ࡱ>  #zbjbj11 4SSq5@@@@@TTT88,T,dLL,N,N,N,N,N,N,$y.+1^r,@r,@@, @@L, L, Vt'@8(&Wk' 8,,0,'x1o18(8(1@L( r,r, ,1 : Beyond Spontaneity: A Study of Intrusive Language Episodes in Hypnagogic Sleep Irving Massey ( HYPERLINK "mailto:massey@buffalo.edu" massey@buffalo.edu) The behavior of the language system at the beginning of sleep remains an unexplored subject. To the best of my knowledge, there has been no examination, by fMRI or by any other means, of those areas of the brain usually associated with language during the hypnagogic state. In an effort to determine whether I had missed some publication on this subject, I wrote in 2008 to the foremost authority on sleep onset, Dr. Pierre Maquet, asking whether some work had been done in this area. A copy of our correspondence follows: E-mail to Dr. Pierre Maquet, University of Lige, 2/05/2008: Dear Dr. Maquet: I am writing to you at the suggestion of Dr. Sophie Schwartz. I am a layman, but I have a strong interest in sleep studies. I have noticed that, at least for myself, at sleep onset there is a dissociation of the language stream from the image/action stream which, for me, is virtually diagnostic of the beginning of sleep. That is, at that point the words that one imagines gradually drift away from relevance to the images and events that one is imagining. I have been looking for years for imaging studies of the language centres at sleep onset, but have not succeeded in finding any. Nor have I found a neurologist willing to attempt such studies. I should be most grateful if you could direct me to work of this sort. Si vous prfrez rpondre en franais, nhsitez pas. Je saurai me dbrouiller! With thanks, Irving Massey Reply, May 03, 2008 As far as I know, and unless Im much mistaken, I dont know of any dataset looking specifically at the language areas during sleep onset using functional neuroimaging. Pierre MAQUET . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Dr. Maquet is recognized as an authority on sleep onset. As far as I can determine, the situation he describes remains unchanged: as of this date, there has been no examination of the brains language system at the beginning of sleep. As early as 1906, Kraepelin (Heynick 1993, p. 141) postulated unusual activity in both Wernickes and Brocas areas during dream speech and related phenomena, but, of course, he was in no position to verify his surmise. Bosinelli (1991, p. 137) says that The psychophysiological determinants of sleep onset (SO) mentation still present dark areas that need exploring. Harsh and Ogilvie (1994, p. xxviii) remark that The study of sleep-onset processes has really just begun. Hubbard (2010, p. 312) argues that dream speech has still not been sufficiently studied. I believe the area that I have defined, dream speech during hypnagogia, would be a fertile field for investigation, presenting an opportunity for pioneering work on an insufficiently researched topic. First Person Perspective. A project that begins from introspection and personal observation (see my e-mail to Maquet, above) may be regarded with doubt by some psychologists. Nevertheless, we have to begin somewhere, and many well-established facts in psychology have their root in self-observation (Schwartz 2004, p. 15; Schwartz, 2005, p. 432, also citing William James). Dr. Sophie Schwartz, head of the Sleep and Cognition Neuroimaging Laboratory at the University of Geneva, whose work comes closest to my own in the area of sleep research, has studied the dream process for many years through self-observation coupled with brain imaging, as has Tore Nielsen (1995); and Mishara (2010, p. 26) remarks on the recent openness in cognitive and clinical neuroscience to studying the so-called first person perspective . . . . In fact, Kraepelins (1906) pioneering study of language behavior in dream and dreamlike states derives almost entirely from self-observation, as does Jouvets work on dreams (see Heynick 1993, p. 250). To get a sense of the importance that some have attached to the observation of their own hypnagogic imagery, one might consider the case of Salvador Dali (Pagel, 2008, p. 30). Dali would hold a coin in his hand while falling asleep and, when the coin fell, would rouse himself in order to capture and paint the images he had just experienced. Apparently the military psychiatrists who examined Richard Feynman also took such experiences seriously, since they classified him 4F on the suspicion that he was subject to auditory hypnagogic illusions (Feynman, 1985, p. 161). Connectivity. It is, of course, understood that the language system at the neurological level is of great complexity, with