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Bresser T, Blanken TF, de Lange SC, Leerssen J, Foster-Dingley JC, Lakbila-Kamal O, Wassing R, Ramautar JR, Stoffers D, van de Heuvel MP, van Someren EJW. Insomnia subtypes have differentiating deviations in brain structural connectivity. Biol Psychiatry 2024:S0006-3223(24)01418-5. [PMID: 38944140 DOI: 10.1016/j.biopsych.2024.06.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Revised: 06/10/2024] [Accepted: 06/18/2024] [Indexed: 07/01/2024]
Abstract
OBJECTIVE Insomnia disorder is the most common sleep disorder. A better understanding of insomnia-related deviations in the brain could inspire better treatment. Insufficiently recognized heterogeneity within the insomnia population could obscure detection of involved brain circuits. The present study investigated whether structural brain connectivity deviations differ between recently discovered and validated insomnia subtypes. METHODS Structural and diffusion weighted 3-Tesla MRI data of four independent studies were harmonized. The sample consisted of 73 controls without sleep complaints and 204 participants with insomnia grouped into five subtypes based on their fingerprint of mood and personality traits assessed with the Insomnia Type Questionnaire. Linear regression correcting for age and sex evaluated group differences in structural connectivity strength, indicated by fractional anisotropy, streamline volume density and mean diffusivity, and evaluated within three different atlases. RESULTS Insomnia subtypes showed differentiating profiles of deviating structural connectivity which concentrated in different functional networks. Permutation testing against randomly drawn heterogeneous subsamples indicated significant specificity of deviation profiles in four of the five subtypes: highly distressed, moderately distressed reward sensitive, slightly distressed low reactive and slightly distressed high reactive. Connectivity deviation profile significance ranged from p= 0.001 to p=0.049 for different resolutions of brain parcellation and connectivity weight. CONCLUSIONS Our results provide a first indication that different insomnia subtypes exhibit distinct profiles of deviations in structural brain connectivity. Subtyping of insomnia could be essential for a better understanding of brain mechanisms that contribute to insomnia vulnerability.
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Affiliation(s)
- Tom Bresser
- Netherlands Institute for Neuroscience, Department of Sleep and Cognition, Amsterdam, Netherlands,; Vrije Universiteit Amsterdam, Department of Integrative Neurophysiology, Amsterdam, Netherlands; Department of Complex Trait Genetics, Center for Neurogenomics and Cognitive Research, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.
| | - Tessa F Blanken
- Netherlands Institute for Neuroscience, Department of Sleep and Cognition, Amsterdam, Netherlands,; University of Amsterdam, Department of Psychological Methods, Amsterdam, Netherlands
| | - Siemon C de Lange
- Netherlands Institute for Neuroscience, Department of Sleep and Cognition, Amsterdam, Netherlands,; Department of Complex Trait Genetics, Center for Neurogenomics and Cognitive Research, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Jeanne Leerssen
- Netherlands Institute for Neuroscience, Department of Sleep and Cognition, Amsterdam, Netherlands
| | - Jessica C Foster-Dingley
- Netherlands Institute for Neuroscience, Department of Sleep and Cognition, Amsterdam, Netherlands
| | - Oti Lakbila-Kamal
- Netherlands Institute for Neuroscience, Department of Sleep and Cognition, Amsterdam, Netherlands,; Vrije Universiteit Amsterdam, Department of Integrative Neurophysiology, Amsterdam, Netherlands; Department of Psychiatry, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands
| | - Rick Wassing
- Netherlands Institute for Neuroscience, Department of Sleep and Cognition, Amsterdam, Netherlands,; Woolcock Institute and School of Psychological Sciences, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, NSW, Australia; Sydney Local Health District, Sydney, NSW, Australia
| | - Jennifer R Ramautar
- Netherlands Institute for Neuroscience, Department of Sleep and Cognition, Amsterdam, Netherlands,; N=You Neurodevelopmental Precision Center, Amsterdam Neuroscience, Amsterdam Reproduction and Development, Amsterdam UMC, Amsterdam, The Netherlands; Child and Adolescent Psychiatry and Psychosocial Care, Emma Children's Hospital, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Diederick Stoffers
- Netherlands Institute for Neuroscience, Department of Sleep and Cognition, Amsterdam, Netherlands,; Spinoza Centre for Neuroimaging, Amsterdam, The Netherlands
| | - Martijn P van de Heuvel
- Department of Complex Trait Genetics, Center for Neurogenomics and Cognitive Research, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands; Department of Child and Adolescent Psychiatry and Psychology, Amsterdam UMC location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Eus J W van Someren
- Netherlands Institute for Neuroscience, Department of Sleep and Cognition, Amsterdam, Netherlands,; Vrije Universiteit Amsterdam, Department of Integrative Neurophysiology, Amsterdam, Netherlands; Department of Psychiatry, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands
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Schwerthöffer D, Förstl H. [Insomniac symptoms and suicidality-link and management]. NEUROPSYCHIATRIE : KLINIK, DIAGNOSTIK, THERAPIE UND REHABILITATION : ORGAN DER GESELLSCHAFT OSTERREICHISCHER NERVENARZTE UND PSYCHIATER 2024; 38:53-61. [PMID: 37171521 PMCID: PMC11143018 DOI: 10.1007/s40211-023-00466-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Accepted: 04/01/2023] [Indexed: 05/13/2023]
Abstract
BACKGROUND A link between insomniac symptoms and suicidality has long been suspected and deserves specific attention. OBJECTIVE We examine the current evidence for this relationship from epidemiology and neurobiology in order to propose a targeted management. MATERIAL AND METHOD Clinical example and selective Medline-literature research for insomnia symptoms and suicidality. RESULTS Epidemiological data and statistical analysis show that symptoms of insomnia are independent risk factors for suicidality. Neurobiological factors associated with combined insomnia symptoms and suicidality are: serotonergic dysfunction and circadian rhythm disorder leading to hypofrontality with reduced problem solving capacity and impaired emotional and impulse-control. Social isolation, recurrent rumination, comorbid psychiatric disorders, access to potentially lethal drugs or weapons need urgent evaluation in patients with a combination of suicidality and symptoms of insomnia. CONCLUSION patients with insomnia and further risk factors for suicide need to be treated resolutely and at an early stage. Modern sleep-promoting antidepressants with low toxicity and antipsychotics must be preferred in the treatment of patients with insomniac sleep disorders and suicidality. Multimodal anti-insomnia and anti-depressive therapy adapted to the circadian rhythm can exert a favorable influence both on depressive-suicidal and insomnia symptoms and their inherent risks.
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Affiliation(s)
- Dirk Schwerthöffer
- Klinik und Poliklinik für Psychiatrie und Psychotherapie, TU-München, Ismaningerstraße 22, 81675, München, Deutschland.
| | - Hans Förstl
- Klinik und Poliklinik für Psychiatrie und Psychotherapie, TU-München, Ismaningerstraße 22, 81675, München, Deutschland
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3
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Hu YX, Shi JY, Xia GY, Liu LF, Li PF, Shan Q, Wang YM. Analysis of functional connectivity changes in attention networks and default mode networks in patients with depression and insomnia. Sleep Breath 2024:10.1007/s11325-024-03064-7. [PMID: 38772968 DOI: 10.1007/s11325-024-03064-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2024] [Revised: 04/22/2024] [Accepted: 05/15/2024] [Indexed: 05/23/2024]
Abstract
PURPOSE Major Depressive Disorder (MDD) and Insomnia Disorder (ID) are prevalent psychiatric conditions often occurring concurrently, leading to substantial impairment in daily functioning. Understanding the neurobiological underpinnings of these disorders and their comorbidity is crucial for developing effective interventions. This study aims to analyze changes in functional connectivity within attention networks and default mode networks in patients with depression and insomnia. METHODS The functional connectivity alterations in individuals with MDD, ID, comorbid MDD and insomnia (iMDD), and healthy controls (HC) were assessed from a cohort of 174 participants. They underwent rs-fMRI scans, demographic assessments, and scale evaluations for depression and sleep quality. Functional connectivity analysis was conducted using region-of-interest (ROI) and whole-brain methods. RESULTS The MDD and iMDD groups exhibited higher Hamilton Depression Scale (HAMD) scores compared to HC and ID groups (P < 0.001). Both ID and MDD groups displayed enhanced connectivity between the left and right orbital frontal cortex compared to HC (P < 0.05), while the iMDD group showed reduced connectivity compared to HC and ID groups (P < 0.05). In the left insula, reduced connectivity with the right medial superior frontal gyrus was observed across patient groups compared to HC (P < 0.05), with the iMDD group showing increased connectivity compared to MDD (P < 0.05). Moreover, alterations in functional connectivity between the left thalamus and left temporal pole were found in iMDD compared to HC and MDD (P < 0.05). Correlation analyses revealed associations between abnormal connectivity and symptom severity in MDD and ID groups. CONCLUSIONS Our findings demonstrate distinct patterns of altered functional connectivity in individuals with MDD, ID, and iMDD compared to healthy controls. These findings contribute to a better understanding of the pathophysiology of depression and insomnia, which could be used as a reference for the diagnosis and treatments of these patients.
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Affiliation(s)
- Yong-Xue Hu
- Guizhou Medical University, Guiyang, 550004, Guizhou, China.
- Department of Psychology, The Affiliated Hospital of Guizhou Medical University, Guiyang, 550004, Guizhou, China.
| | - Jing-Yu Shi
- Department of Neurology, The First Affiliated Hospital of Guizhou University of Traditional Chinese Medicine, Guiyang, 550004, Guizhou, China
| | - Guang-Yuan Xia
- Department of Psychology, The Affiliated Hospital of Guizhou Medical University, Guiyang, 550004, Guizhou, China
| | - Long-Fei Liu
- Guizhou Medical University, Guiyang, 550004, Guizhou, China
- Department of Psychology, The Affiliated Hospital of Guizhou Medical University, Guiyang, 550004, Guizhou, China
| | - Pei-Fan Li
- Department of Psychology, The Affiliated Hospital of Guizhou Medical University, Guiyang, 550004, Guizhou, China
| | - Qing Shan
- Department of Psychology, The Affiliated Hospital of Guizhou Medical University, Guiyang, 550004, Guizhou, China
| | - Yi-Ming Wang
- Department of Psychology, The Affiliated Hospital of Guizhou Medical University, Guiyang, 550004, Guizhou, China.
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Liu X, Zhao X, Shao Z, Guo Y, Yue L, Liu J, Yu D, Sheng X, Zhu Y, Yuan K. Dual roles of the amygdala-hippocampus circuit in the regulation of rapid eye movement sleep and depression symptoms by repetitive transcranial magnetic stimulation in patients with insomnia. Gen Psychiatr 2024; 37:e101183. [PMID: 38650921 PMCID: PMC11033640 DOI: 10.1136/gpsych-2023-101183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Accepted: 01/22/2024] [Indexed: 04/25/2024] Open
Affiliation(s)
- Xiaoyang Liu
- School of Life Science and Technology, Xidian University, Xi'an, Shaanxi, China
| | - Xumeng Zhao
- Department of Psychosomatic Medicine, The Second Hospital of Hebei Medical University, Shijiazhuang, Hebei, China
| | - Ziqiang Shao
- School of Life Science and Technology, Xidian University, Xi'an, Shaanxi, China
| | - Yongjian Guo
- School of Life Science and Technology, Xidian University, Xi'an, Shaanxi, China
| | - Lirong Yue
- School of Life Science and Technology, Xidian University, Xi'an, Shaanxi, China
| | - Jiayi Liu
- Department of Psychosomatic Medicine, The Second Hospital of Hebei Medical University, Shijiazhuang, Hebei, China
| | - Dahua Yu
- Inner Mongolia University of Science and Technology, Baotou, Inner Mongolia, China
| | - Xiaona Sheng
- Department of Psychosomatic Medicine, The Second Hospital of Hebei Medical University, Shijiazhuang, Hebei, China
| | - Yifei Zhu
- Department of Psychosomatic Medicine, The Second Hospital of Hebei Medical University, Shijiazhuang, Hebei, China
| | - Kai Yuan
- School of Life Science and Technology, Xidian University, Xi'an, Shaanxi, China
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Wang Y, Tian Y, Long Z, Dong D, He Q, Qiu J, Feng T, Chen H, Tahmasian M, Lei X. Volume of the Dentate Gyrus/CA4 Hippocampal subfield mediates the interplay between sleep quality and depressive symptoms. Int J Clin Health Psychol 2024; 24:100432. [PMID: 38269356 PMCID: PMC10806754 DOI: 10.1016/j.ijchp.2023.100432] [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: 09/12/2023] [Revised: 12/18/2023] [Accepted: 12/19/2023] [Indexed: 01/26/2024] Open
Abstract
Background Emerging evidence increasingly suggests that poor sleep quality is associated with depressive symptoms. The hippocampus might play a crucial role in the interplay between sleep disturbance and depressive symptomatology, e.g., hippocampal atrophy is typically seen in both insomnia disorder and depression. Thus, examining the role of hippocampal volume in the interplay between poor sleep quality and depressive symptoms in large healthy populations is vital. Methods We investigated the association between self-reported sleep quality, depressive symptoms, and hippocampal total and subfields' volumes in 1603 healthy young adults from the Behavioral Brain Research Project. Mediation analysis explored the mediating role of hippocampal volumes between sleep quality and depressive symptoms. Results Self-reported sleep quality and depressive symptoms were positively correlated. In addition, it negatively related to three hippocampal subfields but not total hippocampal volume. In particular, hippocampal subfield DG and CA4 volumes mediated the interrelationship between poor sleep quality and depressive symptoms. Conclusions Our findings improved the current understanding of the relationship between sleep disturbance, depressive symptomatology, and hippocampal subfields in healthy populations. Considering the crucial role of DG in hippocampal neurogenesis, our results suggest that poor sleep quality may contribute to depression through a reduction of DG volume leading to impaired neurogenesis which is crucial for the regulation of mood.
