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McMorris T, Hale BJ, Pine BS, Williams TB. Creatine supplementation research fails to support the theoretical basis for an effect on cognition: Evidence from a systematic review. Behav Brain Res 2024; 466:114982. [PMID: 38582412 DOI: 10.1016/j.bbr.2024.114982] [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: 09/24/2023] [Revised: 02/15/2024] [Accepted: 04/02/2024] [Indexed: 04/08/2024]
Abstract
Creatine supplementation has been put forward as a possible aid to cognition, particularly for vegans, vegetarians, the elderly, sleep deprived and hypoxic individuals. However, previous narrative reviews have only provided limited support for these claims. This is despite the fact that research has shown that creatine supplementation can induce increased brain concentrations of creatine, albeit to a limited extent. We carried out a systematic review to examine the current state of affairs. The review supported claims that creatine supplementation can increases brain creatine content but also demonstrated somewhat equivocal results for effects on cognition. It does, however, provide evidence to suggest that more research is required with stressed populations, as supplementation does appear to significantly affect brain content. Issues with research design, especially supplementation regimens, need to be addressed. Future research must include measurements of creatine brain content.
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Affiliation(s)
- Terry McMorris
- Institue of Sport, Nursing and Allied Health, University of Chichester, College Lane, Chichester PO19 6PE, United Kingdom; Department of Sport and Exercise Science, University of Portsmouth, Spinnaker Building, Cambridge Road, Portsmouth PO12ER, United Kingdom.
| | - Beverley J Hale
- Institue of Sport, Nursing and Allied Health, University of Chichester, College Lane, Chichester PO19 6PE, United Kingdom
| | - Beatrice S Pine
- Institue of Sport, Nursing and Allied Health, University of Chichester, College Lane, Chichester PO19 6PE, United Kingdom
| | - Thomas B Williams
- Department of Sport and Exercise Science, University of Portsmouth, Spinnaker Building, Cambridge Road, Portsmouth PO12ER, United Kingdom
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2
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Gordji-Nejad A, Matusch A, Kleedörfer S, Jayeshkumar Patel H, Drzezga A, Elmenhorst D, Binkofski F, Bauer A. Single dose creatine improves cognitive performance and induces changes in cerebral high energy phosphates during sleep deprivation. Sci Rep 2024; 14:4937. [PMID: 38418482 PMCID: PMC10902318 DOI: 10.1038/s41598-024-54249-9] [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: 11/22/2023] [Accepted: 02/10/2024] [Indexed: 03/01/2024] Open
Abstract
The inverse effects of creatine supplementation and sleep deprivation on high energy phosphates, neural creatine, and cognitive performances suggest that creatine is a suitable candidate for reducing the negative effects of sleep deprivation. With this, the main obstacle is the limited exogenous uptake by the central nervous system (CNS), making creatine only effective over a long-term diet of weeks. Thus far, only repeated dosing of creatine over weeks has been studied, yielding detectable changes in CNS levels. Based on the hypothesis that a high extracellular creatine availability and increased intracellular energy consumption will temporarily increase the central creatine uptake, subjects were orally administered a high single dose of creatinemonohydrate (0.35 g/kg) while performing cognitive tests during sleep deprivation. Two consecutive 31P-MRS scans, 1H-MRS, and cognitive tests were performed each at evening baseline, 3, 5.5, and 7.5 h after single dose creatine (0.35 g/kg) or placebo during sub-total 21 h sleep deprivation (SD). Our results show that creatine induces changes in PCr/Pi, ATP, tCr/tNAA, prevents a drop in pH level, and improves cognitive performance and processing speed. These outcomes suggest that a high single dose of creatine can partially reverse metabolic alterations and fatigue-related cognitive deterioration.
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Affiliation(s)
- Ali Gordji-Nejad
- Institute of Neuroscience and Medicine (INM-2), Molecular Organization of the Brain, Forschungszentrum Jülich, 52425, Jülich, Germany.
