Problem Statement: Mental health issues in athletes are gaining increasing attention, and proper sleep is an important factor for healthy mental health and improved athletic performance. Objectives: To explore the association between psychological evaluations regarding sports competitions and sleep quality in collegiate springboard divers. Methods: A cross-sectional study design was launched with 26 collegiate springboard diving athletes who answered a State-Trait Anxiety Inventory for evaluating anxiety as well as Diagnostic Inventory of Psychological-Competitive Ability for Athletes, a self-administered psychological questionnaire specific to competitive athletes. Sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI), and the correlation between psychological and sleep variables were assessed as well. Additionally, the psychological variables were compared between poor and normal sleep quality groups. Results: On psychological evaluation, PSQI scores showed significant negative correlations with results for self-control (ρ = −0.670, p < 0.001), ability to relax (ρ = −0.508, p < 0.001), and concentration (ρ = −0.589, p < 0.001). Significantly higher scores for self-control (p < 0.001), ability to relax (p = 0.004), and concentration (p = 0.001) were obtained in the normal sleep group compared to the poor sleep group. Conclusions: Our results suggest that sleep quality and duration are significantly related to psychological variables that reflect the domain of mental stability and concentration, especially the item of self-control. Additionally, the level of trait anxiety was considerably associated with poor sleep quality. Adequate sleep is essential to ameliorate the sense of self-control and vice versa. Considering that psychological testing is not practical because of its complexity as well as the attitude of athletes, sleep assessment can act as a convenient substitute for their psychological evaluation.

<title>Abstract</title>This study explored the effect of long naps on handball-related performance and assessed the role of the cardiac autonomic nervous system in this process. Eleven male collegiate handball players performed a repeated sequential trial consisting of a 20-m consecutive turnaround run, 10-m run with a load, and shooting the ball into a target. Participants were allocated randomly and sequentially to have a short (20 minutes) nap, long (60 minutes) nap, or no nap. The Pittsburgh Sleep Quality Index was used to assess regular sleep quality. Subjective sleepiness before and after napping was measured using the Karolinska Sleepiness Scale. Heart rate variability was recorded to assess cardiac autonomic nervous function during napping. The Pittsburgh Sleep Quality Index score was correlated with shot accuracy only after long naps (ρ=0.636, r=0.048). A negative correlation was observed between the root mean square of successive differences and average load run time (ρ=−0.929, p&lt;0.001). Long napping was associated with a significant benefit on performance in athletes with poor sleep quality, implying a role of the autonomic nervous system in this regard. Our findings indicate the effect of sleep quality on the endurance and resistance of handball players.

Purpose When examining cerebral activity, it is important to decrease a subject's fatigue with an appropriate task design that also maintains data quality. This study evaluated how well devices designed to reduce fatigue would affect functional near-infrared spectroscopy (fNIRS) data. Method A WOT-100 10-channel wearable fNIRS system was used to study the prefrontal areas of thirteen healthy volunteers. The stimulation task was a consistent incongruent Stroop test, but with two variations. First, the subjects' answers could be delivered either by vocalization or keyboard output. Second was whether or not there was an offset such as simple finger movements or vocalization during control periods. Four sessions using both variations were performed. The relative changes of fNIRS data during the stimulation periods were used as a marker for cerebral activity. Results There was only a significant difference in two channels (Channel 3: p = 0.040, Channel 9: p = 0.022) when voice output was used. Conclusion The result might have been due to voice output being generated from the temporal area, near the prefrontal area. We found that the omission of offset with keyboard output might be possible as there was only a small effect, but offset with voice output is necessary.

We recently demonstrated that sleeping on high rebound [HR] mattress toppers induced a continuous and more rapid decline in core body temperature compared to low rebound [LR] mattress toppers during the initial phase of nocturnal sleep in young healthy volunteers. HR toppers are characterized by their supportive feel and high breathability whereas LR toppers are pressure-absorbing. In the current study, we evaluated effects of HR mattress toppers on objectively-(actigraphy) and subjectively-(questionnaires) evaluated sleep, vigilance (psychomotor vigilance test), and athletic performance (40-m sprint time, long jump distance, and star drill time) in youth male athletes age 10-19, in two sessions: fifty-one subjects in 2013 (study I) and 23 subjects in 2014 (study II). Sleeping on HR mattress toppers for four to six weeks improved some athletic performance measures compared to sleeping on LR or sleeping directly on spring mattresses without a topper. Statistically significant improvements in 40-m sprint time in study I (compared to LR) and in star drill time in study II (no topper) were observed. No changes in sleep and psychomotor vigilance were observed. These results suggest selecting optimal sleep surfaces may contribute to the maximization of athletic performances, and further studies are warranted.

