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Zhang D, Sun J, She Y, Cui Y, Zeng X, Lu L, Tang C, Xu N, Chen B, Qin W. A two-branch trade-off neural network for balanced scoring sleep stages on multiple cohorts. Front Neurosci 2023; 17:1176551. [PMID: 37424992 PMCID: PMC10326279 DOI: 10.3389/fnins.2023.1176551] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Accepted: 05/16/2023] [Indexed: 07/11/2023] Open
Abstract
Introduction Automatic sleep staging is a classification process with severe class imbalance and suffers from instability of scoring stage N1. Decreased accuracy in classifying stage N1 significantly impacts the staging of individuals with sleep disorders. We aim to achieve automatic sleep staging with expert-level performance in both N1 stage and overall scoring. Methods A neural network model combines an attention-based convolutional neural network and a classifier with two branches is developed. A transitive training strategy is employed to balance universal feature learning and contextual referencing. Parameter optimization and benchmark comparisons are conducted using a large-scale dataset, followed by evaluation on seven datasets in five cohorts. Results The proposed model achieves an accuracy of 88.16%, Cohen's kappa of 0.836, and MF1 score of 0.818 on the SHHS1 test set, also with comparable performance to human scorers in scoring stage N1. Incorporating multiple cohort data improves its performance. Notably, the model maintains high performance when applied to unseen datasets and patients with neurological or psychiatric disorders. Discussion The proposed algorithm demonstrates strong performance and generalizablility, and its direct transferability is noteworthy among similar studies on automated sleep staging. It is publicly available, which is conducive to expanding access to sleep-related analysis, especially those associated with neurological or psychiatric disorders.
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Affiliation(s)
- Di Zhang
- Engineering Research Center of Molecular and Neuro Imaging of the Ministry of Education, School of Life Science and Technology, Xidian University, Xi’an, China
- Intelligent Non-invasive Neuromodulation Technology and Transformation Joint Laboratory, Xidian University, Xi'an, China
| | - Jinbo Sun
- Engineering Research Center of Molecular and Neuro Imaging of the Ministry of Education, School of Life Science and Technology, Xidian University, Xi’an, China
- Intelligent Non-invasive Neuromodulation Technology and Transformation Joint Laboratory, Xidian University, Xi'an, China
| | - Yichong She
- Engineering Research Center of Molecular and Neuro Imaging of the Ministry of Education, School of Life Science and Technology, Xidian University, Xi’an, China
- Intelligent Non-invasive Neuromodulation Technology and Transformation Joint Laboratory, Xidian University, Xi'an, China
| | - Yapeng Cui
- Engineering Research Center of Molecular and Neuro Imaging of the Ministry of Education, School of Life Science and Technology, Xidian University, Xi’an, China
- Intelligent Non-invasive Neuromodulation Technology and Transformation Joint Laboratory, Xidian University, Xi'an, China
| | - Xiao Zeng
- Engineering Research Center of Molecular and Neuro Imaging of the Ministry of Education, School of Life Science and Technology, Xidian University, Xi’an, China
- Intelligent Non-invasive Neuromodulation Technology and Transformation Joint Laboratory, Xidian University, Xi'an, China
| | - Liming Lu
- South China Research Center for Acupuncture and Moxibustion, Medical College of Acu-Moxi and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Chunzhi Tang
- South China Research Center for Acupuncture and Moxibustion, Medical College of Acu-Moxi and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Nenggui Xu
- South China Research Center for Acupuncture and Moxibustion, Medical College of Acu-Moxi and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Badong Chen
- College of Artificial Intelligence, Xian Jiaotong University, Xian, Shaanxi, China
| | - Wei Qin
- Engineering Research Center of Molecular and Neuro Imaging of the Ministry of Education, School of Life Science and Technology, Xidian University, Xi’an, China
- Intelligent Non-invasive Neuromodulation Technology and Transformation Joint Laboratory, Xidian University, Xi'an, China
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2
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Demirlek C, Bora E. Sleep-dependent memory consolidation in schizophrenia: A systematic review and meta-analysis. Schizophr Res 2023; 254:146-154. [PMID: 36889181 DOI: 10.1016/j.schres.2023.02.028] [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: 05/16/2022] [Revised: 02/06/2023] [Accepted: 02/27/2023] [Indexed: 03/10/2023]
Abstract
Sleep disturbances and cognitive impairment are both persistent and common features of schizophrenia. Accumulating evidence indicates that sleep-dependent memory consolidation might be impaired in patients with schizophrenia compared to healthy controls. The current systematic review was performed in accordance with PRISMA guidelines. A random-effects model was used to calculate effect sizes (Hedge's g). In the quantitative review, three separate meta-analyses were conducted for procedural memory in healthy controls, schizophrenia, and comparison between healthy controls and schizophrenia. Additionally, separate meta-analyses were conducted for the studies using finger tapping motor sequence task, as it is the most commonly used task. The current systematic review included 14 studies including 304 patients with schizophrenia and 209 healthy controls. The random-effects model analyses for sleep-dependent procedural memory consolidation resulted in a small effect size in schizophrenia (g = 0.26), a large effect size in healthy controls (g = 0.98), a moderate effect size in healthy controls vs schizophrenia (g = 0.64). For the studies using finger tapping motor sequence task, meta-analyses resulted in a small effect size in schizophrenia (g = 0.19), a large effect size in healthy controls (g = 1.07), a moderate effect size in healthy controls vs schizophrenia (g = 0.70). In the qualitative review, there was also impaired sleep-dependent declarative memory consolidation in schizophrenia compared to healthy controls. Current findings support that sleep improves memory consolidation in healthy adults, but there is a deficit in sleep-dependent memory consolidation in people with schizophrenia. Future studies investigating sleep-dependent consolidation of different memory subtypes with polysomnography in different stages of psychotic disorders are needed.
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Affiliation(s)
- Cemal Demirlek
- Department of Neurosciences, Institute of Health Sciences, Dokuz Eylul University, Izmir, Turkey.
| | - Emre Bora
- Department of Neurosciences, Institute of Health Sciences, Dokuz Eylul University, Izmir, Turkey; Department of Psychiatry, Dokuz Eylul University Medical School, Izmir, Turkey; Department of Psychiatry, Melbourne Neuropsychiatry Centre, University of Melbourne and Melbourne Health, Carlton South, Victoria 3053, Australia
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3
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Holter KM, Pierce BE, Gould RW. Metabotropic glutamate receptor function and regulation of sleep-wake cycles. INTERNATIONAL REVIEW OF NEUROBIOLOGY 2023; 168:93-175. [PMID: 36868636 DOI: 10.1016/bs.irn.2022.11.002] [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] [Indexed: 01/15/2023]
Abstract
Metabotropic glutamate (mGlu) receptors are the most abundant family of G-protein coupled receptors and are widely expressed throughout the central nervous system (CNS). Alterations in glutamate homeostasis, including dysregulations in mGlu receptor function, have been indicated as key contributors to multiple CNS disorders. Fluctuations in mGlu receptor expression and function also occur across diurnal sleep-wake cycles. Sleep disturbances including insomnia are frequently comorbid with neuropsychiatric, neurodevelopmental, and neurodegenerative conditions. These often precede behavioral symptoms and/or correlate with symptom severity and relapse. Chronic sleep disturbances may also be a consequence of primary symptom progression and can exacerbate neurodegeneration in disorders including Alzheimer's disease (AD). Thus, there is a bidirectional relationship between sleep disturbances and CNS disorders; disrupted sleep may serve as both a cause and a consequence of the disorder. Importantly, comorbid sleep disturbances are rarely a direct target of primary pharmacological treatments for neuropsychiatric disorders even though improving sleep can positively impact other symptom clusters. This chapter details known roles of mGlu receptor subtypes in both sleep-wake regulation and CNS disorders focusing on schizophrenia, major depressive disorder, post-traumatic stress disorder, AD, and substance use disorder (cocaine and opioid). In this chapter, preclinical electrophysiological, genetic, and pharmacological studies are described, and, when possible, human genetic, imaging, and post-mortem studies are also discussed. In addition to reviewing the important relationships between sleep, mGlu receptors, and CNS disorders, this chapter highlights the development of selective mGlu receptor ligands that hold promise for improving both primary symptoms and sleep disturbances.
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Affiliation(s)
- Kimberly M Holter
- Department of Physiology and Pharmacology, Wake Forest University School of Medicine, Winston-Salem, NC, United States
| | - Bethany E Pierce
- Department of Physiology and Pharmacology, Wake Forest University School of Medicine, Winston-Salem, NC, United States
| | - Robert W Gould
- Department of Physiology and Pharmacology, Wake Forest University School of Medicine, Winston-Salem, NC, United States.
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4
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Sahu M, Tripathi R, Jha NK, Jha SK, Ambasta RK, Kumar P. Cross talk mechanism of disturbed sleep patterns in neurological and psychological disorders. Neurosci Biobehav Rev 2022; 140:104767. [PMID: 35811007 DOI: 10.1016/j.neubiorev.2022.104767] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Revised: 06/20/2022] [Accepted: 07/01/2022] [Indexed: 11/25/2022]
Abstract
The incidence and prevalence of sleep disorders continue to increase in the elderly populace, particularly those suffering from neurodegenerative and neuropsychiatric disorders. This not only affects the quality of life but also accelerates the progression of the disease. There are many reasons behind sleep disturbances in such patients, for instance, medication use, nocturia, obesity, environmental factors, nocturnal motor disturbances and depressive symptoms. This review focuses on the mechanism and effects of sleep dysfunction in neurodegenerative and neuropsychiatric disorders. Wherein we discuss disturbed circadian rhythm, signaling cascade and regulation of genes during sleep deprivation. Moreover, we explain the perturbation in brainwaves during disturbed sleep and the ocular perspective of neurodegenerative and neuropsychiatric manifestations in sleep disorders. Further, as the pharmacological approach is often futile and carries side effects, therefore, the non-pharmacological approach opens newer possibilities to treat these disorders and widens the landscape of treatment options for patients.
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Affiliation(s)
- Mehar Sahu
- Molecular Neuroscience and Functional Genomics Laboratory, Delhi Technological University (Formerly Delhi College of Engineering), Delhi, India
| | - Rahul Tripathi
- Molecular Neuroscience and Functional Genomics Laboratory, Delhi Technological University (Formerly Delhi College of Engineering), Delhi, India
| | - Niraj Kumar Jha
- Department of Biotechnology, School of Engineering & Technology (SET) Sharda University, UP, India
| | - Saurabh Kumar Jha
- Department of Biotechnology, School of Engineering & Technology (SET) Sharda University, UP, India.
| | - Rashmi K Ambasta
- Molecular Neuroscience and Functional Genomics Laboratory, Delhi Technological University (Formerly Delhi College of Engineering), Delhi, India
| | - Pravir Kumar
- Molecular Neuroscience and Functional Genomics Laboratory, Delhi Technological University (Formerly Delhi College of Engineering), Delhi, India.
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5
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Weinhold SL, Lechinger J, Timm N, Hansen A, Ngo HVV, Göder R. Auditory stimulation in-phase with slow oscillations to enhance overnight memory consolidation in patients with schizophrenia? J Sleep Res 2022; 31:e13636. [PMID: 35686351 DOI: 10.1111/jsr.13636] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2021] [Revised: 03/24/2022] [Accepted: 04/27/2022] [Indexed: 11/27/2022]
Abstract
Sleep-dependent memory consolidation is disturbed in patients with schizophrenia, who furthermore show reductions in sleep spindles and probably also in delta power during sleep. The memory dysfunction in these patients is one of the strongest markers for worse long-term functional outcome. However, therapeutic interventions to normalise memory functions, e.g., with medication, still do not exist. Against this backdrop, we investigated to what extent a non-invasive approach enhancing sleep with real-time auditory stimulation in-phase with slow oscillations might affect overnight memory consolidation in patients with schizophrenia. To this end, we examined 18 patients with stably medicated schizophrenia in a double-blinded sham-controlled design. Memory performance was assessed by a verbal (word list) and a non-verbal (complex figure) declarative memory task. In comparison to a sham condition without auditory stimuli, we found that in patients with schizophrenia, auditory stimulation evokes an electrophysiological response similar to that in healthy participants leading to an increase in slow wave and temporally coupled sleep spindle activity during stimulation. Despite this finding, patients did not show any beneficial effect on the overnight change in memory performance by stimulation. Although the stimulation in our study did not improve the patient's memory, the electrophysiological response gives hope that auditory stimulation could enable us to provide better treatment for sleep-related detriments in these patients in the future.
