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Biol Psychiatry DOI:10.1016/j.biopsych.2015.10.003

Reduced Sleep Spindles in Schizophrenia: A Treatable Endophenotype That Links Risk Genes to Impaired Cognition?

Publication TypeJournal Article
Year of Publication2016
AuthorsManoach, DS, Pan, JQ, Purcell, SM, Stickgold, R
JournalBiol Psychiatry
Date Published2016 Oct 15
KeywordsAnimals, Cognition Disorders, Endophenotypes, Genetic Predisposition to Disease, Genome-Wide Association Study, Humans, Memory Consolidation, Schizophrenia, Sleep Initiation and Maintenance Disorders, Sleep Stages

Although schizophrenia (SZ) is defined by waking phenomena, abnormal sleep is a common feature. In particular, there is accumulating evidence of a sleep spindle deficit. Sleep spindles, a defining thalamocortical oscillation of non-rapid eye movement stage 2 sleep, correlate with IQ and are thought to promote long-term potentiation and enhance memory consolidation. We review evidence that reduced spindle activity in SZ is an endophenotype that impairs sleep-dependent memory consolidation, contributes to symptoms, and is a novel treatment biomarker. Studies showing that spindles can be pharmacologically enhanced in SZ and that increasing spindles improves memory in healthy individuals suggest that treating spindle deficits in patients with SZ may improve cognition. Spindle activity is highly heritable, and recent large-scale genome-wide association studies have identified SZ risk genes that may contribute to spindle deficits and illuminate their mechanisms. For example, the SZ risk gene CACNA1I encodes a calcium channel that is abundantly expressed in the thalamic spindle generator and plays a critical role in spindle activity based on a mouse knockout. Future genetic studies of animals and humans can delineate the role of this and other genes in spindles. Such cross-disciplinary research, by forging empirical links in causal chains from risk genes to proteins and cellular functions to endophenotypes, cognitive impairments, symptoms, and diagnosis, has the potential to advance the mechanistic understanding, treatment, and prevention of SZ. This review highlights the importance of deficient sleep-dependent memory consolidation among the cognitive deficits of SZ and implicates reduced sleep spindles as a potentially treatable mechanism.


Alternate JournalBiol. Psychiatry
PubMed ID26602589
PubMed Central IDPMC4833702
Grant ListK24 MH099421 / MH / NIMH NIH HHS / United States
R01 MH048832 / MH / NIMH NIH HHS / United States
R01 MH092638 / MH / NIMH NIH HHS / United States
R21 MH099448 / MH / NIMH NIH HHS / United States