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Yalçin M, Peralta AR, Bentes C, Silva C, Guerreiro T, Ferreira JJ, Relógio A. Molecular characterization of the circadian clock in patients with Parkinson's disease-CLOCK4PD Study protocol. PLoS One 2024; 19:e0305712. [PMID: 39028707 PMCID: PMC11259294 DOI: 10.1371/journal.pone.0305712] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Accepted: 06/02/2024] [Indexed: 07/21/2024] Open
Abstract
INTRODUCTION Circadian rhythms (CRs) orchestrate intrinsic 24-hour oscillations which synchronize an organism's physiology and behaviour with respect to daily cycles. CR disruptions have been linked to Parkinson's Disease (PD), the second most prevalent neurodegenerative disorder globally, and are associated to several PD-symptoms such as sleep disturbances. Studying molecular changes of CR offers a potential avenue for unravelling novel insights into the PD progression, symptoms, and can be further used for optimization of treatment strategies. Yet, a comprehensive characterization of the alterations at the molecular expression level for core-clock and clock-controlled genes in PD is still missing. METHODS AND ANALYSIS The proposed study protocol will be used to characterize expression profiles of circadian genes obtained from saliva samples in PD patients and controls. For this purpose, 20 healthy controls and 70 PD patients will be recruited. Data from clinical assessment, questionnaires, actigraphy tracking and polysomnography will be collected and clinical evaluations will be repeated as a follow-up in one-year time. We plan to carry out sub-group analyses considering several clinical factors (e.g., biological sex, treatment dosages, or fluctuation of symptoms), and to correlate reflected changes in CR of measured genes with distinct PD phenotypes (diffuse malignant and mild/motor-predominant). Additionally, using NanoStringⓇ multiplex technology on a subset of samples, we aim to further explore potential CR alterations in hundreds of genes involved in neuropathology pathways. DISCUSSION CLOCK4PD is a mono-centric, non-interventional observational study aiming at the molecular characterization of CR alterations in PD. We further plan to determine physiological modifications in sleep and activity patterns, and clinical factors correlating with the observed CR changes. Our study may provide valuable insights into the intricate interplay between CR and PD with a potential to be used as a predictor of circadian alterations reflecting distinct disease phenotypes, symptoms, and progression outcomes.
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Affiliation(s)
- Müge Yalçin
- Institute for Theoretical Biology (ITB), Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany
- Molecular Cancer Research Center (MKFZ), Medical Department of Hematology, Oncology, and Tumour Immunology, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany
- Institute for Systems Medicine and Faculty of Human Medicine, MSH Medical School Hamburg, Hamburg, Germany
| | - Ana Rita Peralta
- EEG/Sleep Laboratory, Department Neurosciences and Mental Health, Unidade Local de Saude Santa Maria—ULSSM, Lisbon, Portugal
- Department of Neurology, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal
- Instituto de Fisiologia, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal
- CNS-Campus Neurológico, Torres Vedras, Portugal
- Centro de Estudos Egas Moniz, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal
| | - Carla Bentes
- EEG/Sleep Laboratory, Department Neurosciences and Mental Health, Unidade Local de Saude Santa Maria—ULSSM, Lisbon, Portugal
- Department of Neurology, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal
- Centro de Estudos Egas Moniz, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal
| | | | - Tiago Guerreiro
- LASIGE, Faculdade de Ciências, Universidade de Lisboa, Lisbon, Portugal
| | - Joaquim J. Ferreira
- Department of Neurology, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal
- CNS-Campus Neurológico, Torres Vedras, Portugal
- Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal
- Laboratory of Clinical Pharmacology and Therapeutics, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal
| | - Angela Relógio
- Institute for Theoretical Biology (ITB), Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany
- Molecular Cancer Research Center (MKFZ), Medical Department of Hematology, Oncology, and Tumour Immunology, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany
- Institute for Systems Medicine and Faculty of Human Medicine, MSH Medical School Hamburg, Hamburg, Germany
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Chen MY, Wang YY, Si TL, Liu YF, Su Z, Cheung T, Ungvari GS, Jackson T, Zhang Q, Xiang YT. Poor sleep quality in schizophrenia patients: A systematic review and meta-analyses of epidemiological and case-control studies. Schizophr Res 2024; 264:407-415. [PMID: 38241784 DOI: 10.1016/j.schres.2024.01.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Revised: 12/18/2023] [Accepted: 01/01/2024] [Indexed: 01/21/2024]
Abstract
OBJECTIVE Poor sleep quality is common in patients with schizophrenia but estimated prevalence rates in this population have been mixed. This systematic review and meta-analysis examined the prevalence of poor sleep quality in schizophrenia samples and moderators of prevalence from epidemiological studies as well as the risk of poor sleep quality in schizophrenia patients based on case-control studies. METHODS Both international (PubMed, Web of Science, PsycINFO, EMBASE) and Chinese databases [Chinese Nation knowledge Infrastructure (CNKI) and WANFANG] were systematically searched. Studies that estimated the prevalence of poor sleep quality in schizophrenia were analyzed using a random effects model. Funnel plots and Egger's tests were used to assess publication bias. Statistical analyses were performed using R software. RESULTS In total, 23 epidemiological studies and nine case-control studies were included. Based on the epidemiological studies, the pooled overall prevalence of poor sleep quality was 63.4 % [95 % confidence interval (CI): 57.0 %-69.9 %]. Additionally, based on the nine case-control studies, schizophrenia patients had a significantly higher risk for poor sleep quality compared to healthy controls [odd ratio (OR) = 4.5; 95%CI: 2.4-8.3; P < 0.0001]. CONCLUSION Poor sleep quality is common among schizophrenia patients. Considering negative outcomes caused by poor sleep quality, regular screening on poor sleep quality should be conducted and effective interventions should be provided to those in need.
