Journal of Neurology

, Volume 244, Supplement 1, pp S23–S28 | Cite as

Positron emission tomography studies of sleep and sleep disorders

  • P. Maquet


Using positron emission tomography (PET) it is possible to perform an in vivo study of cerebral physiological and biochemical processes in man. Employing this technique in sleep studies, decreased cerebral metabolic rates for glucose during slow wave sleep compared with those seen during wakefulness were first demonstrated, whereas similar rates of cerebral glucose metabolism were observed during paradoxical sleep and wakefulness. More recently, regional modifications of cerebral blood flow during sleep have also been demonstrated. During slow wave sleep, cerebral blood flow is decreased particularly in the prefrontal cortex. Rapid eye movement sleep is characterized by activation of the pons, thalami, amygdaloid complexes and a number of cortical areas (e.g. the anterior cingulate cortex). Although data remain incomplete, a variety of sleep disorders, including narcolepsy, fatal familial insomnia and continuous spike-and-wave discharges during slow sleep have been investigated. These results are briefly reviewed.

Key words

Positron emission tomography Sleep disorders Energy metabolism Cerebrovascular circulation 


  1. 1.
    Akpinar S (1982) Treatment of rest-less-legs syndrome with levodopa plus benzerazid. Arch Neurol 39: 739PubMedGoogle Scholar
  2. 2.
    Aldrich MS, Hollingsworth Z, Penney JB (1992) Dopamine-receptor autoradiography of human narcoleptic brain. Neurology 42: 410–415PubMedGoogle Scholar
  3. 3.
    Balkin TJ, Wesensten NJ, Braun AR, Berman K, Baldwin P, Stein G (1991) Cerebral blood flow as measured by H2 15O positron emission tomography prior to, during, and following recovery sleep. Sleep Res 20: 37Google Scholar
  4. 4.
    Beaumanoir A (1992) The Landau-Kleffner syndrome. In: Roger J, Bureau, M, Dravet C, Dreifuss FE, Perret A, Wolf P (ed) Epileptic syndromes in infancy, childhood and adolescence, 2nd edn. Libbey, Chichester, pp 231–243Google Scholar
  5. 5.
    Brodeur C, Montplaisir J, Godbout R, Marinier R (1988) Treatment of restless legs syndrome and periodic movement during sleep with L-DOPA. Neurology 38: 1845–1848PubMedGoogle Scholar
  6. 6.
    Buchsbaum MS, Gillin JC, Wu, J, Hazlett E, Sicotte N, Dupont RM, Bunney WE (1989) Regional cerebral glucose metabolic rate in human sleep assessed by positron emission tomography. Life Sci 45: 1349–1356PubMedCrossRefGoogle Scholar
  7. 7.
    Chez MG, Major SM, Smith MC, Pierre-Louis S, Ali A, Morrell F (1992) SPECT evaluation of cerebral perfusion series in Landau-Kleffner syndrome: correlation to EEG epileptiform abnormalities. Epilepsia 33: 52CrossRefGoogle Scholar
  8. 8.
    Cole AJ, Andermann F, Taylor F, Olivier A, Rasmussen T, Robitaille Y, Spire JP (1988) The Landau-Kleffner syndrome of acquired epileptic aphasia: unusual clinical outcome, surgical experience, and absence of encephalitis. Neurology 38: 31–38PubMedGoogle Scholar
  9. 9.
    Frackowiak RSJ, Friston KJ (1994) Functional anatomy of the human brain: positron emission tomography — a new neuroanatomical structure. J Anat 184: 211–225PubMedGoogle Scholar
  10. 10.
    Hetta J, Onoe H, Andersson J, Broman JE, Valind S, Lilja A, Sundin A, Lindström K, Watanabe Y, Langström B (1995) Cerebral blood flow during sleep — a positron emission tomographic (PET) study of regional changes. Sleep Res 24A: 87Google Scholar
  11. 11.
    Hirsch E, Marescaux C, Maquet P, Metz-Lutz MN, Kiesmann M, Salmon E, Franck G, Kurtz D (1990) Landau-Kleffner syndrome: a clinical and EEG study of five cases. Epilepsia 21: 756–767CrossRefGoogle Scholar
  12. 12.
    Hu SX, Wu XR, Lin C, Hao SY (1989) Landau-Kleffner syndrome with unilateral EEG abnormalities: two cases from Beijing. Brain Dev 11: 420–422PubMedGoogle Scholar
  13. 13.
    Hublin C, Launes J, Nikkinen P (1995) Dopamine D2-receptors in human narcolepsy: a SPECT study with123I-IBZM. Acta Neurol Scand 90: 186–189CrossRefGoogle Scholar