| | - Andreas Matusch
- Institute of Neuroscience and Medicine (INM-2), Molecular Organization of the Brain, Forschungszentrum Jülich, 52425, Jülich, Germany
| | - Sophie Kleedörfer
- Division of Clinical Cognitive Sciences, Department of Neurology, RWTH Aachen University Hospital, 52074, Aachen, Germany
| | - Harshal Jayeshkumar Patel
- Division of Clinical Cognitive Sciences, Department of Neurology, RWTH Aachen University Hospital, 52074, Aachen, Germany
| | - Alexander Drzezga
- Institute of Neuroscience and Medicine (INM-2), Molecular Organization of the Brain, Forschungszentrum Jülich, 52425, Jülich, Germany
- Department of Nuclear Medicine, Faculty of Medicine and University Hospital Cologne, University of Cologne, 50937, Cologne, Germany
- German Center for Neurodegenerative Diseases (DZNE), Bonn-Cologne, Germany
| | - David Elmenhorst
- Institute of Neuroscience and Medicine (INM-2), Molecular Organization of the Brain, Forschungszentrum Jülich, 52425, Jülich, Germany
- Department of Nuclear Medicine, Faculty of Medicine and University Hospital Cologne, University of Cologne, 50937, Cologne, Germany
| | - Ferdinand Binkofski
- Division of Clinical Cognitive Sciences, Department of Neurology, RWTH Aachen University Hospital, 52074, Aachen, Germany
- Institute of Neuroscience and Medicine (INM-4), Forschungszentrum Jülich, Jülich, Germany
| | - Andreas Bauer
- Institute of Neuroscience and Medicine (INM-2), Molecular Organization of the Brain, Forschungszentrum Jülich, 52425, Jülich, Germany
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3
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Devinney MJ, VanDusen KW, Kfouri JM, Avasarala P, Spector AR, Mathew JP, Berger M. The potential link between obstructive sleep apnea and postoperative neurocognitive disorders: current knowledge and possible mechanisms. Can J Anaesth 2022; 69:1272-1287. [PMID: 35982354 PMCID: PMC9924301 DOI: 10.1007/s12630-022-02302-4] [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: 11/18/2021] [Revised: 04/08/2022] [Accepted: 04/08/2022] [Indexed: 01/12/2023] Open
Abstract
PURPOSE This narrative review examines the current evidence on whether obstructive sleep apnea (OSA) is associated with postoperative delirium (POD) and postoperative cognitive dysfunction (POCD). The mechanisms that could predispose OSA patients to these disorders are also explored. SOURCE Relevant literature was identified by searching for pertinent terms in Medline®, Pubmed, ScopusTM, and Google scholar databases. Case reports, abstracts, review articles, original research articles, and meta-analyses were reviewed. The bibliographies of retrieved sources were also searched to identify relevant papers. PRINCIPAL FINDINGS Seven studies have investigated the association between OSA and POD, with mixed results. No studies have examined the potential link between OSA and POCD. If these relationships exist, they could be mediated by several mechanisms, including increased neuroinflammation, blood-brain barrier breakdown, cerebrovascular disease, Alzheimer's disease neuropathology, disrupted cerebral autoregulation, sleep disruption, sympathovagal imbalance, and/or disrupted brain bioenergetics. CONCLUSION There is very limited evidence that OSA plays a role in postoperative neurocognitive disorders because few studies have been conducted in the perioperative setting. Additional perioperative prospective observational cohort studies and randomized controlled trials of sleep apnea treatment are needed. These investigations should also assess potential underlying mechanisms that could predispose patients with OSA to postoperative neurocognitive disorders. This review highlights the need for more research to improve postoperative neurocognitive outcomes for patients with OSA.
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Affiliation(s)
- Michael J Devinney
- Department of Anesthesiology, Duke University Medical Center, Durham, NC, USA.
- Duke Hospital South, 3094 MS 01, 40 Medicine Circle, Rm 4324, Orange Zone, Durham, NC, 27710, USA.
| | - Keith W VanDusen
- Department of Anesthesiology, Duke University Medical Center, Durham, NC, USA
| | - Jad M Kfouri
- Faculty of Medicine, American University of Beirut, Beirut, Lebanon
| | - Pallavi Avasarala
- Department of Anesthesiology, Duke University Medical Center, Durham, NC, USA
| | - Andrew R Spector
- Department of Neurology, Duke University Medical Center, Durham, NC, USA
| | - Joseph P Mathew
- Department of Anesthesiology, Duke University Medical Center, Durham, NC, USA
| | - Miles Berger
- Department of Anesthesiology, Duke University Medical Center, Durham, NC, USA
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4
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Desai RI, Limoli CL, Stark CEL, Stark SM. Impact of spaceflight stressors on behavior and cognition: A molecular, neurochemical, and neurobiological perspective. Neurosci Biobehav Rev 2022; 138:104676. [PMID: 35461987 DOI: 10.1016/j.neubiorev.2022.104676] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2021] [Revised: 03/15/2022] [Accepted: 04/18/2022] [Indexed: 11/19/2022]
Abstract
The response of the human body to multiple spaceflight stressors is complex, but mounting evidence implicate risks to CNS functionality as significant, able to threaten metrics of mission success and longer-term behavioral and neurocognitive health. Prolonged exposure to microgravity, sleep disruption, social isolation, fluid shifts, and ionizing radiation have been shown to disrupt mechanisms of homeostasis and neurobiological well-being. The overarching goal of this review is to document the existing evidence of how the major spaceflight stressors, including radiation, microgravity, isolation/confinement, and sleep deprivation, alone or in combination alter molecular, neurochemical, neurobiological, and plasma metabolite/lipid signatures that may be linked to operationally-relevant behavioral and cognitive performance. While certain brain region-specific and/or systemic alterations titrated in part with neurobiological outcome, variations across model systems, study design, and the conspicuous absence of targeted studies implementing combinations of spaceflight stressors, confounded the identification of specific signatures having direct relevance to human activities in space. Summaries are provided for formulating new research directives and more predictive readouts of portending change in neurobiological function.
