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da Silva FR, Guerreiro RDC, Barreto AT, Brant VM, Silva A, De-Mello MT. Can Improving Postoperative Sleep Speed Up Surgical Recovery? Sleep Sci 2024; 17:e335-e338. [PMID: 39268341 PMCID: PMC11390163 DOI: 10.1055/s-0044-1785522] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Accepted: 10/20/2023] [Indexed: 09/15/2024] Open
Abstract
Sleep disturbance is common during recovery after surgical procedures and may have an important effect on mortality, and quality of life. Sleep restriction/deprivation, including decreased quantity and continuity, is common in patients who are patients and persons with acute and chronic illnesses. Age, gender, illness, primary sleep disorders, environment, and medical treatment factors are thought to influence sleep throughout the preoperative period, hospitalization, and recovery. Resulting sleep pattern disturbances include decreases in circadian patterning, continuity, duration, and perceived (subjective) sleep quality. This article synthesizes sleep disturbance in patients who have undergone surgery and highlights sleep strategies to improve faster surgical recovery.
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Affiliation(s)
- Flavia Rodrigues da Silva
- Multidisciplinary Center on Somnolence and Accidents, Belo Horizonte, MG, Brazil
- Psychobiology and Physical Exercise Study Center, Belo Horizonte, MG, Brazil
| | - Renato de Carvalho Guerreiro
- Psychobiology and Physical Exercise Study Center, Belo Horizonte, MG, Brazil
- Sports Training Center, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Amaury Tavares Barreto
- Psychobiology and Physical Exercise Study Center, Belo Horizonte, MG, Brazil
- Sports Training Center, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Valdênio Martins Brant
- Psychobiology and Physical Exercise Study Center, Belo Horizonte, MG, Brazil
- Sports Training Center, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Andressa Silva
- Psychobiology and Physical Exercise Study Center, Belo Horizonte, MG, Brazil
- Sports Training Center, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Marco Túlio De-Mello
- Psychobiology and Physical Exercise Study Center, Belo Horizonte, MG, Brazil
- Sports Training Center, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
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Jiang YL, Xia L, Zhao JJ, Zhou HM, Mi D, Wang X, Wang YY, Song CG, Jiang W. Mice harboring the T316N variant in the GABA AR γ 2 subunit exhibit sleep-related hypermotor epilepsy phenotypes and hypersynchronization in the thalamocortical pathway. Exp Neurol 2024; 376:114775. [PMID: 38604438 DOI: 10.1016/j.expneurol.2024.114775] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2023] [Revised: 03/27/2024] [Accepted: 04/06/2024] [Indexed: 04/13/2024]
Abstract
OBJECTIVE Sleep-related hypermotor epilepsy (SHE) is a focal epilepsy syndrome characterized by seizures that predominantly occur during sleep. The pathogenesis of these seizures remains unclear. We previously detected rare variants in GABRG2, which encodes the γ2 subunit of γ-aminobutyric acid type A receptor (GABAAR), in patients with SHE and demonstrated that these variants impaired GABAAR function in vitro. However, the mechanisms by which GABRG2 variants contribute to seizure attacks during sleep remain unclear. METHODS In this study, we designed a knock-in (KI) mouse expressing the mouse Gabrg2 T316N variant, corresponding to human GABRG2 T317N variant, using CRISPR/Cas9. Continuous video-electroencephalogram monitoring and in vivo multichannel electrophysiological recordings were performed to explore seizure susceptibility to pentylenetetrazol (PTZ), alterations in the sleep-wake cycle, spontaneous seizure patterns, and synchronized activity in the motor thalamic nuclei (MoTN) and secondary motor cortex (M2). Circadian variations in the expression of total, membrane-bound, and synaptic GABAAR subunits were also investigated. RESULTS No obvious changes in gross morphology were detected in Gabrg2T316N/+ mice compared to their wild-type (Gabrg2+/+) littermates. Gabrg2T316N/+ mice share key phenotypes with patients, including sleep fragmentation and spontaneous seizures during sleep. Gabrg2T316N/+ mice showed increased susceptibility to PTZ-induced seizures and higher mortality after seizures. Synchronization of the local field potentials between the MoTN and M2 was abnormally enhanced in Gabrg2T316N/+ mice during light phase, when sleep dominates, accompanied by increased local activities in the MoTN and M2. Interestingly, in Gabrg2+/+ mice, GABAAR γ2 subunits showed a circadian increase on the neuronal membrane and synaptosomes in the transition from dark phase to light phase, which was absent in Gabrg2T316N/+ mice. CONCLUSION We generated a new SHE mouse model and provided in vivo evidence that rare variants of GABRG2 contribute to seizure attacks during sleep in SHE.
