Explorations in the Relationship of Dream Sleep to Schizophrenia Using Positron Emisson Tomography

Ma, Weiler; Ms, Buchsbaum; Jc, Gillin; R, Tafalla; We, Bunney

doi:10.1159/000119435

Cited by 17 publications

(4 citation statements)

References 30 publications

(39 reference statements)

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“…On the other hand, the findings rather highlight the discontinuity between hallucinatory symptoms in the two conditions, narcolepsy and schizophrenia, and confirm previous findings from electroencephalographic studies [21,22] and brain imaging studies [23,24] presenting direct and indirect evidence for relevant discrepancies between narcolepsy and other psychiatric conditions. Particularly, the differences in the type and quality of hallucinations (including the posture dependence of hallucinations) between narcoleptic and schizophrenic patients do not corroborate the hypothesis of a common underlying pathophysiological mechanism (e.g., REM intrusion) [8] for hallucinations in both clinical conditions.…”

Section: Resultssupporting

confidence: 88%

Narcoleptic and schizophrenic hallucinations

Dahmen

Kasten

Mittag

et al. 2002

The European Journal of Health Economics

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The differential diagnosis of narcolepsy versus schizophrenia is sometimes complicated by similar phenomenology, particularly when hallucinations predominate. REM sleep disturbances seem fundamental in the pathophysiology of narcolepsy, and REM sleep intrusions during periods of wakefulness are often associated with hallucinations also in healthy controls and in patients with other brain disorders including schizophrenia. This study used a semistructured interview to investigate different aspects of hallucinations (frequency, modality, content, and dependence on body posture) in 148 patients with narcolepsy, 21 patients with acute exacerbation of a schizophrenic disorder, and 128 healthy subjects. About 80% of patients with narcolepsy, 81% of schizophrenics, and 37% of healthy subjects reported lifetime occurrence of hallucinations (at least once). Auditory hallucinations were reported by 81% of schizophrenic patients (narcoleptics 45%, healthy controls 9%), whereas 83% of narcoleptic patients reported visual hallucinations (schizophrenics 29%, healthy controls 19%). Kinetic hallucinations were experienced by 71% of patients with narcolepsy and 53% of healthy controls in contrast to only 5% of schizophrenics. Accordingly, the content of hallucinations differed substantially between the groups. Most hallucinations in narcoleptics but not in schizophrenics, were sleep-related and dependent on body posture. Taken together, the qualitative aspects of hallucinations in narcolepsy and schizophrenia were so different that a common underlying mechanism of hallucinations in the two conditions is unlikely. Although the clinical separation of patients with narcolepsy and schizophrenia with predominant hallucinations is sometimes difficult, clinical features including the patient's illness history, and careful psychopathological assessments can help to avoid misdiagnoses and treatment failures.

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Section: Resultssupporting

confidence: 88%

Narcoleptic and schizophrenic hallucinations

Dahmen

Kasten

Mittag

et al. 2002

The European Journal of Health Economics

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“…Finally, it is possible that psychotic subjects are more likely to reveal the structure of their thinking when reporting on dreams simply due to the similarity between dreaming and psychosis11122425262728. The dream content in patients with schizophrenia is particularly affected by negative symptoms29, and their waking cognition matches the bizarreness of dream reports27, supporting dreaming as an experimental model of psychosis.…”

Section: Discussionmentioning

confidence: 98%

Graph analysis of dream reports is especially informative about psychosis

Mota

Furtado

Maia

et al. 2014

Sci Rep

119

228

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Early psychiatry investigated dreams to understand psychopathologies. Contemporary psychiatry, which neglects dreams, has been criticized for lack of objectivity. In search of quantitative insight into the structure of psychotic speech, we investigated speech graph attributes (SGA) in patients with schizophrenia, bipolar disorder type I, and non-psychotic controls as they reported waking and dream contents. Schizophrenic subjects spoke with reduced connectivity, in tight correlation with negative and cognitive symptoms measured by standard psychometric scales. Bipolar and control subjects were undistinguishable by waking reports, but in dream reports bipolar subjects showed significantly less connectivity. Dream-related SGA outperformed psychometric scores or waking-related data for group sorting. Altogether, the results indicate that online and offline processing, the two most fundamental modes of brain operation, produce nearly opposite effects on recollections: While dreaming exposes differences in the mnemonic records across individuals, waking dampens distinctions. The results also demonstrate the feasibility of the differential diagnosis of psychosis based on the analysis of dream graphs, pointing to a fast, low-cost and language-invariant tool for psychiatric diagnosis and the objective search for biomarkers. The Freudian notion that “dreams are the royal road to the unconscious” is clinically useful, after all.

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“…Only one functional neuroimaging study has explored the relationship between some aspect of sleep and the pathophysiology of schizophrenia. Weiler et al 61 compared cerebral metabolism between 49 awake schizophrenic patients, 30 awake controls, and 12 controls in REM sleep. The aim of the study was to determine whether regional metabolism while awake in a psychotic disorder resembled healthy REM sleep, given some phenomenological similarities between the cognitions reported in dreaming and those in psychosis.…”

Section: Schizophreniamentioning

confidence: 99%

Functional Neuroimaging of Sleep

Nofzinger

2005

Semin Neurol

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Sleep and sleep disorders have traditionally been viewed from a polysomnographic perspective. Although these methods provide information on the timing of various stages of sleep and wakefulness, they do not provide information regarding function in brain structures that have been implicated in the generation of sleep and that may be abnormal in different sleep disorders. Functional neuroimaging methods provide information regarding changes in brain function across the sleep-wake cycle that provides information for models of sleep dysregulation in a variety of sleep disorders. Early studies show reliable increases in function in limbic and anterior paralimbic cortex in rapid eye movement (REM) sleep and decreases in function in higher-order cortical regions in known thalamocortical networks during non-REM sleep. Although most of the early work in this area has been devoted to the study of normal sleep mechanisms, a collection of studies in diverse sleep disorders such as sleep deprivation, depression, insomnia, dyssomnias, narcolepsy, and sleep apnea suggest that functional neuroimaging methods have the potential to clarify the pathophysiology of sleep disorders and to guide treatment strategies.

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Explorations in the Relationship of Dream Sleep to Schizophrenia Using Positron Emisson Tomography

Cited by 17 publications

References 30 publications

Narcoleptic and schizophrenic hallucinations

Narcoleptic and schizophrenic hallucinations

Graph analysis of dream reports is especially informative about psychosis

Functional Neuroimaging of Sleep

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