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Zhou K, Duan G, Liu Y, Peng B, Zhou X, Qin L, Liang L, Wei Y, Zhang Q, Li X, Qin H, Lai Y, Lu Y, Zhang Y, Huang J, Huang J, Ouyang Y, Bin B, Zhao M, Liu J, Yang J, Deng D. Persistent alterations in gray matter in COVID-19 patients experiencing sleep disturbances: a 3-month longitudinal study. Neural Regen Res 2025; 20:3013-3024. [PMID: 38934390 PMCID: PMC11826451 DOI: 10.4103/nrr.nrr-d-23-01651] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Revised: 01/13/2024] [Accepted: 04/19/2024] [Indexed: 06/28/2024] Open
Abstract
JOURNAL/nrgr/04.03/01300535-202510000-00030/figure1/v/2024-11-26T163120Z/r/image-tiff Sleep disturbances are among the most prevalent neuropsychiatric symptoms in individuals who have recovered from severe acute respiratory syndrome coronavirus 2 infections. Previous studies have demonstrated abnormal brain structures in patients with sleep disturbances who have recovered from coronavirus disease 2019 (COVID-19). However, neuroimaging studies on sleep disturbances caused by COVID-19 are scarce, and existing studies have primarily focused on the long-term effects of the virus, with minimal acute phase data. As a result, little is known about the pathophysiology of sleep disturbances in the acute phase of COVID-19. To address this issue, we designed a longitudinal study to investigate whether alterations in brain structure occur during the acute phase of infection, and verified the results using 3-month follow-up data. A total of 26 COVID-19 patients with sleep disturbances (aged 51.5 ± 13.57 years, 8 women and 18 men), 27 COVID-19 patients without sleep disturbances (aged 47.33 ± 15.98 years, 9 women and 18 men), and 31 age- and gender-matched healthy controls (aged 49.19 ± 17.51 years, 9 women and 22 men) were included in this study. Eleven COVID-19 patients with sleep disturbances were included in a longitudinal analysis. We found that COVID-19 patients with sleep disturbances exhibited brain structural changes in almost all brain lobes. The cortical thicknesses of the left pars opercularis and left precuneus were significantly negatively correlated with Pittsburgh Sleep Quality Index scores. Additionally, we observed changes in the volume of the hippocampus and its subfield regions in COVID-19 patients compared with the healthy controls. The 3-month follow-up data revealed indices of altered cerebral structure (cortical thickness, cortical grey matter volume, and cortical surface area) in the frontal-parietal cortex compared with the baseline in COVID-19 patients with sleep disturbances. Our findings indicate that the sleep disturbances patients had altered morphology in the cortical and hippocampal structures during the acute phase of infection and persistent changes in cortical regions at 3 months post-infection. These data improve our understanding of the pathophysiology of sleep disturbances caused by COVID-19.
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Affiliation(s)
- Kaixuan Zhou
- Guangxi Key Laboratory of Special Biomedicine; School of Medicine, Guangxi University, Nanning, Guangxi Zhuang Autonomous Region, China
- Department of Radiology, the People’s Hospital of Guangxi Zhuang Autonomous Region, Guangxi Academy of Medical Sciences, Nanning, Guangxi Zhuang Autonomous Region, China
| | - Gaoxiong Duan
- Department of Radiology, the People’s Hospital of Guangxi Zhuang Autonomous Region, Guangxi Academy of Medical Sciences, Nanning, Guangxi Zhuang Autonomous Region, China
| | - Ying Liu
- Department of Radiology, the People’s Hospital of Guangxi Zhuang Autonomous Region, Guangxi Academy of Medical Sciences, Nanning, Guangxi Zhuang Autonomous Region, China
| | - Bei Peng
- Department of Radiology, the People’s Hospital of Guangxi Zhuang Autonomous Region, Guangxi Academy of Medical Sciences, Nanning, Guangxi Zhuang Autonomous Region, China
| | - Xiaoyan Zhou
- Department of Radiology, the People’s Hospital of Guangxi Zhuang Autonomous Region, Guangxi Academy of Medical Sciences, Nanning, Guangxi Zhuang Autonomous Region, China
| | - Lixia Qin
- Department of Sleep Medicine, the People’s Hospital of Guangxi Zhuang Autonomous Region, Nanning, Guangxi Zhuang Autonomous Region, China
| | - Lingyan Liang
- Department of Radiology, the People’s Hospital of Guangxi Zhuang Autonomous Region, Guangxi Academy of Medical Sciences, Nanning, Guangxi Zhuang Autonomous Region, China
| | - Yichen Wei
- Department of Radiology, the People’s Hospital of Guangxi Zhuang Autonomous Region, Guangxi Academy of Medical Sciences, Nanning, Guangxi Zhuang Autonomous Region, China
| | - Qingping Zhang
- Department of Radiology, the People’s Hospital of Guangxi Zhuang Autonomous Region, Guangxi Academy of Medical Sciences, Nanning, Guangxi Zhuang Autonomous Region, China
| | - Xiaocheng Li
- Department of Radiology, the People’s Hospital of Guangxi Zhuang Autonomous Region, Guangxi Academy of Medical Sciences, Nanning, Guangxi Zhuang Autonomous Region, China
| | - Haixia Qin
- Department of Radiology, the People’s Hospital of Guangxi Zhuang Autonomous Region, Guangxi Academy of Medical Sciences, Nanning, Guangxi Zhuang Autonomous Region, China
| | - Yinqi Lai
- Department of Radiology, the People’s Hospital of Guangxi Zhuang Autonomous Region, Guangxi Academy of Medical Sciences, Nanning, Guangxi Zhuang Autonomous Region, China
| | - Yian Lu
- Department of Sleep Medicine, the People’s Hospital of Guangxi Zhuang Autonomous Region, Nanning, Guangxi Zhuang Autonomous Region, China
| | - Yan Zhang
- Department of Radiology, the People’s Hospital of Guangxi Zhuang Autonomous Region, Guangxi Academy of Medical Sciences, Nanning, Guangxi Zhuang Autonomous Region, China
| | - Jiazhu Huang
- Department of Radiology, the People’s Hospital of Guangxi Zhuang Autonomous Region, Guangxi Academy of Medical Sciences, Nanning, Guangxi Zhuang Autonomous Region, China
| | - Jinli Huang
- Department of Radiology, the People’s Hospital of Guangxi Zhuang Autonomous Region, Guangxi Academy of Medical Sciences, Nanning, Guangxi Zhuang Autonomous Region, China
| | - Yinfei Ouyang
- Department of Radiology, the People’s Hospital of Guangxi Zhuang Autonomous Region, Guangxi Academy of Medical Sciences, Nanning, Guangxi Zhuang Autonomous Region, China
| | - Bolin Bin
- Department of Radiology, the People’s Hospital of Guangxi Zhuang Autonomous Region, Guangxi Academy of Medical Sciences, Nanning, Guangxi Zhuang Autonomous Region, China
| | - Mingming Zhao
- Department of Sleep Medicine, the People’s Hospital of Guangxi Zhuang Autonomous Region, Nanning, Guangxi Zhuang Autonomous Region, China
| | - Jun Liu
- Department of Radiology, The Second Xiangya Hospital, Central South University, Changsha, Hunan Province, China
| | - Jianrong Yang
- Guangxi Clinical Research Center for Sleep Medicine, the People’s Hospital of Guangxi Zhuang Autonomous Region, Nanning, Guangxi Zhuang Autonomous Region, China
| | - Demao Deng
- Guangxi Key Laboratory of Special Biomedicine; School of Medicine, Guangxi University, Nanning, Guangxi Zhuang Autonomous Region, China
- Department of Radiology, the People’s Hospital of Guangxi Zhuang Autonomous Region, Guangxi Academy of Medical Sciences, Nanning, Guangxi Zhuang Autonomous Region, China
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Antonio AON, Hilda-Elizabeth MC, Patricia RV, Omar SF, Roberto FR, Guadalupe GCZ, Alberto AC, Oscar PS, Erica GV, Javier MS, Alicia HGM, Guadalupe RCJ. Sleep deprivation as a risk factor for cortical gray matter reduction in new medical residents. J Neuroradiol 2025:101357. [PMID: 40449887 DOI: 10.1016/j.neurad.2025.101357] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2024] [Revised: 03/16/2025] [Accepted: 05/27/2025] [Indexed: 06/03/2025]
Abstract
BACKGROUND AND PURPOSE Sleep is an essential physiological condition for the proper functioning of humans, both physiologically, cognitively, and psychologically. Sleep deprivation leads to a loss of psychomotor skills in humans. It is important to evaluate the structural changes experienced by medical residents who are sleep-deprived due to extensive work shifts, including night shifts, assigned during their training program. Therefore, the main outcome was to evaluate the structural changes in the cortical gray matter and the hippocampus assessed by brain magnetic resonance imaging (MRI) in newly admitted medical residents four months after the start of the medical specialty. MATERIAL AND METHODS Forty-one newly admitted medical residents were enrolled, and an initial questionnaire was administered to assess sleep quality. All participants underwent a brain MRI study, utilizing an advanced MRI sequence: a 3D inversion recovery (IR)-prepped fast spoiled gradient-recalled (SPGR) high-resolution T1-weighted sequence. The images were then anonymized and reformatted, and volumetric analyses of gray matter and hippocampus were performed using an open-access platform for MRI brain analysis (volBrain). This process was repeated four months later with the acquisition of a new brain MRI study for each participant. RESULTS For gray matter volume, a baseline value of 728.04 ± 63.95 cm³ and a final value of 715.11 ± 59.38 cm³ were found (p < 0.01), and the frontal lobe showed the greatest reduction, with an initial value of 181.92 ± 15.58 cm3 and a final volume of 176.45 ± 17.35 cm3 (p = <0.001). We found an OR of 1.52 (95% CI 0.93-4.14, p = 0.01) between working night shifts and gray matter reduction. CONCLUSIONS The results of this study show a statistically significant reduction in gray matter volume in first-year residents after four months of shift work, with the greatest reduction in the frontal lobe.
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Affiliation(s)
- Alvarez-Ornelas Nahum Antonio
- Radiology Department, Unidad Médica de Alta Especialidad No. 1 Bajío, Instituto Mexicano del Seguro Social, Blvd Adolfo López Mateos esquina Insurgentes S/N, colonia Los Paraísos, 37260, León, Guanajuato, México
| | - Macías Cervantes Hilda-Elizabeth
- Internal Medicine Department, Unidad Médica de Alta Especialidad No. 1 Bajío, Instituto Mexicano del Seguro Social, Blvd. Adolfo López Mateos esquina Insurgentes S/N, colonia Los Paraísos, 37260, León, Guanajuato, México.
| | - Rodríguez-Villaseñor Patricia
- Radiology Department, Unidad Médica de Alta Especialidad No. 1 Bajío, Instituto Mexicano del Seguro Social, Blvd Adolfo López Mateos esquina Insurgentes S/N, colonia Los Paraísos, 37260, León, Guanajuato, México
| | - Sánchez-Figueroa Omar
- Radiology Department, Unidad Médica de Alta Especialidad No. 1 Bajío, Instituto Mexicano del Seguro Social, Blvd Adolfo López Mateos esquina Insurgentes S/N, colonia Los Paraísos, 37260, León, Guanajuato, México
| | - Flores-Rodríguez Roberto
- Radiology Department, Unidad Médica de Alta Especialidad No. 1 Bajío, Instituto Mexicano del Seguro Social, Blvd Adolfo López Mateos esquina Insurgentes S/N, colonia Los Paraísos, 37260, León, Guanajuato, México
| | - García-Cisneros Zyanya Guadalupe
- Radiology Departament, Hospital Gineco-Obstetricia, Instituto Mexicano del Seguro Social, Av. Belisario Domínguez 735. Independencia Oriente, 44340, Guadalajara, Jalisco, México
| | - Aguilar-Chávez Alberto
- Radiology Department, Unidad Médica de Alta Especialidad No. 1 Bajío, Instituto Mexicano del Seguro Social, Blvd Adolfo López Mateos esquina Insurgentes S/N, colonia Los Paraísos, 37260, León, Guanajuato, México
| | - Pérez-Sánchez Oscar
- Head of Neurosurgery Department, Unidad Médica de Alta Especialidad No. 1 Bajío, Instituto Mexicano del Seguro Social, Blvd Adolfo López Mateos esquina Insurgentes S/N, colonia Los Paraísos, 37260, León, Guanajuato, México
| | - García-Valadez Erica
- Director of Health Education and Research, Unidad Médica de Alta Especialidad No. 1 Bajío, Instituto Mexicano del Seguro Social, Blvd Adolfo López Mateos esquina Insurgentes S/N, colonia Los Paraísos, 37260, León, Guanajuato, México
| | - Medrano-Sánchez Javier
- Director of Health Education, Unidad Médica de Alta Especialidad No. 1 Bajío, Instituto Mexicano del Seguro Social, Blvd Adolfo López Mateos esquina Insurgentes S/N, colonia Los Paraísos, 37260, León, Guanajuato, México
| | - Hernández-González Martha Alicia
- Head of Health Research Division, Unidad Médica de Alta Especialidad No. 1 Bajío, Instituto Mexicano del Seguro Social, Blvd. Adolfo López Mateos esquina Insurgentes S/N, colonia Los Paraísos, 37260, León, Guanajuato, México
| | - Rivera-Chávez José Guadalupe
- Internal Medicine Department, Hospital General León, Boulevard Puente Milenio 1001 A, colonia San Carlos La Rocha, CP 37544, León, Guanajuato, México
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Cavaillès C, Artero S, Maller JJ, Jaussent I, Dauvilliers Y. Insomnia, early and late rising are associated with small hippocampal volume and large white matter hyperintensity burden. Alzheimers Res Ther 2025; 17:75. [PMID: 40188123 PMCID: PMC11971846 DOI: 10.1186/s13195-025-01721-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2025] [Accepted: 03/17/2025] [Indexed: 04/07/2025]
Abstract
BACKGROUND Sleep disturbances have been associated with an increased risk of dementia. The mechanisms remain unclear, although neurodegenerative and vascular pathways are potentially involved. Hence, our study aims to investigate the relationships between several clinical sleep and polysomnographic features and volumes of hippocampus (indicative of neurodegeneration) and white matter hyperintensities (WMH) (reflecting vascular processes). METHODS In this cross-sectional study, 678 participants aged 65-80 from the French population-based ESPRIT cohort with MRI-measured hippocampus and/or WMH volumes were included. Self-reported sleep data were collected at baseline, and 176 participants underwent ambulatory polysomnography (PSG). We performed multivariable logistic regression to assess associations between sleep characteristics and hippocampal and WMH volumes. RESULTS Participants' median age was 70.7 years (Q1-Q3 = 67.8-74.0), with 52.4% being women. Early (≤ 6 am; odds ratio (OR) = 2.03, 95% confidence interval (CI) = 1.17;3.53) and late (> 8 am; OR = 2.14, 95%CI = 1.33;3.43) rising times were associated with low hippocampal volume. Early rising time (OR = 2.06, 95%CI = 1.24;3.43) and insomnia symptoms (OR = 1.84, 95%CI = 1.18;2.86 for 1 symptom, OR = 1.91, 95%CI = 1.18;3.09 for 2-3 symptoms) were associated with large WMH volume, whereas late bedtime (≥ 11 pm; OR = 0.56, 95%CI = 0.39;0.80) was associated with low WMH volume. Based on PSG data, higher rapid-eye movement (REM) sleep percentage (OR = 0.70, 95%CI = 0.50;0.96) was associated with low WMH volume, with similar trends for long sleep bouts duration, N3 and REM sleep durations (p = 0.05 to 0.07). Conversely, higher N2 sleep percentage (OR = 1.69, 95%CI = 1.09;2.62), longer NREM sleep bouts (OR = 1.46, 95%CI = 1.02;2.09), and higher periodic leg movements index (OR = 1.55, 95%CI = 1.02;2.26) were associated with large WMH volume. However, no PSG parameter associations remained after false discovery rate correction. CONCLUSIONS Distinct associations between sleep characteristics and hippocampal and WMH volumes were observed, highlighting the important relationships between sleep, sleep timing and brain structure.
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Affiliation(s)
- Clémence Cavaillès
- Institute for Neurosciences of Montpellier INM, University of Montpellier, INSERM, 80 Av. Augustin Fliche, Montpellier, 34295, France
| | - Sylvaine Artero
- Institute of Functional Genomics (IGF), University of Montpellier, CNRS, INSERM, Montpellier, France
| | - Jerome J Maller
- Monash Alfred Psychiatry Research Centre, Melbourne, VIC, Australia
| | - Isabelle Jaussent
- Institute for Neurosciences of Montpellier INM, University of Montpellier, INSERM, 80 Av. Augustin Fliche, Montpellier, 34295, France
| | - Yves Dauvilliers
- Institute for Neurosciences of Montpellier INM, University of Montpellier, INSERM, 80 Av. Augustin Fliche, Montpellier, 34295, France.
- Narcolepsy- Rare hypersomnias, Sleep Unit, Department of Neurology, National Reference Centre for Orphan Diseases, CHU Montpellier, Montpellier, France.
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Leitner C, Dalle Piagge F, Tomic T, Nozza F, Fasiello E, Castronovo V, De Gennaro L, Baglioni C, Ferini-Strambi L, Galbiati A. Sleep alterations in major depressive disorder and insomnia disorder: A network meta-analysis of polysomnographic studies. Sleep Med Rev 2025; 80:102048. [PMID: 40054014 DOI: 10.1016/j.smrv.2025.102048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2024] [Revised: 12/23/2024] [Accepted: 01/02/2025] [Indexed: 03/09/2025]
Abstract
Major depressive disorder (MDD) and Insomnia disorder (ID) are characterized by sleep alterations. To define their polysomnographic profiles, we conducted a Network Meta-Analysis comparing MDD and ID patients versus healthy controls (HCs). The literature search, conducted from 2008 up to January 2023 and following PRISMA guidelines, covered PubMed, Web of Science, Scopus, and Embase databases. We addressed publication bias using funnel plot asymmetry inspection and Egger's test, evaluated statistical heterogeneity with I2, and local and global inconsistencies with the separate indirect from direct evidence method and Q between designs, respectively. Pairwise meta-analyses employed a fixed-effects model, while network analysis utilized a random-effect approach. We evaluated 86 ID and 17 MDD studies, comparing sleep parameters for 636 MDDs versus 491 HCs, and 3661 IDs versus 2792 HCs. The network meta-analysis reported that patients with MDD have greater rapid eye movement (REM) sleep duration and REMs density, and lower REM sleep latency compared to IDs. ID patients instead exhibited lower total sleep time and time in bed, and greater wake after sleep onset and non-REM sleep stage 3 than MDD patients. This work emphasized sleep depth and continuity alterations in both MDD and ID, with major involvement of REM sleep in MDD.
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Affiliation(s)
- Caterina Leitner
- "Vita-Salute" San Raffaele University, Milan, Italy; IRCCS San Raffaele Scientific Institute, Department of Clinical Neurosciences, Neurology - Sleep Disorders Center, Milan, Italy
| | | | - Tijana Tomic
- "Vita-Salute" San Raffaele University, Milan, Italy
| | | | - Elisabetta Fasiello
- "Vita-Salute" San Raffaele University, Milan, Italy; IRCCS San Raffaele Scientific Institute, Department of Clinical Neurosciences, Neurology - Sleep Disorders Center, Milan, Italy
| | - Vincenza Castronovo
- IRCCS San Raffaele Scientific Institute, Department of Clinical Neurosciences, Neurology - Sleep Disorders Center, Milan, Italy
| | - Luigi De Gennaro
- Body and Action Lab, IRCCS Fondazione Santa Lucia, Rome, Italy; Department of Psychology, University of Rome Sapienza, Rome, Italy
| | - Chiara Baglioni
- Human Sciences Department, University of Rome Guglielmo Marconi Rome, Rome, Italy
| | - Luigi Ferini-Strambi
- "Vita-Salute" San Raffaele University, Milan, Italy; IRCCS San Raffaele Scientific Institute, Department of Clinical Neurosciences, Neurology - Sleep Disorders Center, Milan, Italy
| | - Andrea Galbiati
- "Vita-Salute" San Raffaele University, Milan, Italy; IRCCS San Raffaele Scientific Institute, Department of Clinical Neurosciences, Neurology - Sleep Disorders Center, Milan, Italy.