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Affiliation(s)
- Rajeev I Desai
- Harvard Medical School, McLean Hospital, Behavioral Biology Program, Belmont, MA 02478, USA.
| | - Charles L Limoli
- Department of Radiation Oncology, University of California Irvine, Medical Sciences I, B146B, Irvine, CA 92697, USA
| | - Craig E L Stark
- Department of Neurobiology of Behavior, University of California Irvine, 1400 Biological Sciences III, Irvine, CA 92697, USA
| | - Shauna M Stark
- Department of Neurobiology of Behavior, University of California Irvine, 1400 Biological Sciences III, Irvine, CA 92697, USA
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Rietzler A, Steiger R, Mangesius S, Walchhofer LM, Gothe RM, Schocke M, Gizewski ER, Grams AE. Energy metabolism measured by 31P magnetic resonance spectroscopy in the healthy human brain. J Neuroradiol 2021; 49:370-379. [PMID: 34871672 DOI: 10.1016/j.neurad.2021.11.006] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Revised: 11/04/2021] [Accepted: 11/25/2021] [Indexed: 10/19/2022]
Abstract
BACKGROUND AND PURPOSE Phosphorous magnetic resonance spectroscopy (31P-MRS) allows a non-invasive analysis of phosphorus-containing compounds in vivo. The present study investigated the influence of brain region, hemisphere, age, sex and brain volume on 31P-MRS metabolites in healthy adults. MATERIALS AND METHODS Supratentorial brain 31P-MRS spectra of 125 prospectively recruited healthy volunteers (64 female, 61 male) aged 20 to 85 years (mean: 49.4 ± 16.9 years) were examined with a 3D-31P-MRS sequence at 3T, and the compounds phosphocreatine (PCr), inorganic phosphate (Pi) and adenosine triphosphate (ATP) were measured. From this data, the metabolite ratios PCr/ATP, Pi/ATP and PCr/Pi were calculated for different brain regions. In addition, volumes of gray matter, white matter and cerebrospinal fluid were determined. RESULTS For all metabolite ratios significant regional differences and in several regions sex differences were found. In some brain regions and for some metabolites hemispheric differences were detected. In addition, changes with aging were found, which differed between women and men. CONCLUSIONS The present results indicate that 31P-MRS metabolism varies throughout the brain, with age and between sexes, and therefore have important practical implications for the design and the interpretation of future 31P-MRS studies under physiological conditions and in patients with various cerebral diseases.
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Affiliation(s)
- Andreas Rietzler
- Department of Neuroradiology, Medical University of Innsbruck, Innsbruck, Austria; Neuroimaging Core Facility, Medical University of Innsbruck, Innsbruck, Austria.
| | - Ruth Steiger
- Department of Neuroradiology, Medical University of Innsbruck, Innsbruck, Austria; Neuroimaging Core Facility, Medical University of Innsbruck, Innsbruck, Austria.
| | - Stephanie Mangesius
- Department of Neuroradiology, Medical University of Innsbruck, Innsbruck, Austria; Neuroimaging Core Facility, Medical University of Innsbruck, Innsbruck, Austria.
| | | | - Raffaella Matteucci Gothe
- UMIT - Center of Statistical Consulting and Continuing Education, Private University for Health Sciences, Medical Informatics and Technology, Hall, Austria.
| | - Michael Schocke
- RKU - University and Rehabilitation Clinics Ulm, Ulm, Germany.
| | - Elke Ruth Gizewski
- Department of Neuroradiology, Medical University of Innsbruck, Innsbruck, Austria; Neuroimaging Core Facility, Medical University of Innsbruck, Innsbruck, Austria.
| | - Astrid Ellen Grams
- Department of Neuroradiology, Medical University of Innsbruck, Innsbruck, Austria; Neuroimaging Core Facility, Medical University of Innsbruck, Innsbruck, Austria.
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Vakulin A, Green MA, D'Rozario AL, Stevens D, Openshaw H, Bartlett D, Wong K, McEvoy RD, Grunstein RR, Rae CD. Brain mitochondrial dysfunction and driving simulator performance in untreated obstructive sleep apnea. J Sleep Res 2021; 31:e13482. [PMID: 34528315 DOI: 10.1111/jsr.13482] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Revised: 08/29/2021] [Accepted: 08/30/2021] [Indexed: 11/30/2022]
Abstract
It is challenging to determine which patients with obstructive sleep apnea (OSA) have impaired driving ability. Vulnerability to this neurobehavioral impairment may be explained by lower brain metabolites levels involved in mitochondrial metabolism. This study compared markers of brain energy metabolism in OSA patients identified as vulnerable vs resistant to driving impairment following extended wakefulness. 44 patients with moderate-severe OSA underwent 28hr extended wakefulness with three 90min driving simulation assessments. Using a two-step cluster analysis, objective driving data (steering deviation and crashes) from the 2nd driving assessment (22.5 h awake) was used to categorise patients into vulnerable (poor driving, n = 21) or resistant groups (good driving, n = 23). 1 H magnetic resonance spectra were acquired at baseline using two scan sequences (short echo PRESS and longer echo-time asymmetric PRESS), focusing on key metabolites, creatine, glutamate, N-acetylaspartate (NAA) in the hippocampus, anterior cingulate cortex and left orbito-frontal cortex. Based on cluster analysis, the vulnerable group had impaired driving performance compared with the resistant group and had lower levels of creatine (PRESS p = ns, APRESS p = 0.039), glutamate, (PRESS p < 0.01, APRESS p < 0.01), NAA (PRESS p = 0.038, APRESS p = 0.035) exclusively in the left orbito-frontal cortex. Adjusted analysis, higher glutamate was associated with a 21% (PRESS) and 36% (APRESS) reduced risk of vulnerable classification. Brain mitochondrial bioenergetics in the frontal brain regions are impaired in OSA patients who are vulnerable to driving impairment following sleep loss. These findings provide a potential way to identify at risk OSA phenotype when assessing fitness to drive, but this requires confirmation in larger future studies.
