1
|
Mayeli A, Wilson JD, Donati FL, Ferrarelli F. Reduced slow wave density is associated with worse positive symptoms in clinical high risk: An objective readout of symptom severity for early treatment interventions? Psychiatry Res 2024; 333:115756. [PMID: 38281453 PMCID: PMC10923118 DOI: 10.1016/j.psychres.2024.115756] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Revised: 12/13/2023] [Accepted: 01/24/2024] [Indexed: 01/30/2024]
Abstract
Individuals at clinical high risk for psychosis (CHR) present subsyndromal psychotic symptoms that can escalate and lead to the transition to a diagnosable psychotic disorder. Identifying biological parameters that are sensitive to these symptoms can therefore help objectively assess their severity and guide early interventions in CHR. Reduced slow wave oscillations (∼1 Hz) during non-rapid eye movement sleep were recently observed in first-episode psychosis patients and were linked to the intensity of their positive symptoms. Here, we collected overnight high-density EEG recordings from 37 CHR and 32 healthy control (HC) subjects and compared slow wave (SW) activity and other SW parameters (i.e., density and negative peak amplitude) between groups. We also assessed the relationships between clinical symptoms and SW parameters in CHR. While comparisons between HC and the entire CHR group showed no SW differences, CHR individuals with higher positive symptom severity (N = 18) demonstrated a reduction in SW density in an EEG cluster involving bilateral prefrontal, parietal, and right occipital regions compared to matched HC individuals. Furthermore, we observed a negative correlation between SW density and positive symptoms across CHR individuals, suggesting a potential target for early treatment interventions.
Collapse
Affiliation(s)
- Ahmad Mayeli
- Department of Psychiatry, University of Pittsburgh, USA
| | | | | | | |
Collapse
|
2
|
Mayeli A, LaGoy AD, Smagula SF, Wilson JD, Zarbo C, Rocchetti M, Starace F, Zamparini M, Casiraghi L, Calza S, Rota M, D'Agostino A, de Girolamo G, Ferrarelli F. Shared and distinct abnormalities in sleep-wake patterns and their relationship with the negative symptoms of Schizophrenia Spectrum Disorder patients. Mol Psychiatry 2023; 28:2049-2057. [PMID: 37055512 DOI: 10.1038/s41380-023-02050-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Revised: 03/21/2023] [Accepted: 03/23/2023] [Indexed: 04/15/2023]
Abstract
Sleep and rest-activity-rhythm (RAR) abnormalities are commonly reported in schizophrenia spectrum disorder (SSD) patients. However, an in-depth characterization of sleep/RAR alterations in SSD, including patients in different treatment settings, and the relationship between these alterations and SSD clinical features (e.g., negative symptoms) is lacking. SSD (N = 137 altogether, N = 79 residential and N = 58 outpatients) and healthy control (HC) subjects (N = 113) were recruited for the DiAPAson project. Participants wore an ActiGraph for seven consecutive days to monitor habitual sleep-RAR patterns. Sleep/rest duration, activity (i.e., M10, calculated on the 10 most active hours), rhythm fragmentation within days (i.e., intra-daily variability, IV; beta, steepness of rest-active changes), and rhythm regularity across days (i.e., inter-daily stability, IS) were computed in each study participant. Negative symptoms were assessed in SSD patients with the Brief Negative Symptom Scale (BNSS). Both SSD groups showed lower M10 and longer sleep/rest duration vs. HC, while only residential patients had more fragmented and irregular rhythms than HC. Compared to outpatients, residential patients had lower M10 and higher beta, IV and IS. Furthermore, residential patients had worse BNSS scores relative to outpatients, and higher IS contributed to between-group differences in BNSS score severity. Altogether, residentials and outpatients SSD had both shared and unique abnormalities in Sleep/RAR measures vs. HC and relative to one another, which also contributed to the patients' negative symptom severity. Future work will help establish whether improving some of these measures may ameliorate the quality of life and clinical symptoms of SSD patients.
