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Um YH, Hong SC, Jeong JH. Sleep Problems as Predictors in Attention-Deficit Hyperactivity Disorder: Causal Mechanisms, Consequences and Treatment. CLINICAL PSYCHOPHARMACOLOGY AND NEUROSCIENCE 2017; 15:9-18. [PMID: 28138105 PMCID: PMC5290714 DOI: 10.9758/cpn.2017.15.1.9] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/11/2016] [Revised: 09/06/2016] [Accepted: 09/11/2016] [Indexed: 01/11/2023]
Abstract
Attention-deficit hyperactivity disorder (ADHD) is notorious for its debilitating consequences and early age of onset. The need for early diagnosis and intervention has frequently been underscored. Previous studies have attempted to clarify the bidirectional relationship between ADHD and sleep problems, proposing a potential role for sleep problems as early predictors of ADHD. Sleep deprivation, sleep-disordered breathing, and circadian rhythm disturbances have been extensively studied, yielding evidence with regard to their induction of ADHD-like symptoms. Genetic-phenotypic differences across individuals regarding the aforementioned sleep problems have been elucidated along with the possible use of these characteristics for early prediction of ADHD. The long-term consequences of sleep problems in individuals with ADHD include obesity, poor academic performance, and disrupted parent-child interactions. Early intervention has been proposed as an approach to preventing these debilitating outcomes of ADHD, with novel treatment approaches ranging from melatonin and light therapy to myofunctional therapy and adjustments of the time point at which school starts.
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Affiliation(s)
- Yoo Hyun Um
- Department of Psychiatry, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Seung-Chul Hong
- Department of Psychiatry, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Jong-Hyun Jeong
- Department of Psychiatry, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
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Dai XJ, Nie X, Liu X, Pei L, Jiang J, Peng DC, Gong HH, Zeng XJ, Wáng YXJ, Zhan Y. Gender Differences in Regional Brain Activity in Patients with Chronic Primary Insomnia: Evidence from a Resting-State fMRI Study. J Clin Sleep Med 2017; 12:363-74. [PMID: 26715399 DOI: 10.5664/jcsm.5586] [Citation(s) in RCA: 70] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2015] [Accepted: 11/23/2015] [Indexed: 12/15/2022]
Abstract
STUDY OBJECTIVES To explore the regional brain activities in patients with chronic primary insomnia (PCPIs) and their sex differences. METHODS Forty-two PCPIs (27 females, 15 males) and 42 good sleepers (GSs; 24 females, 18 males) were recruited. Six PCPIs (3 males, 3 females) were scanned twice by MRI to examine the test-retest reliability. Amplitude of low frequency fluctuation (ALFF) method was used to assess the local brain features. The mean signal values of the different ALFF areas were analyzed with a receiver operating characteristic (ROC) curve. Simple linear regression analysis was performed to investigate the relationships between clinical features and different brain areas. RESULTS Both female and male PCPIs showed higher ALFF in the temporal lobe and occipital lobe, especially in female PCPIs. Female PCPIs had lower ALFF in the bilateral cerebellum posterior lobe, left dorsolateral prefrontal cortex, and bilateral limbic lobe; however, male PCPIs showed lower ALFF in the left occipital gyrus. The mean signal value of the cerebellum in female PCPIs showed negative correlations with negative emotions. Compared with male PCPIs, female PCPIs showed higher ALFF in the bilateral middle temporal gyrus and lower ALFF in the left limbic lobe. The different areas showed high test-retest stability (Clusters of contiguous volumes ≥ 1080 mm(3) with an intraclass correlation coefficient ≥ 0.80) and high degree of sensitivity and specificity. CONCLUSIONS Female PCPIs showed more regional brain differences with higher and lower ALFF responses than male PCPIs. However, they shared analogous excessive hyperarousal mechanism and wide variations in aberrant brain areas.
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Affiliation(s)
- Xi-Jian Dai
- Department of Radiology, The First Affiliated Hospital of Nanchang University, Jiangxi, China.,Brain Cognition and Brain Disease Institute, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China
| | - Xiao Nie
- Department of Radiology, The First Affiliated Hospital of Nanchang University, Jiangxi, China
| | - Xuming Liu
- Department of Radiology, The Third Clinical Institute Affiliated To Wenzhou Medical University, Zhejiang, China
| | - Li Pei
- Department of Radiology, The First Affiliated Hospital of Nanchang University, Jiangxi, China
| | - Jian Jiang
- Department of Radiology, The First Affiliated Hospital of Nanchang University, Jiangxi, China
| | - De-chang Peng
- Department of Radiology, The First Affiliated Hospital of Nanchang University, Jiangxi, China
| | - Hong-Han Gong
- Department of Radiology, The First Affiliated Hospital of Nanchang University, Jiangxi, China
| | - Xian-Jun Zeng
- Department of Radiology, The First Affiliated Hospital of Nanchang University, Jiangxi, China
| | - Yì-Xiáng J Wáng
- Department of Imaging and Interventional Radiology, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong
| | - Yang Zhan
- Brain Cognition and Brain Disease Institute, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China
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Chen LT, Fan XL, Li HJ, Nie S, Gong HH, Zhang W, Zeng XJ, Long P, Peng DC. Disrupted small-world brain functional network topology in male patients with severe obstructive sleep apnea revealed by resting-state fMRI. Neuropsychiatr Dis Treat 2017; 13:1471-1482. [PMID: 28652747 PMCID: PMC5473494 DOI: 10.2147/ndt.s135426] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
PURPOSE Obstructive sleep apnea (OSA) is a common sleep-related breathing disorder that can damage cognitive function. However, the functional network organization remains poorly understood. The aim of this study was to investigate the topological properties of OSA patients using a graph theoretical analysis. PATIENTS AND METHODS A total of 30 male patients with untreated severe OSA and 25 male education- and age-matched good sleepers (GSs) underwent functional magnetic resonance imaging (MRI) examinations. Clinical and cognitive evaluations were conducted by an experienced psychologist. GRETNA (a toolbox for topological analysis of imaging connectomics) was used to construct the brain functional network and calculate the small-world properties (γ, λ, σ, Eglob, and Eloc). Relationships between these small-world properties and clinical and neuropsychological assessments were investigated in OSA patients. RESULTS The networks of both OSA patients and GSs exhibited efficient small-world topology over the sparsity range of 0.05-0.40. Compared with GSs, the OSA group had significantly decreased γ, but significantly increased λ and σ. The OSA group's brain network showed significantly decreased Eglob (P<0.05) over the sparsity range of 0.09-0.15, but significantly increased Eloc over the sparsity range of 0.23-0.40. In OSA patients, γ was significantly negatively correlated with apnea-hypopnea index (AHI; r=-0.326, P=0.015) and Epworth Sleepiness Scale (ESS; r=-0.274, P=0.043), λ was significantly positively correlated with AHI (r=0.373, P=0.005) and ESS (r=0.269, P=0.047), and σ was significantly negatively correlated with AHI (r=-0.363, P=0.007) and ESS (r=-0.295, P=0.029). CONCLUSION Our results suggest that the high degree of local integration and integrity of the brain connections in OSA patients may be disrupted. The topological alterations of small-world properties may be the mechanism of cognitive impairment in OSA patients. In addition, σ, γ, and λ could be used as a quantitative physiological index for auxiliary clinical diagnoses.