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Affiliation(s)
- Sara Lena Weinhold
- Department of Psychiatry and Psychotherapy (ZIP), University Hospital Schleswig-Holstein (UKSH), Kiel, Germany
| | - Julia Lechinger
- Department of Psychiatry and Psychotherapy (ZIP), University Hospital Schleswig-Holstein (UKSH), Kiel, Germany
| | - Nele Timm
- Department of Psychiatry and Psychotherapy (ZIP), University Hospital Schleswig-Holstein (UKSH), Kiel, Germany
| | - Anja Hansen
- Department of Psychiatry and Psychotherapy (ZIP), University Hospital Schleswig-Holstein (UKSH), Kiel, Germany
| | - Hong-Viet V Ngo
- Department of Psychology, University of Lübeck, Lübeck, Germany
| | - Robert Göder
- Department of Psychiatry and Psychotherapy (ZIP), University Hospital Schleswig-Holstein (UKSH), Kiel, Germany
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6
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The Impact of Sleep on Neurocognition and Functioning in Schizophrenia—Is It Time to Wake-Up? JOURNAL OF PSYCHIATRY AND BRAIN SCIENCE 2022; 7. [PMID: 35224206 PMCID: PMC8880843 DOI: 10.20900/jpbs.20220001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
People with schizophrenia (SZ) display substantial neurocognitive deficits that have been implicated as major contributors to poor daily functioning and disability. Previous reports have identified a number of predictors of poor neurocognition in SZ including demographics, symptoms, and treatment adherence, as well as body mass index, aerobic fitness, and exercise activity. However, the putative impact of sleep has received relatively limited consideration, despite sleep disturbances, which are pervasive in this population, resulting in symptoms that are strikingly similar to the neurocognitive deficits commonly observed in SZ. Here we argue for the consideration of the impact of sleep on neurocognition in people with SZ and propose recommendations for future research to elucidate the links between sleep parameters, neurocognition and daily functioning.
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7
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Bartsch U, Corbin LJ, Hellmich C, Taylor M, Easey KE, Durant C, Marston HM, Timpson NJ, Jones MW. Schizophrenia-associated variation at ZNF804A correlates with altered experience-dependent dynamics of sleep slow waves and spindles in healthy young adults. Sleep 2021; 44:zsab191. [PMID: 34329479 PMCID: PMC8664578 DOI: 10.1093/sleep/zsab191] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Revised: 07/06/2021] [Indexed: 12/12/2022] Open
Abstract
The rs1344706 polymorphism in ZNF804A is robustly associated with schizophrenia and schizophrenia is, in turn, associated with abnormal non-rapid eye movement (NREM) sleep neurophysiology. To examine whether rs1344706 is associated with intermediate neurophysiological traits in the absence of disease, we assessed the relationship between genotype, sleep neurophysiology, and sleep-dependent memory consolidation in healthy participants. We recruited healthy adult males with no history of psychiatric disorder from the Avon Longitudinal Study of Parents and Children (ALSPAC) birth cohort. Participants were homozygous for either the schizophrenia-associated 'A' allele (N = 22) or the alternative 'C' allele (N = 18) at rs1344706. Actigraphy, polysomnography (PSG) and a motor sequence task (MST) were used to characterize daily activity patterns, sleep neurophysiology and sleep-dependent memory consolidation. Average MST learning and sleep-dependent performance improvements were similar across genotype groups, albeit more variable in the AA group. During sleep after learning, CC participants showed increased slow-wave (SW) and spindle amplitudes, plus augmented coupling of SW activity across recording electrodes. SW and spindles in those with the AA genotype were insensitive to learning, whilst SW coherence decreased following MST training. Accordingly, NREM neurophysiology robustly predicted the degree of overnight motor memory consolidation in CC carriers, but not in AA carriers. We describe evidence that rs1344706 polymorphism in ZNF804A is associated with changes in the coordinated neural network activity that supports offline information processing during sleep in a healthy population. These findings highlight the utility of sleep neurophysiology in mapping the impacts of schizophrenia-associated common genetic variants on neural circuit oscillations and function.
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Affiliation(s)
- Ullrich Bartsch
- School of Physiology, Pharmacology & Neuroscience, University of Bristol, Bristol, UK
- Translational Neuroscience, Eli Lilly & Co Ltd UK, Erl Wood Manor, Windlesham, UK
- UK DRI Health Care & Technology at Imperial College London and the University of Surrey, Surrey Sleep Research Centre, University of Surrey, Clinical Research Building, Egerton Road, Guildford, Surrey, UK
| | - Laura J Corbin
- MRC Integrative Epidemiology Unit at University of Bristol, Bristol, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Charlotte Hellmich
- School of Physiology, Pharmacology & Neuroscience, University of Bristol, Bristol, UK
| | - Michelle Taylor
- MRC Integrative Epidemiology Unit at University of Bristol, Bristol, UK
| | - Kayleigh E Easey
- MRC Integrative Epidemiology Unit at University of Bristol, Bristol, UK
- UK Centre for Tobacco and Alcohol Studies, School of Psychological Science, University of Bristol, Bristol, UK
| | - Claire Durant
- Clinical Research and Imaging Centre (CRIC), University of Bristol, Bristol, UK
| | - Hugh M Marston
- Translational Neuroscience, Eli Lilly & Co Ltd UK, Erl Wood Manor, Windlesham, UK
- Böhringer Ingelheim Pharma GmbH & Co. KG, Biberach, Germany
| | - Nicholas J Timpson
- MRC Integrative Epidemiology Unit at University of Bristol, Bristol, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Matthew W Jones
- School of Physiology, Pharmacology & Neuroscience, University of Bristol, Bristol, UK
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8
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Zhang X, Lv L, Min G, Wang Q, Zhao Y, Li Y. Overview of the Complex Figure Test and Its Clinical Application in Neuropsychiatric Disorders, Including Copying and Recall. Front Neurol 2021; 12:680474. [PMID: 34531812 PMCID: PMC8438146 DOI: 10.3389/fneur.2021.680474] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2021] [Accepted: 07/05/2021] [Indexed: 11/13/2022] Open
Abstract
The Rey–Osterrieth Complex Figure (ROCF) test is a commonly used neuropsychological assessment tool. It is widely used to assess the visuo-constructional ability and visual memory of neuropsychiatric disorders, including copying and recall tests. By drawing the complex figure, the functional decline of a patient in multiple cognitive dimensions can be assessed, including attention and concentration, fine-motor coordination, visuospatial perception, non-verbal memory, planning and organization, and spatial orientation. This review first describes the different versions and scoring methods of ROCF. It then reviews the application of ROCF in the assessment of visuo-constructional ability in patients with dementia, other brain diseases, and psychiatric disorders. Finally, based on the scoring method of the digital system, future research hopes to develop a new digital ROCF scoring method combined with machine learning algorithms to standardize clinical practice and explore the characteristic neuropsychological structure information of different disorders.
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Affiliation(s)
- Xiaonan Zhang
- Department of Neurology, First Hospital of Shanxi Medical University, Taiyuan, China
| | - Liangliang Lv
- Department of Neurology, First Hospital of Shanxi Medical University, Taiyuan, China
| | - Guowen Min
- Department of Neurology, First Hospital of Shanxi Medical University, Taiyuan, China
| | - Qiuyan Wang
- Department of Neurology, First Hospital of Shanxi Medical University, Taiyuan, China
| | - Yarong Zhao
- Department of Neurology, First Hospital of Shanxi Medical University, Taiyuan, China
| | - Yang Li
- Department of Neurology, First Hospital of Shanxi Medical University, Taiyuan, China
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9
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Carruthers SP, Brunetti G, Rossell SL. Sleep disturbances and cognitive impairment in schizophrenia spectrum disorders: a systematic review and narrative synthesis. Sleep Med 2021; 84:8-19. [PMID: 34090012 DOI: 10.1016/j.sleep.2021.05.011] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Revised: 04/28/2021] [Accepted: 05/10/2021] [Indexed: 01/19/2023]
Abstract
Individuals with schizophrenia spectrum disorders (SSD) experience frequent sleep disturbances in addition to enduring cognitive impairments. The purpose of the present review was to systematically summarise our current understanding of the association between sleep disturbances and cognition in SSD. Through this, it was aimed to identify features of disturbed sleep that are reliably associated with cognitive deficits in SSD and identify the gaps within the current literature that require future investigation. Eighteen relevant studies were identified following a two-stage screening process. Following a structured narrative synthesis of key study components, no clear and consistent pattern emerged. Considerable methodological variability was present amongst the reviewed studies. Although some broad consistencies were identified, such as associations between sleep spindle density and sleep-dependent memory consolidation, the overall pattern of results lacked a cohesive composition due to the diverse list of sleep parameters and cognitive domains investigated, as well as a lack of replication. Additional research is needed before more definitive remarks can be made regarding the influence of sleep disturbances on cognitive function in SSD.
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Affiliation(s)
- Sean P Carruthers
- Centre for Mental Health, Swinburne University of Technology, Hawthorn, VIC, Australia.
| | - Gemma Brunetti
- Centre for Mental Health, Swinburne University of Technology, Hawthorn, VIC, Australia
| | - Susan L Rossell
- Centre for Mental Health, Swinburne University of Technology, Hawthorn, VIC, Australia; Department of Psychiatry, St Vincent's Hospital, Melbourne, VIC, Australia
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10
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Bian Y, Lin C, Ma B, Han X, Yue W, Yang F, Wang Z. Effect of subjective sleep quality on learning and memory in drug-free patients with schizophrenia. Psychiatry Res 2021; 299:113849. [PMID: 33721784 DOI: 10.1016/j.psychres.2021.113849] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Accepted: 02/28/2021] [Indexed: 11/28/2022]
Abstract
OBJECTIVE This study aims to elucidate the association paths between subjective sleep quality and the learning and memory ability of drug-free patients with schizophrenia. METHODS 150 patients with schizophrenia were recruited. Information on clinical and socio-demographic was obtained, and a neurocognitive battery was administered. The Pittsburgh Sleep Quality Index (PSQI) was used to assess the quality of subjective sleep. The Verbal Learning Test and the Visual Learning Test that were taken from the MATRICS Consensus Cognitive Battery were used to assess the patient's ability to learn and recall. Structural equation modelling (SEM) was performed to examine the relationship between subjective sleep quality and learning and memory ability .The model was further modified and fitted. RESULTS There were significant negative correlations between learning and memory variables and the PSQI scores or the PANSS scores. Significant direct effect of PSQI on Verbal Learning and Visual Learning, and significant indirect effect of PSQI on Verbal Learning and Visual Learning through psychotic symptoms were found in the most plausible SEM model that explains the data. CONCLUSION Subjective sleep quality has a direct impact on the ability to learn and memory, and indirectly affects the ability to learn and memory through psychotic symptoms in drug-free patients with schizophrenia. Sleep quality could be an intervention target for improving cognitive function in patients with schizophrenia.