Collapse
Affiliation(s)
- Ahmad Mayeli
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
| | - Alice D LaGoy
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
| | - Stephen F Smagula
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
| | - James D Wilson
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
| | - Cristina Zarbo
- Unit of Epidemiological Psychiatry and Evaluation, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Matteo Rocchetti
- Department of Mental Health and Dependence, ASST of Pavia, Pavia, Italy
| | - Fabrizio Starace
- Department of Mental Health and Dependence, AUSL of Modena, Modena, Italy
| | - Manuel Zamparini
- Unit of Epidemiological Psychiatry and Evaluation, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Letizia Casiraghi
- Department of Mental Health and Dependence, ASST of Pavia, Pavia, Italy
| | - Stefano Calza
- Unit of Biostatistics and Bioinformatics, Department of Molecular and Translational Medicine, University of Brescia, Brescia, Italy
| | - Matteo Rota
- Unit of Biostatistics and Bioinformatics, Department of Molecular and Translational Medicine, University of Brescia, Brescia, Italy
| | | | - Giovanni de Girolamo
- Unit of Epidemiological Psychiatry and Evaluation, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Fabio Ferrarelli
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA.
| |
Collapse
|
3
|
Qin Y, Mahdavi A, Bertschy M, Anderson PM, Kulikova S, Pinault D. The psychotomimetic ketamine disrupts the transfer of late sensory information in the corticothalamic network. Eur J Neurosci 2023; 57:440-455. [PMID: 36226598 PMCID: PMC10092610 DOI: 10.1111/ejn.15845] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Revised: 08/17/2022] [Accepted: 09/01/2022] [Indexed: 02/04/2023]
Abstract
In prodromal and early schizophrenia, disorders of attention and perception are associated with structural and chemical brain abnormalities and with dysfunctional corticothalamic networks exhibiting disturbed brain rhythms. The underlying mechanisms are elusive. The non-competitive NMDA receptor antagonist ketamine simulates the symptoms of prodromal and early schizophrenia, including disturbances in ongoing and task & sensory-related broadband beta-/gamma-frequency (17-29 Hz/30-80 Hz) oscillations in corticothalamic networks. In normal healthy subjects and rodents, complex integration processes, like sensory perception, induce transient, large-scale synchronised beta/gamma oscillations in a time window of a few hundred ms (200-700 ms) after the presentation of the object of attention (e.g., sensory stimulation). Our goal was to use an electrophysiological multisite network approach to investigate, in lightly anesthetised rats, the effects of a single psychotomimetic dose (2.5 mg/kg, subcutaneous) of ketamine on sensory stimulus-induced oscillations. Ketamine transiently increased the power of baseline beta/gamma oscillations and decreased sensory-induced beta/gamma oscillations. In addition, it disrupted information transferability in both the somatosensory thalamus and the related cortex and decreased the sensory-induced thalamocortical connectivity in the broadband gamma range. The present findings support the hypothesis that NMDA receptor antagonism disrupts the transfer of perceptual information in the somatosensory cortico-thalamo-cortical system.
Collapse
Affiliation(s)
- Yi Qin
- Université de Strasbourg, Strasbourg, France
- INSERM U1114, Neuropsychologie cognitive et physiopathologie de la schizophrénie, Strasbourg, France
- Fédération de Médecine Translationnelle de Strasbourg (FMTS), Faculté de médecine, Strasbourg, France
- Centre de Recherche en Biomédecine de Strasbourg (CRBS), Strasbourg, France
- Netherlands Institute for Neuroscience, The Netherlands
| | - Ali Mahdavi
- Université de Strasbourg, Strasbourg, France
- INSERM U1114, Neuropsychologie cognitive et physiopathologie de la schizophrénie, Strasbourg, France
- Fédération de Médecine Translationnelle de Strasbourg (FMTS), Faculté de médecine, Strasbourg, France
- Centre de Recherche en Biomédecine de Strasbourg (CRBS), Strasbourg, France
- The University of Freiburg, Bernstein Center Freiburg, Freiburg, Germany
| | - Marine Bertschy
- Université de Strasbourg, Strasbourg, France
- INSERM U1114, Neuropsychologie cognitive et physiopathologie de la schizophrénie, Strasbourg, France
- Fédération de Médecine Translationnelle de Strasbourg (FMTS), Faculté de médecine, Strasbourg, France
- Centre de Recherche en Biomédecine de Strasbourg (CRBS), Strasbourg, France
| | - Paul M Anderson
- Dept. Cognitive Neurobiology, Center for Brain Research, Medical University Vienna, Austria
| | - Sofya Kulikova
- National Research University Higher School of Economics, Perm, Russia
| | - Didier Pinault
- Université de Strasbourg, Strasbourg, France
- INSERM U1114, Neuropsychologie cognitive et physiopathologie de la schizophrénie, Strasbourg, France
- Fédération de Médecine Translationnelle de Strasbourg (FMTS), Faculté de médecine, Strasbourg, France
- Centre de Recherche en Biomédecine de Strasbourg (CRBS), Strasbourg, France
| |
Collapse
|
4
|
Sleep and Mental Health Problems in Children and Adolescents. Sleep Med Clin 2023; 18:245-254. [PMID: 37120167 DOI: 10.1016/j.jsmc.2023.01.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/27/2023]
Abstract
Previous reviews have described the links between sleep and mental health extensively. In this narrative review, we focus on literature published during the last decade investigating the links between sleep and mental health difficulties in childhood and adolescence. More specifically, we focus on the mental health disorders listed in the most recent edition of the Diagnostic and Statistical Manual of Mental Disorders. We also discuss possible mechanisms underlying these associations. The review ends with a discussion of possible future lines of enquiry.
