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Ricciardiello A, McKinnon AC, Mowszowski L, LaMonica HM, Schrire ZM, Haroutonian C, Lam A, Hickie IB, D'Rozario A, Naismith SL. Assessing sleep architecture and cognition in older adults with depressive symptoms attending a memory clinic. J Affect Disord 2024; 348:35-43. [PMID: 38123073 DOI: 10.1016/j.jad.2023.12.032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Revised: 11/28/2023] [Accepted: 12/13/2023] [Indexed: 12/23/2023]
Abstract
BACKGROUND While depression is intrinsically and bidirectionally linked with both sleep disturbance and cognition, the inter-relationships between sleep, cognition, and brain integrity in older people with depression, especially those with late-onset depression are undefined. METHODS One hundred and seventy-two older adults (mean age 64.3 ± 6.9 years, Depression: n = 66, Control: n = 106) attending a memory clinic underwent a neuropsychological battery of declarative memory, executive function tasks, cerebral magnetic resonance imaging and overnight polysomnography with quantitative electroencephalography. RESULTS The time spent in slow-wave sleep (SWS) and rapid eye movement (REM) sleep, slow-wave activity, sleep spindles, hippocampal volume and prefrontal cortex thickness did not differ between depression and control and depression onset groups. However, sleep onset latency (p = 0.005) and REM onset latency (p = 0.02) were later in the Depression group compared to controls. Less SWS was associated with poorer memory (r = 0.31, p = 0.023) in the depression group, and less SWS was related to better memory in the control group (r = -0.20, p = 0.043; Fishers r-to-z = -3.19). LIMITATIONS Longitudinal studies are needed to determine if changes in sleep in those with depressive symptoms predict cognitive decline and illness trajectory. CONCLUSION Older participants with depressive symptoms had delayed sleep initiation, suggestive of delayed sleep phase. The association between SWS and memory suggests SWS may be a useful target for cognitive intervention in older adults with depression symptoms. Reduced hippocampal volumes did not mediate this relationship, indicating a broader distributed neural network may underpin these associations.
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Affiliation(s)
- Andrea Ricciardiello
- School of Psychology, Faculty of Science, University of Sydney, Camperdown, NSW, Australia; Healthy Brain Ageing Program, Brain and Mind Centre, University of Sydney, Camperdown, NSW, Australia; CIRUS, Centre for Sleep and Chronobiology, Woolcock Institute of Medical Research, Macquarie University, Camperdown, NSW, Australia.
| | - Andrew C McKinnon
- School of Psychology, Faculty of Science, University of Sydney, Camperdown, NSW, Australia; Healthy Brain Ageing Program, Brain and Mind Centre, University of Sydney, Camperdown, NSW, Australia; CogSleep, Australian National Health and Medical Research Council Centre of Research Excellence, Australia
| | - Loren Mowszowski
- School of Psychology, Faculty of Science, University of Sydney, Camperdown, NSW, Australia; Healthy Brain Ageing Program, Brain and Mind Centre, University of Sydney, Camperdown, NSW, Australia; CogSleep, Australian National Health and Medical Research Council Centre of Research Excellence, Australia
| | - Haley M LaMonica
- School of Psychology, Faculty of Science, University of Sydney, Camperdown, NSW, Australia; Healthy Brain Ageing Program, Brain and Mind Centre, University of Sydney, Camperdown, NSW, Australia; Faculty of Medicine and Health, University of Sydney, Camperdown, NSW, Australia
| | - Zoe Menczel Schrire
- School of Psychology, Faculty of Science, University of Sydney, Camperdown, NSW, Australia; Healthy Brain Ageing Program, Brain and Mind Centre, University of Sydney, Camperdown, NSW, Australia; CIRUS, Centre for Sleep and Chronobiology, Woolcock Institute of Medical Research, Macquarie University, Camperdown, NSW, Australia; CogSleep, Australian National Health and Medical Research Council Centre of Research Excellence, Australia
| | - Carla Haroutonian
- School of Psychology, Faculty of Science, University of Sydney, Camperdown, NSW, Australia; Healthy Brain Ageing Program, Brain and Mind Centre, University of Sydney, Camperdown, NSW, Australia; CIRUS, Centre for Sleep and Chronobiology, Woolcock Institute of Medical Research, Macquarie University, Camperdown, NSW, Australia
| | - Aaron Lam
- School of Psychology, Faculty of Science, University of Sydney, Camperdown, NSW, Australia; Healthy Brain Ageing Program, Brain and Mind Centre, University of Sydney, Camperdown, NSW, Australia; CIRUS, Centre for Sleep and Chronobiology, Woolcock Institute of Medical Research, Macquarie University, Camperdown, NSW, Australia; School of Psychological Sciences, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, NSW, Australia
| | - Ian B Hickie
- School of Psychological Sciences, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, NSW, Australia
| | - Angela D'Rozario
- School of Psychology, Faculty of Science, University of Sydney, Camperdown, NSW, Australia; CIRUS, Centre for Sleep and Chronobiology, Woolcock Institute of Medical Research, Macquarie University, Camperdown, NSW, Australia; CogSleep, Australian National Health and Medical Research Council Centre of Research Excellence, Australia; School of Psychological Sciences, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, NSW, Australia
| | - Sharon L Naismith
- School of Psychology, Faculty of Science, University of Sydney, Camperdown, NSW, Australia; Charles Perkins Centre, University of Sydney, Camperdown, NSW, Australia; Healthy Brain Ageing Program, Brain and Mind Centre, University of Sydney, Camperdown, NSW, Australia; CogSleep, Australian National Health and Medical Research Council Centre of Research Excellence, Australia
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Kishi TT, Andersen ML, Luciano YM, Kakazu VA, Tufik S, Pires GN. Methods for REM Sleep Density Analysis: A Scoping Review. Clocks Sleep 2023; 5:793-805. [PMID: 38131750 PMCID: PMC10742531 DOI: 10.3390/clockssleep5040051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Revised: 11/21/2023] [Accepted: 12/01/2023] [Indexed: 12/23/2023] Open
Abstract
Rapid eye movements (REM) sleep density is the parameter proposed to explain the variability in the amount of eye movements during REM sleep. Alterations in REM sleep density have been proposed as a screening criterion for individuals with depression and other mental health conditions, but its accuracy has not been properly evaluated. The lack of consensus and the variability of the methods used to score it reduces the external validity of the results, hindering an adequate analysis of its diagnostic accuracy and clinical applicability. This scoping review aimed to identify and quantify the methods used to score REM sleep density, describing their main characteristics. A literature search was conducted in PubMed, Scopus, PsycInfo, and Web of Science. Only studies with objective measures for REM sleep density analysis in individuals with depression were considered eligible. The final sample comprised 57 articles, covering 64 analyses of REM sleep density. The relative frequency methods were the predominant measurement parameter for analyzing REM sleep density across studies. The most frequently adopted REM estimation unit was the number of REM events followed by mini-epochs containing REM. The most common unit of measurement were frequency/time measures. The results demonstrate that there is no consistency in the methods used to calculate REM sleep density in the literature, and a high percentage of studies do not describe their methods in sufficient detail. The most used method was the number of REM episodes per minute of REM sleep, but its use is neither unanimous nor consensual. The methodological inconsistencies and omissions among studies limit the replicability, comparability, and clinical applicability of REM sleep density. Future guidelines should discuss and include a specific methodology for the scoring of REM sleep density, so it can be consensually implemented in clinical services and research.
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Affiliation(s)
- Tamires Tiemi Kishi
- Departamento de Psicobiologia, Federal University of São Paulo, São Paulo 04024-002, Brazil; (T.T.K.)
| | - Monica Levy Andersen
- Departamento de Psicobiologia, Federal University of São Paulo, São Paulo 04024-002, Brazil; (T.T.K.)
- Sleep Institute, São Paulo, 04020-060, Brazil
| | - Ygor Matos Luciano
- Departamento de Psicobiologia, Federal University of São Paulo, São Paulo 04024-002, Brazil; (T.T.K.)
| | - Viviane Akemi Kakazu
- Departamento de Psicobiologia, Federal University of São Paulo, São Paulo 04024-002, Brazil; (T.T.K.)
| | - Sergio Tufik
- Departamento de Psicobiologia, Federal University of São Paulo, São Paulo 04024-002, Brazil; (T.T.K.)
- Sleep Institute, São Paulo, 04020-060, Brazil
| | - Gabriel Natan Pires
- Departamento de Psicobiologia, Federal University of São Paulo, São Paulo 04024-002, Brazil; (T.T.K.)
- Sleep Institute, São Paulo, 04020-060, Brazil
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3
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Montini A, Iranzo A, Cortelli P, Gaig C, Muñoz-Lopetegi A, Provini F, Santamaria J. Scoring sleep in neurodegenerative diseases: A pilot study in the synucleinopathies. Sleep Med 2023; 110:268-286. [PMID: 37678074 DOI: 10.1016/j.sleep.2023.08.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2023] [Revised: 08/03/2023] [Accepted: 08/23/2023] [Indexed: 09/09/2023]
Abstract
BACKGROUND Neurodegenerative diseases often alter sleep architecture, complicating the application of the standard sleep scoring rules. There are no recommendations to overcome this problem. Our aim was to develop a scoring method that incorporates the stages previously applied in dementia with Lewy Bodies (DLB), anti-IgLON5 disease, and fatal insomnia, and to test it in patients with alpha-synucleinopathies. METHODS Video-polysomnographies (VPSG) of nine patients (DLB:3, Parkinson's disease (PD):3, and multiple system atrophy (MSA):3) selected for their difficulty in applying standard rules were scored independently by two authors, using additional Sleep/Wake stages. These included Abnormal Wake, Subwake, Undifferentiated NREM sleep (UNREM), Poorly structured N2 (P-S N2) and abnormal REM sleep including REM without atonia (RWA), REM without low-amplitude, mixed-frequency EEG activity (RWL) and REM without rapid eye movements (RWR). RESULTS Patients (4 females) had a median age of 74 (range 63-85). Six patients (all with PD or DLB) had abnormal EEG awake and Subwake stage. UNREM sleep was present in all patients, typically at sleep onset, and was the most common sleep stage in five. P-S N2 was recorded only in the three patients with MSA. Periods of normal and abnormal NREM coexisted in three patients. RWA was the predominant REM subtype, RWR occurred mainly in patients with MSA and RWL in those with DLB. Six patients had brief REM episodes into NREM sleep which we termed "Encapsulated RBD". CONCLUSION Our scoring system allows an accurate description of the complex sleep-wake changes in patients with alpha-synucleinopathies.
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Affiliation(s)
- Angelica Montini
- Department of Biomedical and NeuroMotor Sciences (DiBiNeM), University of Bologna, Bologna, Italy.
| | - Alex Iranzo
- Sleep Disorders Center, Neurology Service, Hospital Clínic de Barcelona, Barcelona, Spain; Clinical Neurophysiology Group, Institut D'Investigacions Biomediques August Pi I Sunyer (IDIBAPS), Barcelona, Spain; CIBERNED CB06/05/0018-ISCIII, Spain; Universitat de Barcelona, Barcelona, Spain.
| | - Pietro Cortelli
- Department of Biomedical and NeuroMotor Sciences (DiBiNeM), University of Bologna, Bologna, Italy; IRCCS Istituto Delle Scienze Neurologiche di Bologna, Bologna, Italy.
| | - Carles Gaig
- Sleep Disorders Center, Neurology Service, Hospital Clínic de Barcelona, Barcelona, Spain; Clinical Neurophysiology Group, Institut D'Investigacions Biomediques August Pi I Sunyer (IDIBAPS), Barcelona, Spain; CIBERNED CB06/05/0018-ISCIII, Spain; Universitat de Barcelona, Barcelona, Spain.
| | - Amaia Muñoz-Lopetegi
- Sleep Disorders Center, Neurology Service, Hospital Clínic de Barcelona, Barcelona, Spain; Clinical Neurophysiology Group, Institut D'Investigacions Biomediques August Pi I Sunyer (IDIBAPS), Barcelona, Spain; CIBERNED CB06/05/0018-ISCIII, Spain.
| | - Federica Provini
- Department of Biomedical and NeuroMotor Sciences (DiBiNeM), University of Bologna, Bologna, Italy; IRCCS Istituto Delle Scienze Neurologiche di Bologna, Bologna, Italy.
| | - Joan Santamaria
- Emeritus Consultant and Researcher, Hospital Clínic of Barcelona and Biomedical Research Institute (IDIBAPS), Spain.
