Evidence map›Paper›PMID 42244756›Full record

ArticlebioRxiv : the preprint server for biology2026

A hypothalamic-brainstem activity sequence underlies arousal fluctuations during daytime drowsiness.

Ewa Beldzik, Nicholas G Cicero, Daniel E P Gomez, Zinong Yang, Juan Eugenio Iglesias, Brian Edlow, Laura D Lewis

Abstract readPreprint
In one paragraph

Article in bioRxiv : the preprint server for biology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Ewa BeldzikInstitute for Medical Engineering and Sciences, Massachusetts Institute of Technology, Cambridge, MA, USA.ORCID 0000-0002-5511-4131
Nicholas G CiceroInstitute for Medical Engineering and Sciences, Massachusetts Institute of Technology, Cambridge, MA, USA.ORCID 0000-0001-6382-7353
Daniel E P GomezAthinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, MA, USA.
Zinong YangInstitute for Medical Engineering and Sciences, Massachusetts Institute of Technology, Cambridge, MA, USA.ORCID 0000-0002-7283-3701
Juan Eugenio IglesiasAthinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, MA, USA.
Brian EdlowAthinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, MA, USA.ORCID 0000-0001-7235-8456
Laura D LewisInstitute for Medical Engineering and Sciences, Massachusetts Institute of Technology, Cambridge, MA, USA.ORCID 0000-0002-4003-0277

Funding

Viral Tool Development Core: Visualization and manipulation of brain fluid dynamics by recombinant viral vectorsU19NS128613 · NINDS · UNIVERSITY OF ROCHESTER · PI Laura Diane Lewis · 2022 to 2026
$13.6M
Project 4U19NS123717 · NINDS · BOSTON UNIVERSITY (CHARLES RIVER CAMPUS) · PI LINNINGER, ANDREAS A · 2021 to 2025
$13.4M
Sleep-dependent modulation of cerebrospinal fluid flow in aging and across genetic risk for Alzheimers diseaseR01AG070135 · NIA · MASSACHUSETTS INSTITUTE OF TECHNOLOGY · PI LEWIS, LAURA DIANE · 2021 to 2025
$3.3M
Imaging neurovascular physiology in persistent fatigue after COVID-19R21NS123412 · NINDS · BOSTON UNIVERSITY (CHARLES RIVER CAMPUS) · PI LEWIS, LAURA DIANE · 2021 to 2021
$469k
Ascending Arousal Network Control of Sleep-Wake Structure in Humans Using Simultaneous EEG and High-Resolution fMRIF31NS139696 · NINDS · BOSTON UNIVERSITY MEDICAL CAMPUS · PI Nicholas Gregory Cicero · 2024 to 2026
$74k
NIA NIH HHS R01 AG070135NINDS NIH HHS F31 NS139696NINDS NIH HHS R21 NS123412NINDS NIH HHS U19 NS123717NINDS NIH HHS U19 NS128613
6 · The paper itself

Abstract

During monotonous tasks, struggling with drowsiness leads to dynamic fluctuations in vigilance and task performance. Whether these moment-to-moment fluctuations are regulated by sleep- wake control circuitry remains unknown. Here, we used high-resolution 7T fMRI optimized for subcortical imaging to resolve activity across the human arousal regulatory system, including the hypothalamus, brainstem nuclei, basal forebrain, and thalamus, during a sustained attention task as subjects spontaneously experienced drowsiness. We identified a coordinated activity pattern locked to behavioral failures: widespread transient suppression during arousal drops and reactivation during recovery across all arousal-promoting regions, with opposite responses in the sleep-promoting hypothalamic preoptic area. These changes unfolded over ~10-15 s in a 30 consistent sequence, led by the hypothalamic nuclei. Furthermore, suppression of brainstem nuclei preceded cortical infraslow (<0.05 Hz) oscillations, implicating a role in global neurovascular dynamics. These findings provide a temporally resolved, network-level portrait of human subcortical dynamics during drowsiness and identify a hypothalamic-led, brainstem-mediated activity sequence underlying behavioral arousal fluctuations and global cortical hemodynamics.

Identifiers

PMID42244756
PMCPMC13232331

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LicenceCC BY-NC-ND
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.