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Affiliation(s)
- Yun Bian
- Peking University Huilongguan Clinical Medical School, Beijing Huilongguan Hospital, Beijing 100096, China.
| | - Chen Lin
- Peking University Huilongguan Clinical Medical School, Beijing Huilongguan Hospital, Beijing 100096, China
| | - Botao Ma
- Peking University Huilongguan Clinical Medical School, Beijing Huilongguan Hospital, Beijing 100096, China
| | - Xiaole Han
- Peking University Huilongguan Clinical Medical School, Beijing Huilongguan Hospital, Beijing 100096, China
| | - Weihua Yue
- Peking University Sixth Hospital, Peking University Institute of Mental Health, Key Laboratory of Mental Health, Ministry of Health (Peking University), Beijing 100191, China
| | - Fude Yang
- Peking University Huilongguan Clinical Medical School, Beijing Huilongguan Hospital, Beijing 100096, China
| | - Zhixiong Wang
- Peking University Huilongguan Clinical Medical School, Beijing Huilongguan Hospital, Beijing 100096, China; Peking University Sixth Hospital, Peking University Institute of Mental Health, Key Laboratory of Mental Health, Ministry of Health (Peking University), Beijing 100191, China
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11
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Ruch S, Fehér K, Homan S, Morishima Y, Mueller SM, Mueller SV, Dierks T, Grieder M. Bi-Temporal Anodal Transcranial Direct Current Stimulation during Slow-Wave Sleep Boosts Slow-Wave Density but Not Memory Consolidation. Brain Sci 2021; 11:brainsci11040410. [PMID: 33805063 PMCID: PMC8064104 DOI: 10.3390/brainsci11040410] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Revised: 03/15/2021] [Accepted: 03/22/2021] [Indexed: 12/31/2022] Open
Abstract
Slow-wave sleep (SWS) has been shown to promote long-term consolidation of episodic memories in hippocampo–neocortical networks. Previous research has aimed to modulate cortical sleep slow-waves and spindles to facilitate episodic memory consolidation. Here, we instead aimed to modulate hippocampal activity during slow-wave sleep using transcranial direct current stimulation in 18 healthy humans. A pair-associate episodic memory task was used to evaluate sleep-dependent memory consolidation with face–occupation stimuli. Pre- and post-nap retrieval was assessed as a measure of memory performance. Anodal stimulation with 2 mA was applied bilaterally over the lateral temporal cortex, motivated by its particularly extensive connections to the hippocampus. The participants slept in a magnetic resonance (MR)-simulator during the recordings to test the feasibility for a future MR-study. We used a sham-controlled, double-blind, counterbalanced randomized, within-subject crossover design. We show that stimulation vs. sham significantly increased slow-wave density and the temporal coupling of fast spindles and slow-waves. While retention of episodic memories across sleep was not affected across the entire sample of participants, it was impaired in participants with below-average pre-sleep memory performance. Hence, bi-temporal anodal direct current stimulation applied during sleep enhanced sleep parameters that are typically involved in memory consolidation, but it failed to improve memory consolidation and even tended to impair consolidation in poor learners. These findings suggest that artificially enhancing memory-related sleep parameters to improve memory consolidation can actually backfire in those participants who are in most need of memory improvement.
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Affiliation(s)
- Simon Ruch
- Cognitive Neuroscience of Memory and Consciousness, Institute of Psychology, University of Bern, 3012 Bern, Switzerland;
- Department of Neurosurgery and Neurotechnology, Institute for Neuromodulation and Neurotechnology, University of Tübingen, 72076 Tübingen, Germany
| | - Kristoffer Fehér
- Translational Research Center, University Hospital of Psychiatry and Psychotherapy, University of Bern, 3000 Bern, Switzerland; (K.F.); (S.H.); (Y.M.); (S.M.M.); (S.V.M.); (T.D.)
| | - Stephanie Homan
- Translational Research Center, University Hospital of Psychiatry and Psychotherapy, University of Bern, 3000 Bern, Switzerland; (K.F.); (S.H.); (Y.M.); (S.M.M.); (S.V.M.); (T.D.)
- Department of Psychiatry, Psychotherapy and Psychosomatics, University Hospital of Psychiatry, University of Zurich, 8032 Zurich, Switzerland
| | - Yosuke Morishima
- Translational Research Center, University Hospital of Psychiatry and Psychotherapy, University of Bern, 3000 Bern, Switzerland; (K.F.); (S.H.); (Y.M.); (S.M.M.); (S.V.M.); (T.D.)
| | - Sarah Maria Mueller
- Translational Research Center, University Hospital of Psychiatry and Psychotherapy, University of Bern, 3000 Bern, Switzerland; (K.F.); (S.H.); (Y.M.); (S.M.M.); (S.V.M.); (T.D.)
| | - Stefanie Verena Mueller
- Translational Research Center, University Hospital of Psychiatry and Psychotherapy, University of Bern, 3000 Bern, Switzerland; (K.F.); (S.H.); (Y.M.); (S.M.M.); (S.V.M.); (T.D.)
| | - Thomas Dierks
- Translational Research Center, University Hospital of Psychiatry and Psychotherapy, University of Bern, 3000 Bern, Switzerland; (K.F.); (S.H.); (Y.M.); (S.M.M.); (S.V.M.); (T.D.)
| | - Matthias Grieder
- Translational Research Center, University Hospital of Psychiatry and Psychotherapy, University of Bern, 3000 Bern, Switzerland; (K.F.); (S.H.); (Y.M.); (S.M.M.); (S.V.M.); (T.D.)
- Correspondence:
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12
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Yazıhan NT, Yetkin S. Sleep, sleep spindles, and cognitive functions in drug-naive patients with first-episode psychosis. J Clin Sleep Med 2020; 16:2079-2087. [PMID: 32870142 DOI: 10.5664/jcsm.8776] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
STUDY OBJECTIVES Various lines of clinical findings have suggested abnormalities in macro- or microstructural parameters of sleep in patients with schizophrenia. Meanwhile findings are inconclusive due to some confounding factors, such as the heterogeneity of the disorder, drug regimen, and duration of the illness. There are a few studies in the literature that have been conducted on drug-free patients with first-episode psychosis (FEP). Based on this knowledge, we aimed to explore sleep characteristics, sleep spindles, and neuropsychological profiles of the drug-naive patients with FEP. METHODS The study sample consisted of 21 drug-naive patients with FEP and 21 healthy participants. Polysomnography recordings were conducted for 2 subsequent nights. A neuropsychological test battery was administered for assessing cognitive functions. The Positive and Negative Syndrome Scale was applied to measure symptom severity of the patients. Spindle detection was performed visually. RESULTS According to the results of the study, the patient group's percentage of stage N2 sleep and sleep efficiency index was lower than in the control group. Among sleep spindle parameters, spindle density was found to be reduced in the patient group. The results of neuropsychological tests measuring executive functions, learning, and memory support the idea that there is a global cognitive deterioration from the early course of the disorder. In the psychotic group, negative symptoms were negatively correlated with verbal memory, learning, verbal fluency, and semantic organization. We found that the percentage of stage N3 sleep decreased while negative symptom severity increased. In addition, the percentage of stage N1 sleep increased as negative symptom severity increased. Reduction in stage N3 sleep was associated with an impairment in learning, verbal fluency, and response inhibition. The sleep spindle density and cognitive functions did not show any associations. CONCLUSIONS Taken together, these findings suggest that patients with FEP show global cognitive impairment (except for attention and processing speed), which is associated with changes in sleep architecture and higher score in a scale assessing negative symptoms. We conclude that cognitive function and spindle parameters differ nonlinearly among patients with FEP.
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Affiliation(s)
| | - Sinan Yetkin
- Department of Psychiatry, Health Sciences University, Ankara, Turkey
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13
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Taliercio J, Bonasera B, Portillo C, Ramjas E, Serper M. Physical Activity, Sleep-related Behaviors and Severity of Symptoms in Schizophrenia. Psychiatry Res 2020; 294:113489. [PMID: 33038793 DOI: 10.1016/j.psychres.2020.113489] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Accepted: 09/25/2020] [Indexed: 12/22/2022]
Abstract
The beneficial effects of a healthy sleep hygiene and regular physical activity have both been noted in improving psychopathology symptom severity. No study to date however, has evaluated the potential therapeutic effects of both sleep and exercise simultaneously in individuals diagnosed with schizophrenia. To examine the two variables concurrently, in the present report, patients with diagnoses of schizophrenia spectrum disorders (n = 64), were administered assessments that measured both their physical activity and sleep-related behaviors. Additionally, patients' symptom severity and cognitive and daily functioning abilities were also assessed. It was found sleep hygiene and physical activity were associated with patients' symptom severity and cognitive capacities, but not with their daily functioning abilities. Further, no interaction effects were found between sleep hygiene and physical activity. These results suggest that physical activity and sleep hygiene should be considered, independently, in their contribution to psychopathology.
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Affiliation(s)
| | | | | | | | - Mark Serper
- Department of Psychology, Hofstra University, Hempstead, NY; Department of Psychiatry, Icahn Mount Sinai School of Medicine.
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14
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Fujii K, Yoshihara Y, Matsumoto Y, Tose K, Takeuchi H, Isobe M, Mizuta H, Maniwa D, Okamura T, Murai T, Kawahara Y, Takahashi H. Cognition and interpersonal coordination of patients with schizophrenia who have sports habits. PLoS One 2020; 15:e0241863. [PMID: 33166326 PMCID: PMC7652240 DOI: 10.1371/journal.pone.0241863] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2020] [Accepted: 10/21/2020] [Indexed: 11/19/2022] Open
Abstract
Team sports activities are effective for improving the negative symptoms and cognitive functions in patients with schizophrenia. However, the interpersonal coordination during the sports and visual cognition of patients with schizophrenia who have team sports habits are unknown. The main objectives of this study were to test two hypotheses: first, patients with schizophrenia perform the skill requiring ball passing and receiving worse than healthy controls; and second, the patients will be impaired in these functionings in accordance with the previous studies regarding schizophrenia in general. Twelve patients with schizophrenia and 15 healthy controls, who had habits in football, participated in this study. The participants performed three conventional cognitive tests and a 3-vs-1 ball possession task to evaluate their interpersonal coordination. The results showed that in the 3-vs-1 possession task, the displacement in the pass angle for the patients was significantly smaller than that for the control. The recall in the complex figure test, the performance in the trail making test, and that in the five-choice reaction task for the patients were worse than those for the control. Moreover, we found the significant partial correlations in the patients between the extradimensional shift error and the pass angle as well as between the time in the trail making test and the displacement in the pass angle, whereas there was no significant correlation in the control group. This study clarified the impaired interpersonal coordination during team sports and the visual cognition of patients with schizophrenia who have team sports habits.
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Affiliation(s)
- Keisuke Fujii
- Graduate School of Informatics, Nagoya University, Nagoya, Japan
- Center for Advanced Intelligence Project, RIKEN, Tokyo, Japan
| | - Yujiro Yoshihara
- Department of Psychiatry, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Yukiko Matsumoto
- Department of Psychiatry and Behavioral Sciences, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Kyoto, Japan
| | - Keima Tose
- Department of Psychiatry, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Hideaki Takeuchi
- Department of Psychiatry, Graduate School of Medicine, Kyoto University, Kyoto, Japan
- Department of Psychiatry and Behavioral Sciences, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Kyoto, Japan
| | - Masanori Isobe
- Department of Psychiatry, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Hiroto Mizuta
- Department of Psychiatry, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Daisuke Maniwa
- Takatsuki Sports Club for Mental Illness, Takatsuki, Japan
| | | | - Toshiya Murai
- Department of Psychiatry, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Yoshinobu Kawahara
- Center for Advanced Intelligence Project, RIKEN, Tokyo, Japan
- Institute of Mathematics for Industry, Kyushu University, Fukuoka, Japan
| | - Hidehiko Takahashi
- Department of Psychiatry and Behavioral Sciences, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Kyoto, Japan
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15
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Castelnovo A, Zago M, Casetta C, Zangani C, Donati F, Canevini M, Riedner BA, Tononi G, Ferrarelli F, Sarasso S, D'Agostino A. Slow wave oscillations in Schizophrenia First-Degree Relatives: A confirmatory analysis and feasibility study on slow wave traveling. Schizophr Res 2020; 221:37-43. [PMID: 32220503 DOI: 10.1016/j.schres.2020.03.025] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2019] [Revised: 03/11/2020] [Accepted: 03/13/2020] [Indexed: 12/14/2022]
Abstract
Abnormal sleep oscillations have recently been proposed as endophenotypes of schizophrenia. However, optimization of methodological approaches is still necessary to standardize analyses of their microstructural characteristics. Additionally, some relevant features of these oscillations remain unexplored in pathological conditions. Among others, slow wave traveling is a promising proxy for diurnal processes of brain connectivity and excitability. The study of slow oscillations propagation appears particularly relevant when schizophrenia is conceptualized as a dys-connectivity syndrome. Given the rising knowledge on the neurobiological mechanisms underlying slow wave traveling, this measure might offer substantial advantages over other approaches in investigating brain connectivity. Herein we: 1) confirm the stability of our previous findings on slow waves and sleep spindles in FDRs using different automated algorithms, and 2) report the dynamics of slow wave traveling in FDRs of Schizophrenia patients. A 256-channel, high-density EEG system was employed to record a whole night of sleep of 16 FDRs and 16 age- and gender-matched control subjects. A recently developed, open source toolbox was used for slow wave visualization and detection. Slow waves were confirmed to be significantly smaller in FDRs compared to the control group. Additionally, several traveling parameters were analyzed. Traveled distances were found to be significantly reduced in FDRs, whereas origins showed a different topographical pattern of distribution from control subjects. In contrast, local speed did not differ between groups. Overall, these results suggest that slow wave traveling might be a viable method to study pathological conditions interfering with brain connectivity.