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Affiliation(s)
- Yulin Wang
- Sleep and NeuroImaging Center, Faculty of psychology, Southwest University, Chongqing, China
- Key Laboratory of Cognition and Personality, Ministry of Education, Faculty of Psychology, Southwest University, Chongqing, China
| | - Yun Tian
- Sleep and NeuroImaging Center, Faculty of psychology, Southwest University, Chongqing, China
- Key Laboratory of Cognition and Personality, Ministry of Education, Faculty of Psychology, Southwest University, Chongqing, China
| | - Zhiliang Long
- Sleep and NeuroImaging Center, Faculty of psychology, Southwest University, Chongqing, China
- Key Laboratory of Cognition and Personality, Ministry of Education, Faculty of Psychology, Southwest University, Chongqing, China
| | - Debo Dong
- Key Laboratory of Cognition and Personality, Ministry of Education, Faculty of Psychology, Southwest University, Chongqing, China
- Institute of Neuroscience and Medicine, Brain & Behaviour (INM-7), Research Centre Jülich, Jülich, Germany
| | - Qinghua He
- Key Laboratory of Cognition and Personality, Ministry of Education, Faculty of Psychology, Southwest University, Chongqing, China
| | - Jiang Qiu
- Key Laboratory of Cognition and Personality, Ministry of Education, Faculty of Psychology, Southwest University, Chongqing, China
| | - Tingyong Feng
- Key Laboratory of Cognition and Personality, Ministry of Education, Faculty of Psychology, Southwest University, Chongqing, China
| | - Hong Chen
- Key Laboratory of Cognition and Personality, Ministry of Education, Faculty of Psychology, Southwest University, Chongqing, China
| | - Masoud Tahmasian
- Institute of Neuroscience and Medicine, Brain & Behaviour (INM-7), Research Centre Jülich, Jülich, Germany
- Institute for Systems Neuroscience, Medical Faculty, Heinrich-Heine-Universität Düsseldorf, Düsseldorf, Germany
- Department of Nuclear Medicine, University Hospital and Medical Faculty, University of Cologne, Cologne, Germany
| | - Xu Lei
- Sleep and NeuroImaging Center, Faculty of psychology, Southwest University, Chongqing, China
- Key Laboratory of Cognition and Personality, Ministry of Education, Faculty of Psychology, Southwest University, Chongqing, China
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6
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Zhou HB, Lu SZ, Yu ZS, Zhang JL, Mei ZN. Mechanisms for the biological activity of Gastrodia elata Blume and its constituents: A comprehensive review on sedative-hypnotic, and antidepressant properties. PHYTOMEDICINE : INTERNATIONAL JOURNAL OF PHYTOTHERAPY AND PHYTOPHARMACOLOGY 2024; 123:155251. [PMID: 38056151 DOI: 10.1016/j.phymed.2023.155251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Revised: 11/15/2023] [Accepted: 11/27/2023] [Indexed: 12/08/2023]
Abstract
BACKGROUND Insomnia and depressive disorder are two common symptoms with a reciprocal causal relationship in clinical practice, which are usually manifested in comorbid form. Several medications have been widely used in the treatment of insomnia and depression, but most of these drugs show non-negligible side effects. Currently, many treatments are indicated for insomnia and depressive symptom, including Chinese herbal medicine such as Gastrodia elata Blume (G. elata), which has excellent sedative-hypnotic and antidepressant effects in clinical and animal studies. PURPOSE To summarize the mechanisms of insomnia and depression and the structure-activity mechanism for G. elata to alleviate these symptoms, particularly by hypothalamic-pituitary-adrenal (HPA) axis and intestinal flora, aiming to discover new approaches for the treatment of insomnia and depression. METHODS The following electronic databases were searched from the beginning to November 2023: PubMed, Web of Science, Google Scholar, Wanfang Database, and CNKI. The following keywords of G. elata were used truncated with other relevant topic terms, such as depression, insomnia, antidepressant, sedative-hypnotic, neuroprotection, application, safety, and toxicity. RESULTS Natural compounds derived from G. elata could alleviate insomnia and depressive disorder, which is involved in monoamine neurotransmitters, inflammatory response, oxidative stress, and gut microbes, etc. Several clinical trials showed that G. elata-derived natural compounds that treat depression and insomnia have significant and safe therapeutic effects, but further well-designed clinical and toxicological studies are needed. CONCLUSION G. elata exerts a critical role in treating depression and insomnia due to its multi-targeting properties and fewer side effects. However, more clinical and toxicological studies should be performed to further explore the sedative-hypnotic and antidepressant mechanisms of G. elata and provide more evidence and recommendations for its clinical application. Our review provides an overview of G. elata treating insomnia with depression for future research direction.
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Affiliation(s)
- Hai-Bo Zhou
- College of Food Science and Technology, Huazhong Agricultural University, No.1, Shizishan Street, Hongshan District, Wuhan, Hubei Province 430070, China
| | - Sheng-Ze Lu
- College of Food Science and Technology, Huazhong Agricultural University, No.1, Shizishan Street, Hongshan District, Wuhan, Hubei Province 430070, China
| | - Zhong-Shun Yu
- College of Food Science and Technology, Huazhong Agricultural University, No.1, Shizishan Street, Hongshan District, Wuhan, Hubei Province 430070, China
| | - Jiu-Liang Zhang
- College of Food Science and Technology, Huazhong Agricultural University, No.1, Shizishan Street, Hongshan District, Wuhan, Hubei Province 430070, China; Key Laboratory of Environment Correlative Dietology, Ministry of Education, Wuhan, 430070, China.
| | - Zhi-Nan Mei
- College of Plant Science & Technology, Huazhong Agricultural University, Wuhan, 430070, China.
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Reimann GM, Küppers V, Camilleri JA, Hoffstaedter F, Langner R, Laird AR, Fox PT, Spiegelhalder K, Eickhoff SB, Tahmasian M. Convergent abnormality in the subgenual anterior cingulate cortex in insomnia disorder: A revisited neuroimaging meta-analysis of 39 studies. Sleep Med Rev 2023; 71:101821. [PMID: 37481961 DOI: 10.1016/j.smrv.2023.101821] [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: 06/29/2022] [Revised: 07/13/2023] [Accepted: 07/13/2023] [Indexed: 07/25/2023]
Abstract
The neurobiological underpinnings of insomnia disorder (ID) are still poorly understood. A previous meta-analysis conducted by our research group in 2018 revealed no consistent regional alterations based on the limited number of eligible studies. Given the number of studies published during the last few years, we revisited the meta-analysis to provide an update to the field. Following the best-practice guidelines for conducting neuroimaging meta-analyses, we searched several databases (PubMed, Web of Science, and BrainMap) and identified 39 eligible structural and functional studies, reporting coordinates reflecting significant group differences between ID patients and healthy controls. A significant convergent regional alteration in the subgenual anterior cingulate cortex (sgACC) was observed using the activation likelihood estimation algorithm. Behavioural decoding using the BrainMap database indicated that this region is involved in fear-related emotional and cognitive processing. The sgACC showed robust task-based co-activation in meta-analytic connectivity modelling and task-free functional connectivity in a resting-state functional connectivity analysis with the main hubs of the salience and default mode networks, including the posterior cingulate cortex and dorsal ACC, amygdala, hippocampus, and medial prefrontal cortex. Collectively, the findings from this large-scale meta-analysis suggest a critical role of the sgACC in the pathophysiology of ID.
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Affiliation(s)
- Gerion M Reimann
- Institute of Neuroscience and Medicine, Brain and Behaviour (INM-7), Research Centre Jülich, Jülich, Germany
| | - Vincent Küppers
- Institute of Neuroscience and Medicine, Brain and Behaviour (INM-7), Research Centre Jülich, Jülich, Germany; Department of Nuclear Medicine, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Julia A Camilleri
- Institute of Neuroscience and Medicine, Brain and Behaviour (INM-7), Research Centre Jülich, Jülich, Germany; Institute of Systems Neuroscience, Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Felix Hoffstaedter
- Institute of Neuroscience and Medicine, Brain and Behaviour (INM-7), Research Centre Jülich, Jülich, Germany; Institute of Systems Neuroscience, Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Robert Langner
- Institute of Neuroscience and Medicine, Brain and Behaviour (INM-7), Research Centre Jülich, Jülich, Germany; Institute of Systems Neuroscience, Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Angela R Laird
- Department of Physics, Florida International University, Miami, FL, USA
| | - Peter T Fox
- Research Imaging Institute, University of Texas Health Science Centre, San Antonio, TX, USA; South Texas Veterans Health Care System, San Antonio, TX, USA
| | - Kai Spiegelhalder
- Department of Psychiatry and Psychotherapy, Medical Centre, University of Freiburg - Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Simon B Eickhoff
- Institute of Neuroscience and Medicine, Brain and Behaviour (INM-7), Research Centre Jülich, Jülich, Germany; Institute of Systems Neuroscience, Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Masoud Tahmasian
- Institute of Neuroscience and Medicine, Brain and Behaviour (INM-7), Research Centre Jülich, Jülich, Germany; Institute of Systems Neuroscience, Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany.
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8
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Bresser T, Leerssen J, Hölsken S, Groote I, Foster-Dingley JC, van den Heuvel MP, Van Someren EJW. The role of brain white matter in depression resilience and response to sleep interventions. Brain Commun 2023; 5:fcad210. [PMID: 37554956 PMCID: PMC10406158 DOI: 10.1093/braincomms/fcad210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Revised: 06/28/2023] [Accepted: 07/31/2023] [Indexed: 08/10/2023] Open
Abstract
Insomnia poses a high risk for depression. Brain mechanisms of sleep and mood improvement following cognitive behavioural therapy for insomnia remain elusive. This longitudinal study evaluated whether (i) individual differences in baseline brain white matter microstructure predict improvements and (ii) intervention affects brain white matter microstructure. People meeting the Diagnostic and Statistical Manual of Mental Disorders-5 criteria for Insomnia Disorder (n = 117) participated in a randomized controlled trial comparing 6 weeks of no treatment with therapist-guided digital cognitive behavioural therapy for insomnia, circadian rhythm support or their combination (cognitive behavioural therapy for insomnia + circadian rhythm support). Insomnia Severity Index and Inventory of Depressive Symptomatology-Self Report were assessed at baseline and followed up at Weeks 7, 26, 39 and 52. Diffusion-weighted magnetic resonance images were acquired at baseline and Week 7. Skeletonized white matter tracts, fractional anisotropy and mean diffusivity were quantified both tract-wise and voxel-wise using tract-based spatial statistics. Analyses used linear and mixed effect models while correcting for multiple testing using false discovery rate and Bonferroni for correlated endpoint measures. Our results show the following: (i) tract-wise lower fractional anisotropy in the left retrolenticular part of the internal capsule at baseline predicted both worse progression of depressive symptoms in untreated participants and more improvement in treated participants (fractional anisotropy × any intervention, PFDR = 0.053, Pcorr = 0.045). (ii) Only the cognitive behavioural therapy for insomnia + circadian rhythm support intervention induced a trend-level mean diffusivity decrease in the right superior corona radiata (PFDR = 0.128, Pcorr = 0.108), and individuals with a stronger mean diffusivity decrease showed a stronger alleviation of insomnia (R = 0.20, P = 0.035). In summary, individual differences in risk and treatment-supported resilience of depression involve white matter microstructure. Future studies could target the role of the left retrolenticular part of the internal capsule and right superior corona radiata and the brain areas they connect.
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Affiliation(s)
- Tom Bresser
- Department of Sleep and Cognition, Netherlands Institute for Neuroscience, 1105 BA, Amsterdam, The Netherlands
- Department of Integrative Neurophysiology, Center for Neurogenomics and Cognitive Research (CNCR), Amsterdam Neuroscience, Vrije Universtiteit Amsterdam, 1081 HV, Amsterdam, The Netherlands
- Department of Clinical Genetics, Amsterdam Neuroscience, VU University Medical Center, 1081 HV, Amsterdam, The Netherlands
| | - Jeanne Leerssen
- Department of Sleep and Cognition, Netherlands Institute for Neuroscience, 1105 BA, Amsterdam, The Netherlands
- Department of Integrative Neurophysiology, Center for Neurogenomics and Cognitive Research (CNCR), Amsterdam Neuroscience, Vrije Universtiteit Amsterdam, 1081 HV, Amsterdam, The Netherlands
| | - Stefanie Hölsken
- Department of Sleep and Cognition, Netherlands Institute for Neuroscience, 1105 BA, Amsterdam, The Netherlands
- Institute of Medical Psychology and Behavioral Immunobiology, University Hospital Essen, University of Duisburg Essen, 45122, Essen, Germany
| | - Inge Groote
- Computational Radiology and Artificial Intelligence (CRAI), Division of Radiology and Nuclear Medicine, Oslo University Hospital, 0372, Oslo, Norway
- Department of Radiology, Vestfold Hospital Trust, 3116, Tønsberg, Norway
| | - Jessica C Foster-Dingley
- Department of Sleep and Cognition, Netherlands Institute for Neuroscience, 1105 BA, Amsterdam, The Netherlands
| | - Martijn P van den Heuvel
- Department of Clinical Genetics, Amsterdam Neuroscience, VU University Medical Center, 1081 HV, Amsterdam, The Netherlands
| | - Eus J W Van Someren
- Department of Sleep and Cognition, Netherlands Institute for Neuroscience, 1105 BA, Amsterdam, The Netherlands
- Department of Integrative Neurophysiology, Center for Neurogenomics and Cognitive Research (CNCR), Amsterdam Neuroscience, Vrije Universtiteit Amsterdam, 1081 HV, Amsterdam, The Netherlands
- Department of Psychiatry, Vrije Universtiteit Amsterdam, Amsterdam UMC, 1081 HV, Amsterdam, The Netherlands
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9
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Ghermezian A, Nami M, Shalbaf R, Khosrowabadi R, Nasehi M, Kamali AM. Sleep Micro-Macro-structures in Psychophysiological Insomnia. PSG Study. SLEEP AND VIGILANCE 2023; 7:1-9. [PMID: 37361911 PMCID: PMC10106013 DOI: 10.1007/s41782-023-00228-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/15/2022] [Revised: 02/24/2023] [Accepted: 04/03/2023] [Indexed: 06/28/2023]
Abstract
Study Objectives To address sleep micro-macro-structures in psychophysiological insomnia (PPI) as denoted by cyclic alternating pattern (CAP), Sleep spindles, and hyperarousal as microstructures and sleep characteristics such as sleep stages' variables, and heart rate as macrostructures. Methods Two statistical populations, with 20 participants in each, are addressed: good sleepers (GS) and patients with psychophysiological insomnia (PPI). The sleep polysomnography (PSG) for one night was performed and sleep macro-micro-structures extraction was implemented for each participant. Cyclic alternating patterns were scored manually and other structures were monitored by the original PSG's device software. Analytical methods are used to dissect the results. Result The findings imply: (a) psychophysiological insomnia is characterized by CAP differences from good sleepers which are associated with hyperarousal; (b) Regarding microstructure, more microarousals in sleep stages caused more number of wake index. (c) The ratio of sleep stages, sleep latency and heart rate as sleep macrostructure are significantly changed. (d) There is no significant difference between PPI and GS groups on spindles length in our research. Conclusion Regarding all sleep disorders and especially PPI, CAP variables, EEG arousals, and sleep spindles as microstructures and Total Sleep Time, Sleep Latency, number of waking, REM duration, and Heart Rate as macrostructures were found to be critical for the diagnosis of psychophysiological insomnia The analysis contributes to understanding better approaches in the quantitative specification of psychophysiological insomnia compare to good sleepers.
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Affiliation(s)
- Ali Ghermezian
- Shahid Beheshti University, Shahid Shahriari Square, Evin, Tehran, Iran
- Department of Cognitive Neuroscience, Institute for Cognitive Science Studies, Tehran, Iran
- Dana Brain Health Institute, Shiraz, Iran
| | - Mohammad Nami
- Brain, Cognition, and Behavior Unit at Dana Brain Health Institute, Shiraz, Iran
- Harvard Alumni for Mental Health dataset, Middle-East Ambassador, Dubai, UAE
- Iranian Academy of Neuroscience, Fars Chapter, Shiraz, Iran
- Society for Brain Mapping and Therapeutics, Brain Mapping Foundation, Los Angeles, CA USA
| | - Reza Shalbaf
- Department of Cognitive Neuroscience, Institute for Cognitive Science Studies, Tehran, Iran
| | - Reza Khosrowabadi
- Shahid Beheshti University, Shahid Shahriari Square, Evin, Tehran, Iran
| | - Mohammad Nasehi
- Department of Cognitive Neuroscience, Institute for Cognitive Science Studies, Tehran, Iran
- Cognitive and Neuroscience research center(cnrc), Tehran Medical Sciences, Islamic Azad University, Tehran, Iran
| | - Ali-Mohammad Kamali
- Department of Neuroscience, School of Advanced Medical Sciences and Technologies, Shiraz University of Medical Sciences, Shiraz, Iran
- Dana Brain Health Institute, Shiraz, Iran
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10
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Lin WC, Winkelman JW. Insomnia and treatment-resistant depression. PROGRESS IN BRAIN RESEARCH 2023; 281:115-129. [PMID: 37806712 DOI: 10.1016/bs.pbr.2023.01.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/09/2023]
Abstract
Depression and sleep disturbance are related closely with bidirectional relationship. The heterogenic diagnostic criteria of major depressive disorder composed by the myriad combination of symptoms including sleep disturbance. Insomnia is an identifiable risk factor for depression and the treatment of insomnia might be able to prevent subsequent major depressive episodes which draws psychiatrists' attention to the interface of psychiatry and sleep medicine field. It is important to identify occult sleep disturbance in patients with treatment-resistant depression to improve treatment outcome. New tools to objectively measure sleep at home environment represent a great march in clinical care and research modalities but need further validation before they can be applying widespread at sleep and depression intersection. Careful evaluation and measurement of the phenotype and nature of sleep disturbance will continue to advance understanding of the biological bases of psychiatric disorders and the connections with sleep.