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Affiliation(s)
| | | | | | | | | | | | | | - Ping Long
- Department of Otolaryngology, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, People's Republic of China
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Chen W, Zhang L, Xu YG, Zhu K, Luo M. Primary angle-closure glaucomas disturb regional spontaneous brain activity in the visual pathway: an fMRI study. Neuropsychiatr Dis Treat 2017; 13:1409-1417. [PMID: 28579788 PMCID: PMC5449125 DOI: 10.2147/ndt.s134258] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
OBJECTIVE To explore the underlying regional brain activity deficits in the visual cortex in patients with primary angle-closure glaucoma (PACG) relative to normal controls (NCs) using regional homogeneity (ReHo) method, and its relationship with behavioral performances. PATIENTS Twenty PACG patients (10 females, 10 males; mean age ± standard deviation [SD]: 54.42±9.46 years) and 20 age-, and sex status-matched NCs (10 females, 10 males; mean age ± SD: 53.75±9.16 years) were included in this study. MEASUREMENTS AND RESULTS Compared with NCs, patients with PACG showed significant atrophic peripapillary retinal nerve fiber layer (pRNFL) and neuroretinal rim area, increased optic disk cup-to-disc ratio (CDR) and optic disk volume (P<0.05), higher ReHo value in the left fusiform gyrus, left cerebellum anterior lobe, right frontal-temporal space, and right insula, and lower ReHo value in the bilateral middle occipital gyrus, left claustrum, and right paracentral lobule lobe. The receiver operating characteristic analysis revealed these different areas with high value of area under curve, and high degree of sensitivity and specificity. The mean beta values of these different areas were extracted. In PACG, the duration of disease showed a negative correlation with the mean beta value of left cerebellum anterior lobe (r=-0.453, P=0.045) and a positive correlation with right middle occipital gyrus (r=0.586, P=0.007); left middle occipital gyrus showed positive correlations with duration of disease (r=0.562, P=0.01) and left pRNFL (r=0.49, P=0.028); left claustrum had a positive correlation with left CDR (r=0.515, P=0.02); and right paracentral lobule lobe demonstrated a positive correlation with left pRNFL (r=0.623, P=0.003). CONCLUSION PACG is involved in abnormal spontaneous brain activity in multiple brain areas, and such changes are associated with clinical performances, which may reflect the underlying pathologic mechanism and play important roles in the initiation and progression of PACG.
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Affiliation(s)
- Wei Chen
- Department of Ophthalmology, Shaoxing People's Hospital, Shaoxing, Zhejiang, People's Republic of China
| | - Li Zhang
- Department of Ophthalmology, Shaoxing People's Hospital, Shaoxing, Zhejiang, People's Republic of China
| | - Yong-Gen Xu
- Department of Ophthalmology, Shaoxing People's Hospital, Shaoxing, Zhejiang, People's Republic of China
| | - Kai Zhu
- Department of Ophthalmology, Shaoxing People's Hospital, Shaoxing, Zhejiang, People's Republic of China
| | - Man Luo
- Department of Ophthalmology, Shaoxing People's Hospital, Shaoxing, Zhejiang, People's Republic of China
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Abnormal Intrinsic Functional Hubs in Severe Male Obstructive Sleep Apnea: Evidence from a Voxel-Wise Degree Centrality Analysis. PLoS One 2016; 11:e0164031. [PMID: 27723821 PMCID: PMC5056709 DOI: 10.1371/journal.pone.0164031] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2016] [Accepted: 09/19/2016] [Indexed: 01/09/2023] Open
Abstract
Purpose Obstructive sleep apnea (OSA) has been associated with changes in brain structure and regional function in certain brain areas. However, the functional features of network organization in the whole brain remain largely uncertain. The purpose of this study was to identify the OSA-related spatial centrality distribution of the whole brain functional network and to investigate the potential altered intrinsic functional hubs. Methods Forty male patients with newly confirmed severe OSA on polysomnography, and well-matched good sleepers, participated in this study. All participants underwent a resting-state functional MRI scan and clinical and cognitive evaluation. Voxel-wise degree centrality (DC) was measured across the whole brain, and group difference in DC was compared. The relationship between the abnormal DC value and clinical variables was assessed using a linear correlation analysis. Results Remarkably similar spatial distributions of the functional hubs (high DC) were found in both groups. However, OSA patients exhibited a pattern of significantly reduced regional DC in the left middle occipital gyrus, posterior cingulate cortex, left superior frontal gyrus, and bilateral inferior parietal lobule, and DC was increased in the right orbital frontal cortex, bilateral cerebellum posterior lobes, and bilateral lentiform nucleus, including the putamen, extending to the hippocampus, and the inferior temporal gyrus, which overlapped with the functional hubs. Furthermore, a linear correlation analysis revealed that the DC value in the posterior cingulate cortex and left superior frontal gyrus were positively correlated with Montreal cognitive assessment scores, The DC value in the left middle occipital gyrus and bilateral inferior parietal lobule were negatively correlated with apnea-hypopnea index and arousal index in OSA patients. Conclusion Our findings suggest that OSA patients exhibited specific abnormal intrinsic functional hubs including relatively reduced and increased DC. This expands our understanding of the functional characteristics of OSA, which may provide new insights into understanding the dysfunction and pathophysiology of OSA patients.
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Park B, Palomares JA, Woo MA, Kang DW, Macey PM, Yan-Go FL, Harper RM, Kumar R. Aberrant Insular Functional Network Integrity in Patients with Obstructive Sleep Apnea. Sleep 2016; 39:989-1000. [PMID: 26943471 PMCID: PMC4835320 DOI: 10.5665/sleep.5738] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2015] [Accepted: 12/17/2015] [Indexed: 12/30/2022] Open
Abstract
STUDY OBJECTIVES Obstructive sleep apnea (OSA) is accompanied by tissue injury to the insular cortices, areas that regulate autonomic pain, dyspnea, and mood, all of which are affected in the syndrome. Presumably, the dysregulation of insular-related functions are mediated by aberrant functional connections with other brain regions; however, the integrity of the functional connectivity (FC) to other sites is undescribed. Our aim was to examine resting-state FC of the insular cortices to other brain areas in OSA, relative to control subjects. METHODS We collected resting-state functional magnetic resonance imaging (MRI) data from 67 newly diagnosed, treatment-naïve OSA and 75 control subjects using a 3.0-Tesla MRI scanner. After standard processing, data were analyzed for the left and right insular FC. RESULTS OSA subjects showed complex aberrant insular FC to several brain regions, including frontal, parietal, cingulate, temporal, limbic, basal ganglia, thalamus, occipital, cerebellar, and brainstem regions. Areas of altered FC in OSA showed linear relationships with magnitudes of sleep related and neuropsychologic-related variables, whereas control subjects showed no such relationships with those measures. CONCLUSIONS Brain functional connections from insular sites to other brain regions in OSA subjects represent abnormal autonomic, affective, sensorimotor, and cognitive control networks that may affect both impaired parasympathetic and sympathetic interactions, as well as abnormal sensorimotor integration, affected in the condition. The functional changes likely result from the previously reported structural changes in OSA subjects, as demonstrated by diverse neuroimaging studies.