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Affiliation(s)
- Meng-Yi Chen
- Unit of Psychiatry, Department of Public Health and Medicinal Administration, Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macao SAR, China; Centre for Cognitive and Brain Sciences, University of Macau, Macao SAR, China
| | - Yue-Ying Wang
- Unit of Psychiatry, Department of Public Health and Medicinal Administration, Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macao SAR, China
| | - Tong Leong Si
- Unit of Psychiatry, Department of Public Health and Medicinal Administration, Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macao SAR, China
| | - Yu-Fei Liu
- Unit of Psychiatry, Department of Public Health and Medicinal Administration, Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macao SAR, China
| | - Zhaohui Su
- School of Public Health, Southeast University, Nanjing, China
| | - Teris Cheung
- School of Nursing, Hong Kong Polytechnic University, Hong Kong SAR, China
| | - Gabor S Ungvari
- University of Notre Dame Australia, Fremantle, Australia; Division of Psychiatry, School of Medicine, University of Western Australia, Perth, Australia
| | - Todd Jackson
- Department of Psychology, University of Macau, Macao SAR, China
| | - Qinge Zhang
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Beijing Anding Hospital; Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China.
| | - Yu-Tao Xiang
- Unit of Psychiatry, Department of Public Health and Medicinal Administration, Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macao SAR, China; Centre for Cognitive and Brain Sciences, University of Macau, Macao SAR, China.
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Berdzenishvili E, Roinishvili M, Okruashvili M, Kenchadze V, Chkonia E. Impact of subjective sleep quality on objective measures of neurocognitive dysfunction in patients with major depressive disorder. Ind Psychiatry J 2024; 33:154-159. [PMID: 38853813 PMCID: PMC11155662 DOI: 10.4103/ipj.ipj_136_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2023] [Revised: 07/17/2023] [Accepted: 07/19/2023] [Indexed: 06/11/2024] Open
Abstract
Background Sleep disturbances are prevalent in major depressive disorder (MDD). MDD and sleep disturbances are both linked to cognitive impairments. Studies exploring the mechanisms and impact of sleep disturbances on neurocognitive functioning in depressed patients are lacking and proper assessment and therapeutic interventions for sleep disturbances are not part of clinical management of MDD. Aim We investigated the association between subjective sleep quality and neurocognitive dysfunction in patients with MDD. Materials and Methods Patients with moderate MDD episode were matched and assigned to two groups with poor and good sleep quality. We used Pittsburgh Sleep Quality Index (PSQI) to assess sleep quality. To measure frontotemporally mediated cognitive functioning, following tests were administered: Wisconsin Card Sorting Test (WCST) and degraded continuous performance test (CPT-DS). Two-tailed independent samples t tests or Mann-Whitney U tests and Pearson's correlation coefficient were performed for the statistical analysis of sleep latency, sleep duration, overall sleep quality, CPT d' value, WCST correct answers, errors, and perseverative errors. Results Participants with MDD and poor sleep quality performed worse on cognitive tests compared to patients with MDD and good sleep quality. Scores of subjective sleep on PSQI positively correlated with WCST errors (r (60) =0.8883 P = .001) and negatively correlated with WCST correct answers (r (60) = -.869 P = .001) and measures of CPT-DS d' value (r (60) = -.9355 P = .001). Conclusions Poor sleep quality, notably sleep duration and sleep latency, worsens the neurocognitive impairments of MDD patients. As these impairments are found to be associated with treatment outcomes, sleep disturbances should be additionally assessed and treated in MDD episode.