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Affiliation(s)
- Wei-Chen Lin
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan; Division of Psychiatry, School of Medicine, National Yang-Ming Chiao-Tung University, Taipei, Taiwan; Institute of Brain Science, National Yang-Ming Chiao-Tung University, Taipei, Taiwan.
| | - John Weyl Winkelman
- Sleep Medicine, Department of Psychiatry, Massachusetts General Hospital, Boston, MA, United States; Sleep Disorders Clinical Research Program, Department of Psychiatry, Massachusetts General Hospital, Boston, MA, United States; Harvard Medical School, Departments of Psychiatry and Neurology, Massachusetts General Hospital, Boston, MA, United States
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11
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Ye Y, Wang C, Lan X, Li W, Fu L, Zhang F, Liu H, Zhang Z, Wu K, Zhou Y, Ning Y. Abnormal amygdala functional connectivity in MDD patients with insomnia complaints. Psychiatry Res Neuroimaging 2023; 328:111578. [PMID: 36525761 DOI: 10.1016/j.pscychresns.2022.111578] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Revised: 08/30/2022] [Accepted: 11/22/2022] [Indexed: 12/02/2022]
Abstract
BACKGROUND Insomnia is one of the major symptom relevant factors in major depressive disorder (MDD), but the neurological mechanisms underlying the multiple effect between insomnia and depression have not been well interpreted. This study aimed at exploring the potential mechanisms between insomnia and depression based on amygdala-based resting-state functional connectivity (RSFC). METHODS In total 56 MDD patients with low insomnia (MDD-LI) patients, 46 MDD patients with high insomnia (MDD-HI) patients, and 57 healthy controls (HCs) were employed and underwent a resting-state functional magnetic resonance imaging (fMRI) scan. ANOVA test was performed on RSFC value for three groups. Correlation analysis was conducted to evaluate the relationship between abnormal RSFC values and clinical features. RESULTS We found that MDD-HI mainly showed increased RSFC in (bilateral superior temporal gyrus (STG), and decreased RSFC in left supplementary motor area (SMA) and bilateral postcentral gyrus (PoCG) compared with MDD-LI. Correlation analysis indicated that RSFC of the bilateral amygdala with STG were positively associated with the sleep disturbance score and adjust HAMD score. CONCLUSION Our findings suggest that RSFC in temporal lobe and other specifically activated regions may be associated with neural circuits involved with insomnia in MDD. These provide new evidence for understanding the potential mechanisms of major depression and insomnia from the perspective of functional connectivity.
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Affiliation(s)
- Yanxiang Ye
- The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China; Guangdong Engineering Technology Research Center for Translational Medicine of Metal Disorders, Guangzhou, China
| | - Chengyu Wang
- The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China; Guangdong Engineering Technology Research Center for Translational Medicine of Metal Disorders, Guangzhou, China
| | - Xiaofeng Lan
- The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China; Guangdong Engineering Technology Research Center for Translational Medicine of Metal Disorders, Guangzhou, China
| | - Weicheng Li
- The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China; The First School of Clinical Medicine, Southern Medical University, Guangzhou, China; Guangdong Engineering Technology Research Center for Translational Medicine of Metal Disorders, Guangzhou, China
| | - Ling Fu
- The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China; The First School of Clinical Medicine, Southern Medical University, Guangzhou, China; Guangdong Engineering Technology Research Center for Translational Medicine of Metal Disorders, Guangzhou, China
| | - Fan Zhang
- The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China; The First School of Clinical Medicine, Southern Medical University, Guangzhou, China; Guangdong Engineering Technology Research Center for Translational Medicine of Metal Disorders, Guangzhou, China
| | - Haiyan Liu
- The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China; Guangdong Engineering Technology Research Center for Translational Medicine of Metal Disorders, Guangzhou, China
| | - Zhipei Zhang
- The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China; The First School of Clinical Medicine, Southern Medical University, Guangzhou, China; Guangdong Engineering Technology Research Center for Translational Medicine of Metal Disorders, Guangzhou, China
| | - Kai Wu
- Department of Biomedical Engineering, School of Material Science and Engineering, South China University of Technology
| | - Yanling Zhou
- The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China; Guangdong Engineering Technology Research Center for Translational Medicine of Metal Disorders, Guangzhou, China.
| | - Yuping Ning
- The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China; The First School of Clinical Medicine, Southern Medical University, Guangzhou, China; Guangdong Engineering Technology Research Center for Translational Medicine of Metal Disorders, Guangzhou, China.
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12
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The moderating effect of prefrontal response to sleep-related stimuli on the association between depression and sleep disturbance in insomnia disorder. Sci Rep 2022; 12:17739. [PMID: 36272992 PMCID: PMC9587997 DOI: 10.1038/s41598-022-22652-9] [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: 06/14/2022] [Accepted: 10/18/2022] [Indexed: 01/18/2023] Open
Abstract
We investigated differences in brain activity in response to sleep-related pictures between chronic insomnia disorder (CID) patients and good sleepers (GS), and examined whether brain activity moderated the relationship between depressive symptoms and sleep disturbance in CID patients and GS. This study included 43 patients diagnosed with CID, based on the International Classification of Sleep Disorders-3, and 42 GS. The participants kept a sleep diary, underwent nocturnal polysomnography to measure sleep parameters, and completed self-report questionnaires to assess sleep and psychiatric symptoms. They underwent functional magnetic resonance imaging (fMRI) to examine differences in brain activity in response to sleep-related pictures compared to neutral pictures. A moderated moderation analysis was performed to investigate the moderating role of brain responses to sleep-related pictures in the association between depressive symptoms and sleep disturbance. Compared to GS, the brain responses to sleep-related stimuli were significantly lower in CID patients in the right lateral prefrontal cortex (LPFC) and dorsomedial prefrontal cortex (DMPFC). More severe depressive symptoms were significantly associated with longer sleep latency only when LPFC activity was low in CID patients, but not in GS. LPFC hypoactivity in response to sleep-related stimuli in CID patients could moderate the relationship between depression and sleep disturbance.
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13
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Akbar SA, Mattfeld AT, Laird AR, McMakin DL. Sleep to Internalizing Pathway in Young Adolescents (SIPYA): A proposed neurodevelopmental model. Neurosci Biobehav Rev 2022; 140:104780. [PMID: 35843345 PMCID: PMC10750488 DOI: 10.1016/j.neubiorev.2022.104780] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Revised: 05/28/2022] [Accepted: 07/12/2022] [Indexed: 01/28/2023]
Abstract
The prevalence of internalizing disorders, i.e., anxiety and depressive disorders, spikes in adolescence and has been increasing amongst adolescents despite the existence of evidence-based treatments, highlighting the need for advancing theories on how internalizing disorders emerge. The current review presents a theoretical model, called the Sleep to Internalizing Pathway in Young Adolescents (SIPYA) Model, to explain how risk factors, namely sleep-related problems (SRPs), are prospectively associated with internalizing disorders in adolescence. Specifically, SRPs during late childhood and early adolescence, around the initiation of pubertal development, contribute to the interruption of intrinsic brain networks dynamics, both within the default mode network and between the default mode network and other networks in the brain. This interruption leaves adolescents vulnerable to repetitive negative thought, such as worry or rumination, which then increases vulnerability to internalizing symptoms and disorders later in adolescence. Sleep-related behaviors are observable, modifiable, low-stigma, and beneficial beyond treating internalizing psychopathology, highlighting the intervention potential associated with understanding the neurodevelopmental impact of SRPs around the transition to adolescence. This review details support for the SIPYA Model, as well as gaps in the literature and future directions.
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Affiliation(s)
- Saima A Akbar
- Department of Psychology, Florida International University, Miami, FL, USA.
| | - Aaron T Mattfeld
- Department of Psychology, Florida International University, Miami, FL, USA
| | - Angela R Laird
- Department of Physics, Florida International University, Miami, FL, USA
| | - Dana L McMakin
- Department of Psychology, Florida International University, Miami, FL, USA
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14
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Insomnia and Post-traumatic Stress Disorder: A Meta-analysis on Interrelated Association (n=57,618) and Prevalence (n=573,665). Neurosci Biobehav Rev 2022; 141:104850. [DOI: 10.1016/j.neubiorev.2022.104850] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Revised: 08/27/2022] [Accepted: 08/27/2022] [Indexed: 12/14/2022]
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15
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Chen Z, He Q, Shi Q, Xu Y, Yang H, Wei R. Anxiety and depression in dry eye patients during the COVID-19 pandemic: Mental state investigation and influencing factor analysis. Front Public Health 2022; 10:929909. [PMID: 35968438 PMCID: PMC9372584 DOI: 10.3389/fpubh.2022.929909] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Accepted: 07/12/2022] [Indexed: 11/17/2022] Open
Abstract
Objective Investigate the anxiety and depression states among dry eye (DE) patients during the COVID-19 outbreak and analyze their influence factors. Methods The study was conducted in a tertiary eye hospital in Tianjin, China from March–April 2021. Four hundred twenty-eight DE patients were tested with the Ocular Surface Disease Index, Short Healthy Anxiety Inventory, Hospital Anxiety and Depression Scale, and Pittsburgh Sleep Quality Index. Descriptive statistics was used to assess the difference between DE with depression or anxiety among different groups. And multiple linear regression was used to explore factors that influence anxiety and depression in DE patients. Results The incidence rates of anxiety and depression among DE patients during COVID-19 were 27.34 and 26.87%, respectively. The proportion with comorbid anxiety and depression was 24.30%. Patients' education level (t = −3.001, P < 0.05; t = −3.631, P < 0.05), course of disease (t = 2.341, P < 0.05; t = 2.444, P < 0.05), health anxiety (t = 3.015, P < 0.05; t = 2.731, P < 0.05), and subjective sleep quality (t = 3.610, P < 0.05; t = 4.203, P < 0.05) had certain influences on anxiety and depression. Conclusion The results showed that subjective symptoms of DE patients were related to depression and anxiety. Higher education, shorter disease duration, lower health anxiety levels, and better subjective sleep quality were associated with the reduced depressive and anxiety symptoms in DE patients. These findings could be deemed beneficial to the treatment and prevention of DE during the COVID-19 epidemic.
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Affiliation(s)
- Zhuo Chen
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, China
| | - Qing He
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, China
| | - Qianhui Shi
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, China
| | - Yifan Xu
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, China
| | - Haibo Yang
- Tianjin Social Science Laboratory of Students' Mental Development and Learning, Academy of Psychology and Behavior, Tianjin Normal University, Tianjin, China
- Haibo Yang
| | - Ruihua Wei
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, China
- *Correspondence: Ruihua Wei
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16
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Zhang R, Wiers CE, Manza P, Tomasi D, Shokri-Kojori E, Kerich M, Almira E, Schwandt M, Diazgranados N, Momenan R, Volkow ND. Severity of alcohol use disorder influences sex differences in sleep, mood and brain functional connectivity impairments. Brain Commun 2022; 4:fcac127. [DOI: 10.1093/braincomms/fcac127] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Revised: 03/14/2022] [Accepted: 05/23/2022] [Indexed: 11/13/2022] Open
Abstract
Abstract
Growing evidence suggests greater vulnerability of women than men to the adverse effects of alcohol on mood and sleep. However, the underlying neurobiological mechanisms are still poorly understood.
Here we examined sex difference in resting state functional connectivity in alcohol use disorder using a whole-brain data driven approach and tested for relationships with mood and self-reported sleep. To examine whether sex effects vary by severity of alcohol use disorder, we studied two cohorts: non-treatment seeking n = 141 participants with alcohol use disorder (low severity; 58 females) from the Human Connectome project, and recently detoxified n = 102 treatment seeking participants with alcohol use disorder (high severity; 34 females) at the National Institute on Alcohol Abuse and Alcoholism.
For both cohorts, participants with alcohol use disorder had greater sleep and mood problems than HC, whereas sex by alcohol use effect varied by severity. Non-treatment seeking females with alcohol use disorder showed significant greater impairments in sleep but not mood compared to non-treatment seeking males with alcohol use disorder, whereas treatment-seeking females with alcohol use disorder reported greater negative mood but not sleep than treatment-seeking males with alcohol use disorder. Greater sleep problems in non-treatment seeking females with alcohol use disorder were associated with lower cerebello-parahippocampal functional connectivity, while greater mood problems in treatment-seeking females with alcohol use disorder were associated with lower fronto-occipital functional connectivity during rest.
The current study suggests that changes in resting state functional connectivity may account for sleep and mood impairments in females with alcohol use disorder. The effect of severity on sex differences might reflect neuroadaptive processes with progression of alcohol use disorder and needs to be tested with longitudinal data in the future.
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Affiliation(s)
- Rui Zhang
- Laboratory of Neuroimaging, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, MD 20892-1013, USA
| | - Corinde E. Wiers
- Laboratory of Neuroimaging, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, MD 20892-1013, USA
| | - Peter Manza
- Laboratory of Neuroimaging, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, MD 20892-1013, USA
| | - Dardo Tomasi
- Laboratory of Neuroimaging, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, MD 20892-1013, USA
| | - Ehsan Shokri-Kojori
- Laboratory of Neuroimaging, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, MD 20892-1013, USA
| | - Mike Kerich
- Clinical NeuroImaging Research Core, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, MD 20892-1108, USA
| | - Erika Almira
- Clinical NeuroImaging Research Core, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, MD 20892-1108, USA
| | - Melanie Schwandt
- Office of Clinical Director, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, MD 20892-1108, USA
| | - Nancy Diazgranados
- Office of Clinical Director, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, MD 20892-1108, USA
| | - Reza Momenan
- Clinical NeuroImaging Research Core, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, MD 20892-1108, USA
| | - Nora D. Volkow
- Laboratory of Neuroimaging, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, MD 20892-1013, USA
- National Institute on Drug Abuse, National Institutes of Health, Bethesda, MD 20892-1013, USA
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17
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Yan R, Geng JT, Huang YH, Zou HW, Wang XM, Xia Y, Zhao S, Chen ZL, Zhou H, Chen Y, Yao ZJ, Shi JB, Lu Q. Aberrant functional connectivity in insular subregions in somatic depression: a resting-state fMRI study. BMC Psychiatry 2022; 22:146. [PMID: 35209866 PMCID: PMC8867834 DOI: 10.1186/s12888-022-03795-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2021] [Accepted: 02/17/2022] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Somatic depression (SD) is different from non-somatic depression (NSD), and insular subregions have been associated with somatic symptoms. However, the pattern of damage in the insular subregions in SD remains unclear. The aim of this study was to use functional connectivity (FC) analyses to explore the bilateral ventral anterior insula (vAI), bilateral dorsal anterior insula (dAI), and bilateral posterior insula (PI) brain circuits in SD patients. METHODS The study included 28 SD patients, 30 NSD patients, and 30 matched healthy control (HC) subjects. All participants underwent 3.0 T resting state functional magnetic resonance imaging. FC analyses were used to explore synchronization between insular subregions and the whole brain in the context of depression with somatic symptoms. Pearson correlation analyses were performed to assess relationships between FC values in brain regions showing significant differences and the total and factor scores on the 17-item Hamilton Rating Scale for Depression (HAMD17). RESULTS Compared with the NSD group, the SD group showed significantly decreased FC between the left vAI and the right rectus gyrus, right fusiform gyrus, and right angular gyrus; between the right vAI and the right middle cingulate cortex, right precuneus, and right superior frontal gyrus; between the left dAI and the left fusiform gyrus; and between the right dAI and the left postcentral gyrus. Relative to the NSD group, the SD group exhibited increased FC between the left dAI and the left fusiform gyrus. There were no differences in FC between bilateral PI and any brain regions among the SD, NSD, and HC groups. Within the SD group, FC values between the left vAI and right rectus gyrus were positively correlated with cognitive impairment scores on the HAMD17; FC values between the right vAI and right superior frontal gyrus were positively related to the total scores and cognitive impairment scores on the HAMD17 (p < 0.05, uncorrected). CONCLUSIONS Aberrant FC between the anterior insula and the frontal and limbic cortices may be one possible mechanism underlying SD.