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Affiliation(s)
- Yong-Li Jiang
- Comprehensive Epilepsy Center, Department of Neurology, Xijing Hospital, Fourth Military Medical University, Xi'an 710032, China
| | - Liang Xia
- Comprehensive Epilepsy Center, Department of Neurology, Xijing Hospital, Fourth Military Medical University, Xi'an 710032, China
| | - Jing-Jing Zhao
- Comprehensive Epilepsy Center, Department of Neurology, Xijing Hospital, Fourth Military Medical University, Xi'an 710032, China
| | - Hui-Min Zhou
- Comprehensive Epilepsy Center, Department of Neurology, Xijing Hospital, Fourth Military Medical University, Xi'an 710032, China
| | - Dan Mi
- Comprehensive Epilepsy Center, Department of Neurology, Xijing Hospital, Fourth Military Medical University, Xi'an 710032, China
| | - Xuan Wang
- Comprehensive Epilepsy Center, Department of Neurology, Xijing Hospital, Fourth Military Medical University, Xi'an 710032, China
| | - Yuan-Yuan Wang
- Comprehensive Epilepsy Center, Department of Neurology, Xijing Hospital, Fourth Military Medical University, Xi'an 710032, China
| | - Chang-Geng Song
- Comprehensive Epilepsy Center, Department of Neurology, Xijing Hospital, Fourth Military Medical University, Xi'an 710032, China.
| | - Wen Jiang
- Comprehensive Epilepsy Center, Department of Neurology, Xijing Hospital, Fourth Military Medical University, Xi'an 710032, China.
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Zhou X, He Y, Xu T, Wu Z, Guo W, Xu X, Liu Y, Zhang Y, Shang H, Huang L, Yao Z, Li Z, Su L, Li Z, Feng T, Zhang S, Monteiro O, Cunha RA, Huang ZL, Zhang K, Li Y, Cai X, Qu J, Chen JF. 40 Hz light flickering promotes sleep through cortical adenosine signaling. Cell Res 2024; 34:214-231. [PMID: 38332199 PMCID: PMC10907382 DOI: 10.1038/s41422-023-00920-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Accepted: 12/20/2023] [Indexed: 02/10/2024] Open
Abstract
Flickering light stimulation has emerged as a promising non-invasive neuromodulation strategy to alleviate neuropsychiatric disorders. However, the lack of a neurochemical underpinning has hampered its therapeutic development. Here, we demonstrate that light flickering triggered an immediate and sustained increase (up to 3 h after flickering) in extracellular adenosine levels in the primary visual cortex (V1) and other brain regions, as a function of light frequency and intensity, with maximal effects observed at 40 Hz frequency and 4000 lux. We uncovered cortical (glutamatergic and GABAergic) neurons, rather than astrocytes, as the cellular source, the intracellular adenosine generation from AMPK-associated energy metabolism pathways (but not SAM-transmethylation or salvage purine pathways), and adenosine efflux mediated by equilibrative nucleoside transporter-2 (ENT2) as the molecular pathway responsible for extracellular adenosine generation. Importantly, 40 Hz (but not 20 and 80 Hz) light flickering for 30 min enhanced non-rapid eye movement (non-REM) and REM sleep for 2-3 h in mice. This somnogenic effect was abolished by ablation of V1 (but not superior colliculus) neurons and by genetic deletion of the gene encoding ENT2 (but not ENT1), but recaptured by chemogenetic inhibition of V1 neurons and by focal infusion of adenosine into V1 in a dose-dependent manner. Lastly, 40 Hz light flickering for 30 min also promoted sleep in children with insomnia by decreasing sleep onset latency, increasing total sleep time, and reducing waking after sleep onset. Collectively, our findings establish the ENT2-mediated adenosine signaling in V1 as the neurochemical basis for 40 Hz flickering-induced sleep and unravel a novel and non-invasive treatment for insomnia, a condition that affects 20% of the world population.