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Alhazmi FH. Exploring the Correlation Between Sleep Chronotype and the Volumes of Subcortical Structures and Hippocampal Subfields in Young Healthy Population. Brain Sci 2025; 15:295. [PMID: 40149816 PMCID: PMC11940034 DOI: 10.3390/brainsci15030295] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2025] [Revised: 03/02/2025] [Accepted: 03/09/2025] [Indexed: 03/29/2025] Open
Abstract
BACKGROUND/OBJECTIVES Chronotypes significantly influence sleep quality, daily performance, and overall activity levels. Although there is growing evidence indicating that individuals with a late chronotype are more likely to experience cognitive decline, the specific neural mechanisms that contribute to this risk remain unclear. This study aims to explore the relationship between morning and evening preferences and the volumes of subcortical structures in a young, healthy population. METHODS A total of 123 participants (80 females), aged between 18 and 35 years, were recruited. They underwent MRI scans and completed several self-reported assessments, including the morningness-eveningness scale of the Chronotype Questionnaire (ChQ-ME), the amplitude scale of the Chronotype Questionnaire (ChQ-AM), the Epworth Sleepiness Scale (ESS), and the Pittsburgh Sleep Quality Index (PSQI). Participants were classified into early chronotype (EC) and late chronotype (LC) groups based on their ChQ-ME scores. High-resolution T1-weighted imaging was utilized to analyze the volumes of subcortical structures and hippocampal subfields. RESULTS The volumetric analysis indicated that the LC group showed significant reductions in the right Caudate (p = 0.03) and the left SR-SL-SM (p = 0.03) compared to the EC group. Additionally, a notable leftward hemispheric laterality of the Subiculum (p = 0.048) was observed in the EC group relative to the LC group. Furthermore, the ChQ-AM revealed significant positive (r = 0.23) and negative (r = -0.19) correlations with the volumes of the left thalamus and right amygdala, respectively. The PSQI demonstrated a significant negative correlation (r = -0.21) with the right SR-SL-SM, while the ESS indicated a significant positive correlation (r = 0.24) with the left SR-SL-SM. Multiple regression analysis indicated that variations in daytime sleepiness are linked to the change of the left SR-SL-SM volume. CONCLUSIONS Overall, the findings suggest that chronotype preferences are associated with the changes in the volumes of subcortical structures and hippocampal subfields and highlight the role of chronotypes in the neural mechanisms of these brain structures.
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Affiliation(s)
- Fahad H Alhazmi
- Department of Diagnostic Radiology, College of Applied Medical Sciences, Taibah University, P.O. Box 344, Almadinah Almunawarah 41477, Saudi Arabia
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Keresztes A, Bankó ÉM, Báthori N, Tomacsek V, Varga VA, Nárai Á, Nemecz Z, Dénes Á, Gál V, Hermann P, Simor P, Vidnyánszky Z. Multi-Night Electroencephalography Reveals Positive Association Between Sleep Efficiency and Hippocampal Subfield and Entorhinal Cortex Volumes in Healthy Aging. Hum Brain Mapp 2024; 45:e70090. [PMID: 39720895 PMCID: PMC11669120 DOI: 10.1002/hbm.70090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2024] [Revised: 11/08/2024] [Accepted: 11/18/2024] [Indexed: 12/26/2024] Open
Abstract
Age-related atrophy of the human hippocampus and the enthorinal cortex starts accelerating at around age 60. Due to the contributions of these regions to many cognitive functions seamlessly used in everyday life, this can heavily impact the lives of elderly people. The hippocampus is not a unitary structure, and mechanisms of its age-related decline appear to differentially affect its subfields. Human and animal studies have suggested that altered sleep is associated with hippocampal atrophy. Yet, we know little about subfield specific effects of altered sleep in healthy aging and their effect on cognition. Here, in a sample of 118 older middle-aged and older adults (Mage = 63.25 y, range: 50-80 y), we examined the association between highly reliable hippocampal subfield and entorhinal cortex volumetry (n = 112), sleep measures derived from multi-night recordings of portable electroencephalography (n = 61) and episodic memory (n = 117). Objective sleep efficiency-but not self-report measures of sleep-was associated with entorhinal cortex volume when controlling for age. Age-related differences in subfield volumes were associated with objective sleep efficiency, but not with self-report measures of sleep. Moreover, participants characterized by a common multivariate pattern of subfield volumes that contributed to positive sleep-subfield volume associations, showed lower rates of forgetting. Our results showcase the benefit of objective sleep measures in identifying potential contributors of age-related differences in brain-behavior couplings.
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Affiliation(s)
- Attila Keresztes
- Brain Imaging CentreHUN‐REN Research Centre for Natural SciencesBudapestHungary
- Institute of PsychologyELTE Eötvös Loránd UniversityBudapestHungary
| | - Éva M. Bankó
- Brain Imaging CentreHUN‐REN Research Centre for Natural SciencesBudapestHungary
| | - Noémi Báthori
- Brain Imaging CentreHUN‐REN Research Centre for Natural SciencesBudapestHungary
- Department of Cognitive ScienceBudapest University of Technology and EconomicsBudapestHungary
| | - Vivien Tomacsek
- Institute of PsychologyELTE Eötvös Loránd UniversityBudapestHungary
- Doctoral School of PsychologyELTE Eötvös Loránd UniversityBudapestHungary
| | - Virág Anna Varga
- Brain Imaging CentreHUN‐REN Research Centre for Natural SciencesBudapestHungary
| | - Ádám Nárai
- Brain Imaging CentreHUN‐REN Research Centre for Natural SciencesBudapestHungary
- Doctoral School of Biology and Sportbiology, Institute of Biology, Faculty of SciencesUniversity of PécsPécsHungary
| | - Zsuzsanna Nemecz
- Brain Imaging CentreHUN‐REN Research Centre for Natural SciencesBudapestHungary
- Institute of PsychologyELTE Eötvös Loránd UniversityBudapestHungary
- Doctoral School of PsychologyELTE Eötvös Loránd UniversityBudapestHungary
| | - Ádám Dénes
- Momentum Laboratory of NeuroimmunologyHUN‐REN Institute of Experimental MedicineBudapestHungary
| | - Viktor Gál
- Brain Imaging CentreHUN‐REN Research Centre for Natural SciencesBudapestHungary
| | - Petra Hermann
- Brain Imaging CentreHUN‐REN Research Centre for Natural SciencesBudapestHungary
| | - Péter Simor
- Institute of PsychologyELTE Eötvös Loránd UniversityBudapestHungary
- Institute of Behavioral SciencesSemmelweis UniversityBudapestHungary
| | - Zoltán Vidnyánszky
- Brain Imaging CentreHUN‐REN Research Centre for Natural SciencesBudapestHungary
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7
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Seo CR, Lee BK, Jee HJ, Yoo JR, Lee CK, Park JW, Jung YS. Ameliorating Effect of Fermented Perilla frutescens on Sleep Deprivation-Induced Cognitive Impairment Through Antioxidant and BDNF Signaling in Mice. Nutrients 2024; 16:4224. [PMID: 39683616 DOI: 10.3390/nu16234224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2024] [Revised: 12/03/2024] [Accepted: 12/05/2024] [Indexed: 12/18/2024] Open
Abstract
Background: Adequate sleep is essential for maintaining cognitive function, as evidenced by literature. Perilla frutescens var. acuta Kudo (PF) is a traditional medicinal herb reported to improve vascular cognitive impairment and induce sedation. However, the effects of PF on cognitive impairment caused by sleep deprivation (SD) have not yet been evaluated. This study aims to evaluate the effects of fermented PF (FPF) and its underlying mechanisms in a model of SD-induced cognitive impairment. Methods: Mice were subjected to SD to establish cognitive impairment, and FPF was administered once daily for 3 days. Cognitive performance was assessed using Y-maze and passive avoidance tests, followed by molecular mechanisms analyses. Results: FPF treatment improved SD-induced cognitive impairment, as evidenced by increased spontaneous alternation and extended latency time. Histological analysis revealed that SD impaired the hippocampus, and this impairment was alleviated by FPF treatment. FPF demonstrated antioxidant activity by increasing glutathione levels and decreasing malondialdehyde levels. Furthermore, the decreased levels of brain-derived neurotrophic factor (BDNF) observed in sleep-deprived mice were restored with FPF treatment. FPF also enhanced the phosphorylation of tropomyosin receptor kinase B, extracellular signal-regulated kinase, and cAMP response element-binding protein. Conclusions: These results indicate that FPF may have beneficial effects on SD-induced cognitive impairment by protecting against oxidative stress and increasing BDNF expression.
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Affiliation(s)
- Chae-Ryeong Seo
- Department of Pharmacy, Ajou University, Suwon 16499, Republic of Korea
| | - Bo Kyung Lee
- Department of Pharmacy, Ajou University, Suwon 16499, Republic of Korea
| | - Hye Jin Jee
- Department of Pharmacy, Ajou University, Suwon 16499, Republic of Korea
| | - Jae Ryeong Yoo
- Department of Pharmacy, Ajou University, Suwon 16499, Republic of Korea
| | - Chul-Kyu Lee
- Headquarters of New Drug Development Support, Corestemchemon Inc., 15 F, Gyeonggi Bio Center, Suwon 16229, Republic of Korea
| | - Jin Wook Park
- Headquarters of New Drug Development Support, Corestemchemon Inc., 15 F, Gyeonggi Bio Center, Suwon 16229, Republic of Korea
| | - Yi-Sook Jung
- Department of Pharmacy, Ajou University, Suwon 16499, Republic of Korea
- Research Institute of Pharmaceutical Sciences and Technology, Ajou University, Suwon 16499, Republic of Korea
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Pan L, Li H, Guo J, Ma C, Li L, Zhan W, Chen H, Wu Y, Jiang G, Li S. Expanded gray matter atrophy with severity stages of adult comorbid insomnia and sleep apnea. Sleep Med 2024; 124:191-200. [PMID: 39321626 DOI: 10.1016/j.sleep.2024.09.027] [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: 04/16/2024] [Revised: 09/07/2024] [Accepted: 09/16/2024] [Indexed: 09/27/2024]
Abstract
OBJECTIVE To investigate gray matter volume (GMV) changes in patients with comorbid insomnia and sleep apnea (COMISA) of differing severity and relationships between GMV alterations and clinical measures. METHODS Thirty-four COMISA patients and 24 healthy controls (HC) were recruited. All patients underwent structural MRI and completed measures related to respiration, sleep, mood, and cognition. COMISA patients were further divided into a mild and moderate COMISA (MC) and a severe COMISA (SC) group. Changes in GMV of COMISA patients were investigated via VBM. The voxel-wise differences in GMV were compared between HC group and COMISA group. Analysis of covariance (ANCOVA) was performed on individual GMV maps in MC, SC, and HC groups to further investigate effects of different stages of COMISA severity on GMV. Partial correlation analysis was then performed to analyze relationships between altered GMV and clinical measures. RESULTS GMV atrophy was mainly located in the temporal lobes and fusiform gyrus in COMISA group. The post-hoc analysis of the ANCOVA revealed temporal lobes and fusiform gyrus atrophy in MC and SC groups compared to HC and the temporal lobe atrophy was expanded in SC group based on cluster size. Moreover, the SC group showed GMV atrophy of the right amygdala compared to both MC and HC groups. Partial correlation analysis revealed positive relationships between the GMV and mood-and cognitive-related measures and negative correlation between GMV and respiration measure. CONCLUSIONS Our findings showed GMV atrophy expansion from temporal lobe to limbic system (right amygdala) as severity stages increase in COMISA patients. These findings contribute to our understanding of neurobiological mechanisms underlying different stages of severity in COMISA patients.
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Affiliation(s)
- Liping Pan
- Department of Medical Imaging, The Affiliated Guangdong Second Provincial General Hospital of Jinan University, Guangzhou, PR China
| | - Hui Li
- People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi, Xinjiang Uygur Autonomous Region, PR China
| | - Jiawei Guo
- People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi, Xinjiang Uygur Autonomous Region, PR China; Xinjiang Medical University, Urumqi, Xinjiang Uygur Autonomous Region, PR China
| | - Chao Ma
- People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi, Xinjiang Uygur Autonomous Region, PR China
| | - Liming Li
- Department of Medical Imaging, Guangdong Second Provincial General Hospital, Guangzhou, PR China
| | - Wenfeng Zhan
- Department of Medical Imaging, Guangdong Second Provincial General Hospital, Guangzhou, PR China
| | - Huiyu Chen
- Department of Medical Imaging, Guangdong Second Provincial General Hospital, Guangzhou, PR China; The Second School of Clinical Medicine, Southern Medical University, Guangzhou, PR China
| | - Yuting Wu
- Department of Medical Imaging, The Affiliated Guangdong Second Provincial General Hospital of Jinan University, Guangzhou, PR China
| | - Guihua Jiang
- Department of Medical Imaging, The Affiliated Guangdong Second Provincial General Hospital of Jinan University, Guangzhou, PR China; Department of Medical Imaging, Guangdong Second Provincial General Hospital, Guangzhou, PR China; Xiamen Humanity Hospital Fujian Medical University, Xiamen, PR China.
| | - Shumei Li
- Department of Medical Imaging, The Affiliated Guangdong Second Provincial General Hospital of Jinan University, Guangzhou, PR China; Department of Medical Imaging, Guangdong Second Provincial General Hospital, Guangzhou, PR China.
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Zhang X, Yin J, Sun X, Qu Z, Zhang J, Zhang H. The association between insomnia and cognitive decline: A scoping review. Sleep Med 2024; 124:540-550. [PMID: 39447528 DOI: 10.1016/j.sleep.2024.10.021] [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: 05/10/2024] [Revised: 10/02/2024] [Accepted: 10/14/2024] [Indexed: 10/26/2024]
Abstract
OBJECTIVE This study aimed to investigate the association between insomnia and cognitive decline to provide insights for clinical interventions and future research. METHODS The PubMed, Embase, Web of Science, Scopus, Cochrane Library, and ProQuest databases were systematically searched to identify studies on the association between insomnia and cognitive decline published within the last decade. The quality of the included studies was evaluated, followed by data extraction and summary analysis. RESULTS A total of 36 studies were included in the review. Both subjective and objective measures were utilized across 12 indices to assess sleep status, while cognitive function was evaluated using 5 scales and 34 tests. The results revealed a significantly increased risk of cognitive decline or Alzheimer's disease among patients with insomnia, alongside notable impairments in attention, memory, visuospatial abilities, executive function, and verbal memory. Comprehensive assessments of cognitive domains were more sensitive in detecting group differences compared to assessments of specific cognitive sub-functions. Furthermore, MRI analyses showed reduced gray matter volumes in regions such as the prefrontal cortex, cingulate gyrus, temporal lobe, and hippocampus, together with reduced integrity of the white matter in patients with insomnia. CONCLUSIONS The findings indicate a potentially bidirectional relationship between insomnia and cognitive decline, suggesting that each may influence and exacerbate the other. Insomnia may increase the risk of cognitive decline and appears to be associated with reduced gray matter volume and compromised white matter integrity in the brain, which could potentially lead to declines in attention, memory, visuospatial abilities, executive function, and verbal memory. Conversely, cognitive decline may contribute to the onset of insomnia, further deteriorating sleep quality. However, further research is necessary to fully comprehend this intricate relationship.
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Affiliation(s)
- Xiaotu Zhang
- School of Nursing, Changchun University of Chinese Medicine, Changchun, China
| | - Jiawei Yin
- School of Nursing, Changchun University of Chinese Medicine, Changchun, China
| | - Xuefeng Sun
- School of Nursing, Changchun University of Chinese Medicine, Changchun, China
| | - Zihan Qu
- School of Nursing, Changchun University of Chinese Medicine, Changchun, China
| | - Jindan Zhang
- School of Nursing, Changchun University of Chinese Medicine, Changchun, China
| | - Hongshi Zhang
- School of Nursing, Changchun University of Chinese Medicine, Changchun, China.
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10
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Kegyes-Brassai AC, Pierson-Bartel R, Bolla G, Kamondi A, Horvath AA. Disruption of sleep macro- and microstructure in Alzheimer's disease: overlaps between neuropsychology, neurophysiology, and neuroimaging. GeroScience 2024:10.1007/s11357-024-01357-z. [PMID: 39333449 DOI: 10.1007/s11357-024-01357-z] [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: 06/24/2024] [Accepted: 09/14/2024] [Indexed: 09/29/2024] Open
Abstract
Alzheimer's disease (AD) is the leading cause of dementia, often associated with impaired sleep quality and disorganized sleep structure. This study aimed to characterize changes in sleep macrostructure and K-complex density in AD, in relation to neuropsychological performance and brain structural changes. We enrolled 30 AD and 30 healthy control participants, conducting neuropsychological exams, brain MRI, and one-night polysomnography. AD patients had significantly reduced total sleep time (TST), sleep efficiency, and relative durations of non-rapid eye movement (NREM) stages 2 (S2), 3 (S3), and rapid eye movement (REM) sleep (p < 0.01). K-complex (KC) density during the entire sleep period and S2 (p < 0.001) was significantly decreased in AD. We found strong correlations between global cognitive performance and relative S3 (p < 0.001; r = 0.86) and REM durations (p < 0.001; r = 0.87). TST and NREM stage 1 (S1) durations showed a moderate negative correlation with amygdaloid and hippocampal volumes (p < 0.02; r = 0.51-0.55), while S3 and REM sleep had a moderate positive correlation with cingulate cortex volume (p < 0.02; r = 0.45-0.61). KC density strongly correlated with global cognitive function (p < 0.001; r = 0.66) and the thickness of the anterior cingulate cortex (p < 0.05; r = 0.45-0.47). Our results indicate significant sleep organization changes in AD, paralleling cognitive decline. Decreased slow wave sleep and KCs are strongly associated with cingulate cortex atrophy. Since sleep changes are prominent in early AD, they may serve as prognostic markers or therapeutic targets.
