Dopamine Transporter Regulation during Four Nights of REM Sleep Deprivation Followed by Recovery – An in vivo Molecular Imaging Study in Humans

Objectives:

To assess the influence of total or selective REM sleep deprivation on the dopamine transporter (DAT) densities and sleep patterns of healthy volunteers.

Design:

Prospective study.

Setting:

Evaluation of polysomnography recordings and DAT density after 4 nights of selective REM sleep deprivation followed by 3 nights of sleep recovery compared to a control group and a group that was subjected to 2 nights of total sleep deprivation. Single positron emission computed tomography and [^99mTc]TRODAT-1 were used to assess the cerebral DAT density in the striatum at baseline, after REM sleep deprivation and total sleep deprivation as well as after sleep recovery. Blood was collected daily to examine prolactin and estradiol levels, which were correlated with dopaminergic activity.

Patients or Participants:

Thirty healthy male volunteers ranging from 19 to 29 years of age were randomly assigned to one of three experimental groups after giving written informed consent (10 non-sleep deprived, 10 total sleep deprived, and 10 REM sleep deprived).

Measurements and Results:

Four nights of REM sleep deprivation and 2 nights of total sleep deprivation induced distinct and heterogeneous patterns of sleep recovery. No significant modulation of DAT availability was observed within groups. In the recovery nights, changes in cortisol, prolactin and estradiol concentrations were significantly correlated with specific sleep stages in the total and REM sleep deprived groups. In addition, DAT density was positively correlated with estradiol concentration and inversely associated with SWS latency only after total sleep deprivation.

Conclusion:

Our study demonstrates that although sleep deprivation did not promote significant alterations in DAT density within the striatum, there were significant correlations among transporter availability, hormonal concentrations and sleep parameters.

Citation:

Martins, RCS; Andersen ML; Garbuio SA; Bittencourt LR: Guindalini C; Shih MC; Hoexter MQ; Bressan RA; Castiglioni MLV; Tufik S. Dopamine transporter regulation during four nights of REM sleep deprivation followed by recovery – an in vivo molecular imaging study in humans. SLEEP 2010;33(2):243-251.     

A description of two surgical and anesthetic management techniques used for a patient with fibrodysplasia ossificans progressiva

Fibrodysplasia ossificans progressiva (FOP) is a rare and debilitating genetic disorder of skeletal malformations and progressive heterotopic ossification. Flare‐ups are episodic, with bone formation in skeletal muscle and connective tissue leading to ankylosis of major joints of the axial and appendicular skeleton. This report outlines the management of a patient with FOP who had ankylosis of the temporomandibular joint and progressive ossification of the neck structures. The patient underwent two different surgical and anesthetic procedures within a 10‐year period to manage his oral pain. The authors compare the surgical techniques, osteotomy versus the more conservative buccal approach, anesthesia techniques, and conventional intubation versus sedated fiberoptic intubation. This report emphasizes the importance of a less invasive surgical technique and an appropriate anesthetic management that reduces the risks, cost, and morbidity associated with routine surgical management of patients with FOP.     

Attitudes of dentists, working in Riyadh, toward people with a sensory impairment

This study was conducted to determine the attitudes of dentists, working in Riyadh, toward people with a sensory impairment (SI), according to the Scale of Attitude Towards Disabled Persons (SADP). The SADP scale was modified to focus solely upon sensory impairment. The modified scale was pre-tested and then incorporated into a self-administered questionnaire. This was then administered to 600 dentists (response rate, 73.7%) working in the city of Riyadh, Saudi Arabia. The modified scale showed itself to be reliable, with a Chronbach's coefficient α 0.616 and four-factor analysis, which accounted for 38.5% of the variance. Ninety-four percent of the dentists were generally positive toward SI in the society. There were, however, significant variations in attitudes, with a more positive score for dentists who had worked for 30 years or more ( p ± 0.005), were specialists ( p < 0.005), received little or no undergraduate training in this subject ( p < 0.05), and who received their undergraduate training in Europe/North America ( p < 0.001). However, in a stepwise regression model, all these variables were significant except for the years of practice. The modified SADP showed dentists, working in Saudi Arabia, having a positive attitude toward people with SI.     

The effect of antiretroviral therapy on the prevalence of oral manifestations in HIV-infected patients: A UK study

OBJECTIVE: The purpose of this study was to compare the prevalence of oral manifestations in human immunodeficiency virus (HIV)-infected patients on monotherapy, dual therapy, or triple therapy with the prevalence of those not on antiretroviral therapy (ART). STUDY DESIGN: A cross-sectional study of the oral manifestations of HIV was carried out on 284 HIV-infected patients, 89 of whom were undergoing ART (12 on monotherapy, 41 on dual therapy, and 36 on triple therapy) and 195 who were not undergoing ART. Oral manifestations were recorded by using established presumptive clinical criteria. Chi-square statistical tests and separate bivariate analyses were conducted by using the Spearman rank correlation to describe the relationship between the prevalence of oral lesions and ART. RESULTS: The detection of oral manifestations was significantly decreased in subjects on dual therapy and subjects on triple therapy in comparison with patients on monotherapy (P <.05) and those on no ART regimen (P =.014). Oral manifestations were also significantly increased, with CD4 counts <200 cells/mm(3) and a viral load >3000 copies/mL (P <.001). CONCLUSIONS: Compared with the non-ART group, subjects on combination ART had significantly fewer HIV-related oral manifestations-probably as a result of an expression of their reconstituted immune system.     

The management of drooling problems in children with neurological dysfunction: a review and case report

Drooling in children with neurological dysfunction indicates neurogenic failure to coordinate the muscles of the tongue, soft palate, and face which act in the first stage of swallowing. This causes excessive pooling of saliva in the anterior part of the mouth and consequent overspill. Treatment for drooling includes behavioral, pharmacological, and surgical modalities. Correcting a malocclusion has also been reported to help eliminate drooling. This paper describes the treatment of a child with neurofibromatosis, psychomotor, developmental, and neurologic retardation, and difficulty with speech. The patient was referred to our clinic to correct his drooling. Simple orthodontic treatment succeeded in eliminating the drooling and Improving his speech .     

Airborne particles produced during enamel cleanup after removal of orthodontic appliances

Airborne particles can be produced during enamel cleanup after the removal of fixed orthodontic appliances. Particles with an aerodynamic diameter of less than 2.5 microm, known as PM2.5, can reach the alveoli of the lungs. The aim of this experiment was to qualitatively determine whether such particles are produced during enamel cleanup at the end of orthodontic treatment. Particles were collected and examined under a scanning electron microscope. Aerodynamic diameters of the particles ranged from approximately 2 to 30 microm. X-ray analysis confirmed not only the presence of components of the adhesives being removed, but also tungsten from the bur and tooth enamel. In conclusion, inhalable particles can be produced during enamel cleanup at the completion of orthodontic treatment. Further investigation is required to determine the clinical significance of such particles, how their production can be minimized, and whether even smaller, fine or ultrafine, particles are produced.