A multimodal 7T MRI and biomarker study reveals reversible brain changes following acute sleep deprivation

Acute sleep deprivation is known to impair vigilance performance and alter brain physiology. This study investigates structural, physiological and cognitive effects of one night of sleep deprivation (SD) and subsequent recovery. Thirty healthy participants underwent (18M/12F, mean age 28.0 ± 4.7 years, range 20–38) a multimodal assessment including 7T MRI, plasma biomarker analysis, and Psychomotor Vigilance Task (PVT) testing at three time points: baseline, after 24 h of SD, and following a 72-h recovery period. Our results demonstrate that SD induced a significant increase in total perivascular space (PVS) volume (from 6711.5 mm 3 to 7475.3 mm 3 ; p < 0.001), a marker of impaired glymphatic function, which completely normalized after recovery. These macrostructural changes were accompanied by reversible microstructural alterations, including decreased T1 relaxation times and shifts in quantitative susceptibility mapping (QSM) in multiple brain regions, indicative of dynamic fluid shifts. Systemically, SD led to an increase in pro-inflammatory markers, notably MMP-9 (from 52.3 pg/mL to 69.2 pg/mL; p < 0.05), and changes in multiple peripheral biomarkers. Behaviorally, participants exhibited significantly more attentional lapses (slowest 10 % RT: 386.4 ms–410 ms; p < 0.05), which were also reversed upon recovery. In conclusion, a single night of SD triggers a cascade of interconnected and fully reversible physiological changes, likely initiated by transient glymphatic disruption. Healthy individuals are able to recover mostly from one night of SD, suggesting that adverse effects of SD, when not in a chronic state, can potentially be reversed. • One night of sleep deprivation reversibly enlarges brain perivascular spaces. • 7T quantitative MRI shows reversible fluid shifts and microstructural changes. • Sleep deprivation induces transient increases in plasma MMP-9 and neurotrophies. • Cognitive deficits from sleep loss fully normalize with subsequent recovery sleep.