REM mentation in narcoleptics and normals: an empirical test of two neurocognitive theories

This study tested the two main neurocognitive models of dreaming by using cognitive data elicited from REM sleep in normals and narcoleptics. The two models were the "activation-only" view which holds that, in the context of sleep, overall activation of the brain is sufficient for consciousness to proceed in the manner of dreaming (e.g., Antrobus, 1991; Foulkes, 1993; Vogel, 1978); and the Activation, Input source, Modulation (AIM model), which predicts that not only brain activation level but also neurochemical modulatory systems exert widespread effects upon dreaming (Hobson & McCarley, 1977; Hobson, Pace-Schott, & Stickgold, 2000). Mental activity was studied in nocturnal REM in 15 narcoleptics and 9 normal healthy persons and in REM at the onset of daytime naps and nighttime sleep (SOREM) in narcoleptics. The study was performed in the subjects' homes, using instrumental awakenings and ambulatory polysomnographic techniques, and focused upon visual vividness, mentation report length, improbable and discontinuous bizarre features, and reflective consciousness. Within each subject group, most cognitive variables tended to fluctuate in line with expected variations in circadian activation level. When comparing the cognitive variables between the two groups, reflective consciousness was clearly highest in narcoleptics, whereas improbabilities and discontinuities were lower, with mentation report length and visual vividness differing less between the groups. These findings are consistent with the AIM model of sleep mentation, but not with the activation-only model.     

Cerebral blood flow in normal and abnormal sleep and dreaming

Measurements of regional or local cerebral blood flow (CBF) by the xenon-133 inhalation method and stable xenon computerized tomography CBF (CTCBF) method were made during relaxed wakefulness and different stages of REM and non-REM sleep in normal age-matched volunteers, narcoleptics, and sleep apneics. In the awake state, CBF values were reduced in both narcoleptics and sleep apneics in the brainstem and cerebellar regions. During sleep onset, whether REM or stage I-II, CBF values were paradoxically increased in narcoleptics but decreased severely in sleep apneics, while in normal volunteers they became diffusely but more moderately decreased. In REM sleep and dreaming CBF values greatly increased, particularly in right temporo-parietal regions in subjects experiencing both visual and auditory dreaming.     

Motivation and affect in REM sleep and the mentation reporting process

Although the emotional and motivational characteristics of dreaming have figured prominently in folk and psychoanalytic conceptions of dream production, emotions have rarely been systematically studied, and motivation, never. Because emotions during sleep lack the somatic components of waking emotions, and they change as the sleeper awakens, their properties are difficult to assess. Recent evidence of limbic system activation during REM sleep suggests a basis in brain architecture for the interaction of motivational and cognitive properties in dreaming. Motivational and emotional content in REM and NREM laboratory mentation reports from 25 participants were compared. Motivational and emotional content was significantly greater in REM than NREM sleep, even after controlling for the greater word count of REM reports.     

Cognitive and emotional processes during dreaming: a neuroimaging view

Dream is a state of consciousness characterized by internally-generated sensory, cognitive and emotional experiences occurring during sleep. Dream reports tend to be particularly abundant, with complex, emotional, and perceptually vivid experiences after awakenings from rapid eye movement (REM) sleep. This is why our current knowledge of the cerebral correlates of dreaming, mainly derives from studies of REM sleep. Neuroimaging results show that REM sleep is characterized by a specific pattern of regional brain activity. We demonstrate that this heterogeneous distribution of brain activity during sleep explains many typical features in dreams. Reciprocally, specific dream characteristics suggest the activation of selective brain regions during sleep. Such an integration of neuroimaging data of human sleep, mental imagery, and the content of dreams is critical for current models of dreaming; it also provides neurobiological support for an implication of sleep and dreaming in some important functions such as emotional regulation.     

Dreaming and the brain: toward a cognitive neuroscience of conscious states

Sleep researchers in different disciplines disagree about how fully dreaming can be explained in terms of brain physiology. Debate has focused on whether REM sleep dreaming is qualitatively different from nonREM (NREM) sleep and waking. A review of psychophysiological studies shows clear quantitative differences between REM and NREM mentation and between REM and waking mentation. Recent neuroimaging and neurophysiological studies also differentiate REM, NREM, and waking in features with phenomenological implications. Both evidence and theory suggest that there are isomorphisms between the phenomenology and the physiology of dreams. We present a three-dimensional model with specific examples from normally and abnormally changing conscious states.     