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Affiliation(s)
- Bumhee Park
- Department of Anesthesiology, University of California at Los Angeles, Los Angeles, CA
| | - Jose A. Palomares
- Department of Anesthesiology, University of California at Los Angeles, Los Angeles, CA
| | - Mary A. Woo
- UCLA School of Nursing, University of California at Los Angeles, Los Angeles, CA
| | - Daniel W. Kang
- Department of Medicine, University of California at Los Angeles, Los Angeles, CA
| | - Paul M. Macey
- UCLA School of Nursing, University of California at Los Angeles, Los Angeles, CA
- The Brain Research Institute, University of California at Los Angeles, Los Angeles, CA
| | - Frisca L. Yan-Go
- Department of Neurology, University of California at Los Angeles
| | - Ronald M. Harper
- The Brain Research Institute, University of California at Los Angeles, Los Angeles, CA
- Department of Neurobiology; University of California at Los Angeles, Los Angeles, CA
| | - Rajesh Kumar
- Department of Anesthesiology, University of California at Los Angeles, Los Angeles, CA
- The Brain Research Institute, University of California at Los Angeles, Los Angeles, CA
- Department of Radiological Sciences, University of California at Los Angeles, Los Angeles, CA
- Department of Bioengineering, University of California at Los Angeles, Los Angeles, CA
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Tahmasian M, Rosenzweig I, Eickhoff SB, Sepehry AA, Laird AR, Fox PT, Morrell MJ, Khazaie H, Eickhoff CR. Structural and functional neural adaptations in obstructive sleep apnea: An activation likelihood estimation meta-analysis. Neurosci Biobehav Rev 2016; 65:142-56. [PMID: 27039344 PMCID: PMC5103027 DOI: 10.1016/j.neubiorev.2016.03.026] [Citation(s) in RCA: 87] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2015] [Revised: 03/27/2016] [Accepted: 03/29/2016] [Indexed: 12/14/2022]
Abstract
The right basolateral amygdala, the hippocampus and the right insular cortex are important nodes in obstructive sleep apnea (OSA). Functional characterization of these regions suggested associated dysfunction of emotional, sensory, and limbic processes in OSA. Connectivity analysis demonstrated that these regions are part of a joint network comprising the anterior insula, posterior-medial frontal cortex and thalamus.
Obstructive sleep apnea (OSA) is a common multisystem chronic disorder. Functional and structural neuroimaging has been widely applied in patients with OSA, but these studies have often yielded diverse results. The present quantitative meta-analysis aims to identify consistent patterns of abnormal activation and grey matter loss in OSA across studies. We used PubMed to retrieve task/resting-state functional magnetic resonance imaging and voxel-based morphometry studies. Stereotactic data were extracted from fifteen studies, and subsequently tested for convergence using activation likelihood estimation. We found convergent evidence for structural atrophy and functional disturbances in the right basolateral amygdala/hippocampus and the right central insula. Functional characterization of these regions using the BrainMap database suggested associated dysfunction of emotional, sensory, and limbic processes. Assessment of task-based co-activation patterns furthermore indicated that the two regions obtained from the meta-analysis are part of a joint network comprising the anterior insula, posterior-medial frontal cortex and thalamus. Taken together, our findings highlight the role of right amygdala, hippocampus and insula in the abnormal emotional and sensory processing in OSA.
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Affiliation(s)
- Masoud Tahmasian
- Sleep Disorders Research Center, Kermanshah University of Medical Sciences (KUMS), Kermanshah, Iran; National Brain Mapping Center, Shahid Beheshti University (General & Medical campus), Tehran, Iran
| | - Ivana Rosenzweig
- Sleep and Brain Plasticity Centre, Department of Neuroimaging, IOPPN, King's College and Imperial College, London, UK
| | - Simon B Eickhoff
- Institute of Clinical Neuroscience & Medical Psychology, Heinrich Heine University Düsseldorf, Düsseldorf, Germany; Institute of Neuroscience and Medicine (INM-1), Research Center Jülich, Jülich, Germany
| | - Amir A Sepehry
- Division of Neurology, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada.
| | - Angela R Laird
- Department of Physics, Florida International University, Miami, FL, USA
| | - Peter T Fox
- Research Imaging Institute, University of Texas Health Science Center, San Antonio, TX, USA; South Texas Veterans Health Care System,San Antonio, TX 78229, USA
| | - Mary J Morrell
- Sleep and Brain Plasticity Centre, Department of Neuroimaging, IOPPN, King's College and Imperial College, London, UK; Academic Unit of Sleep and Breathing, National Heart and Lung Institute, Imperial College London, UK; NIHR Respiratory Disease Biomedical Research Unit at the Royal Brompton and Harefield NHS Foundation Trust and Imperial College London, UK
| | - Habibolah Khazaie
- Sleep Disorders Research Center, Kermanshah University of Medical Sciences (KUMS), Kermanshah, Iran.
| | - Claudia R Eickhoff
- Institute of Neuroscience and Medicine (INM-1), Research Center Jülich, Jülich, Germany; Department of Psychiatry, Psychotherapy, and Psychosomatics, RWTH Aachen University, Aachen, Germany
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Park B, Palomares JA, Woo MA, Kang DW, Macey PM, Yan-Go FL, Harper RM, Kumar R. Disrupted functional brain network organization in patients with obstructive sleep apnea. Brain Behav 2016; 6:e00441. [PMID: 27099802 PMCID: PMC4831421 DOI: 10.1002/brb3.441] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2015] [Revised: 10/30/2015] [Accepted: 12/19/2015] [Indexed: 12/30/2022] Open
Abstract
INTRODUCTION Obstructive sleep apnea (OSA) subjects show impaired autonomic, affective, executive, sensorimotor, and cognitive functions. Brain injury in OSA subjects appears in multiple sites regulating these functions, but the integrity of functional networks within the regulatory sites remains unclear. Our aim was to examine the functional interactions and the complex network organization of these interactions across the whole brain in OSA, using regional functional connectivity (FC) and brain network topological properties. METHODS We collected resting-state functional magnetic resonance imaging (MRI) data, using a 3.0-Tesla MRI scanner, from 69 newly diagnosed, treatment-naïve, moderate-to-severe OSA (age, 48.3 ± 9.2 years; body mass index, 31 ± 6.2 kg/m(2); apnea-hypopnea index (AHI), 35.6 ± 23.3 events/h) and 82 control subjects (47.6 ± 9.1 years; body mass index, 25.1 ± 3.5 kg/m(2)). Data were analyzed to examine FC in OSA over controls as interregional correlations and brain network topological properties. RESULTS Obstructive sleep apnea subjects showed significantly altered FC in the cerebellar, frontal, parietal, temporal, occipital, limbic, and basal ganglia regions (FDR, P < 0.05). Entire functional brain networks in OSA subjects showed significantly less efficient integration, and their regional topological properties of functional integration and specialization characteristics also showed declined trends in areas showing altered FC, an outcome which would interfere with brain network organization (P < 0.05; 10,000 permutations). Brain sites with abnormal topological properties in OSA showed significant relationships with AHI scores. CONCLUSIONS Our findings suggest that the dysfunction extends to resting conditions, and the altered FC and impaired network organization may underlie the impaired responses in autonomic, cognitive, and sensorimotor functions. The outcomes likely result from the prominent structural changes in both axons and nuclear structures, which occur in the condition.
