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Ulgen Temel E, Ozbudak P, Serdaroglu A, Arhan E. Sleep Spindle Alterations in Children With Migraine. Pediatr Neurol 2024; 152:184-188. [PMID: 38301321 DOI: 10.1016/j.pediatrneurol.2023.12.013] [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: 10/30/2023] [Accepted: 12/16/2023] [Indexed: 02/03/2024]
Abstract
BACKGROUND The modulation of thalamocortical activity is the most important site of several levels of interference between sleep spindles and migraine. Thalamocortical circuits are responsible for the electrophysiological phenomenon of sleep spindles. Spindle alterations may be used as a beneficial marker in the diagnosis and follow-up of children with migraine. We aimed to formulate the hypothesis that there is a shared mechanism that underlies migraine and sleep spindle activity. METHODS We analyzed the amplitude, frequency, duration, density, and activity of sleep spindles in non-rapid eye movement stage 2 sleep in patients with migraine without aura when compared with healthy control subjects. RESULTS The amplitudes of average, slow, and fast sleep spindles were higher in children with migraine without aura (P = 0.020, 0.013, and 0.033, respectively). The frequency of fast spindles was lower in children with migraines without aura when compared with the control group (P = 0.03). Although not statistically significant, the fast sleep spindle duration in the migraine group was shorter (P = 0.055). Multivariate analysis revealed an increased risk of migraine associated with increased mean spindle amplitude and decreased fast spindle frequency and duration. CONCLUSIONS Our data suggest that spindle alterations may correlate with the vulnerability to develop migraine and may be used as a model for future research about the association between the thalamocortical networks and migraine.
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Affiliation(s)
- Esra Ulgen Temel
- Division of Child Neurology, Cengiz Gökçek Maternity and Children's Hospital, Gaziantep, Turkey
| | - Pinar Ozbudak
- Division of Child Neurology, Etlik City Training and Research Hospital, University of Health Sciences, Ankara, Turkey
| | - Ayse Serdaroglu
- Department of Child Neurology, Gazi University Faculty of Medicine, Ankara, Turkey
| | - Ebru Arhan
- Department of Child Neurology, Gazi University Faculty of Medicine, Ankara, Turkey.
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Carotenuto M, Messina G, Esposito M, Santoro C, Iacono D, Spruyt K. Polysomnographic study in pediatric neurofibromatosis type 1. Front Neurol 2023; 14:1213430. [PMID: 37538252 PMCID: PMC10394094 DOI: 10.3389/fneur.2023.1213430] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Accepted: 06/29/2023] [Indexed: 08/05/2023] Open
Abstract
Background Neurofibromatosis type 1 (NF1) is a genetic disease that alters neurodevelopment. We aimed to analyze the sleep macrostructure of a sample of children affected by NF1 without neurocognitive co-morbidities and MRI reports of unidentified bright objects (UBOs). Methods A 100 pre-pubertal children participated in the cross-sectional study: 50 subjects were children diagnosed with NF1 and 50 subjects were typically developing healthy children (TDC). All participants underwent polysomnographic evaluation through which conventional sleep parameters were collected: Total sleep time (TST), Sleep latency (SOL), first REM latency (FRL), number of stage shifts/h (SS/h), number of awakenings/h (AWN/h), wake after sleep onset (WASO%), sleep efficiency percentage (SE%), percentage of sleep time spent in sleep stages 1 (N1%) and 2 (N2%), slow-wave sleep (N3%), and REM sleep (REM%). Additionally, nocturnal respiratory events such as apnea/hypopnea index (AHI), oxygen desaturation index (ODI), and periodic limb movement index (PLMI) were recorded. Results Neurofibromatosis type 1 children showed a reduction in sleep duration parameters (TST; p < 0.001), sleep efficiency (SE%; p < 0.001), and stage N2% (p < 0.001). Moreover, the number of awakenings per hour (AWN/h), wake after sleep onset (WASO%), and respiratory events such as AHI, ODI, and PLMI resulted higher in NF1 vs. TDC children. Conclusion The data showed that the sleep macrostructure differs between NF1 and TDC children. These findings suggest that the evaluation of sleep may provide useful support in corroborating the diagnosis and offers additional therapeutic management perspectives in NF1 and genetic neurodevelopmental disorders in general.
