Perogamvros Lampros, Aberg Kristoffer, Gex-Fabry Marianne, Perrig Stephen, Cloninger C Robert, Schwartz Sophie
Department of Psychiatry, University Hospitals of Geneva, Geneva, Switzerland; Department of Neuroscience, University of Geneva, Geneva, Switzerland; Department of Psychiatry, University of Wisconsin, Madison, Wisconsin, United States of America.
Department of Neuroscience, University of Geneva, Geneva, Switzerland; Swiss Center for Affective Sciences, University of Geneva, Geneva, Switzerland.
PLoS One. 2015 Aug 19;10(8):e0134504. doi: 10.1371/journal.pone.0134504. eCollection 2015.
We previously suggested that abnormal sleep behaviors, i.e., as found in parasomnias, may often be the expression of increased activity of the reward system during sleep. Because nightmares and sleepwalking predominate during REM and NREM sleep respectively, we tested here whether exploratory excitability, a waking personality trait reflecting high activity within the mesolimbic dopaminergic (ML-DA) system, may be associated with specific changes in REM and NREM sleep patterns in these two sleep disorders.
Twenty-four unmedicated patients with parasomnia (12 with chronic sleepwalking and 12 with idiopathic nightmares) and no psychiatric comorbidities were studied. Each patient spent one night of sleep monitored by polysomnography. The Temperament and Character Inventory (TCI) was administered to all patients and healthy controls from the Geneva population (n = 293).
Sleepwalkers were more anxious than patients with idiopathic nightmares (Spielberger Trait anxiety/STAI-T), but the patient groups did not differ on any personality dimension as estimated by the TCI. Compared to controls, parasomnia patients (sleepwalkers together with patients with idiopathic nightmares) scored higher on the Novelty Seeking (NS) TCI scale and in particular on the exploratory excitability/curiosity (NS1) subscale, and lower on the Self-directedness (SD) TCI scale, suggesting a general increase in reward sensitivity and impulsivity. Furthermore, parasomnia patients tended to worry about social separation persistently, as indicated by greater anticipatory worry (HA1) and dependence on social attachment (RD3). Moreover, exploratory excitability (NS1) correlated positively with the severity of parasomnia (i.e., the frequency of self-reported occurrences of nightmares and sleepwalking), and with time spent in REM sleep in patients with nightmares.
These results suggest that patients with parasomnia might share common waking personality traits associated to reward-related brain functions. They also provide further support to the notion that reward-seeking networks are active during human sleep.
我们之前曾提出,异常睡眠行为,如在异态睡眠中发现的行为,可能常常是睡眠期间奖赏系统活动增加的表现。由于噩梦和梦游分别在快速眼动(REM)睡眠和非快速眼动(NREM)睡眠期间最为常见,我们在此测试了探索性兴奋性这一反映中脑边缘多巴胺能(ML-DA)系统内高活动水平的清醒人格特质,是否可能与这两种睡眠障碍中REM和NREM睡眠模式的特定变化相关。
对24名未服用药物的异态睡眠患者(12名患有慢性梦游症,12名患有特发性噩梦)且无精神疾病共病情况进行了研究。每位患者接受一晚的多导睡眠图监测。对所有患者以及来自日内瓦人群的健康对照者(n = 293)进行了气质与性格问卷(TCI)测试。
梦游症患者比特发性噩梦患者更焦虑(斯皮尔伯格特质焦虑量表/STAI-T),但根据TCI评估,两组患者在任何人格维度上均无差异。与对照组相比,异态睡眠患者(梦游症患者与特发性噩梦患者)在TCI新奇寻求(NS)量表上得分更高,尤其是在探索性兴奋性/好奇心(NS1)子量表上,而在自我导向性(SD)TCI量表上得分更低,这表明奖赏敏感性和冲动性普遍增加。此外,异态睡眠患者往往持续担心社会分离,如预期性担忧(HA1)和对社会依恋的依赖性(RD3)更高所示。而且,探索性兴奋性(NS1)与异态睡眠的严重程度(即自我报告的噩梦和梦游发作频率)以及噩梦患者的REM睡眠时间呈正相关。
这些结果表明,异态睡眠患者可能具有与奖赏相关脑功能相关的共同清醒人格特质。它们还进一步支持了在人类睡眠期间寻求奖赏的网络处于活跃状态这一观点。