Collapse
|
5
|
LaGoy AD, Mayeli A, Smagula SF, Ferrarelli F. Relationships between rest-activity rhythms, sleep, and clinical symptoms in individuals at clinical high risk for psychosis and healthy comparison subjects. J Psychiatr Res 2022; 155:465-470. [PMID: 36183600 PMCID: PMC10729940 DOI: 10.1016/j.jpsychires.2022.09.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Revised: 08/11/2022] [Accepted: 09/12/2022] [Indexed: 11/18/2022]
Abstract
Sleep-wake disturbances in individuals at clinical high risk (CHR) of psychosis may relate to increased symptom severity and contribute to disease progression. Here, we examined differences in rest-activity rhythms (RAR) measures, derived from actigraphy, and objective sleep outcomes, derived from electroencephalography (EEG), between 12 CHR and 16 healthy comparison (HC) individuals. Further, we examined the relationships between RAR disturbances, objective sleep outcomes and clinical psychosis symptoms (i.e., negative, positive, disorganized, general symptoms). Sleep-wake behaviors were monitored via actigraphy for 3-7 days (CHR: 5.7 ± 1.7 days; HC: 6.3 ± 1.2 days) prior to participants spending a night in the sleep laboratory, which was monitored with EEG. Separate regressions were used to examine the effect of clinical group on RAR measures and objective sleep outcomes after controlling for age and gender. CHR participants were found to be less active, specifically during the evening (17:00-20:00; β = 1.145, SE = 0.362, p = .004) and nighttime (21:00-24:00; β = 1.152, SE = 0.326, p = .002) relative to HC. Further, CHR participants had more fragmented sleep (wake after sleep onset: β = 0.888, SE = 0.395, p = .034) and more hyperarousal during sleep (NREM gamma activity: β = 1.087, SE = 0.348, p = .005), but these sleep disturbances were not related to reduced activity or clinical symptoms, whereas lower nighttime activity was related to more disorganized symptoms (ρ = -.640, p = .025). Thus, increasing activity through behavioral interventions may have additional beneficial effects on CHR clinical symptoms.
Collapse
Affiliation(s)
- Alice D LaGoy
- Department of Psychiatry, University of Pittsburgh School of Medicine, 3811 O'Hara Street, Pittsburgh, PA, 15213, USA; Department of Sports Medicine and Nutrition, University of Pittsburgh, 3600 Atwood Street, Pittsburgh, PA, 15260, USA
| | - Ahmad Mayeli
- Department of Psychiatry, University of Pittsburgh School of Medicine, 3811 O'Hara Street, Pittsburgh, PA, 15213, USA
| | - Stephen F Smagula
- Department of Psychiatry, University of Pittsburgh School of Medicine, 3811 O'Hara Street, Pittsburgh, PA, 15213, USA
| | - Fabio Ferrarelli
- Department of Psychiatry, University of Pittsburgh School of Medicine, 3811 O'Hara Street, Pittsburgh, PA, 15213, USA.