its internal controls (Fu et al., 2006; de Haene, 2009; Hubbard, 2010, p. 318), and that it is not confined to Brodmann areas 22, 44, 45, and the arcuate fasciculus (as Blank, 2002, p. 1829 emphasizes); nevertheless, I would suggest these areas for particular attention, at least as a point of departure. At a later stage in this research, the possibility of a reduction at sleep onset in the connectivity between areas associated with language and those that mediate vision and action would have to be explored; that enterprise, however, would be considerably more demanding, in terms of both technical and interpretive resources. Examples of Verbal Intrusions and/or Dissociation. The particular form of dissociation that I would like to study, the intrusion of irrelevant words or phrases on dream content at the approach of sleep, may be regarded as a subspecies of dream bizarreness. It has been described previously in the literature on overt dream speech, but not as a covert feature of dream onset indicating the beginning of sleep. A striking example of dissociation between mentation and overt dream speech in Arkin (1981) is cited by Heynick (1993, p. 248): on being awakened after an episode of sleep talking concerning the odor of Cassius Clays armpit (etc.!), the subject reported his thought as having been about an attempt to buy a hamburger by depositing money in a subway turnstile. In fact, (loc. cit.; see also Arkin, 1991, pp. 422-423), only about half of the reports of dream mentation following awakening show congruence with the previous overt dream speech episodes. Arkin (1981, p. 290) speaks of cognitive subsystems that may emit speech independent of the executive ego. A few examples from my own experience at sleep onset during a recent stay in London should suffice to clarify the point. On May 25th, while attempting to fall asleep, I was visualizing a large painting, or surface, rather in the manner of Barnett Newmans work, that was black and orange, but the words sepia and orange, rather than black and orange, presented themselves clearly to me as describing the painting. A stronger example: on June 10th, I was falling asleep and articulating to myself, not aloud, in a very calm, relaxed way, the name of a Swiss friend of mine, when the totally irrelevant phrase the only family auction forced itself into my consciousness. On June 13, 2010 I was drifting off to sleep while visualizing a primitive rural scene when the phrase The Gauls imposed itself on my consciousness; I roused myself and wrote it down. About the same date, in the same place, as I was approaching sleep, I was meditating on the possibility that I might have to go in for an MRI in connection with some chest pain that I had been having. The words (the first four approximately, the last five very clearly) Have you any idea where the bread is down? intruded on my awareness. Very recently, while I was thinking about Unitarianism, the sentence Indonesia is right on the road emerged from somewhere. To borrow a phrase from another context (Mishara 2010, p. 41), these are instances of aberrant salience. Numerous other examples may be found in Massey 2009, pp. 59-83, as well as in Mavromatis (2010), pp 33-35. Lia Kvavilashvili and a team of researchers at the University of Hertfordshire have been studying intrusions during wakefulness. It may be possible to account for these apparent intrusions as derived from daytime experiences or preoccupations subliminally remembered and confused, but that is not the point of this inquiry. The point is that they are noticed and identified at the time as irrelevant, as unrelated to the content, action, and imagery of approaching dreams. The question is, then: what physiological events are taking place in the language system when these intrusions occur, so that language seems to have detached itself from everything else that is going on in the mind at the time? At least when these intrusions appear to be nonsensical, they resemble the symptoms of Wernickes or fluent aphasia, and suggest a defect in the function of Wernickes area at sleep onset coupled with continued activity in Brocas. Some suggestions concerning the physiological conditions attending dissociated speech events during sleep have been made, but they are general, provide no concrete physiological information about the behavior of the language centers in particular during such events, and in any case do not focus on sleep onset. One suggestion, following Maury (1862) on desynchronization, Hilgard (1973) on partially subordinate control systems, and later pursued by Arkin (1981), is that there is a loosening