Background: The effects of repetitive transcranial magnetic stimulation (rTMS) on physical activity and sleep patterns in individuals with major depressive disorder (MDD) remain unclear.
Method: We examined the effects of rTMS treatment on the rest-activity cycle and sleep disturbances in MDD. In this open-label pilot study, 14 patients with medication-resistant MDD underwent 10 rTMS sessions over the bilateral dorsolateral prefrontal cortex. In addition to Hamilton Depression Rating Scale and Pittsburgh Sleep Quality Index scores, waist actigraphy was used to evaluate alterations in the rest-activity cycle over the course of rTMS treatments. Actigraphic datawere evaluated at baseline and in the first (rTMS sessions 1-3), second (rTMS sessions 4-7), and third (rTMS sessions 8-10) sections.
Results: Although Hamilton Depression Rating Scale and Pittsburgh Sleep Quality Index scores were significantly improved by rTMS, sleep variables assessed by actigraphy did not show significant changes. However, post hoc tests indicated a significant increase in mean steps per day between the baseline and first section time points (P = 0.014; t(13) = -2.316).
Conclusions: Our data indicated that a daytime physical activity response to rTMS occurred in early sessions, whereas subjective symptom improvements were consistent across all sessions. Future double-blind placebo-controlled studies assessing the effects of rTMS on the restactivity cycle and sleep disturbances in MDD are warranted.

BACKGROUND: Overwork, fatigue, and sleep deprivation due to night duty are likely to be detrimental to the performance of medical residents and can consequently affect patient safety. OBJECTIVE: The aim of this study was to determine the possibility of deterioration of cerebral function of sleep-deprived, fatigued residents using neuroimaging techniques. DESIGN: Six medical residents were instructed to draw blood from artificial vessels installed on the arm of a normal cooperator. Blood was drawn at a similar time of the day, before and after night duty. To assess sleep conditions during night duty, the participants wore actigraphy units throughout the period of night duty. Changes in cerebral hemodynamics, during the course of drawing blood, were measured using a wearable optical topography system. RESULTS: The visual analogue scale scores after night duty correlated negatively with sleep efficiency during the night duty (ρ = -0.812, p = 0.050). The right prefrontal cortex activity was significantly decreased in the second trial after night duty compared with the first (p = 0.028). The extent of [oxy-Hb] decrease, indicating decreased activity, in the right dorsolateral prefrontal cortex correlated negatively with the Epworth sleepiness score after night duty (ρ = -0.841, p = 0.036). CONCLUSIONS: Sleep deprivation and fatigue after night duty, caused a decrease in the activity of the right dorsolateral prefrontal cortex of the residents, even with a relatively easy routine. This result implies that the brain activity of medical residents exposed to stress on night duty, although not substantially sleep-deprived, was impaired after the night duty, even though they apparently performed a simple medical technique appropriately. Reconsideration of the shift assignments of medical residents is strongly advised. ABBREVIATIONS: DLPFC: Dorsolateral prefrontal cortex; ESS: Epworth sleepiness scale; PSQI: Pittsburgh sleep quality index; ROI: Regions of interest; VAS: Visual analogue scale; WOT: Wearable optical topography.