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Affiliation(s)
| | - Maya Roinishvili
- Institute of Cognitive Neurosciences, Agricultural University of Georgia, Tbilisi, Georgia
| | | | - Vaja Kenchadze
- I. Javakhishvili Tbilisi State University, Tbilisi, Georgia
| | - Eka Chkonia
- Department of Psychiatry, Tbilisi State Medical University, Tbilisi, Georgia
- Institute of Cognitive Neurosciences, Agricultural University of Georgia, Tbilisi, Georgia
- Tbilisi Mental Health Centre, Tbilisi, Georgia
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Zahr NM, Sullivan EV, Pfefferbaum A. Poor subjective sleep reported by people living with HIV is associated with impaired working memory. NEUROIMMUNE PHARMACOLOGY AND THERAPEUTICS 2023; 2:127-137. [PMID: 37946876 PMCID: PMC10635409 DOI: 10.1515/nipt-2023-0010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/12/2023]
Abstract
Poor sleep can undermine health and may be especially disruptive to those with chronic conditions including HIV infection. Here, clinically well-described people living with HIV [PLWH] (74 men, 35 women) and healthy control (38 men, 35 women) participants were administered the Pittsburgh Sleep Quality Index (PSQI), a validated measure of subjective sleep with a global score ≥5 able to distinguish good from poor sleepers. In addition, participants completed a battery of neuropsychological tests. PLWH (6.8 ± 3.7) had higher global PSQI scores than healthy controls (4.1 ± 2.8): 39.7 % of uninfected controls and 68.8 % of PLWH had a PSQI≥5 indicative of poor sleep. There were no relations between the global PSQI score and any evaluated variables among uninfected individuals or with demographic or HIV-related variables in PLWH. Instead, a higher global PSQI score among PLWH was associated with worse "Quality of Life" scores [Global Assessment of Functioning (GAF, p=0.0007), Medical Outcomes Study survey (21-item short form, SF-21, p<0.0001), and Activities of Daily Living-Instrumental (ADL-I, p=0.0041)] and higher Beck Depression Index (BDI, p<0.0001) depressive symptoms. Further, in PLWH, higher global PSQI scores were associated with poor performance on a working memory task, the digit backward span (p=0.0036). In PLWH, the 5 variables together explained 32.3 % of the global PSQI score variance; only 3 variables - the SF-21, BDI, and digit backward scores - explained 30.6 % of the variance. To the extent that poor subjective sleep contributes to impaired working memory in HIV, we speculate that this impairment may be ameliorated by improved sleep health.
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Affiliation(s)
- Natalie M. Zahr
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA
- Neuroscience Program, SRI International, Menlo Park CA, USA
| | - Edith V. Sullivan
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA
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Xu W, Bai A, Huang X, Gao Y, Liu L. Association Between Sleep and Motoric Cognitive Risk Syndrome Among Community-Dwelling Older Adults: Results From the China Health and Retirement Longitudinal Study. Front Aging Neurosci 2021; 13:774167. [PMID: 34867301 PMCID: PMC8641045 DOI: 10.3389/fnagi.2021.774167] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2021] [Accepted: 10/11/2021] [Indexed: 12/28/2022] Open
Abstract
Background: Sleep is increasingly recognized as an important lifestyle contributor to health; however, its relationship with Motoric cognitive risk syndrome (MCR) is still unclear. The present study aimed to examine the associations between sleep duration, sleep quality, and MCR among community-dwelling Chinese older adults. Methods: We recruited 5,387 participants aged ≥60 years from the China Health and Retirement Longitudinal Study (CHARLS). Sleep-related variables including night sleep duration and sleep quality were assessed via self-reported questionnaires. MCR syndrome was defined as cognitive complaints and slow gait speed without dementia or impaired mobility. Multivariate logistic regression analysis was performed to explore the associations between sleep-related variables and MCR after controlling for all potential confounders including demographic characteristics, lifestyle factors, and comorbidities. Results: We found that sleep duration was significantly associated with MCR, and the multivariate-adjusted odds ratios (OR) were highest for those with the shortest (<6 h OR = 1.55, 95% CI = 1.18–2.04) and longest (≥10 h OR = 1.73, 95% CI = 1.03–2.91) sleep durations. Moreover, an increasing frequency of self-perceived poor sleep quality was significantly associated with MCR in the adjusted model (3–4 days OR = 1.58, 95% CI = 1.16–2.17; 5–7 days OR = 1.81, 95% CI = 1.37–2.40). Conclusions: Our study indicated an inverted U-shaped association between night sleep duration and MCR. Poor sleep quality was also associated with higher odds of MCR in community-dwelling Chinese elders. Longitudinal studies with a larger population size are needed to establish causality in the future and further explore potential action mechanisms.