  14. 14.
    Kennedy C, Gillin JC, Mendelson W, Suda S, Miyaoka M, Ito M, Nakamura RK, Storch FI, Pettigrew K, Mishkin M, Sokoloff L (1980) Local cerebral glucose utilization in non-rapid eye movement sleep. Nature 297: 325–327CrossRefGoogle Scholar
  15. 15.
    Khan N, Antonini A, Parkes JD, Dahlitz MJ, Meier-Ewert K, Weindl A, Leenders KL (1994) Dopamine D2 receptors in narcolepsy: a PET study. J Sleep Res 3 [Suppl 1]: 127Google Scholar
  16. 16.
    Kish SJ, Mamelak M, Slimovitch C, Dixon LM, Lewis A, Shannak K, DiStefano L, Chang LJ, Hornykiewicz O (1992) Brain neurotransmitter changes in human narcolepsy. Neurology 42: 229–234PubMedGoogle Scholar
  17. 17.
    Lugaresi E, Medori R, Montagna P, Baruzzi A, Cortelli P, Lugaresi A, Tinuper P, Zucconi M, Gambetti P (1986) Fatal familial insomnia and dysautonomia with selective degeneration of thalamic nuclei. N Engl J Med 315: 997–1003PubMedGoogle Scholar
  18. 18.
    Madsen PL, Holm S, Vorstrup S, Friberg L, Lassen NA, Wildschiodtz G (1991) Human regional cerebral blood flow during rapid eye movement sleep. J Cereb Blood Flow Metabol 11: 502–507Google Scholar
  19. 19.
    Madsen PL, Schmidt JF, Holm S, Vorstrup, S, Lassen NL, Wildschiodtz G (1991) Cerebral oxygen metbolism and cerebral blood flow in man during light sleep (stage 2) Brain Res 557: 217–220PubMedCrossRefGoogle Scholar
  20. 20.
    Madsen PL, Schmidt JF, Wildschiodtz G, Friberg L, Holm S, Vorstrup S, Lassen NL (1991) Cerebral O2 metabolism and cerebral blood flow in humans during deep and rapid-eye-movement sleep. J Appl Physiol 70: 2597–2601PubMedGoogle Scholar
  21. 21.
    Maquet P, Dive D, Salmon E, Sadzot B, Franco G, Poirrier R, Franckell R von, Franck G (1990) Cerebral glucose utilization during sleep-wake cycle in man determined by positron emission tomography and18F-2-fluoro-2-deoxy-D-glucose method. Brain Res 513: 136–143PubMedCrossRefGoogle Scholar
  22. 22.
    Maquet P, Hirsch E, Dive D, Salmon E, Poirrier R, Franco G, Marescaux C, Franck G (1990) Cerebral glucose utilization during sleep in Landau-Kleffner syndrome: a PET study. Epilepsia 31: 778–783PubMedCrossRefGoogle Scholar
  23. 23.
    Maquet P, Dive D, Salmon E, Sadzot B, Franco G, Poirrie R, Franck G (1992) Cerebral glucose utilization during stage 2 sleep in man. Brain Res 571: 149–153PubMedCrossRefGoogle Scholar
  24. 24.
    Maquet P, Hirsch E, Metz-Lutz ML, Motte J, Dive D, Marescaux C, Franck G (1995) Regional cerebral glucose metabolism in children with deterioration of one or more cognitive functions and continuous spike-and-wave discharges during sleep. Brain 118: 1497–1520PubMedCrossRefGoogle Scholar
  25. 25.
    Maquet P, Péters J-M, Delfiore G, Aerts J, Degueldre C, Fuchs S, Delvaux V, Quaglia L, Luxen A, Franck G (1995) Regional cerebral haemodynamics during slow sleep and paradoxical sleep. Preliminary results of a positron emission tomographiy (PET) study. Sleep Res 24A: 89Google Scholar
  26. 26.
    Maquet P, Péters JM, Aerts J, Delfiore G, Degueldre C, Luxen A, Franck G (1996) Functional neuroanatomy of human rapid eye movement sleep and dreaming. Nature 383: 163–166PubMedCrossRefGoogle Scholar
  27. 27.
    Marescaux C, Hirsch E, Finck S, Maquet P, Schlumberger E, Sellal F, Metz-Lutz MN, Alembik Y, Salmon E, Franck G, Kurtz D (1990) Landau-Kleffner syndrome: a pharmacological study of five cases. Epilepsia 31: 768–777PubMedCrossRefGoogle Scholar
  28. 28.
    McFarlane JG, Chabursky B, Houle S (1994) Striatal dopamine D1 and D2 receptor binding in treatment-naive human narcoleptics using PET, J Sleep Res 3 [Suppl 1]: 153Google Scholar
  29. 29.
    Meyer JS, Sakai F, Karacan I, Derman S, Yamamoto M (1980) Sleep apnea, narcolepsy and dreaming: regional cerebral haemodynamics. Ann Neurol 7: 479–485PubMedCrossRefGoogle Scholar
  30. 30.