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Affiliation(s)
| | | | - Gergo Bolla
- School of PhD Studies, Semmelweis University, Budapest, Hungary
- Neurocognitive Research Centre, Nyírő Gyula National Institute of Psychiatry, and Addictology, Budapest, Hungary
| | - Anita Kamondi
- Neurocognitive Research Centre, Nyírő Gyula National Institute of Psychiatry, and Addictology, Budapest, Hungary
- Department of Neurosurgery and Neurointervention, Semmelweis University, Budapest, Hungary
- Department of Neurology, Semmelweis University, Budapest, Hungary
| | - Andras Attila Horvath
- Neurocognitive Research Centre, Nyírő Gyula National Institute of Psychiatry, and Addictology, Budapest, Hungary
- Department of Anatomy Histology and Embryology, Semmelweis University, Budapest, Hungary
- HUN-REN Research Centre for Natural Sciences, Budapest, Hungary
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11
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Song Y, Kim S, Joo Y, Ha E, Shim Y, Lee H, Jeong H, Lyoo I, Yoon S, Lee S. Impact of sleep disturbance in shift workers on hippocampal volume and psychomotor speed. Sleep 2024; 47:zsae100. [PMID: 38666299 DOI: 10.1093/sleep/zsae100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Revised: 04/10/2024] [Indexed: 09/10/2024] Open
Abstract
STUDY OBJECTIVES Shift work interferes with circadian rhythms, affecting sleep quality and cognitive function. Poor sleep quality in shift worker (SW)s can impair psychomotor performance due to fatigue and sleepiness, increasing the risk of errors, accidents, and reduced productivity. Given the potential for atrophic changes in the hippocampus due to sleep disturbances, our study investigates how poor sleep quality correlates with hippocampal structural alterations and impacts psychomotor performance among SWs. METHODS We recruited 100 SWs, classifying them based on sleep quality into two groups: good sleep-SW group (n = 59) and poor sleep-SW group (n = 41). Sleep quality was assessed using both 7-day actigraphy for sleep efficiency and the Pittsburgh Sleep Quality Index. A control group of 106 non-SWs without sleep problems (non-SW group) was also included for comparison. The outcome measures were psychomotor speed and hippocampal volumes, both total and by subfield. RESULTS The poor sleep-SW group showed significantly smaller hippocampal volumes than both the good sleep-SW group (p < .001) and the non-SW group (p = .003). Longer shift work years correlated with greater reductions in hippocampal volume in this group (r = -0.42, p = .009), unlike in the good sleep-SW group (r = 0.08, p = .541). Furthermore, they demonstrated declines in psychomotor speed relative to the non-SW group (p = .006), which correlated with smaller hippocampal volumes (r = 0.37, p = .020). CONCLUSIONS SWs with poor sleep quality exhibit significant hippocampal volume reductions and psychomotor speed decline, underscoring the importance of early intervention and support for sleep issues in this population.
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Affiliation(s)
- Yumi Song
- Ewha Brain Institute, Ewha Womans University, Seoul, South Korea
- Department of Brain and Cognitive Sciences, Ewha Womans University, Seoul, South Korea
| | - Shinhye Kim
- Ewha Brain Institute, Ewha Womans University, Seoul, South Korea
- Department of Brain and Cognitive Sciences, Ewha Womans University, Seoul, South Korea
| | - Yoonji Joo
- Ewha Brain Institute, Ewha Womans University, Seoul, South Korea
| | - Eunji Ha
- Ewha Brain Institute, Ewha Womans University, Seoul, South Korea
| | - Youngeun Shim
- Ewha Brain Institute, Ewha Womans University, Seoul, South Korea
- Department of Brain and Cognitive Sciences, Ewha Womans University, Seoul, South Korea
| | - Hyeonji Lee
- Ewha Brain Institute, Ewha Womans University, Seoul, South Korea
- Department of Brain and Cognitive Sciences, Ewha Womans University, Seoul, South Korea
| | - Hyeonseok Jeong
- Department of Radiology, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea
| | - InKyoon Lyoo
- Ewha Brain Institute, Ewha Womans University, Seoul, South Korea
- Department of Brain and Cognitive Sciences, Ewha Womans University, Seoul, South Korea
- Graduate School of Pharmaceutical Sciences, Ewha Womans University, Seoul, South Korea
| | - Sujung Yoon
- Ewha Brain Institute, Ewha Womans University, Seoul, South Korea
- Department of Brain and Cognitive Sciences, Ewha Womans University, Seoul, South Korea
| | - Suji Lee
- College of Pharmacy, Dongduk Women's University, Seoul, South Korea
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12
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Brown A, Gervais NJ, Gravelsins L, O'Byrne J, Calvo N, Ramana S, Shao Z, Bernardini M, Jacobson M, Rajah MN, Einstein G. Effects of early midlife ovarian removal on sleep: Polysomnography-measured cortical arousal, homeostatic drive, and spindle characteristics. Horm Behav 2024; 165:105619. [PMID: 39178647 DOI: 10.1016/j.yhbeh.2024.105619] [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: 04/30/2024] [Revised: 08/08/2024] [Accepted: 08/08/2024] [Indexed: 08/26/2024]
Abstract
Bilateral salpingo-oophorectomy (BSO; removal of ovaries and fallopian tubes) prior to age 48 is associated with elevated risk for both Alzheimer's disease (AD) and sleep disorders such as insomnia and sleep apnea. In early midlife, individuals with BSO show reduced hippocampal volume, function, and hippocampal-dependent verbal episodic memory performance associated with changes in sleep. It is unknown whether BSO affects fine-grained sleep measurements (sleep microarchitecture) and how these changes might relate to hippocampal-dependent memory. We recruited thirty-six early midlife participants with BSO. Seventeen of these participants were taking 17β-estradiol therapy (BSO+ET) and 19 had never taken ET (BSO). Twenty age-matched control participants with intact ovaries (AMC) were also included. Overnight at-home polysomnography recordings were collected, along with subjective sleep quality and hot flash frequency. Multivariate Partial Least Squares (PLS) analysis was used to assess how sleep varied between groups. Compared to AMC, BSO without ET was associated with significantly decreased time spent in non-rapid eye movement (NREM) stage 2 sleep as well as increased NREM stage 2 and 3 beta power, NREM stage 2 delta power, and spindle power and maximum amplitude. Increased spindle maximum amplitude was negatively correlated with verbal episodic memory performance. Decreased sleep latency, increased sleep efficiency, and increased time spent in rapid eye movement sleep were observed for BSO+ET. Findings suggest there is an association between ovarian hormone loss and sleep microarchitecture, which may contribute to poorer cognitive outcomes and be ameliorated by ET.
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Affiliation(s)
- Alana Brown
- Department of Psychology, University of Toronto, Toronto M5S 3G3, Canada.
| | - Nicole J Gervais
- Department of Psychology, University of Toronto, Toronto M5S 3G3, Canada; Groningen Institute for Evolutionary Life Sciences, University of Groningen, Groningen 9712 CP, the Netherlands.
| | - Laura Gravelsins
- Department of Psychology, University of Toronto, Toronto M5S 3G3, Canada.
| | - Jordan O'Byrne
- Psychology Department, University of Montreal, Montreal H3T 1J4, Canada; Department of Health, Kinesiology and Applied Physiology, Concordia University, Montreal H3G 1M8, Canada.
| | - Noelia Calvo
- Department of Psychology, University of Toronto, Toronto M5S 3G3, Canada.
| | - Shreeyaa Ramana
- Department of Psychology, University of Toronto, Toronto M5S 3G3, Canada.
| | - Zhuo Shao
- Genetics Program, North York General Hospital, Toronto M2K 1E1, Canada; Department of Pediatrics, University of Toronto, Toronto M5G 1X8, Canada.
| | | | - Michelle Jacobson
- Princess Margaret Hospital, Toronto M5G 2C4, Canada; Women's College Hospital, Toronto M5S 1B2, Canada.
| | - M Natasha Rajah
- Department of Psychology, Toronto Metropolitan University, Toronto M5B 2K3, Canada.
| | - Gillian Einstein
- Department of Psychology, University of Toronto, Toronto M5S 3G3, Canada; Baycrest Academy of Research and Education, Baycrest Health Sciences, Toronto M6A 2E1, Canada; Tema Genus, Linköping University, Linköping 581 83, Sweden.
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13
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Wang Y, Yang J, Zhang H, Dong D, Yu D, Yuan K, Lei X. Altered morphometric similarity networks in insomnia disorder. Brain Struct Funct 2024; 229:1433-1445. [PMID: 38801538 DOI: 10.1007/s00429-024-02809-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2024] [Accepted: 05/17/2024] [Indexed: 05/29/2024]
Abstract
Previous studies on structural covariance network (SCN) suggested that patients with insomnia disorder (ID) show abnormal structural connectivity, primarily affecting the somatomotor network (SMN) and default mode network (DMN). However, evaluating a single structural index in SCN can only reveal direct covariance relationship between two brain regions, failing to uncover synergistic changes in multiple structural features. To cover this research gap, the present study utilized novel morphometric similarity networks (MSN) to examine the morphometric similarity between cortical areas in terms of multiple sMRI parameters measured at each area. With seven T1-weighted imaging morphometric features from the Desikan-Killiany atlas, individual MSN was constructed for patients with ID (N = 87) and healthy control groups (HCs, N = 84). Two-sample t-test revealed differences in MSN between patients with ID and HCs. Correlation analyses examined associations between MSNs and sleep quality, insomnia symptom severity, and depressive symptoms severity in patients with ID. The right paracentral lobule (PCL) exhibited decreased morphometric similarity in patients with ID compared to HCs, mainly manifested by its de-differentiation (meaning loss of distinctiveness) with the SMN, DMN, and ventral attention network (VAN), as well as its decoupling with the visual network (VN). Greater PCL-based de-differentiation correlated with less severe insomnia and fewer depressive symptoms in the patients group. Additionally, patients with less depressive symptoms showed greater PCL de-differentiation from the SMN. As an important pilot step in revealing the underlying morphometric similarity alterations in insomnia disorder, the present study identified the right PCL as a hub region that is de-differentiated with other high-order networks. Our study also revealed that MSN has an important potential to capture clinical significance related to insomnia disorder.
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Affiliation(s)
- Yulin Wang
- Sleep and NeuroImaging Center, Faculty of Psychology, Southwest University, Chongqing, 400715, China.
- Key Laboratory of Cognition and Personality, Ministry of Education, Faculty of Psychology, Southwest University, Chongqing, 400715, China.
- Institute of Neuroscience and Medicine, Brain & Behaviour (INM-7), Research Centre Jülich, Jülich, Germany.
| | - Jingqi Yang
- Sleep and NeuroImaging Center, Faculty of Psychology, Southwest University, Chongqing, 400715, China
- Key Laboratory of Cognition and Personality, Ministry of Education, Faculty of Psychology, Southwest University, Chongqing, 400715, China
| | - Haobo Zhang
- Sleep and NeuroImaging Center, Faculty of Psychology, Southwest University, Chongqing, 400715, China
- Key Laboratory of Cognition and Personality, Ministry of Education, Faculty of Psychology, Southwest University, Chongqing, 400715, China
| | - Debo Dong
- Key Laboratory of Cognition and Personality, Ministry of Education, Faculty of Psychology, Southwest University, Chongqing, 400715, China
- Institute of Neuroscience and Medicine, Brain & Behaviour (INM-7), Research Centre Jülich, Jülich, Germany
| | - Dahua Yu
- Information Processing Laboratory, School of Information Engineering, Inner Mongolia University of Science and Technology, Baotou, Inner Mongolia, 014010, China
| | - Kai Yuan
- School of Life Science and Technology, Xidian University, Xi'an, Shanxi, 710126, China
| | - Xu Lei
- Sleep and NeuroImaging Center, Faculty of Psychology, Southwest University, Chongqing, 400715, China.
- Key Laboratory of Cognition and Personality, Ministry of Education, Faculty of Psychology, Southwest University, Chongqing, 400715, China.
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14
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Yu Z, Han L, Yan P, Liu W, Ren L, Xu Y, Yang L, Ma L, Liu Y, Wang S. Doxepin is more effective than zolpidem in improving executive function in patients with insomnia disorder. Sleep Breath 2024; 28:929-934. [PMID: 38123719 DOI: 10.1007/s11325-023-02972-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Revised: 12/01/2023] [Accepted: 12/06/2023] [Indexed: 12/23/2023]
Abstract
BACKGROUND : Insomnia disorder is associated with an impairment in cognitive performance. Doxepin and zolpidem have been found to be effective in improving sleep. In this study, we aimed to compare the effects of doxepin and zolpidem on sleep structure and executive function in patients with insomnia disorder. METHODS Patients with primary insomnia were randomly assigned to receive doxepin 6 mg/day orally or zolpidem 5-10 mg/day orally. Polysomnography (PSG) and the Pittsburgh Sleep Quality Index (PSQI) were used at baseline and after the 8-week treatment to compare clinical efficacy in the two groups. Safety was assessed using the Treatment Emergent Symptom Scale (TESS). Executive function was evaluated using the Wisconsin sorting card test (WSCT). RESULTS Of 120 patients enrolled in the study, 60 participants were assigned to each group. A total of 109 participants (53 in the doxepin group and 56 in the zolpidem group) completed the study. After treatment, the wake after sleep onset (WASO) and total sleep time (TST) values in the doxepin group were 80.3 ± 21.4 min and 378.9 ± 21.9 min, respectively, which were significantly better than those in the zolpidem group (132.9 ± 26.5 min and 333.2 ± 24.2 min, respectively; (P < 0.05)). The sleep onset latency (SOL) value in the zolpidem group (20.3 ± 4.7 min) was significantly better than that in the doxepin group (28.2 ± 5.6 min; P < 0.05). The sleep efficiency (SE) in the doxepin group was 77.8 ± 4.2%, which was significantly better than that in the zolpidem group (68.6 ± 5.0%; P < 0.05). The PSQI score of the doxepin group was 6.1 ± 1.1, which was significantly lower than that in the zolpidem group (7.9 ± 1.9; P < 0.05). The treatment adverse events in the doxepin group was 23.3%, which was significantly higher than that in the zolpidem group (13.3%; P < 0.05). The WSCT showed a significant improvement in persistent errors (PE), random errors (RE), and categories in the two groups after 8-week treatment, and the improvement in RE and the categories was more obvious in the doxepin group (P < 0.05). CONCLUSIONS Both doxepin and zolpidem were found to be effective in improving sleep quality, but the effects exhibited different patterns. Doxepin improved executive function more effectively than zolpidem in patients with insomnia disorder.
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Affiliation(s)
- Zhenghe Yu
- Department of Medical Psychology, Hangzhou Seventh People's Hospital, Hangzhou, 310013, China
- Affiliated Mental Health Center, Zhejiang University School of Medicine, Hangzhou, 310013, China
| | - Li Han
- Department of Medical Psychology, Hangzhou Seventh People's Hospital, Hangzhou, 310013, China
- Affiliated Mental Health Center, Zhejiang University School of Medicine, Hangzhou, 310013, China
| | - Pan Yan
- Affiliated Mental Health Center, Zhejiang University School of Medicine, Hangzhou, 310013, China
- The Molecular Biology Laboratory, Hangzhou Seventh People's Hospital, Hangzhou, 310013, China
| | - Wenjuan Liu
- Department of Medical Psychology, Hangzhou Seventh People's Hospital, Hangzhou, 310013, China
- Affiliated Mental Health Center, Zhejiang University School of Medicine, Hangzhou, 310013, China
| | - Lishan Ren
- Department of Medical Psychology, Hangzhou Seventh People's Hospital, Hangzhou, 310013, China
- Affiliated Mental Health Center, Zhejiang University School of Medicine, Hangzhou, 310013, China
| | - You Xu
- Department of Medical Psychology, Hangzhou Seventh People's Hospital, Hangzhou, 310013, China
- Affiliated Mental Health Center, Zhejiang University School of Medicine, Hangzhou, 310013, China
| | - Lili Yang
- Department of Medical Psychology, Hangzhou Seventh People's Hospital, Hangzhou, 310013, China
- Affiliated Mental Health Center, Zhejiang University School of Medicine, Hangzhou, 310013, China
| | - Lisha Ma
- Department of Medical Psychology, Hangzhou Seventh People's Hospital, Hangzhou, 310013, China
- Affiliated Mental Health Center, Zhejiang University School of Medicine, Hangzhou, 310013, China
| | - Yi Liu
- Department of Medical Psychology, Hangzhou Seventh People's Hospital, Hangzhou, 310013, China
- Affiliated Mental Health Center, Zhejiang University School of Medicine, Hangzhou, 310013, China
| | - Shengdong Wang
- Affiliated Mental Health Center, Zhejiang University School of Medicine, Hangzhou, 310013, China.
- The Molecular Biology Laboratory, Hangzhou Seventh People's Hospital, Hangzhou, 310013, China.
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15
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Sørensen C, Kåreholt I, Kalpouzos G, Udeh-Momoh CT, Holleman J, Aspö M, Hagman G, Spulber G, Kivipelto M, Solomon A, Sindi S. Daytime Sleepiness, Apnea, Neuroimaging Correlates and Cortisol Dysregulation in a Memory Clinic Cohort. J Prev Alzheimers Dis 2024; 11:1798-1808. [PMID: 39559891 PMCID: PMC11573860 DOI: 10.14283/jpad.2024.145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2024]
Abstract
BACKGROUND Sleep disturbances as well as cortisol hypersecretion are increasingly acknowledged as risk factors for Alzheimer's disease (AD). However, the mechanisms underlying the association, and the interplay with cortisol abnormalities, remain unclear. OBJECTIVES This study aims to identify how self-reported sleep disturbances are associated with structural brain measures and diurnal cortisol dysregulation among memory clinic patients. DESIGN A cross-sectional study performed at Karolinska University Hospital Memory Clinic, Sweden. PARTICIPANTS The study was based on 146 memory clinic patients diagnosed with either subjective cognitive impairment or mild cognitive impairment. MEASUREMENTS Self-reported sleep was measured using the Karolinska Sleep Questionnaire. MRI or CT was used to quantify structural brain measures using four visual rating scales (Scheltens, Pasquier, Koedam, and Fazekas scales), and salivary cortisol was sampled to measure diurnal cortisol patterns through measures of cortisol immediately after awakening, cortisol awakening response, bedtime cortisol, total cortisol from awakening to bedtime, and the AM/PM cortisol ratio. RESULTS Increased sleep apnea index (OR=1.20, 95% CI=1.04:1.39, p=0.015) was associated with greater odds of posterior brain atrophy, measured by the Koedam visual rating scale, and reduced awakening cortisol (β=-0.03, 95% CI=-0.07:0.00, p=0.045). Increased daytime sleepiness was associated with both reduced awakening cortisol (β=-0.03, 95% CI=-0.06:0.00, p=0.025) and a reduced AM/PM cortisol ratio (β=-0.04, CI=-0.08:-0.01, p= 0.021). CONCLUSION In a memory clinic cohort self-reported sleep disturbances are associated with both worse structural brain tissue integrity and altered diurnal cortisol profiles. These findings may add insights into possible mechanisms behind sleep disturbances in aging with subjective and cognitive impairment.
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Affiliation(s)
- C Sørensen
- Charlotte Sørensen, MSc, Karolinska Vägen 37A, 17164 Solna,
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Wang Y, Tian Y, Long Z, Dong D, He Q, Qiu J, Feng T, Chen H, Tahmasian M, Lei X. Volume of the Dentate Gyrus/CA4 Hippocampal subfield mediates the interplay between sleep quality and depressive symptoms. Int J Clin Health Psychol 2024; 24:100432. [PMID: 38269356 PMCID: PMC10806754 DOI: 10.1016/j.ijchp.2023.100432] [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: 09/12/2023] [Revised: 12/18/2023] [Accepted: 12/19/2023] [Indexed: 01/26/2024] Open
Abstract
Background Emerging evidence increasingly suggests that poor sleep quality is associated with depressive symptoms. The hippocampus might play a crucial role in the interplay between sleep disturbance and depressive symptomatology, e.g., hippocampal atrophy is typically seen in both insomnia disorder and depression. Thus, examining the role of hippocampal volume in the interplay between poor sleep quality and depressive symptoms in large healthy populations is vital. Methods We investigated the association between self-reported sleep quality, depressive symptoms, and hippocampal total and subfields' volumes in 1603 healthy young adults from the Behavioral Brain Research Project. Mediation analysis explored the mediating role of hippocampal volumes between sleep quality and depressive symptoms. Results Self-reported sleep quality and depressive symptoms were positively correlated. In addition, it negatively related to three hippocampal subfields but not total hippocampal volume. In particular, hippocampal subfield DG and CA4 volumes mediated the interrelationship between poor sleep quality and depressive symptoms. Conclusions Our findings improved the current understanding of the relationship between sleep disturbance, depressive symptomatology, and hippocampal subfields in healthy populations. Considering the crucial role of DG in hippocampal neurogenesis, our results suggest that poor sleep quality may contribute to depression through a reduction of DG volume leading to impaired neurogenesis which is crucial for the regulation of mood.