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Affiliation(s)
- Weihao Xu
- Haikou Cadre's sanitarium of Hainan Military Region, Haikou, China
| | - Anying Bai
- Department of Epidemiology and Biostatistics, School of Population Medicine and Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Xin Huang
- Department of Geriatric Cardiology, The Second Medical Center & National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, Beijing, China
| | - Yinghui Gao
- PKU-UPenn Sleep Center, Peking University International Hospital, Beijing, China
| | - Lin Liu
- Department of Pulmonary and Critical Care Medicine, The Second Medical Center & National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, Beijing, China
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Wang X, Cheng B, Roberts N, Wang S, Luo Y, Tian F, Yue S. Shared and distinct brain fMRI response during performance of working memory tasks in adult patients with schizophrenia and major depressive disorder. Hum Brain Mapp 2021; 42:5458-5476. [PMID: 34431584 PMCID: PMC8519858 DOI: 10.1002/hbm.25618] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2020] [Revised: 07/02/2021] [Accepted: 07/13/2021] [Indexed: 02/05/2023] Open
Abstract
Working memory (WM) impairments are common features of psychiatric disorders. A systematic meta-analysis was performed to determine common and disorder-specific brain fMRI response during performance of WM tasks in patients with SZ and patients with MDD relative to healthy controls (HC). Thirty-four published fMRI studies of WM in patients with SZ and 18 published fMRI studies of WM in patients with MDD, including relevant HC, were included in the meta-analysis. In both SZ and MDD there was common stronger fMRI response in right medial prefrontal cortex (MPFC) and bilateral anterior cingulate cortex (ACC), which are part of the default mode network (DMN). The effects were of greater magnitude in SZ than MDD, especially in prefrontal-temporal-cingulate-striatal-cerebellar regions. In addition, a disorder-specific weaker fMRI response was observed in right middle frontal gyrus (MFG) in MDD, relative to HC. For both SZ and MDD a significant correlation was observed between the severity of clinical symptoms and lateralized fMRI response relative to HC. These findings indicate that there may be common and distinct anomalies in brain function underlying deficits in WM in SZ and MDD, which may serve as a potential functional neuroimaging-based diagnostic biomarker with value in supporting clinical diagnosis, measuring illness severity and assessing the efficacy of treatments for SZ and MDD at the brain level.
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Affiliation(s)
- Xiuli Wang
- Department of Psychiatry, the Fourth People's Hospital of Chengdu, Chengdu, China
| | - Bochao Cheng
- Department of Radiology, West China Second University Hospital of Sichuan University, Chengdu, China
| | - Neil Roberts
- Edinburgh Imaging Facility, Queens Medical Research Institute, University of Edinburgh, Edinburgh, UK
| | - Song Wang
- Department of Radiology, Huaxi MR Research Center, West China Hospital of Sichuan University, Chengdu, China
| | - Ya Luo
- Mental Health Center, West China Hospital of Sichuan University, Chengdu, China
| | - Fangfang Tian
- Department of Nuclear Medicine, West China Hospital of Sichuan University, Chengdu, China
| | - Suping Yue
- Department of Psychiatry, the Fourth People's Hospital of Chengdu, Chengdu, China
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Esan O, Ephraim-Oluwanuga OT. Sleep quality and cognitive impairments in remitted patients with schizophrenia in Nigeria. Encephale 2021; 47:401-405. [PMID: 33832716 DOI: 10.1016/j.encep.2020.12.004] [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: 09/19/2020] [Revised: 11/30/2020] [Accepted: 12/02/2020] [Indexed: 11/24/2022]
Abstract
BACKGROUND Despite the ubiquity of sleep disturbance in schizophrenia, it has generally been overlooked as a potential contributor to cognitive impairments. The main aim of this study was to find out if impaired sleep quality contributes to cognitive impairments in patients with a diagnosis of schizophrenia who are in remission. METHODS The study was conducted at the University College Hospital, Ibadan and State Hospital, Ibadan, Nigeria. The Pittsburgh Sleep Quality Index (PSQI) and Screen for Cognitive Impairment in Psychiatry (SCIP) were applied in this cross-sectional study, to all consecutive and consenting remitted outpatients with schizophrenia (N=130). Other instruments such as Hamilton Depression Rating Scale (HDRS), the Positive and Negative Syndrome Scale (PANSS), sociodemographic and clinical measures were also applied. RESULTS There were 130 participants made up of 69 females (53.1%) and 61males(46.9%). The mean age of the participants was 38.5±9.1 years. The prevalence of poor sleep quality in remitted patients with schizophrenia was 56.9%. Sleep quality was significantly negatively correlated with Verbal Learning Test-Immediate (VLT-I) (r(128)=-.18, P=.044) and Verbal Learning Test-Delayed (VLT-D) (r(128)=-.18, P=.037). The variables that independently predicted cognitive functioning were the VLT-I, odds ratio (OR) 0.66; 95% confidence interval ((CI) 0.49-0.88) and education (OR) 0.61;(CI) 0.40- 0.92). CONCLUSION Poor subjective sleep quality measured by the PSQI is linked to cognitive impairment in remitted patients with schizophrenia. We suggest that sleep quality in remitted patients with a diagnosis of schizophrenia should receive better attention by physicians.
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Affiliation(s)
- O Esan
- Department of Psychiatry, University of Ibadan, Ibadan, Nigeria.
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Taliercio J, Bonasera B, Portillo C, Ramjas E, Serper M. Physical Activity, Sleep-related Behaviors and Severity of Symptoms in Schizophrenia. Psychiatry Res 2020; 294:113489. [PMID: 33038793 DOI: 10.1016/j.psychres.2020.113489] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Accepted: 09/25/2020] [Indexed: 12/22/2022]
Abstract
The beneficial effects of a healthy sleep hygiene and regular physical activity have both been noted in improving psychopathology symptom severity. No study to date however, has evaluated the potential therapeutic effects of both sleep and exercise simultaneously in individuals diagnosed with schizophrenia. To examine the two variables concurrently, in the present report, patients with diagnoses of schizophrenia spectrum disorders (n = 64), were administered assessments that measured both their physical activity and sleep-related behaviors. Additionally, patients' symptom severity and cognitive and daily functioning abilities were also assessed. It was found sleep hygiene and physical activity were associated with patients' symptom severity and cognitive capacities, but not with their daily functioning abilities. Further, no interaction effects were found between sleep hygiene and physical activity. These results suggest that physical activity and sleep hygiene should be considered, independently, in their contribution to psychopathology.