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Affiliation(s)
- Anna Castelnovo
- Department of Health Sciences, Università degli Studi di Milano, Italy; Sleep Center, Neurocenter of Southern Switzerland, Regional Civic Hospital of Lugano, Switzerland; University of Southern Switzerland, Lugano, Switzerland.
| | - Matteo Zago
- Department of Electronics, Information and Bioengineering, Politecnico di Milano, Italy
| | - Cecilia Casetta
- King's College London, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, United Kingdom of Great Britain and Northern Ireland
| | - Caroline Zangani
- Department of Health Sciences, Università degli Studi di Milano, Italy
| | - Francesco Donati
- Department of Health Sciences, Università degli Studi di Milano, Italy
| | | | - Brady A Riedner
- Department of Psychiatry, University of Wisconsin, Madison, United States
| | - Giulio Tononi
- Department of Psychiatry, University of Wisconsin, Madison, United States
| | - Fabio Ferrarelli
- Department of Psychiatry, University of Pittsburgh, United States
| | - Simone Sarasso
- "L. Sacco" Department of Biomedical and Clinical Sciences, Università degli Studi di Milano, Italy
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16
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Kumari V, Ettinger U. Controlled sleep deprivation as an experimental medicine model of schizophrenia: An update. Schizophr Res 2020; 221:4-11. [PMID: 32402603 DOI: 10.1016/j.schres.2020.03.064] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Revised: 03/27/2020] [Accepted: 03/29/2020] [Indexed: 12/22/2022]
Abstract
In recent years there has been a surge of interest and corresponding accumulation of knowledge about the role of sleep disturbance in schizophrenia. In this review, we provide an update on the current status of experimentally controlled sleep deprivation (SD) as an experimental medicine model of psychosis, and also consider, given the complexity and heterogeneity of schizophrenia, whether this (state) model can be usefully combined with other state or trait model systems to more powerfully model the pathophysiology of psychosis. We present evidence of dose-dependent aberrations that qualitatively resemble positive, negative and cognitive symptoms of schizophrenia as well as deficits in a range of translational biomarkers for schizophrenia, including prepulse inhibition, smooth pursuit and antisaccades, following experimentally controlled SD, relative to standard sleep, in healthy volunteers. Studies examining the combination of SD and schizotypy, a trait model of schizophrenia, revealed only occasional, task-dependent superiority of the combination model, relative to either of the two models alone. Overall, we argue that experimentally controlled SD is a valuable experimental medicine model of schizophrenia to advance our understanding of the pathophysiology of the clinical disorder and discovery of more effective or novel treatments. Future studies are needed to test its utility in combination with other, especially state, model systems of psychosis such as ketamine.
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Affiliation(s)
- Veena Kumari
- Centre for Cognitive Neuroscience, College of Health and Life Sciences, Brunel University London, Uxbridge, UK.
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17
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Sleep disturbance: a potential target to improve symptoms and quality of life in those living with psychosis. Ir J Psychol Med 2020; 39:329-334. [PMID: 31931896 DOI: 10.1017/ipm.2019.58] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
Sleep has been shown to impact on both physical and mental health, and sleep problems present a considerable burden for individuals and society. There appears to be a complex bidirectional relationship between sleep disturbance and psychiatric symptoms, each potentially influencing the other. In particular, sleep disorders have been associated with more severe symptoms and are predictive of relapse in those with psychotic disorders. This article discusses the relationship between psychosis and insomnia, sleep apnoea, nightmares, circadian rhythm abnormalities and the impact of medications on these relationships. We also discuss the clinical implications of the relationship between sleep disturbance and psychotic disorders along with potential targets for intervention.
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18
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Teal LB, Gould RW, Felts AS, Jones CK. Selective allosteric modulation of muscarinic acetylcholine receptors for the treatment of schizophrenia and substance use disorders. ADVANCES IN PHARMACOLOGY (SAN DIEGO, CALIF.) 2019; 86:153-196. [PMID: 31378251 DOI: 10.1016/bs.apha.2019.05.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Muscarinic acetylcholine receptor (mAChRs) subtypes represent exciting new targets for the treatment of schizophrenia and substance use disorder (SUD). Recent advances in the development of subtype-selective allosteric modulators have revealed promising effects in preclinical models targeting the different symptoms observed in schizophrenia and SUD. M1 PAMs display potential for addressing the negative and cognitive symptoms of schizophrenia, while M4 PAMs exhibit promise in treating preclinical models predictive of antipsychotic-like activity. In SUD, there is increasing support for modulation of mesocorticolimbic dopaminergic circuitry involved in SUD with selective M4 mAChR PAMs or M5 mAChR NAMs. Allosteric modulators of these mAChR subtypes have demonstrated efficacy in rodent models of cocaine and ethanol seeking, with indications that these ligand may also be useful for other substances of abuse, as well as in various stages in the cycle of addiction. Importantly, allosteric modulators of the different mAChR subtypes may provide viable treatment options, while conferring greater subtype specificity and corresponding enhanced therapeutic index than orthosteric muscarinic ligands and maintaining endogenous temporo-spatial ACh signaling. Overall, subtype specific mAChR allosteric modulators represent important novel therapeutic mechanisms for schizophrenia and SUD.
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Affiliation(s)
- Laura B Teal
- Department of Pharmacology, Vanderbilt University, Nashville, TN, United States; Vanderbilt Center for Neuroscience Drug Discovery, Vanderbilt University, Nashville, TN, United States
| | - Robert W Gould
- Department of Pharmacology, Vanderbilt University, Nashville, TN, United States; Vanderbilt Center for Neuroscience Drug Discovery, Vanderbilt University, Nashville, TN, United States
| | - Andrew S Felts
- Department of Pharmacology, Vanderbilt University, Nashville, TN, United States; Vanderbilt Center for Neuroscience Drug Discovery, Vanderbilt University, Nashville, TN, United States
| | - Carrie K Jones
- Department of Pharmacology, Vanderbilt University, Nashville, TN, United States; Vanderbilt Center for Neuroscience Drug Discovery, Vanderbilt University, Nashville, TN, United States.
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19
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Abstract
There is overwhelming evidence that sleep is crucial for memory consolidation. Patients with schizophrenia and their unaffected relatives have a specific deficit in sleep spindles, a defining oscillation of non-rapid eye movement (NREM) Stage 2 sleep that, in coordination with other NREM oscillations, mediate memory consolidation. In schizophrenia, the spindle deficit correlates with impaired sleep-dependent memory consolidation, positive symptoms, and abnormal thalamocortical connectivity. These relations point to dysfunction of the thalamic reticular nucleus (TRN), which generates spindles, gates the relay of sensory information to the cortex, and modulates thalamocortical communication. Genetic studies are beginning to provide clues to possible neurodevelopmental origins of TRN-mediated thalamocortical circuit dysfunction and to identify novel targets for treating the related memory deficits and symptoms. By forging empirical links in causal chains from risk genes to thalamocortical circuit dysfunction, spindle deficits, memory impairment, symptoms, and diagnosis, future research can advance our mechanistic understanding, treatment, and prevention of schizophrenia.
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Affiliation(s)
- Dara S Manoach
- Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts 02114, USA; .,Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital and Harvard Medical School, Charlestown, Massachusetts 02129, USA
| | - Robert Stickgold
- Department of Psychiatry, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts 02215;
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20
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Khalkhali M, Golshahi M, Hasandokht T, Kafie M, Zare R. Cognitive Functioning in Schizophrenia, Methamphetamine-induced Psychotic Disorder, and Healthy People: A Comparative Study. Adv Biomed Res 2018; 7:123. [PMID: 30211136 PMCID: PMC6124221 DOI: 10.4103/abr.abr_14_18] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Background: Methamphetamine-induced psychotic disorder (MIP) cannot be easily differentiated from other psychotic disorders. Some studies have reported that patients with MIP and schizophrenia have differences in their cognitive functioning. We hypothesized that their performance would be different on neuropsychological tests which assess executive functions and visual memory. Materials and Methods: In a cross-sectional study, 30 patients with MIP, 31 patients with schizophrenia, and 31 healthy controls were assessed by Rey–Osterrieth complex figure (ROCF) test and visual search and attention test (VSAT). One-way analysis of variance was performed to compare the mean scores of tests. Tukey's HSD test was used for post hoc analysis. Results: Three groups had significant differences according to ROCF test (F = 15.76, P < 0.0001), VSAT (F = 39.78, P < 0.0001), left VSAT (F = 37.96, P < 0.0001), right VSAT (F = 40.40, P < 0.0001), and the time of the test administration (F = 3.26, P = 0.04). The post hoc analysis showed that the mean score of ROCF test and VSAT (total, right, and left) was significantly higher in the control group than in the other two groups. The time of administering the test in the control group was significantly shorter than in the MIP group (P < 0.03) and nonsignificantly shorter than in the schizophrenia group (P = 0.54). The mean score of right side VSAT was significantly higher in the MIP group than in the schizophrenia group. Conclusion: ROCF could not differentiate MIP from schizophrenia. The better performance of patients with MIP on right side VSAT that is reported in this and in the previous study needs to be reevaluated in more controlled studies.
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Affiliation(s)
- Mohammadrasoul Khalkhali
- Department of Psychiatry, Shafa Psychiatry Hospital, Guilan University of Medical Sciences, Rasht, Iran
| | - Mahboobeh Golshahi
- Department of Psychiatry, Shafa Psychiatry Hospital, Guilan University of Medical Sciences, Rasht, Iran
| | | | - Moosa Kafie
- Department of Psychology, University of Guilan, Rasht, Iran
| | - Roghaye Zare
- Department of Epidemiology and Biostatistics, Tehran University of Medical Sciences, Tehran, Iran
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21
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Drews HJ, Wiesner CD, Bethke-Jaenicke C, Weinhold SL, Baier PC, Göder R. Slow-wave sleep predicts long-term social functioning in severe mental illness. PLoS One 2018; 13:e0202198. [PMID: 30157190 PMCID: PMC6114721 DOI: 10.1371/journal.pone.0202198] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2017] [Accepted: 07/29/2018] [Indexed: 11/18/2022] Open
Abstract
Sleep's relevance for long-term social functioning in psychiatric disorders has been widely overlooked so far. Here, we investigate social functioning in a transdiagnostic sample of 31 patients with severe mental illness, namely schizophrenia (n = 15) or major depression (n = 16), in relation to their polysomnographic sleep characteristics 6 (± 2.4) years earlier. In addition, cognitive performance at follow-up and clinical characteristics (i.e., severity of disorder-related symptoms and number of hospitalizations between baseline and follow-up) are assessed. Multiple regression analysis results in a model with slow-wave sleep (SWS) and number of hospitalizations as significant predictors accounting for 50% (R2 = 0.507; p <0.001) of the variance in social functioning. SWS remains a significant predictor of long-term social functioning throughout a series of refining analyses which also identify baseline functioning as an additional significant predictor, whereas diagnosis is non-significant. Also, the effect of SWS on social functioning is not mediated by number of hospitalizations as assessed by a bootstrapped mediation analysis. We thus conclude that duration of slow-wave sleep is a powerful predictor of long-term social outcome in psychiatric disorders. Also, we discuss the relevance of verbal memory, symptom severity, and diagnostic category for social functioning. Future studies should test this finding by using a prospective design, a bigger sample, optimized predictor variables, and a more diverse set of diagnoses. Moreover, it should be explored whether or not treating sleep disturbances in psychiatric illnesses independently improves long-term social functioning.