Background: Recent studies have indicated the potential clinical use of near-infrared spectroscopy (NIRS) as a tool for assisting in the diagnosis of major depressive disorder (MDD). Although sleep complaints are often manifested in MDD, no study has elucidated the possible association between the objective evaluation of sleep and NIRS signals in MDD.
Methods: Fourteen patients with MDD and 15 healthy controls wore waist actigraphy equipment before the NIRS scan to investigate sleep parameters. We performed a 52-channel NIRS scan and measured changes in oxygenated hemoglobin ([oxy-Hb]) during a verbal fluency task.
Results: In patients with MDD, a significant negative correlation was observed between the 17-item Hamilton Depressive Rating Scale score and cerebral reactivity of the right temporal region (p(s):=-0.804 to -0.762; FDR-corrected; p=0.008-0.012). The Pittsburgh Sleep Questionnaire Index, which enables assessment of continuous sleep quality and disturbances, was negatively correlated with [oxy-Hb] changes in the left prefrontal cortex (p(s)=-0.630 to -0.551; FDR-corrected; p=0.043-0.048). Actigraphic sleep variables prior to the NIRS measurement showed no significant correlation with [oxy-Hb] changes.
Limitations: The limitations were small sample size with the low severity of depression and the use of actigraphy for only one night.
Conclusion: Self-rated sleep disturbance were associated with decreased left prefrontal reactivity during a verbal fluency task in patients with MDD. Our result indicates that the reactivity of the prefrontal region is susceptible to sleep complaints, providing further evidence to support potential clinical application of NIRS.

Severe social withdrawal, called hikikomori, has drawn increased public attention. However, an optimal clinical approach and strategy of treatment has not been well established. Here, we report a case of hikikomori for which an exercise intervention using jogging therapy was effective, showing cerebral hemodynamic improvement. The patient was a 20 year old Japanese male who was hospitalized in order to evaluate and treat severe social withdrawal. Although depressive and anxiety symptoms partially subsided with sertraline alone, social withdrawal persisted due to a lack of self confidence. With his consent, we implemented exercise therapy with 30 minutes of jogging three times a week for three months. We did not change the pharmacotherapy, and his social withdrawal remarkably improved with continuous jogging exercise. Using near infrared spectroscopy to evaluate hemodynamic alteration, bilateral temporal hemodynamics considerably increased after the three-month jogging therapy. Regarding exercise therapy for mental illness, numerous studies have reported the effectiveness of exercise therapy for major depression. This case implied, however, that the applicability of exercise therapy is not limited to major depressive disorder. Jogging therapy may contribute to reinforcing self confidence associated with "resilience" in conjunction with neurophysiological modulation of neural networks.

Delayed encephalopathy (DE) affects not only the cerebral white matter and globus pallidus but also the cortex and thalamus. However, it remains unknown whether these brain lesions alter sleep along with clinical manifestations of DE. A 46-year-old man with DE underwent repetitive hyperbaric oxygen therapy. The patient was evaluated by not only neuropsychological and neuroimaging testing but polysomnography over the clinical course. Neurological symptoms improved markedly; however, profound frontal cognitive deficits continued. The polysomnography revealed prolonged absence and delayed

Introduction: Evidence has accumulated, which indicates that, in healthy individuals, sleep enhances procedural memory consolidation, and that sleep spindle activity modulates this process. However, whether sleep-dependent procedural memory consolidation occurs in patients medicated for major depressive disorder remains unclear, as are the pharmacological and physiological mechanisms that underlie this process. Methods: Healthy control participants (n=17) and patients medicated for major depressive disorder (n=11) were recruited and subjected to a finger-tapping motor sequence test (MST
nondominant hand) paradigm to compare the averaged scores of different learning phases (presleep, postsleep, and overnight improvement). Participants' brain activity was recorded during sleep with 16 electroencephalography channels (between MSTs). Sleep scoring and frequency analyses were performed on the electroencephalography data. Additionally, we evaluated sleep spindle activity, which divided the spindles into fast-frequency spindle activity (12.5-16 Hz) and slow-frequency spindle activity (10.5-12.5 Hz). Result: Sleep-dependent motor memory consolidation in patients with depression was impaired in comparison with that in control participants. In patients with depression, age correlated negatively with overnight improvement. The duration of slow-wave sleep correlated with the magnitude of motor memory consolidation in patients with depression, but not in healthy controls. Slow-frequency spindle activity was associated with reduction in the magnitude of motor memory consolidation in both groups. Conclusion: Because the changes in slow-frequency spindle activity affected the thalamocortical network dysfunction in patients medicated for depression, dysregulated spindle generation may impair sleep-dependent memory consolidation. Our findings may help to elucidate the cognitive deficits that occur in patients with major depression both in the waking state and during sleep.