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Affiliation(s)
- Rui Yan
- grid.41156.370000 0001 2314 964XNanjing Brain Hospital, Medical School, Nanjing University, 22 Hankou Road, Nanjing, 210093 China ,grid.89957.3a0000 0000 9255 8984Department of psychiatry, the Affiliated Brain Hospital of Nanjing Medical University, 264 Guangzhou Road, Nanjing, 210029 China
| | - Ji Ting Geng
- grid.89957.3a0000 0000 9255 8984Department of psychiatry, the Affiliated Brain Hospital of Nanjing Medical University, 264 Guangzhou Road, Nanjing, 210029 China ,grid.13402.340000 0004 1759 700XAffiliated Mental Health Center & Hangzhou Seventh People’s Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Ying Hong Huang
- grid.41156.370000 0001 2314 964XNanjing Brain Hospital, Medical School, Nanjing University, 22 Hankou Road, Nanjing, 210093 China ,grid.89957.3a0000 0000 9255 8984Department of psychiatry, the Affiliated Brain Hospital of Nanjing Medical University, 264 Guangzhou Road, Nanjing, 210029 China
| | - Hao Wen Zou
- grid.41156.370000 0001 2314 964XNanjing Brain Hospital, Medical School, Nanjing University, 22 Hankou Road, Nanjing, 210093 China ,grid.89957.3a0000 0000 9255 8984Department of psychiatry, the Affiliated Brain Hospital of Nanjing Medical University, 264 Guangzhou Road, Nanjing, 210029 China
| | - Xu Miao Wang
- grid.89957.3a0000 0000 9255 8984Department of psychiatry, the Affiliated Brain Hospital of Nanjing Medical University, 264 Guangzhou Road, Nanjing, 210029 China
| | - Yi Xia
- grid.89957.3a0000 0000 9255 8984Department of psychiatry, the Affiliated Brain Hospital of Nanjing Medical University, 264 Guangzhou Road, Nanjing, 210029 China
| | - Shuai Zhao
- grid.89957.3a0000 0000 9255 8984Department of psychiatry, the Affiliated Brain Hospital of Nanjing Medical University, 264 Guangzhou Road, Nanjing, 210029 China
| | - Zhi Lu Chen
- grid.89957.3a0000 0000 9255 8984Department of psychiatry, the Affiliated Brain Hospital of Nanjing Medical University, 264 Guangzhou Road, Nanjing, 210029 China
| | - Hongliang Zhou
- grid.89957.3a0000 0000 9255 8984Department of psychiatry, the Affiliated Brain Hospital of Nanjing Medical University, 264 Guangzhou Road, Nanjing, 210029 China
| | - Yu Chen
- grid.89957.3a0000 0000 9255 8984Department of psychiatry, the Affiliated Brain Hospital of Nanjing Medical University, 264 Guangzhou Road, Nanjing, 210029 China
| | - Zhi Jian Yao
- Nanjing Brain Hospital, Medical School, Nanjing University, 22 Hankou Road, Nanjing, 210093, China. .,Department of psychiatry, the Affiliated Brain Hospital of Nanjing Medical University, 264 Guangzhou Road, Nanjing, 210029, China. .,School of Biological Sciences and Medical Engineering, Southeast University, No. 2 sipailou, Nanjing, 210096, China.
| | - Jia Bo Shi
- Department of psychiatry, the Affiliated Brain Hospital of Nanjing Medical University, 264 Guangzhou Road, Nanjing, 210029, China.
| | - Qing Lu
- School of Biological Sciences and Medical Engineering, Southeast University, No. 2 sipailou, Nanjing, 210096, China. .,Child Development and Learning Science, Key Laboratory of Ministry of Education, Nanjing, 210096, China.
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18
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Jiang T, Zhang Q, Yuan F, Zhang F, Guo J. Efficacy of acupuncture and its influence on the emotional network in adult insomnia patients: protocol for a randomized controlled clinical trial. Trials 2022; 23:11. [PMID: 34983602 PMCID: PMC8725477 DOI: 10.1186/s13063-021-05913-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2021] [Accepted: 12/03/2021] [Indexed: 02/01/2023] Open
Abstract
Introduction Insomnia disorder (ID) is characterized by dissatisfaction with the quantity or quality of sleep and is often accompanied by negative emotions such as anxiety and depression. Patients with insomnia become trapped in a vicious circle of bad moods and poor sleep. Resting-state functional magnetic resonance imaging (r-fMRI) studies have shown abnormalities in emotion-related brain networks in patients with ID. And it has been proven that reducing negative emotions improves sleep quality. As a traditional alternative therapy, acupuncture has been demonstrated to be effective not only in improving sleep quality but also in stabilizing emotions; however, the mode of action needs to be further explored. Therefore, a clinical trial was designed to explore the effect of acupuncture in improving sleep and mood and to intuitively investigate the regulation of the emotional network using fMRI. Methods and analysis A total of 60 participants with ID will be randomly allocated to a spirit-regulating group or a control group using non-effective acupoints acupuncture at a ratio of 1:1. All participants will receive 3 acupuncture treatment sessions per week for 4 weeks. In addition, 30 healthy individuals will be included in the healthy group. The primary outcome is the Pittsburgh Sleep Quality Index (PSQI). Secondary outcomes are the Hamilton Anxiety Scale (HAMA), the Hamilton Depression Scale (HAMD), the Hyperarousal Scale (HAS), and the Fatigue Scale-14 (FS-14), r-fMRI data, sleep diary, and actigraphy. The data will be collected prior to treatment, following treatment, and during the 12-week follow-up period; a sleep diary will be kept during the entire process. Ethics and dissemination This protocol has been approved by the Research Ethical Committee of Beijing Hospital of Traditional Chinese Medicine (Bejing TCM Hospital). The results will be published in peer-reviewed journals or presented at academic conferences. Trial registration Chinese Clinical Trials Register ChiCTR1800015282. Protocol version: Version 1.0. Date: Dec.2020
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Affiliation(s)
- Tongfei Jiang
- Department of Acupuncture and Moxibustion, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing Key Laboratory of Acupuncture Neuromodulation, 23 Art Museum Backstreet, Dongcheng District, Beijing, 100010, China.,Graduate School, Beijing University of Chinese Medicine, Beijing, 100029, China
| | - Qi Zhang
- Graduate School, Capital Medical University, Beijing, 100053, China
| | - Fang Yuan
- Department of Acupuncture and Moxibustion, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing Key Laboratory of Acupuncture Neuromodulation, 23 Art Museum Backstreet, Dongcheng District, Beijing, 100010, China
| | - Fan Zhang
- Department of Acupuncture and Moxibustion, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing Key Laboratory of Acupuncture Neuromodulation, 23 Art Museum Backstreet, Dongcheng District, Beijing, 100010, China
| | - Jing Guo
- Department of Acupuncture and Moxibustion, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing Key Laboratory of Acupuncture Neuromodulation, 23 Art Museum Backstreet, Dongcheng District, Beijing, 100010, China.
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19
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Li Z, Liu J, Chen B, Wu X, Zou Z, Gao H, Wang C, Zhou J, Qi F, Zhang M, He J, Qi X, Yan F, Dou S, Tong L, Zhang H, Han X, Li Y. Improved Regional Homogeneity in Chronic Insomnia Disorder After Amygdala-Based Real-Time fMRI Neurofeedback Training. Front Psychiatry 2022; 13:863056. [PMID: 35845454 PMCID: PMC9279663 DOI: 10.3389/fpsyt.2022.863056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Accepted: 05/31/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Chronic insomnia disorder (CID) is a highly prevalent sleep disorder, which influences people's daily life and is even life threatening. However, whether the resting-state regional homogeneity (ReHo) of disrupted brain regions in CID can be reshaped to normal after treatment remains unclear. METHODS A novel intervention real-time functional magnetic resonance imaging neurofeedback (rtfMRI-NF) was used to train 28 CID patients to regulate the activity of the left amygdala for three sessions in 6 weeks. The ReHo methodology was adopted to explore its role on resting-state fMRI data, which were collected before and after training. Moreover, the relationships between changes of clinical variables and ReHo value of altered regions were determined. RESULTS Results showed that the bilateral dorsal medial pre-frontal cortex, supplementary motor area (SMA), and left dorsal lateral pre-frontal cortex had decreased ReHo values, whereas the bilateral cerebellum anterior lobe (CAL) had increased ReHo values after training. Some clinical scores markedly decreased, including Pittsburgh Sleep Quality Index, Insomnia Severity Index, Beck Depression Inventory, and Hamilton Anxiety Scale (HAMA). Additionally, the ReHo values of the left CAL were positively correlated with the change in the Hamilton depression scale score, and a remarkable positive correlation was found between the ReHo values of the right SMA and the HAMA score. CONCLUSION Our study provided an objective evidence that amygdala-based rtfMRI-NF training could reshape abnormal ReHo and improve sleep in patients with CID. The improved ReHo in CID provides insights into the neurobiological mechanism for the effectiveness of this intervention. However, larger double-blinded sham-controlled trials are needed to confirm our results from this initial study.
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Affiliation(s)
- Zhonglin Li
- Department of Radiology, Henan Provincial People's Hospital and People's Hospital of Zhengzhou University, Zhengzhou, China
| | - Jiao Liu
- Department of Nuclear Medicine, First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.,Henan Medical Key Laboratory of Molecular Imaging, Zhengzhou, China
| | - Bairu Chen
- Department of Medical Imaging, Fifth Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Xiaoling Wu
- Department of Nuclear Medicine, Henan Provincial People's Hospital and People's Hospital of Zhengzhou University, Zhengzhou, China
| | - Zhi Zou
- Department of Radiology, Henan Provincial People's Hospital and People's Hospital of Zhengzhou University, Zhengzhou, China
| | - Hui Gao
- Henan Key Laboratory of Imaging and Intelligent Processing, PLA Strategic Support Force Information Engineering University, Zhengzhou, China
| | - Caiyun Wang
- Department of Radiology, Henan Provincial People's Hospital and People's Hospital of Zhengzhou University, Zhengzhou, China
| | - Jing Zhou
- Health Management Center, Henan Provincial People's Hospital and People's Hospital of Zhengzhou University, Zhengzhou, China
| | - Fei Qi
- Department of Radiology, Henan Provincial People's Hospital and People's Hospital of Zhengzhou University, Zhengzhou, China
| | - Miao Zhang
- Department of Radiology, Henan Provincial People's Hospital and People's Hospital of Zhengzhou University, Zhengzhou, China
| | - Junya He
- Department of Radiology, Henan Provincial People's Hospital and People's Hospital of Zhengzhou University, Zhengzhou, China
| | - Xin Qi
- Department of Radiology, Henan Provincial People's Hospital and People's Hospital of Zhengzhou University, Zhengzhou, China
| | - Fengshan Yan
- Department of Radiology, Henan Provincial People's Hospital and People's Hospital of Zhengzhou University, Zhengzhou, China
| | - Shewei Dou
- Department of Radiology, Henan Provincial People's Hospital and People's Hospital of Zhengzhou University, Zhengzhou, China
| | - Li Tong
- Henan Key Laboratory of Imaging and Intelligent Processing, PLA Strategic Support Force Information Engineering University, Zhengzhou, China
| | - Hongju Zhang
- Department of Neurology, Henan Provincial People's Hospital and People's Hospital of Zhengzhou University, Zhengzhou, China
| | - Xingmin Han
- Department of Nuclear Medicine, First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.,Henan Medical Key Laboratory of Molecular Imaging, Zhengzhou, China
| | - Yongli Li
- Health Management Center, Henan Provincial People's Hospital and People's Hospital of Zhengzhou University, Zhengzhou, China
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20
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Gong L, Xu R, Yang D, Wang J, Ding X, Zhang B, Zhang X, Hu Z, Xi C. Orbitofrontal Cortex Functional Connectivity-Based Classification for Chronic Insomnia Disorder Patients With Depression Symptoms. Front Psychiatry 2022; 13:907978. [PMID: 35873230 PMCID: PMC9299364 DOI: 10.3389/fpsyt.2022.907978] [Citation(s) in RCA: 1] [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] [Received: 03/30/2022] [Accepted: 06/16/2022] [Indexed: 11/24/2022] Open
Abstract
Depression is a common comorbid symptom in patients with chronic insomnia disorder (CID). Previous neuroimaging studies found that the orbital frontal cortex (OFC) might be the core brain region linking insomnia and depression. Here, we used a machine learning approach to differentiate CID patients with depressive symptoms from CID patients without depressive symptoms based on OFC functional connectivity. Seventy patients with CID were recruited and subdivided into CID with high depressive symptom (CID-HD) and low depressive symptom (CID-LD) groups. The OFC functional connectivity (FC) network was constructed using the altered structure of the OFC region as a seed. A linear kernel SVM-based machine learning approach was carried out to classify the CID-HD and CID-LD groups based on OFC FC features. The predict model was further verified in a new cohort of CID group (n = 68). The classification model based on the OFC FC pattern showed a total accuracy of 76.92% (p = 0.0009). The area under the receiver operating characteristic curve of the classification model was 0.84. The OFC functional connectivity with reward network, salience network and default mode network contributed the highest weights to the prediction model. These results were further validated in an independent CID group with high and low depressive symptom (accuracy = 67.9%). These findings provide a potential biomarker for early diagnosis and intervention in CID patients comorbid with depression based on an OFC FC-based machine learning approach.
