Research Reports - Mild traumatic brain injury chronically impairs sleep- and wake-dependent emotional processing

Sleep. 2017 Apr 29. doi: 10.1093/sleep/zsx062. [Epub ahead of print]

Mantua J(1), Henry OS(2), Garskovas NF(3), Spencer RMC(1,)(3).

A single traumatic brain injury (TBI), even when mild (i.e., concussion), can
cause lasting consequences. Individuals with a history of chronic (> 1 year
prior) mild TBI have an increased risk of mood disturbances (e.g., depression,
suicide). This population also has lingering sleep alterations, including poor
sleep quality and changes in sleep stage proportions. Given these sleep deficits,
we aimed to test whether sleep-dependent emotional memory consolidation is
reduced in this population. We utilized a mild TBI group (3.7±2.9 years
post-injury) and an uninjured (non-TBI) population. Participants viewed negative
and neutral images both before and after a 12-hr period containing sleep ("Sleep"
group) or an equivalent period of time spent awake ("Wake" group). Participants
rated images for valence/arousal at both sessions, and memory recognition was
tested at session two. The TBI group had less REM, longer REM latency, and more
sleep complaints. Sleep-dependent memory consolidation of non-emotional images
was present in all participants. However, consolidation of negative images was
only present in the non-TBI group. A lack of differentiation between the TBI
Sleep and Wake groups was due to poor performance in the sleep group and,
unexpectedly, enhanced performance in the wake group. Additionally, although the
non-TBI participants habituated to negative images over a waking period, the TBI
participants did not. We propose disrupted sleep- and wake-dependent emotional
processing contributes to poor emotional outcomes following chronic, mild TBI.
This work has broad implications, as roughly one-third of the US population will
sustain a mild TBI during their lifetime.

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