Automated detection of nocturnal slow eye movements modulated by selective serotonin reuptake inhibitors

Abstract

Introduction: Eye movements convey important information about brain function. Neuropsychiatric conditions and medications may produce abnormal eye movements (EMs) in sleep. Serotonergic drugs are known to increase nocturnal EMs. Few studies have quantified sleep EMs due to technical complexity. We investigated the effects of serotonergic drugs on slow EMs in sleeping patients using an objective automated EM quantification tool.

Methods: We studied patients who had polysomnograms for clinical assessment. We identified 5 sertraline, 7 citalopram, and 4 fluoxetine users who were not using other psychoactive medications. Controls were 10 age-matched patients on no medications. An automated objective EM detection tool was developed. The first and last 5 min of each sleep stage were assessed. ANOVA was used to assess the effects of time, stage, and medication.

Results: No differences were noted between SSRI users and controls in demographics. Medications were associated with more slow EMs compared to controls (p<0.05). Among SSRI users, a non-statistical trend was noted for increasing slow EMs in the following pattern: sertraline<citalopram<fluoxetine; this is in keeping with the known serotonergic effects of these SSRIs in pharmacological studies.

Conclusions: Neurotransmitter effects are reflected in nocturnal EMs during many stages of sleep. Analysis of EMs in sleep may be further developed as an endophenotype for various neuropsychiatric conditions and medication responses.