Electrophysiological and neuropsychological outcomes of severe obstructive sleep apnea: effects of hypoxemia on cognitive performance

Neural mechanisms of attentional bias to emotional faces in patients with chronic insomnia disorder

OBJECTIVE

This study used event-related potential (ERP) and resting-state functional connectivity (rs-FC) approaches to investigate the neural mechanisms underlying the emotional attention bias in patients with chronic insomnia disorder (CID).

METHODS

Twenty-five patients with CID and thirty-three demographically matched healthy controls (HCs) completed clinical questionnaires and underwent electroencephalography (EEG) and functional magnetic resonance imaging (fMRI) scans. EEG analysis examined the group differences in terms of reaction times, P3 amplitudes, event-related spectral perturbations, and inter-trial phase synchrony. Subsequently, seed-based rs-FC analysis of the amygdala nuclei (including the central-medial amygdala [CMA] and basolateral amygdala [BLA]) was performed. The relationship between P3 amplitude, rs-FC and clinical symptom severity in patients with CID was further investigated by correlation analysis.

RESULTS

CID patients exhibited shorter reaction times than HCs in both standard and deviant stimuli, with the abnormalities becoming more pronounced as attention allocation increased. Compared to HCs, ERP analysis revealed increased P3 amplitude, theta wave power, and inter-trial synchrony in CID patients. The rs-FC analysis showed increased connectivity of the BLA-occipital pole, CMA-precuneus, and CMA-angular gyrus and decreased connectivity of the CMA-thalamus in CID patients. Notably, correlation analysis of the EEG and fMRI measurements showed a significant positive correlation between the P3 amplitude and the rs-FC of the CMA-PCU.

CONCLUSION

This study confirms an emotional attention bias in CID, specifically in the neural mechanisms of attention processing that vary depending on the allocation of attentional resources. Abnormal connectivity in the emotion-cognition networks may constitute the neural basis of the abnormal scalp activation pattern.

Active metabolites and potential mechanisms of Notopterygium incisum against obstructive sleep apnea Syndrome (OSAS): network analysis and experimental assessment

Background: Notopterygium incisum K.C. Ting ex H.T. Chang, a synonym of Hansenia weberbaueriana (Fedde ex H. Wolff) Pimenov & Kljuykov, is an anti-inflammatory medicinal plant. Although abrnotopterol has been reported to be its primary active metabolite, the other metabolites and their mechanisms of action remain unclear. This study aims to investigate the potential mechanisms by which its active metabolites treat Obstructive Sleep Apnea Syndrome (OSAS) through network analysis and experimental assessment. Methods: The metabolites and potential targets of Notopterygium incisum were extracted from public databases. We searched for OSAS-related genes in the Genecards, OMIM, PharmGkb, TTD, and DrugBank databases. Cytoscape 3.9.0 was used to construct the drug-target-disease network and screen for hub genes. Human bronchial epithelial (HBE) cells were cultivated in normoxia and chronic intermittent hypoxia (CIH) medium for 24 h. Interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-α), and prostaglandin E2 (PGE2) were quantified using enzyme-linked immunosorbent assay (ELISA). Prostaglandin-endoperoxide synthase 2(PTGS2) mRNA was detected using RT-qPCR, while PTGS2 and nuclear factor-kappa B (NF-κB) proteins were identified using Western blot analysis. Co-Immunoprecipitation (CoIP) and Western blotting were utilized to evaluate the ubiquitination of PTGS2 in HBE cells. Results: Pterostilbene and notopterol, isolated from Notopterygium incisum, had potential therapeutic effects on OSAS. The PTGS2 and estrogen receptor alpha (ESR1) hub genes were associated with OSAS. The pathway enrichment analysis focuses on the NF-κB, apoptosis, and HIF-1A pathways. In response to CIH, pterostilbene and notopterol decreased IL-6, TNF-α, and PGE2 levels. The NF-κB pathway was activated by an increase in PTGS2 levels. Pterostilbene promoted proteasome-mediated ubiquitination of PTGS2 protein and reduced PTGS2 levels, inhibiting the NF-κB pathway. Conclusion: This study reveals the active metabolites of Notopterygium incisum and hub genes involved in treating OSAS, which provide a basis for the follow-up development and exploitation of the botanical drug.

Effects of Tai Chi on working memory in older adults: evidence from combined fNIRS and ERP

Objective

The study aimed to investigate the effects of a 12-week Tai Chi exercise intervention on working memory in older adults using ERP-fNIRS.

Method

Fifty older adults were randomly assigned to either an experimental group receiving a 12-week Tai Chi exercise intervention or a control group receiving regular daily activities. Working memory was assessed using the n-back task before and after the intervention, and spatial and temporal components of neural function underlying the n-back task were measured using ERP-fNIRS.

Results

The experimental group demonstrated significant improvements in reaction time and accuracy on the 2-back task and showed higher activation levels in the R-DLPFC. Additionally, the Tai Chi group displayed significant increases in P3 amplitude in the overall n-back task.

