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      Cortico-autonomic local arousals and heightened somatosensory arousability during NREMS of mice in neuropathic pain

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          Abstract

          Frequent nightly arousals typical for sleep disorders cause daytime fatigue and present health risks. As such arousals are often short, partial, or occur locally within the brain, reliable characterization in rodent models of sleep disorders and in human patients is challenging. We found that the EEG spectral composition of non-rapid eye movement sleep (NREMS) in healthy mice shows an infraslow (~50 s) interval over which microarousals appear preferentially. NREMS could hence be vulnerable to abnormal arousals on this time scale. Chronic pain is well-known to disrupt sleep. In the spared nerve injury (SNI) mouse model of chronic neuropathic pain, we found more numerous local cortical arousals accompanied by heart rate increases in hindlimb primary somatosensory, but not in prelimbic, cortices, although sleep macroarchitecture appeared unaltered. Closed-loop mechanovibrational stimulation further revealed higher sensory arousability. Chronic pain thus preserved conventional sleep measures but resulted in elevated spontaneous and evoked arousability. We develop a novel moment-to-moment probing of NREMS vulnerability and propose that chronic pain-induced sleep complaints arise from perturbed arousability.

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          Most cited references75

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          Ethical guidelines for investigations of experimental pain in conscious animals.

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            Evidence-based guidelines on the therapeutic use of repetitive transcranial magnetic stimulation (rTMS): An update (2014–2018)

            A group of European experts reappraised the guidelines on the therapeutic efficacy of repetitive transcranial magnetic stimulation (rTMS) previously published in 2014 [Lefaucheur et al., Clin Neurophysiol 2014;125:2150-206]. These updated recommendations take into account all rTMS publications, including data prior to 2014, as well as currently reviewed literature until the end of 2018. Level A evidence (definite efficacy) was reached for: high-frequency (HF) rTMS of the primary motor cortex (M1) contralateral to the painful side for neuropathic pain; HF-rTMS of the left dorsolateral prefrontal cortex (DLPFC) using a figure-of-8 or a H1-coil for depression; low-frequency (LF) rTMS of contralesional M1 for hand motor recovery in the post-acute stage of stroke. Level B evidence (probable efficacy) was reached for: HF-rTMS of the left M1 or DLPFC for improving quality of life or pain, respectively, in fibromyalgia; HF-rTMS of bilateral M1 regions or the left DLPFC for improving motor impairment or depression, respectively, in Parkinson's disease; HF-rTMS of ipsilesional M1 for promoting motor recovery at the post-acute stage of stroke; intermittent theta burst stimulation targeted to the leg motor cortex for lower limb spasticity in multiple sclerosis; HF-rTMS of the right DLPFC in posttraumatic stress disorder; LF-rTMS of the right inferior frontal gyrus in chronic post-stroke non-fluent aphasia; LF-rTMS of the right DLPFC in depression; and bihemispheric stimulation of the DLPFC combining right-sided LF-rTMS (or continuous theta burst stimulation) and left-sided HF-rTMS (or intermittent theta burst stimulation) in depression. Level A/B evidence is not reached concerning efficacy of rTMS in any other condition. The current recommendations are based on the differences reached in therapeutic efficacy of real vs. sham rTMS protocols, replicated in a sufficient number of independent studies. This does not mean that the benefit produced by rTMS inevitably reaches a level of clinical relevance.
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              CircStat: AMATLABToolbox for Circular Statistics

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                Author and article information

                Contributors
                Role: Reviewing Editor
                Role: Senior Editor
                Journal
                eLife
                Elife
                eLife
                eLife
                eLife Sciences Publications, Ltd
                2050-084X
                06 July 2021
                2021
                : 10
                : e65835
                Affiliations
                [1 ]Department of Fundamental Neurosciences, Faculty of Biology and Medicine, University of Lausanne LausanneSwitzerland
                [2 ]Pain Center, Department of Anesthesiology, Lausanne University Hospital (CHUV) LausanneSwitzerland
                [3 ]Sleep Medicine Unit, Neurocenter of Southern Switzerland, Civic Hospital (EOC) of Lugano LuganoSwitzerland
                Universität Heidelberg Germany
                University Medical Center Hamburg-Eppendorf Germany
                Universität Heidelberg Germany
                Brown University United States
                Author notes
                [†]

                These authors contributed equally to this work.

                Author information
                https://orcid.org/0000-0002-0595-4175
                https://orcid.org/0000-0002-7942-3369
                https://orcid.org/0000-0003-4341-4206
                https://orcid.org/0000-0001-8416-2610
                https://orcid.org/0000-0002-4820-5289
                https://orcid.org/0000-0002-4954-4143
                Article
                65835
                10.7554/eLife.65835
                8291975
                34227936
                d0be8886-8fe6-4ed3-91ab-3a6f980c0015
                © 2021, Cardis et al

                This article is distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use and redistribution provided that the original author and source are credited.

                History
                : 16 December 2020
                : 02 July 2021
                Funding
                Funded by: FundRef http://dx.doi.org/10.13039/501100001711, Swiss National Science Foundation;
                Award ID: 310030_184759
                Award Recipient :
                Funded by: FundRef http://dx.doi.org/10.13039/501100001711, Swiss National Science Foundation;
                Award ID: 310030_179169
                Award Recipient :
                Funded by: FundRef http://dx.doi.org/10.13039/501100001711, Swiss National Science Foundation;
                Award ID: 320030-179194
                Award Recipient :
                Funded by: Etat de Vaud;
                Award Recipient :
                The funders had no role in study design, data collection and interpretation, or the decision to submit the work for publication.
                Categories
                Research Article
                Neuroscience
                Custom metadata
                Neuropathic pain preserves mouse sleep in architecture and characteristic spectral bands but perturbs arousability in ways reminiscent of insomnia disorders, in which hyperarousal and hyperalertness to environmental stimuli are prevalent.

                Life sciences
                nrems,spared-nerve-injury,arousal,insomnia,gamma power,infraslow,mouse
                Life sciences
                nrems, spared-nerve-injury, arousal, insomnia, gamma power, infraslow, mouse

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