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Affiliation(s)
- Yulin Wang
- Sleep and NeuroImaging Center, Faculty of psychology, Southwest University, Chongqing, China
- Key Laboratory of Cognition and Personality, Ministry of Education, Faculty of Psychology, Southwest University, Chongqing, China
| | - Yun Tian
- Sleep and NeuroImaging Center, Faculty of psychology, Southwest University, Chongqing, China
- Key Laboratory of Cognition and Personality, Ministry of Education, Faculty of Psychology, Southwest University, Chongqing, China
| | - Zhiliang Long
- Sleep and NeuroImaging Center, Faculty of psychology, Southwest University, Chongqing, China
- Key Laboratory of Cognition and Personality, Ministry of Education, Faculty of Psychology, Southwest University, Chongqing, China
| | - Debo Dong
- Key Laboratory of Cognition and Personality, Ministry of Education, Faculty of Psychology, Southwest University, Chongqing, China
- Institute of Neuroscience and Medicine, Brain & Behaviour (INM-7), Research Centre Jülich, Jülich, Germany
| | - Qinghua He
- Key Laboratory of Cognition and Personality, Ministry of Education, Faculty of Psychology, Southwest University, Chongqing, China
| | - Jiang Qiu
- Key Laboratory of Cognition and Personality, Ministry of Education, Faculty of Psychology, Southwest University, Chongqing, China
| | - Tingyong Feng
- Key Laboratory of Cognition and Personality, Ministry of Education, Faculty of Psychology, Southwest University, Chongqing, China
| | - Hong Chen
- Key Laboratory of Cognition and Personality, Ministry of Education, Faculty of Psychology, Southwest University, Chongqing, China
| | - Masoud Tahmasian
- Institute of Neuroscience and Medicine, Brain & Behaviour (INM-7), Research Centre Jülich, Jülich, Germany
- Institute for Systems Neuroscience, Medical Faculty, Heinrich-Heine-Universität Düsseldorf, Düsseldorf, Germany
- Department of Nuclear Medicine, University Hospital and Medical Faculty, University of Cologne, Cologne, Germany
| | - Xu Lei
- Sleep and NeuroImaging Center, Faculty of psychology, Southwest University, Chongqing, China
- Key Laboratory of Cognition and Personality, Ministry of Education, Faculty of Psychology, Southwest University, Chongqing, China
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Zhou HB, Lu SZ, Yu ZS, Zhang JL, Mei ZN. Mechanisms for the biological activity of Gastrodia elata Blume and its constituents: A comprehensive review on sedative-hypnotic, and antidepressant properties. PHYTOMEDICINE : INTERNATIONAL JOURNAL OF PHYTOTHERAPY AND PHYTOPHARMACOLOGY 2024; 123:155251. [PMID: 38056151 DOI: 10.1016/j.phymed.2023.155251] [Citation(s) in RCA: 15] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Revised: 11/15/2023] [Accepted: 11/27/2023] [Indexed: 12/08/2023]
Abstract
BACKGROUND Insomnia and depressive disorder are two common symptoms with a reciprocal causal relationship in clinical practice, which are usually manifested in comorbid form. Several medications have been widely used in the treatment of insomnia and depression, but most of these drugs show non-negligible side effects. Currently, many treatments are indicated for insomnia and depressive symptom, including Chinese herbal medicine such as Gastrodia elata Blume (G. elata), which has excellent sedative-hypnotic and antidepressant effects in clinical and animal studies. PURPOSE To summarize the mechanisms of insomnia and depression and the structure-activity mechanism for G. elata to alleviate these symptoms, particularly by hypothalamic-pituitary-adrenal (HPA) axis and intestinal flora, aiming to discover new approaches for the treatment of insomnia and depression. METHODS The following electronic databases were searched from the beginning to November 2023: PubMed, Web of Science, Google Scholar, Wanfang Database, and CNKI. The following keywords of G. elata were used truncated with other relevant topic terms, such as depression, insomnia, antidepressant, sedative-hypnotic, neuroprotection, application, safety, and toxicity. RESULTS Natural compounds derived from G. elata could alleviate insomnia and depressive disorder, which is involved in monoamine neurotransmitters, inflammatory response, oxidative stress, and gut microbes, etc. Several clinical trials showed that G. elata-derived natural compounds that treat depression and insomnia have significant and safe therapeutic effects, but further well-designed clinical and toxicological studies are needed. CONCLUSION G. elata exerts a critical role in treating depression and insomnia due to its multi-targeting properties and fewer side effects. However, more clinical and toxicological studies should be performed to further explore the sedative-hypnotic and antidepressant mechanisms of G. elata and provide more evidence and recommendations for its clinical application. Our review provides an overview of G. elata treating insomnia with depression for future research direction.
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Affiliation(s)
- Hai-Bo Zhou
- College of Food Science and Technology, Huazhong Agricultural University, No.1, Shizishan Street, Hongshan District, Wuhan, Hubei Province 430070, China
| | - Sheng-Ze Lu
- College of Food Science and Technology, Huazhong Agricultural University, No.1, Shizishan Street, Hongshan District, Wuhan, Hubei Province 430070, China
| | - Zhong-Shun Yu
- College of Food Science and Technology, Huazhong Agricultural University, No.1, Shizishan Street, Hongshan District, Wuhan, Hubei Province 430070, China
| | - Jiu-Liang Zhang
- College of Food Science and Technology, Huazhong Agricultural University, No.1, Shizishan Street, Hongshan District, Wuhan, Hubei Province 430070, China; Key Laboratory of Environment Correlative Dietology, Ministry of Education, Wuhan, 430070, China.
| | - Zhi-Nan Mei
- College of Plant Science & Technology, Huazhong Agricultural University, Wuhan, 430070, China.
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Yan W, Hou D, Li Z, Tang W, Han X, Tang Y. Reduced left hippocampal perfusion is associated with insomnia in patients with cerebral small vessel disease. CNS Spectr 2023; 28:702-709. [PMID: 37095715 DOI: 10.1017/s1092852923002250] [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] [Indexed: 04/26/2023]
Abstract
OBJECTIVES Insomnia was associated with cerebral structural changes and Alzheimer's disease. However, associations among cerebral perfusion, insomnia with cerebral small vessel disease (CSVD), and cognitive performance were little investigated. METHODS This cross-sectional study included 89 patients with CSVDs and white matter hyperintensities (WMHs). They were dichotomized into the normal sleep and poor sleep group, according to Pittsburgh sleep quality index (PSQI). Baseline characteristics, cognitive performance, and cerebral blood flow (CBF) were measured and compared between the two groups. The association or correlation between cerebral perfusion, cognition, and insomnia was analyzed using binary logistic regression. RESULTS Our study found that declined MoCA score (P = .0317) was more prevalent in those with poor sleep. There was a statistical difference in the recall (P = .0342) of MMSE, the delayed recall (P = .0289) of MoCA between the two groups. Logistic regression analysis showed educational background (P < .001) and insomnia severity index (ISI) score (P = .039) were independently correlated with MoCA scores. Arterial spin labeling demonstrated that left hippocampal gray matter perfusion was significantly reduced (P = .0384) in the group with poor sleep. And, negative correlation was found between left hippocampal perfusion and PSQI scores. CONCLUSIONS In the patients with CSVDs, insomnia severity was associated with cognitive decline. Left hippocampal gray matter perfusion was correlated with PSQI scores in CSVDs.
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Affiliation(s)
- Wei Yan
- Department of Neurology, Huashan Hospital, Fudan University, Shanghai, China
| | - Duanlu Hou
- Department of Neurology, Shanghai Fifth People's Hospital, Fudan University, Shanghai, China
| | - Zhixin Li
- Department of Neurology, Huashan Hospital, Fudan University, Shanghai, China
| | - Weijun Tang
- Department of Radiology, Huashan Hospital, Fudan University, Shanghai, China
| | - Xiang Han
- Department of Neurology, Huashan Hospital, Fudan University, Shanghai, China
| | - Yuping Tang
- Department of Neurology, Huashan Hospital, Fudan University, Shanghai, China
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Lee KH, Lee HG, Kwon S, Park SU, Jung WS, Moon SK, Park JM, Ko CN, Cho SY. Effect of Kami Guibi-tang (KGT) in elderly subjects with insomnia: a study protocol from a single center, randomized, double-blind, placebo-controlled trial. BMC Complement Med Ther 2023; 23:375. [PMID: 37872506 PMCID: PMC10594819 DOI: 10.1186/s12906-023-04199-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Accepted: 10/04/2023] [Indexed: 10/25/2023] Open
Abstract
BACKGROUND The incidence of insomnia increases with age and is related to cognitive function in older adults; therefore, it is important to manage it actively. In this study, we report a protocol for the evaluation of the efficacy and safety of Kami Guibi-tang (KGT), a herbal prescription that has been widely used in East Asia for insomnia, forgetfulness, and depression, in older adults with insomnia. METHODS In this single-center, double-blind, randomized controlled trial, 60 older adults with insomnia and subjective cognitive decline will be recruited and randomly assigned to the KGT or placebo group. The KGT group will take KGT granules thrice a day for 12 weeks, whereas the control group will take placebo granules in the same manner. Participants will be assessed for sleep, cognitive function, quality of life, and depression using the Pittsburgh Sleep Quality Index-Korean (PSQI-K), Insomnia Severity Index-Korean (ISI-K), Seoul Neuropsychological Screening Battery-Dement (SNSB-D), 36-item MOS Short Form Survey (SF-36) and Short version of the Geriatric Depression Scale (S-GDS) before and at the end of administration of the investigational product. The PSQI-K, ISI-K, and SF-36 will be further assessed 12 weeks after the end of medication to determine whether the effects on sleep and quality of life are sustained. The PSQI-K total score difference between the two groups at 12 and 24 weeks will be the primary outcome; all other endpoints will be secondary. Safety will be assessed by performing blood tests and electrocardiograms before taking the investigational drug, 6 weeks after taking the drug, and 12 weeks after taking the drug; any adverse events will be observed throughout the study. DISCUSSION The protocol will provide a detailed process for a clinical trial to evaluate the efficacy and safety of KGT in elderly patients with insomnia. We will also investigate if changes in cognitive function correlated with improvements in insomnia. TRIAL REGISTRATION This trial was registered at CRIS (Clinical Research Information Service) on April 27, 2023 (KCT0008391, version 2.0). https://cris.nih.go.kr/cris/search/detailSearch.do?seq=24811&search_page=L .
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Affiliation(s)
- Kyeong-Hwa Lee
- Department of Clinical Korean Medicine, Graduate School, Kyung Hee University, Seoul, Republic of Korea
| | - Han-Gyul Lee
- Department of Cardiology and Neurology, Kyung Hee University College of Korean Medicine, Kyung Hee University Medical Center, Seoul, Republic of Korea
| | - Seungwon Kwon
- Department of Cardiology and Neurology, Kyung Hee University College of Korean Medicine, Kyung Hee University Medical Center, Seoul, Republic of Korea
| | - Seong-Uk Park
- Stroke and Neurological Disorders Center, Kyung Hee University College of Korean Medicine, Kyung Hee University Hospital at Gangdong, Seoul, Republic of Korea
| | - Woo-Sang Jung
- Department of Cardiology and Neurology, Kyung Hee University College of Korean Medicine, Kyung Hee University Medical Center, Seoul, Republic of Korea
| | - Sang-Kwan Moon
- Department of Cardiology and Neurology, Kyung Hee University College of Korean Medicine, Kyung Hee University Medical Center, Seoul, Republic of Korea
| | - Jung-Mi Park
- Stroke and Neurological Disorders Center, Kyung Hee University College of Korean Medicine, Kyung Hee University Hospital at Gangdong, Seoul, Republic of Korea
| | - Chang-Nam Ko
- Stroke and Neurological Disorders Center, Kyung Hee University College of Korean Medicine, Kyung Hee University Hospital at Gangdong, Seoul, Republic of Korea
| | - Seung-Yeon Cho
- Stroke and Neurological Disorders Center, Kyung Hee University College of Korean Medicine, Kyung Hee University Hospital at Gangdong, Seoul, Republic of Korea.
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Paz V, Dashti HS, Garfield V. Is there an association between daytime napping, cognitive function, and brain volume? A Mendelian randomization study in the UK Biobank. Sleep Health 2023; 9:786-793. [PMID: 37344293 DOI: 10.1016/j.sleh.2023.05.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 04/14/2023] [Accepted: 05/03/2023] [Indexed: 06/23/2023]
Abstract
OBJECTIVES Daytime napping has been associated with cognitive function and brain health in observational studies. However, it remains elusive whether these associations are causal. Using Mendelian randomization, we studied the relationship between habitual daytime napping and cognition and brain structure. METHODS Data were from UK Biobank (maximum n = 378,932 and mean age = 57 years). Our exposure (daytime napping) was instrumented using 92 previously identified genome-wide, independent genetic variants (single-nucleotide polymorphisms, SNPs). Our outcomes were total brain volume, hippocampal volume, reaction time, and visual memory. Inverse-variance weighted was implemented, with sensitivity analyses (Mendelian randomization-Egger and Weighted Median Estimator) for horizontal pleiotropy. We tested different daytime napping instruments to ensure the robustness of our results. RESULTS Using Mendelian randomization, we found an association between habitual daytime napping and larger total brain volume (unstandardized ß = 15.80 cm3 and 95% CI = 0.25; 31.34) but not hippocampal volume (ß = -0.03 cm3 and 95% CI = -0.13;0.06), reaction time (expß = 1.01 and 95% CI = 1.00;1.03), or visual memory (expß = 0.99 and 95% CI = 0.94;1.05). Additional analyses with 47 SNPs (adjusted for excessive daytime sleepiness), 86 SNPs (excluding sleep apnea), and 17 SNPs (no sample overlap with UK Biobank) were largely consistent with our main findings. No evidence of horizontal pleiotropy was found. CONCLUSIONS Our findings suggest a modest causal association between habitual daytime napping and larger total brain volume. Future studies could focus on the associations between napping and other cognitive or brain outcomes and replication of these findings using other datasets and methods.
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Affiliation(s)
- Valentina Paz
- Instituto de Psicología Clínica, Facultad de Psicología, Universidad de la República, Montevideo, Uruguay; MRC Unit for Lifelong Health & Ageing, Institute of Cardiovascular Science, University College London, London, UK.
| | - Hassan S Dashti
- Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, USA; Broad Institute, Merkin Building, Cambridge, MA, USA; Department of Anesthesia, Critical Care & Pain Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Victoria Garfield
- MRC Unit for Lifelong Health & Ageing, Institute of Cardiovascular Science, University College London, London, UK
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Reimann GM, Küppers V, Camilleri JA, Hoffstaedter F, Langner R, Laird AR, Fox PT, Spiegelhalder K, Eickhoff SB, Tahmasian M. Convergent abnormality in the subgenual anterior cingulate cortex in insomnia disorder: A revisited neuroimaging meta-analysis of 39 studies. Sleep Med Rev 2023; 71:101821. [PMID: 37481961 PMCID: PMC10718478 DOI: 10.1016/j.smrv.2023.101821] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Revised: 07/13/2023] [Accepted: 07/13/2023] [Indexed: 07/25/2023]
Abstract
The neurobiological underpinnings of insomnia disorder (ID) are still poorly understood. A previous meta-analysis conducted by our research group in 2018 revealed no consistent regional alterations based on the limited number of eligible studies. Given the number of studies published during the last few years, we revisited the meta-analysis to provide an update to the field. Following the best-practice guidelines for conducting neuroimaging meta-analyses, we searched several databases (PubMed, Web of Science, and BrainMap) and identified 39 eligible structural and functional studies, reporting coordinates reflecting significant group differences between ID patients and healthy controls. A significant convergent regional alteration in the subgenual anterior cingulate cortex (sgACC) was observed using the activation likelihood estimation algorithm. Behavioural decoding using the BrainMap database indicated that this region is involved in fear-related emotional and cognitive processing. The sgACC showed robust task-based co-activation in meta-analytic connectivity modelling and task-free functional connectivity in a resting-state functional connectivity analysis with the main hubs of the salience and default mode networks, including the posterior cingulate cortex and dorsal ACC, amygdala, hippocampus, and medial prefrontal cortex. Collectively, the findings from this large-scale meta-analysis suggest a critical role of the sgACC in the pathophysiology of ID.
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Affiliation(s)
- Gerion M Reimann
- Institute of Neuroscience and Medicine, Brain and Behaviour (INM-7), Research Centre Jülich, Jülich, Germany
| | - Vincent Küppers
- Institute of Neuroscience and Medicine, Brain and Behaviour (INM-7), Research Centre Jülich, Jülich, Germany; Department of Nuclear Medicine, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Julia A Camilleri
- Institute of Neuroscience and Medicine, Brain and Behaviour (INM-7), Research Centre Jülich, Jülich, Germany; Institute of Systems Neuroscience, Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Felix Hoffstaedter
- Institute of Neuroscience and Medicine, Brain and Behaviour (INM-7), Research Centre Jülich, Jülich, Germany; Institute of Systems Neuroscience, Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Robert Langner
- Institute of Neuroscience and Medicine, Brain and Behaviour (INM-7), Research Centre Jülich, Jülich, Germany; Institute of Systems Neuroscience, Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Angela R Laird
- Department of Physics, Florida International University, Miami, FL, USA
| | - Peter T Fox
- Research Imaging Institute, University of Texas Health Science Centre, San Antonio, TX, USA; South Texas Veterans Health Care System, San Antonio, TX, USA
| | - Kai Spiegelhalder
- Department of Psychiatry and Psychotherapy, Medical Centre, University of Freiburg - Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Simon B Eickhoff
- Institute of Neuroscience and Medicine, Brain and Behaviour (INM-7), Research Centre Jülich, Jülich, Germany; Institute of Systems Neuroscience, Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Masoud Tahmasian
- Institute of Neuroscience and Medicine, Brain and Behaviour (INM-7), Research Centre Jülich, Jülich, Germany; Institute of Systems Neuroscience, Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany.