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Affiliation(s)
- Marco Carotenuto
- Sleep Lab for Developmental Age, Clinic of Child and Adolescent Neuropsychiatry, Department of Mental and Physical Health and Preventive Medicine, Child and Adolescent Neuropsychiatry Clinic, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Giovanni Messina
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Maria Esposito
- Sleep Lab for Developmental Age, Clinic of Child and Adolescent Neuropsychiatry, Department of Mental and Physical Health and Preventive Medicine, Child and Adolescent Neuropsychiatry Clinic, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Claudia Santoro
- Sleep Lab for Developmental Age, Clinic of Child and Adolescent Neuropsychiatry, Department of Mental and Physical Health and Preventive Medicine, Child and Adolescent Neuropsychiatry Clinic, University of Campania "Luigi Vanvitelli", Naples, Italy
- Department of Women's and Children's Health, and General and Specialized Surgery, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Diego Iacono
- Neuropathology Research, Biomedical Research Institute of New Jersey, BRInj, Cedar Knolls, NJ, United States
- Department of Pediatrics, Neuropathology Research, Mid-Atlantic Neonatology Associates (MANA), Atlantic Health System (AHS), Morristown, NJ, United States
| | - Karen Spruyt
- NeuroDiderot INSERM, Université de Paris, Paris, France
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Onofri A, Ferilli MAN, Tozzi E, Ursitti F, Sforza G, Olivieri L, Proietti Checchi M, Vigevano F, Valeriani M, Moavero R. How to Assess the Headache-Sleep Disorders Comorbidity in Children and Adolescents. J Clin Med 2021; 10:jcm10245887. [PMID: 34945182 PMCID: PMC8707479 DOI: 10.3390/jcm10245887] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Revised: 12/08/2021] [Accepted: 12/10/2021] [Indexed: 11/16/2022] Open
Abstract
Sleep disorders and primary headaches are frequent health problems in childhood, and they are often comorbid in an individual, linked by a mutual and complex relationship. This comorbidity is frequent and well-documented, but the available literature is usually biased in favor of one aspect or another, mainly depending on the expertise of the authors. The aim of this paper is to review existing literature on the diagnostic assessment of comorbid primary headaches and sleep disorders, so as to propose practical suggestions to accurately investigate the presence of comorbid conditions in children evaluated for primary headaches or for sleep disorders.
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Affiliation(s)
- Agnese Onofri
- Neuropsychiatric Clinic—Child Headache Center, Department of Life, Health and Environmental Sciences, San Salvatore Hospital L’Aquila, University of L’Aquila, 67100 L’Aquila, Italy; (A.O.); (E.T.); (L.O.)
| | - Michela Ada Noris Ferilli
- Neuroscience Department, Bambino Gesù Children’s Hospital IRCCS, Piazza di Sant’Onofrio 4, 00165 Rome, Italy; (F.U.); (G.S.); (F.V.); (M.V.); (R.M.)
- Correspondence:
| | - Elisabetta Tozzi
- Neuropsychiatric Clinic—Child Headache Center, Department of Life, Health and Environmental Sciences, San Salvatore Hospital L’Aquila, University of L’Aquila, 67100 L’Aquila, Italy; (A.O.); (E.T.); (L.O.)
| | - Fabiana Ursitti
- Neuroscience Department, Bambino Gesù Children’s Hospital IRCCS, Piazza di Sant’Onofrio 4, 00165 Rome, Italy; (F.U.); (G.S.); (F.V.); (M.V.); (R.M.)
| | - Giorgia Sforza
- Neuroscience Department, Bambino Gesù Children’s Hospital IRCCS, Piazza di Sant’Onofrio 4, 00165 Rome, Italy; (F.U.); (G.S.); (F.V.); (M.V.); (R.M.)
| | - Luca Olivieri
- Neuropsychiatric Clinic—Child Headache Center, Department of Life, Health and Environmental Sciences, San Salvatore Hospital L’Aquila, University of L’Aquila, 67100 L’Aquila, Italy; (A.O.); (E.T.); (L.O.)
| | - Martina Proietti Checchi
- Unit of Clinical Psychology, Neuroscience Department, Bambino Gesù Children’s Hospital IRCCS, 00165 Rome, Italy;
| | - Federico Vigevano
- Neuroscience Department, Bambino Gesù Children’s Hospital IRCCS, Piazza di Sant’Onofrio 4, 00165 Rome, Italy; (F.U.); (G.S.); (F.V.); (M.V.); (R.M.)
| | - Massimiliano Valeriani
- Neuroscience Department, Bambino Gesù Children’s Hospital IRCCS, Piazza di Sant’Onofrio 4, 00165 Rome, Italy; (F.U.); (G.S.); (F.V.); (M.V.); (R.M.)