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Affiliation(s)
- Liang Gong
- Department of Neurology, Chengdu Second People's Hospital, Chengdu, China
| | - Ronghua Xu
- Department of Neurology, Chengdu Second People's Hospital, Chengdu, China
| | - Dan Yang
- Department of Neurology, Chengdu Second People's Hospital, Chengdu, China
| | - Jian Wang
- Department of Neurology, Chengdu Second People's Hospital, Chengdu, China
| | - Xin Ding
- Department of Neurology, Chengdu Second People's Hospital, Chengdu, China
| | - Bei Zhang
- Department of Neurology, Chengdu Second People's Hospital, Chengdu, China
| | - Xingping Zhang
- Department of General Practice, Chengdu Second People's Hospital, Chengdu, China
| | - Zhengjun Hu
- The Third People's Hospital of Chengdu, Chengdu, China
| | - Chunhua Xi
- Department of Neurology, The Third Affiliated Hospital of Anhui Medical University, Hefei, China
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21
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Li Y, Zou G, Shao Y, Yao P, Liu J, Zhou S, Hu S, Xu J, Guo Y, Gao JH, Zou Q, Sun H. Sleep discrepancy is associated with alterations in the salience network in patients with insomnia disorder: An EEG-fMRI study. NEUROIMAGE: CLINICAL 2022; 35:103111. [PMID: 35863180 PMCID: PMC9421431 DOI: 10.1016/j.nicl.2022.103111] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Revised: 05/31/2022] [Accepted: 07/10/2022] [Indexed: 01/27/2023] Open
Abstract
Simultaneous EEG-fMRI was used to clarify the association between the brain functional connectivity and sleep discrepancy between self-report and polysomnography in patients with insomnia disorder. An altered anterior insula-based connectivity across wakefulness and all NREM stages. Sleep discrepancy was significantly associated with anterior insula–putamen/thalamus connectivity during wakefulness.
Background Positron emission tomography – computed tomography (PET-CT) research has shown that sleep discrepancy recorded by self-report and polysomnography (PSG) may be related to the altered metabolic rate of the anterior insula (aINS) during non-rapid eye movement (NREM) sleep in patients with insomnia disorder. We aim to explore the functional connectivity of aINS across wake and NREM sleep in the patients and to reveal the association between aINS connectivity and sleep discrepancy. Methods Patients with insomnia disorder (n = 33) and healthy controls (n = 31) underwent simultaneous electroencephalography and functional magnetic resonance imaging (EEG-fMRI) during nighttime sleep, and aINS-based connectivity was calculated across wake and NREM sleep. A linear mixed-effects model was used to assess the main effect of group and group-by-stage (wake, NREM stages 1–3) interaction effect on aINS connectivity. Similar mixed models were used to assess the potential correlation between aINS connectivity and the sleep misperception index (MI). Results A significant group-by-stage interaction effect on aINS-based connectivity was observed in the bilateral frontal gyrus, right inferior temporal gyrus, bilateral middle occipital gyrus and right postcentral gyrus (p < 0.05, corrected). There was also a significant group-by-MI interaction effect on aINS connectivity with the putamen and thalamus during wakefulness (p < 0.05 corrected); MI was significantly associated with aINS–putamen/thalamus connectivity in the control group, whereas the association was weak or even nonsignificant in the patient group. There was no significant main effect of group. Conclusion The waking activity of a neural pathway containing the aINS, putamen, and thalamus may underlie sleep perception, potentially providing important perspectives to reveal complex mechanisms of sleep discrepancy between self-report and PSG.
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Affiliation(s)
- Yuezhen Li
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health, Beijing, China; Department of Neuropsychiatry, Behavioral Neurology and Clinical Psychology, Sleep Center, Beijing Tian Tan Hospital, Capital Medical University, Beijing, China
| | - Guangyuan Zou
- Beijing City Key Laboratory for Medical Physics and Engineering, Institute of Heavy Ion Physics, School of Physics, Peking University, Beijing, China; Center for MRI Research, Academy for Advanced Interdisciplinary Studies, Peking University, Beijing, China
| | - Yan Shao
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health, Beijing, China; National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China
| | - Ping Yao
- Department of Physiology, College of Basic Medicine, Inner Mongolia Medical University, Hohhot, China
| | - Jiayi Liu
- Beijing City Key Laboratory for Medical Physics and Engineering, Institute of Heavy Ion Physics, School of Physics, Peking University, Beijing, China; Center for MRI Research, Academy for Advanced Interdisciplinary Studies, Peking University, Beijing, China
| | - Shuqin Zhou
- Center for MRI Research, Academy for Advanced Interdisciplinary Studies, Peking University, Beijing, China
| | - Sifan Hu
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health, Beijing, China; National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China
| | - Jing Xu
- Center for MRI Research, Academy for Advanced Interdisciplinary Studies, Peking University, Beijing, China; Laboratory of Applied Brain and Cognitive Sciences, College of International Business, Shanghai International Studies University, Shanghai, China
| | - Yupeng Guo
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health, Beijing, China; National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China
| | - Jia-Hong Gao
- Beijing City Key Laboratory for Medical Physics and Engineering, Institute of Heavy Ion Physics, School of Physics, Peking University, Beijing, China; Center for MRI Research, Academy for Advanced Interdisciplinary Studies, Peking University, Beijing, China; McGovern Institute for Brain Research, Peking University, Beijing, China.
| | - Qihong Zou
- Center for MRI Research, Academy for Advanced Interdisciplinary Studies, Peking University, Beijing, China; National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China.
| | - Hongqiang Sun
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health, Beijing, China; National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China.
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22
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Jeon B, Luyster FS, Sereika SM, DiNardo MM, Callan JA, Chasens ER. Comorbid obstructive sleep apnea and insomnia and its associations with mood and diabetes-related distress in type 2 diabetes mellitus. J Clin Sleep Med 2021; 18:1103-1111. [PMID: 34879902 DOI: 10.5664/jcsm.9812] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
STUDY OBJECTIVES Previous research suggests that obstructive sleep apnea (OSA) and insomnia frequently co-exist and are prevalent in persons with type 2 diabetes mellitus (T2DM). This study compared mood and diabetes-related distress among OSA, insomnia, and comorbid OSA and insomnia (OSA+I) groups in persons with T2DM. METHODS A secondary analysis was conducted with baseline data from two independent randomized controlled trials evaluating the efficacy of OSA and insomnia treatment. The pooled sample (N=224) included participants with OSA only (n=68 [30.4%]), insomnia only (n=107 [47.8%]), and OSA and insomnia (OSA+I; n=49 [21.9%]). OSA was defined as an apnea-hypopnea index ≥ 15 events per hour; insomnia defined as an Insomnia Severity Index score ≥ 15. Mood was measured by the Profile of Mood States total and subscale scores; diabetes-related distress was assessed by the Problem Areas in Diabetes. One-way analysis of covariance and multivariate analysis of covariance were conducted, controlling for demographic characteristics and restless leg syndrome. RESULTS The insomnia group had on average significantly higher scores for total mood disturbance (insomnia vs. OSA= 45.32 vs. 32.15, p=.049), tension-anxiety (insomnia vs. OSA= 12.64 vs. 9.47, p=.008), and confusion-bewilderment (insomnia vs. OSA= 9.45 vs. 7.46, p=.036) than OSA group. The OSA+I group had on average significantly greater diabetes-related distress than OSA group (OSA+I vs. OSA= 40.61 vs. 30.97, p=.036). CONCLUSIONS Insomnia may have greater impact on mood disturbance and diabetes-related distress than OSA in persons with T2DM. In particular, comorbid insomnia may contribute to greater diabetes-related distress in persons with T2DM and OSA.
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Affiliation(s)
- Bomin Jeon
- University of Pittsburgh School of Nursing, Pittsburgh, PA
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23
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Tahmasian M, Aleman A, Andreassen OA, Arab Z, Baillet M, Benedetti F, Bresser T, Bright J, Chee MW, Chylinski D, Cheng W, Deantoni M, Dresler M, Eickhoff SB, Eickhoff CR, Elvsåshagen T, Feng J, Foster-Dingley JC, Ganjgahi H, Grabe HJ, Groenewold NA, Ho TC, Hong SB, Houenou J, Irungu B, Jahanshad N, Khazaie H, Kim H, Koshmanova E, Kocevska D, Kochunov P, Lakbila-Kamal O, Leerssen J, Li M, Luik AI, Muto V, Narbutas J, Nilsonne G, O’Callaghan VS, Olsen A, Osorio RS, Poletti S, Poudel G, Reesen JE, Reneman L, Reyt M, Riemann D, Rosenzweig I, Rostampour M, Saberi A, Schiel J, Schmidt C, Schrantee A, Sciberras E, Silk TJ, Sim K, Smevik H, Soares JC, Spiegelhalder K, Stein DJ, Talwar P, Tamm S, Teresi GI, Valk SL, Van Someren E, Vandewalle G, Van Egroo M, Völzke H, Walter M, Wassing R, Weber FD, Weihs A, Westlye LT, Wright MJ, Wu MJ, Zak N, Zarei M. ENIGMA-Sleep: Challenges, opportunities, and the road map. J Sleep Res 2021; 30:e13347. [PMID: 33913199 PMCID: PMC8803276 DOI: 10.1111/jsr.13347] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Revised: 03/14/2021] [Accepted: 03/16/2021] [Indexed: 12/26/2022]
Abstract
Neuroimaging and genetics studies have advanced our understanding of the neurobiology of sleep and its disorders. However, individual studies usually have limitations to identifying consistent and reproducible effects, including modest sample sizes, heterogeneous clinical characteristics and varied methodologies. These issues call for a large-scale multi-centre effort in sleep research, in order to increase the number of samples, and harmonize the methods of data collection, preprocessing and analysis using pre-registered well-established protocols. The Enhancing NeuroImaging Genetics through Meta-Analysis (ENIGMA) consortium provides a powerful collaborative framework for combining datasets across individual sites. Recently, we have launched the ENIGMA-Sleep working group with the collaboration of several institutes from 15 countries to perform large-scale worldwide neuroimaging and genetics studies for better understanding the neurobiology of impaired sleep quality in population-based healthy individuals, the neural consequences of sleep deprivation, pathophysiology of sleep disorders, as well as neural correlates of sleep disturbances across various neuropsychiatric disorders. In this introductory review, we describe the details of our currently available datasets and our ongoing projects in the ENIGMA-Sleep group, and discuss both the potential challenges and opportunities of a collaborative initiative in sleep medicine.
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Affiliation(s)
- Masoud Tahmasian
- Institute of Medical Science and Technology, Shahid Beheshti University, Tehran, Iran
| | - André Aleman
- University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | - Ole A. Andreassen
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital, Inst of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Zahra Arab
- Institute of Medical Science and Technology, Shahid Beheshti University, Tehran, Iran
| | - Marion Baillet
- GIGA-Institute, Cyclotron Research Center/In Vivo Imaging, Sleep and Chronobiology Lab, University of Liège, Liège, Belgium
| | - Francesco Benedetti
- Psychiatry & Clinical Psychobiology, Division of Neuroscience, IRCCS Scientific Institute Ospedale San Raffaele, Milano, Italy
- Vita-Salute San Raffaele University, Milano, Italy
| | - Tom Bresser
- Department of Sleep and Cognition, Netherlands Institute for Neuroscience (NIN), an Institute of the Royal Netherlands Academy of Arts and Sciences, Amsterdam, The Netherlands
- Department of Integrative Neurophysiology, Center for Neurogenomics and Cognitive Research (CNCR), Amsterdam Neuroscience, VU University Amsterdam, Amsterdam, Netherlands
| | - Joanna Bright
- Imaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine, University of Southern California, Marina del Rey, CA, USA
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Michael W.L. Chee
- Centre for Sleep and Cognition, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Daphne Chylinski
- GIGA-Institute, Cyclotron Research Center/In Vivo Imaging, Sleep and Chronobiology Lab, University of Liège, Liège, Belgium
| | - Wei Cheng
- Institute of Science and Technology for Brain-inspired intelligence, Fudan University, Shanghai, China
- Key Laboratory of Computational Neuroscience and Brain-Inspired Intelligence, Ministry of Education, Fudan University, Shanghai, China
| | - Michele Deantoni
- GIGA-Institute, Cyclotron Research Center/In Vivo Imaging, Sleep and Chronobiology Lab, University of Liège, Liège, Belgium
| | - Martin Dresler
- Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Simon B. Eickhoff
- Institute of Neuroscience and Medicine, Brain & Behaviour (INM-7), Research Centre Jülich, Jülich, Germany
- Institute of Systems Neuroscience, Medical Faculty,, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Claudia R. Eickhoff
- Institute of Neuroscience and Medicine, Structural and functional organisation of the brain (INM-1), Research Centre Jülich, Jülich, Germany
- Institute of Clinical Neuroscience and Medical Psychology, Medical Faculty, University of Düsseldorf, Düsseldorf, Germany
| | - Torbjørn Elvsåshagen
- Norwegian Centre for Mental Disorders Research, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Department of Neurology, Oslo University Hospital, Oslo, Norway
| | - Jianfeng Feng
- Institute of Science and Technology for Brain-inspired intelligence, Fudan University, Shanghai, China
- Key Laboratory of Computational Neuroscience and Brain-Inspired Intelligence, Ministry of Education, Fudan University, Shanghai, China
- Department of Computer Science, University of Warwick, Coventry, UK
| | - Jessica C. Foster-Dingley
- Department of Sleep and Cognition, Netherlands Institute for Neuroscience (NIN), an Institute of the Royal Netherlands Academy of Arts and Sciences, Amsterdam, The Netherlands
| | - Habib Ganjgahi
- Department of Statistics, University of Oxford, Oxford, UK
| | - Hans J. Grabe
- Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Greifswald, Germany
- German Center for Neurodegenerative Diseases (DZNE), Site Rostock/Greifswald, Greifswald, Germany
| | - Nynke A. Groenewold
- SA MRC Unit on Risk & Resilience in Mental Disorders, Department of Psychiatry & Neuroscience Institute, University of Cape Town, Cape Town, South Africa
| | - Tiffany C. Ho
- Department of Psychiatry and Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, USA
| | - Seung Bong Hong
- Department of Neurology, Samsung Medical Center, SBRI (Samsung Biomedical Research Institute), Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Josselin Houenou
- Univ Paris Saclay, NeuroSpin neuroimaging platform, Psychiatry Team, UNIACT Lab, CEA Saclay, Gif-Sur-Yvette Cedex, France
- DMU IMPACT de Psychiatrie et d'Addictologie, APHP, Hôpitaux Universitaires Mondor, Créteil, France
- Univ Paris Est Créteil, INSERM U 955, IMRB Team 15 « Translational Neuropsychiatry », Foundation FondaMental, Créteil, France
| | - Benson Irungu
- Department of Psychiatry & Behavioral Sciences, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Neda Jahanshad
- Imaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine, University of Southern California, Marina del Rey, CA, USA
| | - Habibolah Khazaie
- Sleep Disorders Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Hosung Kim
- Laboratory of Neuro Imaging at USC Stevens Neuroimaging and Informatics Institute, Keck School of Medicine of USC, University of Southern California, Los Angeles, CA, USA