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QIAO L, SHI Y, TAN L, JIANG Y, YANG Y. Efficacy of electroacupuncture stimulating Shenmen (HT7), Baihui (GV20), Sanyinjiao (SP6) on spatial learning and memory deficits in rats with insomnia induced by para-chlorophenylalanine: a single acupoint combined acupoints. J TRADIT CHIN MED 2023; 43:704-714. [PMID: 37454255 PMCID: PMC10320443 DOI: 10.19852/j.cnki.jtcm.20230308.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Accepted: 08/03/2022] [Indexed: 07/18/2023]
Abstract
OBJECTIVE To investiage the effect of electroacupuncture (EA) at a single acupoint of Shenmen (HT7), Baihui (GV20), Sanyinjiao (SP6) and at combined acupoints of Shenmen (HT7) and Baihui (GV20) and Sanyinjiao (SP6) on the PKA/CREB and BDNF/TrkB signaling, as well as neuroapoptosis and neurogenesis in hippocampus and elucidate the underlying mechanism of single and combined acupoints on ameliorating spatial learning and memory deficits in a rat model of primary insomnia. METHODS Primary insomnia was modeled by intraperitoneal injection of para-chlorophenylalanine (PCPA) once daily for 2 d. EA was applied at Shenmen (HT7), Baihui (GV20), Sanyinjiao (SP6), or Shenmen (HT7) + Baihui (GV20) + Sanyinjiao (SP6) (combined) for 30 min daily for 4 d. Spatial learning and memory function was evaluated by the Morris water maze (MWM) test. Protein expressions of hippocampal cAMP-dependent protein kinase (PKA)-Cβ, phosphorylated cAMP-responsive element-binding protein (p-CREB), brain-derived neurotrophic factor (BDNF), and tyrosine kinase receptor B (TrkB) were evaluated by Western blotting. Neuronal apoptosis in the hippocampus was detected with the transferase-mediated dUTP-X nick end labeling assay. Endogenous neurogenesis was examined with bromodeoxyuridine staining. The MWM test and hippocampal p-CREB, BDNF, and TrkB protein levels in the combined acupoints group were evaluated after the administration of a PKA-selective inhibitor (H89). RESULTS Spatial learning and memory were significantly impaired in rats with insomnia. The spatial learning deficits were ameliorated in the Shenmen (HT7), Baihui (GV20), Sanyinjiao (SP6), and combined groups; this improvement was significantly greater in the combined group than the single acupoint groups. The spatial memory impairment was improved in the combined, Baihui (GV20), and Shenmen (HT7) groups, but not the Sanyinjiao (SP6) group. The expressions of PKA-Cβ, p-CREB, BDNF, and TrkB were decreased in rats with insomnia. All these proteins were significantly upregulated in the combined group. PKA/p-CREB protein levels were elevated in the Baihui (GV20) and Shenmen (HT7) groups, whereas BDNF/TrkB expression was upregulated in the Sanyinjiao (SP6) group. The staining results showed significant attenuation of hippocampal cell apoptosis and increased numbers of proliferating cells in the combined group, whereas the single acupoint groups only showed decreased numbers of apoptotic cells. In the combined group, the PKA inhibitor reversed the improvement of spatial memory and upregulation of p-CREB expression caused by EA, but did not affect its activation of BDNF/TrkB signaling. CONCLUSIONS EA at the single acupoints Baihui (GV20), Shenmen (HT7), or Sanyinjiao (SP6) had an ameliorating effect on the spatial learning and memory deficits induced by insomnia. EA at combined acupoints exerted a synergistic effect on the improvements in spatial learning and memory impairment in rats with insomnia by upregulating the hippocampal PKA/CREB and BDNF/TrkB signaling, facilitating neurogenesis, and inhibiting neuronal apoptosis. These findings indicate that EA at combined acupoints [(Baihui (GV20), Shenmen (HT7), and Sanyinjiao (SP6)] achieves a more pronounced regulation of hippocampal neuroplasticity than EA at single acupoints, which may partly explain the underlying mechanisms by which EA at combined acupoints exerts a better ameliorative effect on the cognitive dysfunction caused by insomnia.
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Affiliation(s)
- Lina QIAO
- 1 Department of Biochemistry and Molecular Biology, Institute of Acupuncture and Moxibustion, China Academy of Chinese Medical Sciences, Beijing100700, China
| | - Yinan SHI
- 1 Department of Biochemistry and Molecular Biology, Institute of Acupuncture and Moxibustion, China Academy of Chinese Medical Sciences, Beijing100700, China
| | - Lianhong TAN
- 1 Department of Biochemistry and Molecular Biology, Institute of Acupuncture and Moxibustion, China Academy of Chinese Medical Sciences, Beijing100700, China
| | - Yanshu JIANG
- 2 College of Acupuncture-moxibustion and Massage, Changchun University of Traditional Chinese Medicine, Changchun 130117, China
| | - Yongsheng YANG
- 1 Department of Biochemistry and Molecular Biology, Institute of Acupuncture and Moxibustion, China Academy of Chinese Medical Sciences, Beijing100700, China
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AO YAWEN, LI YUSHUANG, ZHAO YILIN, ZHANG LIANG, YANG RENJIE, ZHA YUNFEI. Hippocampal Subfield Volumes in Amateur Marathon Runners. Med Sci Sports Exerc 2023; 55:1208-1217. [PMID: 36878015 PMCID: PMC10241426 DOI: 10.1249/mss.0000000000003144] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/08/2023]
Abstract
PURPOSE Numerous studies have implicated the involvement of structure and function of the hippocampus in physical exercise, and the larger hippocampal volume is one of the relevant benefits reported in exercise. It remains to be determined how the different subfields of hippocampus respond to physical exercise. METHODS A 3D T1-weighted magnetic resonance imaging was acquired in 73 amateur marathon runners (AMR) and 52 healthy controls (HC) matched with age, sex, and education. The Montreal Cognitive Assessment, the Pittsburgh Sleep Quality Index (PSQI), and the Fatigue Severity Scale were assessed in all participants. We obtained hippocampal subfield volumes using FreeSurfer 6.0. We compared the volumes of the hippocampal subfield between the two groups and ascertained correlation between the significant subfield metrics and the significant behavioral measure in AMR group. RESULTS The AMR had significantly better sleep than HC, manifested as with lower score of PSQI. Sleep duration in AMR and HC was not significantly different from each other. In the AMR group, the left and right hippocampus, cornu ammonis 1 (CA1), CA4, granule cell and molecular layers of the dentate gyrus, molecular layer, left CA2-3, and left hippocampal-amygdaloid transition area volumes were significantly larger compared with those in the HC group. In AMR group, the correlations between the PSQI and the hippocampal subfield volumes were not significant. No correlations were found between hippocampal subfield volumes and sleep duration in AMR group. CONCLUSIONS We reported larger volumes of specific hippocampal subfields in AMR, which may provide a hippocampal volumetric reserve that protects against age-related hippocampal deterioration. These findings should be further investigated in longitudinal studies.
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Künstler ECS, Bublak P, Finke K, Koranyi N, Meinhard M, Schwab M, Rupprecht S. The Relationship Between Cognitive Impairments and Sleep Quality Measures in Persistent Insomnia Disorder. Nat Sci Sleep 2023; 15:491-498. [PMID: 37408565 PMCID: PMC10319274 DOI: 10.2147/nss.s399644] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Accepted: 03/25/2023] [Indexed: 07/07/2023] Open
Abstract
Study Objectives Persistent insomnia disorder (pID) is linked to neurocognitive decline and increased risk of Alzheimer's Disease (AD) in later life. However, research in this field often utilizes self-reported sleep quality data - which may be biased by sleep misperception - or uses extensive neurocognitive test batteries - which are often not feasible in clinical settings. This study therefore aims to assess whether a simple screening tool could uncover a specific pattern of cognitive changes in pID patients, and whether these relate to objective aspect(s) of sleep quality. Methods Neurocognitive performance (Montreal Cognitive Assessment; MoCA), anxiety/depression severity, and subjective sleep quality (Pittsburgh Sleep Quality Index: PSQI; Insomnia Severity Index: ISI) data were collected from 22 middle-aged pID patients and 22 good-sleepers. Patients underwent overnight polysomnography. Results Compared to good-sleepers, patients had lower overall cognitive performance (average: 24.6 versus 26.3 points, Mann-Whitney U = 136.5, p = <0.006), with deficits in clock drawing and verbal abstraction. In patients, poorer overall cognitive performance correlated with reduced subjective sleep quality (PSQI: r(42) = -0.47, p = 0.001; and ISI: r(42) = -0.43, p = 0.004), reduced objective sleep quality (lower sleep efficiency: r(20) = 0.59, p = 0.004 and less REM-sleep: r(20) = 0.52, p = 0.013; and increased sleep latency: r(20) = -0.57, p = 0.005 and time awake: r(20) = -0.59, p = 0.004). Cognitive performance was not related to anxiety/depression scores. Conclusion Using a simple neurocognitive screening tool, we found that pID patients showed cognitive deficiencies that related to both subjective/self-reported and objective/polysomnographic measures of sleep quality. Furthermore, these cognitive changes resembled those seen in preclinical non-amnestic AD, and thus could indicate incumbent neurodegenerative processes in pID. Interestingly, increased REM-sleep was correlated with better cognitive performance. However, whether REM-sleep is protective against neurodegeneration requires further investigation.
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Affiliation(s)
- Erika C S Künstler
- Department of Neurology, Jena University Hospital, Jena, Germany
- Interdisciplinary Centre for Sleep and Ventilatory Medicine, Jena University Hospital, Jena, Germany
| | - Peter Bublak
- Department of Neurology, Jena University Hospital, Jena, Germany
| | - Kathrin Finke
- Department of Neurology, Jena University Hospital, Jena, Germany
| | - Nicolas Koranyi
- Department of Neurology, Jena University Hospital, Jena, Germany
| | - Marie Meinhard
- Department of Neurology, Jena University Hospital, Jena, Germany
| | - Matthias Schwab
- Department of Neurology, Jena University Hospital, Jena, Germany
- Interdisciplinary Centre for Sleep and Ventilatory Medicine, Jena University Hospital, Jena, Germany
| | - Sven Rupprecht
- Department of Neurology, Jena University Hospital, Jena, Germany
- Interdisciplinary Centre for Sleep and Ventilatory Medicine, Jena University Hospital, Jena, Germany
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Yang Y, Liu J, Ou H, Ma X, Li J, Shao B, Jin R, Zhao J. Study on the Mechanism of Jiaotai Pill Intervention on Insomnia Animal Model Based on Gut Microbiome and Metabolomics. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE : ECAM 2023; 2023:2442505. [PMID: 37260523 PMCID: PMC10229250 DOI: 10.1155/2023/2442505] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/13/2022] [Revised: 04/02/2023] [Accepted: 04/13/2023] [Indexed: 06/02/2023]
Abstract
Background With the continuous advancement of clinical application and experimental research of JTP, the application prospect of JTP in nervous system diseases and metabolic diseases is becoming increasingly clear. Jiaotai Pill (JTP) is a traditional Chinese medicine formula for insomnia, consisting of Coptidis rhizoma and Cinnamomi cortex, which dates back to Han Shi Yi Tong in the Ming Dynasty of China. Objective Based on the brain-gut axis theory, this paper aims to explore the potential mechanism of JTP in the intervention of insomnia by using intestinal microbiome and metabolomics technology, taking the animal model of insomnia as the research object, so as to provide experimental basis for its further application and research. Methods The insomnia mouse model was induced by intraperitoneal injection of para-chlorophenylalanine (PCPA). The clinical equivalent dose of JTP was administered by gavage for one week. The efficacy of JTP was evaluated by behavioral tests, serum biochemical detection, and brain histomorphological observation. The contents of cecum were analyzed by microbiomics and metabolomics. Results The results show that insomnia caused by PCPA led to daytime dysfunction, higher HPA axis hormone levels, and morphologically impaired hippocampus. JTP reversed these anomalies. Omics research indicates that JTP significantly reduced gut α diversity; at the phylum level, JTP reduced the relative abundance of Firmicutes, Deferribacterota, Cyanobacteria, and Actinobacteriota and increased the relative abundance of Verrucomicrobiota, Proteobacteria, and Desulfobacterota. At the genus level, JTP reduced the relative abundance of Muribaculaceae, Lachnospiraceae_NK4A136_group, Alistipes, Colidextribacter, Muribaculum, and Mucispirillum and increased the relative abundance of Bacteroides and Akkermansia. JTP also reversed the activation of the linoleic acid metabolism pathway induced by insomnia. The combined analysis of omics suggests that JTP may play a role by regulating the inflammatory state of the body. Further gene expression analysis of brain tissue confirmed this. Conclusions We hypothesize that JTP may achieve insomnia relief by eliminating inflammation-causing bacteria in the gut and reducing inflammation levels through the brain-gut axis, pointing to potential targets and pathways for future research on JTP.
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Affiliation(s)
- Yang Yang
- School of Life Sciences, Beijing University of Chinese Medicine, No. 11 East Road, North 3rd Ring Road, Beijing 100029, China
| | - Jiao Liu
- School of Life Sciences, Beijing University of Chinese Medicine, No. 11 East Road, North 3rd Ring Road, Beijing 100029, China
| | - Haosong Ou
- School of Life Sciences, Beijing University of Chinese Medicine, No. 11 East Road, North 3rd Ring Road, Beijing 100029, China
| | - Xin Ma
- School of Life Sciences, Beijing University of Chinese Medicine, No. 11 East Road, North 3rd Ring Road, Beijing 100029, China
| | - Jia Li
- School of Life Sciences, Beijing University of Chinese Medicine, No. 11 East Road, North 3rd Ring Road, Beijing 100029, China
| | - Binghao Shao
- School of Life Sciences, Beijing University of Chinese Medicine, No. 11 East Road, North 3rd Ring Road, Beijing 100029, China
| | - Ruyi Jin
- School of Life Sciences, Beijing University of Chinese Medicine, No. 11 East Road, North 3rd Ring Road, Beijing 100029, China
| | - Junyun Zhao
- School of Life Sciences, Beijing University of Chinese Medicine, No. 11 East Road, North 3rd Ring Road, Beijing 100029, China
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Lo LLH, Lee EHM, Hui CLM, Chong CSY, Chang WC, Chan SKW, Lin JJ, Lo WTL, Chen EYH. Effect of high-endurance exercise intervention on sleep-dependent procedural memory consolidation in individuals with schizophrenia: a randomized controlled trial. Psychol Med 2023; 53:1708-1720. [PMID: 34615565 DOI: 10.1017/s0033291721003196] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Little is known about the effects of physical exercise on sleep-dependent consolidation of procedural memory in individuals with schizophrenia. We conducted a randomized controlled trial (RCT) to assess the effectiveness of physical exercise in improving this cognitive function in schizophrenia. METHODS A three-arm parallel open-labeled RCT took place in a university hospital. Participants were randomized and allocated into either the high-intensity-interval-training group (HIIT), aerobic-endurance exercise group (AE), or psychoeducation group for 12 weeks, with three sessions per week. Seventy-nine individuals with schizophrenia spectrum disorder were contacted and screened for their eligibility. A total of 51 were successfully recruited in the study. The primary outcome was sleep-dependent procedural memory consolidation performance as measured by the finger-tapping motor sequence task (MST). Assessments were conducted during baseline and follow-up on week 12. RESULTS The MST performance scored significantly higher in the HIIT (n = 17) compared to the psychoeducation group (n = 18) after the week 12 intervention (p < 0.001). The performance differences between the AE (n = 16) and the psychoeducation (p = 0.057), and between the AE and the HIIT (p = 0.999) were not significant. Yet, both HIIT (p < 0.0001) and AE (p < 0.05) showed significant within-group post-intervention improvement. CONCLUSIONS Our results show that HIIT and AE were effective at reverting the defective sleep-dependent procedural memory consolidation in individuals with schizophrenia. Moreover, HIIT had a more distinctive effect compared to the control group. These findings suggest that HIIT may be a more effective treatment to improve sleep-dependent memory functions in individuals with schizophrenia than AE alone.
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Affiliation(s)
| | - Edwin Ho Ming Lee
- Department of Psychiatry, University of Hong Kong, Pok Fu Lam, Hong Kong
| | | | | | - Wing Chung Chang
- Department of Psychiatry, University of Hong Kong, Pok Fu Lam, Hong Kong
- State Key Laboratory of Brain and Cognitive Sciences, University of Hong Kong, Pok Fu Lam, Hong Kong
| | - Sherry Kit Wa Chan
- Department of Psychiatry, University of Hong Kong, Pok Fu Lam, Hong Kong
- State Key Laboratory of Brain and Cognitive Sciences, University of Hong Kong, Pok Fu Lam, Hong Kong
| | - Jessie Jingxia Lin
- Neuroscience and Neurological Rehabilitation, The Hong Kong Polytechnic University, Hung Hom, Hong Kong
| | | | - Eric Yu Hai Chen
- Department of Psychiatry, University of Hong Kong, Pok Fu Lam, Hong Kong
- State Key Laboratory of Brain and Cognitive Sciences, University of Hong Kong, Pok Fu Lam, Hong Kong
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Zaheed AB, Chervin RD, Spira AP, Zahodne LB. Mental and physical health pathways linking insomnia symptoms to cognitive performance 14 years later. Sleep 2023; 46:zsac262. [PMID: 36309871 PMCID: PMC9995792 DOI: 10.1093/sleep/zsac262] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Revised: 09/27/2022] [Indexed: 12/04/2022] Open
Abstract
STUDY OBJECTIVES Insomnia may be a modifiable risk factor for later-life cognitive impairment. We investigated: (1) which insomnia symptoms are associated with subsequent cognitive functioning across domains; (2) whether insomnia-cognition associations are mediated by mental and physical health; and (3) whether these associations are modified by gender. METHODS Participants included 2595 adults ages 51-88 at baseline (Mage=64.00 ± 6.66, 64.5% women) in the Health and Retirement Study. The frequency of insomnia symptoms (difficulty initiating sleep, night time awakenings, early awakenings, and feeling unrested upon awakening) at baseline (2002) were quantified using a modified Jenkins Sleep Questionnaire. Cognition was assessed in 2016 via the Harmonized Cognitive Assessment Protocol and operationalized with factor scores corresponding to five domains. Depressive symptoms and vascular conditions in 2014 were assessed via self-report. Structural equation models estimated total, indirect, and direct effects of insomnia symptoms on subsequent cognition through depressive symptoms and vascular diseases, controlling for baseline sociodemographic and global cognition. RESULTS Frequent difficulty initiating sleep was associated with poorer episodic memory, executive function, language, visuoconstruction, and processing speed 14 years later (-0.06 ≤ β ≤ -0.04; equivalent to 2.2-3.4 years of aging). Depressive symptoms explained 12.3%-19.5% of these associations and vascular disease explained 6.3%-14.6% of non-memory associations. No other insomnia symptoms were associated with cognition, and no associations were modified by gender. CONCLUSIONS Difficulty initiating sleep in later life may predict future cognitive impairment through multiple pathways. Future research with longitudinal assessments of insomnia, insomnia treatments, and cognition is needed to evaluate insomnia as a potential intervention target to optimize cognitive aging.
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Affiliation(s)
- Afsara B Zaheed
- Department of Psychology, University of Michigan, Ann Arbor, MI 48109, USA
| | - Ronald D Chervin
- Sleep Disorders Center and Department of Neurology, University of Michigan, Ann Arbor, MI 48109, USA
| | - Adam P Spira
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD 21287, USA
- Johns Hopkins Center on Aging and Health, Baltimore, MD 21205, USA
| | - Laura B Zahodne
- Department of Psychology, University of Michigan, Ann Arbor, MI 48109, USA
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Zhou L, Kong J, Li X, Ren Q. Sex differences in the effects of sleep disorders on cognitive dysfunction. Neurosci Biobehav Rev 2023; 146:105067. [PMID: 36716906 DOI: 10.1016/j.neubiorev.2023.105067] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Revised: 01/24/2023] [Accepted: 01/26/2023] [Indexed: 01/29/2023]
Abstract
Sleep is an essential physiological function that sustains human life. Sleep disorders involve problems with the quality, duration, and abnormal behaviour of sleep. Insomnia is the most common sleep disorder, followed by sleep-disordered breathing (SDB). Sleep disorders often occur along with medical conditions or other mental health conditions. Of particular interest to researchers is the role of sleep disorders in cognitive dysfunction. Sleep disorder is a risk factor for cognitive dysfunction, yet the exact pathogenesis is still far from agreement. Little is known about how sex differences influence the changes in cognitive functions caused by sleep disorders. This narrative review examines how sleep disorders might affect cognitive impairment, and then explores the sex-specific consequences of sleep disorders as a risk factor for dementia and the potential underlying mechanisms. Some insights on the direction of further research are also presented.
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Affiliation(s)
- Lv Zhou
- School of Medicine, Southeast University, Nanjing 210009, China
| | - Jingting Kong
- School of Medicine, Southeast University, Nanjing 210009, China
| | - Xiaoli Li
- School of Medicine, Southeast University, Nanjing 210009, China; Department of Neurology, Affiliated ZhongDa Hospital of Southeast University, Nanjing 210009, China
| | - Qingguo Ren
- School of Medicine, Southeast University, Nanjing 210009, China; Department of Neurology, Affiliated ZhongDa Hospital of Southeast University, Nanjing 210009, China.