- Denmark Neurology Unit, Center for Sensory-Motor Interaction, Aalborg University, 9220 Aalborg, Denmark
| | - Romina Moavero
- Neuroscience Department, Bambino Gesù Children’s Hospital IRCCS, Piazza di Sant’Onofrio 4, 00165 Rome, Italy; (F.U.); (G.S.); (F.V.); (M.V.); (R.M.)
- Child Neurology Unit, Systems Medicine Department, Tor Vergata University Hospital of Rome, 00133 Rome, Italy
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Esposito M, Antinolfi L, Carotenuto M. Neuropsychological Profile in Pediatric Migraine without Aura: A Pilot Study. Brain Sci 2021; 11:brainsci11121582. [PMID: 34942884 PMCID: PMC8699751 DOI: 10.3390/brainsci11121582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Revised: 11/15/2021] [Accepted: 11/23/2021] [Indexed: 11/30/2022] Open
Abstract
Despite the high prevalence of headache in developmental age, current reports about its neuropsychological effects are still lacking. The aim of the present pilot study is to assess the neuropsychological skills among children affected by migraine without aura (MwoA). Fifteen children (7M/8F) (mean age 10.73 ± 2.13) with MwoA, consecutively referred to the Center for Childhood Headache at Università degli Studi della Campania “Luigi Vanvitelli”, underwent the Italian version of the NEPSY-2 after cognitive evaluation. Moreover, to assess the pain level and disability grade during daily activity, the VAS and PedMIDAS scales were used. MwoA children were comparable with the control group of 38 children with respect to age, gender, language, and education level. Written informed consent was obtained from all parents and from children directly, when appropriate. MwoA children differed from controls significantly among the NEPSY-2 subscales, with a relevant relationship between the frequency and intensity of the attacks. In conclusion, the results of the present pilot study may suggest that MwoA could impact significantly neuropsychological functioning in children.
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Stanyer EC, Creeney H, Nesbitt AD, Holland PR, Hoffmann J. Subjective Sleep Quality and Sleep Architecture in Patients With Migraine: A Meta-analysis. Neurology 2021; 97:e1620-e1631. [PMID: 34551985 PMCID: PMC8548957 DOI: 10.1212/wnl.0000000000012701] [Citation(s) in RCA: 38] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Accepted: 08/12/2021] [Indexed: 01/07/2023] Open
Abstract
Background and Objectives Sleep disturbance is often associated with migraine. However, there is a paucity of research investigating objective and subjective measures of sleep in patients with migraine. This meta-analysis aims to determine whether there are differences in subjective sleep quality measured using the Pittsburgh Sleep Quality Index (PSQI) and objective sleep architecture measured using polysomnography (PSG) between adult and pediatric patients and healthy controls. Methods This review was preregistered on PROSPERO (CRD42020209325). A systematic search of 5 databases (Embase, MEDLINE, Global Health, APA PsycINFO, and APA PsycArticles, last searched on December 17, 2020) was conducted to find case–control studies that measured PSG or PSQI in patients with migraine. Pregnant participants and those with other headache disorders were excluded. Effect sizes (Hedges g) were entered into a random effects model meta-analysis. Study quality was evaluated with the Newcastle Ottawa Scale and publication bias with the Egger regression test. Results Thirty-two studies were eligible, of which 21 measured PSQI or Migraine Disability Assessment Test in adults, 6 measured PSG in adults, and 5 measured PSG in children. The overall mean study quality score was 5/9; this did not moderate any of the results and there was no risk of publication bias. Overall, adults with migraine had higher PSQI scores than healthy controls (g = 0.75, p < 0.001, 95% confidence interval [CI] 0.54–0.96). This effect was larger in those with a chronic rather than episodic condition (g = 1.03, p < 0.001, 95% CI 0.37–1.01; g = 0.63, p < 0.001, 95% CI 0.38–0.88, respectively). For polysomnographic studies, adults and children with migraine displayed a lower percentage of rapid eye movement sleep (g = −0.22, p = 0.017, 95% CI −0.41 to −0.04; g = −0.71, p = 0.025, 95% CI −1.34 to −0.10, respectively) than controls. Pediatric patients displayed less total sleep time (g = −1.37, p = 0.039, 95% CI −2.66 to −0.10), more wake (g = 0.52, p < 0.001, 95% CI 0.08–0.79), and shorter sleep onset latency (g = −0.37, p < 0.001, 95% CI −0.54 to −0.21) than controls. Discussion People with migraine have significantly poorer subjective sleep quality and altered sleep architecture compared to healthy individuals. Further longitudinal empirical studies are required to enhance our understanding of this relationship.