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Affiliation(s)
| | | | | | | | - Mark Serper
- Department of Psychology, Hofstra University, Hempstead, NY; Department of Psychiatry, Icahn Mount Sinai School of Medicine.
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Waite F, Sheaves B, Isham L, Reeve S, Freeman D. Sleep and schizophrenia: From epiphenomenon to treatable causal target. Schizophr Res 2020; 221:44-56. [PMID: 31831262 PMCID: PMC7327507 DOI: 10.1016/j.schres.2019.11.014] [Citation(s) in RCA: 63] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2019] [Revised: 11/08/2019] [Accepted: 11/11/2019] [Indexed: 12/28/2022]
Abstract
BACKGROUND Sleep disturbance is a common clinical issue for patients with psychosis. It has been identified as a putative causal factor in the onset and persistence of psychotic experiences (paranoia and hallucinations). Hence sleep disruption may be a potential treatment target to prevent the onset of psychosis and reduce persistent psychotic experiences. The aim of this review is to describe developments in understanding the nature, causal role, and treatment of sleep disruption in psychosis. METHOD A systematic literature search was conducted to identify studies, published in the last five years, investigating subjective sleep disruption and psychotic experiences. RESULTS Fifty-eight papers were identified: 37 clinical and 21 non-clinical studies. The studies were correlational (n = 38; 20 clinical, 18 non-clinical), treatment (n = 7; 1 non-clinical), qualitative accounts (n = 6 clinical), prevalence estimates (n = 5 clinical), and experimental tests (n = 2 non-clinical). Insomnia (50%) and nightmare disorder (48%) are the most prevalent sleep problems found in patients. Sleep disruption predicts the onset and persistence of psychotic experiences such as paranoia and hallucinations, with negative affect identified as a partial mediator of this relationship. Patients recognise the detrimental effects of disrupted sleep and are keen for treatment. All psychological intervention studies reported large effect size improvements in sleep and there may be modest resultant improvements in psychotic experiences. CONCLUSIONS Sleep disruption is a treatable clinical problem in patients with psychosis. It is important to treat in its own right but may also lessen psychotic experiences. Research is required on how this knowledge can be implemented in clinical services.
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Affiliation(s)
- Felicity Waite
- Department of Psychiatry, University of Oxford, UK; Oxford Health NHS Foundation Trust, UK; Sleep and Circadian Neuroscience Institute, University of Oxford, UK.
| | - Bryony Sheaves
- Department of Psychiatry, University of Oxford, UK,Oxford Health NHS Foundation Trust, UK,Sleep and Circadian Neuroscience Institute, University of Oxford, UK
| | - Louise Isham
- Department of Psychiatry, University of Oxford, UK,Oxford Health NHS Foundation Trust, UK
| | | | - Daniel Freeman
- Department of Psychiatry, University of Oxford, UK,Oxford Health NHS Foundation Trust, UK,Sleep and Circadian Neuroscience Institute, University of Oxford, UK
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Zavecz Z, Nagy T, Galkó A, Nemeth D, Janacsek K. The relationship between subjective sleep quality and cognitive performance in healthy young adults: Evidence from three empirical studies. Sci Rep 2020; 10:4855. [PMID: 32184462 PMCID: PMC7078271 DOI: 10.1038/s41598-020-61627-6] [Citation(s) in RCA: 43] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2019] [Accepted: 02/17/2020] [Indexed: 01/11/2023] Open
Abstract
The role of subjective sleep quality in cognitive performance has gained increasing attention in recent decades. In this paper, our aim was to test the relationship between subjective sleep quality and a wide range of cognitive functions in a healthy young adult sample combined across three studies. Sleep quality was assessed by the Pittsburgh Sleep Quality Index, the Athens Insomnia Scale, and a sleep diary to capture general subjective sleep quality, and the Groningen Sleep Quality Scale to capture prior night’s sleep quality. Within cognitive functions, we tested working memory, executive functions, and several sub-processes of procedural learning. To provide more reliable results, we included robust frequentist as well as Bayesian statistical analyses. Unequivocally across all analyses, we showed that there is no association between subjective sleep quality and cognitive performance in the domains of working memory, executive functions and procedural learning in healthy young adults. Our paper can contribute to a deeper understanding of subjective sleep quality and its measures, and we discuss various factors that may affect whether associations can be observed between subjective sleep quality and cognitive performance.