Purpose:To compare the properties of sleep spindles between healthy subjects and medicated patients with major depressive episode, including frequency range, spectra power, and spatial distribution of spindle power.Methods:Continuous 16-channel EEG was used to record nocturnal sleep in healthy control subjects and medicated depressive patients. Recordings were analyzed for changes in EEG power spectra and power topography. Additionally, we graphically demonstrated the pattern of spatial distribution of each type of sleep spindle, divided into fast (12.5-14 Hz) and slow spindles (11-12.5 Hz).Results:Sleep EEG records of depressive subjects exhibited a significantly higher amplitude of slow spindles in the prefrontal region, compared with the healthy controls (P &lt; 0.01). Fast spindles were dominant in the centroparietal region in both depressive patients and the control group. Enhanced slow spindles in the prefrontal region were observed in the medicated depressive patients and not in the healthy controls. The frequency of fast spindles in depressive patients was globally higher than that in healthy participants.Conclusions:The alteration in sleep spindles seen in medicated depressive subjects may reflect a pharmacological modulation of synaptic function involving the thalamic-reticular and thalamocortical mechanisms.

Introduction. In our case report we describe the case of a patient who experienced a stroke in her left hippocampus that was found following an attempted suicide via glyphosate overdose. To the best of our knowledge this is the first case report to describe a hippocampal infarction associated with a drug overdose. Case presentation. A 64-year-old Japanese woman was brought to our emergency department after ingestion of an unknown dose of glyphosate surfactant herbicide in order to attempt suicide. On admission, she was assumed to be presenting with depression or psychiatric illness, however, sudden-onset memory deficit became apparent. The patient manifested delirium, confusion, and severe anxiety. In addition, short-term memory loss was prominent, with the patient forgetting her attempted suicide. Following an array of standard tests and a brain computed tomography scan (which only showed an old infraction), we performed a magnetic resonance imaging scan and neuropsychological evaluations. The brain magnetic resonance image revealed a small high-intensity lesion in the dorsal part of the left hippocampal body, and memory tests demonstrated severe short-term recall deficits. We diagnosed her with a left hippocampal infarction and administered a course of 75mg of clopidogrel. She gradually became less confused over the course of a week, and a follow-up memory test revealed partial improvement in some domains. No abnormalities were found on a follow-up brain scan. However, despite rehabilitation, memory impairments remain. Conclusions: It is important to note that had the symptom of short-term memory been absent or less severe, she might have been misdiagnosed with depression or another psychiatric illness. Although a computed tomography scan failed to detect hippocampal lesions, a diffusion-weighted magnetic resonance imaging scan clearly revealed a lesion within the left hippocampus. Therefore, in addition to assessments focusing on psychiatric illnesses that might be the root cause of an attempted suicide, organic factors should be considered along with radiological examination and precise memory assessments for diagnosing similar cases. © 2014 Nishiyori et al.
licensee BioMed Central Ltd.

Background/Aims: Modified rock, paper, scissors (RPS) tasks have previously been used in neuroscience to investigate activity of the prefrontal cortex (PFC). In this study, we investigated hemodynamic changes in the PFC using near-infrared spectroscopy (NIRS) during a modified RPS task in which each subject's successful performance rate was equalized; the workload was increased parametrically in order to reveal the resulting pattern of PFC activation. Methods: The subjects were 20 healthy adults. During RPS, the player uses hand gestures to represent rock, paper, and scissors. Rock beats scissors, paper beats rock, and scissors beats paper. In the modified RPS task, the player is instructed to lose intentionally against the computer hand; the computer goes first and the player follows. The interstimulus interval (ISI) level was adjusted with 11 steps. If the level rose, the ISI decreased and the workload increased parametrically. The maximal level (maxLv: the shortest ISI and the biggest workload) in which a subject could perform the task correctly was determined for every subject during rehearsal of the task prior to the experiment. Lowering the level from the maxLv made the task easier. Hemodynamic changes were measured by NIRS over 4 task levels (maxLv-3, maxLv-2, maxLv-1 and maxLv). Results: The hemodynamic changes in the left lateral PFC and bilateral Brodmann area 6 rose significantly with the increase in workload and presented a linear trend. Conclusion: These results suggest that PFC activation may linearly increase with increased workload during a modified RPS task in which successful performance rates of subjects are equalized. Copyright (c) 2013 S. Karger AG, Basel