of executive control in sleep, with the hierarchies of subsystems or modules shifting, and parts of the brain that do not usually achieve full expression blurting out their content (a kind of Tourettism, one might say, or something like what often occurs in OCD. See also Schmidt 2007 on the return of the repressed, not necessarily in a Freudian sense, during dreams). Schwartz also speaks of disturbances in integration between modules during sleep and, in particular, of dissociation between verbal and motor activities (Schwartz, 2004, p. 7; Schwartz, 2005, p. 433). Striking evidence of dissociation is to be found in cases reported as early as 1883 (Charcot, as cited in Schwartz, 2005, p. 428) in which the visual function disappears entirely during dream, leaving the verbal independently preserved. (See also Solms, 1997, and Schwartz, 2005, p. 429, citing the case of a patient of her own who had lost the capacity to dream in images). Role of the Subordinate Hemisphere. A slightly more specific opinion, common at least since the work of Hughlings Jackson (1958) is that the subordinate hemisphere, despite its familiar linguistic limitations, finds access to some degree of independent speech during dream. Bosinelli (1991, p. 142) cites the earlier (1986) work of Bertini et al. suggesting right hemispheric activation in hypnagogic sleep. Bertini (2004) has found that there is a decrease of inhibition of the right-to-left motor cortex during the night. Sperry (1973), Jouvet (1978), and Arkin (1981), all as reported in Heynick (1993, p. 250) suggest that alterations in the conductive patterns of the corpus callosum lead to the partial disinhibition of the subordinate hemisphere during sleep. If I understand their argument correctly, Hori et al (1994, p. 251) seem to be saying that the RH is aroused during periods of hypnagogic imagery (HI). Schwartz (2005, p. 435) also speaks of the loss of reciprocal restraints between brain regions. And Hubbard (2010, p. 318) associates the right auditory cortex with auditory imagery in general; it may therefore be a facilitator of auditory imagery during sleep. Since the intrusions of which I have been speaking are often superimposed upon concurrent normal language processes at sleep onset, there is a possibility that they may be emanating, not from the usual language areas, but from another part of the brain, possibly the contralateral language areas. They may be manifestations of what might be called a ghost language, sometimes referred to in literature, a language that proceeds in us as if indifferent to, or sometimes in violation of, our conscious intentions (see Massey, 2009, pp. 63-70, 77). Stages of Sleep Onset. Recent research by Magnin et al. (2010) points to another aspect of dissociation at sleep onset. It would appear that the thalamus falls asleep before the cortex does, by as much as 10 minutes or more, depending on which Brodmann area is being tested. The authors remark that this is a situation that may be propitious to the development of hypnagogic experiences so common during the wake-sleep transition . . . . (Magnin et al., p. 3830). Even this important discovery adds little to our understanding of the specific phenomenon with which this proposal is concerned, but it does enhance our understanding of the sleep process in general, and it has the merit of specifying the rates at which various areas of the cortex lag behind the thalamus at sleep onset. The rather more radical suggestion that sleep is a local process (Krueger et al., p. 3), that there are local islands of sleep (ibid., p. 5), and that parts of the brain can be asleep while other parts are awake (ibid., p. 24), would reinforce the impression that dissociated or even discordant activities may be common both at sleep onset and during sleep itself. It hardly seems necessary to add another level of complexity to this already intricate subject, but, if, as Zeman (2010, p. 154) implies, content itself is processed in areas possibly distinct from those associated with other neural activities, the subvocal or tacit utterances of hypnagogic sleep could, in principle, sometimes be mere phonological simulacra, entirely without meaning. (See above, p. 3, on Wernickes aphasia). Of course, even if this were so, the fact of their occurrence would still call for explanation. