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Medical Imaging for Understanding Sleep Regulation

Medical Imaging for Understanding Sleep Regulation

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Medical Imaging for Understanding Sleep Regulation

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  1. Medical Imaging for Understanding Sleep Regulation SESAPS October 2011

  2. Research Team Seong K. Mun Linda Larson-Prior Washington Univ. Zang-Hee Cho Gachon University AlpayÖzcan Kenneth H. Wong

  3. Why should we study sleep?

  4. Fundamentals of Sleep • A reversible state of disengagement from the conscious world. • Characterized by specific physiological and neurological changes. • A fundamental rhythm of the brain affected by internal clocks and external signals. • Essential to human life (applies to other animals as well).

  5. Hypnogram a.k.a. Sleep Record http://science.education.nih.gov/supplements/nih3/sleep/guide/info-sleep.htm

  6. SLOW WAVE SLEEP

  7. REM SLEEP

  8. 1. Sleep-related disorders • Insomnia (~30-35% of USA population) • REM Behavior Disorder (RBD) • Periodic Limb Movement Disorders • Restless Leg Syndrome • Narcolepsy • Obstructive Sleep Apnea • Links to Parkinson’s Disorder and other neurodegenerative diseases

  9. Clinical RBD Example “One vivid example involved a man who held his wife's head in a headlock while moving his legs as if running while both were attempting to sleep in bed, then exclaimed, “I'm gonna make that touchdown!” and then attempted to forcefully throw her head down toward the foot of the bed. When awakened, he recalled a dream in which he was running for a touchdown, and he spiked the “football” in the end zone. His wife knew precisely what he had been dreaming about.” Boeve BF, Silber MH, Ferman TJ, et al. REM sleep behavior disorder and degenerative dementia: an association likely reflecting Lewy body disease. Neurology 1998;51:363–370.

  10. 2. Drug Development Opportunities • Significant world market (~3.4B, 2.5B US) • Some major drugs coming off patent (Ambien in 2007, Lunesta in 2014) • Drugs are more effective and targeted now, but side effects still problematic • Sleep-promoting drugs warn that you must have a full night (8+ hrs) available for sleep, but this is often ignored. • Long term consequences have not been studied.

  11. Sleep pharmaceuticals

  12. 3. Why do we sleep so much? • "If sleep doesn't serve an absolutely vital function, it is the biggest mistake evolution ever made” • Alan Rechtschaffen, PhD ? ? bestof.longislandpress.com gurumia.com

  13. http://writteninc.blogspot.com/2009_05_01_archive.html http://howdoistayawake.com

  14. So…how do we study sleep?

  15. Principal Tools • Electroencephalography (EEG) • Brain electrical activity; defines sleep state • Magnetic Resonance Imaging (MRI) • Brain Structure • Positron Emission Tomography (PET) • Brain Biochemistry • Functional MRI (fMRI) • Brain “Activation”

  16. “10-20” electrode locations from Wikimedia Commons EEG High density EEG sensor net from Electrical Geodesics, Inc. MindflexDuelTM

  17. MRI contrast based on: • Proton density • Tissue Composition • Pulse Sequence

  18. Courtesy of Z.H. Cho, Gachon University, South Korea 7.0 T 1.5 T High resolution MRI opens new windows for scientific discovery

  19. 1.5 T Image 7T Image

  20. fMRI is based on changes in cerebral blood flow Blood Oxygen Level Dependence Oxyhemoglobin (diamagnetic) = BOLD Signal Deoxyhemoglobin (paramagnetic)

  21. fMRI examples Visual Signal Motor Activity

  22. Functional Connectivity Larson-Prior et al, 2011

  23. Summary • Sleep is a compelling scientific and medical area of inquiry. • Numerous technologies (designed and improved using physics) can help us to understand more about neuroscience.

  24. Thanks to… Neuroscience Research Institute, Gachon University, South Korea U.S. Army Cooperative Agreement W81XWH-11-2-0187 Michael P. Brazaitis, MD, U.S. Army Grants Officer’s Representative (GOR)

  25. Questions?