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Affiliation(s)
- Henning Johannes Drews
- Department of Psychiatry and Psychotherapy, Christian-Albrechts-University Kiel, Kiel, Schleswig-Holstein, Germany
- * E-mail:
| | - Christian Dirk Wiesner
- Department of Psychology, Christian-Albrechts-University Kiel, Kiel, Schleswig-Holstein, Germany
| | - Christina Bethke-Jaenicke
- Department of Psychiatry and Psychotherapy, Christian-Albrechts-University Kiel, Kiel, Schleswig-Holstein, Germany
| | - Sara Lena Weinhold
- Department of Psychiatry and Psychotherapy, Christian-Albrechts-University Kiel, Kiel, Schleswig-Holstein, Germany
| | - Paul Christian Baier
- Department of Psychiatry and Psychotherapy, Christian-Albrechts-University Kiel, Kiel, Schleswig-Holstein, Germany
| | - Robert Göder
- Department of Psychiatry and Psychotherapy, Christian-Albrechts-University Kiel, Kiel, Schleswig-Holstein, Germany
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22
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D'Agostino A, Castelnovo A, Cavallotti S, Casetta C, Marcatili M, Gambini O, Canevini M, Tononi G, Riedner B, Ferrarelli F, Sarasso S. Sleep endophenotypes of schizophrenia: slow waves and sleep spindles in unaffected first-degree relatives. NPJ SCHIZOPHRENIA 2018; 4:2. [PMID: 29426848 PMCID: PMC5807540 DOI: 10.1038/s41537-018-0045-9] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/01/2017] [Revised: 12/18/2017] [Accepted: 01/16/2018] [Indexed: 11/09/2022]
Abstract
Sleep spindles and slow waves are the main brain oscillations occurring in non-REM sleep. Several lines of evidence suggest that spindles are initiated within the thalamus, whereas slow waves are generated and modulated in the cortex. A decrease in sleep spindle activity has been described in Schizophrenia (SCZ), including chronic, early course, and early onset patients. In contrast, slow waves have been inconsistently found to be reduced in SCZ, possibly due to confounds like duration of illness and antipsychotic medication exposure. Nontheless, the implication of sleep spindles and slow waves in the neurobiology of SCZ and related disorders, including their heritability, remains largely unknown. Unaffected first-degree relatives (FDRs) share a similar genetic background and several neurophysiological and cognitive deficits with SCZ patients, and allow testing whether some of these measures are candidate endophenotypes. In this study, we performed sleep high-density EEG recordings to characterise the spatiotemporal features of sleep spindles and slow waves in FDRs of SCZ probands and healthy subjects (HS) with no family history of SCZ. We found a significant reduction of integrated spindle activity (ISAs) in FDRs relative to HS, whereas spindle density and spindle duration were not different between groups. FDRs also had decreased slow wave amplitude and slopes. Altogether, our results suggest that ISAs deficits might represent a candidate endophenotype for SCZ. Furthermore, given the slow wave deficits observed in FDRs, we propose that disrupted cortical synchronisation increases the risk for SCZ, but thalamic dysfunction is necessary for the disorder to fully develop.
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Affiliation(s)
- Armando D'Agostino
- Department of Health Sciences, University of Milan, Milan, Italy. .,Department of Mental Health, San Paolo Hospital, Milan, Italy.
| | - Anna Castelnovo
- Department of Health Sciences, University of Milan, Milan, Italy
| | | | - Cecilia Casetta
- Department of Health Sciences, University of Milan, Milan, Italy
| | - Matteo Marcatili
- Department of Health Sciences, University of Milan, Milan, Italy
| | - Orsola Gambini
- Department of Health Sciences, University of Milan, Milan, Italy.,Department of Mental Health, San Paolo Hospital, Milan, Italy
| | - Mariapaola Canevini
- Department of Health Sciences, University of Milan, Milan, Italy.,Department of Mental Health, San Paolo Hospital, Milan, Italy
| | - Giulio Tononi
- Department of Psychiatry, University of Wisconsin, Madison, USA
| | - Brady Riedner
- Department of Psychiatry, University of Wisconsin, Madison, USA
| | - Fabio Ferrarelli
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, USA
| | - Simone Sarasso
- 'L. Sacco' Department of Biomedical and Clinical Sciences, University of Milan, Milan, Italy.
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23
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Chan MS, Chung KF, Yung KP, Yeung WF. Sleep in schizophrenia: A systematic review and meta-analysis of polysomnographic findings in case-control studies. Sleep Med Rev 2017; 32:69-84. [DOI: 10.1016/j.smrv.2016.03.001] [Citation(s) in RCA: 91] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2015] [Revised: 02/05/2016] [Accepted: 03/02/2016] [Indexed: 12/27/2022]
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24
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Abstract
Schizophrenia is a major psychiatric disorder that has a massive, long-lasting negative impact on the patients as well as society. While positive symptoms (i.e., delusions and hallucinations), negative symptoms (i.e., anhedonia, social withdrawal), and cognitive impairments are traditionally considered the most prominent features of this disorder, the role of sleep and sleep disturbances has gained increasing prominence in clinical practice. Indeed, the vast majority of patients with schizophrenia report sleep abnormalities, which tend to precede illness onset and can predict an acute exacerbation of psychotic symptoms. Furthermore, schizophrenia patients often have a comorbid sleep disorder, including insomnia, obstructive sleep apnea, restless leg syndrome, or periodic limb movement disorder. Despite accumulating data, the links between sleep disorders and schizophrenia have not been thoroughly examined, in part because they are difficult to disentangle, as numerous factors contribute to their comorbidity, including medication status. Additionally, sleep disorders are often not the primary focus of clinicians treating this population, despite studies suggesting that comorbid sleep disorders carry their own unique risks, including worsening of psychotic symptoms and poorer quality of life. There is also limited information about effective management strategies for schizophrenia patients affected by significant sleep disturbances and/or sleep disorders. To begin addressing these issues, the present review will systematically examine the literature on sleep disorders and schizophrenia, focusing on studies related to 1) links between distinct sleep disorders and schizophrenia; 2) risks unique to patients with a comorbid sleep disorder; and 3) and management challenges and strategies.
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Affiliation(s)
- Rachel E Kaskie
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
| | - Bianca Graziano
- Department of Health Sciences, Università degli Studi di Milano, Milan, Italy
| | - Fabio Ferrarelli
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
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25
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Su L, Han Y, Xue R, Wood K, Shi FD, Liu Y, Fu Y. Thalamic Atrophy Contributes to Low Slow Wave Sleep in Neuromyelitis Optica Spectrum Disorder. Aging Dis 2016; 7:691-696. [PMID: 28053819 PMCID: PMC5198860 DOI: 10.14336/ad.2016.0419] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2016] [Accepted: 04/19/2016] [Indexed: 12/14/2022] Open
Abstract
Slow wave sleep abnormality has been reported in neuromyelitis optica spectrum disorder (NMOSD), but mechanism for such abnormality is unknown. To determine the structural defects in the brain that account for the decrease of slow wave sleep in NMOSD patients. Thirty-three NMOSD patients and 18 matched healthy controls (HC) were enrolled. Polysomnography was used to monitor slow wave sleep and three-dimensional T1-weighted MRIs were obtained to assess the alterations of grey matter volume. The percentage of deep slow wave sleep decreased in 93% NMOSD patients. Compared to HC, a reduction of grey matter volume was found in the bilateral thalamus of patients with a lower percentage of slow wave sleep (FWE corrected at cluster-level, p < 0.05, cluster size > 400 voxels). Furthermore, the right thalamic fraction was positively correlated with the decrease in the percentage of slow wave sleep in NMOSD patients (p < 0.05, FDR corrected, cluster size > 200 voxels). Our study identified that thalamic atrophy is associated with the decrease of slow wave sleep in NMOSD patients. Further studies should evaluate whether neurotransmitters or hormones which stem from thalamus are involved in the decrease of slow wave sleep.
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Affiliation(s)
- Lei Su
- 1Department of Neurology, Tianjin Neurological Institute, Tianjin Medical University General Hospital, Tianjin 300052, China
| | - Yujuan Han
- 2Department of Radiology, Tianjin Third Central Hospital, Tianjin, 300170, China
| | - Rong Xue
- 1Department of Neurology, Tianjin Neurological Institute, Tianjin Medical University General Hospital, Tianjin 300052, China
| | - Kristofer Wood
- 3Department of Neurology, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, AZ 85013, USA
| | - Fu-Dong Shi
- 1Department of Neurology, Tianjin Neurological Institute, Tianjin Medical University General Hospital, Tianjin 300052, China; 3Department of Neurology, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, AZ 85013, USA
| | - Yaou Liu
- 1Department of Neurology, Tianjin Neurological Institute, Tianjin Medical University General Hospital, Tianjin 300052, China; 4Department of Radiology and Nuclear Medicine, Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, Amsterdam 1007 MB, The Netherlands; 5Department of Radiology, Xuanwu Hospital, Capital Medical University, Beijing 100053, China
| | - Ying Fu
- 1Department of Neurology, Tianjin Neurological Institute, Tianjin Medical University General Hospital, Tianjin 300052, China
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Sharma P, Dikshit R, Shah N, Karia S, De Sousa A. Excessive Daytime Sleepiness in Schizophrenia: A Naturalistic Clinical Study. J Clin Diagn Res 2016; 10:VC06-VC08. [PMID: 27891431 DOI: 10.7860/jcdr/2016/21272.8627] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2016] [Accepted: 08/10/2016] [Indexed: 01/06/2023]
Abstract
INTRODUCTION Excessive Daytime Sleepiness (EDS) and sleep problems are common in patients with schizophrenia. The symptom of EDS in schizophrenia can be attributed to various causes including neurobiological changes, sleep disorders, medication or as a symptom of schizophrenia itself. EDS as a symptom in schizophrenia has been understudied. AIM To assess the prevalence of EDS and to the study the same in patients with first episode and chronic schizophrenia. MATERIALS AND METHODS In this cross-sectional study 100 patients suffering from schizophrenia as per International Classification of Diseases (ICD-10) criteria were evaluated for sleep quality using the Pittsburgh Sleep Quality Index (PSQI) and EDS using the Epworth Sleepiness Scale (ESS). The severity of illness was assessed by Positive and Negative Symptom Scale for Schizophrenia (PANSS) while cognition was assessed using the Frontal Assessment Battery (FAB) and the Trail Making Test A and B. The data was statistically analysed. RESULTS A total of 100 patients (72 male and 28 female) aged 18 to 64years (mean age 30.63 years) were studied. Poor sleep quality (PSQI > 6) was exhibited by 83% of patients. Excessive daytime sleepiness (ESS > 7) was found in 32% of patients. There was no statistically significant difference in various parameters according to the age, duration of illness or gender. However, first episode patients differed in having better sleep quality than patients with chronic schizophrenia (p=0.0002). Cognition was not affected by sleep quality. CONCLUSION A high prevalence of sleepiness and poor sleep quality was noted in the entire sample but it did not have any correlation with age and gender. It also did not affect the cognitive test scores. Further research in this area is warranted.
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Affiliation(s)
- Payal Sharma
- Resident, Department of Psychiatry, Lokmanya Tilak Municipal Medical College , Mumbai, Maharashtra, India
| | - Reetika Dikshit
- Resident, Department of Psychiatry, Lokmanya Tilak Municipal Medical College , Mumbai, Maharashtra, India
| | - Nilesh Shah
- Professor and Head, Department of Psychiatry, Lokmanya Tilak Municipal Medical College , Mumbai, Maharashtra, India
| | - Sagar Karia
- Specialty Medical Officer, Department of Psychiatry, Lokmanya Tilak Municipal Medical College , Mumbai, Maharashtra, India
| | - Avinash De Sousa
- Research Associate, Department of Psychiatry, Lokmanya Tilak Municipal Medical College , Mumbai, Maharashtra, India
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Yates NJ. Schizophrenia: the role of sleep and circadian rhythms in regulating dopamine and psychosis. Rev Neurosci 2016; 27:669-687. [DOI: 10.1515/revneuro-2016-0030] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2016] [Accepted: 05/26/2016] [Indexed: 12/27/2022]
Abstract
AbstractSchizophrenia has long been associated with abnormalities in circadian rhythms and sleep. Up until now, there have been no thorough reviews of the potential mechanisms behind the myriad of circadian and sleep abnormalities observed in schizophrenia and psychosis. We present evidence of sleep playing an important role in psychosis predominantly mediated by dopaminergic pathways. A synthesis of both human and animal experimental work suggests that the interplay between sleep and dopamine is important in the generation and maintenance of psychosis. In particular, both animal and human data point to sleep disruption increasing dopamine release and sensitivity. Furthermore, elevated dopamine levels disrupt sleep and circadian rhythms. The synthesis of knowledge suggests that circadian rhythms, dopamine dysregulation, and psychosis are intricately linked. This suggests that treatment of circadian disturbance may be a useful target in improving the lives and symptoms of patients with schizophrenia.
