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Thomas RJ. A matter of fragmentation. Sleep 2024; 47:zsae030. [PMID: 38285604 DOI: 10.1093/sleep/zsae030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Indexed: 01/31/2024] Open
Affiliation(s)
- Robert Joseph Thomas
- Professor of Medicine, Harvard Medical School, Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA
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Kim M, Lee J, Kim N, Hwang Y, Lee KH, Lee J, Lee YJ, Kim SJ. The Influence of Life Stress and Sleep Disturbance on White Matter Integrity. Psychiatry Investig 2023; 20:439-444. [PMID: 37253469 DOI: 10.30773/pi.2022.0285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Accepted: 02/05/2023] [Indexed: 06/01/2023] Open
Abstract
OBJECTIVE This study investigated whether sleep and stress mutually interact to induce changes in white matter integrity. METHODS Diffusion tensor imaging (DTI) was conducted on 36 participants (male=22, female=14; mean age=38.33±12.78 years). Participants were divided into three groups depending on their sleep quality and stress levels: poor sleepers with stress, poor sleepers without stress, and good sleepers. Sleep quality and stress level were evaluated using the Pittsburgh Sleep Quality Index and the Life Experiences Survey, respectively. Fractional anisotropy (FA) values were calculated employing DTI tractography. RESULTS After controlling for age and sex, poor sleepers with stress exhibited a lower FA of the left inferior cerebellar peduncle (ICP) than did poor sleepers without stress (t=2.81, p=0.02). Poor sleepers without stress showed a higher FA of the right middle longitudinal fasciculus (MdLF) than did good sleepers (t=3.35, p=0.006). CONCLUSION The current study reports the effects of sleep, stress, and their interaction on the white matter integrities of the ICP and MdLF. ICP change seems to be associated with sleep disturbances related to stress, while MdLF change would be associated with sleep disturbances unrelated to stress.
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Affiliation(s)
- Minjeong Kim
- Department of Psychiatry, Sungkyunkwan University, College of Medicine, Samsung Medical Center, Seoul, Republic of Korea
| | - Jiye Lee
- Department of Psychiatry, Sungkyunkwan University, College of Medicine, Samsung Medical Center, Seoul, Republic of Korea
| | - Nambeom Kim
- Department of Biomedical Engineering Research Center, Gachon University, Incheon, Republic of Korea
| | - Yunjee Hwang
- Department of Brain and Cognitive Engineering, Korea University, Seoul, Republic of Korea
| | - Kyung Hwa Lee
- Department of Psychiatry and Center for Sleep and Chronobiology, Seoul National University, College of Medicine and Hospital, Seoul, Republic of Korea
- Division of Child and Adolescent Psychiatry, Department of Psychiatry, Seoul National University Hospital, Seoul, Republic of Korea
| | - Jooyoung Lee
- Department of Psychiatry, Sungkyunkwan University, College of Medicine, Samsung Medical Center, Seoul, Republic of Korea
| | - Yu Jin Lee
- Department of Psychiatry and Center for Sleep and Chronobiology, Seoul National University, College of Medicine and Hospital, Seoul, Republic of Korea
| | - Seog Ju Kim
- Department of Psychiatry, Sungkyunkwan University, College of Medicine, Samsung Medical Center, Seoul, Republic of Korea
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Hidese S, Ota M, Matsuo J, Ishida I, Yokota Y, Hattori K, Yomogida Y, Kunugi H. Association between the Pittsburgh sleep quality index and white matter integrity in healthy adults: a whole-brain magnetic resonance imaging study. Sleep Biol Rhythms 2023; 21:249-256. [PMID: 38469289 PMCID: PMC10899930 DOI: 10.1007/s41105-022-00442-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Accepted: 12/26/2022] [Indexed: 01/03/2023]
Abstract
To disclose possible associations between poorer sleep quality and structural brain alterations in a non-psychiatric healthy population, this study investigated the association between the Pittsburgh sleep quality index (PSQI) and brain correlates, using a whole-brain approach. This study included 371 right-handed healthy adults (138 males, mean age: 46.4 ± 14.0 years [range: 18-75]) who were right-handed. Subjective sleep quality was assessed using the Japanese version of the PSQI (PSQI-J), and the cutoff score for poor subjective sleep quality was set at ≥ 6. Voxel-based morphometry (VBM) and diffusion tensor imaging (DTI) were performed to examine whether a higher score of the PSQI-J indicates, poorer sleep quality is associated with gray matter volume and white matter microstructure alternations, respectively. Among the participants, 38.8% had a PSQI-J cutoff score of ≥ 6. VBM did not reveal any correlation between PSQI-J scores and gray matter volume. However, DTI revealed that PSQI-J global scores were significantly and negatively correlated with diffuse white matter fractional anisotropy (FA) values (p < 0.05, corrected). Moreover, the PSQI-J sleep disturbance and use of sleep medication component scores were significantly and negatively correlated with right anterior thalamic radiation and diffuse white matter FA values, respectively (p < 0.05, corrected). There were no significant differences in gray matter volume and white matter metrics (FA, axial, radial, and mean diffusivities) between the groups with PSQI-J scores above or below the cutoff. Our findings suggest that lower sleep quality, especially the use of sleep medication, is associated with impaired white matter integrity in healthy adults. Limitations of this study are relatively small number of participants and cross-sectional design. Fine sleep quality, possibly preventing the use of sleep medication, may contribute to preserve white matter integrity in the brain of healthy adults. Supplementary Information The online version contains supplementary material available at 10.1007/s41105-022-00442-0.