| |
Collapse
|
6
|
Anastasiades PG, de Vivo L, Bellesi M, Jones MW. Adolescent sleep and the foundations of prefrontal cortical development and dysfunction. Prog Neurobiol 2022; 218:102338. [PMID: 35963360 DOI: 10.1016/j.pneurobio.2022.102338] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Revised: 08/04/2022] [Accepted: 08/08/2022] [Indexed: 11/17/2022]
Abstract
Modern life poses many threats to good-quality sleep, challenging brain health across the lifespan. Curtailed or fragmented sleep may be particularly damaging during adolescence, when sleep disruption by delayed chronotypes and societal pressures coincides with our brains preparing for adult life via intense refinement of neural connectivity. These vulnerabilities converge on the prefrontal cortex, one of the last brain regions to mature and a central hub of the limbic-cortical circuits underpinning decision-making, reward processing, social interactions and emotion. Even subtle disruption of prefrontal cortical development during adolescence may therefore have enduring impact. In this review, we integrate synaptic and circuit mechanisms, glial biology, sleep neurophysiology and epidemiology, to frame a hypothesis highlighting the implications of adolescent sleep disruption for the neural circuitry of the prefrontal cortex. Convergent evidence underscores the importance of acknowledging, quantifying and optimizing adolescent sleep's contributions to normative brain development and to lifelong mental health.
Collapse
Affiliation(s)
- Paul G Anastasiades
- University of Bristol, Translational Health Sciences, Dorothy Hodgkin Building, Whitson Street, Bristol BS1 3NY, UK
| | - Luisa de Vivo
- University of Bristol, School of Physiology, Pharmacology & Neuroscience, University Walk, Bristol BS8 1TD, UK; University of Camerino, School of Pharmacy, via Gentile III Da Varano, Camerino 62032, Italy
| | - Michele Bellesi
- University of Bristol, School of Physiology, Pharmacology & Neuroscience, University Walk, Bristol BS8 1TD, UK; University of Camerino, School of Bioscience and Veterinary Medicine, via Gentile III Da Varano, Camerino 62032, Italy
| | - Matt W Jones
- University of Bristol, School of Physiology, Pharmacology & Neuroscience, University Walk, Bristol BS8 1TD, UK
| |
Collapse
|
7
|
Ristanovic I, Haase CM, Lunsford-Avery JR, Mittal VA. The relationship between stress responding in family context and stress sensitivity with sleep dysfunction in individuals at clinical high-risk for psychosis. J Psychiatr Res 2022; 149:194-200. [PMID: 35287048 PMCID: PMC9176292 DOI: 10.1016/j.jpsychires.2022.02.038] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Revised: 02/02/2022] [Accepted: 02/28/2022] [Indexed: 12/13/2022]
Abstract
Stress and sleep have been implicated in the etiology of psychosis, and literature suggests they are closely related. Two distinct domains of stress associated with sleep dysfunction in the general population are responsivity to environmental stressors and stress sensitivity. However, to date, no research has examined relationships between these stress domains and sleep dysfunction in individuals at clinical high-risk (CHR) for psychosis. A total of 57 CHR (mean age = 18.89, SD = 1.82) and 61 healthy control (HC; mean age = 18.34, SD = 2.41) adolescents and young adults completed a measure of emerging stress intolerance. A subset of participants (CHR = 50, HC = 49) completed a measure indexing responsivity to family stressors - an integral context for this developmental stage overlapping with the psychosis-risk period. Sleep efficiency, continuity, and duration were objectively assessed by actigraphy (CHR = 38, HC = 36). Partial correlations with age and sex as covariates were conducted in both groups separately to examine relationships between stress and sleep. Results indicated that automatic maladaptive responsivity to family stressors was associated with disrupted sleep in the CHR but not HC group. Specifically, greater involuntary engagement was associated with poorer sleep efficiency (r = -.42) but not sleep continuity (r = 0.31) and duration (r = .-19). Interestingly, both adaptative and maladaptive voluntary responses to stressors (engagement and disengagement coping) were not associated with sleep. Finally, impaired stress tolerance was associated with sleep efficiency (r = -0.47), continuity (r = 0.37), and duration (r = -0.43). Taken together, findings provided important groundwork for understanding the role of the relationship between involuntary maladaptive responsivity to family stressors and stress sensitivity with sleep in psychosis etiology.
