51
|
Torres-Lopez LV, Cadenas-Sanchez C, Migueles JH, Esteban-Cornejo I, Molina-Garcia P, H. Hillman C, Catena A, Ortega FB. Does sleep-disordered breathing add to impairments in academic performance and brain structure usually observed in children with overweight/obesity? Eur J Pediatr 2022; 181:2055-2065. [PMID: 35142932 PMCID: PMC9056447 DOI: 10.1007/s00431-022-04403-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Revised: 01/26/2022] [Accepted: 01/29/2022] [Indexed: 12/01/2022]
Abstract
UNLABELLED Approximately 4-11% of children suffer from sleep-disordered breathing (SDB), and children with obesity are at increased risk. Both obesity and SDB have been separately associated with poorer brain health, yet whether SDB severity affects brain health in children with obesity remains unanswered. This study aimed to examine associations of SDB severity with academic performance and brain structure (i.e., total brain and gray and white matter volumes and gray matter volume in the hippocampus) in children with overweight/obesity. One hundred nine children aged 8-12 years with overweight/obesity were included. SDB severity and its subscales (i.e., snoring, daytime sleepiness, and inattention/hyperactivity) were evaluated via the Pediatric Sleep Questionnaire (PSQ), and academic performance was evaluated with the Woodcock-Muñoz standardized test and school grades. Brain structure was assessed by magnetic resonance imaging. SDB severity was not associated with academic performance measured by the standardized test (all |β|> 0.160, P > 0.076), yet it was associated with the school grade point average (β = -0.226, P = 0.007) and natural and social science grades (β = -0.269, P = 0.024). Intention/hyperactivity seemed to drive these associations. No associations were found between SDB severity and the remaining school grades (all β < -0.188, P > 0.065) or brain volumes (all P > 0.05). CONCLUSION Our study shows that SDB severity was associated with lower school grades, yet it was not associated with the standardized measurement of academic performance or with brain volumes in children with overweight/obesity. SDB severity may add to academic problems in children beyond the effects contributed by overweight/obesity status alone. WHAT IS KNOWN • Sleep-disordered breathing (SDB) may affect brain structure and academic performance in children. • Children with overweight/obesity are at higher risk for the development of SDB, yet the comorbid obesity-SDB relationship with brain health has not been investigated thus far. WHAT IS NEW • To our knowledge, this is the first study examining the associations of comorbid obesity-SDB severity with brain volumes and academic performance in children. • SDB symptoms may adversely affect academic performance at school in children with overweight/obesity, beyond the effects of weight status alone.
Collapse
Affiliation(s)
- Lucia V. Torres-Lopez
- PROFITH “PROmoting FITness and Health Through Physical Activity” Research Group, Department of Physical Education and Sports, Faculty of Sport Sciences, Sport and Health University Research Institute (iMUDS), University of Granada, Granada, 18011 Spain
| | - Cristina Cadenas-Sanchez
- PROFITH “PROmoting FITness and Health Through Physical Activity” Research Group, Department of Physical Education and Sports, Faculty of Sport Sciences, Sport and Health University Research Institute (iMUDS), University of Granada, Granada, 18011 Spain ,Institute for Innovation and Sustainable Development in the Food Chain (IS-FOOD), Public University of Navarra, Pamplona, Spain
| | - Jairo H. Migueles
- PROFITH “PROmoting FITness and Health Through Physical Activity” Research Group, Department of Physical Education and Sports, Faculty of Sport Sciences, Sport and Health University Research Institute (iMUDS), University of Granada, Granada, 18011 Spain ,Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden ,Department of Biosciences and Nutrition, Karolinska Institutet, Huddinge, 14183 Sweden
| | - Irene Esteban-Cornejo
- PROFITH “PROmoting FITness and Health Through Physical Activity” Research Group, Department of Physical Education and Sports, Faculty of Sport Sciences, Sport and Health University Research Institute (iMUDS), University of Granada, Granada, 18011 Spain
| | - Pablo Molina-Garcia
- PROFITH “PROmoting FITness and Health Through Physical Activity” Research Group, Department of Physical Education and Sports, Faculty of Sport Sciences, Sport and Health University Research Institute (iMUDS), University of Granada, Granada, 18011 Spain
| | - Charles H. Hillman
- Center for Cognitive and Brain Health, Department of Psychology, Department of Physical Therapy, Movement, and Rehabilitation Sciences, Northeastern University, Boston, MA USA
| | - Andres Catena
- School of Psychology, University of Granada, Granada, Spain
| | - Francisco B. Ortega
- PROFITH “PROmoting FITness and Health Through Physical Activity” Research Group, Department of Physical Education and Sports, Faculty of Sport Sciences, Sport and Health University Research Institute (iMUDS), University of Granada, Granada, 18011 Spain ,Department of Biosciences and Nutrition, Karolinska Institutet, Huddinge, 14183 Sweden ,Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| |
Collapse
|
52
|
Li LT, Zhao FF, Jia ZM, Qi LQ, Zhang XZ, Zhang L, Li YY, Yang JJ, Wang SJ, Lin H, Liu CH, An DD, Huang YQ, Gao XL. Cannabinoid receptors promote chronic intermittent hypoxia-induced breast cancer metastasis via IGF-1R/AKT/GSK-3β. MOLECULAR THERAPY-ONCOLYTICS 2021; 23:220-230. [PMID: 34729397 PMCID: PMC8531461 DOI: 10.1016/j.omto.2021.09.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/20/2021] [Accepted: 09/24/2021] [Indexed: 11/15/2022]
Abstract
The progression of breast cancer is closely related to obstructive sleep apnea-hypopnea syndrome (OSAHS). Low concentrations of cannabinoids promote tumor proliferation. However, the role of cannabinoid receptors (CBs) in chronic intermittent hypoxia (CIH)-induced breast cancer has not been reported. The migration and invasion of breast cancer cell lines (MCF-7 and T47D) were measured by scratch assay and transwell assay. Gene and protein expressions were analyzed by qPCR and western blotting. Tumor xenograft mice model were established to evaluate the function of CBs. We observed that chronic hypoxia (CH) and CIH increased CBs expression and promoted migration and invasion in breast cancer. Mice grafted with MCF-7 exhibited obvious tumor growth, angiogenesis, and lung metastasis in CIH compared with CH and control. In addition, CIH induced CBs expression, which subsequently activated insulin-like growth factor-1 receptor (IGF-1R)/AKT/glycogen synthase kinase-3β (GSK-3β) axis. Knockdown of CBs alleviated CIH-induced migration and invasion of breast cancer in vitro. Furthermore, CIH exaggerated the malignancy of breast cancer and silencing of CBs suppressed tumor growth and metastasis in vivo. Our study contributed to understanding the role of CIH in breast cancer development modulation.
Collapse
Affiliation(s)
- Li-Ting Li
- Second School of Clinical Medicine, Shanxi Medical University, Taiyuan 030001, Shanxi Province, P.R. China
| | - Fang-Fang Zhao
- Second School of Clinical Medicine, Shanxi Medical University, Taiyuan 030001, Shanxi Province, P.R. China
| | - Zhi-Mei Jia
- Second School of Clinical Medicine, Shanxi Medical University, Taiyuan 030001, Shanxi Province, P.R. China
| | - Li-Qing Qi
- Second School of Clinical Medicine, Shanxi Medical University, Taiyuan 030001, Shanxi Province, P.R. China
| | - Xi-Zhu Zhang
- School of Basic Medicine, Shanxi Medical University, Taiyuan 030001, Shanxi Province, P.R. China
| | - Lu Zhang
- Second School of Clinical Medicine, Shanxi Medical University, Taiyuan 030001, Shanxi Province, P.R. China
| | - Ying-Ying Li
- Second School of Clinical Medicine, Shanxi Medical University, Taiyuan 030001, Shanxi Province, P.R. China
| | - Jiao-Jiao Yang
- Department of Critical Care, Huili People's Hospital of Liangshan Prefecture, Huili 615100, Sichuan Province, P.R. China
| | - Shu-Juan Wang
- Department of Respiratory and Critical Care Medicine, Jincheng People's Hospital, Jincheng 048000, Shanxi Province, P.R. China
| | - Hui Lin
- Second School of Clinical Medicine, Shanxi Medical University, Taiyuan 030001, Shanxi Province, P.R. China
| | - Chun-Hao Liu
- School of Basic Medicine, Shanxi Medical University, Taiyuan 030001, Shanxi Province, P.R. China
| | - Dong-Dong An
- Tuberculosis Department One, Xi'an Chest Hospital, Xi'an 710100, Shanxi Province, P.R. China
| | - Ya-Qiong Huang
- Department of Respiratory and Critical Care Medicine, Datong Coal Mine Group Corporation General Hospital, Datong 030001, Shanxi Province, P.R. China
| | - Xiao-Ling Gao
- Department of Respiratory and Critical Care Medicine, Second Hospital of Shanxi Medical University, Taiyuan 030001, Shanxi Province, P.R. China
| |
Collapse
|
53
|
Lehert P. Efficacy of Pitolisant 20 mg in Reducing Excessive Daytime Sleepiness and Fatigue in Patients with Obstructive Sleep Apnoea Syndrome: An Individual Patient Data Meta-analysis. Clin Drug Investig 2021; 42:65-74. [PMID: 34859394 PMCID: PMC8755655 DOI: 10.1007/s40261-021-01104-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/07/2021] [Indexed: 11/26/2022]
Abstract
Background and objective Excessive daytime sleepiness (EDS) and fatigue are major complaints in patients with obstructive sleep apnoea (OSA) syndrome. Pitolisant is an orally active selective histamine H3 receptor (H3R) antagonist/inverse agonist, which enhances histaminergic transmissions in the brain and thereby elicits strong wake-promoting effects. This article assesses the efficacy and safety of pitolisant 20 mg in patients with OSA, based on existing randomised controlled studies. Methods An individual patient data (IPD) meta-analytical two-level (study-patient) hierarchical model was used assuming a random treatment effect. The Epworth Sleepiness Scale (ESS) and Oxford Sleep Resistance (OSleR) tests were co-primary endpoints. Results A total of 512 patients, including 384 treated with pitolisant and 128 with placebo, were included in the analysis.
Compared with placebo, pitolisant reduced mean ESS by − 3.1 (95% CI [− 4.1; − 2.1]; p < 0.001) and improved OSleR by 1.18 (1.02; 1.35, p = 0.022); 30% more patients had reduced fatigue (risk ratio [RR] = 1.3, [1.11; 1.53]), p = 0.001) and 46% more patients had improved Clinical Global Impression (CGI) (RR = 1.46 [1.12; 1.89], p = 0.005). No significant differences in safety endpoints were found. These results proved homogeneous across studies and subgroups of the population. Conclusion The results provide evidence of a significant benefit of pitolisant in improving EDS and fatigue, irrespective of baseline conditions. Supplementary Information The online version contains supplementary material available at 10.1007/s40261-021-01104-8.
Collapse
Affiliation(s)
- Philippe Lehert
- Faculty of Medicine, The University of Melbourne, Parkville, VIC, Australia.
- Louvain School of Management, Louvain University, Chaussee de Binche 151/M1.01.01, 7000, Mons, Belgium.
| |
Collapse
|
54
|
Tahmasian M, Aleman A, Andreassen OA, Arab Z, Baillet M, Benedetti F, Bresser T, Bright J, Chee MW, Chylinski D, Cheng W, Deantoni M, Dresler M, Eickhoff SB, Eickhoff CR, Elvsåshagen T, Feng J, Foster-Dingley JC, Ganjgahi H, Grabe HJ, Groenewold NA, Ho TC, Hong SB, Houenou J, Irungu B, Jahanshad N, Khazaie H, Kim H, Koshmanova E, Kocevska D, Kochunov P, Lakbila-Kamal O, Leerssen J, Li M, Luik AI, Muto V, Narbutas J, Nilsonne G, O’Callaghan VS, Olsen A, Osorio RS, Poletti S, Poudel G, Reesen JE, Reneman L, Reyt M, Riemann D, Rosenzweig I, Rostampour M, Saberi A, Schiel J, Schmidt C, Schrantee A, Sciberras E, Silk TJ, Sim K, Smevik H, Soares JC, Spiegelhalder K, Stein DJ, Talwar P, Tamm S, Teresi GI, Valk SL, Van Someren E, Vandewalle G, Van Egroo M, Völzke H, Walter M, Wassing R, Weber FD, Weihs A, Westlye LT, Wright MJ, Wu MJ, Zak N, Zarei M. ENIGMA-Sleep: Challenges, opportunities, and the road map. J Sleep Res 2021; 30:e13347. [PMID: 33913199 PMCID: PMC8803276 DOI: 10.1111/jsr.13347] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Revised: 03/14/2021] [Accepted: 03/16/2021] [Indexed: 12/26/2022]
Abstract
Neuroimaging and genetics studies have advanced our understanding of the neurobiology of sleep and its disorders. However, individual studies usually have limitations to identifying consistent and reproducible effects, including modest sample sizes, heterogeneous clinical characteristics and varied methodologies. These issues call for a large-scale multi-centre effort in sleep research, in order to increase the number of samples, and harmonize the methods of data collection, preprocessing and analysis using pre-registered well-established protocols. The Enhancing NeuroImaging Genetics through Meta-Analysis (ENIGMA) consortium provides a powerful collaborative framework for combining datasets across individual sites. Recently, we have launched the ENIGMA-Sleep working group with the collaboration of several institutes from 15 countries to perform large-scale worldwide neuroimaging and genetics studies for better understanding the neurobiology of impaired sleep quality in population-based healthy individuals, the neural consequences of sleep deprivation, pathophysiology of sleep disorders, as well as neural correlates of sleep disturbances across various neuropsychiatric disorders. In this introductory review, we describe the details of our currently available datasets and our ongoing projects in the ENIGMA-Sleep group, and discuss both the potential challenges and opportunities of a collaborative initiative in sleep medicine.
Collapse
Affiliation(s)
- Masoud Tahmasian
- Institute of Medical Science and Technology, Shahid Beheshti University, Tehran, Iran
| | - André Aleman
- University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | - Ole A. Andreassen
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital, Inst of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Zahra Arab
- Institute of Medical Science and Technology, Shahid Beheshti University, Tehran, Iran
| | - Marion Baillet
- GIGA-Institute, Cyclotron Research Center/In Vivo Imaging, Sleep and Chronobiology Lab, University of Liège, Liège, Belgium
| | - Francesco Benedetti
- Psychiatry & Clinical Psychobiology, Division of Neuroscience, IRCCS Scientific Institute Ospedale San Raffaele, Milano, Italy
- Vita-Salute San Raffaele University, Milano, Italy
| | - Tom Bresser
- Department of Sleep and Cognition, Netherlands Institute for Neuroscience (NIN), an Institute of the Royal Netherlands Academy of Arts and Sciences, Amsterdam, The Netherlands
- Department of Integrative Neurophysiology, Center for Neurogenomics and Cognitive Research (CNCR), Amsterdam Neuroscience, VU University Amsterdam, Amsterdam, Netherlands
| | - Joanna Bright
- Imaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine, University of Southern California, Marina del Rey, CA, USA
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Michael W.L. Chee
- Centre for Sleep and Cognition, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Daphne Chylinski
- GIGA-Institute, Cyclotron Research Center/In Vivo Imaging, Sleep and Chronobiology Lab, University of Liège, Liège, Belgium
| | - Wei Cheng
- Institute of Science and Technology for Brain-inspired intelligence, Fudan University, Shanghai, China
- Key Laboratory of Computational Neuroscience and Brain-Inspired Intelligence, Ministry of Education, Fudan University, Shanghai, China
| | - Michele Deantoni
- GIGA-Institute, Cyclotron Research Center/In Vivo Imaging, Sleep and Chronobiology Lab, University of Liège, Liège, Belgium
| | - Martin Dresler
- Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Simon B. Eickhoff
- Institute of Neuroscience and Medicine, Brain & Behaviour (INM-7), Research Centre Jülich, Jülich, Germany
- Institute of Systems Neuroscience, Medical Faculty,, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Claudia R. Eickhoff
- Institute of Neuroscience and Medicine, Structural and functional organisation of the brain (INM-1), Research Centre Jülich, Jülich, Germany
- Institute of Clinical Neuroscience and Medical Psychology, Medical Faculty, University of Düsseldorf, Düsseldorf, Germany
| | - Torbjørn Elvsåshagen
- Norwegian Centre for Mental Disorders Research, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Department of Neurology, Oslo University Hospital, Oslo, Norway
| | - Jianfeng Feng
- Institute of Science and Technology for Brain-inspired intelligence, Fudan University, Shanghai, China
- Key Laboratory of Computational Neuroscience and Brain-Inspired Intelligence, Ministry of Education, Fudan University, Shanghai, China
- Department of Computer Science, University of Warwick, Coventry, UK
| | - Jessica C. Foster-Dingley
- Department of Sleep and Cognition, Netherlands Institute for Neuroscience (NIN), an Institute of the Royal Netherlands Academy of Arts and Sciences, Amsterdam, The Netherlands
| | - Habib Ganjgahi
- Department of Statistics, University of Oxford, Oxford, UK
| | - Hans J. Grabe
- Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Greifswald, Germany
- German Center for Neurodegenerative Diseases (DZNE), Site Rostock/Greifswald, Greifswald, Germany
| | - Nynke A. Groenewold
- SA MRC Unit on Risk & Resilience in Mental Disorders, Department of Psychiatry & Neuroscience Institute, University of Cape Town, Cape Town, South Africa
| | - Tiffany C. Ho
- Department of Psychiatry and Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, USA
| | - Seung Bong Hong
- Department of Neurology, Samsung Medical Center, SBRI (Samsung Biomedical Research Institute), Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Josselin Houenou
- Univ Paris Saclay, NeuroSpin neuroimaging platform, Psychiatry Team, UNIACT Lab, CEA Saclay, Gif-Sur-Yvette Cedex, France
- DMU IMPACT de Psychiatrie et d'Addictologie, APHP, Hôpitaux Universitaires Mondor, Créteil, France
- Univ Paris Est Créteil, INSERM U 955, IMRB Team 15 « Translational Neuropsychiatry », Foundation FondaMental, Créteil, France
| | - Benson Irungu
- Department of Psychiatry & Behavioral Sciences, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Neda Jahanshad
- Imaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine, University of Southern California, Marina del Rey, CA, USA
| | - Habibolah Khazaie
- Sleep Disorders Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Hosung Kim
- Laboratory of Neuro Imaging at USC Stevens Neuroimaging and Informatics Institute, Keck School of Medicine of USC, University of Southern California, Los Angeles, CA, USA
| | - Ekaterina Koshmanova
- GIGA-Institute, Cyclotron Research Center/In Vivo Imaging, Sleep and Chronobiology Lab, University of Liège, Liège, Belgium
| | - Desi Kocevska
- Department of Sleep and Cognition, Netherlands Institute for Neuroscience (NIN), an Institute of the Royal Netherlands Academy of Arts and Sciences, Amsterdam, The Netherlands
| | - Peter Kochunov
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Oti Lakbila-Kamal
- Department of Sleep and Cognition, Netherlands Institute for Neuroscience (NIN), an Institute of the Royal Netherlands Academy of Arts and Sciences, Amsterdam, The Netherlands
- Department of Integrative Neurophysiology, Center for Neurogenomics and Cognitive Research (CNCR), Amsterdam Neuroscience, VU University Amsterdam, Amsterdam, Netherlands
| | - Jeanne Leerssen
- Department of Sleep and Cognition, Netherlands Institute for Neuroscience (NIN), an Institute of the Royal Netherlands Academy of Arts and Sciences, Amsterdam, The Netherlands
- Department of Integrative Neurophysiology, Center for Neurogenomics and Cognitive Research (CNCR), Amsterdam Neuroscience, VU University Amsterdam, Amsterdam, Netherlands
| | - Meng Li
- Clinical Affective Neuroimaging Laboratory, Otto von Guericke University, Magdeburg, Germany
- Department of Psychiatry and Psychotherapy, Jena University Hospital, Jena, Germany
- Department of Psychiatry and Psychotherapy, University of Tübingen, Tübingen, Germany
| | - Annemarie I. Luik
- Department of Epidemiology, Erasmus MC University Medical Center Rotterdam, Rotterdam, The Netherlands
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC University Medical Center Rotterdam, Rotterdam, Netherlands
| | - Vincenzo Muto
- GIGA-Institute, Cyclotron Research Center/In Vivo Imaging, Sleep and Chronobiology Lab, University of Liège, Liège, Belgium
| | - Justinas Narbutas
- GIGA-Institute, Cyclotron Research Center/In Vivo Imaging, Sleep and Chronobiology Lab, University of Liège, Liège, Belgium
| | - Gustav Nilsonne
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
- Department of Psychology, Stress Research Institute, Stockholm University, Stockholm, Sweden
| | | | - Alexander Olsen
- Department of Physical Medicine and Rehabilitation, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
- Department of Psychology, Norwegian University of Science and Technology, Trondheim, Norway
| | - Ricardo S. Osorio
- Healthy Brain Aging and Sleep Center, Department of Psychiatry, NYU Grossman School of Medicine, New York, NY, USA
- Nathan S. Kline Institute for Psychiatric Research, Orangeburg, NY, USA
| | - Sara Poletti
- Psychiatry & Clinical Psychobiology, Division of Neuroscience, IRCCS Scientific Institute Ospedale San Raffaele, Milano, Italy
- Vita-Salute San Raffaele University, Milano, Italy
| | - Govinda Poudel
- Mary Mackillop Institute for Health Research, Australian Catholic University, Melbourne, Vic., Australia
| | - Joyce E. Reesen
- Department of Sleep and Cognition, Netherlands Institute for Neuroscience (NIN), an Institute of the Royal Netherlands Academy of Arts and Sciences, Amsterdam, The Netherlands
- Department of Integrative Neurophysiology, Center for Neurogenomics and Cognitive Research (CNCR), Amsterdam Neuroscience, VU University Amsterdam, Amsterdam, Netherlands
| | - Liesbeth Reneman
- Department of Radiology and Nuclear Medicine, Amsterdam University Medical Centers, AMC, Amsterdam, The Netherlands
| | - Mathilde Reyt
- GIGA-Institute, Cyclotron Research Center/In Vivo Imaging, Sleep and Chronobiology Lab, University of Liège, Liège, Belgium
- Psychology and Neuroscience of Cognition Research Unit, Faculty of Psychology and Educational Sciences, University of Liège, Liège, Belgium
| | - Dieter Riemann
- Department of Psychiatry and Psychotherapy, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg im Breisgau, Germany
| | - Ivana Rosenzweig
- Sleep and Brain Plasticity Centre, Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King’s College London, London, UK