Dreaming,cognition, and physical illness: Part I

Part I of a two part article on the effect upon dreaming on physical illness briefly explores the historical medico-philosophical antecedents of the notion that dreams can be diagnostic of bodily disease. Modern sleep research findings relating REM sleep to physiologic changes are also explored. The controversy of whether dreams are merely the consequence of random brain activity or whether they are a valid psychological phenomenon is discussed. Six contemporary views of the function of REM sleep are outlined. A seventh view of dreaming, that of a “cognitive monitoring system” is suggested. Like earlier historical notions, it is suggested that dreaming is a cognitive activity that processes bodily cues indicating illness or disease. Part II. presents a clinical compendium of dreams relating to Part I.     

A review of mentation in REM and NREM sleep: "covert" REM sleep as a possible reconciliation of two opposing models

Numerous studies have replicated the finding of mentation in both rapid eye movement (REM) and nonrapid eye movement (NREM) sleep. However, two different theoretical models have been proposed to account for this finding: (1) a one-generator model, in which mentation is generated by a single set of processes regardless of physiological differences between REM and NREM sleep; and (2) a two-generator model, in which qualitatively different generators produce cognitive activity in the two states. First, research is reviewed demonstrating conclusively that mentation can occur in NREM sleep; global estimates show an average mentation recall rate of about 50% from NREM sleep--a value that has increased substantially over the years. Second, nine different types of research on REM and NREM cognitive activity are examined for evidence supporting or refuting the two models. The evidence largely, but not completely, favors the two-generator model. Finally, in a preliminary attempt to reconcile the two models, an alternative model is proposed that assumes the existence of covert REM sleep processes during NREM sleep. Such covert activity may be responsible for much of the dreamlike cognitive activity occurring in NREM sleep.     

Testing the involvement of the prefrontal cortex in lucid dreaming: A tDCS study

Recent studies suggest that lucid dreaming (awareness of dreaming while dreaming) might be associated with increased brain activity over frontal regions during rapid eye movement (REM) sleep. By applying transcranial direct current stimulation (tDCS), we aimed to manipulate the activation of the dorsolateral prefrontal cortex (DLPFC) during REM sleep to increase dream lucidity. Nineteen participants spent three consecutive nights in a sleep laboratory. On the second and third nights they randomly received either 1 mA tDCS for 10 min or sham stimulation during each REM period starting with the second one. According to the participants’ self-ratings, tDCS over the DLPFC during REM sleep increased lucidity in dreams. The effects, however, were not strong and found only in frequent lucid dreamers. While this indicates some preliminary support for the involvement of the DLPFC in lucid dreaming, further research, controlling for indirect effects of stimulation and including other brain regions, is needed.     

The Primary Process: Freud’s Profound Yet Neglected Contribution to the Psychology of Consciousness

ABSTRACT

The primary process model is part of Freud’s struggle to define and distinguish conscious and unconscious mental activity. He created two embryonic models of unconscious mind. One he derived from studying symptoms of dynamic repression or sequestration of content already capable of symbolic mental representation. The other, the primary process, is his landmark effort to define a mental activity different from reflective representational thought, derived from studying dreaming. He could not clearly separate the repression model, as it is also based on the primary process. He vacillated as to whether the primary process is qualitatively different from representational symbolic thought. His efforts to articulate preconscious mentation suggest an ambiguous gray area between conscious thought and the primary process. Although he concluded that the primary process is unconscious because it is not intrinsically reflective, its manifestations are psychologically conscious and directly evident except in the physiologically unconscious state of dreaming. Similar problems color the efforts of others including Klein, Matte-Blanco, and theorists of attachment and implicit learning to separate conscious and unconscious mind and to articulate a model of mental function different from reflective consciousness. A model of conscious mental activity different from reflective representational consciousness, called primordial consciousness, is proposed to account for a wide spectrum of human phenomena both normal and pathological that share characteristics of immediacy and belief. They include, in addition to dreaming, psychosis, creativity, spirituality, and mental process in non-western cultures.     

Cortical arousal and mentation in sleeping and waking subjects

Cognitive variables and cortical arousal levels were examined in order to determine whether differences in cortical arousal levels within REM and waking could account for different aspects of mentation derived from the two states. Cognitive variables were derived from mentation reports collected from 30 subjects in both the waking state and after being awakened from REM sleep. Mentation reports were independently scored on seven content rating scales, by two judges blind to the conditions. These scales include among others, Total Recall Count (TRC), a count of all words in which the subject described his/her experience during the previous interval. The EEG activity, obtained from left and right midtemporoparietal and central sites, was recorded for 5-min periods before obtaining mentation reports. The absolute power of the EEG activity was calculated for each of six bandwidths. EEG power data from both waking and REM were entered into multiple linear regression equations to predict TRC. No relationships were found between TRC and general cortical activation, as measured by the EEG. Other statistical analyses, including relationships between EEG and scales of visual imagery, are discussed.     

