Magazine article Clinical Psychiatry News

Sleep Pattern Abnormalities Shed Light on Schizophrenia. (Dysfunction in Prefrontal, Limbic Systems)

Magazine article Clinical Psychiatry News

Sleep Pattern Abnormalities Shed Light on Schizophrenia. (Dysfunction in Prefrontal, Limbic Systems)

Article excerpt

BALTIMORE -- Sleep patterns among patients with schizophrenia are providing new insights into the pathophysiology of the disorder, Dr. Matched Keshavan said at a conference on clinical electrophysiology sponsored by the EEG and Clinical Neuroscience Society.

The idea is that sleep disturbances, which are some of the most common symptoms among schizophrenic patients, reflect alterations in developmentally mediated synaptic pruning processes that normally occur at the time of adolescence, explained Dr. Keshavan of the University of Pittsburgh.

In healthy adolescents, delta or slow wave sleep patterns diminish, and a process of synaptic pruning begins to sweep out older, weaker synapses. Previous studies have shown strong correlations between delta sleep reductions and prefrontal volume reductions.

At the same time, during adolescence when most experts agree that the onset of schizophrenia usually begins, delta sleep patterns often diminish more sharply than in normal healthy controls, and reductions in the volume of the prefrontal cortex are even more dramatic.

In other words, "there appears to be an exaggeration of normal synaptic pruning processes," he said.

Delta sleep deficits also appear closely correlated with symptomatology. In a study of unmedicated schizophrenia patients, Dr. Keshavan and colleagues found that delta sleep deficits were inversely associated with psychomotor poverty syndrome as well as disorganization syndrome. No relationship, however, was seen between delta sleep and reality distortion syndrome.

And interestingly, even after 1 year of treatment, delta sleep reductions don't appear to normalize in patients.

Current thinking about delta sleep is that it's important for deactivating the prefrontal cortex. It's during this period at night, when the person is unencumbered by mental activity, that restorative processes take place, he said. …

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