- Sleep Disorders Centre, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Masoumeh Rostampour
- Sleep Disorders Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Amin Saberi
- Institute of Medical Science and Technology, Shahid Beheshti University, Tehran, Iran
| | - Julian Schiel
- Department of Psychiatry and Psychotherapy, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg im Breisgau, Germany
| | - Christina Schmidt
- GIGA-Institute, Cyclotron Research Center/In Vivo Imaging, Sleep and Chronobiology Lab, University of Liège, Liège, Belgium
- Psychology and Neuroscience of Cognition Research Unit, Faculty of Psychology and Educational Sciences, University of Liège, Liège, Belgium
| | - Anouk Schrantee
- Department of Radiology and Nuclear Medicine, Amsterdam University Medical Centers, AMC, Amsterdam, The Netherlands
| | - Emma Sciberras
- Department of Paediatrics, University of Melbourne, Parkville, Vic., Australia
- Murdoch Children's Research Institute, Parkville, Vic., Australia
- School of Psychology, Deakin University, Geelong, Vic., Australia
| | - Tim J. Silk
- Department of Paediatrics, University of Melbourne, Parkville, Vic., Australia
- Murdoch Children's Research Institute, Parkville, Vic., Australia
- School of Psychology, Deakin University, Geelong, Vic., Australia
| | - Kang Sim
- Institute of Mental Health, Buangkok, Singapore
| | - Hanne Smevik
- Department of Psychology, Norwegian University of Science and Technology, Trondheim, Norway
| | - Jair C. Soares
- Department of Psychiatry & Behavioral Sciences, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Kai Spiegelhalder
- Department of Psychiatry and Psychotherapy, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg im Breisgau, Germany
| | - Dan J. Stein
- SA MRC Unit on Risk & Resilience in Mental Disorders, Department of Psychiatry & Neuroscience Institute, University of Cape Town, Cape Town, South Africa
| | - Puneet Talwar
- GIGA-Institute, Cyclotron Research Center/In Vivo Imaging, Sleep and Chronobiology Lab, University of Liège, Liège, Belgium
| | - Sandra Tamm
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
- Department of Psychology, Stress Research Institute, Stockholm University, Stockholm, Sweden
- Department of Psychiatry, University of Oxford, Oxford, UK
| | - Giana I. Teresi
- Department of Psychology, Stanford University, Stanford, CA, USA
| | - Sofie L. Valk
- Institute of Neuroscience and Medicine, Brain & Behaviour (INM-7), Research Centre Jülich, Jülich, Germany
- Institute of Systems Neuroscience, Medical Faculty,, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
- Otto Hahn Group Cognitive Neurogenetics, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
| | - Eus Van Someren
- Department of Sleep and Cognition, Netherlands Institute for Neuroscience (NIN), an Institute of the Royal Netherlands Academy of Arts and Sciences, Amsterdam, The Netherlands
- Department of Integrative Neurophysiology, Center for Neurogenomics and Cognitive Research (CNCR), Amsterdam Neuroscience, VU University Amsterdam, Amsterdam, Netherlands
- Vrije Universiteit, Psychiatry, Amsterdam Neuroscience, Amsterdam UMC, Amsterdam, The Netherlands
| | - Gilles Vandewalle
- GIGA-Institute, Cyclotron Research Center/In Vivo Imaging, Sleep and Chronobiology Lab, University of Liège, Liège, Belgium
| | - Maxime Van Egroo
- GIGA-Institute, Cyclotron Research Center/In Vivo Imaging, Sleep and Chronobiology Lab, University of Liège, Liège, Belgium
| | - Henry Völzke
- Institute for Community Medicine, Department SHIP/Clinical Epidemiological Research, University Medicine Greifswald, Greifswald, Germany
- German Centre for Cardiovascular Research (DZHK), Greifswald, Germany
| | - Martin Walter
- Clinical Affective Neuroimaging Laboratory, Otto von Guericke University, Magdeburg, Germany
- Department of Psychiatry and Psychotherapy, Jena University Hospital, Jena, Germany
- Department of Psychiatry and Psychotherapy, University of Tübingen, Tübingen, Germany
- Leibniz Institute for Neurobiology, Magdeburg, Germany
- Department of Psychiatry and Psychotherapy, Otto-von-Guericke University Magdeburg, Magdeburg, Germany
- Department of Psychiatry and Psychotherapy, Jena University Hospital, Jena, Germany
| | - Rick Wassing
- Department of Sleep and Circadian Research, Woolcock Institute of Medical Research, The University of Sydney, Sydney, Australia
| | - Frederik D. Weber
- Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Antoine Weihs
- Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Greifswald, Germany
| | - Lars Tjelta Westlye
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital, Inst of Clinical Medicine, University of Oslo, Oslo, Norway
- Department of Psychology, University of Oslo, Oslo, Norway
- K.G Jebsen Center for Neurodevelopmental Disorders, University of Oslo, Oslo, Norway
| | - Margaret J. Wright
- Queensland Brain Institute, The University of Queensland, Brisbane, Qld, Australia
- Centre for Advanced Imaging, The University of Queensland, St Lucia, Qld, Australia
| | - Mon-Ju Wu
- Department of Psychology and Center for Magnetic Resonance Research, University of Minnesota, Minneapolis, MN, USA
| | - Nathalia Zak
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital, Inst of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Mojtaba Zarei
- Institute of Medical Science and Technology, Shahid Beheshti University, Tehran, Iran
| |
Collapse
|
55
|
O’Regan D, Jackson ML, Young AH, Rosenzweig I. Understanding the Impact of the COVID-19 Pandemic, Lockdowns and Social Isolation on Sleep Quality. Nat Sci Sleep 2021; 13:2053-2064. [PMID: 34795545 PMCID: PMC8593898 DOI: 10.2147/nss.s266240] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Accepted: 10/17/2021] [Indexed: 12/15/2022] Open
Abstract
The uncertain, ever-changing and an ongoing nature of the COVID-19 pandemic means that it may take some time before we can fully appreciate the negative effect of the pandemic and lockdown on our sleep and mental health. It is increasingly recognised that in the aftermath of pandemic, several persistent sleep, neuropsychiatric and physical sequelae may continue long after the pandemic is over. A body of evidence to date also highlights a significant disparity in sleep and mental health difficulties in specific vulnerable groups in the community, with different temporal profiles and sleep issues that are reported. In this perspective, we argue for a possible mechanistic impact of the COVID-19 pandemic, with its imposed restrictions and social isolation on sleep quality. We similarly discuss some of the potential international differences, as well as similarities, behind reported idiosyncratic biological vulnerabilities that may have contributed to the genesis of sleep issues. Lastly, we propose some possible implementations and innovations that may be needed in restructuring of sleep disorders services in order to benefit recovering COVID-19 patients.
Collapse
Affiliation(s)
- David O’Regan
- Sleep Disorders Centre, Guy’s and St Thomas’ Hospital, GSTT NHS, London, UK
- Faculty of Life and Sciences Medicine, King’s College London, London, UK
| | - Melinda L Jackson
- Turner Institute for Brain and Mental Health, Monash University, Melbourne, Australia
| | - Allan H Young
- School of Academic Psychiatry, IoPPN, King’s College London, London, UK
| | - Ivana Rosenzweig
- Sleep Disorders Centre, Guy’s and St Thomas’ Hospital, GSTT NHS, London, UK
- Sleep and Brain Plasticity Centre, CNS, IoPPN, King’s College London, London, UK
| |
Collapse
|
56
|
Chen L, Ren SY, Li RX, Liu K, Chen JF, Yang YJ, Deng YB, Wang HZ, Xiao L, Mei F, Wang F. Chronic Exposure to Hypoxia Inhibits Myelinogenesis and Causes Motor Coordination Deficits in Adult Mice. Neurosci Bull 2021; 37:1397-1411. [PMID: 34292513 PMCID: PMC8490606 DOI: 10.1007/s12264-021-00745-1] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2020] [Accepted: 03/06/2021] [Indexed: 12/18/2022] Open
Abstract
Exposure to chronic hypoxia is considered to be a risk factor for deficits in brain function in adults, but the underlying mechanisms remain largely unknown. Since active myelinogenesis persists in the adult central nervous system, here we aimed to investigate the impact of chronic hypoxia on myelination and the related functional consequences in adult mice. Using a transgenic approach to label newly-generated myelin sheaths (NG2-CreERTM; Tau-mGFP), we found that myelinogenesis was highly active in most brain regions, such as the motor cortex and corpus callosum. After exposure to hypoxia (10% oxygen) 12 h per day for 4 weeks, myelinogenesis was largely inhibited in the 4-month old brain and the mice displayed motor coordination deficits revealed by the beam-walking test. To determine the relationship between the inhibited myelination and functional impairment, we induced oligodendroglia-specific deletion of the transcription factor Olig2 by tamoxifen (NG2-CreERTM; Tau-mGFP; Olig2 fl/fl) in adult mice to mimic the decreased myelinogenesis caused by hypoxia. The deletion of Olig2 inhibited myelinogenesis and consequently impaired motor coordination, suggesting that myelinogenesis is required for motor function in adult mice. To understand whether enhancing myelination could protect brain functions against hypoxia, we treated hypoxic mice with the myelination-enhancing drug-clemastine, which resulted in enhanced myelogenesis and improved motor coordination. Taken together, our data indicate that chronic hypoxia inhibits myelinogenesis and causes functional deficits in the brain and that enhancing myelinogenesis protects brain functions against hypoxia-related deficits.
Collapse
Affiliation(s)
- Lin Chen
- Department of Histology and Embryology, Chongqing Key Laboratory of Neurobiology, Brain and Intelligence Research Key Laboratory of Chongqing Education Commission, Third Military Medical University, Chongqing, 400038, China
| | - Shu-Yu Ren
- Department of Histology and Embryology, Chongqing Key Laboratory of Neurobiology, Brain and Intelligence Research Key Laboratory of Chongqing Education Commission, Third Military Medical University, Chongqing, 400038, China
| | - Rui-Xue Li
- Department of Histology and Embryology, Chongqing Key Laboratory of Neurobiology, Brain and Intelligence Research Key Laboratory of Chongqing Education Commission, Third Military Medical University, Chongqing, 400038, China
| | - Kun Liu
- Department of Histology and Embryology, Chongqing Key Laboratory of Neurobiology, Brain and Intelligence Research Key Laboratory of Chongqing Education Commission, Third Military Medical University, Chongqing, 400038, China
| | - Jing-Fei Chen
- Department of Histology and Embryology, Chongqing Key Laboratory of Neurobiology, Brain and Intelligence Research Key Laboratory of Chongqing Education Commission, Third Military Medical University, Chongqing, 400038, China
| | - Yu-Jian Yang
- Department of Histology and Embryology, Chongqing Key Laboratory of Neurobiology, Brain and Intelligence Research Key Laboratory of Chongqing Education Commission, Third Military Medical University, Chongqing, 400038, China
| | - Yong-Bin Deng
- Department of Neurosurgery, Chongqing Emergency Medical Center, Chongqing University, Chongqing, 400014, China
| | - Han-Zhi Wang
- Department of Histology and Embryology, Chongqing Key Laboratory of Neurobiology, Brain and Intelligence Research Key Laboratory of Chongqing Education Commission, Third Military Medical University, Chongqing, 400038, China
| | - Lan Xiao
- Department of Histology and Embryology, Chongqing Key Laboratory of Neurobiology, Brain and Intelligence Research Key Laboratory of Chongqing Education Commission, Third Military Medical University, Chongqing, 400038, China
| | - Feng Mei
- Department of Histology and Embryology, Chongqing Key Laboratory of Neurobiology, Brain and Intelligence Research Key Laboratory of Chongqing Education Commission, Third Military Medical University, Chongqing, 400038, China.
| | - Fei Wang
- Department of Histology and Embryology, Chongqing Key Laboratory of Neurobiology, Brain and Intelligence Research Key Laboratory of Chongqing Education Commission, Third Military Medical University, Chongqing, 400038, China.
| |
Collapse
|
57
|
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: 7] [Impact Index Per Article: 2.3] [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.
Collapse
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
| |
Collapse
|
58
|
Abstract
Rationale: Evidence suggests that the physiopathologic consequences of obstructive sleep apnea (OSA) resemble those induced by aging. Some studies report that the deleterious effects associated with OSA might be age dependent. Objectives: To evaluate the association of OSA with the aging process and to determine whether this association is maintained across different age groups. Methods: This was an observational, prospective study including 599 patients with suspected OSA. Five hallmarks of aging were evaluated: alteration of cellular communication (serum CRP [C-reactive protein] concentration), deregulation of nutrient sensing (insulin resistance), telomere attrition (leukocyte telomeric length), mitochondrial dysfunction (leukocyte mitochondrial DNA copy number), and genomic instability (urinary 8-hydroxy-2-deoxyguanosine concentration). For age-stratified analyses, subjects were divided into four groups according to the apnea-hypopnea index (AHI) and the median age (50 yr): young patients without OSA (age < 50 yr old, AHI < 15 events/h), young patients with OSA (age < 50 yr old, AHI ⩾ 15 events/h), older patients without OSA (age ⩾ 50 yr old, AHI < 15 events/h), and older patients with OSA (age ⩾ 50 yr old, AHI ⩾ 15 events/h). Results: A dose-response relationship was found between the AHI, arousal index, and time during the night spent with an oxygen saturation less than 90% and the following hallmarks: alteration of cellular communication, deregulation of nutrient sensing, mitochondrial dysfunction, and genomic instability. Considering age-stratified analyses, OSA was associated with an increase in several hallmarks of aging in young patients, but no significant association of OSA was identified in older patients. Conclusions: In subjects under 50 years of age, OSA is associated with an increase in specific hallmarks of aging, independent of several known confounding factors.
Collapse
|
59
|
Park HR, Cha J, Joo EY, Kim H. Altered cerebrocerebellar functional connectivity in patients with obstructive sleep apnea and its association with cognitive function. Sleep 2021; 45:6357664. [PMID: 34432059 DOI: 10.1093/sleep/zsab209] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Revised: 07/19/2021] [Indexed: 11/14/2022] Open
Abstract
STUDY OBJECTIVES Previous functional MRI studies have reported altered brain networks in patients with obstructive sleep apnea (OSA). However, the extent and pattern of abnormal connectivity were inconsistent across studies, and cerebrocerebellar connections have been rarely assessed. We investigated functional network changes in cerebral and cerebellar cortices of OSA patients. METHODS Resting-state functional MRI, polysomnography and neuropsychological (NP) test data were acquired from 74 OSA patients (age: 45.8±10.7 years) and 33 healthy subjects (39.6±9.3 years). Connectivity matrices were extracted by computing correlation coefficients from various ROIs, and Fisher r-to-z transformations. In the functional connections that showed significant group differences, linear regression was conducted to examine the association between connectivity and clinical characteristics. RESULTS Patients with OSA showed reduced functional connectivity (FC) in cerebrocerebellar connections linking different functional networks, and greater FC in cortical between-network connections in prefrontal regions involving the default mode network and the control network. For OSA group, we found no correlation between FC and sleep parameters including lowest SaO2 and arousal index in the connections where significant associations were observed in healthy subjects. FC changes in default mode network (DMN) areas were related to reduced verbal fluency in OSA. Lower local efficiency and lower clustering coefficient of the salience network in the left cerebellum were also observed in OSA. CONCLUSIONS OSA affects mainly the cerebrocerebellar pathway. The disruption of function in these connections are related to sleep fragmentation and hypoxia during sleep. These abnormal network functions, especially DMN, are suggested to participate in cognitive decline of OSA.
Collapse
Affiliation(s)
- Hea Ree Park
- Department of Neurology, Inje University College of Medicine, Ilsan Paik Hospital, Goyang, Republic of Korea
| | - Jungho Cha
- Nash Family Center for Advanced Circuit Therapeutics, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Eun Yeon Joo
- Department of Neurology, Neuroscience Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Hosung Kim
- USC Stevens Neuroimaging and Informatics Institute, Keck School of Medicine of USC, University of Southern California, Los Angeles, CA, USA
| |
Collapse
|
60
|
Ilic K, Mlinac-Jerkovic K, Sedmak G, Rosenzweig I, Kalanj-Bognar S. Neuroplastin in human cognition: review of literature and future perspectives. Transl Psychiatry 2021; 11:394. [PMID: 34282131 PMCID: PMC8289873 DOI: 10.1038/s41398-021-01509-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Revised: 06/16/2021] [Accepted: 06/23/2021] [Indexed: 02/07/2023] Open
Abstract
Synaptic glycoprotein neuroplastin is involved in synaptic plasticity and complex molecular events underlying learning and memory. Studies in mice and rats suggest that neuroplastin is essential for cognition, as it is needed for long-term potentiation and associative memory formation. Recently, it was found that some of the effects of neuroplastin are related to regulation of calcium homeostasis through interactions with plasma membrane calcium ATPases. Neuroplastin is increasingly seen as a key factor in complex brain functions, but studies in humans remain scarce. Here we summarize present knowledge about neuroplastin in human tissues and argue its genetic association with cortical thickness, intelligence, schizophrenia, and autism; specific immunolocalization depicting hippocampal trisynaptic pathway; potential role in tissue compensatory response in neurodegeneration; and high, almost housekeeping, level of spatio-temporal gene expression in the human brain. We also propose that neuroplastin acts as a housekeeper of neuroplasticity, and that it may be considered as an important novel cognition-related molecule in humans. Several promising directions for future investigations are suggested, which may complete our understanding of neuroplastin actions in molecular basis of human cognition.
Collapse
Affiliation(s)
- Katarina Ilic
- Croatian Institute for Brain Research, School of Medicine, University of Zagreb, Šalata12, 10000, Zagreb, Croatia
| | - Kristina Mlinac-Jerkovic
- Croatian Institute for Brain Research, School of Medicine, University of Zagreb, Šalata12, 10000, Zagreb, Croatia
| | - Goran Sedmak
- Croatian Institute for Brain Research, School of Medicine, University of Zagreb, Šalata12, 10000, Zagreb, Croatia
| | - Ivana Rosenzweig
- Sleep and Brain Plasticity Centre, Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London (KCL), Strand, London, WC2R 2LS, UK
- Sleep Disorders Centre, Guy's and St Thomas' Hospital, Great Maze Pond, London, SE1 9RT, UK
| | - Svjetlana Kalanj-Bognar
- Croatian Institute for Brain Research, School of Medicine, University of Zagreb, Šalata12, 10000, Zagreb, Croatia.
| |
Collapse
|
61
|
Cheng L, Guo H, Zhang Z, Yao Y, Yao Q. Obstructive sleep apnea and incidence of malignant tumors: a meta-analysis. Sleep Med 2021; 84:195-204. [PMID: 34166986 DOI: 10.1016/j.sleep.2021.05.029] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/25/2020] [Revised: 05/21/2021] [Accepted: 05/24/2021] [Indexed: 12/17/2022]
Abstract
OBJECTIVES This paper assessed the connection between obstructive sleep apnea (OSA) and the incidence of malignant tumors. METHODS PubMed, Cochrane, Scopus, Health Source Nursing Academic Edition, EMBASE, and Web of Sciences were searched until the date of July 25, 2020. The analysis included an assessment of the overall incidence of OSA malignancies, the incidence of OSA malignancies by age and gender, and the incidence of different types of malignancies in patients with OSA. The total rate and the corresponding 95% confidence interval (CI) of the incidence of malignant tumors in patients with OSA were calculated. Patients with OSA were classified according to age, gender, and different types of malignant tumors for meta-analysis. RESULTS A total of 12 studies involving 862,820 participants were included in this meta-analysis. Random effect model analysis showed that the total incidence of malignant tumors in patients with OSA was 0.046% (95% CI: 0.027-0.065, P < 0.001), higher than that of malignant tumors in the general population. According to the analytical results classified by gender, the incidence of malignant tumor in female patients with OSA was 4.0% (95% CI: 0.014-0.066), higher than that in male patients at 3.5% (95% CI: 0.012-0.058). The analytical results classified by age showed that the incidence of malignant tumors in patients with OSA aged below 60 years was 1.8% (95% CI: 0.000-0.036), lower than that in patients aged above 60 years at 4.3% (95% CI: 0.002-0.084). The analytical results classified by the types of malignant tumors showed that the incidences of breast cancer, lung cancer, colorectal cancer, prostate cancer, kidney cancer, pancreatic cancer, and melanoma in patients with OSA were 0.5% (95% CI: 0.001-0.008), 0.5% (95% CI: 0.002-0.009), 0.5% (95% CI: 0.003-0.008), 1.1% (95% CI: 0.002-0.021), 0.3% (95% CI: 0.001-0.005), 0.1% (95% CI: 0.001-0.002), and 0.4% (95% CI: 0.003-0.005), respectively. Among them, the incidence of prostate cancer was the highest, followed by breast cancer, lung cancer, colorectal cancer, melanoma, and kidney cancer, whereas the incidence of pancreatic cancer was the lowest. However, the incidence of specific malignant tumors in patients with OSA did not have a significant increase compared with that in the general population. CONCLUSIONS The analytical results of this meta-analysis suggested that OSA may be associated with an overall increase in the incidence of malignancies based on the currently available data, but the connection with specific types of malignancies was not significant. Further studies are needed to explore this association in the future.