Brain-mind states: reciprocal variation in thoughts and hallucinations

The exclusion of thinking from recent studies of sleep mentation has hindered a full appreciation of how cognitive activity differs across the states of waking and sleep. To overcome this limitation, this study investigated thoughts and hallucinations using experience sampling, home-based sleep-wake monitoring, and formal analyses of the psychological data. The prevalence of thoughts decreased gradually from waking through sleep onset and non-REM sleep, to reach its nadir in REM sleep, whereas hallucinations increased sharply across these states. Furthermore, multiple occurrences of hallucinations but not of thoughts increased significantly from sleep onset through non-REM sleep, to a peak in REM sleep. This reciprocity in thoughts and hallucinations might reflect a progressive shift from high to low aminergic-to-cholinergic neuromodulatory ratios across wake-sleep states, accompanied by an array of changes in the regional activation patterns of the brain.     

EEG asymmetry and sleep mentation during REM and NREM

The hypothesis that dreaming is mediated by the right hemisphere was evaluated by monitoring EEG power asymmetry during REM and NREM sleep, and obtaining mentation reports when short-term temporal shifts in the EEG indicated relative left- or right-hemispheric dominance. Content analyses provided no support for the right-hemisphere hypothesis; indeed, some scales showed higher content during relative left-hemispheric dominance. In contrast to earlier reports, no difference between REM and NREM in EEG asymmetry was observed.     

Cognitive asymmetry and dreaming: lack of relationship

The present study investigated the relationship between cognitive laterality and dream recall, dream characteristics, and eye movement density in rapid eye movement (REM) sleep. Fifty-two right-handed males, age 20-30 years, were tested on a six-test battery of which three tests measure right hemisphere function and three tests measure left hemisphere function. Based on their performance, 14 subjects were selected for a sleep laboratory study. Each spent 3 experimental nights in the laboratory during which they were awakened from REM sleep for dream reports. Dream reports were scored for bizarreness, emotions, visual elements, and overall "dreamlike" versus "thoughtlike" character. Subjects were awakened from 123 REM periods, of which 96 yielded positive dream reports (78.04%). Neither the rate of recall nor the four evaluation scores were correlated with the laterality scores that were constructed from the six-test battery. Eye movement density during REM sleep was significantly positively correlated with the total performance of the two hemispheres. These results do not support the alleged lateralization of dreaming. In agreement with recent reports in the literature, it is concluded that dreaming cannot be seen as a "right hemisphere" function.     

Dreaming: cognitive processes during cortical activation and high afferent thresholds

The concepts of nonlocal, or distributed, cortical and cognitive activation are examined for their usefulness in describing the relations between sleep and waking neurocognitive processes. Changes in the pattern of distributed activation and inhibition of selected portions of sensory, cognitive, and motor decision modules account for the differences in imagery and thought across sleep and waking states in comparable environments. The massive inhibition of sensory and proprioceptive input to perceptual modules in Stage 1 REM sleep leaves the perceptual and cognitive modules, by default, with their own output as their sole input. Given this constraint, the activation of portions of the cortical structures that execute waking perceptual, cognitive and motor responses is necessary and sufficient to produce the imagery and thought of dreaming sleep. Connectionist models are introduced so that neurophysiological and cognitive concepts of distributed and local activation and inhibition can be translated into a common language, and in so doing, are used to simulate several processes fundamental to the production of imaginal thought and dreaming.     

Auditory Verbal Experience and Agency in Waking,Sleep Onset,REM, and Non‐REM Sleep

We present one of the first quantitative studies on auditory verbal experiences (“hearing voices”) and auditory verbal agency (inner speech, and specifically “talking to (imaginary) voices or characters”) in healthy participants across states of consciousness. Tools of quantitative linguistic analysis were used to measure participants’ implicit knowledge of auditory verbal experiences (VE) and auditory verbal agencies (VA), displayed in mentation reports from four different states. Analysis was conducted on a total of 569 mentation reports from rapid eye movement (REM) sleep, non‐REM sleep, sleep onset, and waking. Physiology was controlled with the nightcap sleep–wake mentation monitoring system. Sleep‐onset hallucinations, traditionally at the focus of scientific attention on auditory verbal hallucinations, showed the lowest degree of VE and VA, whereas REM sleep showed the highest degrees. Degrees of different linguistic‐pragmatic aspects of VE and VA likewise depend on the physiological states. The quantity and pragmatics of VE and VA are a function of the physiologically distinct state of consciousness in which they are conceived.     