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Casagrande M, Forte G, Favieri F, Corbo I. Sleep Quality and Aging: A Systematic Review on Healthy Older People, Mild Cognitive Impairment and Alzheimer’s Disease. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19148457. [PMID: 35886309 PMCID: PMC9325170 DOI: 10.3390/ijerph19148457] [Citation(s) in RCA: 26] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Revised: 06/27/2022] [Accepted: 07/07/2022] [Indexed: 02/01/2023]
Abstract
Aging is characterized by changes in the structure and quality of sleep. When the alterations in sleep become substantial, they can generate or accelerate cognitive decline, even in the absence of overt pathology. In fact, impaired sleep represents one of the earliest symptoms of Alzheimer’s disease (AD). This systematic review aimed to analyze the studies on sleep quality in aging, also considering mild cognitive impairment (MCI) and AD. The review process was conducted according to the PRISMA statement. A total of 71 studies were included, and the whole sample had a mean age that ranged from 58.3 to 93.7 years (62.8–93.7 healthy participants and 61.8–86.7 pathological populations). Of these selected studies, 33 adopt subjective measurements, 31 adopt objective measures, and 10 studies used both. Pathological aging showed a worse impoverishment of sleep than older adults, in both subjective and objective measurements. The most common aspect compromised in AD and MCI were REM sleep, sleep efficiency, sleep latency, and sleep duration. These results underline that sleep alterations are associated with cognitive impairment. In conclusion, the frequency and severity of sleep disturbance appear to follow the evolution of cognitive impairment. The overall results of objective measures seem more consistent than those highlighted by subjective measurements.
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Affiliation(s)
- Maria Casagrande
- Department of Dynamic and Clinical Psychology and Health Studies, Sapienza University of Rome, 00185 Roma, Italy;
- Correspondence: (M.C.); (I.C.)
| | - Giuseppe Forte
- Department of Dynamic and Clinical Psychology and Health Studies, Sapienza University of Rome, 00185 Roma, Italy;
- Body and Action Laboratory, IRCCS Santa Lucia Foundation, Via Ardeatina 306, 00179 Rome, Italy;
| | - Francesca Favieri
- Body and Action Laboratory, IRCCS Santa Lucia Foundation, Via Ardeatina 306, 00179 Rome, Italy;
- Department of Psychology, Sapienza University of Rome, Via dei Marsi 78, 00185 Roma, Italy
| | - Ilaria Corbo
- Department of Psychology, Sapienza University of Rome, Via dei Marsi 78, 00185 Roma, Italy
- Correspondence: (M.C.); (I.C.)
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Sleep in Alzheimer's disease: a systematic review and meta-analysis of polysomnographic findings. Transl Psychiatry 2022; 12:136. [PMID: 35365609 PMCID: PMC8976015 DOI: 10.1038/s41398-022-01897-y] [Citation(s) in RCA: 32] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Revised: 03/04/2022] [Accepted: 03/11/2022] [Indexed: 02/05/2023] Open
Abstract
Polysomnography (PSG) studies of sleep changes in Alzheimer's disease (AD) have reported but not fully established the relationship between sleep disturbances and AD. To better detail this relationship, we conducted a systematic review and meta-analysis of reported PSG differences between AD patients and healthy controls. An electronic literature search was conducted in EMBASE, MEDLINE, All EBM databases, CINAHL, and PsycINFO inception to Mar 2021. Twenty-eight studies were identified for systematic review, 24 of which were used for meta-analysis. Meta-analyses revealed significant reductions in total sleep time, sleep efficiency, and percentage of slow-wave sleep (SWS) and rapid eye movement (REM) sleep, and increases in sleep latency, wake time after sleep onset, number of awakenings, and REM latency in AD compared to controls. Importantly, both decreased SWS and REM were significantly associated with the severity of cognitive impairment in AD patients. Alterations in electroencephalogram (EEG) frequency components and sleep spindles were also observed in AD, although the supporting evidence for these changes was limited. Sleep in AD is compromised with increased measures of wake and decreased TST, SWS, and REM sleep relative to controls. AD-related reductions in SWS and REM sleep correlate with the degree of cognitive impairment. Alterations in sleep EEG frequency components such as sleep spindles may be possible biomarkers with relevance for diagnosing AD although their sensitivity and specificity remain to be clearly delineated. AD-related sleep changes are potential targets for early therapeutic intervention aimed at improving sleep and slowing cognitive decline.
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Kent BA, Feldman HH, Nygaard HB. Sleep and its regulation: An emerging pathogenic and treatment frontier in Alzheimer's disease. Prog Neurobiol 2021; 197:101902. [PMID: 32877742 PMCID: PMC7855222 DOI: 10.1016/j.pneurobio.2020.101902] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Revised: 07/19/2020] [Accepted: 08/18/2020] [Indexed: 02/07/2023]
Abstract
A majority of patients with Alzheimer's disease (AD) experience some form of sleep disruption, including nocturnal sleep fragmentation, increased daytime napping, decreased slow-wave sleep (SWS, stage N3), and decreased rapid-eye-movement sleep (REM). Clinical studies are investigating whether such sleep disturbances are a consequence of the underlying disease, and whether they also contribute to the clinical and pathological manifestations of AD. Emerging research has provided a direct link between several of these sleep disruptions and AD pathophysiology, suggesting that treating sleep disorders in this population may target basic mechanisms of the disease. Here, we provide a comprehensive review of sleep disturbances associated with the spectrum of AD, ranging from the preclinical stages through dementia. We discuss how sleep interacts with AD pathophysiology and, critically, whether sleep impairments can be targeted to modify the disease course in a subgroup of affected AD patients. Ultimately, larger studies that fully utilize new diagnostic and experimental tools will be required to better define the most relevant sleep disturbance to target in AD, the interventions that best modulate this target symptom, and whether successful early intervention can modify AD risk and prevent dementia.
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Affiliation(s)
- Brianne A Kent
- Division of Sleep and Circadian Disorders, Brigham and Women's Hospital, Harvard Medical School, Boston, USA; Division of Neurology, University of British Columbia, Vancouver, Canada.
| | - Howard H Feldman
- Division of Neurology, University of British Columbia, Vancouver, Canada; Department of Neurosciences, University of California, San Diego, La Jolla, USA
| | - Haakon B Nygaard
- Division of Neurology, University of British Columbia, Vancouver, Canada
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7
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Sleep spindle abnormalities related to Alzheimer's disease: a systematic mini-review. Sleep Med 2020; 75:37-44. [PMID: 32853916 DOI: 10.1016/j.sleep.2020.07.044] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Revised: 06/28/2020] [Accepted: 07/22/2020] [Indexed: 11/20/2022]
Abstract
Accumulating evidence supports a bidirectional relationship between sleep disruption and Alzheimer's disease (AD) pathology. Among various sleep electroencephalography activities, the sleep spindle is one specific electroencephalographic rhythm that has potential to be a biomarker for AD. This review explores the association between sleep spindles and AD-related dementia from a neuropsychological perspective by a systematic re-examining of recent findings. In general, sleep spindles, characterized by density, amplitude, duration, and frequency, are disrupted in AD. Moreover, its functional coupling with slow oscillation also suffers in AD. While preliminary, our observations and comparisons suggest that spindle density rather than frequency and fast spindles rather than slow spindles could be more sensitive to AD-related dementia, and spindle plasticity provides possibilities for targeted interference. In conclusion, quantitative and qualitative features of sleep spindles represent potential non-invasive and cost-effective biomarkers for AD and provide both therapeutic and public health implications.
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Uddin MS, Tewari D, Mamun AA, Kabir MT, Niaz K, Wahed MII, Barreto GE, Ashraf GM. Circadian and sleep dysfunction in Alzheimer's disease. Ageing Res Rev 2020; 60:101046. [PMID: 32171783 DOI: 10.1016/j.arr.2020.101046] [Citation(s) in RCA: 83] [Impact Index Per Article: 20.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2019] [Revised: 02/05/2020] [Accepted: 03/10/2020] [Indexed: 12/12/2022]
Abstract
Alzheimer's disease (AD) is a devastating and irreversible cognitive impairment and the most common type of dementia. Along with progressive cognitive impairment, dysfunction of the circadian rhythms also plays a pivotal role in the progression of AD. A mutual relationship among circadian rhythms, sleep, and AD has been well-recommended. The etiopathogenesis of the disturbances of the circadian system and AD share some general features that also unlock the outlook of observing them as a mutually dependent pathway. Indeed, the burden of amyloid β (Aβ), neurofibrillary tangles (NFTs), neuroinflammation, oxidative stress, and dysfunction of circadian rhythms may lead to AD. Aging can alter both sleep timings and quality that can be strongly disrupted in AD. Increased production of Aβ and reduced Aβ clearance are caused by a close interplay of Aβ, sleep disturbance and raised wakefulness. Besides Aβ, the impact of tau pathology is possibly noteworthy to the sleep deprivation found in AD. Hence, this review is focused on the primary mechanistic complexities linked to disruption of circadian rhythms, sleep deprivation, and AD. Furthermore, this review also highlights the potential therapeutic strategies to abate AD pathogenesis.
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9
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Gorgoni M, Reda F, D'Atri A, Scarpelli S, Ferrara M, De Gennaro L. The heritability of the human K-complex: a twin study. Sleep 2020; 42:5370488. [PMID: 30843061 DOI: 10.1093/sleep/zsz053] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2018] [Revised: 01/16/2019] [Indexed: 02/05/2023] Open
Abstract
Sleep electroencephalogram (EEG) has a trait-like nature. Several findings highlighted the heritability of spectral power in specific frequency ranges and sleep spindles during nonrapid eye movement (NREM) sleep. However, a genetic influence on the K-complex (KC), one of the electrophysiological hallmarks of NREM sleep, has never been assessed. Here, we investigated the heritability of the KC detected during NREM stage 2 comparing 10 monozygotic (MZ) and 10 dizygotic (DZ) twin pairs. Genetic variance analysis (GVA) and intraclass correlation coefficients (ICCs) were performed to assess the genetic effect and within-pair similarity for KC density, amplitude, and for the area under the curve (AUC) of the KC average waveform at Fz, Cz, and Pz scalp locations. Moreover, cluster analysis was performed on the KC average waveform profile. We observed a significant genetic effect on KC AUC at Cz and Pz, and on amplitude at Pz. Within-pair similarity (ICCs) was always significant for MZ twins except for KC density at Fz, whereas DZ twins always exhibited ICCs below the significance threshold, with the exception of density at Pz. The largest differences in within-pair similarity between MZ and DZ groups were observed again for AUC at Cz and Pz. MZ pairs accurately clustered for the KC average waveform with a higher frequency (successful clustering rate for MZ pairs: Fz = 60%; Cz = 80%; Pz = 90%) compared with DZ pairs (successful clustering rate for DZ pairs: Fz = 10%; Cz = 10%; Pz = none). Our results suggest the existence of a genetic influence on the human KC, particularly related to its morphology and maximally observable in central and parietal locations.
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Affiliation(s)
- Maurizio Gorgoni
- Department of Psychology, University of Rome "Sapienza," Rome, Italy
| | - Flaminia Reda
- Department of Psychology, University of Rome "Sapienza," Rome, Italy
| | - Aurora D'Atri
- Department of Psychology, University of Rome "Sapienza," Rome, Italy
| | - Serena Scarpelli
- Department of Psychology, University of Rome "Sapienza," Rome, Italy
| | - Michele Ferrara
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
| | - Luigi De Gennaro
- Department of Psychology, University of Rome "Sapienza," Rome, Italy
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10
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Hamann C, Rusterholz T, Studer M, Kaess M, Tarokh L. Association between depressive symptoms and sleep neurophysiology in early adolescence. J Child Psychol Psychiatry 2019; 60:1334-1342. [PMID: 31512761 DOI: 10.1111/jcpp.13088] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/04/2019] [Indexed: 01/01/2023]
Abstract
BACKGROUND Depression is highly prevalent among adolescents, and depressive symptoms rise rapidly during early adolescence. Depression is often accompanied by subjective sleep complaints and alterations in sleep neurophysiology. In this study, we examine whether depressive symptoms, measured on a continuum, are associated with subjective and objective (sleep architecture and neurophysiology) measures of sleep in early adolescence. METHODS High-density sleep EEG, actigraphy, and self-reported sleep were measured in 52 early adolescents (12.31 years; SD: 1.121; 25 female). Depressive symptoms were measured on a continuum using the Center for Epidemiological Studies Depression Scale (CES-D). The association between depressive symptoms and 2 weeks of actigraphy, self-reported sleep, sleep architecture, and sleep neurophysiology (slow wave activity and sigma power) was determined via multiple linear regression with factors age, sex, and pubertal status. RESULTS Despite no association between polysomnography measures of sleep quality and depressive symptoms, individuals with more depressive symptoms manifested worse actigraphically measured sleep. Less sleep spindle activity, as reflected in nonrapid eye movement sleep sigma power, was associated with more depressive symptoms over a large cluster encompassing temporal, parietal, and occipital regions. Furthermore, worse subjectively reported sleep quality was also associated with less sigma power over these same areas. Puberty, age, and sex did not impact this association. CONCLUSIONS Sleep spindles have been hypothesized to protect sleep against environmental disturbances. Thus, diminished spindle power may be a subtle sign of disrupted sleep and its association with depressive symptoms in early adolescence may signal vulnerability for depression.