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Affiliation(s)
- Bumhee Park
- Department of Anesthesiology University of California at Los Angeles Los Angeles CA 90095
| | - Jose A Palomares
- Department of Anesthesiology University of California at Los Angeles Los Angeles CA 90095
| | - Mary A Woo
- UCLA School of Nursing University of California at Los Angeles Los Angeles CA 90095
| | - Daniel W Kang
- Department of Medicine University of California at Los Angeles Los Angeles California 90095
| | - Paul M Macey
- UCLA School of Nursing University of California at Los Angeles Los Angeles CA 90095; The Brain Research Institute University of California at Los Angeles Los Angeles California 90095
| | - Frisca L Yan-Go
- Department of Neurology University of California at Los Angeles Los Angeles California 90095
| | - Ronald M Harper
- The Brain Research Institute University of California at Los Angeles Los Angeles California 90095; Department of Neurobiology University of California at Los Angeles Los Angeles California 90095
| | - Rajesh Kumar
- Department of Anesthesiology University of California at Los Angeles Los Angeles CA 90095; The Brain Research Institute University of California at Los Angeles Los Angeles California 90095; Department of Radiological Sciences University of California at Los Angeles Los Angeles California 90095; Department of Bioengineering University of California at Los Angeles Los Angeles California 90095
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Li HJ, Nie X, Gong HH, Zhang W, Nie S, Peng DC. Abnormal resting-state functional connectivity within the default mode network subregions in male patients with obstructive sleep apnea. Neuropsychiatr Dis Treat 2016; 12:203-12. [PMID: 26855576 PMCID: PMC4725694 DOI: 10.2147/ndt.s97449] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND AND OBJECTIVE Abnormal resting-state functional connectivity (rs-FC) between the central executive network and the default mode network (DMN) in patients with obstructive sleep apnea (OSA) has been reported. However, the effect of OSA on rs-FC within the DMN subregions remains uncertain. This study was designed to investigate whether the rs-FC within the DMN subregions was disrupted and determine its relationship with clinical symptoms in patients with OSA. METHODS Forty male patients newly diagnosed with severe OSA and 40 male education- and age-matched good sleepers (GSs) underwent functional magnetic resonance imaging (fMRI) examinations and clinical and neuropsychologic assessments. Seed-based region of interest rs-FC method was used to analyze the connectivity between each pair of subregions within the DMN, including the medial prefrontal cortex (MPFC), posterior cingulate cortex (PCC), hippocampus formation (HF), inferior parietal cortices (IPC), and medial temporal lobe (MTL). The abnormal rs-FC strength within the DMN subregions was correlated with clinical and neuropsychologic assessments using Pearson correlation analysis in patients with OSA. RESULTS Compared with GSs, patients with OSA had significantly decreased rs-FC between the right HF and the PCC, MPFC, and left MTL. However, patients with OSA had significantly increased rs-FC between the MPFC and left and right IPC, and between the left IPC and right IPC. The rs-FC between the right HF and left MTL was positively correlated with rapid eye movement (r=0.335, P=0.035). The rs-FC between the PCC and right HF was negatively correlated with delayed memory (r=-0.338, P=0.033). CONCLUSION OSA selectively impairs the rs-FC between right HF and PCC, MPFC, and left MTL within the DMN subregions, and provides an imaging indicator for assessment of cognitive dysfunction in OSA patients.
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Affiliation(s)
- Hai-Jun Li
- Department of Radiology, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi Province, People's Republic of China
| | - Xiao Nie
- Department of Radiology, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi Province, People's Republic of China
| | - Hong-Han Gong
- Department of Radiology, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi Province, People's Republic of China
| | - Wei Zhang
- Department of Pneumology, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi Province, People's Republic of China
| | - Si Nie
- Department of Radiology, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi Province, People's Republic of China
| | - De-Chang Peng
- Department of Radiology, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi Province, People's Republic of China
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Wang L, Chen Y, Yao Y, Pan Y, Sun Y. Sleep deprivation disturbed regional brain activity in healthy subjects: evidence from a functional magnetic resonance-imaging study. Neuropsychiatr Dis Treat 2016; 12:801-7. [PMID: 27110113 PMCID: PMC4835129 DOI: 10.2147/ndt.s99644] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
OBJECTIVE The aim of this study was to use amplitude of low-frequency fluctuation (ALFF) to explore regional brain activities in healthy subjects after sleep deprivation (SD). MATERIALS AND METHODS A total of 16 healthy subjects (eight females, eight males) underwent the session twice: once was after normal sleep (NS), and the other was after SD. ALFF was used to assess local brain features. The mean ALFF-signal values of the different brain areas were evaluated to investigate relationships with clinical features and were analyzed with a receiver-operating characteristic curve. RESULTS Compared with NS subjects, SD subjects showed a lower response-accuracy rate, longer response time, and higher lapse rate. Compared with NS subjects, SD subjects showed higher ALFF area in the right cuneus and lower ALFF area in the right lentiform nucleus, right claustrum, left dorsolateral prefrontal cortex, and left inferior parietal cortex. ALFF differences in regional brain areas showed high sensitivity and specificity. In the SD group, mean ALFF of the right claustrum showed a significant positive correlation with accuracy rate (r=0.687, P=0.013) and a negative correlation with lapse rate (r=-0.706, P=0.01). Mean ALFF of the dorsolateral prefrontal cortex showed a significant positive correlation with response time (r=0.675, P=0.016). CONCLUSION SD disturbed the regional brain activity of the default-mode network, its anticorrelated "task-positive" network, and the advanced cognitive function brain areas.