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Affiliation(s)
- Emily Charlotte Stanyer
- From the Wolfson Centre for Age-Related Diseases (E.C.S., H.C., P.R.H., J.H.), Institute of Psychiatry, Psychology & Neuroscience, King's College London; Department of Neurology (A.D.N.), Guy's and St Thomas NHS Foundation Trust; and NIHR-Wellcome Trust King's Clinical Research Facility/SLaM Biomedical Research Centre (J.H.), King's College Hospital, London, UK
| | - Hannah Creeney
- From the Wolfson Centre for Age-Related Diseases (E.C.S., H.C., P.R.H., J.H.), Institute of Psychiatry, Psychology & Neuroscience, King's College London; Department of Neurology (A.D.N.), Guy's and St Thomas NHS Foundation Trust; and NIHR-Wellcome Trust King's Clinical Research Facility/SLaM Biomedical Research Centre (J.H.), King's College Hospital, London, UK
| | - Alexander David Nesbitt
- From the Wolfson Centre for Age-Related Diseases (E.C.S., H.C., P.R.H., J.H.), Institute of Psychiatry, Psychology & Neuroscience, King's College London; Department of Neurology (A.D.N.), Guy's and St Thomas NHS Foundation Trust; and NIHR-Wellcome Trust King's Clinical Research Facility/SLaM Biomedical Research Centre (J.H.), King's College Hospital, London, UK
| | - Philip Robert Holland
- From the Wolfson Centre for Age-Related Diseases (E.C.S., H.C., P.R.H., J.H.), Institute of Psychiatry, Psychology & Neuroscience, King's College London; Department of Neurology (A.D.N.), Guy's and St Thomas NHS Foundation Trust; and NIHR-Wellcome Trust King's Clinical Research Facility/SLaM Biomedical Research Centre (J.H.), King's College Hospital, London, UK
| | - Jan Hoffmann
- From the Wolfson Centre for Age-Related Diseases (E.C.S., H.C., P.R.H., J.H.), Institute of Psychiatry, Psychology & Neuroscience, King's College London; Department of Neurology (A.D.N.), Guy's and St Thomas NHS Foundation Trust; and NIHR-Wellcome Trust King's Clinical Research Facility/SLaM Biomedical Research Centre (J.H.), King's College Hospital, London, UK.
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Pediatric Chronic Migraine Severity and Maternal Stress. Pediatr Rep 2021; 13:576-582. [PMID: 34698274 PMCID: PMC8544694 DOI: 10.3390/pediatric13040068] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2021] [Revised: 10/01/2021] [Accepted: 10/12/2021] [Indexed: 01/07/2023] Open
Abstract
Primary headache is an increasing phenomenon in pediatric age, and very often, it causes disabling limitations in children's daily activities, negatively affecting family well-being. There are conflicting data in the literature on the impact of children's migraines on parental experienced stress. This study aimed to evaluate maternal stress in a sample of school-aged children with a migraine without aura (MwoA) and its correlation with migraine intensity and frequency. A total of 474 mothers aged between 31 and 55 participated in the study: 237 were mothers of children with MwoA, and 237 were mothers of typical developing children. All participants were administered the Parent Stress Index-Short Form (PSI-SF) for the assessment of parental stress; the Pediatric Migraine Disability Assessment (PedMIDAS) was administered to children with MwoA to assess the presence of a related disability migraine. The results showed a significantly higher rate of stress in mothers of MwoA children (p < 0.001) in all the domains explored by the PSI-SF and a statistically significant correlation between the maternal stress total score and the intensity and frequency of migraine attacks (p < 0.0001). This study highlights the need for the holistic contribution of the family to be considered in the clinical management of pediatric migraines.