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Szentkirályi A, Hermesdorf M, Sundermann B, Czira M, Teismann H, Wulms N, Minnerup H, Young P, Berger K. Periodic limb movements in sleep are linked to decreased hippocampus and amygdala volumes in the population-based BiDirect Study. Sleep 2023; 46:6795532. [PMID: 36330698 DOI: 10.1093/sleep/zsac263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Revised: 09/30/2022] [Indexed: 11/06/2022] Open
Abstract
STUDY OBJECTIVES Even though numerous studies indicate that sleep disorders are associated with altered brain morphology, MRI studies focusing on periodic limb movements in sleep (PLMS) are scarce. Our aim was to investigate the association of PLMS with global and regional gray matter volumes as well as white matter hyperintensity (WMH) volume. METHODS One hundred and eighty-nine subjects (57.0 ± 7.8 years, women: 50.5%) of the population-based BiDirect Study underwent a single-night polysomnography (PSG). Standard criteria of the American Academy of Sleep Medicine were applied to evaluate sleep characteristics and calculate the PLMS index (PLMSI). T1w and FLAIR images were acquired with cerebral MRI at 3 Tesla. Voxel-based morphometry was performed to determine the total gray matter volume as well as the volume of cortical segments and subcortical gray matter areas using SPM12 and CAT12. The WMH volume was quantified with the Brain Intensity AbNormality Classification Algorithm. The independent relationship between MRI markers and PLMSI was analyzed using multivariable linear regression with adjustment for age, sex, body mass index, intracranial volume, PSG scorer, PSG device, sleep apnea, and the use of antidepressants. RESULTS PLMSI was not significantly related to global gray matter volume and WMH volume. However, significant inverse associations of the PLMSI with the volume of the hippocampus (left and right hemisphere) and left amygdala were observed. CONCLUSIONS A significant relationship between a higher PLMSI and lower volumes of the hippocampus and amygdala was found among the participants of the BiDirect Study. Since these associations are based on exploratory analyses, further replications are required before drawing firm conclusions.
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Affiliation(s)
- András Szentkirályi
- Institute of Epidemiology and Social Medicine, University of Münster, Münster, Germany
| | - Marco Hermesdorf
- Institute of Epidemiology and Social Medicine, University of Münster, Münster, Germany
| | - Benedikt Sundermann
- Clinic of Radiology, University Hospital Münster, Münster, Germany.,Institute of Radiology and Neuroradiology, Evangelisches Krankenhaus, Medical Campus University of Oldenburg, Oldenburg, Germany.,Research Center Neurosensory Science, University of Oldenburg, Oldenburg, Germany
| | - Maria Czira
- Johannes Keller General Practice, Greven, Germany
| | - Henning Teismann
- Institute of Epidemiology and Social Medicine, University of Münster, Münster, Germany
| | - Niklas Wulms
- Institute of Epidemiology and Social Medicine, University of Münster, Münster, Germany
| | - Heike Minnerup
- Institute of Epidemiology and Social Medicine, University of Münster, Münster, Germany
| | - Peter Young
- Medical Park/Neurological Clinic Reithofpark, Bad Feilnbach, Germany
| | - Klaus Berger
- Institute of Epidemiology and Social Medicine, University of Münster, Münster, Germany
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Bakhshayesh Eghbali B, Ramezani S, Sedaghat Herfeh S, Emir Alavi C, Najafi K, Esmaeeli Lipaei P, Eslamparast Kordmahalleh S, Hosseinpour Sarmadi V, Amini N, Ramezani Kapourchali F. ¬Transcranial direct current stimulation improves sleep quality in patients with insomnia after traumatic brain injury. Brain Inj 2023; 37:63-73. [PMID: 36408966 DOI: 10.1080/02699052.2022.2145363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
INTRODUCTION Insomnia is a serious problem after traumatic brain injury (TBI) and partially improves via sleeping pills. We investigated the efficacy of transcranial direct current stimulation (tDCS) with a focus on the role of age and gender. MATERIALS AND METHODS In a randomized double-blind clinical trial, 60 eligible TBI-induced insomnia patients were assigned to real and sham tDCS groups and were treated for three weeks. Sham but not real tDCS took sleeping pills for the first three weeks of the study and then used the placebo until the end of the study. The placebo was used by the real-tDCS group throughout the study. Sleep quality and insomnia severity were respectively evaluated by Pittsburg Sleep Quality Index (PSQI) and Insomnia Severity Index (ISI) at three time points. RESULTS Real tDCS group reported lower mean ISI and PSQI scores at 3 weeks post treatment onset and maintained this decline for six weeks post treatment onset (P < 0.001). In younger participants and those identified as men, the treatment-induced attenuation of the mean PSQI score was reported higher and more lasting in real than sham tDCS groups. CONCLUSION Gender and age-specific tDCS protocols may be warranted to optimize the therapeutic effect of tDCS.
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Affiliation(s)
- Babak Bakhshayesh Eghbali
- Neuroscience Research Center, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran
| | - Sara Ramezani
- Neuroscience Research Center, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran
| | - Sina Sedaghat Herfeh
- Neuroscience Research Center, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran
| | - Cyrus Emir Alavi
- Neuroscience Research Center, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran
| | - Kiomars Najafi
- Kavosh Research Center for Behavioral-Cognitive Sciences and Addiction, Department of Noninvasive Brain Stimulation, Tolou Clinic Guilan University of Medical Sciences, Rasht, Iran
| | - Pedram Esmaeeli Lipaei
- Student Research Committee, Neuroscience Research Center, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran
| | | | - Vahid Hosseinpour Sarmadi
- Cellular and Molecular Research Centre, Iran University of Medical Sciences, Tehran, Iran.,Institutes of Regenerative Medicine, Faculty of Advanced Technologies in Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Naser Amini
- Cellular and Molecular Research Centre, Iran University of Medical Sciences, Tehran, Iran
| | - Fatemeh Ramezani Kapourchali
- Department of Inflammation and Immunity, Lerner Research Institute, Cleveland Clinic, Cleveland, Ohio 44195, USA
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Burke S, Grudzien A, Li T, Abril M, Spadola C, Barnes C, Hanson K, Grandner M, DeKosky S. Correlations between sleep disturbance and brain structures associated with neurodegeneration in the National Alzheimer's Coordinating Center Uniform Data Set. J Clin Neurosci 2022; 106:204-212. [PMID: 35970678 PMCID: PMC9671822 DOI: 10.1016/j.jocn.2022.07.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Revised: 06/23/2022] [Accepted: 07/13/2022] [Indexed: 10/15/2022]
Abstract
This study aimed to 1) determine the association between sleep disturbance and brain structure volumes, 2) the moderation effect of apolipoprotein ε4 genotype on sleep disturbance and brain structures, and 3) the moderation effect of sleep disturbance on cognitive status and regional brain volumes. Using the National Alzheimer's Coordinating Center Uniform Data Set (n = 1,533), multiple linear regressions were used to evaluate the association between sleep disturbance and brain volumes. Sleep disturbance was measured using one question from the NPI-Q. After controlling for intracranial volume, age, sex, years of education, race, ethnicity, and applying the FDR correction, total cerebrospinal fluid volume, left lateral ventricle volume, total lateral ventricle volume, and total third ventricle volume demonstrated significantly higher means for those with sleep disturbance. Total brain volume, total white and gray matter volume, total cerebrum brain volume (including gray but not white matter), left hippocampus volume, total hippocampal volume, the left, right, and total frontal lobe cortical gray matter volume, and the left, right, and total temporal lobe cortical gray matter volume demonstrated significantly lower mean volumes for those with sleep disturbance. Sleep disturbance moderated the association between cognitive status and lateral ventricular volumes. These findings suggest that disrupted sleep is associated with atrophy across multiple brain regions and ventricular hydrocephalus ex vacuo.
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Affiliation(s)
- Shanna Burke
- School of Social Work, Florida International University, Robert Stempel College of Public Health and Social Work, 11200 SW 8th St. Miami, FL 33199, United States.
| | - Adrienne Grudzien
- School of Social Work, Florida International University, Robert Stempel College of Public Health and Social Work, 11200 SW 8th St. Miami, FL 33199, United States.
| | - Tan Li
- Department of Biostatistics, Robert Stempel College of Public Health and Social Work, Florida International University, 11200 S.W. 8th Street, Miami, FL 33199, United States.
| | - Marlou Abril
- Department of Biostatistics, Robert Stempel College of Public Health and Social Work, Florida International University, 11200 S.W. 8th Street, Miami, FL 33199, United States.
| | - Christine Spadola
- The University of Texas at Arlington, School of Social Work, 211 S. Cooper Street, Box 19129, Arlington, TX 76019-0129, United States.
| | - Christopher Barnes
- Clinical and Translational Science Informatics and Technology, University of Florida Clinical and Translational Science Institute, College of Medicine, University of Florida, Gainesville, FL 32610, United States.
| | - Kevin Hanson
- Clinical and Translational Science Institute, Integrated Data Repository, College of Medicine, University of Florida, Gainesville, FL 32610, United States.
| | - Michael Grandner
- Behavioral Sleep Medicine Clinic, University of Arizona College of Medicine, 1501 N Campbell Avenue, Tucson, AZ 85724-5002, United States.
| | - Steven DeKosky
- McKnight Brain Institute, Aerts-Cosper Professor of Alzheimer's Research, Associate Director, 1Florida Alzheimer's Disease Center, Professor of Neurology and Neuroscience, University of Florida, College of Medicine, United States.
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Zeng HR, Xu F, Zhang J, Cao QF, Wang YH, Zhang P, Shao YC, Wu SP, Weng XC. Vigilant Attention, Cerebral Blood Flow and Grey Matter Volume Change after 36 h of Acute Sleep Deprivation in Healthy Male Adults: A Pilot Study. Brain Sci 2022; 12:1534. [PMID: 36421858 PMCID: PMC9688785 DOI: 10.3390/brainsci12111534] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Revised: 11/09/2022] [Accepted: 11/10/2022] [Indexed: 05/06/2025] Open
Abstract
It is commonly believed that alertness and attention decrease after sleep deprivation (SD). However, there are not enough studies on the changes in psychomotor vigilance testing (PVT) during SD and the corresponding changes in brain function and brain structure after SD. Therefore, we recruited 30 healthy adult men to perform a 36 h acute SD experiment, including the measurement of five indicators of PVT every 2 h, and analysis of cerebral blood flow (CBF) and grey matter volume (GMV) changes, before and after SD by magnetic resonance imaging (MRI). The PVT measurement found that the mean reaction time (RT), fastest 10% RT, minor lapses, and false starts all increased progressively within 20 h of SD, except for major lapses. Subsequently, all indexes showed a significant lengthening or increasing trend, and the peak value was in the range of 24 h-32 h and decreased at 36 h, in which the number of major lapses returned to normal. MRI showed that CBF decreased in the left orbital part of the superior frontal gyrus, the left of the rolandic operculum, the left triangular part, and the right opercular part of the inferior frontal gyrus, and CBF increased in the left lingual gyrus and the right superior gyrus after 36 h SD. The left lingual gyrus was negatively correlated with the major lapses, and both the inferior frontal gyrus and the superior frontal gyrus were positively correlated with the false starts. Still, there was no significant change in GMV. Therefore, we believe that 36 h of acute SD causes alterations in brain function and reduces alert attention, whereas short-term acute SD does not cause changes in brain structure.
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Affiliation(s)
- Han-Rui Zeng
- Department of Clinic Medicine, Chengdu Medical College, Chengdu 610500, China
| | - Fan Xu
- Department of Public Health, Chengdu Medical College, Chengdu 610500, China
| | - Jing Zhang
- MOEMIL Laboratory, School of Optoelectronic Information, University of Electronic Science and Technology of China, Chengdu 610054, China
| | - Qiong-Fang Cao
- Department of Public Health, Chengdu Medical College, Chengdu 610500, China
| | - Yu-Han Wang
- Department of Public Health, Chengdu Medical College, Chengdu 610500, China
| | - Peng Zhang
- Department of Public Health, Chengdu Medical College, Chengdu 610500, China
| | - Yong-Cong Shao
- School of Psychology, Beijing Sport University, Beijing 100084, China
| | - Shao-Ping Wu
- Department of Clinic Medicine, Chengdu Medical College, Chengdu 610500, China
| | - Xie-Chuan Weng
- Department of Neuroscience Beijing Institute of Basic Medical Sciences, Beijing 100850, China
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Yang Y, Liang W, Wang Y, Peng D, Gong L, Wang N, Huang Z, Yang W. Hippocampal atrophy in neurofunctional subfields in insomnia individuals. Front Neurol 2022; 13:1014244. [DOI: 10.3389/fneur.2022.1014244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Accepted: 09/20/2022] [Indexed: 11/13/2022] Open
Abstract
ObjectiveThe aim of this study was to investigate the pattern of volume changes in neurofunctional hippocampal subfields in patients with insomnia and their associations with risk of development of insomnia.MethodsA total of 120 patients with insomnia (78 females, 42 males; mean age ± standard deviation, 43.74 ± 13.02 years) and 120 good sleepers (67 females, 53 males; mean age, 42.69 ± 12.24 years) were recruited. The left hippocampus was segmented into anterior (L1), middle (L2), and posterior (L3) subregions. The right hippocampus was segmented into top anterior (R1), second top anterior (R2), middle (R3), posterior (R4), and last posterior (R5) subregions. Multivariate logistic regression was used to evaluate the associations of hippocampal volume (HV) of each subfield with the risk of the development of insomnia. Mediation analyses were performed to evaluate mediated associations among post-insomnia negative emotion, insomnia severity, and HV atrophy. A visual easy-to-deploy risk nomogram was used for individual prediction of risk of development of insomnia.ResultsHippocampal volume atrophy was identified in the L1, R1, and R2 subregions. L1 and R2 volume atrophy each predisposed to an ~3-fold higher risk of insomnia (L1, odds ratio: 2.90, 95% confidence intervals: [1.24, 6.76], p = 0.014; R2, 2.72 [1.19, 6.20], p = 0.018). Anxiety fully mediates the causal path of insomnia severity leading to R1 volume atrophy with a positive effect. We developed a practical and visual competing risk-nomogram tool for individual prediction of insomnia risk, which stratifies individuals into different levels of insomnia risk with the highest prediction accuracy of 97.4% and an average C-statistic of 0.83.ConclusionHippocampal atrophy in specific neurofunctional subfields was not only found to be associated with insomnia but also a significant risk factor predicting development of insomnia.
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Alfini AJ, Won J, Weiss LR, Nyhuis CC, Zipunnikov V, Spira AP, Liu-Ambrose T, Shackman AJ, Smith JC. Cardiorespiratory Fitness as a Moderator of Sleep-Related Associations with Hippocampal Volume and Cognition. Brain Sci 2022; 12:1360. [PMID: 36291294 PMCID: PMC9599432 DOI: 10.3390/brainsci12101360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Revised: 09/23/2022] [Accepted: 10/03/2022] [Indexed: 11/16/2022] Open
Abstract
The objective of this study was to understand the associations of sleep and cardiorespiratory fitness with hippocampal volume and global cognition among older adults (n = 30, age = 65.8 years, female = 73.3%). Wrist actigraphy provided objective measures of nighttime sleep including sleep duration, average wake bout length (WBL; sleep disturbance), and wake-to-sleep transition probability (WTSP; sleep consolidation). Cardiorespiratory fitness was quantified via cycle exercise using a modified heart rate recovery approach. Magnetic resonance imaging was used to determine hippocampal volume and the Mini-Mental State Examination was used to assess global cognition. Fitness moderated associations of sleep with hippocampal volume and cognitive performance, whereby the association of WBL-an index of poor sleep-with hippocampal atrophy was stronger among less-fit individuals, and the association of sleep duration with cognitive performance was stronger among more-fit individuals. Across the fitness levels, a longer WBL was associated with lower cognitive performance, and a higher WTSP-an index of more consolidated sleep-was associated with greater hippocampal volume. Sleep and fitness were unrelated to the volume of an amygdala control region, suggesting a degree of neuroanatomical specificity. In conclusion, higher cardiorespiratory fitness may attenuate sleep disturbance-related hippocampal atrophy and magnify the cognitive benefits of good sleep. Prospective studies are needed to confirm these findings.
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Affiliation(s)
- Alfonso J. Alfini
- National Center on Sleep Disorders Research, Division of Lung Diseases, National Heart, Lung, and Blood Institute, NIH, Bethesda, MD 20817, USA
| | - Junyeon Won
- Department of Kinesiology, University of Maryland School of Public Health, College Park, MD 20742, USA
| | - Lauren R. Weiss
- Department of Kinesiology, University of Maryland School of Public Health, College Park, MD 20742, USA
- Neuroscience and Cognitive Science Program, University of Maryland, College Park, MD 20742, USA
| | - Casandra C. Nyhuis
- Department of Public Health Sciences, Pennsylvania State University College of Medicine, Hershey, PA 17033, USA
| | - Vadim Zipunnikov
- Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA
| | - Adam P. Spira
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA
- Center on Aging and Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD 21205, USA
| | - Teresa Liu-Ambrose
- Department of Physical Therapy, University of British Columbia, Vancouver, BC V6T 1Z3, Canada
- Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, BC V6T 1Z3, Canada
- Centre for Hip Health and Mobility, Vancouver Coastal Health Research Institute, Vancouver, BC V5Z 1M9, Canada
| | - Alexander J. Shackman
- Neuroscience and Cognitive Science Program, University of Maryland, College Park, MD 20742, USA
- Department of Psychology, University of Maryland, College Park, MD 20742, USA
- Maryland Neuroimaging Center, University of Maryland, College Park, MD 20742, USA
| | - J. Carson Smith
- Department of Kinesiology, University of Maryland School of Public Health, College Park, MD 20742, USA
- Neuroscience and Cognitive Science Program, University of Maryland, College Park, MD 20742, USA
- Maryland Neuroimaging Center, University of Maryland, College Park, MD 20742, USA
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Sahu M, Tripathi R, Jha NK, Jha SK, Ambasta RK, Kumar P. Cross talk mechanism of disturbed sleep patterns in neurological and psychological disorders. Neurosci Biobehav Rev 2022; 140:104767. [PMID: 35811007 DOI: 10.1016/j.neubiorev.2022.104767] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Revised: 06/20/2022] [Accepted: 07/01/2022] [Indexed: 11/25/2022]
Abstract
The incidence and prevalence of sleep disorders continue to increase in the elderly populace, particularly those suffering from neurodegenerative and neuropsychiatric disorders. This not only affects the quality of life but also accelerates the progression of the disease. There are many reasons behind sleep disturbances in such patients, for instance, medication use, nocturia, obesity, environmental factors, nocturnal motor disturbances and depressive symptoms. This review focuses on the mechanism and effects of sleep dysfunction in neurodegenerative and neuropsychiatric disorders. Wherein we discuss disturbed circadian rhythm, signaling cascade and regulation of genes during sleep deprivation. Moreover, we explain the perturbation in brainwaves during disturbed sleep and the ocular perspective of neurodegenerative and neuropsychiatric manifestations in sleep disorders. Further, as the pharmacological approach is often futile and carries side effects, therefore, the non-pharmacological approach opens newer possibilities to treat these disorders and widens the landscape of treatment options for patients.