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Affiliation(s)
- Shinsuke Hidese
- Department of Mental Disorder Research, National Institute of Neuroscience, National Center of Neurology and Psychiatry, 4-1-1, Ogawa-Higashi, Kodaira, Tokyo 187-8502 Japan
- Department of Psychiatry, Teikyo University School of Medicine, 2-11-1, Kaga, Itabashi-Ku, Tokyo 173-8605 Japan
| | - Miho Ota
- Department of Mental Disorder Research, National Institute of Neuroscience, National Center of Neurology and Psychiatry, 4-1-1, Ogawa-Higashi, Kodaira, Tokyo 187-8502 Japan
- Department of Neuropsychiatry, Division of Clinical Medicine, Faculty of Medicine, University of Tsukuba, 2-1-1, Amakubo, Tsukuba, Ibaraki 305-8576 Japan
| | - Junko Matsuo
- Department of Mental Disorder Research, National Institute of Neuroscience, National Center of Neurology and Psychiatry, 4-1-1, Ogawa-Higashi, Kodaira, Tokyo 187-8502 Japan
- Department of Psychiatry, National Center Hospital, National Center of Neurology and Psychiatry, 4-1-1, Ogawa-Higashi, Kodaira, Tokyo 187-8551 Japan
| | - Ikki Ishida
- Department of Mental Disorder Research, National Institute of Neuroscience, National Center of Neurology and Psychiatry, 4-1-1, Ogawa-Higashi, Kodaira, Tokyo 187-8502 Japan
- Department of Psychiatry, Teikyo University School of Medicine, 2-11-1, Kaga, Itabashi-Ku, Tokyo 173-8605 Japan
| | - Yuuki Yokota
- Department of Mental Disorder Research, National Institute of Neuroscience, National Center of Neurology and Psychiatry, 4-1-1, Ogawa-Higashi, Kodaira, Tokyo 187-8502 Japan
- Department of Behavioral Medicine, National Institute of Mental Health, National Center of Neurology and Psychiatry, 4-1-1, Ogawa-Higashi, Kodaira, Tokyo 187-8553 Japan
| | - Kotaro Hattori
- Department of Mental Disorder Research, National Institute of Neuroscience, National Center of Neurology and Psychiatry, 4-1-1, Ogawa-Higashi, Kodaira, Tokyo 187-8502 Japan
- Medical Genome Center, National Center of Neurology and Psychiatry, 4-1-1, Ogawa-Higashi, Kodaira, Tokyo 187-8551 Japan
| | - Yukihito Yomogida
- Department of Mental Disorder Research, National Institute of Neuroscience, National Center of Neurology and Psychiatry, 4-1-1, Ogawa-Higashi, Kodaira, Tokyo 187-8502 Japan
- Araya Inc., 1-12-32, Akasaka, Minato-Ku, Tokyo 107-6024 Japan
| | - Hiroshi Kunugi
- Department of Mental Disorder Research, National Institute of Neuroscience, National Center of Neurology and Psychiatry, 4-1-1, Ogawa-Higashi, Kodaira, Tokyo 187-8502 Japan
- Department of Psychiatry, Teikyo University School of Medicine, 2-11-1, Kaga, Itabashi-Ku, Tokyo 173-8605 Japan
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Zhao J, Kong Q, Zhou X, Zhang Y, Yu Z, Qu W, Huang H, Luo X. Differences in Gray Matter Volume in Cerebral Small Vessel Disease Patients with and without Sleep Disturbance. Brain Sci 2023; 13:brainsci13020294. [PMID: 36831837 PMCID: PMC9953873 DOI: 10.3390/brainsci13020294] [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: 12/20/2022] [Revised: 01/31/2023] [Accepted: 02/07/2023] [Indexed: 02/12/2023] Open
Abstract
Recently, there has been increased interest in the relationship between cerebral small vessel disease (CSVD) and circadian rhythm disruption, particularly sleep disturbance. However, the neural mechanism of sleep disturbance in CSVD patients remains poorly understood. The purpose of this study is to explore the gray matter alterations in CSVD patients with and without sleep disturbance. 59 patients with CSVD and 40 healthy controls (HC) were recruited for the present study. Sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI) questionnaire. CSVD patients were categorized into either the good sleepers group (CSVD-GS, n = 23) or the poor sleepers group (CSVD-PS, n = 36) based on PSQI score. Voxel-based morphometry (VBM) analysis was used to assess differences in gray matter volume (GMV) between groups. Multivariate regression analyses were performed to investigate the relationships between sleep quality, GMV, and white matter hyperintensities (WMH). We observed GMV differences between the three groups in the bilateral caudate, right thalamus, bilateral calcarine cortex, left precentral gyrus, right orbitofrontal cortex, left cingulate gyrus, and right sub-gyral temporal lobe. Additionally, the CSVD-PS group exhibited decreased GMV in the bilateral calcarine cortex yet increased GMV in the right caudate compared to the CSVD-GS group. In fully adjusted models, GMV of the right caudate and bilateral calcarine cortex was associated with sleep quality in CSVD patients. The present study revealed structural brain alterations in CSVD patients with sleep disturbance. These findings may provide novel insights into the neural mechanisms of sleep disturbance in CSVD.