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Abstract
Sleep is a complex brain state with fundamental relevance for cognitive functions, synaptic plasticity, brain resilience, and autonomic balance. Sleep pathologies may interfere with cerebral circuit organization, leading to negative consequences and favoring the development of neurologic disorders. Conversely, the latter can interfere with sleep functions. Accordingly, assessment of sleep quality is always recommended in the diagnosis of patients with neurologic disorders and during neurorehabilitation programs. This review investigates the complex interplay between sleep and brain pathologies, focusing on diseases in which the association with sleep disturbances is commonly overlooked and whereby major benefits may derive from their proper management.
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Affiliation(s)
- Carlotta Mutti
- Sleep Disorders Center, Department of Medicine and Surgery, Neurology Unit, University of Parma, Via Gramsci 14, Parma 43126, Italy
| | - Francesco Rausa
- Sleep Disorders Center, Department of Medicine and Surgery, Neurology Unit, University of Parma, Via Gramsci 14, Parma 43126, Italy
| | - Liborio Parrino
- Sleep Disorders Center, Department of Medicine and Surgery, Neurology Unit, University of Parma, Via Gramsci 14, Parma 43126, Italy.
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Neuropeptides' Hypothalamic Regulation of Sleep Control in Children Affected by Functional Non-Retentive Fecal Incontinence. Brain Sci 2020; 10:brainsci10030129. [PMID: 32106434 PMCID: PMC7139357 DOI: 10.3390/brainsci10030129] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2019] [Revised: 02/21/2020] [Accepted: 02/24/2020] [Indexed: 02/08/2023] Open
Abstract
Functional non-retentive fecal incontinence (FNRFI) is a common problem in pediatric age. FNRFI is defined as unintended loss of stool in a 4-year-old or older child after organic causes have been excluded. FNRFI tends to affects up to 3% of children older than 4 years, with males being affected more frequently than females. Clinically, children affected by FNRFI have normal intestinal movements and stool consistency. Literature data show that children with fecal incontinence have increased levels of separation anxiety, specific phobias, general anxiety, attention-deficit/hyperactivity disorder (ADHD), and oppositional defiant disorder. In terms of possible relationship between incontinence and sleep, disorders of sleep organization have been observed in the pathogenesis of enuresis so generating the hypothesis that the orexinergic system may have a crucial role not only for the sleep organization per se but also for the sphincterial control in general. This study aimed to focus on specific neurophysiological aspects to investigate on the possible relationship between sleep organizational abnormalities and FNRFI. Specifically, we aimed to measure orexin serum levels in children with FNRFI and assess their polysomnographic sleep macrostructure patterns. Two study groups were considered: FNFRI (n = 45) and typically developed (TD) (n = 45) group. In both groups, sleep patterns and respiratory events were assessed by polysomnographic recordings (PSG) during a period of two nights at least, and plasma levels of Orexin-A were measured in each participant. The findings of this initial investigation seem to support a major role of Orexin-A in sleep organization alterations in children with FNFRI. Also, our data suggest that sleep habits evaluation should be considered as screening and complementary tool for the diagnosis of fecal incontinence in children.