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Affiliation(s)
- Christoph Hamann
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Thomas Rusterholz
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland.,Institute of Pharmacology and Toxicology, University of Zurich, Zurich, Switzerland.,Department of Neurology, University Hospital, Inselspital, Bern, Switzerland
| | - Martina Studer
- Department of Neurology, University Hospital, Inselspital, Bern, Switzerland
| | - Michael Kaess
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland.,Section for Translational Child and Adolescent Psychiatry, Department of Child and Adolescent Psychiatry, Center for Psychosocial Medicine, University Hospital Heidelberg, Heidelberg, Germany
| | - Leila Tarokh
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
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11
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Yasugaki S, Liu CY, Kashiwagi M, Kanuka M, Honda T, Miyata S, Yanagisawa M, Hayashi Y. Effects of 3 Weeks of Water Immersion and Restraint Stress on Sleep in Mice. Front Neurosci 2019; 13:1072. [PMID: 31680813 PMCID: PMC6813282 DOI: 10.3389/fnins.2019.01072] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2019] [Accepted: 09/24/2019] [Indexed: 12/27/2022] Open
Abstract
Repeated stress is a risk factor for mental disorders and can also lead to sleep disturbances. Although the effects of stress on sleep architecture have been investigated in rodents, the length of the stress exposure period in most studies has been limited to about 10 days, and few studies have analyzed the effects of chronic stress over a longer period. Here we investigated how sleep is affected in a mouse model of depression induced by 3 weeks of daily water immersion and restraint stress (WIRS). Sleep was recorded after 1, 2, and 3 weeks of stress exposure. Some stress-induced changes in several sleep measures were maintained across the 3 weeks, whereas other changes were most prominent during the 1st week. The total amount of non-rapid eye movement sleep (NREMS) was increased and the total amount of time spent awake was decreased across all 3 weeks. On the other hand, the amount of REMS during the dark phase was significantly increased in the 1st week compared with that at baseline or the 2nd and 3rd weeks. Electroencephalogram (EEG) power in the delta range was decreased during NREMS, although the total amount of NREMS was increased. These findings indicate that repeated WIRS, which eventually leads to a depression-like phenotype, differentially affects sleep between the early and subsequent periods. The increase in the amount of REMS during the dark phase in the 1st week significantly correlated with changes in body weight. Our results show how sleep changes throughout a long period of chronic stress in a mouse model of depression.
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Affiliation(s)
- Shinnosuke Yasugaki
- International Institute for Integrative Sleep Medicine (WPI-IIIS), University of Tsukuba, Tsukuba, Japan.,Doctoral Program in Biomedical Sciences, Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tsukuba, Japan
| | - Chih-Yao Liu
- International Institute for Integrative Sleep Medicine (WPI-IIIS), University of Tsukuba, Tsukuba, Japan.,Ph.D. Program in Human Biology, School of Integrative and Global Majors, University of Tsukuba, Tsukuba, Japan
| | - Mitsuaki Kashiwagi
- International Institute for Integrative Sleep Medicine (WPI-IIIS), University of Tsukuba, Tsukuba, Japan.,Doctoral Program in Kansei, Behavioral and Brain Sciences, Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tsukuba, Japan
| | - Mika Kanuka
- International Institute for Integrative Sleep Medicine (WPI-IIIS), University of Tsukuba, Tsukuba, Japan
| | - Takato Honda
- International Institute for Integrative Sleep Medicine (WPI-IIIS), University of Tsukuba, Tsukuba, Japan.,Ph.D. Program in Human Biology, School of Integrative and Global Majors, University of Tsukuba, Tsukuba, Japan
| | - Shingo Miyata
- Division of Molecular Brain Science, Research Institute of Traditional Asian Medicine, Kindai University, Osaka, Japan
| | - Masashi Yanagisawa
- International Institute for Integrative Sleep Medicine (WPI-IIIS), University of Tsukuba, Tsukuba, Japan.,Department of Molecular Genetics, University of Texas Southwestern Medical Center, Dallas, TX, United States.,Life Science Center for Survival Dynamics, Tsukuba Advanced Research Alliance, University of Tsukuba, Tsukuba, Japan
| | - Yu Hayashi
- International Institute for Integrative Sleep Medicine (WPI-IIIS), University of Tsukuba, Tsukuba, Japan
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12
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Winsky-Sommerer R, de Oliveira P, Loomis S, Wafford K, Dijk DJ, Gilmour G. Disturbances of sleep quality, timing and structure and their relationship with other neuropsychiatric symptoms in Alzheimer’s disease and schizophrenia: Insights from studies in patient populations and animal models. Neurosci Biobehav Rev 2019; 97:112-137. [DOI: 10.1016/j.neubiorev.2018.09.027] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2017] [Revised: 08/31/2018] [Accepted: 09/30/2018] [Indexed: 02/06/2023]
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13
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Sleep spindle and psychopathology characteristics of frequent nightmare recallers. Sleep Med 2018; 50:113-131. [DOI: 10.1016/j.sleep.2017.10.003] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2017] [Accepted: 10/02/2017] [Indexed: 02/01/2023]
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14
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Sleep in older adults and in subjects with dementia. Z Gerontol Geriatr 2017; 50:603-608. [PMID: 28721544 DOI: 10.1007/s00391-017-1289-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2017] [Accepted: 06/23/2017] [Indexed: 10/19/2022]
Abstract
The neuronal structures for the regulation of sleep and wakefulness are located in the brain. This complex network is vulnerable to numerous factors, most importantly neurodegenerative diseases and drugs. The macrostructure and microstructure of sleep change with age. These changes are more pronounced in subjects with dementia. Sleep disorders in subjects with dementia may be independent of dementia or caused by dementia. Furthermore, epidemiological studies reveal that sleep disorders per se may induce dementia by reduction of cerebral clearance of beta-amyloids. The population attributable risk (PAR) of sleep disturbances to the incidence of dementia is estimated to be about 15%; therefore, management of sleep disturbances in older adults and subjects with dementia gives the opportunity of an impact on incidence and course of dementia. Sleep history should be taken from each individual and obvious sleep disturbances, especially sleep apnea, should be managed according to current guidelines. Future studies that concern the incidence and the management of dementia must take into account sleep and sleep disturbances.
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15
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Kang DW, Lee CU, Lim HK. Role of Sleep Disturbance in the Trajectory of Alzheimer's Disease. CLINICAL PSYCHOPHARMACOLOGY AND NEUROSCIENCE 2017; 15:89-99. [PMID: 28449556 PMCID: PMC5426492 DOI: 10.9758/cpn.2017.15.2.89] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/13/2016] [Revised: 10/16/2016] [Accepted: 10/17/2016] [Indexed: 12/21/2022]
Abstract
Sleep disturbances such as insomnia, hypersomnia, and circadian rhythm disturbance are common in normal elderly and Alzheimer’s disease (AD) patients. To date, special attention has been paid to sleep disturbance in the clinical course of AD insofar as the interaction of sleep disturbance with the pathogenesis of AD may impact the clinical course and cognitive function of AD patients. This review covers the bidirectional relationship between sleep disturbance and AD pathogenesis; the associations between sleep disturbance and AD-specific neurotransmitters, brain structure, and aspects of sleep disturbance in each phase of AD; and the effects of sleep disturbance on the cognitive functions of patients in each phase of AD. We consider several factors required to exactly interpret the results and suggest a direction for future studies on the role of sleep disturbance in AD.
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Affiliation(s)
- Dong Woo Kang
- Department of Psychiatry, Seoul Saint Mary's Hospital, College of Medicine, Catholic University of Korea, Seoul, Korea
| | - Chang Uk Lee
- Department of Psychiatry, Seoul Saint Mary's Hospital, College of Medicine, Catholic University of Korea, Seoul, Korea
| | - Hyun Kook Lim
- Department of Psychiatry, Saint Vincent's Hospital, College of Medicine, Catholic University of Korea, Suwon, Korea
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16
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Reda F, Gorgoni M, Lauri G, Truglia I, Cordone S, Scarpelli S, Mangiaruga A, D'Atri A, Ferrara M, Lacidogna G, Marra C, Rossini PM, De Gennaro L. In Search of Sleep Biomarkers of Alzheimer's Disease: K-Complexes Do Not Discriminate between Patients with Mild Cognitive Impairment and Healthy Controls. Brain Sci 2017; 7:E51. [PMID: 28468235 PMCID: PMC5447933 DOI: 10.3390/brainsci7050051] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2017] [Revised: 04/18/2017] [Accepted: 04/27/2017] [Indexed: 02/05/2023] Open
Abstract
The K-complex (KC) is one of the hallmarks of Non-Rapid Eye Movement (NREM) sleep. Recent observations point to a drastic decrease of spontaneous KCs in Alzheimer's disease (AD). However, no study has investigated when, in the development of AD, this phenomenon starts. The assessment of KC density in mild cognitive impairment (MCI), a clinical condition considered a possible transitional stage between normal cognitive function and probable AD, is still lacking. The aim of the present study was to compare KC density in AD/MCI patients and healthy controls (HCs), also assessing the relationship between KC density and cognitive decline. Twenty amnesic MCI patients underwent a polysomnographic recording of a nocturnal sleep. Their data were compared to those of previously recorded 20 HCs and 20 AD patients. KCs during stage 2 NREM sleep were visually identified and KC densities of the three groups were compared. AD patients showed a significant KC density decrease compared with MCI patients and HCs, while no differences were observed between MCI patients and HCs. KC density was positively correlated with Mini-Mental State Examination (MMSE) scores. Our results point to the existence of an alteration of KC density only in a full-blown phase of AD, which was not observable in the early stage of the pathology (MCI), but linked with cognitive deterioration.
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Affiliation(s)
- Flaminia Reda
- Department of Psychology, Sapienza University of Rome, Rome 00185, Italy.
| | - Maurizio Gorgoni
- Department of Psychology, Sapienza University of Rome, Rome 00185, Italy.
| | - Giulia Lauri
- Department of Psychology, Sapienza University of Rome, Rome 00185, Italy.
| | - Ilaria Truglia
- Department of Psychology, Sapienza University of Rome, Rome 00185, Italy.
| | - Susanna Cordone
- Department of Psychology, Sapienza University of Rome, Rome 00185, Italy.
| | - Serena Scarpelli
- Department of Psychology, Sapienza University of Rome, Rome 00185, Italy.
| | | | - Aurora D'Atri
- Department of Psychology, Sapienza University of Rome, Rome 00185, Italy.
| | - Michele Ferrara
- Department of Biotechnological and Applied Clinical Science, University of L'Aquila, L'Aquila 67100, Italy.
| | - Giordano Lacidogna
- Institute of Neurology, Catholic University of The Sacred Heart, Rome 00168, Italy.
| | - Camillo Marra
- Institute of Neurology, Catholic University of The Sacred Heart, Rome 00168, Italy.
| | - Paolo Maria Rossini
- Institute of Neurology, Catholic University of The Sacred Heart, Rome 00168, Italy.
- Istituto di Ricovero e Cura a Carattere Scientifico, San Raffaele Pisana, Rome 00163, Italy.
| | - Luigi De Gennaro
- Department of Psychology, Sapienza University of Rome, Rome 00185, Italy.