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Affiliation(s)
| | | | | | | | | | | | | | - Xiang Luo
- Correspondence: ; Tel.: +86-27-83663337
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Luo XW, Li QX, Shen LS, Zhou X, Zou FY, Tang WJ, Guo RM. Quantitative association of cerebral blood flow, relaxation times and proton density in young and middle-aged primary insomnia patients: A prospective study using three-dimensional arterial spin labeling and synthetic magnetic resonance imaging. Front Neurosci 2023; 17:1099911. [PMID: 37025376 PMCID: PMC10070794 DOI: 10.3389/fnins.2023.1099911] [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: 11/16/2022] [Accepted: 03/03/2023] [Indexed: 04/08/2023] Open
Abstract
Objectives To quantitatively measure the T1 value, T2 value, proton density (PD) value, and cerebral blood flow (CBF) in young and middle-aged primary insomnia (PI) patients, and analyze the correlations between relaxation times, PD, and CBF to explore potential brain changes. Methods Cranial magnetic resonance (MR) images of 44 PI patients and 30 healthy subjects were prospectively collected for analysis. The T1, T2, PD, and CBF values of the frontal lobe, parietal lobe, temporal lobe, and occipital lobe were independently measured using three-dimensional arterial spin labeling (3D-ASL), synthetic magnetic resonance imaging (syMRI) and a whole-brain automatic segmentation method. The differences of these imaging indices were compared between PI patients and healthy subjects. Follow-up MR images were obtained from PI patients after 6 months to compare with pre-treatment images. The Wilcoxon signed rank test and Spearman rank were used for statistical analysis. Results Bilateral CBF asymmetry was observed in 38 patients, with significant differences in both the T2 value and CBF between the four lobes of the brain (p < 0.01). However, no significant difference was found in the T1 and PD values between the bilateral lobes. A negative correlation was found between CBF and T2 values in the right four lobes of patients with primary insomnia (PI). During follow-up examinations, five PI patients showed a disappearance of insomnia symptoms and a decrease in CBF in both brain lobes. Conclusion Insomnia symptoms may be associated with high CBF, and most PI patients have higher CBF and lower T2 values in the right cerebral hemispheres. The right hemisphere appears to play a critical role in the pathophysiology of PI. The 3D-ASL and syMRI technologies can provide a quantitative imaging basis for investigating the brain conditions and changes in young and middle-aged PI patients.