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Affiliation(s)
- Li Wang
- Department of Neurology, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, People's Republic of China
| | - Yin Chen
- Department of Neurology, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, People's Republic of China
| | - Ying Yao
- Department of Neurology, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, People's Republic of China
| | - Yu Pan
- Department of Neurology, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, People's Republic of China
| | - Yi Sun
- Department of Neurology, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, People's Republic of China
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Liu H, Chen H, Wu B, Zhang T, Wang J, Huang K, Song G, Zhan J. Functional cortical changes in relapsing-remitting multiple sclerosis at amplitude configuration: a resting-state fMRI study. Neuropsychiatr Dis Treat 2016; 12:3031-3039. [PMID: 27932883 PMCID: PMC5135476 DOI: 10.2147/ndt.s120909] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
OBJECTIVE The aim of this study was to explore the amplitude of spontaneous brain activity fluctuations in patients with relapsing-remitting multiple sclerosis (RRMS) using the amplitude of low-frequency fluctuation (ALFF) method. METHODS ALFF and SPM8 were utilized to assess alterations in regional spontaneous brain activities in patients with RRMS in comparison with healthy controls (HCs). The beta values of altered brain regions between patients with RRMS and HCs were extracted, and a receiver operating characteristic (ROC) curve was generated to calculate the sensitivities and specificities of these different brain areas for distinguishing patients with RRMS from HCs. Pearson correlation analyses were applied to assess the relationships between the beta values of altered brain regions and disease duration and Expanded Disability Status Scale (EDSS) score. PATIENTS AND PARTICIPANTS A total of 18 patients with RRMS (13 females; five males) and 18 sex-, age-, and education-matched HCs (14 females; four males) were recruited for this study. MEASUREMENTS AND RESULTS Compared with HCs, patients with RRMS showed higher ALFF responses in the right fusiform gyrus (Brodmann area [BA] 37) and lower ALFF responses in the bilateral anterior cingulate cortices (BA 24 and 32), bilateral heads of the caudate nuclei, and bilateral brainstem. The ROC analysis revealed that the beta values of these abnormal brain areas showed high degrees of sensitivity and specificity for distinguishing patients with RRMS from HCs. The EDSS score showed a significant negative Pearson correlation with the beta value of the caudate head (r=-0.474, P=0.047). CONCLUSION RRMS is associated with disturbances in spontaneous regional brain activity in specific areas, and these specific abnormalities may provide important information about the neural mechanisms underlying behavioral impairment in RRMS.
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Affiliation(s)
- Heng Liu
- Department of Radiology, Affiliated Hospital of Zunyi Medical University, Medical Imaging Center of Guizhou Province, Zunyi, Guizhou
| | - Hua Chen
- Department of Radiology, Affiliated Hospital of Zunyi Medical University, Medical Imaging Center of Guizhou Province, Zunyi, Guizhou
| | - Bo Wu
- Department of Radiology, Affiliated Hospital of Zunyi Medical University, Medical Imaging Center of Guizhou Province, Zunyi, Guizhou
| | - Tijiang Zhang
- Department of Radiology, Affiliated Hospital of Zunyi Medical University, Medical Imaging Center of Guizhou Province, Zunyi, Guizhou
| | - Jinhui Wang
- Department of Psychology, Hangzhou Normal University; Zhejiang Key Laboratory for Research in Assessment of Cognitive Impairments, Hangzhou
| | - Kexin Huang
- Department of Radiology, Affiliated Hospital of Zunyi Medical University, Medical Imaging Center of Guizhou Province, Zunyi, Guizhou
| | - Ganjun Song
- Department of Radiology, Affiliated Hospital of Zunyi Medical University, Medical Imaging Center of Guizhou Province, Zunyi, Guizhou
| | - Jian Zhan
- Department of Neurology, Affiliated Hospital of Zunyi Medical University, Zunyi, Guizhou, People's Republic of China
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Luo YG, Wang D, Liu K, Weng J, Guan Y, Chan KCC, Chu WCW, Shi L. Brain Structure Network Analysis in Patients with Obstructive Sleep Apnea. PLoS One 2015; 10:e0139055. [PMID: 26413809 PMCID: PMC4587669 DOI: 10.1371/journal.pone.0139055] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2015] [Accepted: 09/07/2015] [Indexed: 11/19/2022] Open
Abstract
Childhood obstructive sleep apnea (OSA) is a sleeping disorder commonly affecting school-aged children and is characterized by repeated episodes of blockage of the upper airway during sleep. In this study, we performed a graph theoretical analysis on the brain morphometric correlation network in 25 OSA patients (OSA group; 5 female; mean age, 10.1 ± 1.8 years) and investigated the topological alterations in global and regional properties compared with 20 healthy control individuals (CON group; 6 females; mean age, 10.4 ± 1.8 years). A structural correlation network based on regional gray matter volume was constructed respectively for each group. Our results revealed a significantly decreased mean local efficiency in the OSA group over the density range of 0.32-0.44 (p < 0.05). Regionally, the OSAs showed a tendency of decreased betweenness centrality in the left angular gyrus, and a tendency of decreased degree in the right lingual and inferior frontal (orbital part) gyrus (p < 0.005, uncorrected). We also found that the network hubs in OSA and controls were distributed differently. To the best of our knowledge, this is the first study that characterizes the brain structure network in OSA patients and invests the alteration of topological properties of gray matter volume structural network. This study may help to provide new evidence for understanding the neuropathophysiology of OSA from a topological perspective.
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Affiliation(s)
- Yun-gang Luo
- Department of Stomatology, The Second Hospital of Jilin University, Changchun, 130041, Jilin Province, China
- * E-mail: (YL); (LS)
| | - Defeng Wang
- Research Center for Medical Image Computing, Department of Imaging and Interventional Radiology, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong, China
- CUHK Shenzhen research institute, Shenzhen, China
- Department of Biomedical Engineering and Shun Hing Institute of Advanced Engineering, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong, China
| | - Kai Liu
- Research Center for Medical Image Computing, Department of Imaging and Interventional Radiology, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong, China
- Department of Biomedical Engineering and Shun Hing Institute of Advanced Engineering, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong, China
| | - Jian Weng
- Research Center for Medical Image Computing, Department of Imaging and Interventional Radiology, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong, China
| | - Yuefeng Guan
- Department of Stomatology, The Second Hospital of Jilin University, Changchun, 130041, Jilin Province, China
- CUHK Shenzhen research institute, Shenzhen, China
| | - Kate C. C. Chan
- Department of Paediatrics, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong, China
| | - Winnie C. W. Chu
- Research Center for Medical Image Computing, Department of Imaging and Interventional Radiology, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong, China
- CUHK Shenzhen research institute, Shenzhen, China
| | - Lin Shi
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong, China
- * E-mail: (YL); (LS)
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Baril AA, Gagnon K, Arbour C, Soucy JP, Montplaisir J, Gagnon JF, Gosselin N. Regional Cerebral Blood Flow during Wakeful Rest in Older Subjects with Mild to Severe Obstructive Sleep Apnea. Sleep 2015; 38:1439-49. [PMID: 25761981 DOI: 10.5665/sleep.4986] [Citation(s) in RCA: 65] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2014] [Accepted: 01/31/2015] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVES To evaluate changes in regional cerebral blood flow (rCBF) during wakeful rest in older subjects with mild to severe obstructive sleep apnea (OSA) and healthy controls, and to identify markers of OSA severity that predict altered rCBF. DESIGN High-resolution (99m)Tc-HMPAO SPECT imaging during wakeful rest. SETTING Research sleep laboratory affiliated with a University hospital. PARTICIPANTS Fifty untreated OSA patients aged between 55 and 85 years, divided into mild, moderate, and severe OSA, and 20 age-matched healthy controls. INTERVENTIONS N/A. MEASUREMENTS Using statistical parametric mapping, rCBF was compared between groups and correlated with clinical, respiratory, and sleep variables. RESULTS Whereas no rCBF change was observed in mild and moderate groups, participants with severe OSA had reduced rCBF compared to controls in the left parietal lobules, left precentral gyrus, bilateral postcentral gyri, and right precuneus. Reduced rCBF in these regions and in areas of the bilateral frontal and left temporal cortex was associated with more hypopneas, snoring, hypoxemia, and sleepiness. Higher apnea, microarousal, and body mass indexes were correlated to increased rCBF in the basal ganglia, insula, and limbic system. CONCLUSIONS While older individuals with severe obstructive sleep apnea (OSA) had hypoperfusion in the sensorimotor and parietal areas, respiratory variables and subjective sleepiness were correlated with extended regions of hypoperfusion in the lateral cortex. Interestingly, OSA severity, sleep fragmentation, and obesity correlated with increased perfusion in subcortical and medial cortical regions. Anomalies with such a distribution could result in cognitive deficits and reflect impaired vascular regulation, altered neuronal integrity, and/or undergoing neurodegenerative processes.