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Affiliation(s)
- Zsófia Zavecz
- Doctoral School of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary.,Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary.,Institute of Cognitive Neuroscience and Psychology, Hungarian Academy of Sciences, Budapest, Hungary
| | - Tamás Nagy
- Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary
| | - Adrienn Galkó
- Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary
| | - Dezso Nemeth
- Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary. .,Institute of Cognitive Neuroscience and Psychology, Hungarian Academy of Sciences, Budapest, Hungary. .,Lyon Neuroscience Research Center (CRNL), INSERM, CNRS, Université Claude Bernard Lyon 1, Lyon, France.
| | - Karolina Janacsek
- Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary. .,Institute of Cognitive Neuroscience and Psychology, Hungarian Academy of Sciences, Budapest, Hungary. .,School of Human Sciences, Faculty of Education, Health and Human Sciences, University of Greenwich, London, United Kingdom.
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Zavecz Z, Nagy T, Galkó A, Nemeth D, Janacsek K. The relationship between subjective sleep quality and cognitive performance in healthy young adults: Evidence from three empirical studies. Sci Rep 2020; 10:4855. [PMID: 32184462 DOI: 10.1101/328369] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2019] [Accepted: 02/17/2020] [Indexed: 05/23/2023] Open
Abstract
The role of subjective sleep quality in cognitive performance has gained increasing attention in recent decades. In this paper, our aim was to test the relationship between subjective sleep quality and a wide range of cognitive functions in a healthy young adult sample combined across three studies. Sleep quality was assessed by the Pittsburgh Sleep Quality Index, the Athens Insomnia Scale, and a sleep diary to capture general subjective sleep quality, and the Groningen Sleep Quality Scale to capture prior night's sleep quality. Within cognitive functions, we tested working memory, executive functions, and several sub-processes of procedural learning. To provide more reliable results, we included robust frequentist as well as Bayesian statistical analyses. Unequivocally across all analyses, we showed that there is no association between subjective sleep quality and cognitive performance in the domains of working memory, executive functions and procedural learning in healthy young adults. Our paper can contribute to a deeper understanding of subjective sleep quality and its measures, and we discuss various factors that may affect whether associations can be observed between subjective sleep quality and cognitive performance.
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Affiliation(s)
- Zsófia Zavecz
- Doctoral School of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary
- Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary
- Institute of Cognitive Neuroscience and Psychology, Hungarian Academy of Sciences, Budapest, Hungary
| | - Tamás Nagy
- Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary
| | - Adrienn Galkó
- Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary
| | - Dezso Nemeth
- Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary.
- Institute of Cognitive Neuroscience and Psychology, Hungarian Academy of Sciences, Budapest, Hungary.
- Lyon Neuroscience Research Center (CRNL), INSERM, CNRS, Université Claude Bernard Lyon 1, Lyon, France.
| | - Karolina Janacsek
- Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary.
- Institute of Cognitive Neuroscience and Psychology, Hungarian Academy of Sciences, Budapest, Hungary.
- School of Human Sciences, Faculty of Education, Health and Human Sciences, University of Greenwich, London, United Kingdom.
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Phan DV, Chan CL, Pan RH, Yang NP, Hsu HC, Ting HW, Lai KR, Lin KB. Investigating the effect of daily sleep on memory capacity in college students. Technol Health Care 2019; 27:183-194. [DOI: 10.3233/thc-181350] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Dinh-Van Phan
- Department of Information Management, Yuan-Ze University, Taoyuan, Taiwan
- Innovation Center for Big Data and Digital Convergence, Yuan-Ze University, Taoyuan, Taiwan
- Faculty of Statistics and Informatics, University of Economics, The University of Danang, Vietnam
| | - Chien-Lung Chan
- Department of Information Management, Yuan-Ze University, Taoyuan, Taiwan
- Innovation Center for Big Data and Digital Convergence, Yuan-Ze University, Taoyuan, Taiwan
| | - Ren-Hao Pan
- Department of Information Management, Yuan-Ze University, Taoyuan, Taiwan
- Innovation Center for Big Data and Digital Convergence, Yuan-Ze University, Taoyuan, Taiwan
| | - Nan-Ping Yang
- Department of Surgery and Orthopedics, Keelung Hospital, Ministry of Health and Welfare, Keelung, Taiwan
- Faculty of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Hsiu-Chen Hsu
- Department of Information Management, Yuan-Ze University, Taoyuan, Taiwan
- Innovation Center for Big Data and Digital Convergence, Yuan-Ze University, Taoyuan, Taiwan
| | - Hsien-Wei Ting
- Department of Information Management, Yuan-Ze University, Taoyuan, Taiwan
- Department of Neurosurgery, Taipei Hospital, Ministry of Health and Welfare, Taiwan
| | - K. Robert Lai
- Department of Computer Science and Engineering, Yuan-Ze University, Taoyuan, Taiwan
| | - Kai-Biao Lin
- School of Computer and Information Engineering, Xiamen University of Technology, Xiamen, Fujian, China
- Engineering Research Center for Medical Data Mining and Application, Fujian, China
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van den Noort M, Bosch P. Schizophrenia and Sleep Disorders: An Introduction. MEDICINES 2018; 5:medicines5030094. [PMID: 30200201 PMCID: PMC6163767 DOI: 10.3390/medicines5030094] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/17/2018] [Accepted: 08/20/2018] [Indexed: 11/16/2022]
Abstract
This editorial is an introduction to the special issue 'Schizophrenia and Sleep Disorders'.[…].