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Affiliation(s)
- Andrew Vakulin
- Adelaide Institute for Sleep Health/FHMRI Sleep Health, College of Medicine and Public Health, Flinders University, Adelaide, South Australia, Australia.,Centre for Sleep and Chronobiology, Woolcock Institute of Medical Research, Sydney, New South Wales, Australia
| | - Michael A Green
- Neuroscience Research Australia, Sydney, New South Wales, Australia.,School of Medical Sciences, The University of New South Wales, Sydney, New South Wales, Australia
| | - Angela L D'Rozario
- Centre for Sleep and Chronobiology, Woolcock Institute of Medical Research, Sydney, New South Wales, Australia.,School of Psychology, Faculty of Science, Brain and Mind Centre and Charles Perkins Centre, University of Sydney, Sydney, New South Wales, Australia
| | - David Stevens
- Adelaide Institute for Sleep Health/FHMRI Sleep Health, College of Medicine and Public Health, Flinders University, Adelaide, South Australia, Australia.,Centre for Nutritional and Gastrointestinal Diseases, SAHMRI, Adelaide, South Australia, Australia
| | - Hannah Openshaw
- Centre for Sleep and Chronobiology, Woolcock Institute of Medical Research, Sydney, New South Wales, Australia
| | - Delwyn Bartlett
- Centre for Sleep and Chronobiology, Woolcock Institute of Medical Research, Sydney, New South Wales, Australia.,Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia
| | - Keith Wong
- Centre for Sleep and Chronobiology, Woolcock Institute of Medical Research, Sydney, New South Wales, Australia.,Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia.,Royal Prince Alfred Hospital, Sydney Health Partners, Sydney, New South Wales, Australia
| | - R Doug McEvoy
- Adelaide Institute for Sleep Health/FHMRI Sleep Health, College of Medicine and Public Health, Flinders University, Adelaide, South Australia, Australia
| | - Ronald R Grunstein
- Centre for Sleep and Chronobiology, Woolcock Institute of Medical Research, Sydney, New South Wales, Australia.,Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia.,Royal Prince Alfred Hospital, Sydney Health Partners, Sydney, New South Wales, Australia
| | - Caroline D Rae
- Neuroscience Research Australia, Sydney, New South Wales, Australia.,School of Medical Sciences, The University of New South Wales, Sydney, New South Wales, Australia
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Brain Energy Deficit as a Source of Oxidative Stress in Migraine: A Molecular Basis for Migraine Susceptibility. Neurochem Res 2021; 46:1913-1932. [PMID: 33939061 DOI: 10.1007/s11064-021-03335-9] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Revised: 04/06/2021] [Accepted: 04/22/2021] [Indexed: 02/06/2023]
Abstract
People with migraine are prone to a brain energy deficit between attacks, through increased energy demand (hyperexcitable brain) or decreased supply (mitochondrial impairment). However, it is uncertain how this precipitates an acute attack. Here, the central role of oxidative stress is adduced. Specifically, neurons' antioxidant defenses rest ultimately on internally generated NADPH (reduced nicotinamide adenine dinucleotide phosphate), whose levels are tightly coupled to energy production. Mitochondrial NADPH is produced primarily by enzymes involved in energy generation, including isocitrate dehydrogenase of the Krebs (tricarboxylic acid) cycle; and an enzyme, nicotinamide nucleotide transhydrogenase (NNT), that depends on the Krebs cycle and oxidative phosphorylation to function, and that works in reverse, consuming antioxidants, when energy generation fails. In migraine aura, cortical spreading depression (CSD) causes an initial severe drop in level of NADH (reduced nicotinamide adenine dinucleotide), causing NNT to impair antioxidant defense. This is followed by functional hypoxia and a rebound in NADH, in which the electron transport chain overproduces oxidants. In migraine without aura, a similar biphasic fluctuation in NADH very likely generates oxidants in cortical regions farthest from capillaries and penetrating arterioles. Thus, the perturbations in brain energy demand and/or production seen in migraine are likely sufficient to cause oxidative stress, triggering an attack through oxidant-sensing nociceptive ion channels. Implications are discussed for the development of new classes of migraine preventives, for the current use of C57BL/6J mice (which lack NNT) in preclinical studies of migraine, for how a microembolism initiates CSD, and for how CSD can trigger a migraine.
