Targeting sleep oscillations to improve memory in schizophrenia
Open accessAbstract
Although schizophrenia is defined by waking phenomena, a growing literature documents a deficit in sleep spindles, a defining oscillation of stage 2 non-rapid eye movement sleep. Compelling evidence supports an important role for spindles in cognition, and particularly memory. In schizophrenia, although the spindle deficit correlates with impaired sleep-dependent memory consolidation, recent clinical trials find that increasing spindles does not improve memory. This may reflect that sleep-dependent memory consolidation relies not on spindles alone, but also on their precise temporal coordination with cortical slow oscillations and hippocampal sharp-wave ripples. Consequently, interventions to improve memory in schizophrenia must not only increase spindles, but also preserve or enhance slow oscillations, hippocampal ripples and their temporal relations. Because hippocampal ripples and the activity of the thalamic spindle generator are difficult to measure noninvasively, screening potential interventions requires complementary animal and human studies. In this review we (i) propose that sleep oscillations are novel pathophysiological targets for therapy to improve cognition in schizophrenia; (ii) summarize our understanding of how these oscillations interact to consolidate memory; (iii) suggest that a systems neuroscience strategy is essential to selecting and evaluating effective treatments, and illustrate this with findings from clinical trials; and (iv) selectively review the interventional literature relevant to sleep and cognition, covering both pharmacological and noninvasive brain stimulation approaches. We conclude that coordinated sleep oscillations are promising targets for improving cognition in schizophrenia and that effective therapies will need to preserve or enhance sleep oscillatory dynamics and restore function at the network level.
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Closed-loop auditory stimulation has shown promise with clinical populations including people with schizophrenia, older adults, and children with ADHD.
“For example, closed-loop auditory stimulation has shown promise with clinical populations including people with schizophrenia [32] older adults [33], and children with ADHD [34].”
From Sleep and memory consolidation in healthy, neurotypical children, and adults: a summary of systematic reviews and meta-analyses. (2023) · cites this paper as [32]
In the section on noninvasive brain stimulation during sleep (page unavailable), the review reports promising results for closed-loop auditory stimulation, including in people with mild cognitive impairment. It does not report promising results in people with schizophrenia; instead, it says these methods have seldom been used in other clinical populations. The schizophrenia portion attributed to citation [32] is therefore unsupported. (LLM, conf=0.87)
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Schizophrenia, IX: Cognition in Schizophrenia—The MATRICS Initiative
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Interhemispheric Interactions of the Human Thalamic Reticular Nucleus
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Schizophrenia, other neuropsychiatric disorders and sleep
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Self-citation
- Authors
- Manoach, D. S., Mylonas, D., & Baxter, B.
- Affiliations
- Harvard University (US)
- Corresponding author
- Manoach, Dara S.
- Venue
- Schizophrenia Research
- Publisher
- Elsevier BV
- Published
- 2020-07
- Volume
- 221
- Pages
- 63-70
- ISSN
- 0920-9964 (ISSN-L)
- PMC
- PMC7316628
- OpenAlex
- W3003390330
- Cited by
- 36
- References
- 102
- Citations by year
- 2025: 5 · 2024: 4 · 2023: 8 · 2022: 8 · 2021: 6 · 2020: 5
- FWCI
- 3.63
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Schizophrenia Research (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute of Mental Health
- National Heart Lung and Blood Institute
- National Center for Research Resources
- Topics
- Life Sciences › Neuroscience › Cognitive Neuroscience › Sleep and Wakefulness Research
- Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
- Life Sciences › Neuroscience › Cognitive Neuroscience › Neural dynamics and brain function
- Keywords
- schizophrenia, sleep spindles
- MeSH terms
- Memory Consolidation, Animals, Electroencephalography, Hippocampus, Humans, Memory, Schizophrenia, Sleep, Sleep Stages
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