Conclusion

These findings suggest that Tai Chi interventions can enhance working memory in older adults, as evidenced by increasing neural activity and improving HbO in the R-DLPFC during the 2-back task.

Obstructive Sleep Apnea - Influence on the Cardiovascular System and Cognition

Kardiovaskuläre und kognitive Erkrankungen sind ebenso wie die obstruktive Schlafapnoe sehr häufige Krankheiten mit einer erheblichen Beeinträchtigung der Lebensqualität und einer deutlichen sozioökonomischen Bedeutung. Die Auswirkungen einer unbehandelten obstruktiven Schlafapnoe (OSA) auf das kardiovaskuläre und kognitive Erkrankungsrisiko und die Therapieeffekte einer OSA sind für die meisten kardiovaskulären und kognitiven Folgeerkrankungen wissenschaftlich nachgewiesen. Für die klinische Praxis besteht ein deutlicher Bedarf nach mehr Interdisziplinarität. Aus schlafmedizinischer Sicht müssen bei der Therapieindikation das individuelle kardiovaskuläre und kognitive Risiko berücksichtigt und kognitive Erkrankungen bei der Beurteilung der Therapieintoleranz und residuellen Symptomatik beachtet werden. Aus internistischer Sicht sollte bei Patienten mit schlecht einstellbarem Hypertonus, Vorhofflimmern, koronarer Herzkrankheit und Schlaganfall die Abklärung einer OSA in die Diagnostik integriert werden. Bei Patienten mit milder kognitiver Beeinträchtigung, Alzheimer-Krankheit und Depression können sich die typischen Symptome wie Fatigue, Tagesmüdigkeit und Reduktion der kognitiven Leistungen mit OSA-Symptomen überschneiden. Die Diagnostik einer OSA sollte in die Abklärung dieser Krankheitsbilder integriert werden, da eine Therapie der OSA die kognitiven Beeinträchtigungen reduzieren und die Lebensqualität verbessern kann.

Discrimination and Education Quality Moderate the Association of Sleep With Cognitive Function in Older Black Adults: Results From the Einstein Aging Study

OBJECTIVES

Heterogeneity among Black adults' experiences of discrimination and education quality independently influence cognitive function and sleep, and may also influence the extent to which sleep is related to cognitive function. We investigated the effect of discrimination on the relationship between objective sleep characteristics and cognitive function in older Black adults with varying education quality.

METHOD

Cross-sectional analyses include Black participants in the Einstein Aging Study (N = 104, mean age = 77.2 years, 21% males). Sleep measures were calculated from wrist actigraphy (15.4 ± 1.3 days). Mean ambulatory cognitive function (i.e., spatial working memory, processing speed/visual attention, and short-term memory binding) was assessed with validated smartphone-based cognitive tests (6 daily). A modified Williams Everyday Discrimination Scale measured discriminatory experiences. Linear regression, stratified by reading literacy (an indicator of education quality), was conducted to investigate whether discrimination moderated associations between sleep and ambulatory cognitive function for individuals with varying reading literacy levels. Models controlled for age, income, sleep-disordered breathing, and sex assigned at birth.

RESULTS

Higher reading literacy was associated with better cognitive performance. For participants with both lower reading literacy and more discriminatory experiences, longer mean sleep time was associated with slower processing speed, and lower sleep quality was associated with worse working memory. Later sleep midpoint and longer nighttime sleep were associated with worse spatial working memory for participants with low reading literacy, independent of their discriminatory experiences.

DISCUSSION

Sociocultural factors (i.e., discrimination and education quality) can further explain the association between sleep and cognitive functioning and cognitive impairment risk among older Black adults.

Impairment of executive functions due to sleep alterations: An integrative review on the use of P300

Objective

Cognitive impairment due to sleep deprivation (SD) is an important global health concern as part of the growing rates of sleep disorders and sleep deprivation worldwide. Amongst the affected cognitive processes, the effects of SD on the executive functions (EFs) show diverse methods and inconclusive or contradictory results, highlighting the importance of further research in this field. Considering this scenario, we evaluate one of the most used methods for objectively evaluating EFs on SD: the event-related potential (ERP) P300.

Methods

Our study provides a comprehensive review on the use of P300 for evaluating executive functions in sleep alterations on subjects of all ages, as well as an analysis on the efficiency of P300 as an assessment method for executive functions compared to traditional neurocognitive batteries. We review the benefits of P300 application for multiple sleep/wake alterations, whether evoked in laboratory or as part of pre-existing sleep disorders.

Results

We assess the diverse protocols used to elicit and complement P300, the most identified alterations in amplitude and latency, and suggest new lines of study that could benefit from P300 within the field.

Conclusion

We conclude that P300 is a valuable asset for evaluating executive dysfunction under sleep deprivation both as a standalone protocol and in conjunction with subjective methods, with consistently significant results in assessing executive dysfunction in a diversity of subjects and etiologies.