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17
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De Gennaro L, Gorgoni M, Reda F, Lauri G, Truglia I, Cordone S, Scarpelli S, Mangiaruga A, D’atri A, Lacidogna G, Ferrara M, Marra C, Rossini PM. The Fall of Sleep K-Complex in Alzheimer Disease. Sci Rep 2017; 7:39688. [PMID: 28045040 PMCID: PMC5206737 DOI: 10.1038/srep39688] [Citation(s) in RCA: 71] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2016] [Accepted: 11/25/2016] [Indexed: 02/08/2023] Open
Abstract
Although a slowing of electroencephalographic (EEG) activity during wakefulness and -to some extent- sleep of Alzheimer disease (AD) patients (i.e., increased slow-frequency activity) was documented, recent findings in healthy elderly show a decreased 0.6-1 Hz slow wave activity (SWA) during NREM, which was associated to β-amyloid deposition and impaired hippocampal memory consolidation. We hypothesize that the apparent contradiction may be explained by the partial overlap between 0.6-1 Hz EEG activity and K-Complex (KC). According to this view, we studied both frontal KCs and SWA in 20 AD patients and 20 healthy age-matched controls (HC) during nightly sleep, under the hypothesis that KCs better discriminate patients from healthy elderly than ≤1 Hz SWA. A drastic decrease of KC density during stage 2 NREM was found in AD compared to HC. Patients show more than 40% reduction of the KC density, allowing a correct classification of 80%. On the other hand, ≤1 Hz SWA of AD patients is slightly (not significantly) higher in most cortical areas compared to HC. Although no significant changes of ≤1 Hz SWA are detectable over frontal areas in AD, KC density decreases over the same location, and its decrease is related to the cognitive decline.
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Affiliation(s)
- Luigi De Gennaro
- Department of Psychology, “Sapienza” University of Rome, Rome, Italy
| | - Maurizio Gorgoni
- Department of Psychology, “Sapienza” University of Rome, Rome, Italy
| | - Flaminia Reda
- Department of Psychology, “Sapienza” University of Rome, Rome, Italy
| | - Giulia Lauri
- Department of Psychology, “Sapienza” University of Rome, Rome, Italy
| | - Ilaria Truglia
- Department of Psychology, “Sapienza” University of Rome, Rome, Italy
| | - Susanna Cordone
- Department of Psychology, “Sapienza” University of Rome, Rome, Italy
| | - Serena Scarpelli
- Department of Psychology, “Sapienza” University of Rome, Rome, Italy
| | | | - Aurora D’atri
- Department of Psychology, “Sapienza” University of Rome, Rome, Italy
| | - Giordano Lacidogna
- Institute of Neurology, Catholic University of The Sacred Heart, Rome, Italy
| | - Michele Ferrara
- Department of Biotechnological and Applied Clinical Science, University of L’Aquila, L’Aquila, Italy
| | - Camillo Marra
- Institute of Neurology, Catholic University of The Sacred Heart, Rome, Italy
| | - Paolo Maria Rossini
- Institute of Neurology, Catholic University of The Sacred Heart, Rome, Italy
- IRCCS San Raffaele Pisana, Rome, Italy
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18
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Olbrich S, van Dinteren R, Arns M. Personalized Medicine: Review and Perspectives of Promising Baseline EEG Biomarkers in Major Depressive Disorder and Attention Deficit Hyperactivity Disorder. Neuropsychobiology 2016; 72:229-40. [PMID: 26901357 DOI: 10.1159/000437435] [Citation(s) in RCA: 105] [Impact Index Per Article: 13.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2015] [Accepted: 07/06/2015] [Indexed: 11/19/2022]
Abstract
Personalized medicine in psychiatry is in need of biomarkers that resemble central nervous system function at the level of neuronal activity. Electroencephalography (EEG) during sleep or resting-state conditions and event-related potentials (ERPs) have not only been used to discriminate patients from healthy subjects, but also for the prediction of treatment outcome in various psychiatric diseases, yielding information about tailored therapy approaches for an individual. This review focuses on baseline EEG markers for two psychiatric conditions, namely major depressive disorder and attention deficit hyperactivity disorder. It covers potential biomarkers from EEG sleep research and vigilance regulation, paroxysmal EEG patterns and epileptiform discharges, quantitative EEG features within the EEG main frequency bands, connectivity markers and ERP components that might help to identify favourable treatment outcome. Further, the various markers are discussed in the context of their potential clinical value and as research domain criteria, before giving an outline for future studies that are needed to pave the way to an electrophysiological biomarker-based personalized medicine.
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19
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Affiliation(s)
- Charles Bernick
- University of California, Davis, School of Medicine, Sacramento, California
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20
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Abstract
Sleep spindles are wax and waning brain oscillations at a frequency range of 11-16 Hz, lasting 0.5-2 s, that define non-rapid eye movement sleep stage 2. Over the past few years, several independent studies pointed to a decrease of sleep spindles in schizophrenia. The aim of this review is to contextualize these findings within the growing literature on these oscillations across other neuro-psychiatric disorders. Indeed, spindles reflect the coordinated activity of thalamocortical networks, and their abnormality can be observed in a variety of conditions that disrupt local or global thalamocortical connectivity. Although the broad methodological variability across studies limits the possibility of drawing firm conclusions, impaired spindling activity has been observed in several neurodevelopmental and neurodegenerative disorders. Despite such lack of specificity, schizophrenia remains the only condition with a typical late adolescence to young adulthood onset in which impaired spindling has been consistently reported. Further research is necessary to clearly define the pathogenetic mechanisms that lead to this deficit and the validity of its widespread use as a clinical biomarker.
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21
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Kido M, Asakawa A, Koyama KIK, Takaoka T, Tajima A, Takaoka S, Yoshizaki Y, Okutsu K, Takamine KT, Sameshima Y, Inui A. Acute effects of traditional Japanese alcohol beverages on blood glucose and polysomnography levels in healthy subjects. PeerJ 2016; 4:e1853. [PMID: 27069795 PMCID: PMC4824916 DOI: 10.7717/peerj.1853] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2015] [Accepted: 03/07/2016] [Indexed: 01/02/2023] Open
Abstract
Background. Alcohol consumption is a lifestyle factor associated with type 2 diabetes. This relationship is reportedly different depending on the type of alcohol beverage. The purpose of this study was to examine the acute effects of traditional Japanese alcohol beverages on biochemical parameters, physical and emotional state, and sleep patterns. Methods. Six healthy subjects (three men and three women; age, 28.8 ± 9.5 years; body mass index, 21.4 ± 1.6 kg/m2) consumed three different types of alcohol beverages (beer, shochu, and sake, each with 40 g ethanol) or mineral water with dinner on different days in the hospital. Blood samples were collected before and 1, 2, and 12 h after drinking each beverage, and assessments of physical and emotional state were administered at the same time. In addition, sleep patterns and brain waves were examined using polysomnography. Results. Blood glucose levels at 1 h and the 12-h area under the curve (AUC) value after drinking shochu were significantly lower than that with water and beer. The 12-h blood insulin AUC value after drinking shochu was significantly lower than that with beer. Blood glucose × insulin level at 1 h and the 2-h blood glucose × insulin AUC value with shochu were significantly lower than that with beer. The insulinogenic indexes at 2 h with beer and sake, but not shochu, were significantly higher than that with water. The visual analogue scale scores of physical and emotional state showed that the tipsiness levels with beer, shochu, and sake at 1 h were significantly higher than that with water. These tipsiness levels were maintained at 2 h. The polysomnography showed that the rapid eye movement (REM) sleep latency with shochu and sake were shorter than that with water and beer. Conclusions. Acute consumption of alcohol beverages with a meal resulted in different responses in postprandial glucose and insulin levels as well as REM sleep latency. Alcohol beverage type should be taken into consideration for people with impaired glucose tolerance.
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Affiliation(s)
- Megumi Kido
- Psychosomatic Internal Medicine, Kagoshima University Graduate School of Medical and Dental Sciences , Kagoshima , Japan
| | - Akihiro Asakawa
- Psychosomatic Internal Medicine, Kagoshima University Graduate School of Medical and Dental Sciences , Kagoshima , Japan
| | - Ken-Ichiro K Koyama
- Psychosomatic Internal Medicine, Kagoshima University Graduate School of Medical and Dental Sciences , Kagoshima , Japan
| | - Toshio Takaoka
- The Japanese Society of Sleep Research, Kagoshima Takaoka Hospital , Kagoshima , Japan
| | - Aya Tajima
- Kagoshima Takaoka Hospital , Kagoshima , Japan
| | | | - Yumiko Yoshizaki
- Laboratory of Shochu Fermentation Technology, Faculty of Agriculture, Kagoshima University , Kagoshima , Japan
| | - Kayu Okutsu
- Laboratory of Shochu Fermentation Technology, Faculty of Agriculture, Kagoshima University , Kagoshima , Japan
| | - Kazunori T Takamine
- Laboratory of Shochu Fermentation Technology, Faculty of Agriculture, Kagoshima University , Kagoshima , Japan
| | - Yoshihiro Sameshima
- Laboratory of Shochu Fermentation Technology, Faculty of Agriculture, Kagoshima University , Kagoshima , Japan
| | - Akio Inui
- Psychosomatic Internal Medicine, Kagoshima University Graduate School of Medical and Dental Sciences , Kagoshima , Japan
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22
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Olbrich S, Tränkner A, Surova G, Gevirtz R, Gordon E, Hegerl U, Arns M. CNS- and ANS-arousal predict response to antidepressant medication: Findings from the randomized iSPOT-D study. J Psychiatr Res 2016; 73:108-15. [PMID: 26714202 DOI: 10.1016/j.jpsychires.2015.12.001] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2015] [Revised: 12/04/2015] [Accepted: 12/04/2015] [Indexed: 11/26/2022]
Abstract
Arousal systems are one of the recently announced NIMH Research Domain Criteria to inform future diagnostics and treatment prediction. In major depressive disorder (MDD), altered central nervous system (CNS) wakefulness regulation and an increased sympathetic autonomic nervous system (ANS) activity have been identified as biomarkers with possible discriminative value for prediction of antidepressant treatment response. Therefore, the hypothesis of a more pronounced decline of CNS and ANS-arousal being predictive for a positive treatment outcome to selective-serotonin-reuptake-inhibitor (SSRI) treatment was derived from a small, independent exploratory dataset (N = 25) and replicated using data from the randomized international Study to Predict Optimized Treatment Response in Depression (iSPOT-D). There, 1008 MDD participants were randomized to either a SSRI (escitalopram or sertraline) or a serotonin-norepinephrine-reuptake-inhibitor (SNRI-venlafaxine) arm. Treatment response was established after eight weeks using the 17-item Hamilton Rating Scale for Depression. CNS-arousal (i.e. electroencephalogram-vigilance), ANS-arousal (heart rate) and their change across time were assessed during rest. Responders and remitters to SSRI treatment were characterized by a faster decline of CNS-arousal during rest whereas SNRI responders showed a significant increase of ANS-arousal. Furthermore, SSRI responders/remitters showed an association between ANS- and CNS-arousal regulation in comparison to non-responders/non-remitters while this was not the case for SNRI treatment arm. Since positive treatment outcome to SSRI and SNRI was linked to distinct CNS and ANS-arousal profiles, these predictive markers probably are not disorder specific alterations but reflect the responsiveness of the nervous system to specific drugs.