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Affiliation(s)
- Andrée-Ann Baril
- Center for Advanced Research in Sleep Medicine (CARSM), Hôpital du Sacré-Coeur de Montréal, Montreal, Quebec, Canada.,Université de Montréal, Department of Psychiatry, Montreal, Quebec, Canada
| | - Katia Gagnon
- Center for Advanced Research in Sleep Medicine (CARSM), Hôpital du Sacré-Coeur de Montréal, Montreal, Quebec, Canada.,Université du Québec à Montréal, Department of Psychology, Montreal, Quebec, Canada
| | - Caroline Arbour
- Center for Advanced Research in Sleep Medicine (CARSM), Hôpital du Sacré-Coeur de Montréal, Montreal, Quebec, Canada.,Université de Montréal, Department of Psychology, Montreal, Quebec, Canada
| | - Jean-Paul Soucy
- McGill University, McConnell Brain Imaging Centre, Montreal, Quebec, Canada
| | - Jacques Montplaisir
- Center for Advanced Research in Sleep Medicine (CARSM), Hôpital du Sacré-Coeur de Montréal, Montreal, Quebec, Canada.,Université de Montréal, Department of Psychiatry, Montreal, Quebec, Canada
| | - Jean-François Gagnon
- Center for Advanced Research in Sleep Medicine (CARSM), Hôpital du Sacré-Coeur de Montréal, Montreal, Quebec, Canada.,Université du Québec à Montréal, Department of Psychology, Montreal, Quebec, Canada
| | - Nadia Gosselin
- Center for Advanced Research in Sleep Medicine (CARSM), Hôpital du Sacré-Coeur de Montréal, Montreal, Quebec, Canada.,Université de Montréal, Department of Psychology, Montreal, Quebec, Canada
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Huang X, Zhong YL, Zeng XJ, Zhou F, Liu XH, Hu PH, Pei CG, Shao Y, Dai XJ. Disturbed spontaneous brain activity pattern in patients with primary angle-closure glaucoma using amplitude of low-frequency fluctuation: a fMRI study. Neuropsychiatr Dis Treat 2015; 11:1877-83. [PMID: 26251603 PMCID: PMC4524585 DOI: 10.2147/ndt.s87596] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
OBJECTIVE The aim of this study is to use amplitude of low-frequency fluctuation (ALFF) as a method to explore the local features of spontaneous brain activity in patients with primary angle -closure glaucoma (PACG) and ALFFs relationship with the behavioral performances. METHODS A total of twenty one patients with PACG (eight males and 13 females), and twenty one healthy subjects (nine males and twelve females) closely matched in age, sex, and education, each underwent a resting-state functional magnetic resonance imaging scan. The ALFF method was used to assess the local features of spontaneous brain activity. The correlation analysis was used to explore the relationships between the observed mean ALFF signal values of the different areas in PACG patients and the thickness of the retinal nerve fiber layer (RNFL). RESULTS Compared with the healthy subjects, patients with PACG had significant lower ALFF areas in the left precentral gyrus, bilateral middle frontal gyrus, bilateral superior frontal gyrus, right precuneus, and right angular gyrus, and higher areas in the right precentral gyrus. In the PACG group, there were significant negative correlations between the mean ALFF signal value of the right middle frontal gyrus and the left mean RNFL thickness (r=-0.487, P=0.033), and between the mean ALFF signal value of the left middle frontal gyrus and the right mean RNFL thickness (r=-0.504, P=0.020). CONCLUSION PACG mainly involved in the dysfunction in the frontal lobe, which may reflect the underlying pathologic mechanism of PACG.
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Affiliation(s)
- Xin Huang
- Department of Ophthalmology, The First Affiliated Hospital of Nanchang University, Nangchang, Jiangxi, People's Republic of China
| | - Yu-Lin Zhong
- Department of Ophthalmology, The First Affiliated Hospital of Nanchang University, Nangchang, Jiangxi, People's Republic of China
| | - Xian-Jun Zeng
- Department of Radiology, The First Affiliated Hospital of Nanchang University, Nangchang, Jiangxi, People's Republic of China
| | - Fuqing Zhou
- Department of Radiology, The First Affiliated Hospital of Nanchang University, Nangchang, Jiangxi, People's Republic of China
| | - Xin-Hua Liu
- Department of Ophthalmology, The First Affiliated Hospital of Nanchang University, Nangchang, Jiangxi, People's Republic of China
| | - Pei-Hong Hu
- Department of Ophthalmology, The First Affiliated Hospital of Nanchang University, Nangchang, Jiangxi, People's Republic of China
| | - Chong-Gang Pei
- Department of Ophthalmology, The First Affiliated Hospital of Nanchang University, Nangchang, Jiangxi, People's Republic of China
| | - Yi Shao
- Department of Ophthalmology, The First Affiliated Hospital of Nanchang University, Nangchang, Jiangxi, People's Republic of China
| | - Xi-Jian Dai
- Department of Radiology, The First Affiliated Hospital of Nanchang University, Nangchang, Jiangxi, People's Republic of China
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Liu X, Yan Z, Wang T, Yang X, Feng F, Fan L, Jiang J. Connectivity pattern differences bilaterally in the cerebellum posterior lobe in healthy subjects after normal sleep and sleep deprivation: a resting-state functional MRI study. Neuropsychiatr Dis Treat 2015; 11:1279-89. [PMID: 26064046 PMCID: PMC4451850 DOI: 10.2147/ndt.s84204] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
OBJECTIVE The aim of this study was to use functional magnetic resonance imaging (fMRI) technique to explore the resting-state functional connectivity (rsFC) differences of the bilaterial cerebellum posterior lobe (CPL) after normal sleep (NS) and after sleep deprivation (SD). METHODS A total of 16 healthy subjects (eight males, eight females) underwent an fMRI scan twice at random: once following NS and the other following 24 hours' SD, with an interval of 1 month between the two scans. The fMRI scanning included resting state and acupuncture stimulation. The special activated regions located during the acupuncture stimulation were selected as regions of interest for rsFC analysis. RESULTS Bilateral CPLs were positively activated by acupuncture stimulation. In the NS group, the left CPL showed rsFC with the bilateral CPL, bilateral frontal lobe (BFL), left precuneus and right inferior parietal lobule, while the right CPL showed rsFC with the bilateral temporal lobe, right cerebellum anterior lobe, right CPL, left frontal lobe, left anterior cingulate, right posterior cingulate, and bilateral inferior parietal lobule. In the SD group, the left CPL showed rsFC with the left posterior cingulate gyrus bilateral CPL, left precuneus, left precentral gyrus, BFL, and the left parietal lobe, while the right CPL showed rsFC with bilateral cerebellum anterior lobe, bilateral CPL, left frontal lobe and left temporal lobe. Compared with the NS group, the left CPL had increased rsFC in the SD group with the right inferior frontal gyrus, right fusiform gyrus, right cingulate gyrus, right thalamus, and bilateral precuneus, and decreased rsFC with the BFL, while the right CPL had increased rsFC with the left superior frontal gyrus and decreased rsFC with the left precentral gyrus, right superior temporal gyrus, and the BFL. CONCLUSION Bilateral CPL are possibly involved in acupuncture stimulation in different manners, and the right CPL showed more rsFC impairment.