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Affiliation(s)
- Maurits van den Noort
- Research Group of Pain and Neuroscience, Kyung Hee University, Seoul 130-701, Korea.
- Brussels Institute for Applied Linguistics, Vrije Universiteit Brussel, 1050 Brussels, Belgium.
| | - Peggy Bosch
- Psychiatric Research Group, LVR-Klinik Bedburg-Hau, 47511 Bedburg-Hau, Germany.
- Donders Institute for Brain, Cognition and Behaviour, Radboud University, 6525 Nijmegen, The Netherlands.
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Neurocognitive Effects of Agomelatine Treatment in Schizophrenia Patients Suffering From Comorbid Depression: Results From the AGOPSYCH Study. J Clin Psychopharmacol 2018; 38:357-361. [PMID: 29912792 DOI: 10.1097/jcp.0000000000000909] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Cognitive impairment in schizophrenia is highly disabling and remains one of the major therapeutic challenges. Agomelatine (AGO), an agonist at melatonergic MT1/MT2 receptors and antagonist at 5-HT2C receptors, increases dopamine and norepinephrine in the prefrontal cortex and may therefore have the potential of improving neurocognition in patients with schizophrenia. METHODS Twenty-seven patients with schizophrenia and comorbid depression were treated with AGO in addition to stable doses of antipsychotic drugs. Cognitive abilities were assessed with the Measurement and Treatment Research to Improve Cognition in Schizophrenia Consensus Cognitive Battery (MCCB) at study entry and after 12 weeks of AGO treatment after the intention-to-treat principle. RESULTS We observed statistically significant yet clinically negligible increases of the MCCB composite score and the reasoning/problem solving subscore. Patients with unimpaired sleep at baseline showed greater improvements over time than those with sleep disturbances. Changes on the MCCB were not correlated with other psychometric variables. CONCLUSIONS Despite statistically significant, cognitive improvements after 12 weeks of AGO treatment were clinically irrelevant. Our findings may be limited by baseline properties of the study sample and the study design. In particular, lacking a control group, it cannot be ruled out that improvements were unrelated to AGO treatment. That is why randomized controlled trials are needed to validate the relevance of AGO as a cognitive enhancer in schizophrenia.
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Zeng L, Tao Y, Hou W, Zong L, Yu L. Electro-acupuncture improves psychiatric symptoms, anxiety and depression in methamphetamine addicts during abstinence: A randomized controlled trial. Medicine (Baltimore) 2018; 97:e11905. [PMID: 30142795 PMCID: PMC6112927 DOI: 10.1097/md.0000000000011905] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
Abstract
BACKGROUND It aimed to observe the effect of electro-acupuncture on the improvement of psychiatric symptoms, as well as anxiety and depression in methamphetamine (MA) addicts during abstinence using randomized controlled trials. METHODS All patients in the present study received compulsory drug detoxification in Shanghai Drug Rehabilitation Center. All patients were enrolled consecutively from June 2014 to February 2015; data collection was completed in March 2015. According to the randomized, single-blind and control principle, 68 men MA addicts were randomly divided into 2 groups: electro-acupuncture (EA) and sham electro-acupuncture (sham-EA) groups. Patients were given 20 minutes EA or sham-EA treatment every Monday, Wednesday, and Friday, with a total of 4 weeks. Positive and Negative Syndrome Scale (PANSS), Hamilton Anxiety Scale (HAMA), and Hamilton Depression Scale (HAMD) were used to evaluate the patients' psychotic symptoms, anxiety and depression before treatment and after receiving treatment with 1 to 4 weeks, respectively. RESULTS EA could effectively improve the symptoms of psychosis, anxiety, and depression during abstinence in patients with MA addiction. In terms of PANSS score, the scores for positive symptoms and general psychopathological symptoms in patients after receiving 1 to 4 weeks of treatment were significantly decreased compared with the control group, while the score for negative symptoms was significantly decreased after receiving 2 and 4 weeks of treatment. For the HAMA score, the psychotic anxiety scores in patients receiving 1 to 4 weeks of treatment were significant lower than the control group. In terms of HAMD score, there was a significant reduction in anxiety/somatization and sleep disturbance scores after the 4 weeks of EA treatment. CONCLUSION Electroacupuncture helps to improve psychiatric symptoms and anxiety and depression in MA addicts during abstinence, and promote rehabilitation of patients.