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Affiliation(s)
- Nathanael James Yates
- 1School of Animal Biology, Experimental and Regenerative Neurosciences, M317, The University of Western Australia, 35 Stirling Hwy, Crawley 6009, WA, Australia
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Baglioni C, Nanovska S, Regen W, Spiegelhalder K, Feige B, Nissen C, Reynolds CF, Riemann D. Sleep and mental disorders: A meta-analysis of polysomnographic research. Psychol Bull 2016; 142:969-990. [PMID: 27416139 PMCID: PMC5110386 DOI: 10.1037/bul0000053] [Citation(s) in RCA: 540] [Impact Index Per Article: 67.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Investigating sleep in mental disorders has the potential to reveal both disorder-specific and transdiagnostic psychophysiological mechanisms. This meta-analysis aimed at determining the polysomnographic (PSG) characteristics of several mental disorders. Relevant studies were searched through standard strategies. Controlled PSG studies evaluating sleep in affective, anxiety, eating, pervasive developmental, borderline and antisocial personality disorders, attention-deficit-hyperactivity disorder (ADHD), and schizophrenia were included. PSG variables of sleep continuity, depth, and architecture, as well as rapid-eye movement (REM) sleep were considered. Calculations were performed with the "Comprehensive Meta-Analysis" and "R" software. Using random effects modeling, for each disorder and each variable, a separate meta-analysis was conducted if at least 3 studies were available for calculation of effect sizes as standardized means (Hedges' g). Sources of variability, that is, sex, age, and mental disorders comorbidity, were evaluated in subgroup analyses. Sleep alterations were evidenced in all disorders, with the exception of ADHD and seasonal affective disorders. Sleep continuity problems were observed in most mental disorders. Sleep depth and REM pressure alterations were associated with affective, anxiety, autism and schizophrenia disorders. Comorbidity was associated with enhanced REM sleep pressure and more inhibition of sleep depth. No sleep parameter was exclusively altered in 1 condition; however, no 2 conditions shared the same PSG profile. Sleep continuity disturbances imply a transdiagnostic imbalance in the arousal system likely representing a basic dimension of mental health. Sleep depth and REM variables might play a key role in psychiatric comorbidity processes. Constellations of sleep alterations may define distinct disorders better than alterations in 1 single variable. (PsycINFO Database Record
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Affiliation(s)
- Chiara Baglioni
- Department of Clinical Psychology and Psychophysiology, Center for Mental Disorders, University of Freiburg Medical Center, Germany
| | - Svetoslava Nanovska
- Department of Clinical Psychology and Psychophysiology, Center for Mental Disorders, University of Freiburg Medical Center, Germany
| | - Wolfram Regen
- Department of Clinical Psychology and Psychophysiology, Center for Mental Disorders, University of Freiburg Medical Center, Germany
| | - Kai Spiegelhalder
- Department of Clinical Psychology and Psychophysiology, Center for Mental Disorders, University of Freiburg Medical Center, Germany
| | - Bernd Feige
- Department of Clinical Psychology and Psychophysiology, Center for Mental Disorders, University of Freiburg Medical Center, Germany
| | - Christoph Nissen
- Department of Clinical Psychology and Psychophysiology, Center for Mental Disorders, University of Freiburg Medical Center, Germany
| | | | - Dieter Riemann
- Department of Clinical Psychology and Psychophysiology, Center for Mental Disorders, University of Freiburg Medical Center, Germany
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Rivera D, Perrin PB, Morlett-Paredes A, Galarza-Del-Angel J, Martínez C, Garza MT, Saracho CP, Rodríguez W, Rodríguez-Agudelo Y, Rábago B, Aliaga A, Schebela S, Luna M, Longoni M, Ocampo-Barba N, Fernández E, Esenarro L, García-Egan P, Arango-Lasprilla JC. Rey-Osterrieth Complex Figure - copy and immediate recall: Normative data for the Latin American Spanish speaking adult population. NeuroRehabilitation 2016; 37:677-98. [PMID: 26639929 DOI: 10.3233/nre-151285] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE To generate normative data on the Rey-Osterrieth Complex Figure Test (ROCF) across 11 countries in Latin America, with country-specific adjustments for gender, age, and education, where appropriate. METHOD The sample consisted of 3,977 healthy adults who were recruited from Argentina, Bolivia, Chile, Cuba, El Salvador, Guatemala, Honduras, Mexico, Paraguay, Peru, and, Puerto Rico. Each subject was administered the ROCF as part of a larger neuropsychological battery. A standardized five-step statistical procedure was used to generate the norms. RESULTS The final multiple linear regression models explained 7-34% of the variance in ROCF copy scores and 21-41% of the variance in immediate recall scores. Although t-tests showed significant differences between men and women on ROCF copy and immediate recall scores, none of the countries had an effect size larger than 0.3. As a result, gender-adjusted norms were not generated. CONCLUSIONS The present study is the first to create norms for the ROCF in Latin America. As a result, this study will have important implications for the formation and practice of neuropsychology in this region.
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Affiliation(s)
- D Rivera
- Faculty of Psychology and Education, University of Deusto, Bilbao, Spain
| | - P B Perrin
- Department of Psychology, Virginia Commonwealth University, Richmond, VA, USA
| | - A Morlett-Paredes
- Department of Psychology, Virginia Commonwealth University, Richmond, VA, USA
| | | | - C Martínez
- Departamento de Medicina de Rehabilitación, Universidad Nacional Autónoma de Honduras, Tegucigalpa, Honduras
| | - M T Garza
- Facultad de Psicología, Universidad Autónoma de Nuevo León, Monterrey, Mexico
| | | | - W Rodríguez
- Ponce Health Sciences University, Ponce, Puerto Rico
| | | | - B Rábago
- Instituto Vocacional Enrique Díaz de León, Guadalajara, Mexico
| | - A Aliaga
- Servicio Médico Legal, Ministerio de Justicia, Santiago, Chile
| | - S Schebela
- Instituto de Prevención Social, Asuncion, Paraguay
| | - M Luna
- Universidad Dr. José Matías Delgado, San Salvador, El Salvador
| | - M Longoni
- Clínica de rehabilitación Las Araucarias, Buenos Aires, Argentina
| | | | - E Fernández
- International center for neurological Restoration CIREN, Havana, Cuba
| | - L Esenarro
- Instituto de Neuropsicología y Demencias, Lima, Peru
| | - P García-Egan
- Departamento de Psicología, Universidad del Valle de Guatemala, Guatemala City, Guatemala
| | - J C Arango-Lasprilla
- IKERBASQUE, Basque Foundation for Science, Bilbao, Spain.,Faculty of Psychology and Education, University of Deusto, Bilbao, Spain
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Göder R, Weinhold SL, Baier PC, Junghanns K. Störungen der Gedächtnisbildung im Schlaf bei neuropsychiatrischen Erkrankungen. SOMNOLOGIE 2016. [DOI: 10.1007/s11818-015-0037-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Abstract
Sleep disturbances are prevalent in patients with schizophrenia and play a critical role in the morbidity and mortality associated with the illness. Subjective and objective assessments of sleep in patients with schizophrenia have identified certain consistent findings. Findings related to the sleep structure abnormalities have shown correlations with important clinical aspects of the illness. Disruption of specific neurotransmitter systems and dysregulation of clock genes may play a role in the pathophysiology of schizophrenia-related sleep disturbances. Antipsychotic medications play an important role in the treatment of sleep disturbances in these patients and have an impact on their sleep structure.
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Affiliation(s)
- Jayesh Kamath
- Department of Psychiatry, University of Connecticut School of Medicine, 263 Farmington Avenue, Farmington, CT 06030-6415, USA.
| | - Sundeep Virdi
- Department of Psychiatry, University of Connecticut School of Medicine, 263 Farmington Avenue, Farmington, CT 06030-6415, USA
| | - Andrew Winokur
- Department of Psychiatry, University of Connecticut School of Medicine, 263 Farmington Avenue, Farmington, CT 06030-6415, USA
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Gould RW, Nedelcovych MT, Gong X, Tsai E, Bubser M, Bridges TM, Wood MR, Duggan ME, Brandon NJ, Dunlop J, Wood MW, Ivarsson M, Noetzel MJ, Daniels JS, Niswender CM, Lindsley CW, Conn PJ, Jones CK. State-dependent alterations in sleep/wake architecture elicited by the M4 PAM VU0467154 - Relation to antipsychotic-like drug effects. Neuropharmacology 2015; 102:244-53. [PMID: 26617071 DOI: 10.1016/j.neuropharm.2015.11.016] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2015] [Revised: 10/27/2015] [Accepted: 11/18/2015] [Indexed: 11/29/2022]
Abstract
Accumulating evidence indicates direct relationships between sleep abnormalities and the severity and prevalence of other symptom clusters in schizophrenia. Assessment of potential state-dependent alterations in sleep architecture and arousal relative to antipsychotic-like activity is critical for the development of novel antipsychotic drugs (APDs). Recently, we reported that VU0467154, a selective positive allosteric modulator (PAM) of the M4 muscarinic acetylcholine receptor (mAChR), exhibits robust APD-like and cognitive enhancing activity in rodents. However, the state-dependent effects of VU0467154 on sleep architecture and arousal have not been examined. Using polysomnography and quantitative electroencephalographic recordings from subcranial electrodes in rats, we evaluated the effects of VU0467154, in comparison with the atypical APD clozapine and the M1/M4-preferring mAChR agonist xanomeline. VU0467154 induced state-dependent alterations in sleep architecture and arousal including delayed Rapid Eye Movement (REM) sleep onset, increased cumulative duration of total and Non-Rapid Eye Movement (NREM) sleep, and increased arousal during waking periods. Clozapine decreased arousal during wake, increased cumulative NREM, and decreased REM sleep. In contrast, xanomeline increased time awake and arousal during wake, but reduced slow wave activity during NREM sleep. Additionally, in combination with the N-methyl-d-aspartate subtype of glutamate receptor (NMDAR) antagonist MK-801, modeling NMDAR hypofunction thought to underlie many symptoms in schizophrenia, both VU0467154 and clozapine attenuated MK-801-induced elevations in high frequency gamma power consistent with an APD-like mechanism of action. These findings suggest that selective M4 PAMs may represent a novel mechanism for treating multiple symptoms of schizophrenia, including disruptions in sleep architecture without a sedative profile.
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Affiliation(s)
- Robert W Gould
- Department of Pharmacology, Vanderbilt University Medical Center, Nashville, TN 37232, USA; Vanderbilt Center for Neuroscience Drug Discovery, Vanderbilt University Medical Center, Nashville, TN 37232, USA
| | - Michael T Nedelcovych
- Department of Pharmacology, Vanderbilt University Medical Center, Nashville, TN 37232, USA; Vanderbilt Center for Neuroscience Drug Discovery, Vanderbilt University Medical Center, Nashville, TN 37232, USA
| | - Xuewen Gong
- Department of Pharmacology, Vanderbilt University Medical Center, Nashville, TN 37232, USA
| | - Erica Tsai
- Department of Pharmacology, Vanderbilt University Medical Center, Nashville, TN 37232, USA
| | - Michael Bubser
- Department of Pharmacology, Vanderbilt University Medical Center, Nashville, TN 37232, USA; Vanderbilt Center for Neuroscience Drug Discovery, Vanderbilt University Medical Center, Nashville, TN 37232, USA
| | - Thomas M Bridges
- Department of Pharmacology, Vanderbilt University Medical Center, Nashville, TN 37232, USA; Vanderbilt Center for Neuroscience Drug Discovery, Vanderbilt University Medical Center, Nashville, TN 37232, USA
| | - Michael R Wood
- Department of Pharmacology, Vanderbilt University Medical Center, Nashville, TN 37232, USA; Vanderbilt Center for Neuroscience Drug Discovery, Vanderbilt University Medical Center, Nashville, TN 37232, USA; Department of Chemistry, Vanderbilt University, Nashville, TN 37232, USA
| | - Mark E Duggan
- Neuroscience Innovative Medicines, AstraZeneca, Cambridge, MA 02139, USA
| | - Nicholas J Brandon
- Neuroscience Innovative Medicines, AstraZeneca, Cambridge, MA 02139, USA
| | - John Dunlop
- Neuroscience Innovative Medicines, AstraZeneca, Cambridge, MA 02139, USA
| | - Michael W Wood
- Neuroscience Innovative Medicines, AstraZeneca, Cambridge, MA 02139, USA
| | - Magnus Ivarsson
- Proteostasis Therapeutics, 200 Technology Square, Cambridge, MA 02139, USA
| | - Meredith J Noetzel
- Department of Pharmacology, Vanderbilt University Medical Center, Nashville, TN 37232, USA; Vanderbilt Center for Neuroscience Drug Discovery, Vanderbilt University Medical Center, Nashville, TN 37232, USA
| | - J Scott Daniels
- Department of Pharmacology, Vanderbilt University Medical Center, Nashville, TN 37232, USA; Vanderbilt Center for Neuroscience Drug Discovery, Vanderbilt University Medical Center, Nashville, TN 37232, USA
| | - Colleen M Niswender
- Department of Pharmacology, Vanderbilt University Medical Center, Nashville, TN 37232, USA; Vanderbilt Center for Neuroscience Drug Discovery, Vanderbilt University Medical Center, Nashville, TN 37232, USA
| | - Craig W Lindsley
- Department of Pharmacology, Vanderbilt University Medical Center, Nashville, TN 37232, USA; Vanderbilt Center for Neuroscience Drug Discovery, Vanderbilt University Medical Center, Nashville, TN 37232, USA; Department of Chemistry, Vanderbilt University, Nashville, TN 37232, USA
| | - P Jeffrey Conn
- Department of Pharmacology, Vanderbilt University Medical Center, Nashville, TN 37232, USA; Vanderbilt Center for Neuroscience Drug Discovery, Vanderbilt University Medical Center, Nashville, TN 37232, USA
| | - Carrie K Jones
- Department of Pharmacology, Vanderbilt University Medical Center, Nashville, TN 37232, USA; Vanderbilt Center for Neuroscience Drug Discovery, Vanderbilt University Medical Center, Nashville, TN 37232, USA.