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Xia N, Jiang C, Zhou Y, Huang Q, Hu L, Zeng H, Luo L, Yuan Z. A double-blind, randomized, placebo-controlled, single-center clinical trial of jiaotaiwan for the treatment of insomnia symptoms caused by disharmony of the heart and kidney. Front Pharmacol 2022; 13:1011003. [DOI: 10.3389/fphar.2022.1011003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Accepted: 10/24/2022] [Indexed: 11/06/2022] Open
Abstract
Background: Jiaotaiwan (JTW) is a classical tranquillizing prescription in traditional Chinese medicine (TCM) for the treatment of insomnia symptoms caused by disharmony of the heart and kidney (ISDHK). This study aimed to evaluate the effectiveness and safety of JTW for treating ISDHK in a double-blind, randomized, placebo-controlled trial.Methods: From September 2018 to February 2020, 128 participants with ISDHK were included in this single-center clinical trial. All participants were equally and randomly divided into either the JTW group (2-g JTW granules, b.i.d. for 7 days) or placebo group (2-g placebo granules, b.i.d. for 7 days). Pittsburgh Sleep Quality Index (PSQI) scores were set as the primary outcome, and polysomnography (PSG), 1H-magnetic resonance spectroscopy (1H-MRS), blood tests, and Disharmony of Heart and Kidney Scoring System (DHKSS) and clinical global impression (CGI) scores were used as secondary outcomes. Laboratory tests were used to evaluate the safety of JTW. All data were collected at baseline and posttreatment.Results: A total of 106 participants completed this clinical trial. Symptom relief was more apparent in the JTW group than the placebo group (PSQI total score: 9.34 ± 3.578 vs. 10.98 ± 3.073, respectively; p = 0.006). However, no PSG changes were observed between the two groups (p > 0.05). Higher CGI and lower DHKSS scores were observed after JTW treatment. Serum melatonin was increased in patients with ISDHK after JTW treatment (JTW, 339.09 ± 256.894 vs. placebo, 219.59 ± 169.045; p = 0.004). There were significant posttreatment differences in metabolites in the left cerebellum between the two groups (myoinositol: JTW, 13.47 ± 2.094 vs. placebo, 12.48 ± 2.449; p = 0.021; choline: JTW, 3.96 ± 0.657 vs. placebo, 3.65 ± 0.562; p = 0.008). In terms of safety, JTW had no noticeable adverse effects relative to placebo.Conclusion: JTW was effective and well tolerated for the treatment of ISDHK. The development of large-scale trials with longer follow-up durations is recommended to provide further evidence.Clinical Trial Registration:clinicaltrials.gov, identifier ChiCTR1800019239
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Distinct functional brain abnormalities in insomnia disorder and obstructive sleep apnea. Eur Arch Psychiatry Clin Neurosci 2022; 273:493-509. [PMID: 36094570 DOI: 10.1007/s00406-022-01485-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2022] [Accepted: 08/29/2022] [Indexed: 11/03/2022]
Abstract
Insomnia disorder (ID) and obstructive sleep apnea (OSA) are the two most prevalent sleep disorders worldwide, but the pathological mechanism has not been fully understood. Functional neuroimaging findings indicated regional abnormal neural activities existed in both diseases, but the results were inconsistent. This meta-analysis aimed to explore concordant regional functional brain changes in ID and OSA, respectively. We conducted a coordinate-based meta-analysis (CBMA) of resting-state functional magnetic resonance imaging (rs-fMRI) studies using the anisotropic effect-size seed-based d mapping (AES-SDM) approach. Studies that applied regional homogeneity (ReHo), amplitude of low-frequency fluctuations (ALFF) or fractional ALFF (fALFF) to analyze regional spontaneous brain activities in ID or OSA were included. Meta-regressions were then applied to investigate potential associations between demographic variables and regional neural activity alterations. Significantly increased brain activities in the left superior temporal gyrus (STG.L) and right superior longitudinal fasciculus (SLF.R), as well as decreased brain activities in several right cerebral hemisphere areas were identified in ID patients. As for OSA patients, more distinct and complicated functional activation alterations were identified. Several neuroimaging alterations were functionally correlated with mean age, duration or illness severity in two patients groups revealed by meta-regressions. These functionally altered areas could be served as potential targets for non-invasive brain stimulation methods. This present meta-analysis distinguished distinct brain function changes in ID and OSA, improving our knowledge of the neuropathological mechanism of these two most common sleep disturbances, and also provided potential orientations for future clinical applications.Registration number: CRD42022301938.
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Gudberg C, Stevelink R, Douaud G, Wulff K, Lazari A, Fleming MK, Johansen-Berg H. Individual differences in slow wave sleep architecture relate to variation in white matter microstructure across adulthood. Front Aging Neurosci 2022; 14:745014. [PMID: 36092806 PMCID: PMC9453235 DOI: 10.3389/fnagi.2022.745014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Accepted: 08/08/2022] [Indexed: 11/18/2022] Open
Abstract
Sleep plays a key role in supporting brain function and resilience to brain decline. It is well known that sleep changes substantially with aging and that aging is associated with deterioration of brain structure. In this study, we sought to characterize the relationship between slow wave slope (SWslope)—a key marker of sleep architecture and an indirect proxy of sleep quality—and microstructure of white matter pathways in healthy adults with no sleep complaints. Participants were 12 young (24–27 years) and 12 older (50–79 years) adults. Sleep was assessed with nocturnal electroencephalography (EEG) and the Pittsburgh Sleep Quality Index (PSQI). White matter integrity was assessed using tract-based spatial statistics (TBSS) on tensor-based metrics such as Fractional Anisotropy (FA) and Mean Diffusivity (MD). Global PSQI score did not differ between younger (n = 11) and older (n = 11) adults (U = 50, p = 0.505), but EEG revealed that younger adults had a steeper SWslope at both frontal electrode sites (F3: U = 2, p < 0.001, F4: U = 4, p < 0.001, n = 12 younger, 10 older). There were widespread correlations between various diffusion tensor-based metrics of white matter integrity and sleep SWslope, over and above effects of age (n = 11 younger, 9 older). This was particularly evident for the corpus callosum, corona radiata, superior longitudinal fasciculus, internal and external capsule. This indicates that reduced sleep slow waves may be associated with widespread white matter deterioration. Future studies should investigate whether interventions targeted at improving sleep architecture also impact on decline in white matter microstructure in older adults.