Collapse
Affiliation(s)
- Linjie Cheng
- Department of Physiology, School of Basic Medical Sciences, Xinjiang Medical University, Urumqi, Xinjiang, China
| | - Hai Guo
- Department of Physiology, School of Basic Medical Sciences, Xinjiang Medical University, Urumqi, Xinjiang, China; Department of Anesthesiology, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, China
| | - Zhenlian Zhang
- Department of Physiology, School of Basic Medical Sciences, Xinjiang Medical University, Urumqi, Xinjiang, China
| | - Yangyang Yao
- Department of Anesthesiology, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, China
| | - Qiaoling Yao
- Department of Physiology, School of Basic Medical Sciences, Xinjiang Medical University, Urumqi, Xinjiang, China.
| |
Collapse
|
62
|
Legault J, Thompson C, Martineau-Dussault MÈ, André C, Baril AA, Martinez Villar G, Carrier J, Gosselin N. Obstructive Sleep Apnea and Cognitive Decline: A Review of Potential Vulnerability and Protective Factors. Brain Sci 2021; 11:706. [PMID: 34071739 PMCID: PMC8226698 DOI: 10.3390/brainsci11060706] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2021] [Revised: 05/21/2021] [Accepted: 05/25/2021] [Indexed: 02/07/2023] Open
Abstract
Around 40% of dementia risk is attributable to modifiable risk factors such as physical inactivity, hypertension, diabetes and obesity. Recently, sleep disorders, including obstructive sleep apnea (OSA), have also been considered among these factors. However, despite several epidemiological studies investigating the link between OSA and cognitive decline, there is still no consensus on whether OSA increases the risk of dementia or not. Part of the heterogeneity observed in previous studies might be related to some individual characteristics that modulate the association between OSA and cognitive decline. In this narrative review, we present these individual characteristics, namely, age, sex, menopause, obesity, diabetes mellitus, hypertension, cardiovascular diseases, smoking, excessive alcohol consumption, depression, air pollution, Apolipoprotein E ε4 allele, physical activity, and cognitive reserve. To date, large cohort studies of OSA and cognitive decline tended to statistically control for the effects of these variables, but whether they interact with OSA to predict cognitive decline remains to be elucidated. Being able to better predict who is at risk of cognitive decline when they have OSA would improve clinical management and treatment decisions, particularly when patients present relatively mild OSA.
Collapse
Affiliation(s)
- Julie Legault
- Center for Advanced Research in Sleep Medicine, Hôpital du Sacré-Coeur de Montréal, Recherche CIUSSS NIM, Montreal, QC H4J 1C5, Canada; (J.L.); (C.T.); (M.-È.M.-D.); (C.A.); (G.M.V.); (J.C.)
- Department of Psychology, Université de Montréal, Montreal, QC H3C 3J7, Canada
| | - Cynthia Thompson
- Center for Advanced Research in Sleep Medicine, Hôpital du Sacré-Coeur de Montréal, Recherche CIUSSS NIM, Montreal, QC H4J 1C5, Canada; (J.L.); (C.T.); (M.-È.M.-D.); (C.A.); (G.M.V.); (J.C.)
| | - Marie-Ève Martineau-Dussault
- Center for Advanced Research in Sleep Medicine, Hôpital du Sacré-Coeur de Montréal, Recherche CIUSSS NIM, Montreal, QC H4J 1C5, Canada; (J.L.); (C.T.); (M.-È.M.-D.); (C.A.); (G.M.V.); (J.C.)
- Department of Psychology, Université de Montréal, Montreal, QC H3C 3J7, Canada
| | - Claire André
- Center for Advanced Research in Sleep Medicine, Hôpital du Sacré-Coeur de Montréal, Recherche CIUSSS NIM, Montreal, QC H4J 1C5, Canada; (J.L.); (C.T.); (M.-È.M.-D.); (C.A.); (G.M.V.); (J.C.)
- Department of Psychology, Université de Montréal, Montreal, QC H3C 3J7, Canada
| | - Andrée-Ann Baril
- Douglas Mental Health University Institute, McGill University, Montreal, QC H4H 1R3, Canada;
| | - Guillermo Martinez Villar
- Center for Advanced Research in Sleep Medicine, Hôpital du Sacré-Coeur de Montréal, Recherche CIUSSS NIM, Montreal, QC H4J 1C5, Canada; (J.L.); (C.T.); (M.-È.M.-D.); (C.A.); (G.M.V.); (J.C.)
- Department of Psychology, Université de Montréal, Montreal, QC H3C 3J7, Canada
| | - Julie Carrier
- Center for Advanced Research in Sleep Medicine, Hôpital du Sacré-Coeur de Montréal, Recherche CIUSSS NIM, Montreal, QC H4J 1C5, Canada; (J.L.); (C.T.); (M.-È.M.-D.); (C.A.); (G.M.V.); (J.C.)
- Department of Psychology, Université de Montréal, Montreal, QC H3C 3J7, Canada
| | - Nadia Gosselin
- Center for Advanced Research in Sleep Medicine, Hôpital du Sacré-Coeur de Montréal, Recherche CIUSSS NIM, Montreal, QC H4J 1C5, Canada; (J.L.); (C.T.); (M.-È.M.-D.); (C.A.); (G.M.V.); (J.C.)
- Department of Psychology, Université de Montréal, Montreal, QC H3C 3J7, Canada
| |
Collapse
|
63
|
Gnoni V, Drakatos P, Higgins S, Duncan I, Wasserman D, Kabiljo R, Mutti C, Halasz P, Goadsby PJ, Leschziner GD, Rosenzweig I. Cyclic alternating pattern in obstructive sleep apnea: A preliminary study. J Sleep Res 2021; 30:e13350. [PMID: 33939202 DOI: 10.1111/jsr.13350] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2021] [Revised: 03/10/2021] [Accepted: 03/18/2021] [Indexed: 11/29/2022]
Abstract
Obstructive sleep apnea is linked to cardiovascular disease, metabolic disorders and dementia. The precise nature of the association between respiratory events in obstructive sleep apnea, cortical or subcortical arousals, and cognitive, autonomic and oxidative stress consequences remains incompletely elucidated. Previous studies have aimed to understand the relationship between obstructive sleep apnea and arousal patterns, as defined by the cyclic alternating pattern, but results have been inconsistent, in part likely due to the presence of associated comorbidities. To better define this relationship, we analysed cyclic alternating patterns in patients with obstructive sleep apnea without any additional comorbidities. We identified 18 adult male, non-obese subjects with obstructive sleep apnea and no other comorbidities or medication history, who underwent whole-night electroencephalography and polysomnography. Cyclic alternating pattern analysis was performed and verified by certified somnologists. Pairwise linear regression analysis demonstrated an inverse relationship between obstructive sleep apnea severity and cyclic alternating pattern subtype A1, and a direct correlation with cyclic alternating pattern subtype A3. Cyclic alternating pattern subtypes A1 prevail in milder obstructive sleep apnea phenotype, whilst cyclic alternating pattern subtypes A2 and A3 overcome among moderate-to-severe obstructive sleep apnea patients. The milder obstructive sleep apnea group also presented higher sleep efficiency, and increased percentages of non-rapid eye movement stage 3 and rapid eye movement sleep, as well as longer cyclic alternating pattern sequences in N3, while severe obstructive sleep apnea patients spent more time in lighter sleep stages. These results imply/suggest a balance between cyclic alternating pattern's adaptive and maladaptive arousal processes in obstructive sleep apnea of differing severities. In milder obstructive sleep apnea (apnea-hypopnea index < 20), sleep continuity may be reinforced by cyclic alternating pattern subtype A1, whereas in more severe obstructive sleep apnea, decompensation of these sleep-stabilizing mechanisms may occur and more intrusive cyclic alternating pattern fluctuations disrupt sleep circuitry.
Collapse
Affiliation(s)
- Valentina Gnoni
- Department of Neuroimaging, Sleep and Brain Plasticity Centre, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London, UK.,Sleep Disorders Centre, Guy's and St Thomas NHS Foundation Trust, London, UK
| | - Panagis Drakatos
- Department of Neuroimaging, Sleep and Brain Plasticity Centre, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London, UK.,Sleep Disorders Centre, Guy's and St Thomas NHS Foundation Trust, London, UK.,Faculty of Life Sciences and Medicine, King's College London, London, UK
| | - Sean Higgins
- Department of Neuroimaging, Sleep and Brain Plasticity Centre, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London, UK.,Sleep Disorders Centre, Guy's and St Thomas NHS Foundation Trust, London, UK
| | - Iain Duncan
- Department of Neuroimaging, Sleep and Brain Plasticity Centre, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London, UK.,Sleep Disorders Centre, Guy's and St Thomas NHS Foundation Trust, London, UK
| | - Danielle Wasserman
- Department of Neuroimaging, Sleep and Brain Plasticity Centre, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London, UK
| | - Renata Kabiljo
- Department of Neuroimaging, Sleep and Brain Plasticity Centre, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London, UK
| | - Carlotta Mutti
- Neurology Unit, Department of General Medicine, Parma University Hospital, Parma, Italy
| | - Peter Halasz
- National Institute of Clinical Neuroscience, Budapest, Hungary
| | - Peter J Goadsby
- NIHR-Wellcome Trust King's Clinical Research Facility, King's College London, London, UK
| | - Guy D Leschziner
- Department of Neuroimaging, Sleep and Brain Plasticity Centre, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London, UK.,Sleep Disorders Centre, Guy's and St Thomas NHS Foundation Trust, London, UK.,Department of Neurology, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Ivana Rosenzweig
- Department of Neuroimaging, Sleep and Brain Plasticity Centre, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London, UK.,Sleep Disorders Centre, Guy's and St Thomas NHS Foundation Trust, London, UK
| |
Collapse
|
64
|
A randomized sham-controlled trial on the effect of continuous positive airway pressure treatment on gait control in severe obstructive sleep apnea patients. Sci Rep 2021; 11:9329. [PMID: 33927278 PMCID: PMC8085224 DOI: 10.1038/s41598-021-88642-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2020] [Accepted: 04/09/2021] [Indexed: 11/21/2022] Open
Abstract
To determine the effect of continuous positive airway pressure (CPAP), the gold standard treatment for obstructive sleep apnea syndrome (OSAS), on gait control in severe OSAS patients. We conducted a randomized, double-blind, parallel-group, sham-controlled monocentric study in Grenoble Alpes University Hospital, France. Gait parameters were recorded under single and dual-task conditions using a visuo-verbal cognitive task (Stroop test), before and after the 8-week intervention period. Stride-time variability, a marker of gait control, was the primary study endpoint. Changes in the determinants of gait control were the main secondary outcomes. ClinicalTrials.gov Identifier: (NCT02345694). 24 patients [median (Q1; Q3)]: age: 59.5 (46.3; 66.8) years, 87.5% male, body mass index: 28.2 (24.7; 29.8) kg. m−2, apnea–hypopnea index: 51.6 (35.0; 61.4) events/h were randomized to be treated by effective CPAP (n = 12) or by sham-CPAP (n = 12). A complete case analysis was performed, using a mixed linear regression model. CPAP elicited no significant improvement in stride-time variability compared to sham-CPAP. No difference was found regarding the determinants of gait control. This study is the first RCT to investigate the effects of CPAP on gait control. Eight weeks of CPAP treatment did not improve gait control in severe non-obese OSAS patients. These results substantiate the complex OSAS-neurocognitive function relationship.
Collapse
|
65
|
Pelletier-Fleury N, Le Vaillant M, Goupil F, Paris A, Pigeane T, Gagnadoux F, Meslier N. Risk-seeking attitude in health and safety domain is associated with continuous positive airway pressure discontinuation in patients with obstructive sleep apnea-a multicenter prospective cohort study. Sleep 2021; 44:5896478. [PMID: 32832982 DOI: 10.1093/sleep/zsaa156] [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: 03/26/2020] [Revised: 07/03/2020] [Indexed: 11/12/2022] Open
Abstract
STUDY OBJECTIVES Many studies have already looked at factors that may influence adherence to continuous positive airway pressure (CPAP) (severity of obstructive sleep apnea (OSA), patients' age, technical aspects, socioeconomic factors, living conditions, psychological factors). Although it has been shown that individuals' preference for risky behaviors in daily life can influence the use of care or adherence to drug therapies in care settings, this has never been tested in OSA. This study aims to analyze the association between risk attitude in the health/safety domain and CPAP discontinuation in a cohort of OSA patients. METHODS In a prospective multicenter cohort study nested within the IRSR sleep cohort, consecutive patients who were prescribed CPAP were monitored for at least 6 months. In addition to the data usually collected in the IRSR sleep cohort at baseline, patients also completed a risk-taking questionnaire using the Domain-Specific Risk-Taking (DOSPERT) scale. Cox's proportional hazards regression was used to model the risk of CPAP discontinuation as a function of a linear combination of variables hypothetically related to this risk including health risk attitude. RESULTS Of the 489 patients under CPAP, 12.1% (n = 59) were risk-seeking, 87.9% (n = 430) were risk-neutral, and none were risk-averse. Cox's model indicated that a risk-seeking attitude (p = 0.04) and an AHI <30 (p < 0.01) were significantly associated with CPAP discontinuation. CONCLUSIONS Patients with risk-seeking behaviors in daily life have been shown to be more likely to discontinue CPAP. The DOSPERT scale can be a useful tool for screening this specific group of patients in clinical practice.
Collapse
Affiliation(s)
- Nathalie Pelletier-Fleury
- Institut National de la Santé Et de la Recherche Médicale (INSERM UMR 1018), Université Paris-Saclay, Centre de Recherche en Epidémiologie et Santé des Populations, Hôpital Paul Brousse, 16 av Paul Vaillant Couturier, Villejuif, France
| | - Marc Le Vaillant
- Institut de Recherche en Santé Respiratoire des Pays de la Loire, Beaucouzé, France
| | - François Goupil
- Département de pneumologie, Centre Hospitalier, Le Mans, France
| | - Audrey Paris
- Département de pneumologie, Centre Hospitalier, Le Mans, France
| | | | - Frédéric Gagnadoux
- Département de pneumologie, Centre hospitalier universitaire, Angers, France
| | - Nicole Meslier
- Département de pneumologie, Centre hospitalier universitaire, Angers, France
| | | |
Collapse
|
66
|
Binar M, Gokgoz MC. Olfactory function in patients with obstructive sleep apnea and the effect of positive airway pressure treatment: a systematic review and meta-analysis. Sleep Breath 2021; 25:1791-1802. [PMID: 33738753 PMCID: PMC7972818 DOI: 10.1007/s11325-021-02349-5] [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: 11/12/2020] [Revised: 02/26/2021] [Accepted: 03/09/2021] [Indexed: 11/28/2022]
Abstract
OBJECTIVES To investigate olfactory function (OF) in patients with obstructive sleep apnea (OSA) and evaluate whether or not the use of positive airway pressure (PAP) treatment has an impact on olfactory performance. METHODS All studies published in English that gave satisfactory data regarding the assessment of OF in patients with OSA were included in this review. First, a baseline assessment of OF in patients with OSA who had not received any treatment was examined. Second, the effect of PAP therapy on OF was assessed to be able to make before and after comparisons. The primary outcome of this study was the threshold-discrimination identification (TDI) scores, obtained from the Sniffin' Sticks test. RESULTS The database search identified 552 articles. According to the exclusion criteria, 11 studies involving 557 patients diagnosed with OSA were included in this meta-analysis. The general rate of olfactory dysfunction was 73% (95% CI: 56.481-87.057) among the patients with OSA. The patients with OSA had lower TDI scores compared to the control group and the difference was statistically significant (p < 0.001). PAP treatment significantly improved the TDI scores in patients with OSA (p < 0.001). There was a significant negative correlation between the severity of apnea-hypopnea index and TDI scores (p = 0.001, z = -3.377, r = -0.438) and between age and TDI scores (p = 0.007, z = -2.695, r = -0.236). CONCLUSION This meta-analysis demonstrates that OSA impairs OF, while PAP treatment can reverse the olfactory performance of patients with OSA.
Collapse
Affiliation(s)
- Murat Binar
- Department of Otolaryngology, Head and Neck Surgery, Ento KBB Medical Center, Kazımdirik Mah. 364/1. Sk. No: 36/A, 35100, Bornova, Izmir, Turkey.
| | - Mert Cemal Gokgoz
- Department of Otolaryngology, Head and Neck Surgery, Manisa City Hospital, Manisa, Turkey
| |
Collapse
|
67
|
Breitenstein RS, Hoyniak CP, McQuillan ME, Bates JE. Sleep and self-regulation in early childhood. ADVANCES IN CHILD DEVELOPMENT AND BEHAVIOR 2021; 60:111-137. [PMID: 33641790 DOI: 10.1016/bs.acdb.2020.08.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
What is the role of sleep in children's behavioral, emotional, and cognitive regulation? This chapter considers theoretical and conceptual links between sleep and self-regulation, with special attention to sleep and self-regulation in early childhood. We selectively review the growing body of research on associations between sleep and self-regulation, mentioning some methodological issues. We also consider how child characteristics and sociocontextual factors may interact with sleep in the development of self-regulation in early childhood. We provide some relevant empirical examples from our own research.
Collapse
Affiliation(s)
- Reagan S Breitenstein
- Department of Psychological and Brain Sciences, Indiana University-Bloomington, Bloomington, IN, United States.
| | - Caroline P Hoyniak
- Department of Psychiatry, Washington University, School of Medicine, St. Louis, MO, United States
| | - Maureen E McQuillan
- Department of Pediatrics, Indiana University, School of Medicine, Indianapolis, IN, United States
| | - John E Bates
- Department of Psychological and Brain Sciences, Indiana University-Bloomington, Bloomington, IN, United States
| |
Collapse
|
68
|
Marillier M, Bernard AC, Verges S, Moran-Mendoza O, O’Donnell DE, Neder JA. Influence of exertional hypoxemia on cerebral oxygenation in fibrotic interstitial lung disease. Respir Physiol Neurobiol 2021; 285:103601. [DOI: 10.1016/j.resp.2020.103601] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Revised: 12/10/2020] [Accepted: 12/13/2020] [Indexed: 11/17/2022]
|
69
|
Baril AA, Martineau-Dussault MÈ, Sanchez E, André C, Thompson C, Legault J, Gosselin N. Obstructive Sleep Apnea and the Brain: a Focus on Gray and White Matter Structure. Curr Neurol Neurosci Rep 2021; 21:11. [PMID: 33586028 DOI: 10.1007/s11910-021-01094-2] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/13/2021] [Indexed: 12/24/2022]
Abstract
PURPOSE OF REVIEW Obstructive sleep apnea is extremely prevalent in the elderly and may precipitate dementia. We review recent advances on gray and white matter structure in obstructive sleep apnea, the impact of treatment, and potential pathological and neurodegenerative processes underlying brain structural changes. RECENT FINDINGS Two opposite patterns are observed in neuroimaging studies of obstructive sleep apnea. One may indicate cellular damage (gray matter atrophy, higher white matter hyperintensity burden, lower white matter fractional anisotropy, higher water diffusivities), while the other (gray matter hypertrophy, restricted white matter diffusivities) may reflect transitory responses, such as intracellular edema, reactive gliosis or compensatory structural changes. Treating obstructive sleep apnea could partly reverse these structural changes. Structural alterations related to obstructive sleep apnea may follow a multi-determined biphasic pattern depending on numerous factors (e.g. severity, symptomatology, age) that could tip the scale toward neurodegeneration and need to be investigated by longitudinal studies.
Collapse
Affiliation(s)
- Andrée-Ann Baril
- The Framingham Heart Study, Boston University School of Medicine, Boston, MA, USA
| | - Marie-Ève Martineau-Dussault
- Center for Advanced Research in Sleep Medicine, Centre Intégré Universitaire de Santé et de Services Sociaux du Nord-de-l'Île-de-Montréal, 5400 boul. Gouin Ouest, local J-5135, Montréal, Québec, H4J 1C5, Canada.,Department of Psychology, Université de Montréal, Montréal, Canada
| | - Erlan Sanchez
- Center for Advanced Research in Sleep Medicine, Centre Intégré Universitaire de Santé et de Services Sociaux du Nord-de-l'Île-de-Montréal, 5400 boul. Gouin Ouest, local J-5135, Montréal, Québec, H4J 1C5, Canada.,Department of Neuroscience, Université de Montréal, Montréal, Canada
| | - Claire André
- Physiopathology and Imaging of Neurological Disorders, Institut National de la Santé et de la Recherche Médicale, Institut Blood and Brain, Université de Caen, Normandie Université, GIP Cyceron, Caen, France.,Neuropsychologie et Imagerie de la Mémoire Humain, Institut National de la Santé et de la Recherche Médicale, Centre Hospitalier Universitaire de Caen, Université de Caen, Normandie Université, Paris Sciences & Lettres Université, École Pratique des Hautes Études, GIP Cyceron, Caen, France
| | - Cynthia Thompson
- Center for Advanced Research in Sleep Medicine, Centre Intégré Universitaire de Santé et de Services Sociaux du Nord-de-l'Île-de-Montréal, 5400 boul. Gouin Ouest, local J-5135, Montréal, Québec, H4J 1C5, Canada
| | - Julie Legault
- Center for Advanced Research in Sleep Medicine, Centre Intégré Universitaire de Santé et de Services Sociaux du Nord-de-l'Île-de-Montréal, 5400 boul. Gouin Ouest, local J-5135, Montréal, Québec, H4J 1C5, Canada.,Department of Psychology, Université de Montréal, Montréal, Canada
| | - Nadia Gosselin
- Center for Advanced Research in Sleep Medicine, Centre Intégré Universitaire de Santé et de Services Sociaux du Nord-de-l'Île-de-Montréal, 5400 boul. Gouin Ouest, local J-5135, Montréal, Québec, H4J 1C5, Canada. .,Department of Psychology, Université de Montréal, Montréal, Canada.
| |
Collapse
|
70
|
Suckert T, Beyreuther E, Müller J, Azadegan B, Meinhardt M, Raschke F, Bodenstein E, von Neubeck C, Lühr A, Krause M, Dietrich A. Late Side Effects in Normal Mouse Brain Tissue After Proton Irradiation. Front Oncol 2021; 10:598360. [PMID: 33520710 PMCID: PMC7842140 DOI: 10.3389/fonc.2020.598360] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Accepted: 11/16/2020] [Indexed: 12/16/2022] Open
Abstract
Radiation-induced late side effects such as cognitive decline and normal tissue complications can severely affect quality of life and outcome in long-term survivors of brain tumors. Proton therapy offers a favorable depth-dose deposition with the potential to spare tumor-surrounding normal tissue, thus potentially reducing such side effects. In this study, we describe a preclinical model to reveal underlying biological mechanisms caused by precise high-dose proton irradiation of a brain subvolume. We studied the dose- and time-dependent radiation response of mouse brain tissue, using a high-precision image-guided proton irradiation setup for small animals established at the University Proton Therapy Dresden (UPTD). The right hippocampal area of ten C57BL/6 and ten C3H/He mice was irradiated. Both strains contained four groups (nirradiated = 3, ncontrol = 1) treated with increasing doses (0 Gy, 45 Gy, 65 Gy or 85 Gy and 0 Gy, 40 Gy, 60 Gy or 80 Gy, respectively). Follow-up examinations were performed for up to six months, including longitudinal monitoring of general health status and regular contrast-enhanced magnetic resonance imaging (MRI) of mouse brains. These findings were related to comprehensive histological analysis. In all mice of the highest dose group, first symptoms of blood-brain barrier (BBB) damage appeared one week after irradiation, while a dose-dependent delay in onset was observed for lower doses. MRI contrast agent leakage occurred in the irradiated brain areas and was progressive in the higher dose groups. Mouse health status and survival corresponded to the extent of contrast agent leakage. Histological analysis revealed tissue changes such as vessel abnormalities, gliosis, and granule cell dispersion, which also partly affected the non-irradiated contralateral hippocampus in the higher dose groups. All observed effects depended strongly on the prescribed radiation dose and the outcome, i.e. survival, image changes, and tissue alterations, were very consistent within an experimental dose cohort. The derived dose–response model will determine endpoint-specific dose levels for future experiments and may support generating clinical hypotheses on brain toxicity after proton therapy.
