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VOLUME 36, ISSUE 06

SLEEP DEPRIVED-INDUCED WORKING MEMORY DEFICITS AND FMRI-GUIDED RTMS
Extended Remediation of Sleep Deprived-Induced Working Memory Deficits Using fMRI-guided Transcranial Magnetic Stimulation

http://dx.doi.org/10.5665/sleep.2712

Bruce Luber, PhD1,2; Jason Steffener, PhD3; Adrienne Tucker, PhD7; Christian Habeck, PhD3; Angel V. Peterchev, PhD1,5; Zhi-De Deng, MEng1,6; Robert C. Basner, MD4; Yaakov Stern, PhD3; Sarah H. Lisanby, MD1,2

1Departments of Psychiatry and Behavioral Sciences; 2Psychology and Neuroscience; 5Biomedical Engineering, Duke University, Durham, NC; 3Cognitive Neuroscience Division, Department of Neurology; 4Department of Medicine, Columbia University College of Physicians and Surgeons, New York, NY; 6Department of Electrical Engineering, Columbia University, New York, NY; 7Department of Psychology, University of Colorado, Denver, CO



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Study Objectives:

We attempted to prevent the development of working memory (WM) impairments caused by sleep deprivation using fMRI-guided repetitive transcranial magnetic stimulation (rTMS). Novel aspects of our fMRI-guided rTMS paradigm included the use of sophisticated covariance methods to identify functional networks in imaging data, and the use of fMRI-targeted rTMS concurrent with task performance to modulate plasticity effects over a longer term.

Design:

Between-groups mixed model.

Setting:

TMS, MRI, and sleep laboratory study.

Participants:

27 subjects (13 receiving Active rTMS, and 14 Sham) completed the sleep deprivation protocol, with another 21 (10 Active, 11 Sham) non-sleep deprived subjects run in a second experiment.

Interventions:

Our previous covariance analysis had identified a network, including occipital cortex, which demonstrated individual differences in resilience to the deleterious effects of sleep deprivation on WM performance. Five Hz rTMS was applied to left lateral occipital cortex while subjects performed a WM task during 4 sessions over the course of 2 days of total sleep deprivation.

Measurements and Results:

At the end of the sleep deprivation period, Sham sleep deprived subjects exhibited degraded performance in the WM task. In contrast, those receiving Active rTMS did not show the slowing and lapsing typical in sleep deprivation, and instead performed similarly to non- sleep deprived subjects. Importantly, the Active sleep deprivation group showed rTMS-induced facilitation of WM performance a full 18 hours after the last rTMS session.

Conclusions:

Over the course of sleep deprivation, these results indicate that rTMS applied concurrently with WM task performance affected neural circuitry involved in WM to prevent its full impact.

Citation:

Luber B; Steffener J; Tucker A; Habeck C; Peterchev AV; Deng ZD; Basner RC; Stern Y; Lisanby SH. Extended remediation of sleep deprived-induced working memory deficits using fMRI-guided transcranial magnetic stimulation. SLEEP 2013;36(6):857-871.

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