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Nita SA, Teleanu RI, Bajenaru OA. The Role of Polysomnography in Identifying Sleep Disorders in Children with Migraine. J Med Life 2020; 13:64-67. [PMID: 32341703 PMCID: PMC7175440 DOI: 10.25122/jml-2020-0025] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Migraine pathophysiology and sleep share common neural pathways, and there are clinical as well as paraclinical observations, which lead to the hypothesis of an association between migraine and sleep disorders. The objective of this study consisted of the evaluation of a possible correlation between migraine and sleep disorders in children, as reflected by sleep architecture and electroencephalographic patterns. Eighteen patients aged five to seventeen were recruited for the migraine group, and sixteen age-matched patients with no criteria for migraine or any underlying organic disorder, diagnosed with emotional disorders, were enrolled in the control group. All patients underwent inpatient full night polysomnographic recordings, the results of which were analyzed using appropriate statistical methods. Patients in the migraine group had decreased REM sleep (p = 0.049) and increased N1 sleep (p = 0.018) percentages, compared to the control group. Also, more arousals (p = 0.011) and lower sleep latency (p = 0.029) were noted in the migraine group. A statistically significant association was observed between migraine and sleep disorders when the latter was defined with respect to normal values of polysomnographic parameters published in studies conducted on healthy children. Polysomnography can be a useful tool for studying sleep in pediatric migraine patients. The results of this study can be regarded as a starting point for a better understanding of the complex role of sleep in the developing brain and of eventual intricacies with migraine pathophysiological mechanisms.
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Affiliation(s)
- Smaranda Antonia Nita
- Clinical Neurosciences Department, “Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania,Neurology Department, University Emergency Hospital, Bucharest, Romania,Corresponding author: Smaranda Antonia Nita MD, PhD student, University Emergency Hospital, 169 Splaiul Independentei, 050098, Bucharest, Romania E-mail: , Phone: +40766214513
| | - Raluca Ioana Teleanu
- Clinical Neurosciences Department, “Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania,Pediatric Neurology Department, “Dr. Victor Gomoiu” Children's Hospital, Bucharest, Romania
| | - Ovidiu Alexandru Bajenaru
- Clinical Neurosciences Department, “Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania,Neurology Department, University Emergency Hospital, Bucharest, Romania
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Effects of Very Low Calorie Ketogenic Diet on the Orexinergic System, Visceral Adipose Tissue, and ROS Production. Antioxidants (Basel) 2019; 8:antiox8120643. [PMID: 31847149 PMCID: PMC6943716 DOI: 10.3390/antiox8120643] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2019] [Revised: 12/11/2019] [Accepted: 12/11/2019] [Indexed: 12/16/2022] Open
Abstract
Background: Caloric restriction is a valid strategy to reduce the visceral adipose tissue (VAT) content in obese persons. Hypocretin-1 (orexin-A) is a neuropeptide synthesized in the lateral hypothalamus that strongly modulates food intake, thus influencing adipose tissue accumulation. Therapeutic diets in obesity treatment may combine the advantages of caloric restriction and dietary ketosis. The current study aimed to evaluate the effect of a very low calorie ketogenic diet (VLCKD) in a population of obese patients. Methods: Adiposity parameters and orexin-A serum profiling were quantified over an 8 week period. The effect of the VLCKD on reactive oxygen species (ROS) production and cell viability was evaluated, in vitro, by culturing Hep-G2 cells in the presence of VLCKD sera. Results: Dietary intervention induced significant effects on body weight, adiposity, and blood chemistry parameters. Moreover, a selective reduction in VAT was measured by dual-energy X-ray absorptiometry. Orexin-A levels significantly increased after dietary treatment. Hep-G2 cell viability was not affected after 24, 48, and 72 h incubation with patients’ sera, before and after the VLCKD. In the same model system, ROS production was not significantly influenced by dietary treatment. Conclusion: The VLCKD exerts a positive effect on VAT decrease, ameliorating adiposity and blood chemistry parameters. Furthermore, short-term mild dietary ketosis does not appear to have a cytotoxic effect, nor does it represent a factor capable of increasing oxidative stress. Finally, to the best of our knowledge, this is the first study that shows an effect of the VLCKD upon the orexinergic system, supporting the usefulness of such a therapeutic intervention in promoting obesity reduction in the individual burden of this disease.
