The mechanisms underlying the generation of rapid eye movement (REM) sleep are poorly understood. Despite a lack of direct support, neurons maximally active during REM sleep (REM sleep-active) located in the pedunculopontine tegmental nucleus (PPTn) are hypothesized to generate this state and its component phenomenology. This hypothesis has never been directly tested, since the results of selectively inhibiting this cell-group have never been determined. Using microdialysis, electrophysiology, histochemical and pharmacological methods in freely-behaving rats (n=22) instrumented for sleep-wake state and respiratory muscle recordings, I selectively inhibited REM sleep-active PPTn neurons. Contrary to the prevailing hypothesis, I showed that REM sleep-active PPTn neurons suppress REM sleep by limiting the frequency of its onset. These neurons also shape the impact of REM sleep on breathing. REM sleep-active PPTn neurons restrain behavioural activation of upper-airway musculature during REM sleep, while depressing breathing rate and respiratory activation of the upper-airway musculature across sleep-wake-states.

The mechanisms underlying the generation of rapid eye movement (REM) sleep are poorly understood. Despite a lack of direct support, neurons maximally active during REM sleep (REM sleep-active) located in the pedunculopontine tegmental nucleus (PPTn) are hypothesized to generate this state and its component phenomenology. This hypothesis has never been directly tested, since the results of selectively inhibiting this cell-group have never been determined. Using microdialysis, electrophysiology, histochemical and pharmacological methods in freely-behaving rats (n=22) instrumented for sleep-wake state and respiratory muscle recordings, I selectively inhibited REM sleep-active PPTn neurons. Contrary to the prevailing hypothesis, I showed that REM sleep-active PPTn neurons suppress REM sleep by limiting the frequency of its onset. These neurons also shape the impact of REM sleep on breathing. REM sleep-active PPTn neurons restrain behavioural activation of upper-airway musculature during REM sleep, while depressing breathing rate and respiratory activation of the upper-airway musculature across sleep-wake-states.

Major depressive disorder (MDD) is a mood disorder majorly responsible for disability and mortality worldwide. With a lifetime prevalence of 15-20%, it is the main cause of functional impairment in Western societies as well as the fourth most debilitating illness in the world. Although the pathophysiology of MDD is not yet fully understood, some evidence that suggest the presence of a neuroanatomical deficiency have given rise to the theory of a specific imbalance in the monoamine neurotransmitters noradrenaline (NA) and/or serotonin (5-HT) levels in the brain. Overall, the various classes of antidepressant agents that have been developed to increase monoamine levels on the basis of this proposal have been successful. However, facts relating to prevalent escalation in the illness and recurring episodes of depression point towards a need to enhance clinical treatment. Most conventional antidepressants such as selective serotonin reuptake inhibitors (SSRI) and selective serotonin and noradrenaline inhibitors (SNRI) pose problems in symptomatic improvement. These include therapeutic lag, safety and tolerability issues, making more than 30% patients with MDD unable to reach adequate relief. In this respect, the action mechanism has moved beyond conventional SSRI and lead to the introduction of vilazodone, a novel antidepressant with an additional 5-HT1A partial agonist profile argued to be of potential benefit for a greater efficacy, faster onset of action and better tolerability. Using secondary data, this project aimed to evaluate the role of vilazodone as a SPARI-drug in the overall clinical treatment of MDD as well as its potential in addressing some of the most common obstacles in antidepressant treatment. Study results proved vilazodone’s efficacy to be superior to placebo. Patients across all studies showed significant improvement in depressive symptoms measured in MADRS and HAMD17. Vilazodone was also shown to be generally safe and tolerable but was not positively distinguished from placebo with regards to adverse effects. An overall, meaningful improvement in depressive symptoms was demonstrated in vilazodone, which reinforces its merit as an important treatment option for patients with MDD.