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Zeng B, Zhou J, Li Z, Zhang H, Li Z, Yu P. Altered Percent Amplitude of Fluctuation in Healthy Subjects After 36 h Sleep Deprivation. Front Neurol 2021; 11:565025. [PMID: 33519662 PMCID: PMC7843545 DOI: 10.3389/fneur.2020.565025] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2020] [Accepted: 08/26/2020] [Indexed: 12/16/2022] Open
Abstract
Objective: To investigate regional brain activity alteration in healthy subjects in a sleep deprivation (SD) status relative to a rested wakefulness status using a percent amplitude of fluctuation (PerAF) method. Methods: A total of 20 healthy participants (12 males, 8 females; age, 22.25 ± 1.12 years) were recruited. All participants underwent attention tests and resting-state functional MRI scans during rested wakefulness before SD and after 36 h SD, respectively. The PerAF method was applied to identify SD-related regional brain activity alteration. A ROC curve was conducted to evaluate the ability of the PerAF method in distinguishing different sleep statuses. The relationships between SD-induced brain alterations and attention deficits were determined by Pearson correlation analysis. Results: SD resulted in a 2.23% decrease in accuracy rate and an 8.82% increase in reaction time. SD was associated with increased PerAF differences in the bilateral visual cortex and bilateral sensorimotor cortex, and was associated with decreased PerAF differences in bilateral dorsolateral prefrontal cortex and bilateral cerebellum posterior lobe. These SD-induced brain alterations exhibited a high discriminatory power of extremely high AUC values (0.993-1) in distinguishing the two statuses. The accuracy rate positively correlated with the bilateral cerebellum posterior lobe, and bilateral dorsolateral prefrontal cortex, and negatively correlated with the bilateral sensorimotor cortex. Conclusions: Acute SD could lead to an ~8% attention deficit, which was associated with regional brain activity deficits. The PerAF method might work as a potential sensitivity biomarker for identifying different sleep statuses.
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Affiliation(s)
- Bingliang Zeng
- Department of Radiology, Jiangxi Provincial People's Hospital Affiliated to Nanchang University, Nanchang, China
| | - Jian Zhou
- Department of Radiology, Jiangxi Provincial People's Hospital Affiliated to Nanchang University, Nanchang, China
| | - Zicong Li
- Department of Radiology, Jiangxi Provincial People's Hospital Affiliated to Nanchang University, Nanchang, China
| | - Hua Zhang
- Department of Imaging, The Third Affiliated Hospital of Nanchang University, Nanchang, China
- Department of Imaging, The First Hospital of Nanchang, Nanchang, China
| | - Zongliang Li
- Department of Radiology, Nanfeng County People's Hospital, Fuzhou, China
| | - Peng Yu
- Radiology Department, Jinxian County People's Hospital, Nanchang, China
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9
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Zhang F, Li W, Li H, Gao S, Sweeney JA, Jia Z, Gong Q. The effect of jet lag on the human brain: A neuroimaging study. Hum Brain Mapp 2020; 41:2281-2291. [PMID: 32125068 PMCID: PMC7268074 DOI: 10.1002/hbm.24945] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2019] [Revised: 10/01/2019] [Accepted: 01/29/2020] [Indexed: 02/05/2023] Open
Abstract
Jet lag is commonly experienced when travelers cross multiple time zones, leaving the wake-sleep cycle and intrinsic biological "clocks" out of synchrony with the current environment. The effect of jet lag on intrinsic cortical function remains unclear. Twenty-two healthy individuals experiencing west-to-east jet lag flight were recruited. Brain structural and functional magnetic resonance studies, as well as psychological and neurohormonal tests, were carried out when participants returned from travel over six time zones and 50 days later when their jet lag symptoms had resolved. During jet lag, the functional brain network exhibited a small-world topology that was shifted toward regularity. Alterations during jet lag relative to recovery included decreased basal ganglia-thalamocortical network connections and increased functional connectivity between the medial temporal lobe subsystem and medial visual cortex. The lower melatonin and higher thyroid hormone levels during jet lag showed the same trend as brain activity in the right lingual gyrus. Although there was no significant difference between cortisol measurements during and after jet lag, cortisol levels were associated with temporal lobe activity in the jet lag condition. Brain and neuroendocrine changes during jet lag were related to jet lag symptoms. Further prospective studies are needed to explore the time course over which jet lag acts on the human brain.
