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, 41 (7), 470-482

Slow-Wave Activity Enhancement to Improve Cognition


Slow-Wave Activity Enhancement to Improve Cognition

Kristine A Wilckens et al. Trends Neurosci.


Slow-wave activity (SWA), and its coupling with other sleep features, reorganizes cortical circuitry, supporting cognition. This raises the question: can cognition be improved through SWA enhancement? SWA enhancement techniques range from behavioral interventions (such as exercise), which have high feasibility but low specificity, to laboratory-based techniques (such as transcranial stimulation), which have high specificity but are less feasible for widespread use. In this review we describe the pathways through which SWA is enhanced. Pathways encompass enhanced neural activity, increased energy metabolism, and endocrine signaling during wakefulness; also direct enhancement during sleep. We evaluate the robustness and practicality of SWA-enhancement techniques, discuss approaches for determining a causal role of SWA on cognition, and present questions to clarify the mechanisms of SWA-dependent cognitive improvements.

Keywords: NREM sleep; executive function; memory consolidation; slow-wave activity.

Conflict of interest statement

Conflict of Interest Statement:

Over the past 5 years, Dr. Buysse has served as a paid consultant for the following companies, each at a level of less than $5000 per 12-month period: Bayer HealthCare, BeHealth Solutions, Cereve, CMEOutfitters, Emmi Solutions, Medscape, Merck, Purdue. The authors have no other conflicts of interest to disclose.


Figure 1 (Key Figure)
Figure 1 (Key Figure). Cascade of events resulting in behaviorally induced NREM SWA and the central nervous system consequences
Neural activity results in ATP release, which either converts to adenosine or activates astrocyte signaling of SWA-promoting cytokines, IL1 and TNFα. GABA-ergic neural inhibition leads to neural synchrony characterizing SWA. This groups phasic bursts of activity through thalamocortical spindles and hippocampal ripples that change the firing rate of synapses to consolidate memories and restore daytime function. Ellipses list examples of wake-based (yellow) and sleep-based (blue) techniques that enhance SWA through this cascade.
Figure 2
Figure 2. Process Sunder baseline conditions (gray) and under increased brain energy consumption (yellow)
Sleep drive and propensity for SWA accumulate during wakefulness and dissipate during sleep (gray). Sleep drive accumulates more rapidly with increased brain energy consumption, as with increased neural activity and energy metabolism (yellow). Thus, slow-wave activity is higher following sleep onset. A similar function would be hypothesized for endocrine signaling.

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