Citicoline and COVID-19-Related Cognitive and Other Neurologic Complications

With growing concerns about COVID-19’s hyperinflammatory condition and its potentially damaging impact on the neurovascular system, there is a need to consider potential treatment options for managing short- and long-term effects on neurological complications, especially cognitive function. While maintaining adequate structure and function of phospholipid in brain cells, citicoline, identical to the natural metabolite phospholipid phosphatidylcholine precursor, can contribute to a variety of neurological diseases and hypothetically toward post-COVID-19 cognitive effects. In this review, we comprehensively describe in detail the potential citicoline mechanisms as adjunctive therapy and prevention of COVID-19-related cognitive decline and other neurologic complications through citicoline properties of anti-inflammation, anti-viral, neuroprotection, neurorestorative, and acetylcholine neurotransmitter synthesis, and provide a recommendation for future clinical trials.

Exploration of the Association Between Obesity and Cognitive Impairment in Chinese Children with Mild or Moderate Obstructive Sleep Apnea-Hypopnea Syndrome

PURPOSE

To explore the association between obesity and cognitive impairment in children with mild or moderate obstructive sleep apnea-hypopnea syndrome (OSAHS).

DESIGN AND METHODS

A total of 71 children with obesity and 71 age- and sex- matched children who were non-obese were included. The Wechsler Intelligence Scale for Children fourth edition (WISC-IV) was adopted to evaluate the cognition of the participating children. Pearson and partial correlation analysis were performed to investigate the relationships between neurocognitive functions and demographic and polysomnography parameters. Two-way Analysis of Variance was performed to evaluate the effect of obesity and apnea-hypopnea index (AHI) on cognitive functions.

RESULTS

Full-scale intelligence quotient (FSIQ, 92.4 ± 12.3 vs. 98.6 ± 13.1; P < 0.01), verbal comprehension index (VCI, 92.8 ± 10.8 vs. 98.7 ± 10.9; P < 0.01), working memory index (WMI, 92.6 ± 11.3 vs. 96.5 ± 11.0; P = 0.04) and perceptual reasoning index (PRI, 93.8 ± 12.1 vs. 99.2 ± 12.5; P < 0.01) were significantly lower in the children with obesity compared with those in the control group. Partial correlation analysis showed that FSIQ were negatively and significantly correlated with body mass index (BMI, r = -0.347, P < 0.01) and AHI (r = -0.304, P < 0.01). Two-way ANOVA revealed that both obesity and AHI had independent effects on FSIQ (both P < 0.05). The interaction between the effect of obesity and AHI on cognitive functions was not significant, indicating that obesity is a risk factor of cognitive impairment independent of AHI.

CONCLUSIONS

Obesity aggravates cognitive impairment in children with mild or moderate OSAHS.

PRACTICE IMPLICATIONS

Children diagnosed with OSAHS and obesity are recommended to control their body weight for the prevention, management and treatment of cognitive impairment.

Emotional Intelligence in Children with Severe Sleep-Related Breathing Disorders

Background

Obstructive sleep apnea syndrome (OSAS) affects up to 4% of a pediatric population, with many comorbidities in the medium-long term. Functional alterations in the prefrontal cortex (PFC) may explain why OSAS impacts aspects such as executive functions, memory, motor control, attention, visual-spatial skills, learning, and mood regulation. Emotional intelligence (EI) is a complex neuropsychological function that could be impaired in many clinical conditions.

Purpose

The aim of the study is to evaluate the difference in emotional intelligence skills among children with OSAS and healthy subjects (nOSAS).

Methods

129 children (72 males; mean age 7.64 ± 1.98 years) affected by OSAS were compared to 264 non-OSAS (nOSAS) children (138 males; mean age 7.98 ± 2.13) similar for gender, age, and socioeconomic status. In order to assess the emotional quotient, the Bar-On Emotional Quotient Inventory: Youth Version (EQ-i:YV) was used.

Results

The comparison for means and standard deviation between OSAS children and nOSAS children for EQ-i:YV scores showed significant differences for Interpersonal, Adaptability, and Stress Management scales and EQ Total score.

Conclusions

Our findings highlighted the role of intermittent hypoxia in the genesis of the effects of sleep-related respiratory disorders, which involves also aspects different from physical impairments.

EEG spectral powers and source localization in depressing, sad, and fun music videos focusing on gender differences

Previously, gender-specific affective responses have been shown using neurophysiological signals. The present study intended to compare the differences in electroencephalographic (EEG) power spectra and EEG brain sources between men and women during the exposure of affective music video stimuli. The multi-channel EEG signals of 15 males and 15 females available in the database for emotion analysis using physiological signals were studied, while subjects were watching sad, depressing, and fun music videos. Seven EEG frequency bands were computed using average Fourier cross-spectral matrices. Then, standardized low-resolution electromagnetic tomography (sLORETA) was used to localize regions involved specifically in these emotional responses. To evaluate gender differences, independent sample t test was calculated for the sLORETA source powers. Our results showed that (1) the mean EEG power for all frequency bands in the women's group was significantly higher than that of the men's group; (2) spatial distribution differentiation between men and women was detected in all EEG frequency bands. (3) This difference has been related to the emotional stimuli, which was more evident for negative emotions. Taken together, our results showed that men and women recruited dissimilar brain networks for processing sad, depressing, and fun audio-visual stimuli.