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Affiliation(s)
- Liang Zeng
- Department of Acupuncture, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Ying Tao
- Department of Acupuncture, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Wenguang Hou
- Department of Acupuncture, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Lei Zong
- Department of Acupuncture, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Lei Yu
- Department of Genetics, Rutgers University, New Jersey
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Bosch P, Lim S, Staudte H, Yeo S, Lee SH, Barisch P, Perriard B, Van den Noort M. Pharmacological Treatment for Long-Term Patients with Schizophrenia and Its Effects on Sleep in Daily Clinical Practice: A Pilot Study. MEDICINES 2018; 5:medicines5020044. [PMID: 29757197 PMCID: PMC6023313 DOI: 10.3390/medicines5020044] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/30/2018] [Revised: 04/26/2018] [Accepted: 05/10/2018] [Indexed: 01/06/2023]
Abstract
Background: Pharmacological treatment is still the key intervention in the disease management of long-term patients with schizophrenia; however, how it affects sleep and whether gender differences exist remains unclear. Methods: Forty-six long-term outpatients with schizophrenia entered the study. The numbers of antipsychotics, sleep medications, antidepressants, and anxiolytics were analyzed. Moreover, all patients were tested using the Pittsburgh Sleep Quality Index (PSQI) and the Epworth Sleepiness Scale (ESS). Correlation analyses were conducted between the medication used and the scores on the two subjective sleep inventories. Results: A large variability, ranging from 0 to 8, in the total number of psychiatric drugs per person was found between the patients. Despite ongoing pharmacological treatment, the patients scored high on the PSQI, but not on the ESS; this indicates that they report problems with sleep, but not with daytime sleepiness. A significant positive correlation between the use of antipsychotics and the ESS score, but not the PSQI score, was found; moreover, no gender differences were found. Conclusions: A large variability exists in the pharmacological treatment of long-term patients with schizophrenia. To date, patients’ sleep problems have been insufficiently treated, and gender differences have not been adequately accounted for in the pharmacological treatment of schizophrenia. More and larger international clinical studies are warranted to verify the findings of the present preliminary pilot study before any firm conclusions can be drawn and before any changes to the drug treatment of male and female patients with schizophrenia can be recommended.
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Affiliation(s)
- Peggy Bosch
- Psychiatric Research Group, LVR-Klinik Bedburg-Hau, 47511 Bedburg-Hau, Germany.
- Donders Institute for Brain, Cognition and Behaviour, Radboud University, 6525 Nijmegen, The Netherlands.
| | - Sabina Lim
- Research Group of Pain and Neuroscience, College of Korean Medicine, Kyung Hee University, Seoul 130-701, Korea.
| | - Heike Staudte
- Psychiatric Research Group, LVR-Klinik Bedburg-Hau, 47511 Bedburg-Hau, Germany.
| | - Sujung Yeo
- College of Korean Medicine, Sang Ji University, Wonju 26339, Korea.
| | - Sook-Hyun Lee
- Research Group of Pain and Neuroscience, College of Korean Medicine, Kyung Hee University, Seoul 130-701, Korea.
| | - Pia Barisch
- Institute of Experimental Psychology, Heinrich Heine University, 40225 Düsseldorf, Germany.
| | - Benoît Perriard
- Department of Medicine, Neurology, University of Fribourg, 1700 Fribourg, Switzerland.
| | - Maurits Van den Noort
- Research Group of Pain and Neuroscience, College of Korean Medicine, Kyung Hee University, Seoul 130-701, Korea.
- Brussels Institute for Applied Linguistics, Vrije Universiteit Brussel, 1050 Brussels, Belgium.
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Treatment preferences and help-seeking behaviors for sleep problems among psychiatric outpatients. Gen Hosp Psychiatry 2018; 51:112-117. [PMID: 28865845 DOI: 10.1016/j.genhosppsych.2017.08.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2017] [Revised: 08/10/2017] [Accepted: 08/11/2017] [Indexed: 11/22/2022]
Abstract
OBJECTIVE To understand treatment preferences and help-seeking behaviors among psychiatric patients for their sleep problems, and to examine determinants of problem recognition and help-seeking among patients with sleep difficulties. METHOD A cross-sectional survey was conducted among psychiatric outpatients in Singapore (n=400). Participants completed questionnaires that assessed their sleep quality, daytime fatigue, help-seeking behavior, treatment preferences for sleep problems, and sociodemographic information. Multiple logistic regressions were used to identify correlates of patients who recognized their sleep difficulties and of those who had sought help. RESULTS Mental health professionals were the most preferred choice (60.8%) for consultation on sleep problems. Among patients with poor sleep quality (n=275), 28.4% denied having any problems and 38.9% had not sought help. Patients with chronic physical comorbidity were less likely to recognize their sleep problems (OR=0.432, p-value=0.009), while those with psychiatric comorbidity were twice as likely to perceive the problems (OR=2.094, p-value=0.021) and to seek help (OR=1.957, p-value=0.022). Daytime fatigue was associated with higher odds of problem recognition (OR=1.106, p-value=0.001) and help-seeking (OR=1.064, p-value=0.016). CONCLUSION A considerable number of patients did not perceive their poor sleep as an issue and had not sought help for it. General sleep hygiene education is needed for psychiatric patients.
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