    Mouridsen SE, Videbaek C, Sogaard H, Andersen AR (1993) Regional cerebral blood-flow measured by HMPAO and SPECT in a 5-year-old boy with Landau-Kleffner syndrome. Neuropediatrics 24: 47–50PubMedCrossRefGoogle Scholar
  31. 31.
    O’tuama LA, Urion DK, Janicek MJ, Treves ST, Bjornson B, Moriarty JM (1992) Regional cerebral perfusion in Landau-Kleffner syndrome and related childhood aphasias. J Nucl Med 33: 1758–1765PubMedGoogle Scholar
  32. 32.
    Park YD, Hoffman JM, Radtke RA, Delong GR (1994) Focal cerebral metabolic abnormality in a patient with continuous spike waves during slow-wave sleep. J Child Neurol 9: 139–143PubMedCrossRefGoogle Scholar
  33. 33.
    Perani D, Cortelli P, Lucignani G, Montagna P, Tinuper P, Gallassi R, Gambetti P, Lenzi GL, Lugaresi E, Fazio F (1993) [18F] FDG PET in fatal familial insomnia: the functional effects of thalamic lesions. Neurology 43: 2565–2569PubMedGoogle Scholar
  34. 34.
    Phelps ME, Huang SC, Hoffmann EJ, Selin C, Sokoloff L, Kuhl DE (1979) Tomographic measurement of local cerebral glucose metabolic rate in humans with (F-18)2-fluoro-2-deoxy-D-glucose: validation of method. Ann Neurol 6: 371–388PubMedCrossRefGoogle Scholar
  35. 35.
    Phelps ME, Mazziotta JC, Shelbert HR (1986) Positron emission tomography and autoradiography. Raven Press, New YorkGoogle Scholar
  36. 36.
    Ramm P, Frost BJ (1986) Cerebral and local cerebral metabolism in the cat during slow wave and REM sleep. Brain Res 365: 112–124PubMedCrossRefGoogle Scholar
  37. 37.
    Rinne JO, Ublin C, Partinen M, Ruottinen H, Ruotsalainen U, Nagren K, Lehikoinen P, Laihinen A (1995) Positron emission tomography study of human narcolepsy: no increase in striatal dopamine D2 receptors. Neurology 45: 1735–1738PubMedGoogle Scholar
  38. 38.
    Sankar R, Chugani HT, Lubens P, Philippart M, Phelps ME (1990) Heterogeneity in the patterns of cerebral glucose utilization in children with Landau-Kleffner syndrome. Neurology 40: 257Google Scholar
  39. 39.
    Staedt J, Stoppe A, Kögler A, Riemann H, Hajak G, Munz DL, Emrich D, Rüther E (1995) Nocturnal myoclonus syndrome (periodic movements in sleep) related to central dopamine D2-receptor alteration. Eur Arch Psychiatr Clin Neurosci 245: 8–10CrossRefGoogle Scholar
  40. 40.
    Staedt J, Stoppe G, Kögler A, Riemann H, Hajak G, Rodenbeck A, Mayer G, Steinhoff BJ, Munz DL, Emrich D, Rüther E (1996) [123I]IBZM SPET analysis of dopamine D2 receptor occupancy in narcoleptic patients in the course of treatment. Biol Psychiatry 39: 107–111PubMedCrossRefGoogle Scholar
  41. 41.
    Steriade M, McCarley RW (1990) Brainstem control of wakefulness and sleep. Plenum Press, New YorkGoogle Scholar
  42. 42.
    Steriade M, Contreras D, Curro Dossi R, Nunez A (1993) The slow (<1 Hz) oscillation in reticular thalamic and thalamocortical neurons: scenario of sleep rhythm generation in interacting thalamic and cortical networks. J Neurosci 13: 3284–3299PubMedGoogle Scholar
  43. 43.
    Tassinari CA, Bureau M, Dravet C, Dalla Berdardina B, Roger J (1992) Epilepsie avec pointes-ondes continues pendant le sommeil lent — antérieurement décrite sous le nom d’ESES (épilepsie avec état de mal électroencéphalographique pendant le sommeil lent). In: Roger J, Bureau M, Dravet C, Dreifuss FE, Perret A, Wolf P (eds) Epileptic syndromes in infancy, childhood and adolescence, 2nd edn. Libbey, Chichester, pp 245–256Google Scholar
  44. 44.
    Toga AW, Mazziotta JC (1996) Brain mapping. The methods, Academic Press, San DiegoGoogle Scholar
  45. 45.
    Wolf P, Dinkhauser L (1988) Landau-Kleffner syndrome — case report. Neurol Psychiatr 11: [Suppl 1]: 123–126Google Scholar
  46. 46.
    Worsley KJ, Evans AC, Marret S (1992) A three-dimensional statistical analysis for CBF activation studies in human brain. J Cereb Blood Flow Metabol 12: 900–918Google Scholar

Copyright information

© Springer-Verlag 1997

Authors and Affiliations

  1. 1.Department of NeurologyCHU Sart TilmanLiègeBelgium

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