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . The Sleeping Brain. Before attempting to implement a physiological study of the behavior of the language system during sleep onset, one may ask whether that target, the language system, is identical in the sleeping and in the waking brain. There are some indications that the resources called upon during the two conditions, although they overlap, are not identical. To begin with, it has been observed that imagery, whether auditory or visual, employs only certain portions of the areas involved in actual perception (Hubbard, 2010, p. 321; Zeman, 2010, p. 153). What is more intriguing is the possibility that the dreaming brain, as it generates its images, may have certain resources unavailable to the waking brain: here the case of the stroke patient who recovered his mental imagery in dream before he was able to summon or experience imagery when awake (Zeman, 2010, pp. 147, 154) is striking. (It must be acknowledged, though, that this phenomenon may have been caused simply by damage to the voluntary pathway to imagery). Fosse et als observation (Fosse et al., 2004, p. 302) of phasic activity in the muscles of the middle ear during REM sleep is of special interest for the present inquiry, which is concerned with imagined speech during sleep onset. Localization and Baselines. For the purposes of this investigation, though, such a fine discrimination between systems is not necessary. The main task would be to define the principal physical areas of observation, to establish certain base lines of function for each of these areas during normal waking conditions, whether in active or in default mode (and/or as profiled in the Connectome), and to observe changes in the signature of these areas during sleep onset. For the localization of vocalization, Fu (2006) is satisfactory; for the localization of inner speech, see Hubbard (2010) pp. 311, 317-318. For the localization of the self-monitoring system of speech in the superior temporal gyrus and the middle temporal gyrus see Zheng (2010) as well as Fu (2006). Behavior of Language Areas During Sleep Onset. At the present stage of inquiry, even if the attempt to capture a particular strange phrase as it slips through the mind and to correlate it, by the subjects verbal report, with a specific event in the record of brain activity, should not be successful, it would still be of great utility to obtain a fuller general record than has heretofore been available of the behaviour of the major areas associated with language at sleep onset as well as, if possible, during sleep itself. That record could then become a basis for further research and eventually for a variety of correlations. In an e-mail of 02/4/11, the dream researcher Dr. Sophie Schwartz has suggested that the broader framework for such a study would be investigating factors that modulate functional brain/mental inter-modal integration, with a view to seeing some aspects of the multimodal incongruent processing. Dr. Schwartz has proposed some strategies for such procedures, and may herself soon be in a position to provide preliminary data in this area of inquiry. Hypothesis: The hypothesis to be explored is that episodes of inner speech unrelated to other mentation occur in hypnagogic and hypnopompic sleep. Supporting Theory: In an e-mail to me of 06/17/11, Dr. Max Garagnani of mrc-cbu.ca.ac.uk writes that, as soon as global inhibition . . . is removed or lowered (as might happen when we fall asleep), a sea of C[ell] A[ssemblie]s is released from suppression, and each of them becomes free to self-ignite. The prediction is that such a spontaneous surge of non-relevant thoughts/words/images may *only* be experienced if the consciousness threshold is (1) sufficiently low to release CAs from their global inhibition and enable diffused spontaneous ignition of non-relevant CAs, but still (2) sufficiently high so that consciousness/attention is able to wake up and regain control, while what has just been witnessed (i. e., the intrusion of one or more non-relevant thoughts) can still be remembered. If this hypothesis is correct, such episodes of spontaneous thoughts/images perception should occur only while we are just about to fall asleep, or when we are close to waking up. . . . one may be able to use EEG to test whether this is the case. Procedure. Subjects would be provided with timed voice recorders that would register any utterances of the subjects and the exact time when such utterances were made. Subjects would be instructed to say aloud words or phrases that occurred to them as they were falling asleep or waking up, with a summary of attendant mental content. For instance, a subject might say I heard the words Berlin was a real thing during a boat race. [Authors own example]. The experiment should be conducted in as natural an environment as possible. At the same time, EEG recordings (preferably High Density EEG) would