Repetitive Transcranial Magnetic Stimulation On The Brain Function Impairment Induced By Sleep Deprivation:Application And Mechanism

Objective:sleep deprivation(SD)is a major cause of brain function impairment,including cognitive impairment and low frontal lobe activation.However,an efficient method for improving cognitive impairment due to sleep deprivation is lacking.The aim of this study is to evaluate the effect of high-frequency repetitive transcranial magnetic stimulation(r TMS)during sleep deprivation on reversing the adverse effects of sleep deprivation.Methods:The present study can be divided into following two parts.Part I: Sixty-six healthy people were randomized to the r TMS group and sham group.Both groups were deprived of sleep for 24 h.During sleep deprivation,participants were asked to complete some cognitive tasks and underwent mood assessments.Saliva cortisol levels,plasma concentrations of brain-derived neurotrophic factor(BDNF),precursor BDNF(pro BDNF),tissue-type plasminogen activator(t PA),and frontal blood activation were detected before and after sleep deprivation.The r TMS group received real r TMS stimulation for 2 sessions of 10 Hz r TMS(40 trains of 50 pulses with a 20-second intertrain interval)to the left dorsolateral prefrontal cortex and the sham group received sham stimulation during sleep deprivation.Part II: 32 rats were randomly divided into 4 groups:sleep deprivation + r TMS(SD+r TMS),sleep deprivation + sham(SD+sham),control + r TMS and control +sham group.The rats in SD group undergo 24 hours sleep deprivation while the control group were fed normally.The r TMS group received real r TMS stimulation for one session of 5 Hz r TMS(20 trains of 20 pulses with a 20-second intertrain interval)and the sham group received sham stimulation during sleep deprivation.After sleep deprivation,all rats completed open field test and Y-maze test,then cut off the head and took blood to get the brain,and evaluate the concentration of.BDNF、t PA、GNDNF and NPS.Results:Twenty four hours of sleep deprivation induced a reduced accuracy in the n-back task,increases in both anxiety and depression,increased cortisol levels,abnormal electrical activity at the scalp and decreased frontal blood activation and decreased BDNF levels in healthy people.Notably,r TMS improved the hyperactivity of the hypothalamic-pituitary-adrenal axis and decreased frontal blood activation induced by sleep deprivation,and reduced the consumption of plasma pro BDNF.After 24 hours sleep deprivation,poor performance of rats was observed in Y-maze test with hyperactive HPA axis,decreased BDNF m RNA and increased plasma GDNF level.Moerever,r TMS improved the cognitive function in sleep deprived rats.Conclusion:Twenty-four hours of sleep deprivation induced brain function impairment,including cognitive impairment,hyperactive HPA axis,decreased brain activation and neurotrophic factor system imbalance.The administration of high-frequency r TMS during sleep deprivation exerted positive effects on HPA axis and frontal activation and might help alleviate cognitive impairment in the long term.