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Affiliation(s)
- Christel Gudberg
- Wellcome Centre for Integrative Neuroimaging, FMRIB, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, United Kingdom
| | - Remi Stevelink
- Wellcome Centre for Integrative Neuroimaging, FMRIB, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, United Kingdom
| | - Gwenaëlle Douaud
- Wellcome Centre for Integrative Neuroimaging, FMRIB, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, United Kingdom
| | - Katharina Wulff
- Nuffield Laboratory of Ophthalmology, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, United Kingdom
- Department of Radiation Sciences and Molecular Biology, Umeå University, Umeå, Sweden
- Wallenberg Centre for Molecular Medicine, Umeå University, Umeå, Sweden
| | - Alberto Lazari
- Wellcome Centre for Integrative Neuroimaging, FMRIB, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, United Kingdom
| | - Melanie K. Fleming
- Wellcome Centre for Integrative Neuroimaging, FMRIB, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, United Kingdom
- *Correspondence: Melanie K. Fleming,
| | - Heidi Johansen-Berg
- Wellcome Centre for Integrative Neuroimaging, FMRIB, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, United Kingdom
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Wang C, Fang P, Li Y, Wu L, Hu T, Yang Q, Han A, Chang Y, Tang X, Lv X, Xu Z, Xu Y, Li L, Zheng M, Zhu Y. Predicting Attentional Vulnerability to Sleep Deprivation: A Multivariate Pattern Analysis of DTI Data. Nat Sci Sleep 2022; 14:791-803. [PMID: 35497645 PMCID: PMC9041361 DOI: 10.2147/nss.s345328] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Accepted: 04/14/2022] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Large individual differences exist in sleep deprivation (SD) induced sustained attention deterioration. Several brain imaging studies have suggested that the activities within frontal-parietal network, cortico-thalamic connections, and inter-hemispheric connectivity might underlie the neural correlates of vulnerability/resistance to SD. However, those traditional approaches are based on average estimates of differences at the group level. Currently, a neuroimaging marker that can reliably predict this vulnerability at the individual level is lacking. METHODS Efficient transfer of information relies on the integrity of white matter (WM) tracts in the human brain, we therefore applied machine learning approach to investigate whether the WM diffusion metrics can predict vulnerability to SD. Forty-nine participants completed the psychomotor vigilance task (PVT) both after resting wakefulness (RW) and after 24 h of sleep deprivation (SD). The number of PVT lapse (reaction time > 500 ms) was calculated for both RW condition and SD condition and participants were categorized as vulnerable (24 participants) or resistant (25 participants) to SD according to the change in the number of PVT lapses between the two conditions. Diffusion tensor imaging were acquired to extract four multitype WM features at a regional level: fractional anisotropy, mean diffusivity, axial diffusivity, and radial diffusivity. A linear support vector machine (LSVM) learning approach using leave-one-out cross-validation (LOOCV) was performed to assess the discriminative power of WM features in SD-vulnerable and SD-resistant participants. RESULTS LSVM analysis achieved a correct classification rate of 83.67% (sensitivity: 87.50%; specificity: 80.00%; and area under the receiver operating characteristic curve: 0.85) for differentiating SD-vulnerable from SD-resistant participants. WM fiber tracts that contributed most to the classification model were primarily commissural pathways (superior longitudinal fasciculus), projection pathways (posterior corona radiata, anterior limb of internal capsule) and association pathways (body and genu of corpus callosum). Furthermore, we found a significantly negative correlation between changes in PVT lapses and the LSVM decision value. CONCLUSION These findings suggest that WM fibers connecting (1) regions within frontal-parietal attention network, (2) the thalamus to the prefrontal cortex, and (3) the left and right hemispheres contributed the most to classification accuracy.