Here, we report a case of rapid eye movement sleep behavioural disorder in an elderly patient with dementia with Lewy bodies. Pretreatment polysomnography revealed atonia during rapid eye movement sleep, absence of sleep spindles and loss of slow-wave sleep. Administration of donepezil, an acetylcholinesterase inhibitor, markedly improved delusional symptoms and cognitive function. Pretreatment polysomnography performed after donepezil administration revealed a considerable number of sleep spindles. The effects of cholinergic modulation induced by donepezil seemed to cause remarkable improvement in mental status, incorporating associated with sleep spindles generated by the thalamocortical circuit involved in this patient.

While a role for sleep in declarative memory processing is established, the qualitative nature of this consolidation benefit, and the physiological mechanisms mediating it, remain debated. Here, we investigate the impact of sleep physiology on characteristics of episodic memory using an item- (memory elements) and context- (contextual details associated with those elements) learning paradigm; the latter being especially dependent on the hippocampus. Following back-to-back encoding of two word lists, each associated with a different context, participants were assigned to either a Nap-group, who obtained a 120-min nap, or a No Nap-group. Six hours post-encoding, participants performed a recognition test involving item-memory and context- memory judgments. In contrast to item- memory, which demonstrated no between-group differences, a significant benefit in context- memory developed in the Nap-group, the extent of which correlated both with the amount of stage-2 NREM sleep and frontal fast sleep-spindles. Furthermore, a difference was observed on the basis of word-list order, with the sleep benefit and associated physiological correlations being selective for the second word-list, learned last (most proximal to sleep). These findings suggest that sleep may preferentially benefit contextual (hippocampal-dependent) aspects of memory, supported by sleep-spindle oscillations, and that the temporal order of initial learning differentially determines subsequent offline consolidation.

スポーツにおける外傷性の高次脳機能障害は多く症例報告されているが、臨床現場では診断が困難であることも多い。脳外傷例では損傷部位、損傷過程も多様であり、脳形態・機能画像においても責任部位を同定することが容易ではない。今回われわれは、スポーツ外傷によって特異的な記憶障害を呈した症例を経験した。右側頭部の打撲外傷のあと、記憶保持が3〜4日しかできない、特殊な記憶障害であった。リハビリテーションも導入し、受傷後2年で高次機能は完全に回復した。回復前後で、FDG-PETにおいて低下していた側頭葉脳代謝の著明な改善を認めた。頭部外傷が脳に与える障害の神経科学的なメカニズム、および回復過程も含めた治療、リハビリテーションについては、研究の途上の段階である。今後の外傷性高次脳機能障害の機序解明、治療の発展が期待される。(著者抄録)

非定型抗精神病薬はせん妄の治療に広く用いられている。しかしながら,せん妄に対するaripiprazoleの報告は少ない。今回我々は,aripiprazoleのせん妄に対する有効性と安全性について検討したので報告する。対象はICD-10でせん妄と診断された患者17例で,有効性の判定には日本語版せん妄評価尺度98年改訂版の重症度得点を使用した。13例において有効性が認められ,有効率は76.5%であった。初回投与量は5.8±0.8mg/日,最大投与量は8.1±3.3mg/日,効果が最大に達するまでの日数は5.4±4.6日であった。ふらつきが3例(17.6%),眠気が2例(11.8%)に認められたが,重大な有害事象は認められなかった。以上から,aripiprazoleのせん妄に対する有効性と安全性が示唆された。今後さらなる研究が望まれる。(著者抄録)

The authors herein report the case of a young male with memory deficits due to a traumatic head injury, who presented with sleep-related symptoms such as hypersomnia and dream alterations. Although MRI and polysomnography showed no abnormalities, 18F-fluorodeoxyglucose positron emission tomography (FDG-PET) and 11C flumazenil (FMZ)-PET revealed findings consistent with cerebral damage to the affected temporal region. The memory deficit of the patient gradually improved in parallel with the relief of the sleep-related symptoms. FDG-PET showed considerable improvement in glucose metabolism when he had recovered, however, evidence of neural loss remained in the FMZ-PET findings. Copyright 2011 BMJ Publishing Group. All rights reserved.