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Affiliation(s)
- Sebastian Olbrich
- Dept. of Psychiatry and Psychotherapy, University of Leipzig, Germany; Dept. of Psychiatry, Psychotherapy and Psychosomatic, University Zürich, Switzerland.
| | - Anja Tränkner
- Dept. of Psychiatry and Psychotherapy, University of Leipzig, Germany
| | - Galina Surova
- Dept. of Psychiatry and Psychotherapy, University of Leipzig, Germany
| | | | - Evian Gordon
- Brain Resource Ltd, Sydney, NSW, Australia; Brain Resource Ltd, San Francisco, CA, USA
| | - Ulrich Hegerl
- Dept. of Psychiatry and Psychotherapy, University of Leipzig, Germany
| | - Martijn Arns
- Dept. of Experimental Psychology, Utrecht University, Utrecht, The Netherlands; Research Institute Brainclinics, Nijmegen, The Netherlands
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23
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Miller MA. The Role of Sleep and Sleep Disorders in the Development, Diagnosis, and Management of Neurocognitive Disorders. Front Neurol 2015; 6:224. [PMID: 26557104 PMCID: PMC4615953 DOI: 10.3389/fneur.2015.00224] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2015] [Accepted: 10/12/2015] [Indexed: 12/31/2022] Open
Abstract
It is becoming increasingly apparent that sleep plays an important role in the maintenance, disease prevention, repair, and restoration of both mind and body. The sleep and wake cycles are controlled by the pacemaker activity of the superchiasmic nucleus in the hypothalamus but can be disrupted by diseases of the nervous system causing disordered sleep. A lack of sleep has been associated with an increase in all-cause mortality. Likewise, sleep disturbances and sleep disorders may disrupt neuronal pathways and have an impact on neurological diseases. Sleep deprivation studies in normal subjects demonstrate that a lack of sleep can cause attention and working memory impairment. Moreover, untreated sleep disturbances and sleep disorders such as obstructive sleep apnoe (OSA) can also lead to cognitive impairment. Poor sleep and sleep disorders may present a significant risk factor for the development of dementia. In this review, the underlying mechanisms and the role of sleep and sleep disorders in the development of neurocognitive disorders [dementia and mild cognitive impairment (MCI)] and how the presence of sleep disorders could direct the process of diagnosis and management of neurocognitive disorders will be discussed.
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24
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Buzsáki G. Hippocampal sharp wave-ripple: A cognitive biomarker for episodic memory and planning. Hippocampus 2015; 25:1073-188. [PMID: 26135716 PMCID: PMC4648295 DOI: 10.1002/hipo.22488] [Citation(s) in RCA: 891] [Impact Index Per Article: 99.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2015] [Accepted: 06/30/2015] [Indexed: 12/23/2022]
Abstract
Sharp wave ripples (SPW-Rs) represent the most synchronous population pattern in the mammalian brain. Their excitatory output affects a wide area of the cortex and several subcortical nuclei. SPW-Rs occur during "off-line" states of the brain, associated with consummatory behaviors and non-REM sleep, and are influenced by numerous neurotransmitters and neuromodulators. They arise from the excitatory recurrent system of the CA3 region and the SPW-induced excitation brings about a fast network oscillation (ripple) in CA1. The spike content of SPW-Rs is temporally and spatially coordinated by a consortium of interneurons to replay fragments of waking neuronal sequences in a compressed format. SPW-Rs assist in transferring this compressed hippocampal representation to distributed circuits to support memory consolidation; selective disruption of SPW-Rs interferes with memory. Recently acquired and pre-existing information are combined during SPW-R replay to influence decisions, plan actions and, potentially, allow for creative thoughts. In addition to the widely studied contribution to memory, SPW-Rs may also affect endocrine function via activation of hypothalamic circuits. Alteration of the physiological mechanisms supporting SPW-Rs leads to their pathological conversion, "p-ripples," which are a marker of epileptogenic tissue and can be observed in rodent models of schizophrenia and Alzheimer's Disease. Mechanisms for SPW-R genesis and function are discussed in this review.
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Affiliation(s)
- György Buzsáki
- The Neuroscience Institute, School of Medicine and Center for Neural Science, New York University, New York, New York
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25
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Smagula SF, Reynolds CF, Ancoli-Israel S, Barrett-Connor E, Dam TT, Hughes-Austin JM, Paudel M, Redline S, Stone KL, Cauley JA. Sleep Architecture and Mental Health Among Community-Dwelling Older Men. J Gerontol B Psychol Sci Soc Sci 2015; 70:673-81. [PMID: 24326077 PMCID: PMC4553710 DOI: 10.1093/geronb/gbt125] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES To investigate the association of mood and anxiety symptoms with sleep architecture (the distribution of sleep stages) in community-dwelling older men. METHOD We used in-home unattended polysomnography to measure sleep architecture in older men. Men were categorized into 4 mental health categories: (a) significant depressive symptoms only (DEP+ only, Geriatric Depression Scale ≥ 6), (b) significant anxiety symptoms only (ANX+ only, Goldberg Anxiety Scale ≥ 5), (c) significant depressive and anxiety symptoms (DEP+/ANX+), or (d) no significant depressive or anxiety symptoms (DEP-/ANX-). RESULTS Compared with men without clinically significant symptomology, men with depressive symptoms spent a higher percentage of time in Stage 2 sleep (65.42% DEP+ only vs 62.47% DEP-/ANX-, p = .003) and a lower percentage of time in rapid eye movement sleep (17.05% DEP+ only vs 19.44% DEP-/ANX-, p = .0005). These differences persisted after adjustment for demographic/lifestyle characteristics, medical conditions, medications, and sleep disturbances, and after excluding participants using psychotropic medications. The sleep architecture of ANX+ or DEP+/ANX+ men did not differ from asymptomatic men. DISCUSSION Depressed mood in older adults may be associated with accelerated age-related changes in sleep architecture. Longitudinal community-based studies using diagnostic measures are needed to further clarify relationships among common mental disorders, aging, and sleep.
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Affiliation(s)
- Stephen F Smagula
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pennsylvania
| | - Charles F Reynolds
- Department of Psychiatry, Western Psychiatric Institute and Clinic of UPMC, Pennsylvania. Department of Behavioral and Community Health Sciences, Graduate School of Public Health, University of Pittsburgh, Pennsylvania
| | - Sonia Ancoli-Israel
- Departments of Psychiatry and Medicine, University of California San Diego, La Jolla. VA Center of Excellence for Stress and Mental Health (CESAMH), San Diego, California
| | - Elizabeth Barrett-Connor
- Division of Epidemiology, Department of Family and Preventive Medicine, University of California, San Diego, La Jolla
| | - Thuy-Tien Dam
- Division of Geriatrics and Aging, Columbia University, New York
| | - Jan M Hughes-Austin
- Division of Epidemiology, Department of Family and Preventive Medicine, University of California, San Diego, La Jolla
| | - Misti Paudel
- Division of Epidemiology & Community Health, University of Minnesota, Minneapolis
| | - Susan Redline
- Division of Sleep Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts
| | - Katie L Stone
- Research Institute, California Pacific Medical Center, San Francisco
| | - Jane A Cauley
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pennsylvania.
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26
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Wilckens KA, Hall MH, Nebes RD, Monk TH, Buysse DJ. Changes in Cognitive Performance Are Associated with Changes in Sleep in Older Adults With Insomnia. Behav Sleep Med 2015; 14:295-310. [PMID: 26322904 PMCID: PMC4775463 DOI: 10.1080/15402002.2014.1002034] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
The present study examined sleep features associated with cognition in older adults and examined whether sleep changes following insomnia treatment were associated with cognitive improvements. Polysomnography and cognition (recall, working memory, and reasoning) were assessed before and after an insomnia intervention (Brief Behavioral Treatment of Insomnia [BBTI] or information control [IC]) in 77 older adults with insomnia. Baseline wake-after-sleep-onset (WASO) was associated with recall. Greater NREM (nonrapid eye movement) delta power and lower NREM sigma power were associated with greater working memory and reasoning. The insomnia intervention did not improve performance. However, increased absolute delta power and decreased relative sigma power were associated with improved reasoning. Findings suggest that improvements in executive function may occur with changes in NREM architecture.
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Affiliation(s)
- Kristine A Wilckens
- a Department of Psychiatry , University of Pittsburgh School of Medicine , USA
| | - Martica H Hall
- a Department of Psychiatry , University of Pittsburgh School of Medicine , USA
| | - Robert D Nebes
- a Department of Psychiatry , University of Pittsburgh School of Medicine , USA
| | - Timothy H Monk
- a Department of Psychiatry , University of Pittsburgh School of Medicine , USA
| | - Daniel J Buysse
- a Department of Psychiatry , University of Pittsburgh School of Medicine , USA
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Witton J, Staniaszek LE, Bartsch U, Randall AD, Jones MW, Brown JT. Disrupted hippocampal sharp-wave ripple-associated spike dynamics in a transgenic mouse model of dementia. J Physiol 2015; 594:4615-30. [PMID: 25480798 DOI: 10.1113/jphysiol.2014.282889] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2014] [Accepted: 11/24/2014] [Indexed: 12/12/2022] Open
Abstract
KEY POINTS High frequency (100-250 Hz) neuronal oscillations in the hippocampus, known as sharp-wave ripples (SWRs), synchronise the firing behaviour of groups of neurons and play a key role in memory consolidation. Learning and memory are severely compromised in dementias such as Alzheimer's disease; however, the effects of dementia-related pathology on SWRs are unknown. The frequency and temporal structure of SWRs was disrupted in a transgenic mouse model of tauopathy (one of the major hallmarks of several dementias). Excitatory pyramidal neurons were more likely to fire action potentials in a phase-locked manner during SWRs in the mouse model of tauopathy; conversely, inhibitory interneurons were less likely to fire phase-locked spikes during SWRs. These findings indicate there is reduced inhibitory control of hippocampal network events and point to a novel mechanism which may underlie the cognitive impairments in this model of dementia. ABSTRACT Neurons within the CA1 region of the hippocampus are co-activated during high frequency (100-250 Hz) sharp-wave ripple (SWR) activity in a manner that probably drives synaptic plasticity and promotes memory consolidation. In this study we have used a transgenic mouse model of dementia (rTg4510 mice), which overexpresses a mutant form of tau protein, to examine the effects of tauopathy on hippocampal SWRs and associated neuronal firing. Tetrodes were used to record simultaneous extracellular action potentials and local field potentials from the dorsal CA1 pyramidal cell layer of 7- to 8-month-old wild-type and rTg4510 mice at rest in their home cage. At this age point these mice exhibit neurofibrillary tangles, neurodegeneration and cognitive deficits. Epochs of sleep or quiet restfulness were characterised by minimal locomotor activity and a low theta/delta ratio in the local field potential power spectrum. SWRs detected off-line were significantly lower in amplitude and had an altered temporal structure in rTg4510 mice. Nevertheless, the average frequency profile and duration of the SWRs were relatively unaltered. Putative interneurons displayed significantly less temporal and phase locking to SWRs in rTg4510 mice, whilst putative pyramidal neurons showed increased temporal and phase locking to SWRs. These findings indicate there is reduced inhibitory control of hippocampal network events and point to a novel mechanism which may contribute to impairments in memory consolidation in this model of dementia.
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Affiliation(s)
- Jonathan Witton
- School of Physiology and Pharmacology, University of Bristol, University Walk, Bristol, BS8 1TD, UK
| | - Lydia E Staniaszek
- Institute of Biomedical and Clinical Sciences, University of Exeter Medical School, University of Exeter, Hatherly Laboratories, Prince of Wales Road, Exeter, EX4 4PS, UK
| | - Ullrich Bartsch
- School of Physiology and Pharmacology, University of Bristol, University Walk, Bristol, BS8 1TD, UK
| | - Andrew D Randall
- School of Physiology and Pharmacology, University of Bristol, University Walk, Bristol, BS8 1TD, UK.,Institute of Biomedical and Clinical Sciences, University of Exeter Medical School, University of Exeter, Hatherly Laboratories, Prince of Wales Road, Exeter, EX4 4PS, UK
| | - Matthew W Jones
- School of Physiology and Pharmacology, University of Bristol, University Walk, Bristol, BS8 1TD, UK
| | - Jonathan T Brown
- School of Physiology and Pharmacology, University of Bristol, University Walk, Bristol, BS8 1TD, UK.,Institute of Biomedical and Clinical Sciences, University of Exeter Medical School, University of Exeter, Hatherly Laboratories, Prince of Wales Road, Exeter, EX4 4PS, UK
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28
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Wang YQ, Li R, Zhang MQ, Zhang Z, Qu WM, Huang ZL. The Neurobiological Mechanisms and Treatments of REM Sleep Disturbances in Depression. Curr Neuropharmacol 2015; 13:543-53. [PMID: 26412074 PMCID: PMC4790401 DOI: 10.2174/1570159x13666150310002540] [Citation(s) in RCA: 80] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2014] [Revised: 01/11/2015] [Accepted: 01/25/2015] [Indexed: 12/23/2022] Open
Abstract
Most depressed patients suffer from sleep abnormalities, which are one of the critical symptoms of depression. They are robust risk factors for the initiation and development of depression. Studies about sleep electroencephalograms have shown characteristic changes in depression such as reductions in non-rapid eye movement sleep production, disruptions of sleep continuity and disinhibition of rapid eye movement (REM) sleep. REM sleep alterations include a decrease in REM sleep latency, an increase in REM sleep duration and REM sleep density with respect to depressive episodes. Emotional brain processing dependent on the normal sleep-wake regulation seems to be failed in depression, which also promotes the development of clinical depression. Also, REM sleep alterations have been considered as biomarkers of depression. The disturbances of norepinephrine and serotonin systems may contribute to REM sleep abnormalities in depression. Lastly, this review also discusses the effects of different antidepressants on REM sleep disturbances in depression.
