Summary: Owing to the coupling between CBP and neu ronal activity, regional CBP is a reflection of neural ac tivity in different brain regions. In this study we measured regional CBP during polysomnographically well-defined rapid-eye-movement (REM) sleep by the use of single photon emission computerized tomography and the new tracer 99mTc-dl-hexamethylpropyleneamine. Eleven healthy volunteers aged between 22 and 27 years were studied. CBP was measured on separate nights during REM sleep and during EEG-verified wakefulness. On awakening from REM sleep, all subjects reported visual dreams. During REM sleep CBP increased by 4% (p < Sleep represents a reversible state of disengage ment from the external environment. Sleep is not a uniform state of genuine unconsciousness, but is composed of a cyclical sequence of stages defined on the basis of electrophysiological parameters (Aserinsky and Kleitman, 1953;Rechtschaffen and Kales, 1968). In the sleep-wake cycle, rapid eye-movement (REM) sleep represents a distinct mental condition in the sense that it is closely cor related to the experience of dreams (Dement and Kleitman, 1957;McCarley, 1983). The understand ing of the dream phenomenon is sparse; we can only speculate on its significance, and the functional state of the dreaming brain is largely unknown. CBF is coupled to cerebral neuronal activity Received July 5, 1990; revised October 9, 1990; accepted Oc tober 10, 1990.Address correspondence and reprint requests to Dr. P. L. Madsen at Department of Clinical Physiology, Bispebjerg Hos pital, 23, Bispebjerg Bakke, DK-2400 Copenhagen NV, Den mark.Abbreviations used: HMPAO, dl-hexamethylpropyleneamine; OM, orbitomeatal plane; rCBF, regional CBF; REM, rapid eye movement; ROI, region of interest; SPECT, single photon emis sion computerized tomography. 502 0.01) in the associative visual area, while it decreased by 9% (p < 0.01) in the inferior frontal cortex. The CBP increase in the associative visual area suggests that acti vation of cerebral structures processing complex visual material is correlated to visual dream experiences. On the other hand, the reduced involvement of the inferior fron tal cortex observed during REM sleep might explain the poor temporal organization and bizarreness often experi enced in dreams. Key Words: Cerebral blood flow Dreams-99mTc-dl-Hexamethylpropyleneamine-Rapid eye-movement sleep--Single photon emission computer ized tomography. (Sokoloff, 1981). This means that information on the functional landscape of the brain can be ob tained by measuring CBF in different brain regions. However, owing to the elusive nature of sleep, ma jor restrictions are imposed on the examination methodology and during REM sleep only measure ments of regional CBF (rCBF) with a low resolution have been obtained. To study CBF during sleep, the examination technique should allow sleep in a seg regated room without causing interference. Single photon emission computerized tomography (SPECT) and the new tracer 99 mTc-dl-hexamethyl propyleneamine ( 99 mTc-HMPAO) meet...