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Affiliation(s)
- Chen Wang
- Department of Radiology, Xijing Hospital, Fourth Military Medical University, Xi'an, People's Republic of China
| | - Peng Fang
- Department of Military Medical Psychology, Air Force Medical University, Xi'an, People's Republic of China
| | - Ya Li
- Department of Radiology, Xijing Hospital, Fourth Military Medical University, Xi'an, People's Republic of China
| | - Lin Wu
- Department of Military Medical Psychology, Air Force Medical University, Xi'an, People's Republic of China
| | - Tian Hu
- Department of Radiology, Yan'an University Affiliated Hospital, Yan'an, People's Republic of China
| | - Qi Yang
- Department of Radiology, Affiliated Hospital of Shaanxi University of Traditional Chinese Medicine, Xianyang, People's Republic of China
| | - Aiping Han
- Imaging Diagnosis and Treatment Center, Xi'an International Medical Center Hospital, Xi'an, People's Republic of China
| | - Yingjuan Chang
- Department of Radiology, Xijing Hospital, Fourth Military Medical University, Xi'an, People's Republic of China
| | - Xing Tang
- Department of Radiology, Xijing Hospital, Fourth Military Medical University, Xi'an, People's Republic of China
| | - Xiuhua Lv
- Department of Radiology, Xijing Hospital, Fourth Military Medical University, Xi'an, People's Republic of China
| | - Ziliang Xu
- Department of Radiology, Xijing Hospital, Fourth Military Medical University, Xi'an, People's Republic of China
| | - Yongqiang Xu
- Department of Radiology, Xijing Hospital, Fourth Military Medical University, Xi'an, People's Republic of China
| | - Leilei Li
- Department of Radiology, Xijing Hospital, Fourth Military Medical University, Xi'an, People's Republic of China
| | - Minwen Zheng
- Department of Radiology, Xijing Hospital, Fourth Military Medical University, Xi'an, People's Republic of China
| | - Yuanqiang Zhu
- Department of Radiology, Xijing Hospital, Fourth Military Medical University, Xi'an, People's Republic of China
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Reyes S, Rimkus CDM, Lozoff B, Algarin C, Peirano P. Nighttime Sleep Characteristics and White Matter Integrity in Young Adults. Nat Sci Sleep 2022; 14:1363-1373. [PMID: 35965887 PMCID: PMC9364986 DOI: 10.2147/nss.s360311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Accepted: 07/07/2022] [Indexed: 11/23/2022] Open
Abstract
PURPOSE Sleep is essential for life and plays a key role for optimal physiology, brain functioning, and health. Evidence suggests a relation between sleep and cerebral white matter integrity. Human studies report that sleep duration shows a U-shaped association with brain functioning. We hypothesized that participants with longer or shorter sleep time in the nighttime period show altered microstructural white matter integrity. PARTICIPANTS AND METHODS Seventy-three young adult participants were evaluated. Sleep-wake cycle parameters were assessed objectively using actigraphy. Diffusion tensor imaging studies were performed to assess white matter integrity using fractional anisotropy and mean, axial, and radial diffusivities. Relations between white matter microstructure indexes and sleep parameters were investigated through tract-based spatial statistics. Participants were grouped according to their nocturnal total sleep time: 27 in the Reference sleep group (6.5-8.0 h), 23 in the Short sleep group (<6.5 h) and 23 in the Long sleep group (>8.0 h). RESULTS Compared with the Reference sleep group, participants in the Long sleep group showed lower fractional anisotropy (p < 0.05) and higher radial diffusivity (p < 0.05) values in white matter tracts linked to sleep regulation (corona radiata, body of the corpus callosum, superior longitudinal fasciculus, and anterior thalamic radiation). CONCLUSION This pattern of reduced fractional anisotropy and increased radial diffusivity in the Long sleep group indicates an association between sleep duration and lower integrity of myelin sheaths. Because myelin is continuously remodeled in the brain, nighttime sleep characteristics appear to be a key player for its quality and maintenance.