| | - Ekaterina Koshmanova
- GIGA-Institute, Cyclotron Research Center/In Vivo Imaging, Sleep and Chronobiology Lab, University of Liège, Liège, Belgium
| | - Desi Kocevska
- Department of Sleep and Cognition, Netherlands Institute for Neuroscience (NIN), an Institute of the Royal Netherlands Academy of Arts and Sciences, Amsterdam, The Netherlands
| | - Peter Kochunov
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Oti Lakbila-Kamal
- Department of Sleep and Cognition, Netherlands Institute for Neuroscience (NIN), an Institute of the Royal Netherlands Academy of Arts and Sciences, Amsterdam, The Netherlands
- Department of Integrative Neurophysiology, Center for Neurogenomics and Cognitive Research (CNCR), Amsterdam Neuroscience, VU University Amsterdam, Amsterdam, Netherlands
| | - Jeanne Leerssen
- Department of Sleep and Cognition, Netherlands Institute for Neuroscience (NIN), an Institute of the Royal Netherlands Academy of Arts and Sciences, Amsterdam, The Netherlands
- Department of Integrative Neurophysiology, Center for Neurogenomics and Cognitive Research (CNCR), Amsterdam Neuroscience, VU University Amsterdam, Amsterdam, Netherlands
| | - Meng Li
- Clinical Affective Neuroimaging Laboratory, Otto von Guericke University, Magdeburg, Germany
- Department of Psychiatry and Psychotherapy, Jena University Hospital, Jena, Germany
- Department of Psychiatry and Psychotherapy, University of Tübingen, Tübingen, Germany
| | - Annemarie I. Luik
- Department of Epidemiology, Erasmus MC University Medical Center Rotterdam, Rotterdam, The Netherlands
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC University Medical Center Rotterdam, Rotterdam, Netherlands
| | - Vincenzo Muto
- GIGA-Institute, Cyclotron Research Center/In Vivo Imaging, Sleep and Chronobiology Lab, University of Liège, Liège, Belgium
| | - Justinas Narbutas
- GIGA-Institute, Cyclotron Research Center/In Vivo Imaging, Sleep and Chronobiology Lab, University of Liège, Liège, Belgium
| | - Gustav Nilsonne
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
- Department of Psychology, Stress Research Institute, Stockholm University, Stockholm, Sweden
| | | | - Alexander Olsen
- Department of Physical Medicine and Rehabilitation, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
- Department of Psychology, Norwegian University of Science and Technology, Trondheim, Norway
| | - Ricardo S. Osorio
- Healthy Brain Aging and Sleep Center, Department of Psychiatry, NYU Grossman School of Medicine, New York, NY, USA
- Nathan S. Kline Institute for Psychiatric Research, Orangeburg, NY, USA
| | - Sara Poletti
- Psychiatry & Clinical Psychobiology, Division of Neuroscience, IRCCS Scientific Institute Ospedale San Raffaele, Milano, Italy
- Vita-Salute San Raffaele University, Milano, Italy
| | - Govinda Poudel
- Mary Mackillop Institute for Health Research, Australian Catholic University, Melbourne, Vic., Australia
| | - Joyce E. Reesen
- Department of Sleep and Cognition, Netherlands Institute for Neuroscience (NIN), an Institute of the Royal Netherlands Academy of Arts and Sciences, Amsterdam, The Netherlands
- Department of Integrative Neurophysiology, Center for Neurogenomics and Cognitive Research (CNCR), Amsterdam Neuroscience, VU University Amsterdam, Amsterdam, Netherlands
| | - Liesbeth Reneman
- Department of Radiology and Nuclear Medicine, Amsterdam University Medical Centers, AMC, Amsterdam, The Netherlands
| | - Mathilde Reyt
- GIGA-Institute, Cyclotron Research Center/In Vivo Imaging, Sleep and Chronobiology Lab, University of Liège, Liège, Belgium
- Psychology and Neuroscience of Cognition Research Unit, Faculty of Psychology and Educational Sciences, University of Liège, Liège, Belgium
| | - Dieter Riemann
- Department of Psychiatry and Psychotherapy, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg im Breisgau, Germany
| | - Ivana Rosenzweig
- Sleep and Brain Plasticity Centre, Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King’s College London, London, UK
- Sleep Disorders Centre, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Masoumeh Rostampour
- Sleep Disorders Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Amin Saberi
- Institute of Medical Science and Technology, Shahid Beheshti University, Tehran, Iran
| | - Julian Schiel
- Department of Psychiatry and Psychotherapy, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg im Breisgau, Germany
| | - Christina Schmidt
- GIGA-Institute, Cyclotron Research Center/In Vivo Imaging, Sleep and Chronobiology Lab, University of Liège, Liège, Belgium
- Psychology and Neuroscience of Cognition Research Unit, Faculty of Psychology and Educational Sciences, University of Liège, Liège, Belgium
| | - Anouk Schrantee
- Department of Radiology and Nuclear Medicine, Amsterdam University Medical Centers, AMC, Amsterdam, The Netherlands
| | - Emma Sciberras
- Department of Paediatrics, University of Melbourne, Parkville, Vic., Australia
- Murdoch Children's Research Institute, Parkville, Vic., Australia
- School of Psychology, Deakin University, Geelong, Vic., Australia
| | - Tim J. Silk
- Department of Paediatrics, University of Melbourne, Parkville, Vic., Australia
- Murdoch Children's Research Institute, Parkville, Vic., Australia
- School of Psychology, Deakin University, Geelong, Vic., Australia
| | - Kang Sim
- Institute of Mental Health, Buangkok, Singapore
| | - Hanne Smevik
- Department of Psychology, Norwegian University of Science and Technology, Trondheim, Norway
| | - Jair C. Soares
- Department of Psychiatry & Behavioral Sciences, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Kai Spiegelhalder
- Department of Psychiatry and Psychotherapy, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg im Breisgau, Germany
| | - Dan J. Stein
- SA MRC Unit on Risk & Resilience in Mental Disorders, Department of Psychiatry & Neuroscience Institute, University of Cape Town, Cape Town, South Africa
| | - Puneet Talwar
- GIGA-Institute, Cyclotron Research Center/In Vivo Imaging, Sleep and Chronobiology Lab, University of Liège, Liège, Belgium
| | - Sandra Tamm
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
- Department of Psychology, Stress Research Institute, Stockholm University, Stockholm, Sweden
- Department of Psychiatry, University of Oxford, Oxford, UK
| | - Giana I. Teresi
- Department of Psychology, Stanford University, Stanford, CA, USA
| | - Sofie L. Valk
- Institute of Neuroscience and Medicine, Brain & Behaviour (INM-7), Research Centre Jülich, Jülich, Germany
- Institute of Systems Neuroscience, Medical Faculty,, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
- Otto Hahn Group Cognitive Neurogenetics, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
| | - Eus Van Someren
- Department of Sleep and Cognition, Netherlands Institute for Neuroscience (NIN), an Institute of the Royal Netherlands Academy of Arts and Sciences, Amsterdam, The Netherlands
- Department of Integrative Neurophysiology, Center for Neurogenomics and Cognitive Research (CNCR), Amsterdam Neuroscience, VU University Amsterdam, Amsterdam, Netherlands
- Vrije Universiteit, Psychiatry, Amsterdam Neuroscience, Amsterdam UMC, Amsterdam, The Netherlands
| | - Gilles Vandewalle
- GIGA-Institute, Cyclotron Research Center/In Vivo Imaging, Sleep and Chronobiology Lab, University of Liège, Liège, Belgium
| | - Maxime Van Egroo
- GIGA-Institute, Cyclotron Research Center/In Vivo Imaging, Sleep and Chronobiology Lab, University of Liège, Liège, Belgium
| | - Henry Völzke
- Institute for Community Medicine, Department SHIP/Clinical Epidemiological Research, University Medicine Greifswald, Greifswald, Germany
- German Centre for Cardiovascular Research (DZHK), Greifswald, Germany
| | - Martin Walter
- Clinical Affective Neuroimaging Laboratory, Otto von Guericke University, Magdeburg, Germany
- Department of Psychiatry and Psychotherapy, Jena University Hospital, Jena, Germany
- Department of Psychiatry and Psychotherapy, University of Tübingen, Tübingen, Germany
- Leibniz Institute for Neurobiology, Magdeburg, Germany
- Department of Psychiatry and Psychotherapy, Otto-von-Guericke University Magdeburg, Magdeburg, Germany
- Department of Psychiatry and Psychotherapy, Jena University Hospital, Jena, Germany
| | - Rick Wassing
- Department of Sleep and Circadian Research, Woolcock Institute of Medical Research, The University of Sydney, Sydney, Australia
| | - Frederik D. Weber
- Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Antoine Weihs
- Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Greifswald, Germany
| | - Lars Tjelta Westlye
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital, Inst of Clinical Medicine, University of Oslo, Oslo, Norway
- Department of Psychology, University of Oslo, Oslo, Norway
- K.G Jebsen Center for Neurodevelopmental Disorders, University of Oslo, Oslo, Norway
| | - Margaret J. Wright
- Queensland Brain Institute, The University of Queensland, Brisbane, Qld, Australia
- Centre for Advanced Imaging, The University of Queensland, St Lucia, Qld, Australia
| | - Mon-Ju Wu
- Department of Psychology and Center for Magnetic Resonance Research, University of Minnesota, Minneapolis, MN, USA
| | - Nathalia Zak
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital, Inst of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Mojtaba Zarei
- Institute of Medical Science and Technology, Shahid Beheshti University, Tehran, Iran
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24
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Shi X, Guo Y, Zhu L, Wu W, Hordacre B, Su X, Wang Q, Chen X, Lan X, Dang G. Electroencephalographic connectivity predicts clinical response to repetitive transcranial magnetic stimulation in patients with insomnia disorder. Sleep Med 2021; 88:171-179. [PMID: 34773788 DOI: 10.1016/j.sleep.2021.10.017] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Revised: 09/10/2021] [Accepted: 10/12/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Accumulating evidence suggests that low frequency repetitive transcranial magnetic stimulation (rTMS), which generally decreases cortical excitability and remodels plastic connectivity, improves sleep quality in patients with insomnia disorder. However, the effects of rTMS vary substantially across individuals and treatment is sometimes unsatisfactory, calling for biomarkers for predicting clinical outcomes. OBJECTIVE This study aimed to investigate whether functional connectivity of the target network in electroencephalography is associated with the clinical response to low frequency rTMS in patients with insomnia disorder. METHODS Twenty-five patients with insomnia disorder were subjected to 10 sessions of treatment with 1 Hz rTMS over the right dorsolateral prefrontal cortex. Resting-state electroencephalography was collected before rTMS. Pittsburgh Sleep Quality Index, Hamilton Depression Rating Scale, Hamilton Anxiety Rating Scale, and Mini-Mental State Exam were performed before and after rTMS treatment, with a follow-up after one month. Electroencephalographic connectivity was measured by the power envelope connectivity at the source level. Partial least squares regression identified models of connectivity that maximally accounted for the rTMS response. RESULTS Scores of Pittsburgh Sleep Quality Index, Hamilton Depression Rating Scale, and Hamilton Anxiety Rating Scale were decreased after rTMS and one-month later. Baseline weaker connectivity of a network in the beta and alpha bands between a brain region approximating the stimulated right dorsolateral prefrontal cortex and areas located in the frontal, insular, and limbic cortices was associated with a greater change in Pittsburgh Sleep Quality Index and Hamilton Depression Rating Scale following rTMS. CONCLUSIONS Low frequency rTMS could improve sleep quality and depressive moods in patients with insomnia disorder. Moreover, electroencephalographic functional connectivity would potentially be a robust biomarker for predicting the therapeutic effects.
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Affiliation(s)
- Xue Shi
- Department of Neurology, Shenzhen People's Hospital, The Second Clinical Medical College, Jinan University, The First Affiliated Hospital, Southern University of Science and Technology, Shenzhen, 518020, Guangdong, China
| | - Yi Guo
- Department of Neurology, Shenzhen People's Hospital, The Second Clinical Medical College, Jinan University, The First Affiliated Hospital, Southern University of Science and Technology, Shenzhen, 518020, Guangdong, China; Shenzhen Bay Laboratory, Shenzhen, 518020, Guangdong, China
| | - Lin Zhu
- Department of Neurology, Shenzhen People's Hospital, The Second Clinical Medical College, Jinan University, The First Affiliated Hospital, Southern University of Science and Technology, Shenzhen, 518020, Guangdong, China
| | - Wei Wu
- School of Automation Science and Engineering, South China University of Technology, Guangzhou, 510641, China
| | - Brenton Hordacre
- Innovation, Implementation and Clinical Translation (IIMPACT) in Health, Allied Health and Human Performance, University of South Australia, Australia
| | - Xiaolin Su
- Department of Neurology, Shenzhen People's Hospital, The Second Clinical Medical College, Jinan University, The First Affiliated Hospital, Southern University of Science and Technology, Shenzhen, 518020, Guangdong, China
| | - Qian Wang
- Department of Neurology, Shenzhen People's Hospital, The Second Clinical Medical College, Jinan University, The First Affiliated Hospital, Southern University of Science and Technology, Shenzhen, 518020, Guangdong, China
| | - Xiaoxia Chen
- Department of Neurology, Shenzhen People's Hospital, The Second Clinical Medical College, Jinan University, The First Affiliated Hospital, Southern University of Science and Technology, Shenzhen, 518020, Guangdong, China
| | - Xiaoyong Lan
- Department of Neurology, Shenzhen People's Hospital, The Second Clinical Medical College, Jinan University, The First Affiliated Hospital, Southern University of Science and Technology, Shenzhen, 518020, Guangdong, China
| | - Ge Dang
- Department of Neurology, Shenzhen People's Hospital, The Second Clinical Medical College, Jinan University, The First Affiliated Hospital, Southern University of Science and Technology, Shenzhen, 518020, Guangdong, China.
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25
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Zhang S, He JK, Meng H, Zhao B, Zhao YN, Wang Y, Li SY, Wang L, Wu MZ, Chen Y, Xiao X, Hou LW, Fang JL, Rong PJ. Effects of transcutaneous auricular vagus nerve stimulation on brain functional connectivity of medial prefrontal cortex in patients with primary insomnia. Anat Rec (Hoboken) 2021; 304:2426-2435. [PMID: 34623769 DOI: 10.1002/ar.24785] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Revised: 08/29/2021] [Accepted: 09/02/2021] [Indexed: 01/26/2023]
Abstract
As a representative of acupuncture and nonpharmaceutical therapy, auricular acupuncture has been widely for the treatment of insomnia. Transcutaneous auricular vagus nerve stimulation (taVNS) is a combination of auricular point stimulation and vagus nerve stimulation. It can not only treat primary insomnia effectively, but also is noninvasive, painless, portable and economical. The medial prefrontal cortex (mPFC) is a core region of default mode network (DMN), which is important for maintenance of sleep. However, the mechanism of taVNS in alleviating primary insomnia (PI) remains to be clarified. In this study, we found that taVNS could not only effectively reduce the score of Pittsburgh Sleep Quality Index, but also decreased functional connection (FC) between the left mPFC and bilateral dorsal anterior cingulate gyrus as well as FC between the right mPFC and the occipital cortex in patients with PI. Furthermore, the decrease in FC was positively correlated with the decline of sleep index score. Therefore, we proposed that treatment with taVNS can improve sleep quality and prolong sleep duration in patients with PI by reducing FC within DMN, FC between DMN and salience network, as well as FC between DMN and the occipital cortex. This may be one of mechanisms of taVNS in treating PI.