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Affiliation(s)
- Yi-Qun Wang
- Department of Pharmacology, Shanghai Key Laboratory of Bioactive Small Molecules, and State
Key Laboratory of Medical Neurobiology, School of Basic Medical Sciences
| | - Rui Li
- Department of Pharmacology, Shanghai Key Laboratory of Bioactive Small Molecules, and State
Key Laboratory of Medical Neurobiology, School of Basic Medical Sciences
| | - Meng-Qi Zhang
- Department of Pharmacology, Shanghai Key Laboratory of Bioactive Small Molecules, and State
Key Laboratory of Medical Neurobiology, School of Basic Medical Sciences
| | - Ze Zhang
- Department of Pharmacology, Shanghai Key Laboratory of Bioactive Small Molecules, and State
Key Laboratory of Medical Neurobiology, School of Basic Medical Sciences
- Institutes of Brain
Science and the Collaborative Innovation Center for Brain Science, Fudan University, Shanghai,
China
| | - Wei-Min Qu
- Department of Pharmacology, Shanghai Key Laboratory of Bioactive Small Molecules, and State
Key Laboratory of Medical Neurobiology, School of Basic Medical Sciences
- Institutes of Brain
Science and the Collaborative Innovation Center for Brain Science, Fudan University, Shanghai,
China
| | - Zhi-Li Huang
- Department of Pharmacology, Shanghai Key Laboratory of Bioactive Small Molecules, and State
Key Laboratory of Medical Neurobiology, School of Basic Medical Sciences
- Institutes of Brain
Science and the Collaborative Innovation Center for Brain Science, Fudan University, Shanghai,
China
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Scullin MK, Bliwise DL. Sleep, cognition, and normal aging: integrating a half century of multidisciplinary research. PERSPECTIVES ON PSYCHOLOGICAL SCIENCE 2015; 10:97-137. [PMID: 25620997 PMCID: PMC4302758 DOI: 10.1177/1745691614556680] [Citation(s) in RCA: 290] [Impact Index Per Article: 32.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Sleep is implicated in cognitive functioning in young adults. With increasing age, there are substantial changes to sleep quantity and quality, including changes to slow-wave sleep, spindle density, and sleep continuity/fragmentation. A provocative question for the field of cognitive aging is whether such changes in sleep physiology affect cognition (e.g., memory consolidation). We review nearly a half century of research across seven diverse correlational and experimental domains that historically have had little crosstalk. Broadly speaking, sleep and cognitive functions are often related in advancing age, though the prevalence of null effects in healthy older adults (including correlations in the unexpected, negative direction) indicates that age may be an effect modifier of these associations. We interpret the literature as suggesting that maintaining good sleep quality, at least in young adulthood and middle age, promotes better cognitive functioning and serves to protect against age-related cognitive declines.
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Affiliation(s)
- Michael K Scullin
- Department of Psychology and Neuroscience, Baylor University Department of Neurology, Emory University School of Medicine
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30
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Picchioni D, Reith RM, Nadel JL, Smith CB. Sleep, plasticity and the pathophysiology of neurodevelopmental disorders: the potential roles of protein synthesis and other cellular processes. Brain Sci 2014; 4:150-201. [PMID: 24839550 PMCID: PMC4020186 DOI: 10.3390/brainsci4010150] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2013] [Revised: 02/26/2014] [Accepted: 03/07/2014] [Indexed: 12/28/2022] Open
Abstract
Sleep is important for neural plasticity, and plasticity underlies sleep-dependent memory consolidation. It is widely appreciated that protein synthesis plays an essential role in neural plasticity. Studies of sleep-dependent memory and sleep-dependent plasticity have begun to examine alterations in these functions in populations with neurological and psychiatric disorders. Such an approach acknowledges that disordered sleep may have functional consequences during wakefulness. Although neurodevelopmental disorders are not considered to be sleep disorders per se, recent data has revealed that sleep abnormalities are among the most prevalent and common symptoms and may contribute to the progression of these disorders. The main goal of this review is to highlight the role of disordered sleep in the pathology of neurodevelopmental disorders and to examine some potential mechanisms by which sleep-dependent plasticity may be altered. We will also briefly attempt to extend the same logic to the other end of the developmental spectrum and describe a potential role of disordered sleep in the pathology of neurodegenerative diseases. We conclude by discussing ongoing studies that might provide a more integrative approach to the study of sleep, plasticity, and neurodevelopmental disorders.
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Affiliation(s)
- Dante Picchioni
- Behavioral Biology Branch, Walter Reed Army Institute of Research, Silver Spring, MD 20910, USA; E-Mail:
- Advanced MRI Section, National Institute of Neurological Disorders and Stroke, Bethesda, MD 20892, USA
- Section on Neuroadaptation and Protein Metabolism, National Institute of Mental Health, Bethesda, MD 20892, USA; E-Mails: (R.M.R.); (J.L.N.)
| | - R. Michelle Reith
- Section on Neuroadaptation and Protein Metabolism, National Institute of Mental Health, Bethesda, MD 20892, USA; E-Mails: (R.M.R.); (J.L.N.)
| | - Jeffrey L. Nadel
- Section on Neuroadaptation and Protein Metabolism, National Institute of Mental Health, Bethesda, MD 20892, USA; E-Mails: (R.M.R.); (J.L.N.)
| | - Carolyn B. Smith
- Section on Neuroadaptation and Protein Metabolism, National Institute of Mental Health, Bethesda, MD 20892, USA; E-Mails: (R.M.R.); (J.L.N.)
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31
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Arfken CL, Joseph A, Sandhu GR, Roehrs T, Douglass AB, Boutros NN. The status of sleep abnormalities as a diagnostic test for major depressive disorder. J Affect Disord 2014; 156:36-45. [PMID: 24412322 DOI: 10.1016/j.jad.2013.12.007] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2013] [Revised: 10/21/2013] [Accepted: 12/01/2013] [Indexed: 01/01/2023]
Abstract
BACKGROUND Psychiatry lags other fields in development of diagnostic tests. METHODS A literature review and meta-analysis was conducted to ascertain if polysomnographic abnormalities (REM density, REM latency, sleep efficiency, slow wave sleep, stage 1 and stage 2 sleep) warrant additional effort to develop them into a clinical diagnostic test for major depressive disorder (MDD). The 31 publications meeting inclusion criteria were then classified into one of three progressive steps using guidelines for evaluating the clinical usefulness of a diagnostic test. RESULTS Most of the abnormalities found in MDD patients, when compared to healthy controls, occurred in the expected direction with moderate effect sizes but with substantial publication bias and heterogeneity. Eleven studies compared abnormalities in MDD to other psychiatric disorders (step 2a), and four studies provided data on the sensitivity or specificity of the findings in differentiating among the psychiatric disorders that frequently appear on the same differential diagnostic list as MDD (step 2b). No multicenter trial has been conducted prospectively to test the clinical utility of the diagnostic test (step 3). LIMITATIONS Only published articles in the English language were used. CONCLUSIONS Sleep studies for the detection of MDD appear replicable with a moderate effect size. However, additional step 1 studies are needed to define the sensitivity and specificity. The heterogeneity of sleep recording, scoring techniques, and MDD must also be addressed.
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Affiliation(s)
- C L Arfken
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University, Detroit, MI 48207, USA.
| | - A Joseph
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University, Detroit, MI 48207, USA
| | - G R Sandhu
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University, Detroit, MI 48207, USA
| | - T Roehrs
- Henry Ford Sleep Disorders & Research Center, Henry Ford Health System & Department of Psychiatry and Behavioral Neurosciences, Wayne State University, Detroit, MI 48207, USA
| | - A B Douglass
- (c)University of Ottawa, Department of Psychiatry and Royal Ottawa Mental Health Center, Ottawa, ON, Canada
| | - N N Boutros
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University, Detroit, MI 48207, USA
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Pisarenco I, Caporro M, Prosperetti C, Manconi M. High-density electroencephalography as an innovative tool to explore sleep physiology and sleep related disorders. Int J Psychophysiol 2014; 92:S0167-8760(14)00003-8. [PMID: 24412343 DOI: 10.1016/j.ijpsycho.2014.01.002] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2013] [Revised: 12/30/2013] [Accepted: 01/02/2014] [Indexed: 10/25/2022]
Abstract
High density EEG represents a promising tool to achieve new insights regarding sleep physiology and pathology. It combines the advantages of an EEG technique as an optimal temporal resolution with the spatial resolution of the neuroimaging. So far its application in sleep research contributed to better characterize some of the peculiar microstructural figures of sleep such as spindles and K-complexes, and to understand the fundamental relationships between sleep and synaptic plasticity, learning and consciousness. Its application is not limited to neurophysiology, being recently also applied to study some sleep related psychiatric and neurological disorders such as depression, schizophrenia, attention-deficit hyperactivity disorder, and stroke. adding some interesting new pieces in the pathophysiological puzzle of these diseases. Due to its non-invasive, repetitive and reliable tempo-spatial resolution it is reasonable that the field of application of this tool will be soon enlarged to other areas of neuroscience. The present review aims to offer a complete overview regarding the use of high density EEG over the last decade in sleep research and sleep medicine, including its possible future perspective.
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Affiliation(s)
- I Pisarenco
- Sleep and Epilepsy Center, Neurocenter of Southern Switzerland, Civic Hospital (EOC) of Lugano, Lugano, Switzerland
| | - M Caporro
- Sleep and Epilepsy Center, Neurocenter of Southern Switzerland, Civic Hospital (EOC) of Lugano, Lugano, Switzerland
| | - C Prosperetti
- Sleep and Epilepsy Center, Neurocenter of Southern Switzerland, Civic Hospital (EOC) of Lugano, Lugano, Switzerland
| | - M Manconi
- Sleep and Epilepsy Center, Neurocenter of Southern Switzerland, Civic Hospital (EOC) of Lugano, Lugano, Switzerland.
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Genzel L, Kroes MC, Dresler M, Battaglia FP. Light sleep versus slow wave sleep in memory consolidation: a question of global versus local processes? Trends Neurosci 2014; 37:10-9. [DOI: 10.1016/j.tins.2013.10.002] [Citation(s) in RCA: 136] [Impact Index Per Article: 13.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2013] [Revised: 10/07/2013] [Accepted: 10/08/2013] [Indexed: 01/06/2023]
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Plante DT, Goldstein MR. Medroxyprogesterone acetate is associated with increased sleep spindles during non-rapid eye movement sleep in women referred for polysomnography. Psychoneuroendocrinology 2013; 38:3160-6. [PMID: 24054762 PMCID: PMC3844048 DOI: 10.1016/j.psyneuen.2013.08.012] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2013] [Revised: 08/21/2013] [Accepted: 08/27/2013] [Indexed: 10/26/2022]
Abstract
Sleep spindles are characteristic electroencephalographic waveforms that may play functionally significant roles in sleep-dependent memory consolidation, cortical development, and neuropsychiatric disorders. Circumstantial evidence has connected endogenous progesterone and its metabolites to the production of sleep spindles; however, the effects of exogenous progestins on sleep spindles have not been described in women. We examined differences in sleep spindle frequency and morphology in a clinical sample of women (n=21) referred for polysomnography taking depot medroxyprogesterone acetate (MPA), relative to a matched comparison group. Consistent with our hypotheses, women taking MPA demonstrated significantly higher sleep spindle density and maximal amplitude relative to comparison patients. Our results suggest that progestins potentiate the generation of sleep spindles, which may have significant implications for research that examines the role of these waveforms in learning, development, and mental illness.