Collapse
Affiliation(s)
- Ivanka Ristanovic
- Northwestern University, Department of Psychology, Evanston, IL, USA.
| | - Claudia M. Haase
- Northwestern University, School of Education and Social Policy Evanston, IL
| | | | - Vijay A. Mittal
- Northwestern University, Department of Psychology, Evanston, IL,Northwestern University, Department of Psychiatry, Chicago, IL,Northwestern University, Medical Social Sciences, Chicago IL,Norhtwestern University, Institute for Policy Research, Evanston, IL
| |
Collapse
|
8
|
Examining First Night Effect on Sleep Parameters with hd-EEG in Healthy Individuals. Brain Sci 2022; 12:brainsci12020233. [PMID: 35203996 PMCID: PMC8870064 DOI: 10.3390/brainsci12020233] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Revised: 02/02/2022] [Accepted: 02/04/2022] [Indexed: 12/04/2022] Open
Abstract
Difficulty sleeping in a novel environment is a common phenomenon that is often described as the first night effect (FNE). Previous works have found FNE on sleep architecture and sleep power spectra parameters, especially during non-rapid eye movement (NREM) sleep. However, the impact of FNE on sleep parameters, including local differences in electroencephalographic (EEG) activity across nights, has not been systematically assessed. Here, we performed high-density EEG sleep recordings on 27 healthy individuals on two nights and examined differences in sleep architecture, NREM (stages 2 and 3) EEG power spectra, and NREM power topography across nights. We found higher wakefulness after sleep onset (WASO), reduced sleep efficiency, and less deep NREM sleep (stage 3), along with increased high-frequency NREM EEG power during the first night of sleep, corresponding to small to medium effect sizes (Cohen’s d ≤ 0.5). Furthermore, study individuals showed significantly lower slow-wave activity in right frontal/prefrontal regions as well as higher sigma and beta activities in medial and left frontal/prefrontal areas, yielding medium to large effect sizes (Cohen’s d ≥ 0.5). Altogether, these findings suggest the FNE is characterized by less efficient, more fragmented, shallower sleep that tends to affect especially certain brain regions. The magnitude and specificity of these effects should be considered when designing sleep studies aiming to compare across night effects.
Collapse
|
9
|
Fekih-Romdhane F, Hallit S, Cheour M, Jahrami H. The nature, consequences, mechanisms, and management of sleep disturbances in individuals at-risk for psychosis. Front Psychiatry 2022; 13:1011963. [PMID: 36203842 PMCID: PMC9530454 DOI: 10.3389/fpsyt.2022.1011963] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Accepted: 09/05/2022] [Indexed: 11/26/2022] Open
Abstract
There is strong evidence that sleep disturbances are commonly experienced by people with psychosis. Evidence has also shown that sleep disturbances are present since the very early stages of the disease, even during the pre-diagnostic phase. More recently, research involving young individuals at ultra-high risk (UHR) for psychosis documented frequent occurrence of sleep disturbances in this group. The very early onset of sleep disturbances in the course of psychosis has drawn attention to the possible links between sleep parameters and the risk of psychosis. To date, the nature of sleep disturbances characterizing the UHR stage remains unclear, with available studies having yielded mixed findings. In this regard, we performed this review to update the body of literature on the nature of sleep disturbances, their underlying mechanisms, their clinical and functional consequences, the prevention and intervention strategies in the at-risk for psychosis population. Our findings provided further support to the presence of disturbed sleep in UHR individuals as evidenced by subjective and objective sleep measures such as polysomnography, sleep electroencephalograms, and actigraphy. Reviewing the possible mechanisms underlying the relationship between sleep and psychosis emphasized its complex and multifactorial nature which is yet to be determined and understood. Further research is warranted to determine which facets of sleep disturbances are most detrimental to this specific population, and to what extent they can be causal factors or markers of psychosis.
Collapse
Affiliation(s)
- Feten Fekih-Romdhane
- Faculty of Medicine of Tunis, Tunis El Manar University, Tunis, Tunisia.,The Tunisian Center of Early Intervention in Psychosis, Department of Psychiatry Ibn Omrane, Razi Hospital, Tunis, Tunisia
| | - Souheil Hallit
- School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, Jounieh, Lebanon.,Psychology Department, College of Humanities, Effat University, Jeddah, Saudi Arabia.,Research Department, Psychiatric Hospital of the Cross, Jal Eddib, Lebanon
| | - Majda Cheour
- Faculty of Medicine of Tunis, Tunis El Manar University, Tunis, Tunisia.,The Tunisian Center of Early Intervention in Psychosis, Department of Psychiatry Ibn Omrane, Razi Hospital, Tunis, Tunisia
| | - Haitham Jahrami
- College of Medicine and Medical Sciences, Arabian Gulf University, Manama, Bahrain.,Department of Psychiatry, Ministry of Health, Manama, Bahrain
| |
Collapse
|