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Affiliation(s)
- Sussanne Reyes
- Laboratory of Sleep and Functional Neurobiology, Institute of Nutrition and Food Technology (INTA), University of Chile, Santiago, Chile
| | - Carolina de Medeiros Rimkus
- Laboratory of Medical Investigation (LIM-44), Department of Radiology and Oncology, Faculty of Medicine, University of Sao Paulo, São Paulo, São Paulo, Brazil
| | - Betsy Lozoff
- Department of Pediatrics and Environmental Health Sciences, University of Michigan, Ann Arbor, MI, USA
| | - Cecilia Algarin
- Laboratory of Sleep and Functional Neurobiology, Institute of Nutrition and Food Technology (INTA), University of Chile, Santiago, Chile
| | - Patricio Peirano
- Laboratory of Sleep and Functional Neurobiology, Institute of Nutrition and Food Technology (INTA), University of Chile, Santiago, Chile
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Guo M, Shen B, Li J, Huang X, Hu J, Wei X, Wang S, Yuan R, He C, Li Y. Diffusion Abnormality in Temporal Lobe Epilepsy Patients With Sleep Disorders: A Diffusion Kurtosis Imaging Study. Front Psychiatry 2022; 13:885477. [PMID: 35693954 PMCID: PMC9177985 DOI: 10.3389/fpsyt.2022.885477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Accepted: 04/13/2022] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Patients with temporal lobe epilepsy (TLE) frequently complain of poor sleep quality, which is a condition that clinicians are typically neglecting. In this study, Epworth Sleepiness Scale (ESS), Pittsburgh Sleep Quality Index (PSQI), and Athens Insomnia Scale (AIS) were used to assess the sleep status of patients with temporal lobe epilepsy (TLE). Simultaneously diffusion kurtosis imaging (DKI) was applied to examine the white matter microstructure abnormalities in patients with TLE and sleep disorders. METHODS TLE patients who have been diagnosed in the cardio-cerebrovascular ward of the Yanan University Affiliated Hospital from October 2020 to August 2021 were recruited. Finally, 51 patients and 30 healthy controls were enrolled in our study, with all subjects completing the sleep evaluation questionnaire and undergoing a DKI examination. Using independent sample t-test, analysis of variance (ANOVA), and Mann-Whitney U test to compare groups. RESULTS Thirty patients (58.82%) complained of long-term sleep difficulties. The overall differences among the evaluation of AIS, ESS, and PSQI are significant (P = 0.00, P = 0.00, P = 0.03). The scores of AIS, ESS in Left and Right-TLE (L/R-TLE) with sleep disorders, as well as PSQI in L-TLE, are statistically higher than the control group (P = 0.00, P = 0.00, P = 0.00, P = 0.00, P = 0.02). L-TLE with sleep disorders showed decreased MK on affected sides (P = 0.01). However, statistical differences in MD and FA have not been observed (P = 0.34, P = 0.06); R-TLE with sleep disorders showed significantly decreased MK and increased MD on affected sides (P = 0.00, P = 0.00), but FA's statistical difference has not been observed (P = 0.20). CONCLUSIONS TLE patients with sleep disorders have different DKI parameters than individuals who do not have sleep issues. During this process, the kurtosis parameter (MK) was more sensitive than the tensor parameters (MD, FA) in detecting the patient's aberrant white matter diffusion. DKI may be a better choice for in vivo investigation of anomalous craniocerebral water diffusion.
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Affiliation(s)
- Min Guo
- Department of Radiology, Yanan University Affiliated Hospital, Yanan, China
| | - Boxing Shen
- Department of Radiology, Yanan University Affiliated Hospital, Yanan, China
| | - Jinhong Li
- Department of Radiology, Yanan University Affiliated Hospital, Yanan, China
| | - Xiaoqi Huang
- Department of Radiology, Yanan University Affiliated Hospital, Yanan, China
| | - Jie Hu
- Department of Radiology, Yanan University Affiliated Hospital, Yanan, China
| | | | - Shaoyu Wang
- MR Scientific Marketing, Siemens Healthineers, Shanghai, China
| | - Ruohan Yuan
- Department of Radiology, Yanan University Affiliated Hospital, Yanan, China
| | - Chengcheng He
- Department of Radiology, Yanan University Affiliated Hospital, Yanan, China
| | - Yanjing Li
- Department of Radiology, Yanan University Affiliated Hospital, Yanan, China
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Ji B, Dai M, Guo Z, Li J, Cao Y, Zhang Z, Zhang Y, Liu X. Functional Connectivity Density in the Sensorimotor Area is Associated with Sleep Latency in Patients with Primary Insomnia. Neuropsychiatr Dis Treat 2022; 18:1-10. [PMID: 35035217 PMCID: PMC8755708 DOI: 10.2147/ndt.s338489] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Accepted: 11/23/2021] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE It is unclear whether the patterns of functional connectivity density (FCD) differ between patients with primary insomnia (PI) and healthy subjects. In the present study, we investigated the features of FCD in patients with PI using resting-state functional MRI (rsfMRI). METHODS rsfMRI datasets of 32 patients with PI and 34 healthy controls (HCs) were obtained using a 3-Tesla scanner. FCD analysis was performed to compare voxels with abnormal whole-brain functional connectivity with other voxels among patients with PI and HCs. Abnormal brain regions were then used as seed points for FC analysis. RESULTS Compared with HCs, patients with PI exhibited significantly decreased FCD in the left medial frontal gyrus and increased FCD in the left supplementary motor area (SMA). With the left medial frontal gyrus as the seed point, patients with PI showed decreased FC between the left medial frontal gyrus and the left fusiform gyrus compared with HCs. With the left SMA as the seed point, patients with PI exhibited increased FC between the left SMA and the right anterior cingulate gyrus. Correlation analysis revealed that the increased FCD values in the left SMA were positively correlated with sleep latency in patients with PI. CONCLUSION Default-mode network and SMA dysfunctions may be related to the pathophysiology of PI.