Collapse
Affiliation(s)
- Theresa Suckert
- German Cancer Consortium (DKTK), Partner Site Dresden, and German Cancer Research Center (DKFZ), Heidelberg, Germany.,OncoRay - National Center for Radiation Research in Oncology, Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Helmholtz-Zentrum Dresden-Rossendorf, Dresden, Germany
| | - Elke Beyreuther
- OncoRay - National Center for Radiation Research in Oncology, Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Helmholtz-Zentrum Dresden-Rossendorf, Dresden, Germany.,Helmholtz-Zentrum Dresden-Rossendorf, Institute of Radiation Physics, Dresden, Germany
| | - Johannes Müller
- OncoRay - National Center for Radiation Research in Oncology, Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Helmholtz-Zentrum Dresden-Rossendorf, Dresden, Germany.,Helmholtz-Zentrum Dresden-Rossendorf, Institute of Radiooncology - OncoRay, Dresden, Germany
| | - Behnam Azadegan
- OncoRay - National Center for Radiation Research in Oncology, Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Helmholtz-Zentrum Dresden-Rossendorf, Dresden, Germany.,Department of Physics, Hakim Sabzevari University, Sabzevar, Iran
| | - Matthias Meinhardt
- Neuropathology, Institute of Pathology, University Hospital Carl Gustav Carus, TU Dresden, Dresden, Germany
| | - Felix Raschke
- OncoRay - National Center for Radiation Research in Oncology, Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Helmholtz-Zentrum Dresden-Rossendorf, Dresden, Germany.,Helmholtz-Zentrum Dresden-Rossendorf, Institute of Radiooncology - OncoRay, Dresden, Germany
| | - Elisabeth Bodenstein
- OncoRay - National Center for Radiation Research in Oncology, Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Helmholtz-Zentrum Dresden-Rossendorf, Dresden, Germany
| | - Cläre von Neubeck
- German Cancer Consortium (DKTK), Partner Site Dresden, and German Cancer Research Center (DKFZ), Heidelberg, Germany.,OncoRay - National Center for Radiation Research in Oncology, Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Helmholtz-Zentrum Dresden-Rossendorf, Dresden, Germany.,Department of Particle Therapy, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Armin Lühr
- German Cancer Consortium (DKTK), Partner Site Dresden, and German Cancer Research Center (DKFZ), Heidelberg, Germany.,OncoRay - National Center for Radiation Research in Oncology, Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Helmholtz-Zentrum Dresden-Rossendorf, Dresden, Germany.,Helmholtz-Zentrum Dresden-Rossendorf, Institute of Radiooncology - OncoRay, Dresden, Germany.,Department of Medical Physics and Radiotherapy, Faculty of Physics, TU Dortmund University, Dortmund, Germany
| | - Mechthild Krause
- German Cancer Consortium (DKTK), Partner Site Dresden, and German Cancer Research Center (DKFZ), Heidelberg, Germany.,OncoRay - National Center for Radiation Research in Oncology, Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Helmholtz-Zentrum Dresden-Rossendorf, Dresden, Germany.,Helmholtz-Zentrum Dresden-Rossendorf, Institute of Radiooncology - OncoRay, Dresden, Germany.,National Center for Tumor Diseases (NCT), Partner Site Dresden, Dresden, Germany.,Department of Radiotherapy and Radiation Oncology, Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Antje Dietrich
- German Cancer Consortium (DKTK), Partner Site Dresden, and German Cancer Research Center (DKFZ), Heidelberg, Germany.,OncoRay - National Center for Radiation Research in Oncology, Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Helmholtz-Zentrum Dresden-Rossendorf, Dresden, Germany
| |
Collapse
|
71
|
Ren H, Jiang X, Xu K, Chen C, Yuan Y, Dai C, Chen W. A Review of Cerebral Hemodynamics During Sleep Using Near-Infrared Spectroscopy. Front Neurol 2020; 11:524009. [PMID: 33329295 PMCID: PMC7710901 DOI: 10.3389/fneur.2020.524009] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2020] [Accepted: 10/26/2020] [Indexed: 11/13/2022] Open
Abstract
Investigating cerebral hemodynamic changes during regular sleep cycles and sleep disorders is fundamental to understanding the nature of physiological and pathological mechanisms in the regulation of cerebral oxygenation during sleep. Although sleep neuroimaging methods have been studied and have been well-reviewed, they have limitations in terms of technique and experimental design. Neurologists are convinced that Near-infrared spectroscopy (NIRS) provides essential information and can be used to assist the assessment of cerebral hemodynamics, and numerous studies regarding sleep have been carried out based on NIRS. Thus, a brief historical overview of the sleep studies using NIRS will be helpful for the biomedical students, academicians, and engineers to better understand NIRS from various perspectives. In this study, the existing literature on sleep studies is reviewed, and an overview of the NIRS applications is synthesized and provided. The paper first reviews the application scenarios, as well as the patterns of fluctuation of NIRS, which includes the investigation in regular sleep and sleep-disordered breathing. Various factors such as different sleep stages, populations, and degrees of severity were considered. Furthermore, the experimental design and signal processing, as well as the regulation mechanisms involved in regular and pathological sleep, are investigated and discussed. The strengths and weaknesses of the existing NIRS applications are addressed and presented, which can direct further NIRS analysis and utilization.
Collapse
Affiliation(s)
- Haoran Ren
- The Center for Intelligent Medical Electronics, School of Information Science and Technology, Fudan University, Shanghai, China
| | - Xinyu Jiang
- The Center for Intelligent Medical Electronics, School of Information Science and Technology, Fudan University, Shanghai, China
| | - Ke Xu
- The Center for Intelligent Medical Electronics, School of Information Science and Technology, Fudan University, Shanghai, China
| | - Chen Chen
- The Center for Intelligent Medical Electronics, School of Information Science and Technology, Fudan University, Shanghai, China
| | - Yafei Yuan
- The Center for Intelligent Medical Electronics, School of Information Science and Technology, Fudan University, Shanghai, China
| | - Chenyun Dai
- The Center for Intelligent Medical Electronics, School of Information Science and Technology, Fudan University, Shanghai, China
| | - Wei Chen
- The Center for Intelligent Medical Electronics, School of Information Science and Technology, Fudan University, Shanghai, China.,Human Phenome Institute, Fudan University, Shanghai, China.,Shanghai Key Laboratory of Medical Imaging Computing and Computer Assisted Intervention, Shanghai, China
| |
Collapse
|
72
|
Zhou L, Liu G, Luo H, Li H, Peng Y, Zong D, Ouyang R. Aberrant Hippocampal Network Connectivity Is Associated With Neurocognitive Dysfunction in Patients With Moderate and Severe Obstructive Sleep Apnea. Front Neurol 2020; 11:580408. [PMID: 33362692 PMCID: PMC7759642 DOI: 10.3389/fneur.2020.580408] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Accepted: 11/11/2020] [Indexed: 01/20/2023] Open
Abstract
Objectives: This work aims to explore the changes of functional connectivity (FC) within the hippocampus network in patients with moderate and severe obstructive sleep apnea (OSA) and its correlation with neurocognitive dysfunction to explore the potential neurophysiological mechanism. Methods: A total of 32 treatment-naïve patients with moderate or severe OSA and 26 healthy controls (HCs), matched in age, gender, and education, underwent the evaluations of Epworth Sleep Scale, neurocognitive function, full-night polysomnography, and resting-state functional magnetic resonance imaging. The FC map of the hippocampus to other brain areas was compared among 15 OSA patients and 15 HCs with little head motion. Finally, the correlation between hippocampus FC strength and respiratory sleep parameters and neurocognitive assessments was analyzed. Results: Compared with HCs, the right hippocampus showed a significantly decreased FC with the bilateral insular lobe, right thalamus, and right anterior cingulate gyrus (ACG) and an increased FC with the right superior and middle temporal gyrus, left posterior cingulate gyrus, and left angular gyrus in the patients with OSA. The left hippocampus presented a significantly decreased FC with the left anterior cerebellum in patients with OSA. In addition, the aberrant right hippocampal FC with the right ACG was significantly correlated with disease severity and disrupted sleep architecture in the OSA group. Furthermore, after adjusting the related confounding factors, the FC strength between the right hippocampus, right insular lobe, and right thalamus was positively associated with the scores of Stroop Color-Word Test (SCWT) or Hopkins Verbal Learning Test-Revised (HVLT-R), while the FC between the right hippocampus and the right middle temporal gyrus was negatively correlated with the scores of HVLT-R. The right hippocampus FC with right superior temporal gyrus, left angular gyrus, and ACG were all negatively related to the scores of the symbol coding test (r = -0.642, p = 0.045; r = -0.638, p = 0.047; r = -0.753, p = 0.012), respectively. The FC between the left hippocampal and the left anterior cerebellar lobe showed a positive relationship with the scores of HVLT-R (r = 0.757, p = 0.011) and CPT-3D (r = -0.801, p = 0.005). Conclusion: The hippocampus presented abnormal FC with the cerebral and cerebellar regions extensively in OSA, and the correlation between abnormal hippocampal network FC and neurocognitive dysfunction in OSA suggests a promising insight to explore the potential biomarker and pathophysiologic mechanism of neurocognitive dysfunction of OSA.
Collapse
Affiliation(s)
- Li Zhou
- Department of Pulmonary and Critical Care Medicine, The Second Xiangya Hospital, Central South University, Changsha, China
- Research Unit of Respiratory Disease, Central South University, Changsha, China
- Diagnosis and Treatment Center of Respiratory Disease, Central South University, Changsha, China
| | - Guiqian Liu
- Hunan Province Prevention and Treatment Institute for Occupational Diseases, Changsha, China
| | - Hong Luo
- Department of Pulmonary and Critical Care Medicine, The Second Xiangya Hospital, Central South University, Changsha, China
- Research Unit of Respiratory Disease, Central South University, Changsha, China
- Diagnosis and Treatment Center of Respiratory Disease, Central South University, Changsha, China
| | - Huabing Li
- Department of Radiology, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Yating Peng
- Department of Pulmonary and Critical Care Medicine, The Second Xiangya Hospital, Central South University, Changsha, China
- Research Unit of Respiratory Disease, Central South University, Changsha, China
- Diagnosis and Treatment Center of Respiratory Disease, Central South University, Changsha, China
| | - Dandan Zong
- Department of Pulmonary and Critical Care Medicine, The Second Xiangya Hospital, Central South University, Changsha, China
- Research Unit of Respiratory Disease, Central South University, Changsha, China
- Diagnosis and Treatment Center of Respiratory Disease, Central South University, Changsha, China
| | - Ruoyun Ouyang
- Department of Pulmonary and Critical Care Medicine, The Second Xiangya Hospital, Central South University, Changsha, China
- Research Unit of Respiratory Disease, Central South University, Changsha, China
- Diagnosis and Treatment Center of Respiratory Disease, Central South University, Changsha, China
| |
Collapse
|
73
|
Rostampour M, Noori K, Heidari M, Fadaei R, Tahmasian M, Khazaie H, Zarei M. White matter alterations in patients with obstructive sleep apnea: a systematic review of diffusion MRI studies. Sleep Med 2020; 75:236-245. [DOI: 10.1016/j.sleep.2020.06.024] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Revised: 06/17/2020] [Accepted: 06/18/2020] [Indexed: 12/25/2022]
|
74
|
Mullins AE, Kam K, Parekh A, Bubu OM, Osorio RS, Varga AW. Obstructive Sleep Apnea and Its Treatment in Aging: Effects on Alzheimer's disease Biomarkers, Cognition, Brain Structure and Neurophysiology. Neurobiol Dis 2020; 145:105054. [PMID: 32860945 PMCID: PMC7572873 DOI: 10.1016/j.nbd.2020.105054] [Citation(s) in RCA: 51] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2019] [Revised: 08/13/2020] [Accepted: 08/18/2020] [Indexed: 02/08/2023] Open
Abstract
Here we review the impact of obstructive sleep apnea (OSA) on biomarkers of Alzheimer's disease (AD) pathogenesis, neuroanatomy, cognition and neurophysiology, and present the research investigating the effects of continuous positive airway pressure (CPAP) therapy. OSA is associated with an increase in AD markers amyloid-β and tau measured in cerebrospinal fluid (CSF), by Positron Emission Tomography (PET) and in blood serum. There is some evidence suggesting CPAP therapy normalizes AD biomarkers in CSF but since mechanisms for amyloid-β and tau production/clearance in humans are not completely understood, these findings remain preliminary. Deficits in the cognitive domains of attention, vigilance, memory and executive functioning are observed in OSA patients with the magnitude of impairment appearing stronger in younger people from clinical settings than in older community samples. Cognition improves with varying degrees after CPAP use, with the greatest effect seen for attention in middle age adults with more severe OSA and sleepiness. Paradigms in which encoding and retrieval of information are separated by periods of sleep with or without OSA have been done only rarely, but perhaps offer a better chance to understand cognitive effects of OSA than isolated daytime testing. In cognitively normal individuals, changes in EEG microstructure during sleep, particularly slow oscillations and spindles, are associated with biomarkers of AD, and measures of cognition and memory. Similar changes in EEG activity are reported in AD and OSA, such as "EEG slowing" during wake and REM sleep, and a degradation of NREM EEG microstructure. There is evidence that CPAP therapy partially reverses these changes but large longitudinal studies demonstrating this are lacking. A diagnostic definition of OSA relying solely on the Apnea Hypopnea Index (AHI) does not assist in understanding the high degree of inter-individual variation in daytime impairments related to OSA or response to CPAP therapy. We conclude by discussing conceptual challenges to a clinical trial of OSA treatment for AD prevention, including inclusion criteria for age, OSA severity, and associated symptoms, the need for a potentially long trial, defining relevant primary outcomes, and which treatments to target to optimize treatment adherence.
Collapse
Affiliation(s)
- Anna E Mullins
- Mount Sinai Integrative Sleep Center, Division of Pulmonary, Critical Care, and Sleep Medicine, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Korey Kam
- Mount Sinai Integrative Sleep Center, Division of Pulmonary, Critical Care, and Sleep Medicine, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Ankit Parekh
- Mount Sinai Integrative Sleep Center, Division of Pulmonary, Critical Care, and Sleep Medicine, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Omonigho M Bubu
- Center for Brain Health, Department of Psychiatry, NYU Langone Medical Center, New York, NY 10016, USA
| | - Ricardo S Osorio
- Center for Brain Health, Department of Psychiatry, NYU Langone Medical Center, New York, NY 10016, USA
| | - Andrew W Varga
- Mount Sinai Integrative Sleep Center, Division of Pulmonary, Critical Care, and Sleep Medicine, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA.
| |
Collapse
|
75
|
Pépin JL, Georgiev O, Tiholov R, Attali V, Verbraecken J, Buyse B, Partinen M, Fietze I, Belev G, Dokic D, Tamisier R, Lévy P, Lecomte I, Lecomte JM, Schwartz JC, Dauvilliers Y. Pitolisant for Residual Excessive Daytime Sleepiness in OSA Patients Adhering to CPAP: A Randomized Trial. Chest 2020; 159:1598-1609. [PMID: 33121980 DOI: 10.1016/j.chest.2020.09.281] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Revised: 08/11/2020] [Accepted: 09/28/2020] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Excessive daytime sleepiness (EDS) in individuals with OSA syndrome persisting despite good adherence to CPAP is a disabling condition. Pitolisant is a selective histamine H3-receptor antagonist with wake-promoting effects. RESEARCH QUESTION Is pitolisant effective and safe for reducing daytime sleepiness in individuals with moderate to severe OSA adhering to CPAP treatment but experiencing residual EDS? STUDY DESIGN AND METHODS In a multicenter, double-blind, randomized (3:1), placebo-controlled, parallel-design trial, pitolisant was titrated individually at up to 20 mg/day and taken over 12 weeks. The primary end point was change in the Epworth Sleepiness Scale (ESS) score in the intention-to-treat population. Key secondary end points were maintenance of wakefulness assessed by the Oxford Sleep Resistance Test, Clinical Global Impressions scale of severity, the patient's global opinion, EuroQoL quality-of-life questionnaire score, Pichot fatigue questionnaire score, and safety. RESULTS Two hundred forty-four OSA participants (82.8% men; mean age, 53.1 years; mean Apnea Hypopnea Index with CPAP, 4.2/h; baseline ESS score, 14.7) were randomized to pitolisant (n = 183) or placebo (n = 61). ESS significantly decreased with pitolisant compared with placebo (-2.6; 95% CI, -3.9 to -1.4; P < .001), and the rate of responders to therapy (ESS ≤ 10 or change in ESS ≥ 3) was significantly higher with pitolisant (71.0% vs 54.1%; P = .013). Adverse event occurrence (mainly headache and insomnia) was higher in the pitolisant group compared with the placebo group (47.0% and 32.8%, respectively; P = .03). No cardiovascular or other significant safety concerns were reported. INTERPRETATION Pitolisant used as adjunct to CPAP therapy for OSA with residual sleepiness despite good CPAP adherence significantly reduced subjective and objective sleepiness and improved participant-reported outcomes and physician-reported disease severity. TRIAL REGISTRY ClinicalTrials.gov; No.: NCT01071876; URL: www.clinicaltrials.gov; EudraCT N°: 2009-017248-14; URL: eudract.ema.europa.eu.
Collapse
Affiliation(s)
- Jean-Louis Pépin
- HP2 Laboratory, INSERM U1042, University Grenoble Alpes, and EFCR Laboratory, Grenoble Alpes University Hospital, Grenoble, France.
| | - Ognian Georgiev
- Department of Internal Medicine, Pulmonology, Alexandrovska Hospital Medical University, Sofia, Bulgaria
| | - Rumen Tiholov
- Department of Internal Diseases, Sv. Ivan Rilski Multiprofile Hospital for Active Treatment, Kozloduy, Bulgaria
| | - Valérie Attali
- Neurophysiologie Respiratoire Expérimentale et Clinique UMRS1158, Sorbonne Université, INSERM, and Service des Pathologies du Sommeil (Departement R3S, DMU APPROCHES), Groupe Hospitalier Universitaire APHP-Sorbonne Université, Paris, France
| | - Johan Verbraecken
- Universitair Multidisciplinair Slaap Centrum, Edegem-Antwerp, Belgium
| | - Bertien Buyse
- Leuvens Universitair Centrum voor Slaap-en waakstoornissen, Department of Respiratory Diseases, University Hospitals Leuven and KU Leuven, Leuven, Belgium
| | - Markku Partinen
- Helsinki Sleep Clinic, Vitalmed Research Center, Department of Clinical Neurosciences, University of Helsinki, Finland
| | - Ingo Fietze
- Interdisziplinares Schlafmedizinisches Zentrum, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Georgi Belev
- Pulmonology Division, Department of Internal Medicine, St. George Hospital Medical University, Plovdiv, Bulgaria
| | - Dejan Dokic
- Department of Pulmology and Allergy, Mother Teresa Medical University, Skopje, Macedonia
| | - Renaud Tamisier
- HP2 Laboratory, INSERM U1042, University Grenoble Alpes, and EFCR Laboratory, Grenoble Alpes University Hospital, Grenoble, France
| | - Patrick Lévy
- HP2 Laboratory, INSERM U1042, University Grenoble Alpes, and EFCR Laboratory, Grenoble Alpes University Hospital, Grenoble, France
| | - Isabelle Lecomte
- Bioprojet, Paris, France; Department of Pulmology and Allergy, Mother Teresa Medical University, Skopje, Macedonia
| | | | | | - Yves Dauvilliers
- Centre National de Référence Narcolepsie, Unité du Sommeil, CHU Montpellier, Hôpital Gui-de-Chauliac, Service de Neurologie, Université de Montpellier, INSERM U1061, Montpellier, France
| |
Collapse
|
76
|
Mari PV, Pasciuto G, Siciliano M, Simonetti J, Ballacci F, Macagno F, Iovene B, Martone F, Corbo GM, Richeldi L. Obstructive sleep apnea in sarcoidosis and impact of cpap treatment on fatigue. SARCOIDOSIS VASCULITIS AND DIFFUSE LUNG DISEASES 2020; 37:169-178. [PMID: 33093780 PMCID: PMC7569553 DOI: 10.36141/svdld.v37i2.9169] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Accepted: 03/18/2020] [Indexed: 12/19/2022]
Abstract
Rationale An increased incidence of Obstructive Sleep Apnea (OSA) in sarcoidosis has been described in small sample size studies. Fatigue is common in sarcoidosis and OSA could be a relevant, treatable comorbidity. To date, the effect of Continuous Positive Airway Pressure (CPAP) on fatigue has never been assessed. Objectives To investigate the prevalence of OSA in sarcoidosis, fatigue status and daytime sleepiness in patients of our center. To explore the effect of CPAP in fatigue and daytime sleepiness after 3 months using validated questionnaires. Method Single group, one center, open-label prospective cohort study. Measurements and main result We enrolled 68 patients and OSA was diagnosed in 60 (88.2%): 25 (36.8%) were mild while 35 (51.5%) were moderate-to-severe. 38 (55.9%) patients received CPAP but only 20 (30.9%) were compliant at 3-month evaluation. Questionnaires demonstrated fatigue in 34 (50%) and daytime sleepiness in 21 (30.9%). In multivariate regression analysis, Scadding stage and FAS behave as predictors of Apnea-Hypopnea Index (AHI) severity while sleepiness and steroids weren't associated. FAS score (ΔFAS = 6.3; p = 0.001) and ESS score (ΔESS = 2.8; p = 0.005) improved after three months of CPAP. Conclusions OSA is highly prevalent in patients affected by sarcoidosis. ESS questionnaire is not reliable for OSA screening and other pre-test probability tool should be evaluated in further studies. CPAP leads to a significative reduction of fatigue and daytime sleepiness at three-month. Further studies are needed to confirm the high prevalence of OSA in sarcoidosis and the positive role of CPAP in fatigue. (Sarcoidosis Vasc Diffuse Lung Dis 2020; 37 (2): 169-178).