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Affiliation(s)
- Feifei Zhang
- Huaxi MR Research Center (HMRRC), Department of RadiologyWest China Hospital of Sichuan UniversityChengduChina
| | - Weikai Li
- College of Computer Science & TechnologyNanjing University of Aeronautics & Astronautics (NUAA)NanjingChina
| | - Huiru Li
- Huaxi MR Research Center (HMRRC), Department of RadiologyWest China Hospital of Sichuan UniversityChengduChina
| | - Shaobing Gao
- Huaxi MR Research Center (HMRRC), Department of RadiologyWest China Hospital of Sichuan UniversityChengduChina
- College of Computer ScienceSichuan UniversityChengduChina
| | - John A. Sweeney
- Huaxi MR Research Center (HMRRC), Department of RadiologyWest China Hospital of Sichuan UniversityChengduChina
- Department of Psychiatry and Behavioral NeuroscienceUniversity of CincinnatiCincinnatiOhio
| | - Zhiyun Jia
- Huaxi MR Research Center (HMRRC), Department of RadiologyWest China Hospital of Sichuan UniversityChengduChina
- Department of Nuclear Medicine, West China HospitalSichuan UniversityChengduChina
| | - Qiyong Gong
- Huaxi MR Research Center (HMRRC), Department of RadiologyWest China Hospital of Sichuan UniversityChengduChina
- Psychoradiology Research Unit of Chinese Academy of Medical SciencesSichuan UniversityChengduChina
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10
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D'Rozario AL, Bartlett DJ, Wong KKH, Sach T, Yang Q, Grunstein RR, Rae CD. Brain bioenergetics during resting wakefulness are related to neurobehavioral deficits in severe obstructive sleep apnea: a 31P magnetic resonance spectroscopy study. Sleep 2019; 41:5026697. [PMID: 29868772 DOI: 10.1093/sleep/zsy117] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2017] [Indexed: 11/15/2022] Open
Abstract
Study Objectives Obstructive sleep apnea (OSA) is a well-established cause of impaired daytime functioning. However, there is a complex inter-individual variability in neurobehavioral performance in OSA patients. We previously reported compromised brain bioenergetics during apneic sleep in severe OSA. In this study, we investigate whether brain bioenergetics during resting wakefulness are related to neurobehavioral performance. Methods Patients attended the sleep laboratory in the evening and were kept awake over-night. Repeated testing on the 10-minute psychomotor vigilance task (PVT, at 9 pm, 11 pm, 1 am, 3 am, 5 am) and 30-minute AusEd driving simulator task (9 pm and 5 am) was performed. Brain bioenergetics (inorganic phosphate/adenosine triphosphate ratio, Pi/ATP) were measured in the temporal lobe during resting wakefulness at 7 am in a 1.5T MRI scanner using phosphorus magnetic resonance spectroscopy (31P MRS). Results Fifteen males with severe OSA (age 47.7 ± 10.4 years, body mass index [BMI] 34 ± 6.6 kg/m2, apnea hypopnea index [AHI] 79.7 ± 21.8/hour) were investigated. A higher Pi/ATP ratio in the brain (lower phosphorylation potential) was correlated with worse PVT and driving simulator performance across the testing period (PVT lapses: r = 0.632, r2 = 0.399, p = 0.012; and AusEd braking reaction time: r = 0.609, p = 0.016). In contrast, the conventional AHI measure of disease severity was not significantly correlated with performance (PVT lapses: r = -0.084, p = 0.8; and AusEd braking reaction time: r = -0.326, p = 0.2). Conclusions Lower phosphorylation potential was associated with worse performance. Compromised brain bioenergetics may in part underlie the neurobehavioral deficits in untreated OSA. We speculate that better brain bioenergetics may explain why some OSA patients are relatively asymptomatic compared with others.
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Affiliation(s)
- Angela L D'Rozario
- CIRUS, Woolcock Institute of Medical Research, University of Sydney and Sydney Health Partners, Sydney, New South Wales, Australia
- School of Psychology, Faculty of Science, Brain and Mind Centre and Charles Perkins Centre, University of Sydney, Sydney, New South Wales, Australia
- Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia
| | - Delwyn J Bartlett
- CIRUS, Woolcock Institute of Medical Research, University of Sydney and Sydney Health Partners, Sydney, New South Wales, Australia
- Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia
| | - Keith K H Wong
- CIRUS, Woolcock Institute of Medical Research, University of Sydney and Sydney Health Partners, Sydney, New South Wales, Australia
- Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia
- Respiratory and Sleep Disorders Department, Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia
| | - Toos Sach
- Rayscan Imaging, Goulburn St, Liverpool, New South Wales, Australia
| | - Qiao Yang
- CIRUS, Woolcock Institute of Medical Research, University of Sydney and Sydney Health Partners, Sydney, New South Wales, Australia
| | - Ronald R Grunstein
- CIRUS, Woolcock Institute of Medical Research, University of Sydney and Sydney Health Partners, Sydney, New South Wales, Australia
- Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia
- Respiratory and Sleep Disorders Department, Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia
| | - Caroline D Rae
- Neuroscience Research Australia, Sydney, New South Wales, Australia
- School of Medical Sciences, University of New South Wales, Sydney, New South Wales, Australia
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Phosphocreatine Levels in the Left Thalamus Decline during Wakefulness and Increase after a Nap. J Neurosci 2018; 38:10552-10565. [PMID: 30282723 DOI: 10.1523/jneurosci.0865-18.2018] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2018] [Revised: 09/19/2018] [Accepted: 09/25/2018] [Indexed: 12/14/2022] Open
Abstract