Although the impact of sleep on cognitive function is increasingly well established, the role of sleep in modulating affective brain processes remains largely uncharacterized. Using a face recognition task, here we demonstrate an amplified reactivity to anger and fear emotions across the day, without sleep. However, an intervening nap blocked and even reversed this negative emotional reactivity to anger and fear while conversely enhancing ratings of positive (happy) expressions. Most interestingly, only those subjects who obtained rapid eye movement (REM) sleep displayed this remodulation of affective reactivity for the latter 2 emotion categories. Together, these results suggest that the evaluation of specific human emotions is not static across a daytime waking interval, showing a progressive reactivity toward threat-related negative expressions. However, an episode of sleep can reverse this predisposition, with REM sleep depotentiating negative reactivity toward fearful expressions while concomitantly facilitating recognition and ratings of reward-relevant positive expressions. These findings support the view that sleep, and specifically REM neurophysiology, may represent an important factor governing the optimal homeostasis of emotional brain regulation.

Both emotion and sleep are independently known to modulate declarative memory. Memory can be facilitated by emotion, leading to enhanced consolidation across increasing time delays. Sleep also facilitates offline memory processing, resulting in superior recall the next day. Here we explore whether rapid eye movement (REM) sleep, and aspects of its unique neurophysiology, underlie these convergent influences on memory. Using a nap paradigm, we measured the consolidation of neutral and negative emotional memories, and the association with REM-sleep electrophysiology. Subjects that napped showed a consolidation benefit for emotional but not neutral memories. The No-Nap control group showed no evidence of a consolidation benefit for either memory type. Within the Nap group, the extent of emotional memory facilitation was significantly correlated with the amount of REM sleep and also with right-dominant prefrontal theta power during REM. Together, these data support the role of REM-sleep neurobiology in the consolidation of emotional human memories, findings that have direct translational implications for affective psychiatric and mood disorders.

Background. Increasing evidence demonstrates that motor-skill memories improve across a night of sleep, and that non-rapid eye movement (NREM) sleep commonly plays a role in orchestrating these consolidation enhancements. Here we show the benefit of a daytime nap on motor memory consolidation and its relationship not simply with global sleep-stage measures, but unique characteristics of sleep spindles at regionally specific locations; mapping to the corresponding memory representation. Methodology/Principal Findings. Two groups of subjects trained on a motor-skill task using their left hand-a paradigm known to result in overnight plastic changes in the contralateral, right motor cortex. Both groups trained in the morning and were tested 8 hr later, with one group obtaining a 60-90 minute intervening midday nap, while the other group remained awake. At testing, subjects that did not nap showed no significant performance improvement, yet those that did nap expressed a highly significant consolidation enhancement. Within the nap group, the amount of offline improvement showed a significant correlation with the global measure of stage-2 NREM sleep. However, topographical sleep spindle analysis revealed more precise correlations. Specifically, when spindle activity at the central electrode of the non-learning hemisphere (left) was subtracted from that in the learning hemisphere (right), representing the homeostatic difference following learning, strong positive relationships with offline memory improvement emerged-correlations that were not evident for either hemisphere alone. Conclusions/Significance. These results demonstrate that motor memories are dynamically facilitated across daytime naps, enhancements that are uniquely associated with electrophysiological events expressed at local, anatomically discrete locations of the brain.

Objective To investigate the prevalence and characteristics of depressed patients living in a Japanese leprosarium who have been isolated by national law and are now becoming very elderly.
Methods We surveyed the prevalence of depressed patients living in the National Tamazenshouen Sanatorium, a major leprosarium in Japan. We also investigated the characteristics of patients who had suffered a depressive episode during the last 5 years (2000-2004). The characteristics of residents who committed suicide were also studied.
Results At the time of the investigation, 48 out of 385 (12.5%) patients were depressed or had experienced a depressive episode. Forty-one residents had committed suicide since the leprosarium was established in 1907. Somatic symptoms and depressive moods were the predominant symptoms and were not limited to symptoms unique to leprosy. The period of isolation was not statistically correlated with the GDS-SF or PGC morale scale scores.
Conclusion The findings of this study emphasize the importance of consultation psychiatric for elderly leprosy residents and could be used as a reference for treatment in countries with ageing leprosy residents.