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Affiliation(s)
- Mehar Sahu
- Molecular Neuroscience and Functional Genomics Laboratory, Delhi Technological University (Formerly Delhi College of Engineering), Delhi, India
| | - Rahul Tripathi
- Molecular Neuroscience and Functional Genomics Laboratory, Delhi Technological University (Formerly Delhi College of Engineering), Delhi, India
| | - Niraj Kumar Jha
- Department of Biotechnology, School of Engineering & Technology (SET) Sharda University, UP, India
| | - Saurabh Kumar Jha
- Department of Biotechnology, School of Engineering & Technology (SET) Sharda University, UP, India.
| | - Rashmi K Ambasta
- Molecular Neuroscience and Functional Genomics Laboratory, Delhi Technological University (Formerly Delhi College of Engineering), Delhi, India
| | - Pravir Kumar
- Molecular Neuroscience and Functional Genomics Laboratory, Delhi Technological University (Formerly Delhi College of Engineering), Delhi, India.
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Thapaliya K, Staines D, Marshall-Gradisnik S, Su J, Barnden L. Volumetric differences in hippocampal subfields and associations with clinical measures in myalgic encephalomyelitis/chronic fatigue syndrome. J Neurosci Res 2022; 100:1476-1486. [PMID: 35355311 PMCID: PMC9321967 DOI: 10.1002/jnr.25048] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Revised: 03/13/2022] [Accepted: 03/15/2022] [Indexed: 12/02/2022]
Abstract
Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) patients suffer from a cognitive and memory dysfunction. Because the hippocampus plays a key role in both cognition and memory, we tested for volumetric differences in the subfields of the hippocampus in ME/CFS. We estimated hippocampal subfield volumes for 25 ME/CFS patients who met Fukuda criteria only (ME/CFSFukuda), 18 ME/CFS patients who met the stricter ICC criteria (ME/CFSICC), and 25 healthy controls (HC). Group comparisons with HC detected extensive differences in subfield volumes in ME/CFSICC but not in ME/CFSFukuda. ME/CFSICC patients had significantly larger volume in the left subiculum head (p < 0.001), left presubiculum head (p = 0.0020), and left fimbria (p = 0.004). Correlations of hippocampus subfield volumes with clinical measures were stronger in ME/CFSICC than in ME/CFSFukuda patients. In ME/CFSFukuda patients, we detected positive correlations between fatigue and hippocampus subfield volumes and a negative correlation between sleep disturbance score and the right CA1 body volume. In ME/CFSICC patients, we detected a strong negative relationship between fatigue and left hippocampus tail volume. Strong negative relationships were also detected between pain and SF36 physical scores and two hippocampal subfield volumes (left: GC‐ML‐DG head and CA4 head). Our study demonstrated that volumetric differences in hippocampal subfields have strong statistical inference for patients meeting the ME/CFSICC case definition and confirms hippocampal involvement in the cognitive and memory problems of ME/CFSICC patients.
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Affiliation(s)
- Kiran Thapaliya
- National Centre for Neuroimmunology and Emerging Diseases, Menzies Health Institute Queensland, Griffith University, Gold Coast, QLD, Australia.,Centre for Advanced Imaging, The University of Queensland, Brisbane, QLD, Australia
| | - Donald Staines
- National Centre for Neuroimmunology and Emerging Diseases, Menzies Health Institute Queensland, Griffith University, Gold Coast, QLD, Australia
| | - Sonya Marshall-Gradisnik
- National Centre for Neuroimmunology and Emerging Diseases, Menzies Health Institute Queensland, Griffith University, Gold Coast, QLD, Australia
| | - Jiasheng Su
- National Centre for Neuroimmunology and Emerging Diseases, Menzies Health Institute Queensland, Griffith University, Gold Coast, QLD, Australia
| | - Leighton Barnden
- National Centre for Neuroimmunology and Emerging Diseases, Menzies Health Institute Queensland, Griffith University, Gold Coast, QLD, Australia
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Baril AA, Beiser AS, Sanchez E, Mysliwiec V, Redline S, Gottlieb DJ, O’Connor GT, Gonzales MM, Himali D, Seshadri S, Himali JJ, Pase MP. Insomnia symptom severity and cognitive performance: Moderating role of APOE genotype. Alzheimers Dement 2022; 18:408-421. [PMID: 34310026 PMCID: PMC8802306 DOI: 10.1002/alz.12405] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Revised: 04/13/2021] [Accepted: 05/12/2021] [Indexed: 11/11/2022]
Abstract
INTRODUCTION We evaluated whether insomnia symptom severity was associated with cognitive function, and whether this relationship was modified by biomarkers associated with Alzheimer's disease risk. METHODS We examined insomnia symptoms and neuropsychological performance 3.4 years later in 511 dementia-free Framingham Heart Study participants (62.65 ± 8.7 years, 50.9% male). Additionally, we explored insomnia symptoms combined with self-reported short habitual sleep duration and effect modification by apolipoprotein E (APOE) ε4 allele status. RESULTS More severe insomnia symptoms were associated with lower performance on global cognition, and immediate and delayed Logical Memory recall, especially when insomnia symptoms were combined with short sleep duration. The association between insomnia symptoms and poorer memory recall was more pronounced in APOE ε4 allele carriers. DISCUSSION Insomnia symptom severity was associated with worse subsequent global cognitive and memory performance, which was especially apparent in APOE ε4 allele carriers, suggesting that poor sleep might be particularly detrimental when the brain is already vulnerable to neurodegeneration.
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Affiliation(s)
- Andrée-Ann Baril
- The Framingham Heart Study, Framingham, Massachusetts, USA
- Department of Neurology, Boston University School of Medicine, Boston, Massachusetts, USA
| | - Alexa S. Beiser
- The Framingham Heart Study, Framingham, Massachusetts, USA
- Department of Neurology, Boston University School of Medicine, Boston, Massachusetts, USA
- Department of Biostatistics, Boston University School of Public Health, Boston, Massachusetts, USA
| | - Erlan Sanchez
- Centre for Advanced Research in Sleep Medicine, Hôpital du Sacré-Coeur de MontréalCIUSSS-NIM, Montreal, Québec, Canada
- Department of Neuroscience, Université de Montréal, Montreal, Québec, Canada
| | - Vincent Mysliwiec
- Glenn Biggs Institute for Alzheimer’s & Neurodegenerative DiseasesUniversity of Texas Health Sciences Center, San Antonio, Texas, USA
| | - Susan Redline
- Division of Sleep and Circadian Disorders, Brigham & Women’s Hospital, Boston, Massachusetts, USA
- Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA
- Division of Sleep Medicine, Harvard Medical School, Boston, Massachusetts, USA
| | - Daniel J. Gottlieb
- Division of Sleep and Circadian Disorders, Brigham & Women’s Hospital, Boston, Massachusetts, USA
- Division of Sleep Medicine, Harvard Medical School, Boston, Massachusetts, USA
- VA Boston Healthcare System, Boston, Massachusetts, USA
| | - George T. O’Connor
- The Framingham Heart Study, Framingham, Massachusetts, USA
- Department of Medicine, Boston University School of Medicine, Boston, Massachusetts, USA
| | - Mitzi M. Gonzales
- Glenn Biggs Institute for Alzheimer’s & Neurodegenerative DiseasesUniversity of Texas Health Sciences Center, San Antonio, Texas, USA
| | - Dibya Himali
- The Framingham Heart Study, Framingham, Massachusetts, USA
| | - Sudha Seshadri
- The Framingham Heart Study, Framingham, Massachusetts, USA
- Department of Neurology, Boston University School of Medicine, Boston, Massachusetts, USA
- Glenn Biggs Institute for Alzheimer’s & Neurodegenerative DiseasesUniversity of Texas Health Sciences Center, San Antonio, Texas, USA
| | - Jayandra J. Himali
- The Framingham Heart Study, Framingham, Massachusetts, USA
- Department of Neurology, Boston University School of Medicine, Boston, Massachusetts, USA
- Department of Biostatistics, Boston University School of Public Health, Boston, Massachusetts, USA
- Glenn Biggs Institute for Alzheimer’s & Neurodegenerative DiseasesUniversity of Texas Health Sciences Center, San Antonio, Texas, USA
- Department of Population Health Sciences, University of Texas Health Science Center, San Antonio, Texas, USA
| | - Matthew P. Pase
- The Framingham Heart Study, Framingham, Massachusetts, USA
- School of Psychological Sciences, Turner Institute for Brain and Mental Health Monash University, Clayton, VIC, Australia
- Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
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Wang Q, Zhu H, Dai R, Zhang T. Associations Between Total Sleep Duration and Cognitive Function Among Middle-Aged and Older Chinese Adults: Does Midday Napping Have an Effect on It? Int J Gen Med 2022; 15:1381-1391. [PMID: 35173475 PMCID: PMC8843353 DOI: 10.2147/ijgm.s343286] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Accepted: 01/10/2022] [Indexed: 11/23/2022] Open
Abstract
Aim The effect of sleep duration on cognitive function has been reported. However, the studies about the combined effects of total sleep duration and midday napping on cognition in elders were limited and inconclusive. We aimed to investigate the associations between total sleep duration, midday napping and cognitive function among middle-aged and older Chinese adults. Methods Based on the 3rd wave of the China Health and Retirement Longitudinal Study (CHARLS) in 2015, a total of 9218 participants aged ≥45 years with completed cognition measurements were included. Cognitive functions were assessed by a combined global cognition score of episodic memory and mental status. Information about sleep-related variables, demographic characteristics, and health status were collected by validated questionnaires. Multivariate linear regression models were performed to evaluate the associations between total sleep duration, midday napping, and cognitive function. Stratified analyses were used to explore the potential effect modifier. Results Overall, the global cognition score was 10.38 ± 4.30 among the participants (mean age: 61.5 ± 8.7 years). For sleep duration, both short sleep and long sleep duration were significantly associated with the increased risk of cognitive impairment after controlling for demographics and other confounders. Compared with sleeping for 7h per day, the adjusted β-coefficient and 95% CI of the risk of cognitive impairment was −0.967 (95% CIs: −1.191, −0.742) for ≤5h, −0.257 (−0.498, −0.016) for 6h, −0.424 (−0.650, −0.198) for 8h and −0.664 (−0.876, −0.452) for ≥9h. The combined effect analysis indicated that subjects with extended or without naps had a significantly higher risk of cognitive impairment in the ≤5h sleep time group (ref: 7h) and in extended nappers or without naps group (ref: short nappers). Subjects with extended naps or without naps might increase the risk of cognitive impairment, especially those having ≤5h total sleep time. Stratified analysis showed that participants aged ≥60 years without social activity increased the risk of cognitive decline. Conclusion An inverted U-shaped association was observed between total sleep duration and cognitive function in Chinese elders, especially in those aged ≥60 years or without social activity. Short midday naps could mitigate the deleterious effects of poor sleep quality and shorter sleep duration on cognitive function. The findings could help us identify the vulnerable population and decrease the burden of cognitive impairment.
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Affiliation(s)
- Qian Wang
- School of Public Health, Fudan University, Shanghai, 200032, People’s Republic of China
- Key Laboratory of Public Health Safety of the Ministry of Education and Key Laboratory of Health Technology Assessment of the Ministry of Health, Fudan University, Shanghai, 200032, People’s Republic of China
| | - Huanhuan Zhu
- School of Public Health, Fudan University, Shanghai, 200032, People’s Republic of China
| | - Ruiming Dai
- School of Public Health, Fudan University, Shanghai, 200032, People’s Republic of China
| | - Tiantian Zhang
- School of Public Health, Fudan University, Shanghai, 200032, People’s Republic of China
- Correspondence: Tiantian Zhang, School of Public Health, Fudan University, 130 Dong’an Road, Xuhui District, Shanghai, 200032, People’s Republic of China, Email
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Yang L, Yu S, Zhang L, Peng W, Hu Y, Feng F, Yang J. Gender Differences in Hippocampal/Parahippocampal Functional Connectivity Network in Patients Diagnosed with Chronic Insomnia Disorder. Nat Sci Sleep 2022; 14:1175-1186. [PMID: 35761887 PMCID: PMC9233514 DOI: 10.2147/nss.s355922] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/26/2021] [Accepted: 05/31/2022] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Gender differences in hippocampal and parahippocampal gyrus (HIP/PHG) volumes have been reported in sleep disorders. Therefore, this study investigated the moderating effect of gender on the relationship between chronic insomnia disorder (CID) and the HIP/PHG functional connectivity (FC) network. METHODS For this study, 110 patients diagnosed with CID (43 men and 67 women) and 60 matched good sleep control (GSC) (22 men and 38 women) were recruited. These participants underwent resting-state functional magnetic resonance imaging scans, after which a 2 × 2 (diagnosis × gender) analysis of variance was used to detect the main and interactive effect of insomnia and gender on their HIP/PHG FC networks. RESULTS Although the main effect of insomnia on the HIP FC network was observed in the bilateral cerebellar tonsil, superior frontal gyrus, and the medial orbitofrontal cortex, effects on the PHG FC network were observed in the bilateral HIP and amygdala. In contrast, the main effect of gender on the HIP FC network was observed in the right cerebellum posterior lobe, the dorsolateral prefrontal cortex (DLPFC), and the supplemental motor area. Of note, the interactive effect of both insomnia and gender was observed in FCs between the right HIP and the dorsal anterior cingulate cortex, and then between the right PHG and DLPFC. Moreover, the FC between the right PHG and left DLPFC was positively associated with anxiety scores in the female patients with CID. CONCLUSION Our study identified that gender differences in brain connectivity existed between the HIP/PHG and executive control network in patients diagnosed with CID, these results will eventually extend our understanding of the important role that gender plays in the pathophysiology of CID.
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Affiliation(s)
- Lili Yang
- Department of Acupuncture & Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, 610075, People's Republic of China
| | - Siyi Yu
- Department of Acupuncture & Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, 610075, People's Republic of China.,Acupuncture and Brain Science Research Center, Chengdu University of Traditional Chinese Medicine, Chengdu, 610075, People's Republic of China
| | - Leixiao Zhang
- Department of Integrated Traditional and Western Medicine, West China Hospital, Sichuan University, Chengdu, 610041, People's Republic of China
| | - Wei Peng
- Department of Acupuncture & Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, 610075, People's Republic of China
| | - Youping Hu
- Department of Acupuncture & Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, 610075, People's Republic of China
| | - Fen Feng
- Affiliated Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, 610072, People's Republic of China
| | - Jie Yang
- Department of Acupuncture & Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, 610075, People's Republic of China
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Guan C, Cheng Z, Xie F, Wang R, Zhang J, Yao F, Fang M. Efficacy of abdomen-rubbing qigong exercise for chronic insomnia: study protocol for a randomized controlled trial. Trials 2021; 22:774. [PMID: 34742345 PMCID: PMC8571850 DOI: 10.1186/s13063-021-05528-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Accepted: 08/09/2021] [Indexed: 12/29/2022] Open
Abstract
Background Insomnia is a common sleeping disorder which affects the quality of life which can bring harms to physical and mental health of human beings and even economic development. Traditional Chinese medicine (TCM) plays an outstanding role in treating chronic diseases and alleviating their symptoms. Therefore, the purpose of this study is to assess the treatment efficacy in patients with insomnia treated with abdomen-rubbing qigong exercise (ARQE). In addition, the brain function changes of patients will be explored by resting state functional magnetic resonance imaging (rs-fMRI). Method/design This trial is a randomized, single-blind, controlled study planned to transpire between July 1, 2020, and July 31, 2021. A sample size of 114 participants (57 per group) with chronic insomnia will be randomly assigned to receive ARQE or CBTI for 8 weeks. The study duration will be 13 weeks, including a 1-week screening period, 8 weeks of intervention, and another 4 weeks of follow-up. The primary outcome is the Pittsburgh sleep quality index scores. Secondary outcomes include insomnia severity index, gastrointestinal symptom rating scale, the Hamilton Depression Scale, and rs-fMRI scan. The adverse events will be in control. Discussion The results of this study will help to clarify the efficacy of ARQE in the treatment of insomnia and try to use rs-fMRI technology to explore the brain function changes of ARQE in improving sleep quality in patients with insomnia disorder. If the results are as expected, this study will provide high-quality evidence for the treatment of insomnia with ARQE. Trial registration China Clinical Registration Agency ChiCTR1900028009. Registered on 19 December 2019.
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Affiliation(s)
- Chong Guan
- Shanghai University of Traditional Chinese Medicine, Shanghai, 201203, China
| | - Ziji Cheng
- Shanghai University of Traditional Chinese Medicine, Shanghai, 201203, China
| | - Fangfang Xie
- Shanghai University of Traditional Chinese Medicine, Shanghai, 201203, China
| | - Ruiping Wang
- Shanghai Skin Disease Hospital, Shanghai, 200050, China
| | - Jing Zhang
- Shanghai University of Traditional Chinese Medicine, Shanghai, 201203, China
| | - Fei Yao
- Shanghai University of Traditional Chinese Medicine, Shanghai, 201203, China.
| | - Min Fang
- Shanghai University of Traditional Chinese Medicine, Shanghai, 201203, China. .,Institute of Tuina, Shanghai Institute of Traditional Chinese Medicine, Shanghai, 200437, China.
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Piber D. The role of sleep disturbance and inflammation for spatial memory. Brain Behav Immun Health 2021; 17:100333. [PMID: 34589818 PMCID: PMC8474561 DOI: 10.1016/j.bbih.2021.100333] [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: 03/26/2021] [Revised: 08/19/2021] [Accepted: 08/20/2021] [Indexed: 11/09/2022] Open
Abstract
Spatial memory is a brain function involved in multiple behaviors such as planning a route or recalling an object's location. The formation of spatial memory relies on the homeostasis of various biological systems, including healthy sleep and a well-functioning immune system. While sleep is thought to promote the stabilization and storage of spatial memories, considerable evidence shows that the immune system modulates neuronal processes underlying spatial memory such as hippocampal neuroplasticity, long-term potentiation, and neurogenesis. Conversely, when sleep is disturbed and/or states of heightened immune activation occur, hippocampal regulatory pathways are altered, which - on a behavioral level - may result in spatial memory impairments. In this Brief Review, I summarize how sleep and the immune system contribute to spatial memory processes. In addition, I present emerging evidence suggesting that sleep disturbance and inflammation might jointly impair spatial memory. Finally, potentials of integrated strategies that target sleep disturbance and inflammation to possibly mitigate risk for spatial memory impairment are discussed.
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Affiliation(s)
- Dominique Piber
- Department of Psychiatry, Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Hindenburgdamm 30, 12203, Berlin, Germany
- Berlin Institute of Health (BIH), Berlin, Germany
- Cousins Center for Psychoneuroimmunology, Semel Institute for Neuroscience and Human Behavior, Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California Los Angeles (UCLA), Los Angeles, USA
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Lee S, Kim TD, Kim RY, Joo Y, Chung YA, Lim SM, Lyoo IK, Kim J, Yoon S. Hippocampal subregional alterations and verbal fluency in the early stage of type 2 diabetes mellitus. Eur J Neurosci 2021; 54:7550-7559. [PMID: 34687097 DOI: 10.1111/ejn.15505] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Revised: 10/16/2021] [Accepted: 10/21/2021] [Indexed: 11/30/2022]
Abstract
Growing evidence indicates that type 2 diabetes mellitus (T2DM)-related cognitive dysfunction may develop in the early stage of the disease and is often accompanied by hippocampal structural alterations. In the current study, we investigated volume and shape alterations of the hippocampus at a subregional level in patients with T2DM. With the use of high-resolution brain structural images that were obtained from 30 T2DM patients with less than 5 years of disease duration and 30 healthy individuals, volumetric and shape analyses were performed. We also assessed the relationship between T2DM-related hippocampal structural alterations and performance on verbal fluency. In volumetric analysis, total hippocampal volume was smaller in the T2DM group, relative to the control group. At a subregional level, T2DM patients showed significant inward deformation and volume reduction of the right dentate gyrus and cornu ammonis 2/3 subregions as compared with healthy individuals. In particular, T2DM patients with lower performance on verbal fluency had smaller right dentate gyrus volumes relative to those with higher performance. These findings suggest that the hippocampus may undergo atrophy at a subregional level even in the early stage of T2DM, and this subregion-specific atrophy may be associated with reduced performance on verbal fluency.