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Affiliation(s)
- Xuming Liu
- Department of Radiology, The Third Clinical Institute Affiliated to Wenzhou Medical University, Wenzhou, People's Republic of China
| | - Zhihan Yan
- Department of Radiology, The 2nd Affiliated Hospital of Wenzhou Medical University, Wenzhou, People's Republic of China
| | - Tingyu Wang
- Department of Radiology, The Third Clinical Institute Affiliated to Wenzhou Medical University, Wenzhou, People's Republic of China
| | - Xiaokai Yang
- Department of Radiology, The Third Clinical Institute Affiliated to Wenzhou Medical University, Wenzhou, People's Republic of China
| | - Feng Feng
- Peking Union Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, People's Republic of China
| | - Luping Fan
- Department of Radiology, The Third Clinical Institute Affiliated to Wenzhou Medical University, Wenzhou, People's Republic of China
| | - Jian Jiang
- Department of Radiology, The First Affiliated Hospital of Nanchang University, Nanchang, People's Republic of China
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Nie X, Shao Y, Liu SY, Li HJ, Wan AL, Nie S, Peng DC, Dai XJ. Functional connectivity of paired default mode network subregions in primary insomnia. Neuropsychiatr Dis Treat 2015; 11:3085-93. [PMID: 26719693 PMCID: PMC4689284 DOI: 10.2147/ndt.s95224] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
OBJECTIVE The aim of this study is to explore the resting-state functional connectivity (FC) differences between the paired default mode network (DMN) subregions in patients with primary insomnia (PIs). METHODS Forty-two PIs and forty-two age- and sex-matched good sleepers (GSs) were recruited. All subjects underwent the resting-state functional magnetic resonance imaging scans. The seed-based region-to-region FC method was used to evaluate the abnormal connectivity within the DMN subregions between the PIs and the GSs. Pearson correlation analysis was used to investigate the relationships between the abnormal FC strength within the paired DMN subregions and the clinical features in PIs. RESULTS Compared with the GSs, the PIs showed higher Pittsburgh Sleep Quality Index score, Hamilton Anxiety Rating Scale score, Hamilton Depression Rating Scale score, Self-Rating Depression Scale score, Self Rating Anxiety Scale score, Self-Rating Scale of Sleep score, and Profile of Mood States score (P<0.001). Compared with the GSs, the PIs showed significant decreased region-to-region FC between the medial prefrontal cortex and the right medial temporal lobe (t=-2.275, P=0.026), and between the left medial temporal lobe and the left inferior parietal cortices (t=-3.32, P=0.001). The abnormal FC strengths between the DMN subregions did not correlate with the clinical features. CONCLUSION PIs showed disrupted FC within the DMN subregions.
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Affiliation(s)
- Xiao Nie
- Department of Radiology, The First Affiliated Hospital of Nanchang University, Nangchang, Jiangxi, People's Republic of China
| | - Yi Shao
- Department of Ophthalmology,The First Affiliated Hospital of Nanchang University, Nangchang, Jiangxi, People's Republic of China
| | - Si-Yu Liu
- Medical College of Nanchang University, Nangchang, Jiangxi, People's Republic of China
| | - Hai-Jun Li
- Department of Radiology, The First Affiliated Hospital of Nanchang University, Nangchang, Jiangxi, People's Republic of China
| | - Ai-Lan Wan
- Department of Psychosomatic Medicine, The First Affiliated Hospital of Nanchang University, Nangchang, Jiangxi, People's Republic of China
| | - Si Nie
- Department of Radiology, The First Affiliated Hospital of Nanchang University, Nangchang, Jiangxi, People's Republic of China
| | - De-Chang Peng
- Department of Radiology, The First Affiliated Hospital of Nanchang University, Nangchang, Jiangxi, People's Republic of China
| | - Xi-Jian Dai
- Department of Radiology, The First Affiliated Hospital of Nanchang University, Nangchang, Jiangxi, People's Republic of China ; Brain Cognition and Brain Disease Institute, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, People's Republic of China
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67
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Dai XJ, Liu CL, Zhou RL, Gong HH, Wu B, Gao L, Wang YXJ. Long-term total sleep deprivation decreases the default spontaneous activity and connectivity pattern in healthy male subjects: a resting-state fMRI study. Neuropsychiatr Dis Treat 2015; 11:761-72. [PMID: 25834451 PMCID: PMC4372006 DOI: 10.2147/ndt.s78335] [Citation(s) in RCA: 80] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
OBJECTIVE The aim of this study is to use resting-state functional connectivity (rsFC) and amplitude of low-frequency fluctuation (ALFF) methods to explore intrinsic default-mode network (DMN) impairment after sleep deprivation (SD) and its relationships with clinical features. METHODS Twelve healthy male subjects underwent resting-state functional magnetic resonance imaging twice: once following rested wakefulness (RW) and the other following 72 hours of total SD. Before the scans, all subjects underwent the attention network test (ANT). The independent component analysis (ICA), rsFC, and ALFF methods were used to examine intrinsic DMN impairment. Receiver operating characteristic (ROC) curve was used to distinguish SD status from RW status. RESULTS Compared with RW subjects, SD subjects showed a lower accuracy rate (RW =96.83%, SD =77.67%; P<0.001), a slower reaction time (RW =695.92 ms; SD =799.18 ms; P=0.003), a higher lapse rate (RW =0.69%, SD =19.29%; P<0.001), and a higher intraindividual coefficient of variability in reaction time (RW =0.26, SD =0.33; P=0.021). The ICA method showed that, compared with RW subjects, SD subjects had decreased rsFC in the right inferior parietal lobule (IPL, BA40) and in the left precuneus (PrC)/posterior cingulate cortex (PCC) (BA30, 31). The two different areas were selected as regions of interest (ROIs) for future rsFC analysis. Compared with the same in RW subjects, in SD subjects, the right IPL showed decreased rsFC with the left PrC (BA7) and increased rsFC with the left fusiform gyrus (BA37) and the left cluster of middle temporal gyrus and inferior temporal gyrus (BA37). However, the left PrC/PCC did not show any connectivity differences. Compared with RW subjects, SD subjects showed lower ALFF area in the left IPL (BA39, 40). The left IPL, as an ROI, showed decreased rsFC with the right cluster of IPL and superior temporal gyrus (BA39, 40). ROC curve analysis showed that the area under the curve (AUC) value of the left IPL was 0.75, with a cutoff point of 0.834 (mean ALFF signal value). Further diagnostic analysis exhibited that the AUC alone discriminated SD status from RW status, with 75% sensitivity and 91.7% specificity. CONCLUSION Long-term SD disturbed the spontaneous activity and connectivity pattern of DMN.