Collapse
Affiliation(s)
- Pier-Valerio Mari
- Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome (Italy).,Università Cattolica del Sacro Cuore
| | - Giuliana Pasciuto
- Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome (Italy).,Università Cattolica del Sacro Cuore
| | - Matteo Siciliano
- Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome (Italy).,Università Cattolica del Sacro Cuore
| | - Jacopo Simonetti
- Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome (Italy).,Università Cattolica del Sacro Cuore
| | | | - Francesco Macagno
- Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome (Italy).,Università Cattolica del Sacro Cuore
| | - Bruno Iovene
- Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome (Italy)
| | | | - Giuseppe Maria Corbo
- Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome (Italy).,Università Cattolica del Sacro Cuore
| | - Luca Richeldi
- Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome (Italy).,Università Cattolica del Sacro Cuore
| |
Collapse
|
77
|
Reduced regional homogeneity and neurocognitive impairment in patients with moderate-to-severe obstructive sleep apnea. Sleep Med 2020; 75:418-427. [PMID: 32980663 DOI: 10.1016/j.sleep.2020.09.009] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Revised: 08/03/2020] [Accepted: 09/03/2020] [Indexed: 01/10/2023]
Abstract
BACKGROUND Neurocognitive dysfunction and abnormal regional homogeneity (ReHo) have been reported in patients with obstructive sleep apnea (OSA). However, little is known about whether brain functional alteration could be used to differentiate from healthy controls (HCs) and its correlation with neurocognitive impairment. METHODS Thirty-three treatment-naive patients with moderate-to-severe OSA and 22 HCs with matched age, sex and education underwent the evaluation of Epworth sleepiness scale, neurocognitive function, full night polysomnography and resting-state functional magnetic resonance imaging scan. ReHo, support vector machine, and correlation with neurocognitive function were administrated to analyze the data. RESULTS Compared with HCs, patients with OSA showed decreased ReHo in the bilateral superior frontal gyrus (FG), bilateral superior medial prefrontal cortex (PFC)/right supplementary motor area (SMA), left middle FG, and right precentral/postcentral gyrus. Negative correlations were observed between the ReHo values in the left superior FG/middle FG and apnea hypopnea index, oxygen desaturation index in the OSA group. The scores of Stroop word test, Stroop color-word test, symbol coding test were all negatively correlated with the ReHo values in the right precentral gyrus/postcentral gyrus in patients. Scores of the animal naming fluency test were positively correlated with the ReHo values in the left superior FG/middle FG in patients. Moreover, support vector machine analysis showed the ReHo values in the left superior FG/middle FG or bilateral superior medial PFC/right SMA both could discriminate patients from HCs with good accuracies, sensitivities, and specificities (85.45%, 87.88%, 81.82% and 81.82%, 84.85%, 77.27%, respectively). CONCLUSION Dysfunction in the frontal lobe is a potentially pivotal neuro-pathophysiological mechanism of neurocognitive impairment in patients with moderate-to-severe OSA. And significantly lower ReHo values in the left superior FG/middle FG and/or superior medial PFC/SMA are promising imaging biomarkers to discriminate moderate-to-severe patients with OSA from HCs.
Collapse
|
78
|
Liguori C, Maestri M, Spanetta M, Placidi F, Bonanni E, Mercuri NB, Guarnieri B. Sleep-disordered breathing and the risk of Alzheimer's disease. Sleep Med Rev 2020; 55:101375. [PMID: 33022476 DOI: 10.1016/j.smrv.2020.101375] [Citation(s) in RCA: 73] [Impact Index Per Article: 18.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2020] [Revised: 05/28/2020] [Accepted: 05/28/2020] [Indexed: 12/15/2022]
Abstract
Sleep-disordered breathing is highly prevalent in the elderly population. Obstructive sleep apnea (OSA) represents the most common sleep disorder among the adult and elderly population. Recently, OSA diagnosis has been associated with an increased risk of developing cognitive decline and dementia, including vascular dementia and Alzheimer's disease (AD). Subsequently, there have been studies on AD biomarkers investigating cerebrospinal fluid, blood, neuroimaging, and nuclear medicine biomarkers in patients with OSA. Furthermore, studies have attempted to assess the possible effects of continuous positive airway pressure (CPAP) treatment on the cognitive trajectory and AD biomarkers in patients with OSA. This review summarizes the findings of studies on each AD biomarker (cognitive, biofluid, neuroimaging, and nuclear medicine imaging) in patients with OSA, also accounting for the related effects of CPAP treatment. In addition, the hypothetical model connecting OSA to AD in a bi-directional interplay is analyzed. Finally, the sex-based differences in prevalence and clinical symptoms of OSA between men and women have been investigated in relation to AD risk. Further studies investigating AD biomarkers changes in patients with OSA and the effect of CPAP treatment should be auspicated in future for identifying strategies to prevent the development of AD.
Collapse
Affiliation(s)
- Claudio Liguori
- Sleep Medicine Centre, Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy; Neurology Unit, Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy.
| | - Michelangelo Maestri
- Department of Clinical and Experimental Medicine, Neurology Unit, University of Pisa, Pisa, Italy
| | - Matteo Spanetta
- Sleep Medicine Centre, Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Fabio Placidi
- Sleep Medicine Centre, Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy; Neurology Unit, Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Enrica Bonanni
- Department of Clinical and Experimental Medicine, Neurology Unit, University of Pisa, Pisa, Italy
| | - Nicola B Mercuri
- Neurology Unit, Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy; Santa Lucia Foundation, Rome, Italy
| | - Biancamaria Guarnieri
- Center of Sleep Medicine, Department of Neurology, Villa Serena Hospital, Città S. Angelo, Pescara, Italy; Villa Serena Foundation for the Research, Città S. Angelo, Pescara, Italy
| |
Collapse
|
79
|
Kitamura T, Miyazaki S, Sulaiman HB, Akaike R, Ito Y, Suzuki H. Insomnia and obstructive sleep apnea as potential triggers of dementia: is personalized prediction and prevention of the pathological cascade applicable? EPMA J 2020; 11:355-365. [PMID: 32849926 PMCID: PMC7429588 DOI: 10.1007/s13167-020-00219-w] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2020] [Accepted: 07/15/2020] [Indexed: 12/29/2022]
Abstract
INTRODUCTION Sleep disorders ultimately result in sleep deficiency and poor-quality adversely impacts the immune system, glucose metabolism, body weight control, cardiovascular and cerebrovascular function, cognitive function, psychological stability, work productivity, quality of life, and social safety. Sleep disorders are very common among the elderly and are often comorbid with other diseases such as dementia, and further accelerating the underlying neurodegenerative processes. Initial studies have not clearly revealed the relationship between sleep disorders and dementia. Nonetheless, recent findings have suggested that insomnia and obstructive sleep apnea (OSA) are closely associated with dementia and perhaps they could be good predictors of occurrence of dementia and optimal treatments for sleep deficiencies may prevent or delay the onset dementia. METHODS Here, we conducted a systematic review based on the criteria of predictive, preventive, and personalized medicine on the association of dementia in elderlies with sleep disorder, namely insomnia and OSA. We included 7432 studies and analyzed a total of 14 publications after applying appropriate exclusion criteria. RESULTS We found that OSA patients had a large tendency to develop and/or experience accelerations of both Alzheimer's disease (AD) and also vascular dementia, whereas insomnia patients only develop and/or experience accelerations of AD. This may be reflected in the fact that AD and vascular dementia have similar and at the same time also different mechanisms of action. Several studies have also revealed that treating sleep disorders in elderly patients prevented or delayed the onset of dementia, mitigating the progression of symptoms in patients who already manifested dementic symptoms and even reversing neurodegeneration in particular brain areas. DISCUSSION Currently, the general medical consensus has poorly addressed the role of sleep disorders in exacerbating the risk of dementia. Critically, studies such as the present one emphasizes that the treatment of sleep disorders could be one the preventive measures to evade or to improve dementia symptoms. Additionally, elderly individuals often manifest different sleep deficiency symptoms than younger ones. Given this, an improved age-specific categorization and evaluation methods for sleep deficiency need to be implemented in diagnosing dementia in order to enable personalized assessments and treatments. Collectively, these findings may also assist to improve efforts in predictively detecting and eventually treating dementia.
Collapse
Affiliation(s)
- Takuro Kitamura
- Department of Otorhinolaryngology-Head and Neck Surgery, University of Occupational and Environmental Health, 1-1, Iseigaoka, Yahatanishi-ku, Kitakyushu, 807-8555 Japan
| | - Soichiro Miyazaki
- Research Institute of Life and Sciences, Chubu University, Kasugai, Japan
| | - Harun Bin Sulaiman
- Department of Otorhinolaryngology-Head and Neck Surgery, University of Occupational and Environmental Health, 1-1, Iseigaoka, Yahatanishi-ku, Kitakyushu, 807-8555 Japan
| | - Ryota Akaike
- Department of Otorhinolaryngology-Head and Neck Surgery, University of Occupational and Environmental Health, 1-1, Iseigaoka, Yahatanishi-ku, Kitakyushu, 807-8555 Japan
| | - Yuki Ito
- Department of Otorhinolaryngology-Head and Neck Surgery, University of Occupational and Environmental Health, 1-1, Iseigaoka, Yahatanishi-ku, Kitakyushu, 807-8555 Japan
| | - Hideaki Suzuki
- Department of Otorhinolaryngology-Head and Neck Surgery, University of Occupational and Environmental Health, 1-1, Iseigaoka, Yahatanishi-ku, Kitakyushu, 807-8555 Japan
| |
Collapse
|
80
|
Dauvilliers Y, Verbraecken J, Partinen M, Hedner J, Saaresranta T, Georgiev O, Tiholov R, Lecomte I, Tamisier R, Lévy P, Scart-Gres C, Lecomte JM, Schwartz JC, Pépin JL. Pitolisant for Daytime Sleepiness in Patients with Obstructive Sleep Apnea Who Refuse Continuous Positive Airway Pressure Treatment. A Randomized Trial. Am J Respir Crit Care Med 2020; 201:1135-1145. [PMID: 31917607 PMCID: PMC7193861 DOI: 10.1164/rccm.201907-1284oc] [Citation(s) in RCA: 58] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Rationale: Excessive daytime sleepiness is a common disabling symptom in obstructive sleep apnea syndrome. Objectives: To evaluate the efficacy and safety of pitolisant, a selective histamine H3 receptor antagonist with wake-promoting effects, for the treatment of daytime sleepiness in patients with moderate to severe obstructive sleep apnea refusing continuous positive airway pressure treatment. Methods: In an international, multicenter, double-blind, randomized (3:1), placebo-controlled, parallel-design trial, pitolisant was individually titrated at up to 20 mg/d over 12 weeks. The primary endpoint was the change in the Epworth Sleepiness Scale score. Key secondary endpoints were maintenance of wakefulness assessed on the basis of the Oxford Sleep Resistance test, safety, Clinical Global Impression of severity, patient’s global opinion, EuroQol quality-of-life questionnaire, and Pichot fatigue questionnaire. Measurements and Main Results: A total of 268 patients with obstructive sleep apnea (75% male; mean age, 52 yr; apnea–hypopnea index, 49/h; baseline sleepiness score, 15.7) were randomized (200 to pitolisant and 68 to placebo) and analyzed on an intention-to-treat basis. The Epworth Sleepiness Scale score was reduced more with pitolisant than with placebo (−2.8; 95% confidence interval, −4.0 to −1.5; P < 0.001). Wake maintenance tests were not improved. The Pichot fatigue score was reduced with pitolisant. The overall impact of pitolisant was confirmed by both physicians’ and patients’ questionnaires. Adverse event incidence, mainly headache, insomnia, nausea, and vertigo, was similar in the pitolisant and placebo groups (29.5% and 25.4%, respectively), with no cardiovascular or other significant safety concerns. Conclusions: Pitolisant significantly reduced self-reported daytime sleepiness and fatigue and improved patient-reported outcomes and physician disease severity assessment in sleepy patients with obstructive sleep apnea refusing or nonadherent to continuous positive airway pressure. Clinical trial registered with www.clinicaltrials.gov (NCT01072968) and EU Clinical Trials Register (EudraCT 2009-017251-94).
Collapse
Affiliation(s)
- Yves Dauvilliers
- National Reference Center for Narcolepsy, Sleep and Wake Unit, Department of Neurology, Gui-de-Chauliac Hospital, Montpellier University Hospital, Montpellier, France.,INSERM U1061, Montpellier University, Montpellier, France
| | - Johan Verbraecken
- Multidisciplinary Sleep Disorders Center, Antwerp University Hospital and University of Antwerp, Antwerp, Belgium.,University of Antwerp, Antwerp, Belgium
| | - Markku Partinen
- Helsinki Sleep Clinic, Vitalmed Research Center, Helsinki, Finland.,Department of Clinical Neurosciences, University of Helsinki, Helsinki, Finland
| | - Jan Hedner
- Sleep and Vigilance Laboratory, Department of Internal Medicine, University of Göteborg, Sahlgrenska University Hospital, University of Göteborg, Göteborg, Sweden
| | - Tarja Saaresranta
- Sleep Research Center, Department of Pulmonary Diseases and Clinical Allergology, University of Turku, Turku, Finland.,Department of Pulmonary Diseases, Turku University Hospital, Turku, Finland
| | - Ognian Georgiev
- Pulmonology Unit, Department of Internal Medicine, Alexandrovska Hospital Medical University, Sofia, Bulgaria
| | - Rumen Tiholov
- Department of Internal Diseases, Sveti Ivan Rilski Multiprofile Hospital for Active Treatment, Kozloduy, Bulgaria
| | | | - Renaud Tamisier
- Hypoxia-Physiopathology (HP2) Laboratory, INSERM U1042, University Grenoble Alpes, Grenoble, France; and.,Cardio-Respiratory Functional Exploration Laboratory (EFCR), Grenoble Alpes University Hospital, Grenoble, France
| | - Patrick Lévy
- Hypoxia-Physiopathology (HP2) Laboratory, INSERM U1042, University Grenoble Alpes, Grenoble, France; and.,Cardio-Respiratory Functional Exploration Laboratory (EFCR), Grenoble Alpes University Hospital, Grenoble, France
| | | | | | | | - Jean-Louis Pépin
- Hypoxia-Physiopathology (HP2) Laboratory, INSERM U1042, University Grenoble Alpes, Grenoble, France; and.,Cardio-Respiratory Functional Exploration Laboratory (EFCR), Grenoble Alpes University Hospital, Grenoble, France
| | | |
Collapse
|
81
|
Polsek D, Cash D, Veronese M, Ilic K, Wood TC, Milosevic M, Kalanj-Bognar S, Morrell MJ, Williams SCR, Gajovic S, Leschziner GD, Mitrecic D, Rosenzweig I. The innate immune toll-like-receptor-2 modulates the depressogenic and anorexiolytic neuroinflammatory response in obstructive sleep apnoea. Sci Rep 2020; 10:11475. [PMID: 32651433 PMCID: PMC7351955 DOI: 10.1038/s41598-020-68299-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2020] [Accepted: 06/16/2020] [Indexed: 12/19/2022] Open
Abstract
The increased awareness of obstructive sleep apnoea’s (OSA) links to Alzheimer’s disease and major psychiatric disorders has recently directed an intensified search for their potential shared mechanisms. We hypothesised that neuroinflammation and the microglial TLR2-system may act as a core process at the intersection of their pathophysiology. Moreover, we postulated that inflammatory-response might underlie development of key behavioural and neurostructural changes in OSA. Henceforth, we set out to investigate effects of 3 weeks’ exposure to chronic intermittent hypoxia in mice with or without functional TRL2 (TLR2+/+, C57BL/6-Tyrc-Brd-Tg(Tlr2-luc/gfp)Kri/Gaj;TLR2−/−,C57BL/6-Tlr2tm1Kir). By utilising multimodal imaging in this established model of OSA, a discernible neuroinflammatory response was demonstrated for the first time. The septal nuclei and forebrain were shown as the initial key seed-sites of the inflammatory cascade that led to wider structural changes in the associated neurocircuitry. Finally, the modulatory role for the functional TLR2-system was suggested in aetiology of depressive, anxious and anorexiolytic symptoms in OSA.
Collapse
Affiliation(s)
- Dora Polsek
- Sleep and Brain Plasticity Centre, Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London (KCL), De Crespigny Park, Box 089, London, SE5 8AF, UK.,University of Zagreb School of Medicine, Croatian Institute for Brain Research, Zagreb, Croatia
| | - Diana Cash
- Sleep and Brain Plasticity Centre, Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London (KCL), De Crespigny Park, Box 089, London, SE5 8AF, UK.,BRAIN, Department of Neuroimaging, KCL, London, UK
| | | | - Katarina Ilic
- University of Zagreb School of Medicine, Croatian Institute for Brain Research, Zagreb, Croatia
| | | | - Milan Milosevic
- School of Public Health, University of Zagreb School of Medicine, Zagreb, Croatia
| | - Svjetlana Kalanj-Bognar
- University of Zagreb School of Medicine, Croatian Institute for Brain Research, Zagreb, Croatia
| | - Mary J Morrell
- The National Heart and Lung Institute, Imperial College London, London, UK
| | | | - Srecko Gajovic
- University of Zagreb School of Medicine, Croatian Institute for Brain Research, Zagreb, Croatia
| | - Guy D Leschziner
- Sleep and Brain Plasticity Centre, Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London (KCL), De Crespigny Park, Box 089, London, SE5 8AF, UK.,Department of Neurology, Guy's and St Thomas' Hospital (GSTT) and Clinical Neurosciences, KCL, London, UK.,Sleep Disorders Centre, GSTT, London, UK
| | - Dinko Mitrecic
- University of Zagreb School of Medicine, Croatian Institute for Brain Research, Zagreb, Croatia
| | - Ivana Rosenzweig
- Sleep and Brain Plasticity Centre, Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London (KCL), De Crespigny Park, Box 089, London, SE5 8AF, UK. .,Sleep Disorders Centre, GSTT, London, UK.
| |
Collapse
|
82
|
Marchi NA, Ramponi C, Hirotsu C, Haba-Rubio J, Lutti A, Preisig M, Marques-Vidal P, Vollenweider P, Kherif F, Heinzer R, Draganski B. Mean Oxygen Saturation during Sleep Is Related to Specific Brain Atrophy Pattern. Ann Neurol 2020; 87:921-930. [PMID: 32220084 DOI: 10.1002/ana.25728] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2019] [Revised: 03/22/2020] [Accepted: 03/23/2020] [Indexed: 12/12/2022]
Abstract
OBJECTIVE There is much controversy about the neurobiological mechanisms underlying the effects of sleep-disordered breathing on the brain. The aim of this study was to investigate the association between markers of sleep-related hypoxemia and brain anatomy. METHODS We used data from a large-scale cohort from the general population (n = 775, 50.6% males, age range = 45-86 years, mean age = 60.3 ± 9.9) that underwent full polysomnography and brain magnetic resonance imaging to correlate respiratory variables with regional brain volume estimates. RESULTS After adjusting for age, gender, and cardiovascular risk factors, only mean oxygen saturation during sleep was associated with bilateral volume of hippocampus (right: p = 0.001; left: p < 0.001), thalamus (right: p < 0.001; left: p < 0.001), putamen (right: p = 0.001; left: p = 0.001), and angular gyrus (right: p = 0.011; left: p = 0.001). We observed the same relationship in left hemispheric amygdala (p = 0.010), caudate (p = 0.008), inferior frontal gyrus (p = 0.004), and supramarginal gyrus (p = 0.003). The other respiratory variables-lowest oxygen saturation, percentage of sleep time with oxygen saturation < 90%, apnea-hypopnea index, and oxygen desaturation index-did not show any significant association with brain volumes. INTERPRETATION Lower mean oxygen saturation during sleep was associated with atrophy of cortical and subcortical brain areas known for high sensitivity to oxygen supply. Their vulnerability to hypoxemia may contribute to behavioral phenotype and cognitive decline in patients with sleep-disordered breathing. ANN NEUROL 2020;87:921-930.