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Goerke M, Müller NG, Cohrs S. Sleep-dependent memory consolidation and its implications for psychiatry. J Neural Transm (Vienna) 2015; 124:163-178. [PMID: 26518213 DOI: 10.1007/s00702-015-1476-3] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2015] [Accepted: 10/20/2015] [Indexed: 02/06/2023]
Abstract
Both sleep disturbance and memory impairment are very common in psychiatric disorders. Since sleep has been shown to play a role in the process of transferring newly acquired information into long-term memory, i.e., consolidation, it is important to highlight this link in the context of psychiatric disorders. Along these lines, after providing a brief overview of healthy human sleep, current neurobiological models on sleep-dependent memory consolidation and resultant opportunities to manipulate the memory consolidation process, recent findings on sleep disturbances and sleep-dependent memory consolidation in patients with insomnia, major depression, schizophrenia, and post-traumatic stress disorder are systematically reviewed. Furthermore, possible underlying neuropathologies and their implications on therapeutic strategies are discussed. This review aims at sensitizing the reader for recognizing sleep disturbances as a potential contributor to cognitive deficits in several disorders, a fact which is often overlooked up to date.
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Affiliation(s)
- Monique Goerke
- German Center for Neurodegenerative Diseases (DZNE) Magdeburg, Leipziger Str. 44, 39120, Magdeburg, Germany. .,Department of Psychiatry and Psychotherapy, University of Rostock, Gehlsheimer Str. 20, 18147, Rostock, Germany.
| | - Notger G Müller
- German Center for Neurodegenerative Diseases (DZNE) Magdeburg, Leipziger Str. 44, 39120, Magdeburg, Germany
| | - Stefan Cohrs
- Department of Psychiatry and Psychotherapy, University of Rostock, Gehlsheimer Str. 20, 18147, Rostock, Germany
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Changing maladaptive memories through reconsolidation: A role for sleep in psychotherapy? Behav Brain Sci 2015; 38:e6. [DOI: 10.1017/s0140525x14000156] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
AbstractLike Lane et al., we believe that change in psychotherapy comes about by updating dysfunctional memories with new adaptive experiences. We suggest that sleep is essential to (re-)consolidate such corrective experiences. Sleep is well-known to strengthen and integrate new memories into pre-existing networks. Targeted sleep interventions might be promising tools to boost this process and thereby increase therapy effectiveness.
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Göder R, Graf A, Ballhausen F, Weinhold S, Baier PC, Junghanns K, Prehn-Kristensen A. Impairment of sleep-related memory consolidation in schizophrenia: relevance of sleep spindles? Sleep Med 2015; 16:564-9. [PMID: 25912599 DOI: 10.1016/j.sleep.2014.12.022] [Citation(s) in RCA: 88] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2014] [Revised: 11/21/2014] [Accepted: 12/04/2014] [Indexed: 11/30/2022]
Abstract
OBJECTIVES Deficits in declarative memory performance are among the most severe neuropsychological impairments in schizophrenia and contribute to poor clinical outcomes. The importance of sleep for brain plasticity and memory consolidation is widely accepted, and sleep spindles seem to play an important role in these processes. The aim of this study was to test the associations of sleep spindles and picture memory consolidation in patients with schizophrenia and healthy controls. METHODS We studied 16 patients with schizophrenia on stable antipsychotic medication (mean age ± standard deviation, 29.4 ± 6.4 years) and 16 healthy controls matched for age and educational level. Sleep was recorded and scored according to American Academy of Sleep Medicine (AASM) standard criteria. We performed a picture recognition paradigm and compared recognition performance for neutral and emotional pictures in sleep and wake conditions. RESULTS Recognition accuracy was better in healthy controls than in patients with schizophrenia in the sleep and wake conditions. However, the memory-promoting effect of sleep was significantly lower in schizophrenia patients than in controls. Sleep spindle activity was reduced in patients, and sleep spindle density was correlated with sleep-associated facilitation of recognition accuracy for neutral pictures. CONCLUSION Reduced sleep spindles seem to play an important role as a possible mechanism or biomarker for impaired sleep-related memory consolidation in patients with schizophrenia, and are a new target for treatment to improve memory functions and clinical outcomes in these patients.
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Affiliation(s)
- Robert Göder
- Department of Psychiatry and Psychotherapy, University Hospital Schleswig-Holstein, Kiel, Germany.
| | - Anna Graf
- Department of Psychiatry and Psychotherapy, University Hospital Schleswig-Holstein, Kiel, Germany
| | - Felix Ballhausen
- Department of Psychiatry and Psychotherapy, University Hospital Schleswig-Holstein, Kiel, Germany
| | - Sara Weinhold
- Department of Psychiatry and Psychotherapy, University Hospital Schleswig-Holstein, Kiel, Germany
| | - Paul Christian Baier
- Department of Psychiatry and Psychotherapy, University Hospital Schleswig-Holstein, Kiel, Germany
| | - Klaus Junghanns
- Department of Psychiatry and Psychotherapy, University Hospital Schleswig-Holstein, Lübeck, Germany
| | - Alexander Prehn-Kristensen
- Department of Adolescent and Child Psychiatry and Psychotherapy, University Hospital Schleswig-Holstein, Kiel, Germany
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Schizophrenia and Psychosis. Sleep Med 2015. [DOI: 10.1007/978-1-4939-2089-1_39] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Sprecher KE, Ferrarelli F, Benca RM. Sleep and plasticity in schizophrenia. Curr Top Behav Neurosci 2015; 25:433-58. [PMID: 25608723 DOI: 10.1007/7854_2014_366] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Schizophrenia is a devastating mental illness with a worldwide prevalence of approximately 1%. Although the clinical features of the disorder were described over one hundred years ago, its neurobiology is still largely elusive despite several decades of research. Schizophrenia is associated with marked sleep disturbances and memory impairment. Above and beyond altered sleep architecture, sleep rhythms including slow waves and spindles are disrupted in schizophrenia. In the healthy brain, these rhythms reflect and participate in plastic processes during sleep. This chapter discusses evidence that schizophrenia patients exhibit dysfunction of sleep-mediated plasticity on a behavioral, cellular, and molecular level and offers suggestions on how the study of sleeping brain activity can shed light on the pathophysiological mechanisms of the disorder.
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Affiliation(s)
- Kate E Sprecher
- Department of Psychiatry, Neuroscience Training Program, University of Wisconsin, Madison, WI, USA
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Tek C, Palmese LB, Krystal AD, Srihari VH, DeGeorge PC, Reutenauer EL, Guloksuz S. The impact of eszopiclone on sleep and cognition in patients with schizophrenia and insomnia: a double-blind, randomized, placebo-controlled trial. Schizophr Res 2014; 160:180-5. [PMID: 25454802 PMCID: PMC5589464 DOI: 10.1016/j.schres.2014.10.002] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2014] [Revised: 10/01/2014] [Accepted: 10/03/2014] [Indexed: 11/17/2022]
Abstract
BACKGROUND Insomnia is frequent in schizophrenia and may contribute to cognitive impairment as well as overuse of weight inducing sedative antipsychotics. We investigated the effects of eszopiclone on sleep and cognition for patients with schizophrenia-related insomnia in a double-blind placebo controlled study, followed by a two-week, single-blind placebo phase. METHODS Thirty-nine clinically stable outpatients with schizophrenia or schizoaffective disorder and insomnia were randomized to either 3mg eszopiclone (n=20) or placebo (n=19). Primary outcome measure was change in Insomnia Severity Index (ISI) over 8 weeks. Secondary outcome measure was change in MATRICS Consensus Cognitive Battery (MATRICS). Sleep diaries, psychiatric symptoms, and quality of life were also monitored. RESULTS ISI significantly improved more in eszopiclone (mean=-10.7, 95% CI=-13.2; -8.2) than in placebo (mean=-6.9, 95% CI=-9.5; -4.3) with a between-group difference of -3.8 (95% CI=-7.5; -0.2). MATRICS score change did not differ between groups. On further analysis there was a significant improvement in the working memory test, letter-number span component of MATRICS (mean=9.8±9.2, z=-2.00, p=0.045) only for subjects with schizophrenia on eszopiclone. There were improvements in sleep diary items in both groups with no between-group differences. Psychiatric symptoms remained stable. Discontinuation rates were similar. Sleep remained improved during single-blind placebo phase after eszopiclone was stopped, but the working memory improvement in patients with schizophrenia was not durable. CONCLUSIONS Eszopiclone stands as a safe and effective alternative for the treatment of insomnia in patients with schizophrenia. Its effects on cognition require further study.
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Affiliation(s)
- Cenk Tek
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA.
| | - Laura B. Palmese
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - Andrew D. Krystal
- Department of Psychiatry, Duke University School of Medicine, Durham, NC, USA
| | - Vinod H. Srihari
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - Pamela C. DeGeorge
- Department of Anesthesiology, University of Virginia School of Medicine, Charlottesville, VA, USA
| | - Erin L. Reutenauer
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - Sinan Guloksuz
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
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Cleutjens FAHM, Spruit MA, Ponds RWHM, Dijkstra JB, Franssen FME, Wouters EFM, Janssen DJA. Cognitive functioning in obstructive lung disease: results from the United Kingdom biobank. J Am Med Dir Assoc 2014; 15:214-219. [PMID: 24513227 DOI: 10.1016/j.jamda.2013.12.007] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2013] [Accepted: 12/04/2013] [Indexed: 10/25/2022]
Abstract
OBJECTIVES To compare domains of cognitive functioning between persons with and without obstructive lung disease (OLD) and to analyze the relationship between cognitive functioning and the degree of airflow limitation. DESIGN An observational population-based study. SETTING This research was conducted using the United Kingdom Biobank Resource. PARTICIPANTS The study population consisted of 43,039 persons with complete data on cognitive functioning and spirometry. MEASUREMENTS Cognitive functioning was compared between persons with and without OLD using linear regression analysis. The relationship between impairment in lung function and cognitive impairment was assessed among persons with OLD. RESULTS Persons with OLD had significantly worse scores than persons without OLD on prospective memory [β = -0.15 (-0.22 to -0.09)], visuospatial memory [β round 1 = 0.06 (0.03‒0.10)]; β round 2 = 0.09 (<0.001‒0.18)), numeric short-term memory [β = ‒0.05 (‒0.10 to <0.001)] and cognitive processing speed [β = 4.62 (1.25‒8.01)] after correction for possible confounders. Impairment in prospective memory [β = 0.004 (<0.001‒0.01)] and numeric short-term memory [β = 0.01 (0.003‒0.01)] were weakly related to FEV1 (adjusted P < .05). CONCLUSIONS Persons with OLD experience cognitive impairment in different domains, which is partially related to airway obstruction. In particular, memory and information processing are affected. Further assessment of the relationship with patient-related outcomes is needed to optimize patient-oriented treatment.