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Affiliation(s)
- Xi-Jian Dai
- Department of Radiology, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, People's Republic of China ; Department of Imaging and Interventional Radiology, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong SAR, People's Republic of China
| | - Chun-Lei Liu
- Beijing Key Lab of Applied Experimental Psychology, School of Psychology, and National Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing, People's Republic of China ; School of Education, Qufu Normal University, Qufu, Shandong, People's Republic of China
| | - Ren-Lai Zhou
- Beijing Key Lab of Applied Experimental Psychology, School of Psychology, and National Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing, People's Republic of China
| | - Hong-Han Gong
- Department of Radiology, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, People's Republic of China
| | - Bin Wu
- National Key Laboratory of Human Factors Engineering, China Astronaut Research and Training Center, Beijing, People's Republic of China
| | - Lei Gao
- Department of Radiology, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, People's Republic of China
| | - Yi-Xiang J Wang
- Department of Imaging and Interventional Radiology, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong SAR, People's Republic of China
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Li HJ, Dai XJ, Gong HH, Nie X, Zhang W, Peng DC. Aberrant spontaneous low-frequency brain activity in male patients with severe obstructive sleep apnea revealed by resting-state functional MRI. Neuropsychiatr Dis Treat 2015; 11:207-14. [PMID: 25653530 PMCID: PMC4311758 DOI: 10.2147/ndt.s73730] [Citation(s) in RCA: 57] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND The majority of previous neuroimaging studies have demonstrated both structural and functional abnormalities in obstructive sleep apnea (OSA). However, few studies have focused on the regional intensity of spontaneous fluctuations during the resting state and the relationship between the abnormal properties and the behavioral performances. In the present study, we employed the amplitude of low-frequency fluctuation (ALFF) method to explore the local features of spontaneous brain activity in OSA patients (OSAs). METHODS Twenty-five untreated male severe OSAs and 25 age-matched and years-of-education-matched male good sleepers (GSs) were included in this study. The ALFF method was used to assess the local features of spontaneous brain activity. The mean signal values of the altered ALFF areas were analyzed with receiver operating characteristic curve. Partial correlation analysis was used to explore the relationship between the observed mean ALFF values of the different areas and the behavioral performances. RESULTS Compared with GSs, OSAs had significantly higher scores for body mass index, apnea-hypopnea index, arterial oxygen saturation <90%, arousal index, and Epworth Sleepiness Scale (ESS) score; furthermore, OSAs had significantly lower scores for rapid eye movement sleep and in the Montreal Cognitive Assessment (MoCA). Compared with GSs, OSAs showed significant lower-ALFF areas in the cluster of the right precuneus and bilateral posterior cingulate gyrus, as well as a higher-ALFF area in the left inferior frontal gyrus. The area under the curve values of the lower- and higher-ALFF areas were 0.90 and 0.93, respectively. Further diagnostic analysis exhibited that the sensibility and specificity of the two clusters were 80% and 92%, respectively. The mean signal value of the lower-ALFF cluster displayed significant positive correlations with lowest oxygen saturation (r=0.447, P=0.025) and MoCA score (r =0.405, P=0.045). CONCLUSION OSAs may involve in a dysfunction in the default mode network and an adaptive compensatory response in the frontal lobe, which reflect the underlying pathophysiology of cognitive impairment.
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Affiliation(s)
- Hai-Jun Li
- Department of Radiology, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, People's Republic of China
| | - Xi-Jian Dai
- Department of Radiology, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, People's Republic of China ; Department of Imaging and Interventional Radiology, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong Special Administrative Region, People's Republic of China
| | - Hong-Han Gong
- Department of Radiology, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, People's Republic of China
| | - Xiao Nie
- Department of Radiology, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, People's Republic of China
| | - Wei Zhang
- Department of Pneumology, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, People's Republic of China
| | - De-Chang Peng
- Department of Radiology, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, People's Republic of China
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Dai XJ, Peng DC, Gong HH, Wan AL, Nie X, Li HJ, Wang YXJ. Altered intrinsic regional brain spontaneous activity and subjective sleep quality in patients with chronic primary insomnia: a resting-state fMRI study. Neuropsychiatr Dis Treat 2014; 10:2163-75. [PMID: 25484585 PMCID: PMC4238753 DOI: 10.2147/ndt.s69681] [Citation(s) in RCA: 88] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Abstract
STUDY OBJECTIVE To prospectively explore the underlying regional homogeneity (ReHo) brain-activity deficit in patients with chronic primary insomnia (PCPIs) and its relationship with clinical features. DESIGN The ReHo method and Statistical Parametric Mapping 8 software were used to evaluate whether resting-state localized brain activity was modulated between PCPIs and good sleepers (GSs), and correlation analysis between altered regional brain areas and clinical features was calculated. PATIENTS AND PARTICIPANTS Twenty-four PCPIs (17 females, seven males) and 24 (12 females, 12 males) age-, sex-, and education-matched GSs. MEASUREMENTS AND RESULTS PCPIs disturbed subjective sleep quality, split positive mood, and exacerbated negative moods. Compared with GSs, PCPIs showed higher ReHo in left fusiform gyrus, and lower ReHo in bilateral cingulate gyrus and right cerebellum anterior lobe. Compared with female GSs, female PCPIs showed higher ReHo in the left fusiform gyrus and right posterior cingulate, and lower ReHo in the left cerebellum anterior lobe and left superior frontal gyrus. Compared with male GSs, male PCPIs showed higher ReHo in the right temporal lobe and lower ReHo in the bilateral frontal lobe. The fusiform gyrus showed strong positive correlations and the frontal lobe showed negative correlations with the clinical measurements. CONCLUSION The ReHo analysis is a useful noninvasive imaging tool for the detection of cerebral changes and the indexing of clinical features. The abnormal spontaneous activity areas provided important information on the neural mechanisms underlying emotion and sleep-quality impairment in PCPIs.
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Affiliation(s)
- Xi-Jian Dai
- Department of Radiology, The First Affiliated Hospital of Nanchang University, Nangchang, Jiangxi, People's Republic of China ; Department of Imaging and Interventional Radiology, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - De-Chang Peng
- Department of Radiology, The First Affiliated Hospital of Nanchang University, Nangchang, Jiangxi, People's Republic of China
| | - Hong-Han Gong
- Department of Radiology, The First Affiliated Hospital of Nanchang University, Nangchang, Jiangxi, People's Republic of China
| | - Ai-Lan Wan
- Department of Psychosomatic Medicine, the First Affiliated Hospital of Nangchang University, Nangchang, Jiangxi, People's Republic of China
| | - Xiao Nie
- Department of Radiology, The First Affiliated Hospital of Nanchang University, Nangchang, Jiangxi, People's Republic of China
| | - Hai-Jun Li
- Department of Radiology, The First Affiliated Hospital of Nanchang University, Nangchang, Jiangxi, People's Republic of China
| | - Yi-Xiang J Wang
- Department of Imaging and Interventional Radiology, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong
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