Collapse
Affiliation(s)
- Nicola Andrea Marchi
- Laboratory for Research in Neuroimaging, Department of Clinical Neurosciences, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.,Center for Investigation and Research in Sleep, Department of Medicine, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Cristina Ramponi
- Laboratory for Research in Neuroimaging, Department of Clinical Neurosciences, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Camila Hirotsu
- Center for Investigation and Research in Sleep, Department of Medicine, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - José Haba-Rubio
- Center for Investigation and Research in Sleep, Department of Medicine, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Antoine Lutti
- Laboratory for Research in Neuroimaging, Department of Clinical Neurosciences, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Martin Preisig
- Center for Research in Psychiatric Epidemiology and Psychopathology, Department of Psychiatry, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Pedro Marques-Vidal
- Department of Medicine, Internal Medicine, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Peter Vollenweider
- Department of Medicine, Internal Medicine, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Ferath Kherif
- Laboratory for Research in Neuroimaging, Department of Clinical Neurosciences, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Raphael Heinzer
- Center for Investigation and Research in Sleep, Department of Medicine, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Bogdan Draganski
- Laboratory for Research in Neuroimaging, Department of Clinical Neurosciences, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.,Department of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
| |
Collapse
|
83
|
Tahmasian M, Samea F, Khazaie H, Zarei M, Kharabian Masouleh S, Hoffstaedter F, Camilleri J, Kochunov P, Yeo BTT, Eickhoff SB, Valk SL. The interrelation of sleep and mental and physical health is anchored in grey-matter neuroanatomy and under genetic control. Commun Biol 2020; 3:171. [PMID: 32273564 PMCID: PMC7145855 DOI: 10.1038/s42003-020-0892-6] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2019] [Accepted: 03/16/2020] [Indexed: 12/15/2022] Open
Abstract
Humans need about seven to nine hours of sleep per night. Sleep habits are heritable, associated with brain function and structure, and intrinsically related to well-being, mental, and physical health. However, the biological basis of the interplay of sleep and health is incompletely understood. Here we show, by combining neuroimaging and behavioral genetic approaches in two independent large-scale datasets (HCP (n = 1106), age range: 22-37, eNKI (n = 783), age range: 12-85), that sleep, mental, and physical health have a shared neurobiological basis in grey matter anatomy; and that these relationships are driven by shared genetic factors. Though local associations between sleep and cortical thickness were inconsistent across samples, we identified two robust latent components, highlighting the multivariate interdigitation of sleep, intelligence, BMI, depression, and macroscale cortical structure. Our observations provide a system-level perspective on the interrelation of sleep, mental, and physical conditions, anchored in grey-matter neuroanatomy.
Collapse
Affiliation(s)
- Masoud Tahmasian
- Institute of Medical Science and Technology, Shahid Beheshti University, Tehran, Iran
| | - Fateme Samea
- Institute of Medical Science and Technology, Shahid Beheshti University, Tehran, Iran
| | - Habibolah Khazaie
- Sleep Disorders Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Mojtaba Zarei
- Institute of Medical Science and Technology, Shahid Beheshti University, Tehran, Iran
| | - Shahrzad Kharabian Masouleh
- Institute of Neuroscience and Medicine (INM-7: Brain and Behaviour), Research Centre Jülich, 52425, Jülich, Germany
- Institute of Systems Neuroscience, Heinrich Heine University Düsseldorf, 40225, Düsseldorf, Germany
| | - Felix Hoffstaedter
- Institute of Neuroscience and Medicine (INM-7: Brain and Behaviour), Research Centre Jülich, 52425, Jülich, Germany
- Institute of Systems Neuroscience, Heinrich Heine University Düsseldorf, 40225, Düsseldorf, Germany
| | - Julia Camilleri
- Institute of Neuroscience and Medicine (INM-7: Brain and Behaviour), Research Centre Jülich, 52425, Jülich, Germany
- Institute of Systems Neuroscience, Heinrich Heine University Düsseldorf, 40225, Düsseldorf, Germany
| | - Peter Kochunov
- Maryland Psychiatric Research Center, University of Maryland School of Medicine, Baltimore, MD, 21201, USA
| | - B T Thomas Yeo
- Department of Electrical and Computer Engineering, Clinical Imaging Research Centre, N.1 Institute for Health and Memory Networks Program, National University of Singapore, Singapore, 119077, Singapore
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, MA, 02114, USA
- Centre for Sleep and Cognition, National University of Singapore, Singapore, 119077, Singapore
- NUS Graduate School for Integrative Sciences and Engineering, National University of Singapore, Singapore, 119077, Singapore
| | - Simon Bodo Eickhoff
- Institute of Neuroscience and Medicine (INM-7: Brain and Behaviour), Research Centre Jülich, 52425, Jülich, Germany
- Institute of Systems Neuroscience, Heinrich Heine University Düsseldorf, 40225, Düsseldorf, Germany
| | - Sofie Louise Valk
- Institute of Neuroscience and Medicine (INM-7: Brain and Behaviour), Research Centre Jülich, 52425, Jülich, Germany.
- Institute of Systems Neuroscience, Heinrich Heine University Düsseldorf, 40225, Düsseldorf, Germany.
| |
Collapse
|
84
|
Baril AA, Gagnon K, Descoteaux M, Bedetti C, Chami S, Sanchez E, Montplaisir J, De Beaumont L, Gilbert D, Poirier J, Pelleieux S, Osorio RS, Carrier J, Gosselin N. Cerebral white matter diffusion properties and free-water with obstructive sleep apnea severity in older adults. Hum Brain Mapp 2020; 41:2686-2701. [PMID: 32166865 PMCID: PMC7294053 DOI: 10.1002/hbm.24971] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2019] [Revised: 01/25/2020] [Accepted: 02/16/2020] [Indexed: 12/13/2022] Open
Abstract
Characterizing the effects of obstructive sleep apnea (OSA) on the aging brain could be key in our understanding of neurodegeneration in this population. Our objective was to assess white matter properties in newly diagnosed and untreated adults with mild to severe OSA. Sixty‐five adults aged 55 to 85 were recruited and divided into three groups: control (apnea‐hypopnea index ≤5/hr; n = 18; 65.2 ± 7.2 years old), mild (>5 to ≤15 hr; n = 27; 64.2 ± 5.3 years old) and moderate to severe OSA (>15/hr; n = 20; 65.2 ± 5.5 years old). Diffusion tensor imaging metrics (fractional anisotropy (FA), axial diffusivity (AD), radial diffusivity, and mean diffusivity) were compared between groups with Tract‐Based Spatial Statistics within the white matter skeleton created by the technique. Groups were also compared for white matter hyperintensities volume and the free‐water (FW) fraction. Compared with controls, mild OSA participants showed widespread areas of lower diffusivity (p < .05 corrected) and lower FW fraction (p < .05). Participants with moderate to severe OSA showed lower AD in the corpus callosum compared with controls (p < .05 corrected). No between‐group differences were observed for FA or white matter hyperintensities. Lower white matter diffusivity metrics is especially marked in mild OSA, suggesting that even the milder form may lead to detrimental outcomes. In moderate to severe OSA, competing pathological responses might have led to partial normalization of diffusion metrics.
Collapse
Affiliation(s)
- Andrée-Ann Baril
- Research Centre, Hôpital du Sacré-Coeur de Montréal, Montréal, Québec, Canada.,Faculty of Medicine, Université de Montréal, Montréal, Québec, Canada.,The Framingham Heart Study, Boston University School of Medicine, Boston, Massachussetts
| | - Katia Gagnon
- Research Centre, Hôpital du Sacré-Coeur de Montréal, Montréal, Québec, Canada.,Department of Psychology, Université du Québec à Montréal, Montréal, Québec, Canada.,Research Centre, Hôpital Rivière-des-Prairies, Montréal, Québec, Canada.,Department of Psychology, Université de Montréal, Montréal, Québec, Canada
| | - Maxime Descoteaux
- Research Centre, Centre hospitalier universitaire de Sherbrooke, Sherbrooke, Québec, Canada.,Computer Science Department, Faculty of Sciences, Université de Sherbrooke, Sherbrooke, Québec, Canada
| | - Christophe Bedetti
- Research Centre, Hôpital du Sacré-Coeur de Montréal, Montréal, Québec, Canada.,Research Centre, Institut universitaire de gériatrie de Montréal, Montréal, Québec, Canada
| | - Sirin Chami
- Research Centre, Hôpital du Sacré-Coeur de Montréal, Montréal, Québec, Canada.,Faculty of Medicine, Université de Montréal, Montréal, Québec, Canada
| | - Erlan Sanchez
- Research Centre, Hôpital du Sacré-Coeur de Montréal, Montréal, Québec, Canada.,Faculty of Medicine, Université de Montréal, Montréal, Québec, Canada
| | - Jacques Montplaisir
- Research Centre, Hôpital du Sacré-Coeur de Montréal, Montréal, Québec, Canada.,Faculty of Medicine, Université de Montréal, Montréal, Québec, Canada
| | - Louis De Beaumont
- Research Centre, Hôpital du Sacré-Coeur de Montréal, Montréal, Québec, Canada.,Faculty of Medicine, Université de Montréal, Montréal, Québec, Canada
| | - Danielle Gilbert
- Research Centre, Hôpital du Sacré-Coeur de Montréal, Montréal, Québec, Canada
| | - Judes Poirier
- Centre for Studies on Prevention of Alzheimer's disease, Douglas Institute, Verdun, Québec, Canada.,Department of Psychiatry and Medicine, McGill University, Montréal, Québec, Canada
| | - Sandra Pelleieux
- Centre for Studies on Prevention of Alzheimer's disease, Douglas Institute, Verdun, Québec, Canada.,Department of Psychiatry and Medicine, McGill University, Montréal, Québec, Canada
| | - Ricardo S Osorio
- Department of Psychiatry, Center for Brain Health, NYU Langone Medical Center, New York, New York, USA
| | - Julie Carrier
- Research Centre, Hôpital du Sacré-Coeur de Montréal, Montréal, Québec, Canada.,Research Centre, Institut universitaire de gériatrie de Montréal, Montréal, Québec, Canada.,Department of Psychology, Université de Montréal, Montréal, Québec, Canada
| | - Nadia Gosselin
- Research Centre, Hôpital du Sacré-Coeur de Montréal, Montréal, Québec, Canada.,Department of Psychology, Université de Montréal, Montréal, Québec, Canada
| |
Collapse
|
85
|
Lee NR, Perez M, Hamner T, Adeyemi E, Clasen LS. A preliminary examination of brain morphometry in youth with Down syndrome with and without parent-reported sleep difficulties. RESEARCH IN DEVELOPMENTAL DISABILITIES 2020; 99:103575. [PMID: 32106035 PMCID: PMC7483358 DOI: 10.1016/j.ridd.2020.103575] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/01/2019] [Revised: 12/23/2019] [Accepted: 01/10/2020] [Indexed: 05/27/2023]
Abstract
BACKGROUND Down syndrome is associated with poor sleep but little is known about its neural correlates. AIMS The current research compared brain morphometry in youth with Down syndrome with parent-reported sleep problems (DS-S) to peers with Down syndrome (DS) and typical development (TD) without parent-reported sleep problems matched on age (M = 15.15) and sex ratio (62 % female). METHODS AND PROCEDURES Magnetic resonance imaging was completed on a 3 T scanner. Participants were stratified into groups based on parent-report: DS-S (n = 17), DS (n = 9), TD (n = 22). Brain morphometry, processed with the FreeSurfer Image Analysis Suite, was compared across groups. In addition, the co-occurrence of medical conditions in the DS groups was examined. OUTCOMES AND RESULTS Youth with DS-S had reduced total, frontal, parietal, and temporal brain volumes relative to DS and TD peers. They also had higher rates of congenital heart defects than the DS-only group; however, this comorbidity did not appear to account for morphometry differences. CONCLUSIONS AND IMPLICATIONS Parent-reported sleep problems in DS appear to relate to global and localized volume reductions. These preliminary results have implications for understanding the neural correlates of poor sleep in DS; they also highlight the importance of examining relations between sleep and other medical comorbidities.
Collapse
Affiliation(s)
- Nancy Raitano Lee
- Drexel University, 3141 Chestnut St., Stratton Hall, Suite 119, Philadelphia 19104, United States.
| | - Megan Perez
- Drexel University, 3141 Chestnut St., Stratton Hall, Suite 119, Philadelphia 19104, United States
| | - Taralee Hamner
- Drexel University, 3141 Chestnut St., Stratton Hall, Suite 119, Philadelphia 19104, United States
| | | | - Liv S Clasen
- National Institute of Mental Health, Bethesda, MD, United States
| |
Collapse
|
86
|
Is Sleep Disruption a Cause or Consequence of Alzheimer's Disease? Reviewing Its Possible Role as a Biomarker. Int J Mol Sci 2020; 21:ijms21031168. [PMID: 32050587 PMCID: PMC7037733 DOI: 10.3390/ijms21031168] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2019] [Revised: 02/07/2020] [Accepted: 02/08/2020] [Indexed: 12/21/2022] Open
Abstract
In recent years, the idea that sleep is critical for cognitive processing has gained strength. Alzheimer's disease (AD) is the most common form of dementia worldwide and presents a high prevalence of sleep disturbances. However, it is difficult to establish causal relations, since a vicious circle emerges between different aspects of the disease. Nowadays, we know that sleep is crucial to consolidate memory and to remove the excess of beta-amyloid and hyperphosphorilated tau accumulated in AD patients' brains. In this review, we discuss how sleep disturbances often precede in years some pathological traits, as well as cognitive decline, in AD. We describe the relevance of sleep to memory consolidation, focusing on changes in sleep patterns in AD in contrast to normal aging. We also analyze whether sleep alterations could be useful biomarkers to predict the risk of developing AD and we compile some sleep-related proposed biomarkers. The relevance of the analysis of the sleep microstructure is highlighted to detect specific oscillatory patterns that could be useful as AD biomarkers.
Collapse
|
87
|
Clavel L, Rémy-Neris S, Skalli W, Rouch P, Lespert Y, Similowski T, Sandoz B, Attali V. Cervical Spine Hyperextension and Altered Posturo-Respiratory Coupling in Patients With Obstructive Sleep Apnea Syndrome. Front Med (Lausanne) 2020; 7:30. [PMID: 32118015 PMCID: PMC7020015 DOI: 10.3389/fmed.2020.00030] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2019] [Accepted: 01/21/2020] [Indexed: 12/26/2022] Open
Abstract
Obstructive sleep apnea syndrome (OSAS) is associated with postural dysfunction characterized by abnormal spinal curvature and disturbance of balance and walking, whose pathophysiology is poorly understood. We hypothesized that it may be the result of a pathological interaction between postural and ventilatory functions. Twelve patients with OSAS (4 women, age 53 years [51–63] (median [quartiles]), apnea hypopnea index 31/h [24–41]) were compared with 12 healthy matched controls. Low dose biplanar X-rays (EOS® system) were acquired and personalized three-dimensional models of the spine and pelvis were reconstructed. We also estimated posturo-respiratory coupling by measurement of respiratory emergence, obtaining synchronized center of pressure data from a stabilometric platform and ventilation data recorded by an optico-electronic system of movement analysis. Compared with controls, OSAS patients, had cervical hyperextension with anterior projection of the head (angle OD-C7 12° [8; 14] vs. 5° [4; 8]; p = 0.002), and thoracic hyperkyphosis (angle T1–T12 65° [51; 71] vs. 49° [42; 59]; p = 0.039). Along the mediolateral axis: (1) center of pressure displacement was greater in OSAS patients, whose balance was poorer (19.2 mm [14.2; 31.5] vs. 8.5 [1.4; 17.8]; p = 0.008); (2) respiratory emergence was greater in OSAS patients, who showed increased postural disturbance of respiratory origin (19.2% [9.9; 24.0] vs. 8.1% [6.4; 10.4]; p = 0.028). These results are evidence for the centrally-mediated and primarily respiratory origin of the postural dysfunction in OSAS. It is characterized by an hyperextension of the cervical spine with a compensatory hyperkyphosis, and an alteration in posturo-respiratory coupling, apparently secondary to upper airway instability.
Collapse
Affiliation(s)
- Louis Clavel
- Sorbonne Université, INSERM, UMRS1158 Neurophysiologie Respiratoire Expérimentale et Clinique, Paris, France.,Arts et Métiers, Institut de Biomécanique Humaine Georges Charpak (IBHGC), Paris, France
| | - Ségolène Rémy-Neris
- Sorbonne Université, INSERM, UMRS1158 Neurophysiologie Respiratoire Expérimentale et Clinique, Paris, France
| | - Wafa Skalli
- Arts et Métiers, Institut de Biomécanique Humaine Georges Charpak (IBHGC), Paris, France
| | - Philippe Rouch
- Arts et Métiers, Institut de Biomécanique Humaine Georges Charpak (IBHGC), Paris, France
| | - Yoann Lespert
- Sorbonne Université, INSERM, UMRS1158 Neurophysiologie Respiratoire Expérimentale et Clinique, Paris, France.,Arts et Métiers, Institut de Biomécanique Humaine Georges Charpak (IBHGC), Paris, France
| | - Thomas Similowski
- Sorbonne Université, INSERM, UMRS1158 Neurophysiologie Respiratoire Expérimentale et Clinique, Paris, France.,AP-HP, Groupe Hospitalier Universitaire APHP-Sorbonne Université, site Pitié-Salpêtrière, Service de Pneumologie, Médecine Intensive et Réanimation (Département R3S), Paris, France
| | - Baptiste Sandoz
- Arts et Métiers, Institut de Biomécanique Humaine Georges Charpak (IBHGC), Paris, France
| | - Valérie Attali
- Sorbonne Université, INSERM, UMRS1158 Neurophysiologie Respiratoire Expérimentale et Clinique, Paris, France.,Arts et Métiers, Institut de Biomécanique Humaine Georges Charpak (IBHGC), Paris, France.,AP-HP, Groupe Hospitalier Universitaire APHP-Sorbonne Université, site Pitié-Salpêtrière, Service des Pathologies du Sommeil (Département R3S), Paris, France
| |
Collapse
|
88
|
Attier-Zmudka J, Sérot JM, Valluy J, Saffarini M, Douadi Y, Malinowski KP, Balédent O. Sleep Apnea Syndrome in an Elderly Population Admitted to a Geriatric Unit: Prevalence and Effect on Cognitive Function. Front Aging Neurosci 2020; 11:361. [PMID: 31998116 PMCID: PMC6966603 DOI: 10.3389/fnagi.2019.00361] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2018] [Accepted: 12/10/2019] [Indexed: 12/12/2022] Open
Abstract
Background Sleep apnea leads to cognitive impairment in older patients, but its association with neurodegeneration remains controversial, and most studies do not distinguish between the more common obstructive form (OSAS) and the rarer central form (CSAS). Objective The purpose of this study was to assess the prevalence of the different forms of sleep apnea in a cohort of cognitively impaired elderly patients (>70 years) and to investigate their associations with cognitive deficit, weighted against known risk factors for neurodegeneration. Methods Overnight polygraphy was performed for 76 consecutive patients admitted to our geriatric unit. Their cognitive function was assessed using the Mini Mental-State Exam (MMSE), Mattis Dementia Rating Scale (MDRS) and Stroop test. Multivariable analyses were performed to determine associations between cognitive function and independent variables describing demographics, sleep apnea measures, and cardiovascular risk factors. Results The cohort comprised 58 women and 18 men aged a mean of 84 years (range, 73-96). Sleep apnea syndrome (SAS) was diagnosed in 48 patients (63%), of which 31 (41%) with OSAS and 17 (22%) with CSAS. Multivariable regression analysis revealed that MDRS was lower in patients with OSAS (β = -10.03, p = 0.018), that Stroop Colors and Words delays increased with AHI (β = 0.17, p = 0.030 and β = 0.31, p = 0.047) and that that Stroop Interference delay was higher in patients with CSAS (β = 24.45, p = 0.002). Conclusion Sleep apnea is thus highly prevalent in elderly patients with cognitive impairment. OSAS was associated with lower general cognitive function, while CSAS was only associated with increased Stroop Interference delays. Elderly patients with cognitive deficit could benefit from sleep apnea screening and treatment.
