title: Modulation of Total Sleep Time by Transcranial Direct Current Stimulation (tDCS).
abstract: Arousal and sleep are fundamental physiological processes, and their modulation is of high clinical significance. This study tested the hypothesis that total sleep time (TST) in humans can be modulated by the non-invasive brain stimulation technique transcranial direct current stimulation (tDCS) targeting a 'top-down' cortico-thalamic pathway of sleep-wake regulation. Nineteen healthy participants underwent a within-subject, repeated-measures protocol across five nights in the sleep laboratory with polysomnographic monitoring (adaptation, baseline, three experimental nights). tDCS was delivered via bi-frontal target electrodes and bi-parietal return electrodes before sleep (anodal 'activation', cathodal 'deactivation', and sham stimulation). Bi-frontal anodal stimulation significantly decreased TST, compared with cathodal and sham stimulation. This effect was location specific. Bi-frontal cathodal stimulation did not significantly increase TST, potentially due to ceiling effects in good sleepers. Exploratory resting-state EEG analyses before and after the tDCS protocols were consistent with the notion of increased cortical arousal after anodal stimulation and decreased cortical arousal after cathodal stimulation. The study provides proof-of-concept that TST can be decreased by non-invasive bi-frontal anodal tDCS in healthy humans. Further elucidating the 'top-down' pathway of sleep-wake regulation is expected to increase knowledge on the fundamentals of sleep-wake regulation and to contribute to the development of novel treatments for clinical conditions of disturbed arousal and sleep.
authors.affiliation: Department of Psychiatry and Psychotherapy, University Medical Center Freiburg, Freiburg, Germany.|Department of Clinical Psychology and Psychophysiology, University Medical Center Freiburg, Freiburg, Germany.
authors.forename: Lukas
authors.initials: L
authors.lastname: Frase
authors.affiliation: Department of Psychiatry and Psychotherapy, University Medical Center Freiburg, Freiburg, Germany.|Department of Clinical Psychology and Psychophysiology, University Medical Center Freiburg, Freiburg, Germany.
authors.forename: Hannah
authors.initials: H
authors.lastname: Piosczyk
authors.affiliation: Department of Psychiatry and Psychotherapy, University Medical Center Freiburg, Freiburg, Germany.|Department of Clinical Psychology and Psychophysiology, University Medical Center Freiburg, Freiburg, Germany.
authors.forename: Sulamith
authors.initials: S
authors.lastname: Zittel
authors.affiliation: Department of Psychiatry and Psychotherapy, University Medical Center Freiburg, Freiburg, Germany.|Department of Clinical Psychology and Psychophysiology, University Medical Center Freiburg, Freiburg, Germany.
authors.forename: Friederike
authors.initials: F
authors.lastname: Jahn
authors.affiliation: Department of Psychiatry and Psychotherapy, University Medical Center Freiburg, Freiburg, Germany.|Department of Clinical Psychology and Psychophysiology, University Medical Center Freiburg, Freiburg, Germany.
authors.forename: Peter
authors.initials: P
authors.lastname: Selhausen
authors.affiliation: Department of Psychiatry and Psychotherapy, University Medical Center Freiburg, Freiburg, Germany.|Department of Clinical Psychology and Psychophysiology, University Medical Center Freiburg, Freiburg, Germany.
authors.forename: Lukas
authors.initials: L
authors.lastname: Krone
authors.affiliation: Department of Psychiatry and Psychotherapy, University Medical Center Freiburg, Freiburg, Germany.|Department of Clinical Psychology and Psychophysiology, University Medical Center Freiburg, Freiburg, Germany.
authors.forename: Bernd
authors.identifier: 0000-0002-9436-1258
authors.initials: B
authors.lastname: Feige
authors.affiliation: Department of Psychiatry and Psychotherapy, University Medical Center Freiburg, Freiburg, Germany.
authors.forename: Florian
authors.initials: F
authors.lastname: Mainberger
authors.affiliation: Department of Psychiatry and Psychotherapy, University Medical Center Freiburg, Freiburg, Germany.|Department of Clinical Psychology and Psychophysiology, University Medical Center Freiburg, Freiburg, Germany.
authors.forename: Jonathan G
authors.initials: JG
authors.lastname: Maier
authors.affiliation: Department of Psychiatry and Psychotherapy, University Medical Center Freiburg, Freiburg, Germany.|Department of Clinical Psychology and Psychophysiology, University Medical Center Freiburg, Freiburg, Germany.
authors.forename: Marion
authors.initials: M
authors.lastname: Kuhn
authors.affiliation: Department of Psychiatry and Psychotherapy, University Medical Center Freiburg, Freiburg, Germany.|Department of Neurology, University Medical Center Freiburg, Freiburg, Germany.
authors.forename: Stefan
authors.initials: S
authors.lastname: Klöppel
authors.affiliation: Department of Psychiatry and Psychotherapy, University Medical Center Freiburg, Freiburg, Germany.
authors.forename: Claus
authors.initials: C
authors.lastname: Normann
authors.affiliation: Department of Psychology, University of Surrey, Guildford, UK.
authors.forename: Annette
authors.initials: A
authors.lastname: Sterr
authors.affiliation: Department of Clinical Psychology and Psychophysiology, University Medical Center Freiburg, Freiburg, Germany.
authors.forename: Kai
authors.initials: K
authors.lastname: Spiegelhalder
authors.affiliation: Department of Clinical Psychology and Psychophysiology, University Medical Center Freiburg, Freiburg, Germany.
authors.forename: Dieter
authors.initials: D
authors.lastname: Riemann
authors.affiliation: Department of Clinical Neurophysiology, University Medical Center Göttingen, Göttingen, Germany.|Leibniz Research Centre for Working Environment and Human Factors, Dortmund, Germany.|Department of Neurology, University Medical Hospital Bergmannsheil, Bochum, Germany.
authors.forename: Michael A
authors.initials: MA
authors.lastname: Nitsche
authors.affiliation: Department of Psychiatry and Psychotherapy, University Medical Center Freiburg, Freiburg, Germany.|Department of Clinical Psychology and Psychophysiology, University Medical Center Freiburg, Freiburg, Germany.
authors.forename: Christoph
authors.initials: C
authors.lastname: Nissen
mesh_terms: D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D004569:Electroencephalography; D005260:Female; D064368:Healthy Volunteers; D006801:Humans; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D017286:Polysomnography; D012890:Sleep / Q000502:physiology*; D013057:Spectrum Analysis; D013997:Time Factors; D065908:Transcranial Direct Current Stimulation