Psychoanalytic dream theory and recent neurobiological findings about REM sleep

I have reviewed Hobson and McCarley's activation-synthesis hypothesis of dreaming which attempts to show that the instigation and certain formal aspects of dreaming are physiologically determined by a brainstem neuronal mechanism, their reasons for suggesting major revisions in psychoanalytic dream theory, and neurophysiological data that are inconsistent with their hypothesis. I then discussed the concept of mind-body isomorphism pointing out that they use this concept inconsistently, that despite their denials they regularly view physiology as primary and psychological processes as secondary, and that they frequently make the error of mixing the languages of physiology and psychology in their explanatory statements. Finally, in order to evaluate Hobson and McCarley's claim that their findings require revision of psychoanalytic dream theory, I examined their discussions of chase dreams, flying dreams, sexual dreams, the formal characteristics of dreams, the forgetting of dreams, and the instigation of dreams. I concluded that although their fascinating physiological findings may be central to understanding the neurobiology of REM sleep, they do not alter the meaning and interpretation of dreams gleaned through psychoanalytic study.     

Dreaming and REM sleep are controlled by different brain mechanisms

The paradigmatic assumption that REM sleep is the physiological equivalent of dreaming is in need of fundamental revision. A mounting body of evidence suggests that dreaming and REM sleep are dissociable states, and that dreaming is controlled by forebrain mechanisms. Recent neuropsychological, radiological, and pharmacological findings suggest that the cholinergic brain stem mechanisms that control the REM state can only generate the psychological phenomena of dreaming through the mediation of a second, probably dopaminergic, forebrain mechanism. The latter mechanism (and thus dreaming itself) can also be activated by a variety of nonREM triggers. Dreaming can be manipulated by dopamine agonists and antagonists with no concomitant change in REM frequency, duration, and density. Dreaming can also be induced by focal forebrain stimulation and by complex partial (forebrain) seizures during nonREM sleep, when the involvement of brainstem REM mechanisms is precluded. Likewise, dreaming is obliterated by focal lesions along a specific (probably dopaminergic) forebrain pathway, and these lesions do not have any appreciable effects on REM frequency, duration, and density. These findings suggest that the forebrain mechanism in question is the final common path to dreaming and that the brainstem oscillator that controls the REM state is just one of the many arousal triggers that can activate this forebrain mechanism. The "REM-on" mechanism (like its various NREM equivalents) therefore stands outside the dream process itself, which is mediated by an independent, forebrain "dream-on" mechanism.     

Strengths and weaknesses of McNamara's evolutionary psychological model of dreaming

This article includes a brief overview of McNamara's (2004) evolutionary model of dreaming. The strengths and weaknesses of this model are then evaluated in terms of its consonance with measurable neurological and biological properties of dreaming, its fit within the tenets of evolutionary theories of dreams, and its alignment with evolutionary concepts of cooperation and spirituality. McNamara's model focuses primarily on dreaming that occurs during rapid eye movement (REM) sleep; therefore this article also focuses on REM dreaming.     

Mental time travel to the future might be reduced in sleep

We present a quantitative study of mental time travel to the future in sleep. Three independent, blind judges analysed a total of 563 physiology-monitored mentation reports from sleep onset, REM sleep, non-REM sleep, and waking. The linguistic tool for the mentation report analysis is based on established grammatical and cognitive-semantic theories and has been validated in previous studies. Our data indicate that REM and non-REM sleep must be characterized by a reduction in mental time travel to the future, which would support earlier physiological evidence at the level of brain function.     

The prefrontal cortex in sleep

Experimental data indicate a role for the prefrontal cortex in mediating normal sleep physiology, dreaming and sleep-deprivation phenomena. During nonrandom-eye-movement (NREM) sleep, frontal cortical activity is characterized by the highest voltage and the slowest brain waves compared to other cortical regions. The differences between the self-awareness experienced in waking and its diminution in dreaming can be explained by deactivation of the dorsolateral prefrontal cortex during REM sleep. Here, we propose that this deactivation results from a direct inhibition of the dorsolateral prefrontal cortical neurons by acetylcholine, the release of which is enhanced during REM sleep. Sleep deprivation influences frontal executive functions in particular, which further emphasizes the sensitivity of the prefrontal cortex to sleep.