Collapse
Affiliation(s)
- Jadwiga Attier-Zmudka
- Department of Gerontology, Saint-Quentin Hospital, Saint-Quentin, France.,CHIMERE, EA 7516 Head & Neck Research Group, University of Picardy Jules Verne, Amiens, France
| | - Jean-Marie Sérot
- Department of Gerontology, Saint-Quentin Hospital, Saint-Quentin, France
| | | | | | - Youcef Douadi
- Department of Pulmonology, Saint-Quentin Hospital, Saint-Quentin, France
| | - Krzysztof Piotr Malinowski
- Institute of Public Health, Faculty of Health Sciences, Jagiellonian University Medical College, Kraków, Poland
| | - Olivier Balédent
- CHIMERE, EA 7516 Head & Neck Research Group, University of Picardy Jules Verne, Amiens, France.,BioFlowImage, Image Processing Unit, University Hospital of Amiens, Amiens, France
| |
Collapse
|
89
|
Pépin JL, Letesson C, Le-Dong NN, Dedave A, Denison S, Cuthbert V, Martinot JB, Gozal D. Assessment of Mandibular Movement Monitoring With Machine Learning Analysis for the Diagnosis of Obstructive Sleep Apnea. JAMA Netw Open 2020; 3:e1919657. [PMID: 31968116 PMCID: PMC6991283 DOI: 10.1001/jamanetworkopen.2019.19657] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
IMPORTANCE Given the high prevalence of obstructive sleep apnea (OSA), there is a need for simpler and automated diagnostic approaches. OBJECTIVE To evaluate whether mandibular movement (MM) monitoring during sleep coupled with an automated analysis by machine learning is appropriate for OSA diagnosis. DESIGN, SETTING, AND PARTICIPANTS Diagnostic study of adults undergoing overnight in-laboratory polysomnography (PSG) as the reference method compared with simultaneous MM monitoring at a sleep clinic in an academic institution (Sleep Laboratory, Centre Hospitalier Universitaire Université Catholique de Louvain Namur Site Sainte-Elisabeth, Namur, Belgium). Patients with suspected OSA were enrolled from July 5, 2017, to October 31, 2018. MAIN OUTCOMES AND MEASURES Obstructive sleep apnea diagnosis required either evoking signs or symptoms or related medical or psychiatric comorbidities coupled with a PSG-derived respiratory disturbance index (PSG-RDI) of at least 5 events/h. A PSG-RDI of at least 15 events/h satisfied the diagnosis criteria even in the absence of associated symptoms or comorbidities. Patients who did not meet these criteria were classified as not having OSA. Agreement analysis and diagnostic performance were assessed by Bland-Altman plot comparing PSG-RDI and the Sunrise system RDI (Sr-RDI) with diagnosis threshold optimization via receiver operating characteristic curves, allowing for evaluation of the device sensitivity and specificity in detecting OSA at 5 events/h and 15 events/h. RESULTS Among 376 consecutive adults with suspected OSA, the mean (SD) age was 49.7 (13.2) years, the mean (SD) body mass index was 31.0 (7.1), and 207 (55.1%) were men. Reliable agreement was found between PSG-RDI and Sr-RDI in patients without OSA (n = 46; mean difference, 1.31; 95% CI, -1.05 to 3.66 events/h) and in patients with OSA with a PSG-RDI of at least 5 events/h with symptoms (n = 107; mean difference, -0.69; 95% CI, -3.77 to 2.38 events/h). An Sr-RDI underestimation of -11.74 (95% CI, -20.83 to -2.67) events/h in patients with OSA with a PSG-RDI of at least 15 events/h was detected and corrected by optimization of the Sunrise system diagnostic threshold. The Sr-RDI showed diagnostic capability, with areas under the receiver operating characteristic curve of 0.95 (95% CI, 0.92-0.96) and 0.93 (95% CI, 0.90-0.93) for corresponding PSG-RDIs of 5 events/h and 15 events/h, respectively. At the 2 optimal cutoffs of 7.63 events/h and 12.65 events/h, Sr-RDI had accuracy of 0.92 (95% CI, 0.90-0.94) and 0.88 (95% CI, 0.86-0.90) as well as posttest probabilities of 0.99 (95% CI, 0.99-0.99) and 0.89 (95% CI, 0.88-0.91) at PSG-RDIs of at least 5 events/h and at least 15 events/h, respectively, corresponding to positive likelihood ratios of 14.86 (95% CI, 9.86-30.12) and 5.63 (95% CI, 4.92-7.27), respectively. CONCLUSIONS AND RELEVANCE Automatic analysis of MM patterns provided reliable performance in RDI calculation. The use of this index in OSA diagnosis appears to be promising.
Collapse
Affiliation(s)
- Jean-Louis Pépin
- Pôle Thorax et Vaisseaux, Centre Hospitalier Universitaire (CHU) de Grenoble-Alpes (CHUGA), Université Grenoble Alpes, Institut National de la Santé et de la Recherche Medicale, Grenoble, France
| | | | | | | | | | - Valérie Cuthbert
- Sleep Laboratory, CHU Université Catholique de Louvain (UCL) Namur Site Sainte-Elisabeth, Namur, Belgium
| | - Jean-Benoît Martinot
- Sleep Laboratory, CHU Université Catholique de Louvain (UCL) Namur Site Sainte-Elisabeth, Namur, Belgium
- Institute of Experimental and Clinical Research, UCL Bruxelles Woluwe, Brussels, Belgium
| | - David Gozal
- Department of Child Health, University of Missouri, Columbia
- Child Health Research Institute, University of Missouri, Columbia
| |
Collapse
|
90
|
Bubu OM, Andrade AG, Umasabor-Bubu OQ, Hogan MM, Turner AD, de Leon MJ, Ogedegbe G, Ayappa I, Jean-Louis G G, Jackson ML, Varga AW, Osorio RS. Obstructive sleep apnea, cognition and Alzheimer's disease: A systematic review integrating three decades of multidisciplinary research. Sleep Med Rev 2019; 50:101250. [PMID: 31881487 DOI: 10.1016/j.smrv.2019.101250] [Citation(s) in RCA: 185] [Impact Index Per Article: 37.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2019] [Revised: 11/25/2019] [Accepted: 11/28/2019] [Indexed: 12/29/2022]
Abstract
Increasing evidence links cognitive-decline and Alzheimer's disease (AD) to various sleep disorders, including obstructive sleep apnea (OSA). With increasing age, there are substantial differences in OSA's prevalence, associated comorbidities and phenotypic presentation. An important question for sleep and AD researchers is whether OSA's heterogeneity results in varying cognitive-outcomes in older-adults compared to middle-aged adults. In this review, we systematically integrated research examining OSA and cognition, mild cognitive-impairment (MCI) and AD/AD biomarkers; including the effects of continuous positive airway pressure (CPAP) treatment, particularly focusing on characterizing the heterogeneity of OSA and its cognitive-outcomes. Broadly, in middle-aged adults, OSA is often associated with mild impairment in attention, memory and executive function. In older-adults, OSA is not associated with any particular pattern of cognitive-impairment at cross-section; however, OSA is associated with the development of MCI or AD with symptomatic patients who have a higher likelihood of associated disturbed sleep/cognitive-impairment driving these findings. CPAP treatment may be effective in improving cognition in OSA patients with AD. Recent trends demonstrate links between OSA and AD-biomarkers of neurodegeneration across all age-groups. These distinct patterns provide the foundation for envisioning better characterization of OSA and the need for more sensitive/novel sleep-dependent cognitive assessments to assess OSA-related cognitive-impairment.
Collapse
Affiliation(s)
- Omonigho M Bubu
- Center for Brain Health, Department of Psychiatry, NYU Langone Medical Center, New York, NY, USA; Department of Population Health, New York University School of Medicine, Center for Healthful Behavior Change, New York, USA; Department of Epidemiology and Biostatistics, College of Public Health, University of South Florida, Tampa, FL, USA; Department of Applied Health Sciences, Wheaton College, Wheaton, IL, USA.
| | - Andreia G Andrade
- Center for Brain Health, Department of Psychiatry, NYU Langone Medical Center, New York, NY, USA
| | | | - Megan M Hogan
- Department of Applied Health Sciences, Wheaton College, Wheaton, IL, USA
| | - Arlener D Turner
- Center for Brain Health, Department of Psychiatry, NYU Langone Medical Center, New York, NY, USA; Department of Human Services and Psychology, National Louis University, Chicago, IL, USA
| | - Mony J de Leon
- Center for Brain Health, Department of Psychiatry, NYU Langone Medical Center, New York, NY, USA; Department of Radiology, Weill Cornell Medicine, New York, NY 10065, USA
| | - Gbenga Ogedegbe
- Department of Population Health, New York University School of Medicine, Center for Healthful Behavior Change, New York, USA
| | - Indu Ayappa
- Division of Pulmonary, Critical Care and Sleep Medicine at the Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Girardin Jean-Louis G
- Center for Brain Health, Department of Psychiatry, NYU Langone Medical Center, New York, NY, USA; Department of Population Health, New York University School of Medicine, Center for Healthful Behavior Change, New York, USA
| | - Melinda L Jackson
- Institute for Breathing and Sleep, Austin Health, Heidelberg, Victoria, Australia; School of Health & Biomedical Sciences, RMIT University, Bundoora, Victoria, Australia
| | - Andrew W Varga
- Division of Pulmonary, Critical Care and Sleep Medicine at the Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Ricardo S Osorio
- Center for Brain Health, Department of Psychiatry, NYU Langone Medical Center, New York, NY, USA.
| |
Collapse
|
91
|
Wimms AJ, Kelly JL, Turnbull CD, McMillan A, Craig SE, O'Reilly JF, Nickol AH, Hedley EL, Decker MD, Willes LA, Calverley PMA, Benjafield AV, Stradling JR, Morrell MJ. Continuous positive airway pressure versus standard care for the treatment of people with mild obstructive sleep apnoea (MERGE): a multicentre, randomised controlled trial. THE LANCET RESPIRATORY MEDICINE 2019; 8:349-358. [PMID: 31806413 DOI: 10.1016/s2213-2600(19)30402-3] [Citation(s) in RCA: 53] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/27/2019] [Revised: 09/27/2019] [Accepted: 10/14/2019] [Indexed: 12/19/2022]
Abstract
BACKGROUND The evidence base for the treatment of mild obstructive sleep apnoea is limited and definitions of disease severity vary. The MERGE trial investigated the clinical effectiveness of continuous positive airway pressure in patients with mild obstructive sleep apnoea. METHODS MERGE, a multicentre, parallel, randomised controlled trial enrolled patients (≥18 years to ≤80 years) with mild obstructive sleep apnoea (apnoea-hypopnoea index [AHI] ≥5 to ≤15 events per h using either AASM 2007 or AASM 2012 scoring criteria) from 11 UK sleep centres. Participants were assigned (1:1) to either 3 months of continuous positive airway pressure plus standard care (sleep counselling), or standard care alone, by computer-generated randomisation; neither participants nor researchers were blinded. The primary outcome was a change in the score on the Short Form-36 questionnaire vitality scale in the intention-to-treat population of patients with mild obstructive sleep apnoea diagnosed using the American Academy of Sleep Medicine 2012 scoring criteria. The study is registered with ClinicalTrials.gov, NCT02699463. FINDINGS Between Nov 28, 2016 and Feb 12, 2019, 301 patients were recruited and randomised. 233 had mild obstructive sleep apnoea using AASM 2012 criteria and were included in the intention-to-treat analysis: 115 were allocated to receive continuous positive airway pressure and 118 to receive standard care. 209 (90%) of these participants completed the trial. The vitality score significantly increased with a treatment effect of a mean of 10·0 points (95% CI 7·2-12·8; p<0·0001) after 3 months of continuous positive airway pressure, compared with standard care alone (9·2 points [6·8 to 11·6] vs -0·8 points [-3·2 to 1·5]). Using the ANCOVA last-observation-carried-forward analysis, a more conservative estimate, the vitality score also significantly increased with a treatment effect of a mean of 7·5 points (95% CI 5·3 to 9·6; p<0·0001) after 3 months of continuous positive airway pressure, compared with standard care alone (7·5 points [6·0 to 9·0] vs 0·0 points [-1·5 to 1·5]). Three serious adverse events occurred (one allocated to the continuous positive airway pressure group) and all were unrelated to the intervention. INTERPRETATION 3 months of treatment with continuous positive airway pressure improved the quality of life in patients with mild obstructive sleep apnoea. These results highlight the need for health-care professionals and providers to consider treatment for patients with mild obstructive sleep apnoea. FUNDING ResMed Ltd.
Collapse
Affiliation(s)
- Alison J Wimms
- Department of Medicine, University of Sydney, Sydney, Australia; ResMed Science Center, ResMed Ltd, Sydney, Australia
| | - Julia L Kelly
- National Heart and Lung Institute, Imperial College London, London, UK; Royal Brompton and Harefield NHS Foundation Trust, London, UK.
| | | | | | | | | | - Annabel H Nickol
- Oxford University Hospital NHS Foundation Trust, Hospital, Oxford, UK
| | | | | | | | - Peter M A Calverley
- Institute of Ageing and Chronic Disease, University of Liverpool, Liverpool, UK
| | | | | | - Mary J Morrell
- National Heart and Lung Institute, Imperial College London, London, UK; Royal Brompton and Harefield NHS Foundation Trust, London, UK
| | | |
Collapse
|
92
|
Canora A, Nicoletta C, Ghinassi G, Bruzzese D, Rea G, Capaccio A, Castaldo S, Coppola A, Polistina GE, Sanduzzi A, Bocchino M. First Description of the Hyperpnea-Hypopnea Periodic Breathing in Patients with Interstitial Lung Disease-Obstructive Sleep Apnea: Treatment Implications in a Real-Life Setting. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16234712. [PMID: 31779226 PMCID: PMC6926841 DOI: 10.3390/ijerph16234712] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/20/2019] [Revised: 11/22/2019] [Accepted: 11/23/2019] [Indexed: 11/16/2022]
Abstract
There is evidence that hypopneas are more common than apneas in obstructive sleep apnea (OSA) related to idiopathic pulmonary fibrosis (IPF). We investigated the frequency distribution of hypopneas in 100 patients with interstitial lung diseases (ILDs) (mean age 69 yrs ± 7.8; 70% males), including 54 IPF cases, screened for OSA by home sleep testing. Fifty age- and sex-matched pure OSA patients were included as controls. In ILD-OSA patients the sleep breathing pattern was characterized by a high prevalence of hypopneas that were preceded by hyperpnea events configuring a sort of periodic pattern. This finding, we arbitrarily defined hyperpnea–hypopnea periodic breathing (HHPB), was likely reflecting a central event and was completely absent in control OSA. Also, the HHPB was highly responsive to oxygen but not to the continuous positive pressure support. Thirty-three ILD-OSA patients (42%) with a HHPB associated with a hypopnea/apnea ratio ≥3 had the best response to oxygen with a median residual AHI of 2.6 (1.8–5.6) vs. 28.3 (20.7–37.8) at baseline (p < 0.0001). ILD-OSA patients with these characteristics were similarly distributed in IPF (54.5%) and no-IPF cases (45.5%), the most of them being affected by moderate–severe OSA (p = 0.027). Future studies addressing the pathogenesis and therapy management of the HHPB should be encouraged in ILD-OSA patients.
Collapse
Affiliation(s)
- Angelo Canora
- Dipartimento di Medicina Clinica e Chirurgia, Sezione di Malattie dell’Apparato Respiratorio, Università Federico II, 80131 Napoli, Italy; (A.C.); (C.N.); (G.G.); (A.C.); (S.C.); (A.C.); (G.E.P.); (A.S.)
| | - Carmine Nicoletta
- Dipartimento di Medicina Clinica e Chirurgia, Sezione di Malattie dell’Apparato Respiratorio, Università Federico II, 80131 Napoli, Italy; (A.C.); (C.N.); (G.G.); (A.C.); (S.C.); (A.C.); (G.E.P.); (A.S.)
| | - Giacomo Ghinassi
- Dipartimento di Medicina Clinica e Chirurgia, Sezione di Malattie dell’Apparato Respiratorio, Università Federico II, 80131 Napoli, Italy; (A.C.); (C.N.); (G.G.); (A.C.); (S.C.); (A.C.); (G.E.P.); (A.S.)
| | - Dario Bruzzese
- Dipartimento di Sanità Pubblica, Università Federico II, 80131 Napoli, Italy;
| | - Gaetano Rea
- Dipartimento dei Servizi Diagnostici e Generali, Ospedali dei Colli, Monaldi-Cotugno, 80131 Napoli, Italy;
| | - Annalisa Capaccio
- Dipartimento di Medicina Clinica e Chirurgia, Sezione di Malattie dell’Apparato Respiratorio, Università Federico II, 80131 Napoli, Italy; (A.C.); (C.N.); (G.G.); (A.C.); (S.C.); (A.C.); (G.E.P.); (A.S.)
| | - Sabrina Castaldo
- Dipartimento di Medicina Clinica e Chirurgia, Sezione di Malattie dell’Apparato Respiratorio, Università Federico II, 80131 Napoli, Italy; (A.C.); (C.N.); (G.G.); (A.C.); (S.C.); (A.C.); (G.E.P.); (A.S.)
| | - Antonietta Coppola
- Dipartimento di Medicina Clinica e Chirurgia, Sezione di Malattie dell’Apparato Respiratorio, Università Federico II, 80131 Napoli, Italy; (A.C.); (C.N.); (G.G.); (A.C.); (S.C.); (A.C.); (G.E.P.); (A.S.)
| | - Giorgio Emanuele Polistina
- Dipartimento di Medicina Clinica e Chirurgia, Sezione di Malattie dell’Apparato Respiratorio, Università Federico II, 80131 Napoli, Italy; (A.C.); (C.N.); (G.G.); (A.C.); (S.C.); (A.C.); (G.E.P.); (A.S.)
| | - Alessandro Sanduzzi
- Dipartimento di Medicina Clinica e Chirurgia, Sezione di Malattie dell’Apparato Respiratorio, Università Federico II, 80131 Napoli, Italy; (A.C.); (C.N.); (G.G.); (A.C.); (S.C.); (A.C.); (G.E.P.); (A.S.)
| | - Marialuisa Bocchino
- Dipartimento di Medicina Clinica e Chirurgia, Sezione di Malattie dell’Apparato Respiratorio, Università Federico II, 80131 Napoli, Italy; (A.C.); (C.N.); (G.G.); (A.C.); (S.C.); (A.C.); (G.E.P.); (A.S.)
- Correspondence: ; Tel.: +30-081-7062773
| |
Collapse
|
93
|
Li X, Joehanes R, Hoeschele I, Rich SS, Rotter JI, Levy D, Liu Y, Redline S, Sofer T. Association between sleep disordered breathing and epigenetic age acceleration: Evidence from the Multi-Ethnic Study of Atherosclerosis. EBioMedicine 2019; 50:387-394. [PMID: 31761615 PMCID: PMC6921369 DOI: 10.1016/j.ebiom.2019.11.020] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2019] [Revised: 10/31/2019] [Accepted: 11/11/2019] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Sleep disordered breathing (SDB) is a common disorder that results in oxidative stress and inflammation and is associated with multiple age-related health outcomes. Epigenetic age acceleration is a DNA methylation (DNAm)-based marker of fast biological aging. We examined the associations of SDB traits with epigenetic age acceleration. METHODS A sample of 622 participants from the Multi-Ethnic Study of Atherosclerosis (MESA) had blood DNAm measured and underwent Type 2 in-home polysomnography that assessed apnea-hypopnea index (AHI), percentage of sleep time with oxygen saturation lower than 90% (Per90), and arousal index. DNAm data provided measures of DNAm-Age acceleration and DNAm-PhenoAge acceleration. The association of each SDB trait with age acceleration was estimated using linear regression, controlling for covariates. In secondary analyses, we studied the associations of SDB traits with epigenetic age acceleration 2-10 years after sleep study in 530 individuals from the Framingham Heart Study (FHS). FINDINGS In MESA, AHI was associated with greater DNAm-PhenoAge acceleration (β = 0.03; 95% CI [0.001, 0.06]). Arousal index was associated with greater DNAm-Age acceleration (β = 0.04; 95% CI [0.01, 0.07]). Both associations were stronger in women than men. In the secondary FHS analyses, Per90 was associated with greater DNAm-Age acceleration and this association was stronger in men. INTERPRETATION More severe SDB was associated with epigenetic age acceleration in both cohorts. Future work should prospectively study short- and long-term effects of SDB, and whether treatment reduces epigenetic age acceleration among those individuals with SBD. FUNDING National Institutes of Health.
Collapse
Affiliation(s)
- Xiaoyu Li
- Division of Sleep and Circadian Disorders, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, 221 Longwood Avenue, BL252, Boston, MA 02115, United States; Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, United States.
| | - Roby Joehanes
- The Population Sciences Branch of the National Heart, Lung and Blood Institute, Bethesda, MD and the Framingham Heart Study, Framingham, MA, United States
| | - Ina Hoeschele
- Fralin Life Sciences Institute, Virginia Tech, Blacksburg, VA, United States; Department of Statistics, Virginia Tech, Blacksburg, VA, United States; Wake Forest Medical School, Winston-Salem, NC, United States
| | - Stephen S Rich
- Center for Public Health Genomics, University of Virginia, Charlottesville, VA, United States
| | - Jerome I Rotter
- Institute for Translational Genomics and Population Sciences, Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, CA, United States; Division of Genomic Outcomes, Departments of Pediatrics and Medicine, Harbor-UCLA Medical Center, Torrance, CA, United States
| | - Daniel Levy
- The Population Sciences Branch of the National Heart, Lung and Blood Institute, Bethesda, MD and the Framingham Heart Study, Framingham, MA, United States
| | - Yongmei Liu
- Department of Medicine, Duke University School of Medicine, Durham, NC, United States
| | - Susan Redline
- Division of Sleep and Circadian Disorders, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, 221 Longwood Avenue, BL252, Boston, MA 02115, United States
| | - Tamar Sofer
- Division of Sleep and Circadian Disorders, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, 221 Longwood Avenue, BL252, Boston, MA 02115, United States
| |
Collapse
|
94
|
Gosselin N, Baril AA, Osorio RS, Kaminska M, Carrier J. Obstructive Sleep Apnea and the Risk of Cognitive Decline in Older Adults. Am J Respir Crit Care Med 2019; 199:142-148. [PMID: 30113864 DOI: 10.1164/rccm.201801-0204pp] [Citation(s) in RCA: 74] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Affiliation(s)
- Nadia Gosselin
- 1 Center for Advanced Research in Sleep Medicine, Hôpital du Sacré-Cœur de Montréal, Montreal, Canada.,2 Université de Montréal, Montreal, Canada.,3 Canadian Sleep and Circadian Network, Canada
| | - Andrée-Ann Baril
- 1 Center for Advanced Research in Sleep Medicine, Hôpital du Sacré-Cœur de Montréal, Montreal, Canada.,2 Université de Montréal, Montreal, Canada.,3 Canadian Sleep and Circadian Network, Canada
| | - Ricardo S Osorio
- 4 Center for Brain Health, New York University Langone Medical Center, Manhattan, New York.,5 Nathan S. Kline Institute for Psychiatric Research, Orangeburg, New York; and
| | - Marta Kaminska
- 3 Canadian Sleep and Circadian Network, Canada.,6 Respiratory Epidemiology and Clinical Research Unit, Respiratory Division and Sleep Laboratory, Department of Medicine, McGill University Health Center, Montreal, Canada
| | - Julie Carrier
- 1 Center for Advanced Research in Sleep Medicine, Hôpital du Sacré-Cœur de Montréal, Montreal, Canada.,2 Université de Montréal, Montreal, Canada.,3 Canadian Sleep and Circadian Network, Canada
| |
Collapse
|
95
|
Li HY, Tsai MS, Huang CG, Wang RYL, Chuang LP, Chen NH, Liu CH, Hsu CM, Cheng WN, Lee LA. Alterations in Alzheimer's Disease-Associated Gene Expression in Severe Obstructive Sleep Apnea Patients. J Clin Med 2019; 8:jcm8091361. [PMID: 31480626 PMCID: PMC6780075 DOI: 10.3390/jcm8091361] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2019] [Revised: 08/24/2019] [Accepted: 08/28/2019] [Indexed: 01/18/2023] Open
Abstract
Background: Obstructive sleep apnea (OSA) increases the risk of Alzheimer’s disease (AD), and inflammation may be involved in the early pathogenesis of AD in patients with OSA. However, the potential pathways between OSA and AD have yet to be established. In this study, we aimed to investigate differential expressions of AD-associated genes in OSA patients without evident AD or dementia. Methods: This prospective case-control study included five patients with severe OSA and five age and sex-matched patients with non-severe OSA without evident dementia who underwent uvulopalatopharyngoplasty between 1 January 2013 and 31 December 2015. The expressions of genes associated with AD were analyzed using whole-exome sequencing. Unsupervised two-dimensional hierarchical clustering was performed on these genes. Pearson’s correlation was used as the distance metric to simultaneously cluster subjects and genes. Results: The expressions of CCL2, IL6, CXCL8, HLA-A, and IL1RN in the patients with severe OSA were significantly different from those in the patients with non-severe OSA and contributed to changes in the immune response, cytokine–cytokine receptor interactions, and nucleotide-binding oligomerization domain-like receptor signaling pathways. Conclusions: Inflammation may contribute to the onset of AD and physicians need to be aware of the potential occurrence of AD in patients with severe OSA.