Scientists have hypothesized that the availability of phosphocreatine (PCr) and its ratio to inorganic phosphate (Pi) in cerebral tissue form a substrate of wakefulness. It follows then, according to this hypothesis, that the exhaustion of PCr and the decline in the ratio of PCr to Pi form a substrate of fatigue. We used 31P-magnetic resonance spectroscopy (31P-MRS) to investigate quantitative levels of PCr, the γ-signal of ATP, and Pi in 30 healthy humans (18 female) in the morning, in the afternoon, and while napping (n = 15) versus awake controls (n = 10). Levels of PCr (2.40 mM at 9 A.M.) decreased by 7.0 ± 0.8% (p = 7.1 × 10-6, t = -5.5) in the left thalamus between 9 A.M. and 5 P.M. Inversely, Pi (0.74 mM at 9 A.M.) increased by 17.1 ± 5% (p = 0.005, t = 3.1) and pH levels dropped by 0.14 ± 0.07 (p = 0.002; t = 3.6). Following a 20 min nap after 5 P.M., local PCr, Pi, and pH were restored to morning levels. We did not find respective significant changes in the contralateral thalamus or in other investigated brain regions. Left hemispheric PCr was signficantly lower than right hemispheric PCr only at 5 P.M. in the thalamus and at all conditions in the temporal region. Thus, cerebral daytime-related and sleep-related molecular changes are accessible in vivo Prominent changes were identified in the thalamus. This region is heavily relied on for a series of energy-consuming tasks, such as the relay of sensory information to the cortex. Furthermore, our data confirm that lateralization of brain function is regionally dynamic and includes PCr.SIGNIFICANCE STATEMENT The metabolites phosphocreatine (PCr) and inorganic phosphate (Pi) are assumed to inversely reflect the cellular energy load. This study detected a diurnal decrease of intracellular PCr and a nap-associated reincrease in the left thalamus. Pi behaved inversely. This outcome corroborates the role of the thalamus as a region of high energy consumption in agreement with its function as a gateway that relays and modulates information flow. Conversely to the dynamic lateralization of thalamic PCr, a constantly significant lateralization was observed in other regions. Increasing fatigue over the course of the day may also be a matter of cerebral energy supply. Comparatively fast restoration of that supply may be part of the biological basis for the recreational value of "power napping."
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Sleep/wake movement velocities, trajectories and micro-arousals during maturation in rats. BMC Neurosci 2017; 18:24. [PMID: 28173758 PMCID: PMC5297220 DOI: 10.1186/s12868-017-0343-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2016] [Accepted: 02/01/2017] [Indexed: 11/25/2022] Open
Abstract
Background
Sleep is regulated by two main processes.
The circadian process provides a 24-h rhythm and the homeostatic process reflects sleep pressure, which increases in the course of wakefulness and decreases during sleep. Both of these processes undergo major changes during development. For example, sleep homeostasis, measured by means of electroencephalogram (EEG) slow-wave activity (SWA, EEG power between 0.5 and 4.5 Hz), peaks around puberty and decreases during adolescence. In humans and rats these changes have been related to cortical maturation. We aimed to explore whether additional parameters as state dynamic (dynamic of sleep/wake behavior) parameters of movement velocity, trajectories and micro-arousals provide markers of rat maturation. The state dynamics reflect the stability of sleep within a specific sleep stage. We applied a state space technique (SST), a quantitative and unbiased method, based on frequency band ratios of the EEG to analyze the development of different sleep/wake states and state dynamics between vigilance states. EEG of recording electrodes at the frontal and parietal lobe were analyzed using conventional scoring criteria and SST.
Results We found that movement velocity, trajectories between sleep states and micro-arousals changed as an inverse U-shaped curve across maturation. At all ages, movement velocity over the frontal lobe is higher compared to the parietal lobe, while the number of trajectories and micro-arousals are reduced. Furthermore, we showed that SWA correlates negatively with movement velocity and the number of micro-arousals. The velocity in the parietal lobe correlates positively with the number of micro-arousals. As for SWA, trajectories seem primarily to depend on sleep homeostasis regulatory mechanisms while the movement velocity seems to be modulated by other sleep regulators like the circadian rhythms. Conclusions New insights in sleep/wake state dynamics are established with the SST, because trajectories, micro-arousals and velocities are not evident by traditional scoring methods. These dynamic measures may represent new indicators for changes in sleep regulatory processes across maturation. Electronic supplementary material The online version of this article (doi:10.1186/s12868-017-0343-6) contains supplementary material, which is available to authorized users.
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Rhoades SD, Sengupta A, Weljie AM. Time is ripe: maturation of metabolomics in chronobiology. Curr Opin Biotechnol 2016; 43:70-76. [PMID: 27701007 DOI: 10.1016/j.copbio.2016.09.007] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2016] [Revised: 09/15/2016] [Accepted: 09/18/2016] [Indexed: 12/14/2022]
Abstract
Sleep and circadian rhythms studies have recently benefited from metabolomics analyses, uncovering new connections between chronobiology and metabolism. From untargeted mass spectrometry to quantitative nuclear magnetic resonance spectroscopy, a diversity of analytical approaches has been applied for biomarker discovery in the field. In this review we consider advances in the application of metabolomics technologies which have uncovered significant effects of sleep and circadian cycles on several metabolites, namely phosphatidylcholine species, medium-chain carnitines, and aromatic amino acids. Study design and data processing measures essential for detecting rhythmicity in metabolomics data are also discussed. Future developments in these technologies are anticipated vis-à-vis validating early findings, given metabolomics has only recently entered the ring with other systems biology assessments in chronometabolism studies.
