Sleep and daytime sleepiness in retinitis pigmentosa patients

OBJECTIVE: We examined sleep, daytime sleepiness and the ability to stay awake during the day in patients affected with retinitis pigmentosa (RP), to further delineate the role of photoreceptors in the circadian cycle. METHODS: Twelve individuals diagnosed with RP (40 +/- 8 years) And 12 normally sighted healthy individuals (39 +/- 7 years) matched for age, body mass index (BMI) and sex were selected for the study. Participants had their sleep recorded on two consecutive nights and were monitored on the two following days. On the first day, their ability to stay awake and on the second, their sleep propensity were assessed using the Maintenance of Wakefulness Test (MWT) and the Multiple Sleep Latency Test (MSLT), respectively. Self-report measures were obtained using the Pittsburgh Sleep Quality Index (PSQI), the Epworth Sleepiness Scale (ESS), and the Toronto Hospital Alertness Test (THAT). RESULTS: Subjective daytime sleepiness (ESS: 9 +/- 5 vs. 6 +/- 4, P=0.053) and objectively measured sleep propensity (MSLT: 10 +/- 5 vs. 17 +/- 3 min, P < 0.000) were significantly higher in RP patients than controls, whilst their alertness (THAT: 29 +/- 9 vs. 38 +/- 7, P=0.016) and ability to stay awake (MWT: 21 +/- 9 vs. 29 +/- 2 min, P=0.006) were significantly reduced. Retinitis pigmentosa participants had more disturbed nighttime sleep, with significantly more awakenings (arousal index: 14 +/- 8 vs. 8 +/- 6 h, P=0.039), and tended to have less rapid eye movement (REM) sleep (19 +/- 5 vs. 22 +/- 3%, P=0.094). CONCLUSION: Patients with RP have increased daytime sleepiness, reduced alertness and more disturbed nighttime sleep of poorer quality than their normally sighted counterparts, suggesting an influence of photoreceptor degeneration on the circadian cycle.     

Spatial deployment of attention within and across hemifields in an auditory task

Research on visual attention has demonstrated that covert attention can be focused on particular locations within one hemifield, but that a specific "meridian" cost may also be found for shifting attention between hemifields. These issues have received less consideration for audition, even though reliable behavioral measures for the effects of spatial attention on hearing are now available. We examined the spatial distribution of covert attention in an auditory task following spatially non-predictive peripheral auditory cues (which should induce exogenous attention shifts), or following symbolic central cues that predicted the likely location for the auditory target (to induce endogenous attention shifts). In both cases, we found that attention can be focused not only on one hemifield versus another, but also within one hemifield in an auditory task. However, there was no unequivocal evidence for a meridian effect in audition. Electronic Publication     

BOLD repetition decreases in object-responsive ventral visual areas depend on spatial attention

Functional imaging studies of priming-related repetition phenomena have become widely used to study neural object representation. Although blood oxygenation level-dependent (BOLD) repetition decreases can sometimes be observed without awareness of repetition, any role for spatial attention in BOLD repetition effects remains largely unknown. We used fMRI in 13 healthy subjects to test whether BOLD repetition decreases for repeated objects in ventral visual cortices depend on allocation of spatial attention to the prime. Subjects performed a size-judgment task on a probe object that had been attended or ignored in a preceding prime display of 2 lateralized objects. Reaction times showed faster responses when the probe was the same object as the attended prime, independent of the view tested (identical vs. mirror image). No behavioral effect was evident from unattended primes. BOLD repetition decreases for attended primes were found in lateral occipital and fusiform regions bilaterally, which generalized across identical and mirror-image repeats. No repetition decreases were observed for ignored primes. Our results suggest a critical role for attention in achieving visual representations of objects that lead to both BOLD signal decreases and behavioral priming on repeated presentation.     

Beneficial physiological and performance responses to a month of restricted energy intake in healthy overweight women

Changes in mood, performance, cortisol, and physiological variables with a month-long energy restricting diet (3.347 MJ/day) were studied in nine overweight (mean mass 71.2 +/- 8 kg; body mass index 26.1 +/- 2.8 kg/m(2)), healthy premenopausal (age 20-36 years) women. Measurements were taken in the 2 weeks before the diet (baseline) and again in the final 2 weeks of the diet to attenuate menstrual cycle differences. A reduction in energy intake and concomitant weight loss (5.80 +/- 1.65 kg) were accompanied by a significant decline in systolic blood pressure (5.4%), heart rate (7.6%), and cortisol concentration (13.6%). Fatigue and vigour on the Profile of Mood States (POMS) questionnaire were adversely affected; however, subjective assessments of mood, concentration, temperature sensitivity, appetite, and sleep quality using visual analogue scales, were not significantly altered during the month-long period of energy restriction. Motor performance, as assessed by hand-eye coordination, improved with both a reduction in mean reaction time and improved accuracy in response to visual stimuli. The very low-energy diet appeared to be neither physiologically nor psychologically stressful. Beneficial effects were evident with a reduction in BMI, reduced risk of cardiovascular stress, improved motor performance, and a decline in physiological stress with dieting success.     

A longitudinal study of sleep stages in young women during pregnancy and postpartum.

We conducted a longitudinal polysomnographic study in five healthy primiparous subjects, whose sleep was first recorded between 8 and 16 weeks of gestation, then every 2 months until parturition and at 1 month postpartum. The first 6 hours of sleep were used for statistical analysis. In contrast to previous studies, we found no reduction in stage 4 sleep with pregnancy. Slow-wave sleep (comprising stages 3 and 4), was significantly higher at 27-39 weeks of gestation than at 8-16 weeks, as predicted by the restorative theory of sleep. There was no significant difference in rapid eye movement (REM) sleep time. When compared to a group of normal ovulating women, however, REM sleep time decreased during the last two months of pregnancy and, although there was no change in sleep onset latency, the time spent awake during the first six hours of sleep was increased. Future research into the effects of cortisol and progesterone is indicated.     

An event-related brain potential study of cross-modal links in spatial attention between vision and touch

Event-related potential (ERP) evidence for the existence of cross-modal links in endogenous spatial attention between vision and touch was obtained in an experiment where participants had to detect tactile or visual targets on the attended side and to ignore the irrelevant modality and stimuli on the unattended side. For visual ERPs, attentional modulations of occipital P1 and N1 components were present when attention was directed both within vision and within touch, indicating that links in spatial attention from touch to vision can affect early stages of visual processing. For somatosensory ERPs, attentional negativities starting around 140 ms poststimulus were present at midline and lateral central electrodes when touch was relevant. No attentional somatosensory ERP modulations were present when vision was relevant and tactile stimuli could be entirely ignored. However, in another task condition where responses were also required to infrequent tactile targets regardless of their location, visual-spatial attention modulated somatosensory ERPs. Unlike vision, touch apparently can be decoupled from attentional orienting within another modality unless it is potentially relevant.     

The media/information richness model as prescription for some health care service ills

Because consumers are demanding more and better information from their health care providers, improving effectiveness and efficiency of communications is one way that health care providers can gain a competitive edge. The authors propose that health care communication effectiveness and efficiency can be improved by using the Media/Information Richness Model (MIR) in planning service delivery systems.