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Affiliation(s)
- Suji Lee
- Ewha Brain Institute, Ewha Womans University, Seoul, South Korea
| | - Tammy D Kim
- Ewha Brain Institute, Ewha Womans University, Seoul, South Korea
| | - Rye Young Kim
- Ewha Brain Institute, Ewha Womans University, Seoul, South Korea.,Graduate School of Pharmaceutical Sciences, Ewha Womans University, Seoul, South Korea
| | - Yoonji Joo
- Ewha Brain Institute, Ewha Womans University, Seoul, South Korea.,Graduate School of Pharmaceutical Sciences, Ewha Womans University, Seoul, South Korea
| | - Yong-An Chung
- Department of Radiology, Incheon St. Mary's Hospital, The Catholic University of Korea College of Medicine, Incheon, South Korea
| | - Soo Mee Lim
- Department of Radiology, College of Medicine, Ewha Womans University, Seoul, South Korea
| | - In Kyoon Lyoo
- Ewha Brain Institute, Ewha Womans University, Seoul, South Korea.,Graduate School of Pharmaceutical Sciences, Ewha Womans University, Seoul, South Korea.,Department of Brain and Cognitive Sciences, Ewha Womans University, Seoul, South Korea.,The Brain Institute and Department of Psychiatry, University of Utah, Salt Lake City, Utah, USA
| | - Jungyoon Kim
- Ewha Brain Institute, Ewha Womans University, Seoul, South Korea.,Department of Brain and Cognitive Sciences, Ewha Womans University, Seoul, South Korea
| | - Sujung Yoon
- Ewha Brain Institute, Ewha Womans University, Seoul, South Korea.,Department of Brain and Cognitive Sciences, Ewha Womans University, Seoul, South Korea
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Won J, Alfini AJ, Smith JC. Cardiovascular Endurance Modifies the Link between Subjective Sleep Quality and Entorhinal Cortex Thickness in Younger Adults. Med Sci Sports Exerc 2021; 53:2131-2139. [PMID: 33988545 PMCID: PMC8440339 DOI: 10.1249/mss.0000000000002697] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
INTRODUCTION Poor sleep is linked to impaired cognitive function, cortical brain atrophy, and lower cortical thickness. Independently, higher cardiovascular endurance has neuroprotective effects. It remains in question, however, whether cardiovascular endurance moderates the relationship between sleep and brain health. The aims of this study included the following: 1) the association between subjective sleep quality and cognitive performance, hippocampus volume, and entorhinal cortex (EC) thickness, and 2) the moderating effects of cardiovascular endurance on the associations of sleep quality with cognitive and magnetic resonance imaging measures in healthy younger adults. METHODS A total of 1095 younger adults (28.8 ± 3.6 yr) from the Human Connectome Project were included in the analyses. The 2-min walk test was used as a proxy of cardiovascular endurance. Self-reported sleep quality was measured using the Pittsburgh Sleep Quality Index. Composite cognitive tests were used to assess global cognition, and T1-weighted structural magnetic resonance imaging data (obtained using Siemens 3T scanner) was used to assess hippocampus volume and EC thickness. Linear regression was used to examine the moderating effects of fitness on the relationships between sleep and each of these neurocognitive outcomes after controlling for age, sex, and education year. RESULTS Poorer sleep quality was associated with both a lower crystalized intelligence score (B = -0.198, P = 0.034) and lower EC thickness (B = -0.013, P = 0.003). With greater 2-min walk test score, the association between greater Pittsburgh Sleep Quality Index score and lower EC thickness was attenuated (B = 0.0008, P = 0.028). CONCLUSIONS Higher cardiovascular endurance may mitigate the relationship between poorer subjective sleep quality and lower EC thickness. Future longitudinal studies should examine the interactive effects of sleep and fitness on brain health among older and more vulnerable populations.
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Affiliation(s)
- Junyeon Won
- Department of Kinesiology, University of Maryland, College Park, MD
| | - Alfonso J. Alfini
- Department of Neurology, Johns Hopkins School of Medicine, Baltimore, MD
| | - J. Carson Smith
- Department of Kinesiology, University of Maryland, College Park, MD
- Program in Neuroscience and Cognitive Science, University of Maryland, College Park, MD
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De Looze C, Feeney JC, Scarlett S, Hirst R, Knight SP, Carey D, Meaney JF, Kenny RA. Sleep duration, sleep problems and perceived stress are associated with hippocampal subfield volumes in later life: Findings from The Irish Longitudinal Study on Ageing (TILDA). Sleep 2021; 45:6374891. [PMID: 34558630 DOI: 10.1093/sleep/zsab241] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Revised: 09/15/2021] [Indexed: 02/07/2023] Open
Abstract
STUDY OBJECTIVES This study examines the cross-sectional and two-year follow-up relationships between sleep and stress and total hippocampal volume and hippocampal subfield volumes among older adults. METHODS 417 adults (aged 68.8±7.3; 54% women) from the Irish Longitudinal Study on Ageing completed an interview, a questionnaire and multiparametric brain MRI. The relationships between self-reported sleep duration, sleep problems, perceived stress and total hippocampal volume were examined by using ordinary least squares regressions. Linear mixed-effects models were used to investigate the relationships between sleep duration, sleep problems, perceived stress, changes in these measures over two-years and hippocampal subfield volumes. RESULTS No cross-sectional and follow-up associations between sleep and total hippocampal volume and between stress and total hippocampal volume were found. By contrast, Long sleep (≥9-10 hours / night) was associated with smaller volumes of molecular layer, hippocampal tail, presubiculum and subiculum. The co-occurrence of Short sleep (≤6 hours) and perceived stress was associated with smaller cornu ammonis 1, molecular layer, subiculum and tail. Sleep problems independently and in conjunction with higher stress, and increase in sleep problems over 2 years were associated with smaller volumes of these same subfields. CONCLUSION Our study highlights the importance of concurrently assessing sub-optimal sleep and stress for phenotyping individuals at risk of hippocampal subfield atrophy.
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Affiliation(s)
- Céline De Looze
- The Irish Longitudinal Study on Ageing, Trinity College Dublin, Ireland
| | - Joanne C Feeney
- The Irish Longitudinal Study on Ageing, Trinity College Dublin, Ireland
| | - Siobhan Scarlett
- The Irish Longitudinal Study on Ageing, Trinity College Dublin, Ireland
| | - Rebecca Hirst
- The Irish Longitudinal Study on Ageing, Trinity College Dublin, Ireland
| | - Silvin P Knight
- The Irish Longitudinal Study on Ageing, Trinity College Dublin, Ireland
| | - Daniel Carey
- The Irish Longitudinal Study on Ageing, Trinity College Dublin, Ireland
| | - James F Meaney
- The National Centre for Advanced Medical Imaging (CAMI), St. James's Hospital, Dublin, Ireland
| | - Rose Anne Kenny
- The Irish Longitudinal Study on Ageing, Trinity College Dublin, Ireland.,Mercer's Institute for Successful Ageing (MISA), St James's Hospital, Dublin, Ireland
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Abstract
To date, our understanding of the role of abnormal hippocampal volume in imaging studies of insomnia disorders (ID) has remained in apparent contradiction. Given that hippocampal function can be mapped to anatomically defined substructures, the hippocampal substructure volume can be examined in detail at present. In this study, we examined the volumes of hippocampal substructures between IDs and healthy controls (HC) to accurately find hippocampal markers of ID. First, we used the automated hippocampal substructure module in FreeSurfer6.0 to inspect T1-weighted magnetic resonance images between 22 IDs and 30 HC. Then, 12 hippocampal substructures were computed. Volumetric assessment was performed at the hippocampal substructure level between groups. Our study revealed significant reduced volume of the bilateral fimbria in IDs compared with HC (p < 0.05/12, Bonferroni corrected), although there was no difference in the total volume of hippocampus. In addition, the correlation analysis showed that the total hippocampal volume of the left hemisphere was negatively correlated with Pittsburgh Sleep Quality Index (PSQI) scores. With regard to hippocampal substructure results, negative correlations were detected between bilateral fimbria volume and clinical variables (i.e., PSQI, SDS, and SAS) in all subjects. Taken together, we revealed marked differences in the volume of the hippocampal substructure between IDs and HC, which provided a more accurate structural imaging marker for the pathological of ID.
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46
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Wang X, Hua D, Tang X, Li S, Sun R, Xie Z, Zhou Z, Zhao Y, Wang J, Li S, Luo A. The Role of Perioperative Sleep Disturbance in Postoperative Neurocognitive Disorders. Nat Sci Sleep 2021; 13:1395-1410. [PMID: 34393534 PMCID: PMC8354730 DOI: 10.2147/nss.s320745] [Citation(s) in RCA: 45] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Accepted: 07/21/2021] [Indexed: 12/19/2022] Open
Abstract
Postoperative neurocognitive disorder (PND) increases the length of hospital stay, mortality, and risk of long-term cognitive impairment. Perioperative sleep disturbance is prevalent and commonly ignored and may increase the risk of PND. However, the role of perioperative sleep disturbances in PND remains unclear. Nocturnal sleep plays an indispensable role in learning, memory, and maintenance of cerebral microenvironmental homeostasis. Hospitalized sleep disturbances also increase the incidence of postoperative delirium and cognitive dysfunction. This review summarizes the role of perioperative sleep disturbances in PND and elucidates the potential mechanisms underlying sleep-deprivation-mediated PND. Activated neuroinflammation and oxidative stress; impaired function of the blood-brain barrier and glymphatic pathway; decreased hippocampal brain-derived neurotrophic factor, adult neurogenesis, and sirtuin1 expression; and accumulated amyloid-beta proteins are associated with PND in individuals with perioperative sleep disorders. These findings suggest that the improvement of perioperative sleep might reduce the incidence of postoperative delirium and postoperative cognitive dysfunction. Future studies should further investigate the role of perioperative sleep disturbance in PND.
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Affiliation(s)
- Xuan Wang
- Department of Anesthesiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, Hubei, People’s Republic of China
| | - Dongyu Hua
- Department of Anesthesiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, Hubei, People’s Republic of China
| | - Xiaole Tang
- Department of Anesthesiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, Hubei, People’s Republic of China
| | - Shan Li
- Department of Anesthesiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, Hubei, People’s Republic of China
| | - Rao Sun
- Department of Anesthesiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, Hubei, People’s Republic of China
| | - Zheng Xie
- Department of Anesthesiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, Hubei, People’s Republic of China
| | - Zhiqiang Zhou
- Department of Anesthesiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, Hubei, People’s Republic of China
| | - Yilin Zhao
- Department of Anesthesiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, Hubei, People’s Republic of China
| | - Jintao Wang
- Department of Anesthesiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, Hubei, People’s Republic of China
| | - Shiyong Li
- Department of Anesthesiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, Hubei, People’s Republic of China
| | - Ailin Luo
- Department of Anesthesiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, Hubei, People’s Republic of China
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47
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Liu C, Lee SH, Hernandez-Cardenache R, Loewenstein D, Kather J, Alperin N. Poor sleep is associated with small hippocampal subfields in cognitively normal elderly individuals. J Sleep Res 2021; 30:e13362. [PMID: 33949039 DOI: 10.1111/jsr.13362] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Revised: 03/21/2021] [Accepted: 04/05/2021] [Indexed: 11/30/2022]
Abstract
Recent studies demonstrated reduced hippocampal volumes in elderly healthy individuals who are cognitively normal but poor sleepers. The association between sleep quality and the pattern of volume loss across hippocampal subfields (HSs) is not well known. Thus, it is the focus of the present study. Sleep quality was self-assessed using the Pittsburgh Sleep Quality Index (PSQI). The HS volumes were measured using sub-millimetre in-plane resolution T2-weighted magnetic resonance imaging data. A total of 67 cognitively normal elderly individuals aged 60-83 years were classified into 30 normal sleepers with a PSQI <5 and 37 poor sleepers with a PSQI ≥5. The two groups were equivalent in age, gender distribution, ethnicity, education attainment, handedness and cognitive performance. Compared to normal sleepers, poor sleepers exhibited significantly lower normalised volumes in the left cornu ammonis field 1 (CA1), dentate gyrus (DG) and subiculum. In contrast, there were no significant differences in normalised grey and white matter volumes between the two groups. The global PSQI was negatively associated with the normalised volumes of the left CA1, DG and subiculum. Sleep duration was associated with the normalised volumes of the bilateral CA1, DG, left CA2 and subiculum. Verbal memory scores were associated with the left CA1 volume. In conclusion, poor sleep quality, especially insufficient sleep duration, was associated with volume loss in several HSs that are involved in specific learning and memory tasks. As the hippocampus does not regulate sleep, it is more likely that poor sleep leads to small hippocampi. Thus, based on this assumption, improving sleep quality of poor sleeper elderly individuals could benefit hippocampal health.
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Affiliation(s)
- Che Liu
- Department of Radiology, University of Miami Miller School of Medicine, Miami, FL, USA.,Department of Biomedical Engineering, University of Miami, Coral Gables, FL, USA
| | - Sang H Lee
- Department of Radiology, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Rene Hernandez-Cardenache
- Department of Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine, Miami, FL, USA
| | - David Loewenstein
- Department of Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Josefina Kather
- Department of Neurology, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Noam Alperin
- Department of Radiology, University of Miami Miller School of Medicine, Miami, FL, USA.,Department of Biomedical Engineering, University of Miami, Coral Gables, FL, USA
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48
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Decreased modulation of segregated SEEKING and selective attention systems in chronic insomnia. Brain Imaging Behav 2021; 15:430-443. [PMID: 32367486 DOI: 10.1007/s11682-020-00271-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Sleep-related attentional bias and instinctual craving-sleep status may be associated with value-driven selective attention network and SEEKING system. We hypothesized that the two networks might be important components and underlie etiology of inability to initiate or/and maintain sleep in patients with chronic insomnia (PIs). Our aim is to investigate whether frequency-frequency couplings(temporal and spatial coupling, and differences of a set of imaging parameters) could elevate the sensibility to characterize the two insomnia-related networks in studying their relationships with sleep parameters and post-insomnia emotions. Forty-eight PIs and 48 status-matched good sleepers were requested to complete sleep and emotion-related questionnaires. Receiver operating characteristic curve was used to calculate the discriminatory power of a set of parameters. Granger causality and mediating causality analysis were used to address the causal relationships between the two networks and sleep/emotion-related parameters. Frequency-frequency couplings could characterize the two networks with high discriminatory power (AUC, 0.951; sensitivity, 87.5%; specificity, 95.8%), which suggested that the frequency-frequency couplings could be served as a useful biomarker to address the insomnia-related brain networks. Functional deficits of the SEEKING system played decreased mediator acting in post-insomnia negative emotions (decreased frequency-frequency coupling). Functional hyperarousal of the value-driven attention network played decreased mediator acting in sleep regulation (increased frequency-frequency coupling). Granger causality analysis showed decreased causal effect connectivity between and within the two networks. The between-network causal effect connectivity segregation played decreased mediator acting in sleep regulation (decreased connectivity). These findings suggest that the functional deficits and segregation of the two systems may underlie etiology of PIs.
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49
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Gong L, Yu S, Xu R, Liu D, Dai X, Wang Z, Hu Y, Yan B, Kui Y, Zhang B, Feng F. The abnormal reward network associated with insomnia severity and depression in chronic insomnia disorder. Brain Imaging Behav 2021; 15:1033-1042. [PMID: 32710331 DOI: 10.1007/s11682-020-00310-w] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Previous research has shown that acute sleep deprivation can influence the reward networks. However, it is unclear whether and how the intrinsic reward network is altered in chronic insomnia disorder (CID). In the present study, we aimed to investigate whether the reward network is altered in patients with CID using resting-state functional magnetic resonance imaging (fMRI) data. Forty-two patients with CID and 33 healthy controls (HCs) were enrolled and underwent resting-state fMRI. Nucleus accumbens (NAc) - based functional connectivity (NAFC) was evaluated to explore the differences in the reward network between the CID and HC groups. Pearson correlation analysis was used to evaluate the clinical significance of altered NAFC networks. Compared to those in the HC group, increased NAFC was found in the salience and limbic networks, while decreased NAFC was found in the default mode network (DMN) and within the reward circuit in patients with CID. In addition, decreased FC between the NAc and DMN was associated with insomnia severity, while NAFC within the reward network was associated with depression symptoms in patients with CID. These findings showed that the reward network is dysfunctional and associated with depression symptom in patients with CID. Future studies of CID should consider both insomnia and depression symptoms to disentangle the role of insomnia and depression in the relationship under study.
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Affiliation(s)
- Liang Gong
- Department of Neurology, Chengdu Second People's Hospital, Chengdu, 610017, Sichuan, China
| | - Siyi Yu
- Department of Acupuncture & Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu, 610075, Sichuan, China
| | - Ronghua Xu
- Department of Neurology, Chengdu Second People's Hospital, Chengdu, 610017, Sichuan, China
| | - Duan Liu
- Department of Neurology, Chengdu Second People's Hospital, Chengdu, 610017, Sichuan, China
| | - Xijian Dai
- Department of Medical Imaging, Jinling Hospital, Medical School of Nanjing University, Nanjing, 210002, Jiangsu, China
| | - Zhengyan Wang
- Department of Pain Management, Sichuan Integrative Medicine, Sichuan, 610041, Chengdu, China
| | - Youping Hu
- Department of Acupuncture & Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu, 610075, Sichuan, China
| | - Bohua Yan
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, 610072, Sichuan, China
| | - Yu Kui
- The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, 510120, Guangdong, China
| | - Bei Zhang
- Department of Neurology, Chengdu Second People's Hospital, Chengdu, 610017, Sichuan, China
| | - Fen Feng
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, 610072, Sichuan, China.
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50
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Convergent and divergent functional connectivityalterations of hippocampal subregions between short-term and chronic insomnia disorder. Brain Imaging Behav 2021; 15:986-995. [PMID: 32720181 DOI: 10.1007/s11682-020-00306-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Insomnia disorder (ID) is reclassified into short-term and chronic subtypes based on recent etiological advances, however, neural mechanisms underlying the subtypes are rarely examined. In this study, we investigated gray matter volume and resting-state functional connectivity (RSFC) alterations of hippocampal subregions in short-term and chronic ID using multimodal MRI. We found convergent and divergent alterations between both ID groups in specific hippocampal subregions [right cornu ammonis 1 (CA1), subicular complex (Subc), and caudal hippocampus, (cHipp)] with prefrontal cortex [bilateral medial prefrontal cortex (MPFC), and right middle frontal gyrus] and limbic/paralimbic regions (bilateral middle cingulate cortex and left parahippocampal gyrus). Intriguingly, the RSFC of the right CA1/cHipp, particularly the intersection between these two subregions, with bilateral MPFC exhibited gradual increases from healthy controls to short-term ID and from short-term ID to chronic ID. Moreover, a negative correlation between the right CA1-left parahippocampal gyrus RSFC and Epworth Sleepiness Scale scores, and a positive correlation between the right CA1-bilateral MPFC RSFC and Insomnia Severity Index scores were found in the chronic ID group (P < 0.05). Our findings suggest convergent and divergent RSFC alterations of specific hippocampal subregions with the prefrontal cortex and limbic/paralimbic regions between short-term and chronic ID. These findings suggest that the hippocampus is a key node in establishing diagnostic and categorical biomarkers in ID and developing more effective treatment strategies.
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