Total sleep deprivation (SD) for as little as 24 hours can result in measurable decline in cognitive performance.¹ Beyond experimental settings, changes in attention, memory, and decision-making contribute to increased physician errors while on shift duty,^2,3 and deficits in vigilant attention can result in fatal transport accidents.⁴ Despite a growing number of editorials and advisories5 regarding the health risks of SD, selfimposed denial of sleep has become increasingly prevalent in urban societies. As such, what was formerly of interest primarily to the military has become a global health and safety concern. This has motivated an awakening of research into the mechanisms underlying SD-related cognitive decline. Additionally, it has become of interest to identify individuals susceptible to the effects of SD and to ascertain the appropriateness of countermeasures deployed to reduce functional deficits where SD is unavoidable. Functional magnetic resonance imaging (fMRI) has attracted considerable interest as a tool in these research areas because it complements observing behavior, provides a clearer spatial localization of cognitive effects than electroencephalography (EEG), and can be performed repeatedly without significant safety concerns. The fMRI studies reviewed here pertain to studies examining task-related activation in sleep-deprived individuals and to reports on the delayed effects of sleep or SD on neural activation. The latter set of studies were performed primarily to characterize memory consolidation.

Imaging Task-related Activation During Sleep Deprivation
Several cognitive domains have been evaluated in the context of 24, 35, and 48 hours of total SD (see Table 1). Chronic partial SD, while more common, is more difficult to study because proper experimental control is difficult and more expensive to realize.

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