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Affiliation(s)
- Fiona A H M Cleutjens
- Program Development Center, CIRO+, Center of Expertise for Chronic Organ Failure, Horn, The Netherlands.
| | - Martijn A Spruit
- Program Development Center, CIRO+, Center of Expertise for Chronic Organ Failure, Horn, The Netherlands
| | - Rudolf W H M Ponds
- Department of Psychology, Maastricht UMC+/School for Mental Health and Neurosciences (MHeNS), Maastricht, The Netherlands
| | - Jeanette B Dijkstra
- Department of Psychology, Maastricht UMC+/School for Mental Health and Neurosciences (MHeNS), Maastricht, The Netherlands
| | - Frits M E Franssen
- Program Development Center, CIRO+, Center of Expertise for Chronic Organ Failure, Horn, The Netherlands
| | - Emiel F M Wouters
- Program Development Center, CIRO+, Center of Expertise for Chronic Organ Failure, Horn, The Netherlands; Department of Respiratory Medicine, Maastricht UMC+, Maastricht, The Netherlands
| | - Daisy J A Janssen
- Program Development Center, CIRO+, Center of Expertise for Chronic Organ Failure, Horn, The Netherlands
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Lazowski LK, Townsend B, Hawken ER, Jokic R, du Toit R, Milev R. Sleep architecture and cognitive changes in olanzapine-treated patients with depression: a double blind randomized placebo controlled trial. BMC Psychiatry 2014; 14:202. [PMID: 25030264 PMCID: PMC4223523 DOI: 10.1186/1471-244x-14-202] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2013] [Accepted: 07/10/2014] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND Disturbance in sleep quality is a symptom of Major Depressive Disorder (MDD) and Bipolar Disorder (BD) and thus improving quality of sleep is an important aspect of successful treatment. Here, a prospective, double-blind, randomized, placebo-controlled study examined the effect of olanzapine (an atypical antipsychotic) augmentation therapy on sleep architecture, specifically slow wave sleep (SWS), in the treatment of depression. The effect of olanzapine augmentation therapy on other features of sleep (e.g., sleep continuity) and depression (e.g., illness severity and cognitive function) were also determined. METHODS Patients currently experiencing a major depressive episode and who were on a stable medication were included. Sleep architecture was measured by overnight ambulatory polysomnography. Illness severity was determined using the Montgomery-Asberg Depression Rating Scale (MADRS). Cognitive function was examined using Cambridge Neuropsychological Test Automated Battery (CANTAB): Spatial Working Memory (SWM), Spatial Span (SSP), and Reaction Time (RTI) tasks. Polysomnographs, clinical measures and cognitive tests were administered at baseline, after 2-4 days of treatment and after 28-31 days of treatment. Twenty-five patients participated in the study (N = 10, N = 15 for placebo and olanzapine treated groups respectively). RESULTS The primary objective of the study was to assess the objective (polysomnographic) changes in sleep quality, defined as changes in SWS, following olanzapine treatment for depression. Latency to but not duration of SWS was found to significantly differ between olanzapine- and placebo-treated participants (Hedge's g: 0.97, 0.13 respectively). A significant improvement in olanzapine-treated participants over placebo-treated participants was observed in secondary outcome measures, including sleep efficiency, total sleep time, and sleep latency. Secondary objectives assessed the subjective changes in sleep quality parameters and correlated them with measures of illness severity and changes in cognition. MADRS scores were significantly improved in olanzapine-treated participants over time but not more than placebo treatment. There was no significant difference between olanzapine- and placebo-treated participants in SWM, SSP or RTI tasks. CONCLUSIONS Olanzapine augmentation treatment generally did not improve SWS but did improve sleep continuity and depression. Olanzapine may be one of few medications that improve sleep continuity, thus directly targeting symptoms of depression. TRIAL REGISTRATION ClinicalTrials.gov, NCT00520507.
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Affiliation(s)
- Lauren K Lazowski
- Centre for Neuroscience Studies, Queen’s University, Kingston, Canada
| | - Ben Townsend
- Department of Psychology, Carleton University, Ottawa, Canada
| | - Emily R Hawken
- Centre for Neuroscience Studies, Queen’s University, Kingston, Canada,Department of Psychiatry, Queen’s University, 752 King Street West, Kingston, ON K7L 4X3, Canada
| | - Ruzica Jokic
- Department of Psychiatry, Queen’s University, 752 King Street West, Kingston, ON K7L 4X3, Canada
| | - Regina du Toit
- Department of Psychiatry, Queen’s University, 752 King Street West, Kingston, ON K7L 4X3, Canada
| | - Roumen Milev
- Department of Psychiatry, Queen's University, 752 King Street West, Kingston, ON K7L 4X3, Canada.
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Gardner RJ, Kersanté F, Jones MW, Bartsch U. Neural oscillations during non-rapid eye movement sleep as biomarkers of circuit dysfunction in schizophrenia. Eur J Neurosci 2014; 39:1091-106. [DOI: 10.1111/ejn.12533] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2013] [Revised: 01/06/2014] [Accepted: 01/29/2014] [Indexed: 12/25/2022]
Affiliation(s)
- Richard J. Gardner
- School of Physiology and Pharmacology; University of Bristol; Medical Sciences Building University Walk Bristol BS8 1TD UK
| | - Flavie Kersanté
- School of Physiology and Pharmacology; University of Bristol; Medical Sciences Building University Walk Bristol BS8 1TD UK
| | - Matthew W. Jones
- School of Physiology and Pharmacology; University of Bristol; Medical Sciences Building University Walk Bristol BS8 1TD UK
| | - Ullrich Bartsch
- School of Physiology and Pharmacology; University of Bristol; Medical Sciences Building University Walk Bristol BS8 1TD UK
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Genzel L, Kroes MC, Dresler M, Battaglia FP. Light sleep versus slow wave sleep in memory consolidation: a question of global versus local processes? Trends Neurosci 2014; 37:10-9. [DOI: 10.1016/j.tins.2013.10.002] [Citation(s) in RCA: 136] [Impact Index Per Article: 13.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2013] [Revised: 10/07/2013] [Accepted: 10/08/2013] [Indexed: 01/06/2023]
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Kalucy MJ, Grunstein R, Lambert T, Glozier N. Obstructive sleep apnoea and schizophrenia – A research agenda. Sleep Med Rev 2013; 17:357-65. [DOI: 10.1016/j.smrv.2012.10.003] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2011] [Revised: 10/08/2012] [Accepted: 10/09/2012] [Indexed: 01/10/2023]
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Lunsford-Avery JR, Mittal VA. Sleep dysfunction prior to the onset of schizophrenia: A review and neurodevelopmental diathesis–stress conceptualization. ACTA ACUST UNITED AC 2013. [DOI: 10.1111/cpsp.12041] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Abstract
Over more than a century of research has established the fact that sleep benefits the retention of memory. In this review we aim to comprehensively cover the field of "sleep and memory" research by providing a historical perspective on concepts and a discussion of more recent key findings. Whereas initial theories posed a passive role for sleep enhancing memories by protecting them from interfering stimuli, current theories highlight an active role for sleep in which memories undergo a process of system consolidation during sleep. Whereas older research concentrated on the role of rapid-eye-movement (REM) sleep, recent work has revealed the importance of slow-wave sleep (SWS) for memory consolidation and also enlightened some of the underlying electrophysiological, neurochemical, and genetic mechanisms, as well as developmental aspects in these processes. Specifically, newer findings characterize sleep as a brain state optimizing memory consolidation, in opposition to the waking brain being optimized for encoding of memories. Consolidation originates from reactivation of recently encoded neuronal memory representations, which occur during SWS and transform respective representations for integration into long-term memory. Ensuing REM sleep may stabilize transformed memories. While elaborated with respect to hippocampus-dependent memories, the concept of an active redistribution of memory representations from networks serving as temporary store into long-term stores might hold also for non-hippocampus-dependent memory, and even for nonneuronal, i.e., immunological memories, giving rise to the idea that the offline consolidation of memory during sleep represents a principle of long-term memory formation established in quite different physiological systems.
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Affiliation(s)
- Björn Rasch
- Division of Biopsychology, Neuroscience Center Zurich, University of Zurich, Zurich, Switzerland.
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Abstract
Sleep has been described as being of the brain, by the brain, and for the brain. This fundamental neurobiological behavior is controlled by homeostatic and circadian (24-hour) processes and is vital for normal brain function. This review will outline the normal sleep-wake cycle, the changes that occur during aging, and the specific patterns of sleep disturbance that occur in association with both mental health disorders and neurodegenerative disorders. The role of primary sleep disorders such as insomnia, obstructive sleep apnea, and REM sleep behavior disorder as potential causes or risk factors for particular mental health or neurodegenerative problems will also be discussed.
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Affiliation(s)
- Kirstie N Anderson
- Department of Neurology, Newcastle Upon Tyne Hospitals NHS Trust, Newcastle Upon Tyne, UK
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Peth J, Regen F, Bajbouj M, Heuser I, Anghelescu I, Hornung OP. The influence of daytime napping versus controlled activity on the subjective well-being of patients with major depression. Psychiatry Res 2012; 200:368-73. [PMID: 22789840 DOI: 10.1016/j.psychres.2012.06.020] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2011] [Revised: 06/13/2012] [Accepted: 06/15/2012] [Indexed: 11/25/2022]
Abstract
While the impact of sleep on cognitive functions such as memory is under extensive study, the role of sleep in modulating a persons' subjective well-being remains largely uncharacterized, especially in groups with psychiatric disorders. To gather more information on this topic a study was conducted with 20 patients suffering from Major Depression (MD) and 20 healthy controls, matched for age, gender and education. All subjects rated their subjective well-being at 10a.m. in the morning. Half of the subjects in each experimental group were given the opportunity to nap in the afternoon between 2p.m. and 3.30p.m., while the other half stayed awake accompanied by controlled activity. All subjects rated their subjective well-being again at 4p.m. Only the group of patients with MD who were given the opportunity to sleep during the day showed a significant improvement in subjective well-being from morning to afternoon. All the other subgroups showed no significant changes across the time interval. The results of this study suggest that depressive patients benefit from daytime naps with regard to their subjective well-being. Further research is needed to determine the exact mechanisms of this improvement.
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Affiliation(s)
- Judith Peth
- Department of Systems Neuroscience, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20251 Hamburg, Germany.
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Pritchett D, Wulff K, Oliver PL, Bannerman DM, Davies KE, Harrison PJ, Peirson SN, Foster RG. Evaluating the links between schizophrenia and sleep and circadian rhythm disruption. J Neural Transm (Vienna) 2012; 119:1061-75. [PMID: 22569850 DOI: 10.1007/s00702-012-0817-8] [Citation(s) in RCA: 69] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2012] [Accepted: 04/20/2012] [Indexed: 12/22/2022]
Abstract
Sleep and circadian rhythm disruption (SCRD) and schizophrenia are often co-morbid. Here, we propose that the co-morbidity of these disorders stems from the involvement of common brain mechanisms. We summarise recent clinical evidence that supports this hypothesis, including the observation that the treatment of SCRD leads to improvements in both the sleep quality and psychiatric symptoms of schizophrenia patients. Moreover, many SCRD-associated pathologies, such as impaired cognitive performance, are routinely observed in schizophrenia. We suggest that these associations can be explored at a mechanistic level by using animal models. Specifically, we predict that SCRD should be observed in schizophrenia-relevant mouse models. There is a rapidly accumulating body of evidence which supports this prediction, as summarised in this review. In light of these emerging data, we highlight other models which warrant investigation, and address the potential challenges associated with modelling schizophrenia and SCRD in rodents. Our view is that an understanding of the mechanistic overlap between SCRD and schizophrenia will ultimately lead to novel treatment approaches, which will not only ameliorate SCRD in schizophrenia patients, but also will improve their broader health problems and overall quality of life.
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Affiliation(s)
- David Pritchett
- Nuffield Department of Clinical Neurosciences-Nuffield Laboratory of Ophthalmology, University of Oxford, John Radcliffe Hospital, Level 5-6 West Wing, Headley Way, Oxford OX3 9DU, UK
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Sleep-related cognitive function and the K-complex in schizophrenia. Behav Brain Res 2012; 234:161-6. [DOI: 10.1016/j.bbr.2012.06.019] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2012] [Revised: 06/15/2012] [Accepted: 06/17/2012] [Indexed: 11/22/2022]
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