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Affiliation(s)
- Seth D Rhoades
- Department of Systems Pharmacology and Translational Therapeutics, University of Pennsylvania, Philadelphia, PA 19104, United States; Institute of Translational Medicine and Therapeutics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, United States
| | - Arjun Sengupta
- Department of Systems Pharmacology and Translational Therapeutics, University of Pennsylvania, Philadelphia, PA 19104, United States; Institute of Translational Medicine and Therapeutics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, United States
| | - Aalim M Weljie
- Department of Systems Pharmacology and Translational Therapeutics, University of Pennsylvania, Philadelphia, PA 19104, United States; Institute of Translational Medicine and Therapeutics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, United States.
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Lovati C, Giani L, D'Amico D, Mariani C. Sleep, headaches and cerebral energy control: a synoptic view. Expert Rev Neurother 2016; 17:239-250. [PMID: 27547918 DOI: 10.1080/14737175.2016.1226133] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
INTRODUCTION The amount of cerebral functions is particularly elevated. This intense activity requires a great expenditure of energy: the restoration of energy is the fundamental function of sleep whilst the slowdown in energy consumption may be considered the physiological effect of primary headaches. The continuous interaction of sleep and primary headaches is possible as they share many anatomical and functional cerebral systems. Areas covered: This review describes how sleep and headaches are reciprocally involved in preservation and restoration of brain energy. Data were obtained from the most relevant and recent works available in PubMed about this topic. Expert commentary: The energetic view of sleep, primary headaches and their relationship may have relevant clinical consequences: the investigation and the modification of the multiple aspects, primarily environmental, that may influence sleep and headache, become mandatory to facilitate the cerebral energy preservation by reducing its consumption and by ensuring its recovery.
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Affiliation(s)
| | - Luca Giani
- b Neurology Unit , Luigi Sacco Hospital, Milan Study University , Milan , Italy
| | - Domenico D'Amico
- c Headache Center , C. Besta Neurological Institute and Foundation , Milan , Italy
| | - Claudio Mariani
- b Neurology Unit , Luigi Sacco Hospital, Milan Study University , Milan , Italy
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Shaffer J. Neuroplasticity and Clinical Practice: Building Brain Power for Health. Front Psychol 2016; 7:1118. [PMID: 27507957 PMCID: PMC4960264 DOI: 10.3389/fpsyg.2016.01118] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2016] [Accepted: 07/12/2016] [Indexed: 01/26/2023] Open
Abstract
The focus of this review is on driving neuroplasticity in a positive direction using evidence-based interventions that also have the potential to improve general health. One goal is to provide an overview of the many ways new neuroscience can inform treatment protocols to empower and motivate clients to make the lifestyle choices that could help build brain power and could increase adherence to healthy lifestyle changes that have also been associated with simultaneously enhancing vigorous longevity, health, happiness, and wellness. Another goal is to explore the use of a focus in clinical practice on helping clients appreciate this new evidence and use evolving neuroscience in establishing individualized goals, designing strategies for achieving them and increasing treatment compliance. The timing is urgent for such interventions with goals of enhancing brain health across the lifespan and improving statistics on dementia worldwide.
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Affiliation(s)
- Joyce Shaffer
- Department of Psychiatry and Behavioral Sciences, University of Washington Seattle, WA, USA
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Rae CD, Bröer S. Creatine as a booster for human brain function. How might it work? Neurochem Int 2015; 89:249-59. [PMID: 26297632 DOI: 10.1016/j.neuint.2015.08.010] [Citation(s) in RCA: 66] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2015] [Revised: 08/04/2015] [Accepted: 08/15/2015] [Indexed: 01/19/2023]
Abstract
Creatine, a naturally occurring nitrogenous organic acid found in animal tissues, has been found to play key roles in the brain including buffering energy supply, improving mitochondrial efficiency, directly acting as an anti-oxidant and acting as a neuroprotectant. Much of the evidence for these roles has been established in vitro or in pre-clinical studies. Here, we examine the roles of creatine and explore the current status of translation of this research into use in humans and the clinic. Some further possibilities for use of creatine in humans are also discussed.
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Affiliation(s)
- Caroline D Rae
- Neuroscience Research Australia, Barker St Randwick, NSW 2031, Australia; School of Medical Sciences, UNSW, High Street, Randwick, NSW 2052, Australia.
| | - Stefan Bröer
- Research School of Biology, The Australian National University, Canberra, ACT 0200, Australia
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Rae CD. The energetic cost of a night on the town. Sleep 2014; 37:1881-2. [PMID: 25406115 DOI: 10.5665/sleep.4230] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2014] [Accepted: 04/25/2014] [Indexed: 11/03/2022] Open
Affiliation(s)
- Caroline D Rae
- Neuroscience Research Australia and School of Medical Sciences, The University of New South Wales, Barker St, Randwick, NSW, 2031 Australia
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