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Affiliation(s)
- David T. Plante
- Department of Psychiatry, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Michael R. Goldstein
- Department of Psychiatry, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA,Department of Psychology, University of Arizona, Tucson, AZ, USA
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Olbrich S, Arns M. EEG biomarkers in major depressive disorder: discriminative power and prediction of treatment response. Int Rev Psychiatry 2013; 25:604-18. [PMID: 24151805 DOI: 10.3109/09540261.2013.816269] [Citation(s) in RCA: 179] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Major depressive disorder (MDD) has high population prevalence and is associated with substantial impact on quality of life, not least due to an unsatisfactory time span of sometimes several weeks from initiation of treatment to clinical response. Therefore extensive research focused on the identification of cost-effective and widely available electroencephalogram (EEG)-based biomarkers that not only allow distinguishing between patients and healthy controls but also have predictive value for treatment response for a variety of treatments. In this comprehensive overview on EEG research on MDD, biomarkers that are either assessed at baseline or during the early course of treatment and are helpful in discriminating patients from healthy controls and assist in predicting treatment outcome are reviewed, covering recent decades up to now. Reviewed markers include quantitative EEG (QEEG) measures, connectivity measures, EEG vigilance-based measures, sleep-EEG-related measures and event-related potentials (ERPs). Further, the value and limitations of these different markers are discussed. Finally, the need for integrated models of brain function and the necessity for standardized procedures in EEG biomarker research are highlighted to enhance future research in this field.
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Affiliation(s)
- Sebastian Olbrich
- Clinic for Psychiatry and Psychotherapy, University Hospital Leipzig , Germany
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Affiliation(s)
- Bryce A. Mander
- Department of Psychology, University of California, Berkeley, CA
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37
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Gruber R, Wise MS, Frenette S, Knäauper B, Boom A, Fontil L, Carrier J. The association between sleep spindles and IQ in healthy school-age children. Int J Psychophysiol 2013; 89:229-40. [DOI: 10.1016/j.ijpsycho.2013.03.018] [Citation(s) in RCA: 51] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2012] [Revised: 03/22/2013] [Accepted: 03/24/2013] [Indexed: 01/07/2023]
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Ju YES, McLeland JS, Toedebusch CD, Xiong C, Fagan AM, Duntley SP, Morris JC, Holtzman DM. Sleep quality and preclinical Alzheimer disease. JAMA Neurol 2013; 70:587-93. [PMID: 23479184 DOI: 10.1001/jamaneurol.2013.2334] [Citation(s) in RCA: 467] [Impact Index Per Article: 42.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
IMPORTANCE Sleep and circadian problems are very common in Alzheimer disease (AD). Recent animal studies suggest a bidirectional relationship between sleep and β-amyloid (Aβ), a key molecule involved in AD pathogenesis. OBJECTIVE To test whether Aβ deposition in preclinical AD, prior to the appearance of cognitive impairment, is associated with changes in quality or quantity of sleep. DESIGN Cross-sectional study conducted from October 2010 to June 2012. SETTING General community volunteers at the Washington University Knight Alzheimer's Disease Research Center. PARTICIPANTS Cognitively normal individuals (n = 145) 45 years and older were recruited from longitudinal studies of memory and aging at the Washington University Knight Alzheimer's Disease Research Center. Valid actigraphy data were recorded in 142. The majority (124 of 142) were recruited from the Adult Children Study, in which all were aged 45 to 75 years at baseline and 50% have a parental history of late-onset AD. The rest were recruited from a community volunteer cohort in which all were older than 60 years and healthy at baseline. MAIN OUTCOME MEASURES Sleep was objectively measured using actigraphy for 2 weeks. Sleep efficiency, which is the percentage of time in bed spent asleep, was the primary measure of sleep quality. Total sleep time was the primary measure of sleep quantity. Cerebrospinal fluid Aβ42 levels were used to determine whether amyloid deposition was present or absent. Concurrent sleep diaries provided nap information. RESULTS Amyloid deposition, as assessed by Aβ42 levels, was present in 32 participants (22.5%). This group had worse sleep quality, as measured by sleep efficiency (80.4% vs 83.7%), compared with those without amyloid deposition, after correction for age, sex, and APOEε4 allele carrier status (P = .04). In contrast, quantity of sleep was not significantly different between groups, as measured by total sleep time. Frequent napping, 3 or more days per week, was associated with amyloid deposition (31.2% vs 14.7%; P = .03). CONCLUSIONS AND RELEVANCE Amyloid deposition in the preclinical stage of AD appears to be associated with worse sleep quality but not with changes in sleep quantity.
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Affiliation(s)
- Yo-El S Ju
- Department of Neurology, Washington University School of Medicine, St Louis, MO 63110, USA
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Plante D, Goldstein M, Landsness E, Peterson M, Riedner B, Ferrarelli F, Wanger T, Guokas J, Tononi G, Benca R. Topographic and sex-related differences in sleep spindles in major depressive disorder: a high-density EEG investigation. J Affect Disord 2013; 146:120-5. [PMID: 22974470 PMCID: PMC3648867 DOI: 10.1016/j.jad.2012.06.016] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2012] [Accepted: 06/13/2012] [Indexed: 10/27/2022]
Abstract
BACKGROUND Sleep spindles are believed to mediate several sleep-related functions including maintaining disconnection from the external environment during sleep, cortical development, and sleep-dependent memory consolidation. Prior studies that have examined sleep spindles in major depressive disorder (MDD) have not demonstrated consistent differences relative to control subjects, which may be due to sex-related variation and limited spatial resolution of spindle detection. Thus, this study sought to characterize sleep spindles in MDD using high-density electroencephalography (hdEEG) to examine the topography of sleep spindles across the cortex in MDD, as well as sex-related variation in spindle topography in the disorder. METHODS All-night hdEEG recordings were collected in 30 unipolar MDD participants (19 women) and 30 age and sex-matched controls. Topography of sleep spindle density, amplitude, duration, and integrated spindle activity (ISA) were assessed to determine group differences. Spindle parameters were compared between MDD and controls, including analysis stratified by sex. RESULTS As a group, MDD subjects demonstrated significant increases in frontal and parietal spindle density and ISA compared to controls. When stratified by sex, MDD women demonstrated increases in frontal and parietal spindle density, amplitude, duration, and ISA; whereas MDD men demonstrated either no differences or decreases in spindle parameters. LIMITATIONS Given the number of male subjects, this study may be underpowered to detect differences in spindle parameters in male MDD participants. CONCLUSIONS This study demonstrates topographic and sex-related differences in sleep spindles in MDD. Further research is warranted to investigate the role of sleep spindles and sex in the pathophysiology of MDD.
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Affiliation(s)
- D.T. Plante
- Department of Psychiatry, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
,
Corresponding author at: Wisconsin Psychiatric Institute and Clinics, 6001 Research Park Blvd. Madison, WI 53719, USA. Tel.: +1 608 232 3328; fax: +1 608 231 9011. .
| | - M.R. Goldstein
- Department of Psychiatry, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - E.C. Landsness
- Department of Psychiatry, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - M.J. Peterson
- Department of Psychiatry, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - B.A. Riedner
- Department of Psychiatry, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - F. Ferrarelli
- Department of Psychiatry, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
,Department of Clinical Sciences, “Luigi Sacco,” Universita degli Studi di Milano, Milan, Italy
| | - T. Wanger
- Department of Psychiatry, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - J.J. Guokas
- Department of Psychiatry, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - G. Tononi
- Department of Psychiatry, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - R.M. Benca
- Department of Psychiatry, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
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Slats D, Claassen JA, Verbeek MM, Overeem S. Reciprocal interactions between sleep, circadian rhythms and Alzheimer's disease: focus on the role of hypocretin and melatonin. Ageing Res Rev 2013; 12:188-200. [PMID: 22575905 DOI: 10.1016/j.arr.2012.04.003] [Citation(s) in RCA: 72] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2012] [Revised: 04/04/2012] [Accepted: 04/23/2012] [Indexed: 01/02/2023]
Abstract
AD, sleep and circadian rhythm physiology display an intricate relationship. On the one hand, AD pathology leads to sleep and circadian disturbances, with a clear negative influence on quality of life. On the other hand, there is increasing evidence that both sleep and circadian regulating systems exert an influence on AD pathology. In this review we describe the impairments of both sleep regulating systems and circadian rhythms in AD and their link to clinical symptoms, as this may increase knowledge on appropriate diagnosis and adequate treatment of sleep problems in AD. Furthermore we discuss how sleep regulating systems, and especially neurotransmitters such as melatonin and hypocretin, may affect AD pathophysiology, as this may provide a role for lack of sleep and circadian rhythm deterioration in the onset of AD.
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41
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Pillai V, Kalmbach DA, Ciesla JA. A meta-analysis of electroencephalographic sleep in depression: evidence for genetic biomarkers. Biol Psychiatry 2011; 70:912-9. [PMID: 21937023 DOI: 10.1016/j.biopsych.2011.07.016] [Citation(s) in RCA: 123] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2011] [Revised: 07/07/2011] [Accepted: 07/19/2011] [Indexed: 01/12/2023]
Abstract
BACKGROUND Research on whether any electroencephalographic (EEG) sleep abnormalities observed among individuals with major depressive disorder (MDD) represent genetic biomarkers remains inconclusive. We aimed to identify EEG-based biomarkers of MDD through a review of studies from three populations: individuals with MDD, individuals with MDD under remission, and never depressed high-risk probands (HRPs) of individuals with MDD. METHODS We searched databases such as MEDLINE and PsycINFO for EEG studies published since 1970. Of the 886 records, our selection criteria identified 56 studies that employed standardized EEG scoring procedures and addressed confounds such as participant reactivity and drug effects. We then used fixed-effects models to calculate average weighted mean differences in EEG parameters between clinical groups across these studies. RESULTS Individuals with MDD differed significantly from control subjects on several EEG variables. However, remitted individuals showed normalization of all affected EEG parameters except rapid eye movement (REM) density and slow-wave sleep (SWS). Surprisingly, proportion of SWS was significantly shorter during remission than depression. Never-depressed HRPs also exhibited significantly elevated REM density and reduced SWS. Finally, these parameters constituted the only two EEG variables that were not moderated by depression severity. CONCLUSIONS Individuals experiencing MDD and those in remission exhibit increased REM density and shortened SWS, as do HRPs with no history of MDD. Thus, this combination of EEG features may represent a genetic biomarker of MDD. Further, SWS appears to be shorter during remission than depression, suggesting its role as both a genetic marker as well as a biological scar of the disorder.
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Affiliation(s)
- Vivek Pillai
- Department of Psychology, Kent State University, Ohio, USA
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Naismith SL, Rogers NL, Lewis SJG, Diamond K, Terpening Z, Norrie L, Hickie IB. Sleep disturbance in mild cognitive impairment: differential effects of current and remitted depression. Acta Neuropsychiatr 2011; 23:167-72. [PMID: 25379794 DOI: 10.1111/j.1601-5215.2011.00555.x] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
Naismith SL, Rogers NL, Lewis SJG, Diamond K, Terpening Z, Norrie L, Hickie IB. Sleep disturbance in mild cognitive impairment: differential effects of current and remitted depression.Objective:Although patients with mild cognitive impairment (MCI) commonly report sleep disturbance, the extent to which depressive symptoms contribute to this relationship is unclear. This study sought to delineate the contribution of current and remitted major depression (MD) to sleep disturbance in MCI.Methods:Seventy-seven patients meeting criteria for MCI (mean age = 66.6 ± 8.8 years) were grouped according to those withnohistory of depression (MCI,n= 33), those meeting criteria forcurrentMD [mild cognitive impairment and meeting criteria for current major depression (DEP-C),n= 14] and those withremittedMD [mild cognitive impairment and remitted major depression (DEP-R),n= 30]. Additionally, 17 healthy controls (CON) participated. Sleep was patient-rated using the Pittsburgh Sleep Quality Index and included assessment of sleep quality, duration, efficiency, disturbances, medications, sleep onset latency and daytime dysfunction. Depression severity was clinician-rated using the Hamilton Depression Rating Scale.Results:Overall sleep disturbance was significantly greater in the DEP-C and DEP-R groups in comparison to the CON and MCI groups (p< 0.001). Only 12% of CON reported sleep disturbance, compared to 30% of MCI, 63% of DEP-R and 86% of DEP-C. Sub-scale analysis showed that the sleep disturbance in depressive groups was most evident across the domains of sleep quality, sleep efficiency, sleep latency and daytime dysfunction.Conclusion:Sleep disturbance in MCI is strongly associated with a current or past diagnosis of MD. The finding that sleep complaints are still prominent in those with remitted depression, suggests that ‘trait' markers exist that may reflect underlying neurobiological changes within the sleep–wake system.
