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Cerebral perfusion during pharmacologically induced sleep: Cortical and subcortical changes quantified by ASL MRI
Balázs Örzsik1, Iris Asllani2, Derk-Jan Dijk3
1Radiology, Leiden University Medical Center, Leiden, Netherlands; CISC, Brighton and Sussex Medical School, Brighton, United Kingdom.
Neuroimage
|November 25, 2025
Summary
Arterial spin labeling MRI revealed significant decreases in cerebral blood flow during sleep, particularly in arousal network regions. This noninvasive technique offers new insights into sleep-related brain function.
Area of Science:
- Neuroimaging
- Sleep Science
- Vascular Biology
Background:
- Positron emission tomography (PET) studies show reduced cerebral blood flow (CBF) during non-REM sleep, but PET has limitations.
- Arterial spin labeling (ASL) MRI offers noninvasive, repeatable CBF measurement but is underutilized in sleep research.
- The ascending arousal network (AAN) plays a crucial role in maintaining wakefulness.
Purpose of the Study:
- To examine global and regional CBF changes during wakefulness and pharmacologically induced sleep using ASL MRI.
- To explore the impact of sleep on the ascending arousal network (AAN).
- To provide a detailed ASL characterization of perfusion changes during sleep.
Main Methods:
- Twenty-one healthy participants underwent ASL MRI during wakefulness and pharmacologically induced sleep (10 mg Zolpidem after sleep deprivation).
- Sleep was verified by reduced button-press responses and increased high-frequency heart rate variability (HF-HRV).
- Pseudo-continuous ASL was acquired with specific labeling duration and post-labeling delay parameters.
Main Results:
- CBF decreased significantly in both grey matter (59.7 to 49.5 ml/100g/min) and white matter (28.7 to 25.1 ml/100g/min).
- Voxelwise analysis showed CBF reductions in the cingulate cortex, medial prefrontal cortex, precuneus, insula, thalamus, and caudate.
- Significant decreases were observed in AAN regions, including the Locus Coeruleus, Medial Reticular Formation, Pontis Oralis, and Pedunculopontine Nucleus.
Conclusions:
- The observed perfusion decreases align with PET findings of cortical and thalamic downregulation during sleep.
- These results indicate suppression of brainstem arousal nuclei during pharmacologically induced sleep.
- ASL MRI provides a valuable tool for characterizing brain perfusion changes during sleep, extending previous PET research and offering insights into arousal systems.
