REM期睡眠梦境改变对创伤记忆的影响及机制

Nightmares during sleep are the pattern of manifestation of traumatic memories of posttraumatic stress disorder (PTSD). Nevertheless, there are no effective ways to eliminate traumatic memories (nightmares) in clinical practice till now. Traumatic memory is a severe fear memory. Our previous study found that exposure to conditioned stimulus during the non-rapid eye movement sleep promoted fear memory extinction without altering sleep profiles. Nightmares often occurred during rapid eye movement (REM) sleep. Transcranial electric stimulation (tES) could manipulate the lucidity of dreams and even induce lucid dreams. Self-awareness and the ability to control dreams during lucid dreams may help to change the content of nightmares, thus creating the conditions for the extinction of the traumatic memories. Therefore, we speculate that the lucid dreams induced by tES may contribute to extinct traumatic memories. We will apply Hall and Van de Castle system of classification coding on dreaming to analyze the dreams of PTSD patients in order to understand their features of content and composition. tES during REM sleep will be used to induce lucid dream and extinct traumatic memories. Meanwhile, the activation degree of brain areas and functional connectivity between brain areas are observed with functional magnetic resonance imaging to elucidate the mechanisms. Our study aims to provide a new idea and theoretical basis for developing new non-pharmaceutical interventions to remove the traumatic memories.

创伤后应激障碍（PTSD）的创伤记忆在夜间表现为噩梦，目前临床上缺乏消除创伤记忆（噩梦）的有效措施。创伤记忆是一种严重的恐惧记忆，我们前期研究发现在非快速眼动睡眠期暴露恐惧关联线索可消退恐惧记忆。噩梦常发生于快速眼动（REM）睡眠期，经颅电刺激可调控REM期睡眠梦境的清晰程度诱发清醒梦（Lucid dream），清醒梦中梦境内容自我感知和控制能力有助于改变噩梦内容，可消除创伤记忆。故我们推测经颅电刺激诱发清醒梦可能有助于消除创伤记忆。申请人拟采用梦分类编码系统分析PTSD患者的梦境内容，确立梦境构成特点；然后用经颅电刺激调控REM期睡眠梦境，诱发清醒梦，消退创伤记忆；同时在经颅电刺激调控睡眠梦境时，用功能神经影像学方法，观察调控前中后的功能脑区激活程度和不同脑区的功能连接强度，阐明其神经影像机制，为临床开发新型非药物消除创伤记忆的干预措施提供新的思路和理论依据。

睡眠是一种基本的生理现象，包括梦境在内的睡眠状态下的大脑功能活动的神经生理学基础是睡眠研究的基础科学问题。.在本项目的支持下，我们发现了与梦境相关的静息态脑功能连接和与REM睡眠相关的静息态脑功能连接之间的差异；发现了单项抑郁患者中失眠障碍的发生率；发现了失眠障碍患者睡眠状态下脑电纺锤波相关的活动脑区；发现了失眠患者丘脑功能活动的和健康人之间的差异；失眠患者客观睡眠时长与认知功能之间的关系及脑源性神经营养因子在其中起到的作用；探索了通过安慰剂干预失眠障碍患者首夜效应的效果。.本研究的发现为睡眠的基础研究和对失眠障碍的认识及干预治疗等提供了新的思路和靶点。