifrontal tDCS on arousal and sleep duration in insomnia patients and healthy controls
title_full_unstemmed Differential effects of bifrontal tDCS on arousal and sleep duration in insomnia patients and healthy controls
title_short Differential effects of bifrontal tDCS on arousal and sleep duration in insomnia patients and healthy controls
title_sort differential effects of bifrontal tdcs on arousal and sleep duration in insomnia patients and healthy controls
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