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Affiliation(s)
- Xuzhao Zhou
- The Eye and Brain Center, State Key Laboratory of Ophthalmology, Optometry and Visual Science, Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China
- Oujiang Laboratory (Zhejiang Laboratory for Regenerative Medicine, Vision and Brain Health), School of Ophthalmology & Optometry and Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Yan He
- The Eye and Brain Center, State Key Laboratory of Ophthalmology, Optometry and Visual Science, Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Tao Xu
- The Eye and Brain Center, State Key Laboratory of Ophthalmology, Optometry and Visual Science, Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Zhaofa Wu
- State Key Laboratory of Membrane Biology, School of Life Sciences, Peking University, Beijing, China
| | - Wei Guo
- The Eye and Brain Center, State Key Laboratory of Ophthalmology, Optometry and Visual Science, Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Xi Xu
- Department of Pediatrics, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Yuntao Liu
- The Eye and Brain Center, State Key Laboratory of Ophthalmology, Optometry and Visual Science, Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Yi Zhang
- Oujiang Laboratory (Zhejiang Laboratory for Regenerative Medicine, Vision and Brain Health), School of Ophthalmology & Optometry and Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China
- Institute of Genomic Medicine, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Huiping Shang
- The Eye and Brain Center, State Key Laboratory of Ophthalmology, Optometry and Visual Science, Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Libin Huang
- The Eye and Brain Center, State Key Laboratory of Ophthalmology, Optometry and Visual Science, Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Zhimo Yao
- The Eye and Brain Center, State Key Laboratory of Ophthalmology, Optometry and Visual Science, Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Zewen Li
- The Eye and Brain Center, State Key Laboratory of Ophthalmology, Optometry and Visual Science, Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Lingya Su
- The Eye and Brain Center, State Key Laboratory of Ophthalmology, Optometry and Visual Science, Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Zhihui Li
- The Eye and Brain Center, State Key Laboratory of Ophthalmology, Optometry and Visual Science, Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Tao Feng
- Key Laboratory of Biomedical Engineering of Ministry of Education, Qiushi Academy for Advanced Studies, Zhejiang University, Hangzhou, Zhejiang, China
| | - Shaomin Zhang
- Key Laboratory of Biomedical Engineering of Ministry of Education, Qiushi Academy for Advanced Studies, Zhejiang University, Hangzhou, Zhejiang, China
| | - Olivia Monteiro
- Faculty of Medicine, Macau University of Science and Technology, Taipa, Macau, China
| | - Rodrigo A Cunha
- CNC-Center for Neuroscience and Cell Biology, Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - Zhi-Li Huang
- Department of Pharmacology, School of Basic Medical Sciences; State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, and Institutes of Brain Science, Fudan University, Shanghai, China
| | - Kang Zhang
- The Eye and Brain Center, State Key Laboratory of Ophthalmology, Optometry and Visual Science, Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China.
- Faculty of Medicine, Macau University of Science and Technology, Taipa, Macau, China.
| | - Yulong Li
- State Key Laboratory of Membrane Biology, School of Life Sciences, Peking University, Beijing, China
| | - Xiaohong Cai
- Department of Pediatrics, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China.
| | - Jia Qu
- The Eye and Brain Center, State Key Laboratory of Ophthalmology, Optometry and Visual Science, Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China.
- Oujiang Laboratory (Zhejiang Laboratory for Regenerative Medicine, Vision and Brain Health), School of Ophthalmology & Optometry and Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China.
| | - Jiang-Fan Chen
- The Eye and Brain Center, State Key Laboratory of Ophthalmology, Optometry and Visual Science, Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China.
- Oujiang Laboratory (Zhejiang Laboratory for Regenerative Medicine, Vision and Brain Health), School of Ophthalmology & Optometry and Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China.
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Niu Y, Cheng Y, Miao Z, Xu J, Jiang H, Yan J. Inhibitory neuron map of sevoflurane induced neurotoxicity model in young primates. Front Cell Neurosci 2023; 17:1252782. [PMID: 38026701 PMCID: PMC10643782 DOI: 10.3389/fncel.2023.1252782] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Accepted: 10/16/2023] [Indexed: 12/01/2023] Open
Abstract
Introduction Sevoflurane, one of the most commonly used anesthetic agents in children, may induce neuronal dysfunction and cognitive impairment. Exposure to sevoflurane might induce an imbalance between neural excitation and inhibition which could be a mechanism behind anesthesia-induced cognitive and affective dysfunctions. However, the underlying mechanisms remain unclear. Methods In this study, we used two rhesus macaques in the control group, and one rhesus macaques in the anesthesia group. We employed single-nucleus RNA sequencing (snRNA-seq) technology to explore alterations in distinct types of inhibitory neurons involved in the long-term cognitive impairment caused by sevoflurane in young macaques. Results Following sevoflurane treatment, an upregulation was observed in the SST+ inhibitory neuron in the LHX6+ neighborhood in the hippocampus of rhesus macaques. This alteration might impact brain development by influencing interneuron migration and maturation. Additionally, we proposed a novel classification of inhibitory neurons, defined by CNR1 and LHX6 applicable to both humans and macaques. Discussion Our study proposed a novel classification of inhibitory neurons defined by LHX6 and CNR1, relevant in macaques and humans. We also provide evidence that sevoflurane upregulated the SST+ inhibitory neuron in the LHX6+ neighborhood in the hippocampus of rhesus macaques, which may underlie the potential neurotoxic effects induced by general anesthetics. Our results also offer a more reliable approach for studying the structure and function of the human brain.
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Affiliation(s)
| | | | | | | | | | - Jia Yan
- Department of Anesthesiology, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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