Collapse
Affiliation(s)
- Hsueh-Yu Li
- Department of Otolaryngology-Head and Neck Surgery, Linkou Chang Gung Memorial Hospital, Taoyuan 333, Taiwan
- Faculty of Medicine, College of Medicine, Chang Gung University, Taoyuan 333, Taiwan
| | - Ming-Shao Tsai
- Faculty of Medicine, College of Medicine, Chang Gung University, Taoyuan 333, Taiwan
- Department of Otolaryngology-Head and Neck Surgery, Chiayi Chang Gung Memorial Hospital, Chiayi 613, Taiwan
- Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Taoyuan 333, Taiwan
- Health Information and Epidemiology Laboratory, Chiayi, Chang Gung Memorial Hospital, Chiayi 613, Taiwan
| | - Chung-Guei Huang
- Department of Laboratory Medicine, Linkou Chang Gung Memorial Hospital, Taoyuan 333, Taiwan.
- Research Center for Emerging Viral Infections, Chang Gung University, Taoyuan 333, Taiwan.
- Graduate Institute of Biomedical Sciences, Department of Medical Biotechnology and Laboratory Science, College of Medicine, Chang Gung University, Taoyuan 333, Taiwan.
| | - Robert Y L Wang
- Research Center for Emerging Viral Infections, Chang Gung University, Taoyuan 333, Taiwan
| | - Li-Pang Chuang
- Faculty of Medicine, College of Medicine, Chang Gung University, Taoyuan 333, Taiwan
- Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Taoyuan 333, Taiwan
- Department of Pulmonary and Critical Care Medicine, Taoyuan Chang Gung Memorial Hospital, Taoyuan 333, Taiwan
| | - Ning-Hung Chen
- Faculty of Medicine, College of Medicine, Chang Gung University, Taoyuan 333, Taiwan
- Department of Pulmonary and Critical Care Medicine, Taoyuan Chang Gung Memorial Hospital, Taoyuan 333, Taiwan
| | - Chi-Hung Liu
- Faculty of Medicine, College of Medicine, Chang Gung University, Taoyuan 333, Taiwan
- Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Taoyuan 333, Taiwan
- Stroke Center and Department of Neurology, Linkou Chang Gung Memorial Hospital, Taoyuan 333, Taiwan
| | - Cheng-Ming Hsu
- Department of Otolaryngology-Head and Neck Surgery, Chiayi Chang Gung Memorial Hospital, Chiayi 613, Taiwan
- School of Traditional Chinese Medicine, College of Medicine, Chang Gung University, Taoyuan 333, Taiwan
| | - Wen-Nuan Cheng
- Department of Sports Sciences, University of Taipei, Taipei 111, Taiwan
| | - Li-Ang Lee
- Department of Otolaryngology-Head and Neck Surgery, Linkou Chang Gung Memorial Hospital, Taoyuan 333, Taiwan.
- Faculty of Medicine, College of Medicine, Chang Gung University, Taoyuan 333, Taiwan.
- Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Taoyuan 333, Taiwan.
| |
Collapse
|
96
|
Wang J, Gu BJ, Masters CL, Wang YJ. A systemic view of Alzheimer disease - insights from amyloid-β metabolism beyond the brain. Nat Rev Neurol 2019; 13:612-623. [PMID: 28960209 DOI: 10.1038/nrneurol.2017.111] [Citation(s) in RCA: 484] [Impact Index Per Article: 96.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Alzheimer disease (AD) is the most common type of dementia, and is currently incurable; existing treatments for AD produce only a modest amelioration of symptoms. Research into this disease has conventionally focused on the CNS. However, several peripheral and systemic abnormalities are now understood to be linked to AD, and our understanding of how these alterations contribute to AD is becoming more clearly defined. This Review focuses on amyloid-β (Aβ), a major hallmark of AD. We review emerging findings of associations between systemic abnormalities and Aβ metabolism, and describe how these associations might interact with or reflect on the central pathways of Aβ production and clearance. On the basis of these findings, we propose that these abnormal systemic changes might not only develop secondary to brain dysfunction but might also affect AD progression, suggesting that the interactions between the brain and the periphery have a crucial role in the development and progression of AD. Such a systemic view of the molecular pathogenesis of AD could provide a novel perspective for understanding this disease and present new opportunities for its early diagnosis and treatment.
Collapse
Affiliation(s)
- Jun Wang
- Department of Neurology and Centre for Clinical Neuroscience, Daping Hospital, Third Military Medical University, 10 Changjiang branch road, Daping, Chongqing, 400042, China
| | - Ben J Gu
- The Florey Institute, The University of Melbourne, 30 Royal Parade, Parkville, Victoria 3052, Australia
| | - Colin L Masters
- The Florey Institute, The University of Melbourne, 30 Royal Parade, Parkville, Victoria 3052, Australia
| | - Yan-Jiang Wang
- Department of Neurology and Centre for Clinical Neuroscience, Daping Hospital, Third Military Medical University, 10 Changjiang branch road, Daping, Chongqing, 400042, China
| |
Collapse
|
97
|
Abstract
Eukaryotic cells require sufficient oxygen (O2) for biological activity and survival. When the oxygen demand exceeds its supply, the oxygen levels in local tissues or the whole body decrease (termed hypoxia), leading to a metabolic crisis, threatening physiological functions and viability. Therefore, eukaryotes have developed an efficient and rapid oxygen sensing system: hypoxia-inducible factors (HIFs). The hypoxic responses are controlled by HIFs, which induce the expression of several adaptive genes to increase the oxygen supply and support anaerobic ATP generation in eukaryotic cells. Hypoxia also contributes to a functional decline during the aging process. In this review, we focus on the molecular mechanisms regulating HIF-1α and aging-associated signaling proteins, such as sirtuins, AMP-activated protein kinase, mechanistic target of rapamycin complex 1, UNC-51-like kinase 1, and nuclear factor κB, and their roles in aging and aging-related diseases. In addition, the effects of prenatal hypoxia and obstructive sleep apnea (OSA)-induced intermittent hypoxia have been reviewed due to their involvement in the progression and severity of many diseases, including cancer and other aging-related diseases. The pathophysiological consequences and clinical manifestations of prenatal hypoxia and OSA-induced chronic intermittent hypoxia are discussed in detail.
Collapse
|
98
|
Menon RN, Radhakrishnan A, Sreedharan SE, Sarma PS, Kumari RS, Kesavadas C, Sasi D, Lekha VS, Justus S, Unnikrishnan JP. Do quantified sleep architecture abnormalities underlie cognitive disturbances in amnestic mild cognitive impairment? J Clin Neurosci 2019; 67:85-92. [PMID: 31221582 DOI: 10.1016/j.jocn.2019.06.014] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2019] [Revised: 05/10/2019] [Accepted: 06/09/2019] [Indexed: 10/26/2022]
Abstract
The study was designed to gauge association between occult sleep-related breathing disturbances and sleep architecture changes on cognitive trajectories in subjects with amnestic mild cognitive impairment (aMCI) relative to cognitively normal healthy controls, phenotyped by neuroimaging. Subjects with aMCI and normal cognition were prospectively recruited. Following standardized neuropsychological and sleep questionnaire assessment they underwent a single overnight polysomnography (PSG); multimodality MRI was used to ascertain age-corrected radiological differences between the 2 groups. The aMCI cohort was followed up longitudinally with serial cognitive assessments for the next 3 years. Thirty seven subjects with aMCI and 24 control subjects consented for evaluation. Although occult moderate to severe obstructive sleep apnea (OSA) was more prevalent in aMCI (43.6%) as opposed to controls (22.7%); higher median apnea-hypopnea index (AHI = 11.5) and total apnea-hypopnea time (26.6 min) were also noted in aMCI relative to controls (6.6 and 11.4 min respectively), the differences were not statistically significant. In the aMCI group, better sleep efficiency, longer duration of REM sleep correlated with higher associative learning, free-recall/recognition memory performance. Higher AHI had negative correlation with visual memory scores. However longitudinal cognitive trends in the aMCI group over 3 years reflected relative stability (only 5% progressed to AD) notwithstanding imaging differences from controls and appeared to be independent of sleep parameters. The study concluded that despite associations between sleep efficiency, REM sleep and sleep-related breathing variables with neuropsychological test-scores in aMCI, these appear to be comorbidities rather than causative factors for the degree of cognitive impairment or its longitudinal trajectory.
Collapse
Affiliation(s)
- Ramshekhar N Menon
- Cognition and Behavioural Neurology Section, Department of Neurology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum 695011, India.
| | - Ashalatha Radhakrishnan
- Comprehensive Care Centre for Sleep Disorders, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum 695011, India
| | - Sapna Erat Sreedharan
- Comprehensive Care Centre for Sleep Disorders, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum 695011, India
| | - P Sankara Sarma
- Achutha Menon Centre for Health Science Studies, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum 695011, India
| | - R Sheela Kumari
- Cognition and Behavioural Neurology Section, Department of Neurology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum 695011, India
| | - C Kesavadas
- Department of Imaging Sciences and Interventional Radiology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum 695011, India
| | - Deepak Sasi
- Cognition and Behavioural Neurology Section, Department of Neurology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum 695011, India
| | - V S Lekha
- Cognition and Behavioural Neurology Section, Department of Neurology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum 695011, India
| | - Sunitha Justus
- Cognition and Behavioural Neurology Section, Department of Neurology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum 695011, India
| | - J P Unnikrishnan
- Comprehensive Care Centre for Sleep Disorders, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum 695011, India
| |
Collapse
|
99
|
Heinrich EC, Djokic MA, Gilbertson D, DeYoung PN, Bosompra NO, Wu L, Anza-Ramirez C, Orr JE, Powell FL, Malhotra A, Simonson TS. Cognitive function and mood at high altitude following acclimatization and use of supplemental oxygen and adaptive servoventilation sleep treatments. PLoS One 2019; 14:e0217089. [PMID: 31188839 PMCID: PMC6561544 DOI: 10.1371/journal.pone.0217089] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2018] [Accepted: 05/03/2019] [Indexed: 11/19/2022] Open
Abstract
Impairments in cognitive function, mood, and sleep quality occur following ascent to high altitude. Low oxygen (hypoxia) and poor sleep quality are both linked to impaired cognitive performance, but their independent contributions at high altitude remain unknown. Adaptive servoventilation (ASV) improves sleep quality by stabilizing breathing and preventing central apneas without supplemental oxygen. We compared the efficacy of ASV and supplemental oxygen sleep treatments for improving daytime cognitive function and mood in high-altitude visitors (N = 18) during acclimatization to 3,800 m. Each night, subjects were randomly provided with ASV, supplemental oxygen (SpO2 > 95%), or no treatment. Each morning subjects completed a series of cognitive function tests and questionnaires to assess mood and multiple aspects of cognitive performance. We found that both ASV and supplemental oxygen (O2) improved daytime feelings of confusion (ASV: p < 0.01; O2: p < 0.05) and fatigue (ASV: p < 0.01; O2: p < 0.01) but did not improve other measures of cognitive performance at high altitude. However, performance improved on the trail making tests (TMT) A and B (p < 0.001), the balloon analog risk test (p < 0.0001), and the psychomotor vigilance test (p < 0.01) over the course of three days at altitude after controlling for effects of sleep treatments. Compared to sea level, subjects reported higher levels of confusion (p < 0.01) and performed worse on the TMT A (p < 0.05) and the emotion recognition test (p < 0.05) on nights when they received no treatment at high altitude. These results suggest that stabilizing breathing (ASV) or increasing oxygenation (supplemental oxygen) during sleep can reduce feelings of fatigue and confusion, but that daytime hypoxia may play a larger role in other cognitive impairments reported at high altitude. Furthermore, this study provides evidence that some aspects of cognition (executive control, risk inhibition, sustained attention) improve with acclimatization.
Collapse
Affiliation(s)
- Erica C. Heinrich
- Department of Medicine, Division of Pulmonary, Critical Care, and Sleep Medicine, University of California San Diego, La Jolla, California, United States of America
| | - Matea A. Djokic
- Department of Medicine, Division of Pulmonary, Critical Care, and Sleep Medicine, University of California San Diego, La Jolla, California, United States of America
| | - Dillon Gilbertson
- Department of Medicine, Division of Pulmonary, Critical Care, and Sleep Medicine, University of California San Diego, La Jolla, California, United States of America
| | - Pamela N. DeYoung
- Department of Medicine, Division of Pulmonary, Critical Care, and Sleep Medicine, University of California San Diego, La Jolla, California, United States of America
| | - Naa-Oye Bosompra
- Department of Medicine, Division of Pulmonary, Critical Care, and Sleep Medicine, University of California San Diego, La Jolla, California, United States of America
| | - Lu Wu
- Department of Medicine, Division of Pulmonary, Critical Care, and Sleep Medicine, University of California San Diego, La Jolla, California, United States of America
| | - Cecilia Anza-Ramirez
- Departamento de Ciencias Biológicas y Fisiológicas, Facultad de Ciencias y Filosofía, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Jeremy E. Orr
- Department of Medicine, Division of Pulmonary, Critical Care, and Sleep Medicine, University of California San Diego, La Jolla, California, United States of America
| | - Frank L. Powell
- Department of Medicine, Division of Pulmonary, Critical Care, and Sleep Medicine, University of California San Diego, La Jolla, California, United States of America
| | - Atul Malhotra
- Department of Medicine, Division of Pulmonary, Critical Care, and Sleep Medicine, University of California San Diego, La Jolla, California, United States of America
| | - Tatum S. Simonson
- Department of Medicine, Division of Pulmonary, Critical Care, and Sleep Medicine, University of California San Diego, La Jolla, California, United States of America
| |
Collapse
|
100
|
Bubu OM, Pirraglia E, Andrade AG, Sharma RA, Gimenez-Badia S, Umasabor-Bubu OQ, Hogan MM, Shim AM, Mukhtar F, Sharma N, Mbah AK, Seixas AA, Kam K, Zizi F, Borenstein AR, Mortimer JA, Kip KE, Morgan D, Rosenzweig I, Ayappa I, Rapoport DM, Jean-Louis G, Varga AW, Osorio RS. Obstructive sleep apnea and longitudinal Alzheimer's disease biomarker changes. Sleep 2019; 42:zsz048. [PMID: 30794315 PMCID: PMC6765111 DOI: 10.1093/sleep/zsz048] [Citation(s) in RCA: 105] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2018] [Revised: 01/11/2019] [Accepted: 02/19/2019] [Indexed: 11/14/2022] Open
Abstract
STUDY OBJECTIVES To determine the effect of self-reported clinical diagnosis of obstructive sleep apnea (OSA) on longitudinal changes in brain amyloid PET and CSF biomarkers (Aβ42, T-tau, and P-tau) in cognitively normal (NL), mild cognitive impairment (MCI), and Alzheimer's disease (AD) elderly. METHODS Longitudinal study with mean follow-up time of 2.52 ± 0.51 years. Data were obtained from the Alzheimer's Disease Neuroimaging Initiative (ADNI) database. Participants included 516 NL, 798 MCI, and 325 AD elderly. Main outcomes were annual rate of change in brain amyloid burden (i.e. longitudinal increases in florbetapir PET uptake or decreases in CSF Aβ42 levels); and tau protein aggregation (i.e. longitudinal increases in CSF total tau [T-tau] and phosphorylated tau [P-tau]). Adjusted multilevel mixed effects linear regression models with randomly varying intercepts and slopes was used to test whether the rate of biomarker change differed between participants with and without OSA. RESULTS In NL and MCI groups, OSA+ subjects experienced faster annual increase in florbetapir uptake (B = .06, 95% CI = .02, .11 and B = .08, 95% CI = .05, .12, respectively) and decrease in CSF Aβ42 levels (B = -2.71, 95% CI = -3.11, -2.35 and B = -2.62, 95% CI = -3.23, -2.03, respectively); as well as increases in CSF T-tau (B = 3.68, 95% CI = 3.31, 4.07 and B = 2.21, 95% CI = 1.58, 2.86, respectively) and P-tau (B = 1.221, 95% CI = 1.02, 1.42 and B = 1.74, 95% CI = 1.22, 2.27, respectively); compared with OSA- participants. No significant variations in the biomarker changes over time were seen in the AD group. CONCLUSIONS In both NL and MCI, elderly, clinical interventions aimed to treat OSA are needed to test if OSA treatment may affect the progression of cognitive impairment due to AD.
Collapse
Affiliation(s)
- Omonigho M Bubu
- Department of Epidemiology and Biostatistics, College of Public Health, University of South Florida, Tampa, FL
- Center for Brain Health, Department of Psychiatry, NYU Langone Medical Center, New York, NY
- Department of Applied Health Sciences, Wheaton College, Wheaton, IL
- Department of Population Health, New York University School of Medicine, Center for Healthful Behavior Change, New York, NY
| | - Elizabeth Pirraglia
- Center for Brain Health, Department of Psychiatry, NYU Langone Medical Center, New York, NY
| | - Andreia G Andrade
- Center for Brain Health, Department of Psychiatry, NYU Langone Medical Center, New York, NY
| | - Ram A Sharma
- Center for Brain Health, Department of Psychiatry, NYU Langone Medical Center, New York, NY
| | - Sandra Gimenez-Badia
- Multidisciplinary Sleep Unit - Respiratory Department, Hospital de la Santa Creu i Sant Pau. IIB Sant Pau Department of Clinical Psychobiology, University of Barcelona, Barcelona, Spain
| | | | - Megan M Hogan
- Department of Applied Health Sciences, Wheaton College, Wheaton, IL
| | - Amanda M Shim
- Department of Applied Health Sciences, Wheaton College, Wheaton, IL
| | - Fahad Mukhtar
- Department of Epidemiology and Biostatistics, College of Public Health, University of South Florida, Tampa, FL
| | - Nidhi Sharma
- Dipartmento Di Scienze Biochimica A. Rossi Fanelli, University of Rome, Rome, Italy
| | - Alfred K Mbah
- Department of Epidemiology and Biostatistics, College of Public Health, University of South Florida, Tampa, FL
| | - Azizi A Seixas
- Department of Population Health, New York University School of Medicine, Center for Healthful Behavior Change, New York, NY
| | - Korey Kam
- Division of Pulmonary, Critical Care and Sleep Medicine at the Icahn School of Medicine at Mount Sinai, New York, NY
| | - Ferdinand Zizi
- Department of Population Health, New York University School of Medicine, Center for Healthful Behavior Change, New York, NY
| | - Amy R Borenstein
- Department of Family Medicine and Public Health, University of California—San Diego, San Diego, CA
| | - James A Mortimer
- Department of Epidemiology and Biostatistics, College of Public Health, University of South Florida, Tampa, FL
| | - Kevin E Kip
- Department of Epidemiology and Biostatistics, College of Public Health, University of South Florida, Tampa, FL
| | - David Morgan
- Department of Molecular Science and Translational Medicine, Michigan State University, Grand Rapids, MI
- Byrd Alzheimer’s Disease Institute, College of Medicine, Psychiatry and Behavioral Neurosciences, University of South Florida Health, Tampa, FL
| | - Ivana Rosenzweig
- Sleep Disorders Centre, Guy’s Hospital, Great Maze Pond, London, UK
- Sleep and Brain Plasticity Centre, Department of Neuroimaging, IoPPN, King’s College London, London, UK
| | - Indu Ayappa
- Division of Pulmonary, Critical Care and Sleep Medicine at the Icahn School of Medicine at Mount Sinai, New York, NY
| | - David M Rapoport
- Division of Pulmonary, Critical Care and Sleep Medicine at the Icahn School of Medicine at Mount Sinai, New York, NY
| | - Girardin Jean-Louis
- Department of Population Health, New York University School of Medicine, Center for Healthful Behavior Change, New York, NY
| | - Andrew W Varga
- Division of Pulmonary, Critical Care and Sleep Medicine at the Icahn School of Medicine at Mount Sinai, New York, NY
| | - Ricardo S Osorio
- Center for Brain Health, Department of Psychiatry, NYU Langone Medical Center, New York, NY
- Nathan S. Kline Institute for Psychiatric Research, Orangeburg, NY
| |
Collapse
|