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Affiliation(s)
- Bin Ji
- Department of Anesthesiologyand Perioperative Medicine, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, 325027, People's Republic of China
| | - Min Dai
- Department of Radiology of the Second Affiliated Hospital and Yuying Children's Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, 325027, People's Republic of China
| | - Zhongwei Guo
- The Sleep Medical Center of Tongde Hospital of Zhejiang Province, Hangzhou, Zhejiang, 310012, People's Republic of China
| | - Jiapeng Li
- Department of Radiology of Tongde Hospital of Zhejiang Province, Hangzhou, Zhejiang, 310012, People's Republic of China
| | - Yulin Cao
- Department of Radiology of Tongde Hospital of Zhejiang Province, Hangzhou, Zhejiang, 310012, People's Republic of China
| | - Zhenzhong Zhang
- The Sleep Medical Center of Tongde Hospital of Zhejiang Province, Hangzhou, Zhejiang, 310012, People's Republic of China
| | - Yan Zhang
- The Sleep Medical Center of Tongde Hospital of Zhejiang Province, Hangzhou, Zhejiang, 310012, People's Republic of China
| | - Xiaozheng Liu
- Department of Radiology of the Second Affiliated Hospital and Yuying Children's Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, 325027, People's Republic of China
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Yan G, Liao Y, Li K, Zhang X, Zheng W, Zhang Y, Zou Y, Chen D, Wu D. Diffusion MRI Based Myometrium Tractography for Detection of Placenta Accreta Spectrum Disorder. J Magn Reson Imaging 2021; 55:255-264. [PMID: 34155718 DOI: 10.1002/jmri.27794] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Revised: 05/29/2021] [Accepted: 06/02/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Prenatal diagnosis of placenta accreta spectrum (PAS) disorders is difficult. Magnetic resonance imaging (MRI) has been shown to be a useful supplementary method to ultrasound. PURPOSE To investigate diffusion MRI (dMRI) based tractography as a tool for detecting PAS disorders, and to evaluate its performance compared with anatomical MRI. STUDY TYPE Prospective. POPULATION Forty-seven pregnant women in the third trimester with risk factors for PAS. FIELD STRENGTH/SEQUENCE Using fast imaging employing steady-state acquisition and high-angular resolution dMRI at 1.5 Tesla. ASSESSMENT Diagnosis of PAS was performed by three radiologists based on the dMRI-based feature of myometrial fiber discontinuity and on commonly used anatomical features including presence of dark band, discontinuous myometrium and bladder wall interruption. We evaluated the sensitivity, specificity, accuracy, and area-under-the-curve (AUC) of the individual features and established an integrated model with random forest analysis. STATISTICAL TESTS Maternal age and gestational age at scan were compared between PAS and control group using a t-test, and childbearing history was compared using a chi-squared test. The random forest model was employed to combine the anatomical and dMRI features with 5-fold cross-validation, and the weight of each feature was normalized to evaluate its importance in predicting PAS. RESULTS Based on surgical pathology reports, 16 out of 47 patients had confirmed PAS. The anatomical feature of dark bands and tractography marker achieved the highest AUC of 0.842 for predicting PAS, and the integrated anatomical and tractography features further improved the AUC of 0.880 with an accuracy of 87.2%. The tractography feature contributed most (30.1%) to the integrated model. DATA CONCLUSION Myometrial tractography demonstrated superior performance in detecting PAS. Moreover, the combination of dMRI-based tractography and anatomical MRI could potentially improve the diagnosis of PAS disorders in clinical practice. LEVEL OF EVIDENCE 2 TECHNICAL EFFICACY STAGE: 2.
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Affiliation(s)
- Guohui Yan
- Department of Radiology, Women's Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Yuhao Liao
- Key Laboratory for Biomedical Engineering of Ministry of Education, Department of Biomedical Engineering, College of Biomedical Engineering & Instrument Science, Zhejiang University, Hangzhou, China
| | - Kui Li
- Department of Radiology, Women's Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Xiaodan Zhang
- Department of Radiology, Women's Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Weizeng Zheng
- Department of Radiology, Women's Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Yi Zhang
- Key Laboratory for Biomedical Engineering of Ministry of Education, Department of Biomedical Engineering, College of Biomedical Engineering & Instrument Science, Zhejiang University, Hangzhou, China
| | - Yu Zou
- Department of Radiology, Women's Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Danqing Chen
- Department of Obstetrics, Women's Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Dan Wu
- Key Laboratory for Biomedical Engineering of Ministry of Education, Department of Biomedical Engineering, College of Biomedical Engineering & Instrument Science, Zhejiang University, Hangzhou, China
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