be made, which would be correlated with the subjects utterances, as well as providing information about brain processes occurring at the time. As Dr. Tristan Bekinschtein of mrc-cbu.cam.ac.uk puts it, in an e-mail to the author of 06/18/11, I think first there is the need of defining when in EEG terms the intrusions occur. . . In principle, if the eeg stage where the intrusions occur it [sic] is not that variable, then it would be possible to catch these particular moments of incoherence of inner speech as a change in the language network configuration or connectivity. Remarks. Using a self-reporting technique, with a timed voice recorder, avoids the necessity of employing an attendant to monitor subjects speech, as well as the intrusive effect of involving another person in an interaction with subjects, thereby disturbing the delicate stages of the transition between waking and sleep, as with requests for information. In observing results, the possibility that intrusive language may be overlaid on other kinds of language, and not only on imagery or action, should not be ignored. Discrepancies between intrusive phrases and mental context as reported by subjects are of special interest. On the EEG, attention should be paid to any surge of activity in the language areas of the subordinate hemisphere, particularly in the equivalent of Brocas area. In a personal interview, Dr. Schwartz offered the opinion that High Density EEG would be the most appropriate technique for studying the language system at sleep onset, especially since the areas to be examined do not, for the most part, lie deep within the skull. (See the University of Utah HD-EEG program as described on the Web under Template Text for Protocol Summary). As a noninvasive technique, and one that does not have to deal with the noise levels associated with fMRI, it would have obvious advantages. Optical Imaging, such as that offered by the EROS system, is another possibility (see Zheng, 2010). Czisch (2002) has used masking methods to reduce the noise of fMRI, but also required prolonged sleep deprivation to make sure that his subjects would be asleep when they were being studied; this procedure may have produced unnatural sleep patterns. There are also Magnetic Source Imaging (Castillo, 2001), Diffusion Spectrum Imaging (Sporns, 2010, p. 3), and other methods that might be considered. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . It has recently been suggested to me, by Dr. Tristan Bekinschtein of the Department of Psychology at the University of Cambridge, that another, or possibly a supplementary, approach to the study of hypnagogia might be attempted. Ideally it would be combined with the one outlined above, in a two-pronged strategy. Rather than beginning with the acquisition of fresh data, it would cull data from previous sleep studies. Since most such studies concern themselves with the sleep state itself rather than with pre-sleep, or the transition to sleep, a vast amount of information about the behaviour of the language centres during hypnagogic state must lie fallow in the files of any sleep researcher. Dr. Bekinschtein has suggested that I approach some established scholar in sleep studies with a request that she/he share with me data of this kind, i. e., the part of her/his fMRI records that pertain to that interval during which subjects are in the scanner but are not yet asleep; these records would be the unused byproduct of that scholars research into the sleep state itself. (Dr. Schwartz has, in fact, agreed to share such information from her lab as it becomes available.) Assurances of full acknowledgment in any published results would, of course, be given. Such information, analyzed, possibly, by a student at the post-doctoral level, could then be combined with the more narrowly focused results of the EEG studies proposed above. Personnel with competence in several different specialties might be involved, from those familiar with imaging techniques, whether HD-EEG or other, to those expert in reading and interpreting the results, to those knowledgeable in the statistical language in which those results would be expressed. Bibliography  ADDIN EN.REFLIST Arkin, A. M. (1981). Sleep-talking: psychology and psychophysiology. Hillsdale, NJ: Lawrence Erlbaum Associates, Inc. Arkin, A. M. (1991). Sleeptalking. In S. J. Ellman & J. S. Antrobus (Eds.), The mind in sleep: Psychology and psychophysiology (pp. 415-436). New York: John Wiley & Sons. Bertini, M., De Gennaro, L., Ferrara, M., Curcio, G., Cristiani, R., Romei, V., et al. (2004). 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