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Noli Me Tangere: Social Touch, Tactile Defensiveness, and Communication in Neurodevelopmental Disorders. Brain Sci 2019; 9:brainsci9120368. [PMID: 31842265 PMCID: PMC6955721 DOI: 10.3390/brainsci9120368] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2019] [Revised: 11/27/2019] [Accepted: 12/10/2019] [Indexed: 12/15/2022] Open
Abstract
Tactile defensiveness is a common feature in neurodevelopmental disorders (NDDs). Since the first studies, tactile defensiveness has been described as the result of an abnormal response to sensory stimulation. Moreover, it has been studied how the tactile system is closely linked to socio-communicative development and how the interoceptive sensory system supports both a discriminating touch and an affective touch. Therefore, several neurophysiological studies have been conducted to investigate the neurobiological basis of the development and functioning of the tactile system for a better understanding of the tactile defensiveness behavior and the social touch of NDDs. Given the lack of recent literature on tactile defensiveness, the current study provides a brief overview of the original contributions on this research topic in children with NDDs focusing attention on how this behavior has been considered over the years in the clinical setting.
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Roccella M, Smirni D, Smirni P, Precenzano F, Operto FF, Lanzara V, Quatrosi G, Carotenuto M. Parental Stress and Parental Ratings of Behavioral Problems of Enuretic Children. Front Neurol 2019; 10:1054. [PMID: 31681143 PMCID: PMC6797845 DOI: 10.3389/fneur.2019.01054] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2019] [Accepted: 09/18/2019] [Indexed: 12/27/2022] Open
Abstract
Background: Primary monosymptomatic nocturnal enuresis (PMNE) may have a stressful impact on the everyday life of children and parents, and it may represent a cumulative stress factor increasing feelings of “learned helplessness.” Methods: The current study investigated parental stress in a group of parents (n = 330) of children affected by PMNE, compared to a group of parents (n = 330) of typical developing children (TDC). In addition, the study evaluated whether parents of PMNE children experience more emotional, social, and behavioral problems in their children, compared to parents of TDC. Finally, the study correlated frequency of enuresis with stress values and Child Behavior Checklist (CBCL) subscales and total stress with CBCL. Both groups were given The Parental Stress Inventory-Short Form (PSI-SF) and the Child Behavior Checklist (CBCL). Results: Parents of PMNE children showed significantly higher stress level than parents of TDC. Nocturnal enuresis, as a demanding clinical condition difficult to control, represents a relevant stress factor. Mothers appeared as more vulnerable to stress than fathers. Parents of PMNE children reported higher behavioral and emotional problems, compared to reports of parents of TDC. PMNE children appeared to their parents as having lower competency in social activities, school performance, and social relationships than TDC. Moreover, they were rated as more withdrawn, anxious-depressed, more aggressive, inattentive, and with more somatic complaints than healthy children. It was always the mother who rated a significantly higher number of emotional, social, and behavioral problems compared to fathers. Correlational analysis showed that the higher the frequency of enuresis, the greater the parental stress level, the lower the social activities, school performance and relational competencies and the higher the emotional, social and behavioral problems in children, according to the parents' evaluations. The greater the parental stress level, the lower the competencies rated and the higher the behavioral problems detected by parents. Conclusion: The physicians who deal with PMNE children have taken into account the stressful role and emotional dimensions of this clinical condition, both for children and mothers, in order to improve clinical management. Psychological support is needed for parents, and mothers especially, for a more functional stress management related to the PMNE.
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Affiliation(s)
- Michele Roccella
- Department of Psychology, Educational Science and Human Movement, University of Palermo, Palermo, Italy
| | - Daniela Smirni
- Department of Psychology, Educational Science and Human Movement, University of Palermo, Palermo, Italy
| | - Pietro Smirni
- Department of Educational Sciences, University of Catania, Catania, Italy
| | - Francesco Precenzano
- Clinic of Child and Adolescent Neuropsychiatry, Department of Mental Health and Physical and Preventive Medicine, Università Degli Studi Della Campania "Luigi Vanvitelli", Caserta, Italy
| | | | - Valentina Lanzara
- Clinic of Child and Adolescent Neuropsychiatry, Department of Mental Health and Physical and Preventive Medicine, Università Degli Studi Della Campania "Luigi Vanvitelli", Caserta, Italy
| | - Giuseppe Quatrosi
- Dipartimento Promozione della Salute, Materno-Infantile, di Medicina Interna e Specialistica di Eccellenza "G. D'Alessandro", Palermo, Italy
| | - Marco Carotenuto
- Clinic of Child and Adolescent Neuropsychiatry, Department of Mental Health and Physical and Preventive Medicine, Università Degli Studi Della Campania "Luigi Vanvitelli", Caserta, Italy
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