We recorded human orbitofrontal electrocorticogram during wakefulness and sleep in epileptic patients using subdural electrodes. During wakefulness and rapid eye movement (REM) sleep, we observed beta activity in the raw orbitofrontal signals. Power spectral analysis demonstrated beta enhancement during wakefulness and REM sleep when compared to slow wave sleep (SWS). During the phasic REM periods, the beta power was significantly lower than during the tonic REM periods. Gamma enhancement manifested itself in four out of six subjects during the phasic periods. This study is the first that has focused on electrical activity in the human orbitofrontal cortex. Although the role of the orbitofrontal cortex during sleep still remains unclear, high frequency activities give us important suggestions in elucidating the human sleep mechanism. (c) 2004 Elsevier Ireland Ltd. All rights reserved.

Ten epileptic patients each with subdural electrodes surgically attached to the anterior cingulate cortex (ACC; two cases), the orbitofrontal cortex (OFC: seven cases), or both (one case) were included in this study. We recorded each patient's ACC or OFC electrocorticogram (ECoG) during the time period that the patient was awake and naturally asleep. We performed a Fast Fourier Transformation (FFT) power spectral analysis on each ECoG to examine its frequency component. We found that the ACC showed regular and continuous theta oscillation (5-7Hz) during wakefulness and rapid eye movement (REM) sleep, but not during slow wave sleep. Theta waves observed in REM sleep were not as distinct as those found in wakefulness. We also discovered that the orbitofrontal signals represented spectral peaks in the theta band only during wakefulness. This suggests the coexistence of theta oscillation in the ACC. Considering our previous observations of gamma and beta oscillations in the human hippocampus, we hypothesize that the human limbic system manifests two oscillatory activities. The results obtained in this study suggest that electrophysiological activity in the ACC could be related to particular psychological functions in wakefulness and in REM sleep. These results are useful in elucidating the human brain mechanism. (C) 2004 Elsevier Ireland Ltd and the Japan Neuroscience Society. All rights reserved.

The purpose of this study is to propose and investigate a new approach for discriminating between focal and non-focal hemispheres in intractable temporal lobe epilepsy, based on applying multivariate time series analysis to the discharge-free background brain activity observed in nocturnal electrocorticogram (ECoG) time series.
Five unilateral focal patients and one bilateral focal patient were studied. In order to detect the location of epileptic foci, linear multivariate autoregressive (MAR) models were fitted to the ECoG data; as a new approach for the purpose of summarizing these models in a single relevant parameter, the behaviour of the corresponding impulse response functions was studied and described by an attenuation coefficient.
In the majority of unilateral focal patients, the averaged attenuation coefficient was found to be almost always significantly larger in the focal hemisphere, as compared to the non-focal hemisphere. Also the amplitude of the fluctuations of the attenuation coefficient was significantly larger in the focal hemisphere. Moreover, in one patient showing a typical regular sleep cycle, the attenuation coefficient in the focal hemisphere tended to be larger during REM sleep and smaller during Non-REM sleep. In the bilateral focal patient, no statistically significant distinction between the hemispheres was found.
This study provides encouraging results for new investigations of brain dynamics by multivariate parametric modeling. It opens up the possibility of relating diseases like epilepsy to the properties of inconspicuous background brain dynamics, without the need to record and analyze epileptic seizures or other evidently pathological waveforms. (C) 2004 Elsevier B.V. All rights reserved.

We report that perospirone may have had positive effects on the obesity of three patients with schizophrenia and on the fasting blood sugar (FBS) and HbA1C of two of them who had type 2 diabetes mellitus. (C) 2004 Lippincott Williams Wilkins.

Benign adult familial myoclonus epilepsy (BAFME) is a rare epileptic disease that has predominantly been reported in the Japanese population. To date, there have been no reports of psychotic symptoms in BAFME patients. We recently encountered one patient with BAFME accompanied by an apparently related major depressive episode. The depressive state did not improve after trials of several antidepressive agents, including clomipramine, fluvoxamine and alprazolam. However, clonazapam was very effective and immediately improved both the affective disorder and epileptic symptoms. Electroencephalographic (EEG) findings also improved, reflected by normalization of background activity and spikey waves. This clinical course could indicate that the depressive state derived from epileptic pathophysiology.