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Affiliation(s)
- Shuai Zhang
- Institute of Acupuncture and Moxibustion, China Academy of Chinese Medical Sciences, Beijing, China
| | - Jia-Kai He
- Institute of Acupuncture and Moxibustion, China Academy of Chinese Medical Sciences, Beijing, China
| | - Hong Meng
- Beijing Key Lab of Plant Resource Research and Development, Beijing Technology and Business University, Beijing, China
| | - Bin Zhao
- Institute of Acupuncture and Moxibustion, China Academy of Chinese Medical Sciences, Beijing, China.,School of Traditional Chinese Medicine, Southern Medical University, Guangdong, China
| | - Ya-Nan Zhao
- Institute of Acupuncture and Moxibustion, China Academy of Chinese Medical Sciences, Beijing, China
| | - Yu Wang
- Institute of Acupuncture and Moxibustion, China Academy of Chinese Medical Sciences, Beijing, China
| | - Shao-Yuan Li
- Institute of Acupuncture and Moxibustion, China Academy of Chinese Medical Sciences, Beijing, China
| | - Lei Wang
- Institute of Acupuncture and Moxibustion, China Academy of Chinese Medical Sciences, Beijing, China
| | - Mo-Zheng Wu
- Institute of Acupuncture and Moxibustion, China Academy of Chinese Medical Sciences, Beijing, China
| | - Yu Chen
- Institute of Acupuncture and Moxibustion, China Academy of Chinese Medical Sciences, Beijing, China
| | - Xue Xiao
- Department of Psychiatry, Beijing First Hospital of Integrated Chinese and Western Medicine, Beijing, China
| | - Li-Wei Hou
- Institute of Acupuncture and Moxibustion, China Academy of Chinese Medical Sciences, Beijing, China
| | - Ji-Liang Fang
- Guang 'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Pei-Jing Rong
- Institute of Acupuncture and Moxibustion, China Academy of Chinese Medical Sciences, Beijing, China
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Ling J, Lin X, Li X, Chan NY, Zhang J, Wing YK, Hu X, Li SX. Neural Response to Rewards in Youths with Insomnia. Sleep 2021; 45:6380671. [PMID: 34604904 DOI: 10.1093/sleep/zsab238] [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: 01/23/2021] [Revised: 08/03/2021] [Indexed: 11/12/2022] Open
Abstract
STUDY OBJECTIVES Insomnia and depression are common comorbid conditions in youths. Emerging evidence suggests that disrupted reward processing may be implicated in the association between insomnia and the increased risk for depression. Reduced reward positivity (RewP) as measured by event-related potential (ERP) has been linked to depression, but has not been tested in youths with insomnia. METHODS Twenty-eight participants with insomnia disorder and without any comorbid psychiatric disorders and 29 healthy sleepers aged between 15-24 completed a monetary reward task, the Cued Door task, whilst electroencephalographic activity was recorded. RewP (reward minus non-reward difference waves) was calculated as the mean amplitudes within 200ms to 300ms time window at FCz. Two analyses of covariance (ANCOVAs) were conducted with age as a covariate on RewP amplitude and latency, respectively. RESULTS Participants with insomnia had a significantly lower RewP amplitude regardless of cue types (Gain, Control, and Loss) than healthy sleepers, F (1, 51) = 4.95, p = .031, indicating blunted reward processing. On the behavioural level, healthy sleepers were more prudential (slower reaction time) in decision making towards Loss/Gain cues than their insomnia counterparts. Trial-by-trial behavioural adjustment analyses showed that, compared with healthy sleepers, participants with insomnia were less likely to dynamically change their choices in response to Loss cues. CONCLUSIONS Dysfunctional reward processing, coupled with inflexibility of behavioural adjustment in decision-making, is associated with insomnia disorder among youth, independent of mood disorders. Future studies with long-term follow-up are needed to further delineate the developmental trajectory of insomnia-related reward dysfunctions in youth.
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Affiliation(s)
- Jiefan Ling
- Sleep Research Clinic and Laboratory, Department of Psychology, The University of Hong Kong
| | - Xuanyi Lin
- The Social and Cognitive Neuroscience Lab, Department of Psychology, The University of Hong Kong
| | - Xiao Li
- Sleep Research Clinic and Laboratory, Department of Psychology, The University of Hong Kong
| | - Ngan Yin Chan
- Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong
| | - Jihui Zhang
- Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong.,Guang Dong Mental Health Center, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences
| | - Yun Kwok Wing
- Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong
| | - Xiaoqing Hu
- The Social and Cognitive Neuroscience Lab, Department of Psychology, The University of Hong Kong.,The State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong
| | - Shirley Xin Li
- Sleep Research Clinic and Laboratory, Department of Psychology, The University of Hong Kong.,The State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong
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Abstract
Sleep disturbances and depression are closely linked and share a bidirectional relationship. These interconnections can inform the pathophysiology underlying each condition. Insomnia is an established and modifiable risk factor for depression, the treatment of which offers the critical opportunity to prevent major depressive episodes, a paradigm-shifting model for psychiatry. Identification of occult sleep disorders may also improve outcomes in treatment-resistant depression. Sleep alterations and manipulations may additionally clarify the mechanisms that underlie rapid-acting antidepressant therapies. Both sleep disturbance and depression are heterogeneous processes, and evolving standards in psychiatric research that consider the transdiagnostic components of each are more likely to lead to translational progress at their nexus. Emerging tools to objectively quantify sleep and its disturbances in the home environment offer great potential to advance clinical care and research, but nascent technologies require further advances and validation prior to widespread application at the interface of sleep and depression.
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Affiliation(s)
- David T Plante
- Department of Psychiatry, University of Wisconsin School of Medicine and Public Health, Madison
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28
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Zhou F, Guo Y, Wang Z, Liu S, Xu H. Assessing the causal associations of insomnia with depressive symptoms and subjective well-being: a bidirectional Mendelian randomization study. Sleep Med 2021; 87:85-91. [PMID: 34544013 DOI: 10.1016/j.sleep.2021.08.025] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Revised: 08/02/2021] [Accepted: 08/24/2021] [Indexed: 12/13/2022]
Abstract
BACKGROUND The interactions and associations between insomnia, depressive symptoms, and subjective well-being are complex, thus it is hard to explore the effect and direction of causalities. This bidirectional Mendelian randomization (MR) study was to assess the causal associations of insomnia with depressive symptoms and subjective well-being. METHODS Summary statistics for insomnia, depressive symptoms, and subjective well-being were obtained from three large-scale genome-wide association studies (GWAS) of European ancestry. MR analyses were mainly conducted with the inverse-variance-weighted (IVW) method. The weighted-median method, MR-Egger method, and MR-Pleiotropy RESidual Sum and Outlier (PRESSO) test were adopted to test whether the estimates were robust. The adjusted MR analysis was performed to avoid the effect of potential pleiotropy. RESULTS There was evidence to support a causal association between genetically predicted insomnia and depressive symptoms (beta (β) = 0.086, 95% confidence interval (CI) = 0.068 to 0.104, P = 8.6E-21). Meanwhile, genetically predicted depressive symptoms was associated with a higher risk of insomnia (β = 0.543, 95% CI = 0.331 to 0.754, P = 4.8E-07). Genetically predicted insomnia was negatively associated with subjective well-being (β = -0.043, 95% CI = -0.063 to -0.024, P = 1.2E-05). There was evidence of reverse causality between insomnia and subjective well-being (β = -0.821, 95% CI = -1.012 to -0.630, P = 4.0E-17). CONCLUSIONS MR analysis indicates bidirectional causal associations of insomnia with depressive symptoms and subjective well-being. People should give serious attention to and attempt to resolve the problems of insomnia, depressive symptoms, and subjective well-being, whichever comes first.
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Affiliation(s)
- Feixiang Zhou
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, 410078, Hunan, China
| | - Yicong Guo
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, 410078, Hunan, China
| | - Zhe Wang
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, 410078, Hunan, China
| | - Siyue Liu
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, 410078, Hunan, China
| | - Huilan Xu
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, 410078, Hunan, China.
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29
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Huang HL, Yang SB, Mei ZG, Huang YG, Chen MH, Mei QL, Lei HP, Mei QX, Chen JH. Efficacy and safety of electroacupuncture combined with Suanzaoren decoction for insomnia following stroke: study protocol for a randomized controlled trial. Trials 2021; 22:485. [PMID: 34496928 PMCID: PMC8427963 DOI: 10.1186/s13063-021-05399-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2020] [Accepted: 06/25/2021] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND Insomnia is a common but frequently overlooked sleep disorder after stroke, and there are limited effective therapies for insomnia following stroke. Traditional Chinese medicine (TCM), including acupuncture and the Chinese herbal medication (CHM) Suanzaoren decoction (SZRD), has been reported as an alternative option for insomnia relief after stroke in China for thousands of years. Here, this study aims to investigate the efficacy and safety of electroacupuncture (EA) in combination with SZRD in the treatment of insomnia following stroke. METHODS A total of 240 patients with post-stroke insomnia will be included and randomized into four groups: the EA group, SZRD group, EA & SZRD group, and sham group. The same acupoints (GV20, GV24, HT7, and SP6) will be used in the EA group, EA & SZRD group, and sham group, and these patients will receive the EA treatment or sham manipulation every other day for 4 consecutive weeks. SZRD treatments will be given to participants in the SZRD group and EA & SZRD group twice a day for 4 consecutive weeks. The primary outcome measures include Pittsburgh Sleep Quality Index scores and polysomnography. Secondary outcome measures include the Insomnia Severity Index, the National Institutes of Health Stroke Scale, the Hospital Anxiety and Depression Scale, brain magnetic resonance imaging, functional magnetic resonance imaging, and nocturnal melatonin concentrations. The primary and secondary outcomes will be assessed at baseline (before treatment), during the 2nd and 4th weeks of the intervention, and at the 8th and 12th weeks of follow-up. Safety assessments will be evaluated at baseline and during the 4th week of the intervention. DISCUSSION This study will contribute to assessing whether the combination of these two therapies is more beneficial for post-stroke insomnia than their independent use, and the results of this clinical trial will improve our understanding of the possible mechanisms underlying the effects of combination therapies. TRIAL REGISTRATION Chinese Clinical Trials Register ChiCTR2000031413 . Registered on March 30, 2020.
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Affiliation(s)
- Hui-Lian Huang
- School of Basic Medical Sciences, Zhejiang Chinese Medical University, Zhejiang, 310053, Hangzhou, China.,College of Traditional Chinese Medicine, China Three Gorges University & Yichang Hospital of Traditional Chinese Medicine, Yichang, 443003, Hubei, China
| | - Song-Bai Yang
- College of Traditional Chinese Medicine, China Three Gorges University & Yichang Hospital of Traditional Chinese Medicine, Yichang, 443003, Hubei, China
| | - Zhi-Gang Mei
- Key Laboratory of Hunan Province for Integrated Traditional Chinese and Western Medicine on Prevention and Treatment of Cardio-Cerebral Diseases, Hunan University of Chinese Medicine, Changsha, 410208, Hunan, China. .,Medical College of China Three Gorges University, Yichang, 443002, Hubei, China.
| | - Ya-Guang Huang
- Affiliated Renhe Hospital of China Three Gorges University, Yichang, 443001, Hubei, China
| | - Mao-Hua Chen
- College of Traditional Chinese Medicine, China Three Gorges University & Yichang Hospital of Traditional Chinese Medicine, Yichang, 443003, Hubei, China
| | - Qun-Li Mei
- College of Traditional Chinese Medicine, China Three Gorges University & Yichang Hospital of Traditional Chinese Medicine, Yichang, 443003, Hubei, China
| | - Hua-Ping Lei
- College of Traditional Chinese Medicine, China Three Gorges University & Yichang Hospital of Traditional Chinese Medicine, Yichang, 443003, Hubei, China
| | - Qing-Xian Mei
- College of Traditional Chinese Medicine, China Three Gorges University & Yichang Hospital of Traditional Chinese Medicine, Yichang, 443003, Hubei, China
| | - Jian-Hua Chen
- College of Traditional Chinese Medicine, China Three Gorges University & Yichang Hospital of Traditional Chinese Medicine, Yichang, 443003, Hubei, China
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30
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Severe sleep disturbance is associated with executive function impairment in patients with first-episode, treatment-naïve major depressive disorders. BMC Psychiatry 2021; 21:198. [PMID: 33874911 PMCID: PMC8054425 DOI: 10.1186/s12888-021-03194-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2020] [Accepted: 04/02/2021] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND Sleep disturbance and executive function impairment are common in patients with major depressive disorder (MDD), though the relationship between the two remains unclear. We investigated this association in first-episode, treatment-naïve patients with MDD. METHODS We analyzed data from 242 patients with MDD. We divided the patients into 2 groups based on sleep disturbance severity and compared the executive function odds ratios between the groups. RESULTS A total of 121 pairs of patients were matched (age 39.4 ± 10.1, 70.2% female). After propensity score matching, the odds ratios for cognitive impairment in patients with MDD and severe sleep disturbance were 1.922 (1.068-3.459, P = 0.029, q = 0.044) in executive functioning; 2.023 (1.211-3.379, P = 0.007, q = 0.021) in executive shifting. CONCLUSIONS Sleep disturbance is associated with executive functioning impairment in first-episode, treatment-naïve patients with MDD. Severe sleep disturbance can be a marker and aid in recognizing executive function impairment in patients with first-episode treatment-naïve MDD. Severe sleep disturbance can be a potential modifiable factor to improve executive function in MDD, as well as an effective measurement to improve cognition for sleep symptom management that should be enforced at initial treatment of first-episode MDD. Further study is required to confirm our results. TRIAL REGISTRATION ClinicalTrials.gov: NCT02023567 ; registration date: December 2013.
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31
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Sanjari Moghaddam H, Mohammadi E, Dolatshahi M, Mohebi F, Ashrafi A, Khazaie H, Aarabi MH. White matter microstructural abnormalities in primary insomnia: A systematic review of diffusion tensor imaging studies. Prog Neuropsychopharmacol Biol Psychiatry 2021; 105:110132. [PMID: 33049323 DOI: 10.1016/j.pnpbp.2020.110132] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Revised: 09/12/2020] [Accepted: 10/06/2020] [Indexed: 02/01/2023]
Abstract
Primary insomnia (PI), the most common sleep disorder, is primarily characterized by difficulties in initiating and maintaining sleep and deficits in daytime functioning. Study of white matter (WM) connections of the brain might provide valuable information regarding the underlying neural mechanism of PI. Diffusion tensor imaging (DTI) provides non-invasive access to the microstructural and network properties of brain WM, and thus, a great opportunity to quantitatively and sensitively study the human brain. The current literature of PI does not provide a consistent explanation of the etiology and pathology of the disorder; thus, we searched PubMed, EMBASE, and SCOPUS for DTI studies that compared WM integrity or network organization between PI patients and healthy controls to integrate all existing literature as an insight for further studies, and, hopefully, effective prevention and management of the disorder. English peer-reviewed full-text publications that investigated the diffusion indices of PI patients or those with insomnia symptoms compared with a group of healthy controls were included. We included 11 studies and extracted the data for qualitative synthesis. Except for one study, all studies were rated as high-quality, based on quality assessment. In aggregation, a total of 541 patients with PI and 679 healthy controls were included in this study. Our review of DTI studies suggests that WM disruptions in PI are better characterized in the context of neural networks. Frontostriatal, frontothalamic, and corticocortiscal networks, as well as the limbic system, seem to be the main neural networks with microstructural and network alterations in patients with PI. To illustrate, different parts of corona radiate and internal capsule within the corticosubcortical networks and superior longitudinal fasciculus within the corticocortical networks showed altered microstructural properties in PI patients. In view of the fact that the findings from individual studies are heterogeneous, it is difficult to derive consistent findings from the results, and the divergence of the findings must not be disregarded. Thus, this study is a starting point for future studies, and its implications for etiology and pathogenesis of insomnia should be regarded cautiously.