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Affiliation(s)
- Sharon L Naismith
- Ageing Brain Centre, Clinical Research Unit, Brain & Mind Research Institute, The University of Sydney, Camperdown, NSW, Australia
| | - Naomi L Rogers
- Chronobiology and Sleep Group, Clinical Research Unit, Brain & Mind Research Institute, The University of Sydney, Camperdown, NSW, Australia
| | - Simon J G Lewis
- Ageing Brain Centre, Clinical Research Unit, Brain & Mind Research Institute, The University of Sydney, Camperdown, NSW, Australia
| | - Keri Diamond
- Ageing Brain Centre, Clinical Research Unit, Brain & Mind Research Institute, The University of Sydney, Camperdown, NSW, Australia
| | - Zoë Terpening
- Ageing Brain Centre, Clinical Research Unit, Brain & Mind Research Institute, The University of Sydney, Camperdown, NSW, Australia
| | - Louisa Norrie
- Ageing Brain Centre, Clinical Research Unit, Brain & Mind Research Institute, The University of Sydney, Camperdown, NSW, Australia
| | - Ian B Hickie
- Ageing Brain Centre, Clinical Research Unit, Brain & Mind Research Institute, The University of Sydney, Camperdown, NSW, Australia
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Weldemichael DA, Grossberg GT. Circadian rhythm disturbances in patients with Alzheimer's disease: a review. Int J Alzheimers Dis 2010; 2010. [PMID: 20862344 PMCID: PMC2939436 DOI: 10.4061/2010/716453] [Citation(s) in RCA: 60] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2010] [Accepted: 07/27/2010] [Indexed: 11/20/2022] Open
Abstract
Circadian Rhythm Disturbances (CRDs) affect as many as a quarter of Alzheimer's disease (AD) patients during some stage of their illness. Alterations in the suprachiasmatic nucleus and melatonin secretion are the major factors linked with the cause of CRDs. As a result, the normal physiology of sleep, the biological clock, and core body temperature are affected. This paper systematically discusses some of the causative factors, typical symptoms, and treatment options for CRDs in patients with AD. This paper also emphasizes the implementation of behavioral and environmental therapies before embarking on medications to treat CRDs. Pharmacotherapeutic options are summarized to provide symptomatic benefits for the patient and relieve stress on their families and professional care providers. As of today, there are few studies relative to CRDs in AD. Large randomized trials are warranted to evaluate the effects of treatments such as bright light therapy and engaging activities in the reduction of CRDs in AD patients.
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Affiliation(s)
- Dawit A Weldemichael
- Department of Neurology & Psychiatry, Saint Louis University School of Medicine, St. Louis, MO 63104, USA
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Lopez J, Hoffmann R, Armitage R. Reduced sleep spindle activity in early-onset and elevated risk for depression. J Am Acad Child Adolesc Psychiatry 2010; 49:934-43. [PMID: 20732629 PMCID: PMC2946379 DOI: 10.1016/j.jaac.2010.05.014] [Citation(s) in RCA: 62] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2010] [Revised: 05/24/2010] [Accepted: 05/25/2010] [Indexed: 11/15/2022]
Abstract
OBJECTIVE Sleep disturbances are common in major depressive disorder (MDD), although polysomnographic (PSG) abnormalities are more prevalent in adults than in children and adolescents with MDD. Sleep spindle activity (SPA) is associated with neuroplasticity mechanisms during brain maturation and is more abundant in childhood and adolescence than in adulthood, and as such, may be a more sensitive measure of sleep alteration than PSG in early-onset depression. This study investigated SPA changes related to early-onset MDD, comparing individuals already ill with MDD and individuals at high-risk for MDD with healthy nondepressed controls. METHOD The study included 63 participants (8 to 15 years of age): 21 currently depressed individuals, 21 individuals at high risk for MDD based on positive family history of MDD, and 21 healthy control individuals with no personal or family history of psychiatric illness. All participants maintained a regular sleep/wake schedule for 5 days, followed by 2 nights in the laboratory. SPA was analyzed in Stage 2 of non-rapid eye movement sleep. RESULTS SPA differed significantly between groups, particularly in the late part of the night (F(2,62) = 7.3, p = .001). Although the difference was greatest between the MDD and healthy control groups, both the MDD (p = .0004) and at high-risk groups (p = .02) had significantly lower SPA compared with healthy controls. SPA deficit was more prominent in females than in males (F(5,62) = 5.19, p = .005). CONCLUSIONS Low SPA characterizes youths with MDD and those at high risk for MDD, particularly girls, suggesting that early-onset depression and risk for the MDD are associated with decreased neuroplasticity.
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Affiliation(s)
- Jorge Lopez
- Sleep and Chronophysiology Laboratory, University of Michigan, Department of Psychiatry, 4250 Plymouth Road, Ann Arbor, MI 48109, USA.
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Doerr JP, Hirscher V, Riemann D, Voderholzer U. [Disturbances of slow-wave sleep and psychiatric disorders]. DER NERVENARZT 2010; 81:347-54. [PMID: 20012932 DOI: 10.1007/s00115-009-2897-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Slow-wave sleep is defined as sleep stages 3 and 4 that characteristically show slow delta EEG activity during polysomnography. The percentage of slow-wave sleep normally declines with age. Sleep disorders are a common symptom of many psychiatric disorders. In polysomnographic recordings they mostly manifest as disturbances of sleep continuity. In some disorders changes in REM sleep are also found. A reduction of slow-wave sleep has most often been described in patients with depression and addictive disorders. More recent research implicates slow-wave sleep as an important factor in memory consolidation, especially the contents of declarative memory. Psychotropic drugs influence sleep in different ways. Hypnotic substances can reduce the deep sleep stages (e.g. benzodiazepines), whereas 5-HT2C antagonists increase the percentage of slow-wave sleep. Whether a selective impairment/alteration of slow-wave sleep is clinically relevant has not yet been proved.
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Affiliation(s)
- J P Doerr
- Abteilung für Psychiatrie und Psychotherapie, Universitätsklinikum, Hauptstrasse 5, 79104, Freiburg.
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Naismith SL, Rogers NL, Hickie IB, Mackenzie J, Norrie LM, Lewis SJG. Sleep well, think well: sleep-wake disturbance in mild cognitive impairment. J Geriatr Psychiatry Neurol 2010; 23:123-30. [PMID: 20354239 DOI: 10.1177/0891988710363710] [Citation(s) in RCA: 87] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
While literature suggests that sleep is important for cognition and mood, and that sleep disturbance is a prominent feature of neurodegenerative and neuropsychiatric disorders, these relationships have not yet been examined in older people ''at risk" of dementia. In this study, 15 older people with the nonamnestic subtype of mild cognitive impairment ([MCI] mean age = 66.7 years, SD = 8.7) underwent psychiatric and neuropsychological assessment. Participants completed sleep diaries, questionnaires, and 2 weeks of actigraphy. Key outcome data during the rest interval were time spent ''awake" or wake after sleep onset (WASO) and the number of arousals/wake bouts. Results showed that even after controlling for age, greater WASO was associated with reduced attention and executive functioning and increased arousals were related to poorer nonverbal learning and problem solving. This preliminary data suggests that sleep-wake disturbance in nonamnestic forms of MCI is related to cognitive functioning and may be indicative of shared neurobiological underpinnings.
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Affiliation(s)
- Sharon L Naismith
- Ageing Brain Centre, Clinical Research Unit, Brain & Mind Research Institute, University of Sydney, Camperdown, NSW, Australia.
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Naismith SL, Norrie L, Lewis SJ, Rogers NL, Scott EM, Hickie IB. Does sleep disturbance mediate neuropsychological functioning in older people with depression? J Affect Disord 2009; 116:139-43. [PMID: 19128840 DOI: 10.1016/j.jad.2008.11.017] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2008] [Revised: 11/25/2008] [Accepted: 11/25/2008] [Indexed: 01/25/2023]
Abstract
BACKGROUND Depression in older adults is associated with neuropsychological dysfunction, fronto-subcortical brain changes and sleep disturbance. Research suggests that adequate sleep is critical for many aspects of cognition including processing speed, verbal skills and memory. However, the association between sleep disturbance and neuropsychological functioning in depression has not been well evaluated. The current study therefore aimed to investigate these relationships. METHODS Forty-eight people (mean age=59.6, sd=8.2) meeting DSM-IV criteria for unipolar major depression were included for analysis. Neuropsychological assessment included assessment of processing speed, learning and memory, verbal fluency and executive functions. Early and late insomnia were defined by scores on the Hamilton Depression Rating Scale. RESULTS While early insomnia was related to depression severity and poorer global cognition, late insomnia was associated with later age of depression onset, depression severity, and poorer scores on tests of verbal fluency and memory. The associations between cognition and late insomnia were not accounted for by depression severity or age of onset of disorder. LIMITATIONS This study was retrospective in nature, and did not include objective measures of sleep. CONCLUSIONS This is the first known study to indicate that late insomnia in older people with major depression may be independently and aetiologically linked to neuropsychological performance, particularly verbal fluency and memory. It may also indicate underlying structural and neurochemical changes. Sleep and circadian disturbance may serve as a biomarker for ongoing cognitive decline and may be a potentially modifiable risk factor.
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Affiliation(s)
- Sharon L Naismith
- Clinical Research Unit, Brain and Mind Research Institute, University of Sydney, 94 Mallet Street, Camperdown NSW 2050, Australia.
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Murphy PJ, Campbell SS. Sex hormones, sleep, and core body temperature in older postmenopausal women. Sleep 2008; 30:1788-94. [PMID: 18246988 DOI: 10.1093/sleep/30.12.1788] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
STUDY OBJECTIVES Assessment of relationships between polysomnographic sleep, sex hormones, and core body temperature in postmenopausal women. DESIGN AND PARTICIPANTS Ten women aged 57 to 71 years, at least 5 years past menopause. SETTING Laboratory of Human Chronobiology at Weill Cornell Medical College. INTERVENTIONS N/A. MEASUREMENTS AND RESULTS Lower estradiol (E2) and higher luteinizing hormone (LH) levels were significantly correlated with indices of poor sleep quality. Relationships between LH and polysomnographic variables were more robust than those for E2. Significant increases from basal LH levels (i.e., LH pulses) occurred more frequently after sleep onset than prior to sleep onset, and 30 of 32 of these LH pulses occurred prior to long awakenings from sleep. In addition, higher body core temperature prior to and during sleep was significantly correlated with poorer sleep efficiency and higher LH levels. CONCLUSIONS Most investigations of relationships between sleep, sex hormones, and body temperature have focused on perimenopausal women, menopausal phenomena such as hot flashes, the role of declining estrogen, and treatment with exogenous estrogen. The current results suggest that altered levels of both sex steroids and gonadotropins may contribute to sleep disturbance in older women and confirm the results of previous studies indicating that higher body core temperature is associated with poorer sleep quality, even in women without vasomotor symptoms. The findings also raise the possibility of alternate treatment avenues for menopause- and age-related sleep disturbance that focus on altering LH levels.
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Affiliation(s)
- Patricia J Murphy
- Laboratory of Human Chronobiology, Weill Cornell Medical College, White Plains, NY 10605, USA.
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A Combined-Constructionist Therapeutic Approach to Couples Experiencing Erectile Dysfunction: Part II. CONTEMPORARY FAMILY THERAPY 2006. [DOI: 10.1007/s10591-006-9022-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Davis B, Sadik K. Circadian cholinergic rhythms: implications for cholinesterase inhibitor therapy. Dement Geriatr Cogn Disord 2006; 21:120-9. [PMID: 16391473 DOI: 10.1159/000090630] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/18/2005] [Indexed: 11/19/2022] Open
Abstract
Therapies for Alzheimer's disease (AD) at present augment the deteriorating cholinergic system, are reasonably well tolerated, and are convenient, given once or twice a day. They may, however, support or oppose endogenous circadian cholinergic rhythms. Drugs with a duration of action longer than a day are at odds with the physiology of the cholinergic system, which is active during the day and quiescent at night. Sleep and the consolidation of daytime experience into memory may be disturbed. Tolerance commonly develops, substantial counterregulatory increases in acetylcholinesterase (AChE) have been measured, and brain AChE inhibition is lower than predicted. Therefore, the duration of action and timing of administration, as they relate to natural cholinergic rhythms, are factors to be considered in optimizing cholinergic AD therapeutics.
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