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Affiliation(s)
| | - Esmaeil Mohammadi
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mahsa Dolatshahi
- Faculty of medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Farnam Mohebi
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Agaah Ashrafi
- Department of Psychiatry, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Habibolah Khazaie
- Sleep Disorders Research Center, Department of Psychiatry, Kermanshah University of Medical Sciences (KUMS), Kermanshah, Iran
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32
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Roche GC, Fung P, Ransing R, Noor IM, Shalbafan M, El Hayek S, Koh EBY, Gupta AK, Kudva KG. The state of psychiatric research in the Asia Pacific region. Asia Pac Psychiatry 2021; 13:e12432. [PMID: 33145988 DOI: 10.1111/appy.12432] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2020] [Accepted: 10/10/2020] [Indexed: 12/18/2022]
Abstract
INTRODUCTION This study aims to review recent scientific publications and research output in the field of psychiatry, from a series of countries in the Asia-Pacific region (Australia, India, Indonesia, Iran, Lebanon, Malaysia, and Nepal), with a view to identify themes and similarities across regions, as well as to examine the barriers and challenges in mental health research faced by countries in the region. METHODS Seven psychiatrists from seven countries reviewed recent published and ongoing research in psychiatry in their respective nations, with respect to themes, as well as any barriers or challenges faced by mental health researchers. RESULTS While the seven nations included in this review vary in terms of research capabilities and economic development level, they share many similarities both in terms of research direction, and with regards to challenges faced. Limitations in the form of sociocultural differences from the West, and a lack of funding were some of the barriers identified. DISCUSSION Mental health research in the region has been progressing well. However, more varied research in the form of qualitative or economic studies are lacking, as are multi-center studies. The similar issues that nations face with regards to research could perhaps benefit from collaborative efforts and initiatives for the furtherance of research in the region.
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Affiliation(s)
- Glen Cedric Roche
- Department of Psychological Medicine, Changi General Hospital, Singapore
| | - Paul Fung
- Paramatta Mission, Parramatta, New South Wales, Australia.,Health Education and Training Institute Higher Education, North Paramatta, New South Wales, Australia
| | - Ramdas Ransing
- Department of Psychiatry, BKL Walawalkar Rural Medical College, Ratnagiri, Maharashtra, India
| | - Isa Multazam Noor
- Department of Psychiatry, Dr. Soeharto Heerdjan Mental Hospital, Jakarta, Indonesia
| | - Mohammadreza Shalbafan
- Mental Health Research Center, Department of Psychiatry, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Samer El Hayek
- Department of Psychiatry, American University of Beirut, Beirut, Lebanon
| | - Eugene Boon Yau Koh
- Department of Psychiatry, Faculty of Medicine & Health Sciences, Universiti Putra Malaysia, Serdang, Malaysia
| | | | - Kundadak Ganesh Kudva
- Early Psychosis Intervention Programme and East Region, Institute of Mental Health, Singapore
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Jeon B, Luyster FS, Callan JA, Chasens ER. Depressive Symptoms in Comorbid Obstructive Sleep Apnea and Insomnia: An Integrative Review. West J Nurs Res 2021:193945921989656. [PMID: 33533324 PMCID: PMC8329133 DOI: 10.1177/0193945921989656] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
The purpose of this integrative review was to synthesize evidence concerning the relationship between comorbid obstructive sleep apnea and insomnia (OSA+I), and depressive symptoms. OSA and insomnia are common sleep disorders, recently comorbid OSA+I has been recognized as prevalent in adults. Although each sleep disorder increases the risk and severity of depressive symptoms, the effect of comorbid OSA+I on depressive symptoms remains unclear. A systematic search of PubMed, CINAHL, and PsycINFO identified 15 data-based studies. All the studies were observational with either a cross-sectional (n = 14) or a case-control design (n = 1). Study quality was assessed. Most of the studies (n = 14) indicated that comorbid OSA+I had an additive role on depressive symptoms. Insomnia appeared to have a more important role than OSA in increasing the severity of depressive symptoms in persons with comorbid OSA+I.
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Affiliation(s)
- Bomin Jeon
- School of Nursing, University of Pittsburgh, Pittsburgh, PA, USA
| | - Faith S Luyster
- School of Nursing, University of Pittsburgh, Pittsburgh, PA, USA
| | - Judith A Callan
- School of Nursing, University of Pittsburgh, Pittsburgh, PA, USA
| | - Eileen R Chasens
- School of Nursing, University of Pittsburgh, Pittsburgh, PA, USA
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Emamian F, Mahdipour M, Noori K, Rostampour M, Mousavi SB, Khazaie H, Khodaie-Ardakani M, Tahmasian M, Zarei M. Alterations of Subcortical Brain Structures in Paradoxical and Psychophysiological Insomnia Disorder. Front Psychiatry 2021; 12:661286. [PMID: 34025484 PMCID: PMC8139557 DOI: 10.3389/fpsyt.2021.661286] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Accepted: 04/07/2021] [Indexed: 12/29/2022] Open
Abstract
Insomnia disorder (ID) is a common illness associated with mood and cognitive impairments. Subtyping ID is an ongoing debate in sleep medicine, but the underlying mechanisms of each subtype is poorly understood. Growing evidence suggests that subcortical brain structures play the key roles in pathophysiology of ID and its subtypes. Here, we aimed to investigate structural alteration of subcortical regions in patients with two common ID subtypes i.e., paradoxical and psychophysiological insomnia. Fifty-five patients and 49 healthy controls were recruited for this study and T1-weighted images and subjective and objective sleep parameters (i.e., Pittsburgh Sleep Quality Index and polysomnography) were collected from participants. Subcortical structures including the hippocampus, amygdala, caudate, putamen, globus pallidus, nucleus accumbens, and thalamus were automatically segmented in FSL. Volume and shape (using surface vertices) of each structure were compared between the groups, controlled for covariates, and corrected for multiple comparisons. In addition, correlations of sleep parameters and surface vertices or volumes were calculated. The caudate's volume was smaller in patients than controls. Compared with controls, we found regional shrinkage in the caudate, nucleus accumbens, posterior putamen, hippocampus, thalamus, and amygdala in paradoxical insomnia and shrinkage in the amygdala, caudate, hippocampus, and putamen in psychophysiological insomnia. Interestingly, comparing two patients groups, shape alteration in the caudate, putamen, and nucleus accumbens in paradoxical insomnia and shrinkage in the thalamus, amygdala, and hippocampus in psychophysiological insomnia were observed. Both subjective and objective sleep parameters were associated with these regional shape alterations in patients. Our results support the differential role of subcortical brain structures in pathophysiology of paradoxical and psychophysiological insomnia.
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Affiliation(s)
- Farnoosh Emamian
- Department of Psychiatry, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran.,Sleep Disorders Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Mostafa Mahdipour
- Institute of Medical Science and Technology, Shahid Beheshti University, Tehran, Iran
| | - Khadijeh Noori
- Sleep Disorders Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Masoumeh Rostampour
- Sleep Disorders Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - S Bentolhoda Mousavi
- Psychosis Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Habibolah Khazaie
- Sleep Disorders Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | | | - Masoud Tahmasian
- Institute of Medical Science and Technology, Shahid Beheshti University, Tehran, Iran
| | - Mojtaba Zarei
- Institute of Medical Science and Technology, Shahid Beheshti University, Tehran, Iran
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Functional connectome fingerprint of sleep quality in insomnia patients: Individualized out-of-sample prediction using machine learning. NEUROIMAGE-CLINICAL 2020; 28:102439. [PMID: 32980600 PMCID: PMC7522804 DOI: 10.1016/j.nicl.2020.102439] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Revised: 08/13/2020] [Accepted: 09/15/2020] [Indexed: 11/22/2022]
Abstract
Short-term and chronic insomnia are two subtypes of insomnia. Functional connectome predicts individual sleep quality for both two subtypes. Shared and distinct neural basis underlying poor sleep quality between two subtypes.
Objectives Insomnia disorder has been reclassified into short-term/acute and chronic subtypes based on recent etiological advances. However, understanding the similarities and differences in the neural mechanisms underlying the two subtypes and accurately predicting the sleep quality remain challenging. Methods Using 29 short-term/acute insomnia participants and 44 chronic insomnia participants, we used whole-brain regional functional connectivity strength to predict unseen individuals’ Pittsburgh sleep quality index (PSQI), applying the multivariate relevance vector regression method. Evaluated using both leave-one-out and 10-fold cross-validation, the pattern of whole-brain regional functional connectivity strength significantly predicted an unseen individual’s PSQI in both datasets. Results There were both similarities and differences in the regions that contributed the most to PSQI prediction between the two groups. Further functional connectivity analysis suggested that between-network connectivity was re-organized between short-term/acute insomnia and chronic insomnia. Conclusions The present study may have clinical value by informing the prediction of sleep quality and providing novel insights into the neural basis underlying the heterogeneity of insomnia.
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Schiel JE, Holub F, Petri R, Leerssen J, Tamm S, Tahmasian M, Riemann D, Spiegelhalder K. Affect and Arousal in Insomnia: Through a Lens of Neuroimaging Studies. Curr Psychiatry Rep 2020; 22:44. [PMID: 32661938 PMCID: PMC7359160 DOI: 10.1007/s11920-020-01173-0] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
PURPOSE OF REVIEW Previous research has struggled with identifying clear-cut, objective counterparts to subjective distress in insomnia. Approaching this discrepancy with a focus on hyperarousal and dysfunctional affective processes, studies examining brain structures and neural networks involved in affect and arousal are reviewed and conclusions for an updated understanding of insomnia are drawn. RECENT FINDINGS Recent studies found that amygdala reactivity, morphometry and adaptation in insomnia are altered, indicating that processing of negative stimuli is intensified and more lasting. Also, patients with insomnia show aberrant connectivity in the default mode network (DMN) and the salience network (SN), which is associated with subjective sleep disturbances, hyperarousal, maladaptive emotion regulation and disturbed integration of emotional states. The limbic circuit is assumed to play a crucial role in enhanced recall of negative experiences. There is reason to consider insomnia as a disorder of affect and arousal. Dysregulation of the limbic circuit might perpetuate impaired connectivity in the DMN and the SN. However, the interplay between the networks is yet to be researched.
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Affiliation(s)
- Julian E Schiel
- Department of Psychiatry and Psychotherapy, Faculty of Medicine, Medical Center - University of Freiburg, Hauptstraße 6, 79104, Freiburg, Germany.
| | - Florian Holub
- Department of Psychiatry and Psychotherapy, Faculty of Medicine, Medical Center - University of Freiburg, Hauptstraße 6, 79104, Freiburg, Germany
| | - Roxana Petri
- Department of Psychiatry and Psychotherapy, Faculty of Medicine, Medical Center - University of Freiburg, Hauptstraße 6, 79104, Freiburg, Germany
| | - Jeanne Leerssen
- Department of Sleep and Cognition, Netherlands Institute for Neuroscience, Amsterdam, The Netherlands
- Department of Integrative Neurophysiology, Center for Neurogenomics and Cognitive Research (CNCR), Amsterdam Neuroscience, VU University Amsterdam, Amsterdam, The Netherlands
| | - Sandra Tamm
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
- Department of Psychiatry, Oxford University, Oxford, UK
| | - Masoud Tahmasian
- Institute of Medical Science and Technology, Shahid Beheshti University, Tehran, Iran
| | - Dieter Riemann
- Department of Psychiatry and Psychotherapy, Faculty of Medicine, Medical Center - University of Freiburg, Hauptstraße 6, 79104, Freiburg, Germany
| | - Kai Spiegelhalder
- Department of Psychiatry and Psychotherapy, Faculty of Medicine, Medical Center - University of Freiburg, Hauptstraße 6, 79104, Freiburg, Germany
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Schiel JE, Spiegelhalder K. [Interaction of insomnia in old age and associated diseases : Cognitive, behavioral and neurobiological aspects]. Z Gerontol Geriatr 2020; 53:112-118. [PMID: 32020285 DOI: 10.1007/s00391-020-01694-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2019] [Accepted: 12/19/2019] [Indexed: 12/16/2022]
Abstract
The prevalence of insomnia is particularly high in old age. Sleep disturbances and impaired daytime functioning reflected in mood swings and concentration difficulties are often accompanied by other mental disorders such as depression. The objective of this article is to shed light on the role of insomnia in the context of frequent comorbidities in middle and old age. The focus is on the identification of linkage points between insomnia and associated diseases on a neurobiological level; however, possible distinguishing features are also named and deliberations on cognitive behavioral aspects and integrative theories, such as the hyperarousal theory are discussed. In order to provide an outlook for future research opportunities, the UK Biobank is presented as a promising resource of long-term data. Finally, the contents of the preceding deliberations are critically reflected and practical implications for the treatment of older patients with insomnia are derived.
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Affiliation(s)
- J E Schiel
- Klinik für Psychiatrie und Psychotherapie, Universitätsklinikum Freiburg, Medizinische Fakultät, Albert-Ludwigs-Universität, Hauptstr. 6, 79104, Freiburg, Deutschland.
| | - K Spiegelhalder
- Klinik für Psychiatrie und Psychotherapie, Universitätsklinikum Freiburg, Medizinische Fakultät, Albert-Ludwigs-Universität, Hauptstr. 6, 79104, Freiburg, Deutschland
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Qi XR, Kamphuis W, Shan L. Astrocyte Changes in the Prefrontal Cortex From Aged Non-suicidal Depressed Patients. Front Cell Neurosci 2019; 13:503. [PMID: 31798416 PMCID: PMC6874137 DOI: 10.3389/fncel.2019.00503] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2019] [Accepted: 10/24/2019] [Indexed: 11/13/2022] Open
Abstract
Glia alterations in the anterior cingulate cortex (ACC) and dorsolateral prefrontal cortex (DLPFC) have been postulated to play an important role in the pathophysiology of psychiatric disorders. Astroglia is the most abundant type of glial cells in the central nervous system. The expression levels of astrocyte markers (glial fibrillary acidic protein (GFAP), synemin-α, synemin-β, vimentin, nestin) in isolated gray matter from postmortem ACC and DLPFC were determined to investigate the possible involvement of astrocytes in depression. Donors were aged non-suicidal subjects with bipolar disorder (BPD) or major depressive disorder (MDD), and matched controls. GFAP mRNA levels were significantly increased in the ACC of BPD patients. However, GFAP immunohistochemistry showed that the area fraction of GFAP immunoreactive astrocytes was decreased in the ACC of BPD patients, while there were no changes in the cell density and integrated optical density (IOD), indicating that there might be a reduction of GFAP-positive astrocyte processes and remodeling of the astrocyte network in BPD. Furthermore, in controls, DLPFC GFAP mRNA levels were significantly lower with a time of death at daytime (08:01–20:00 h) compared to nighttime (20:01–08:00 h). In depression, such a diurnal pattern was not present. These findings in BPD and MDD subjects warrant further studies given the crucial roles of astrocytes in the central nervous system.
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Affiliation(s)
- Xin-Rui Qi
- Center for Translational Neurodegeneration and Regenerative Therapy, Shanghai Tenth People's Hospital Affiliated to Tongji University School of Medicine, Shanghai, China
| | - Willem Kamphuis
- Netherlands Institute for Neuroscience, Royal Netherlands Academy of Arts and Sciences (KNAW), Amsterdam, Netherlands
| | - Ling Shan
- Netherlands Institute for Neuroscience, Royal Netherlands Academy of Arts and Sciences (KNAW), Amsterdam, Netherlands
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