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Niu X, Utayde MF, Sanders KEG, Cunningham TJ, Zhang G, Kensinger EA, Payne JD. The effects of shared, depression-specific, and anxiety-specific internalizing symptoms on negative and neutral episodic memories following post-learning sleep. COGNITIVE, AFFECTIVE & BEHAVIORAL NEUROSCIENCE 2024:10.3758/s13415-024-01209-5. [PMID: 39138784 DOI: 10.3758/s13415-024-01209-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 05/24/2024] [Indexed: 08/15/2024]
Abstract
Emotional memory bias is a common characteristic of internalizing symptomatology and is enhanced during sleep. The current study employs bifactor S-1 modeling to disentangle depression-specific anhedonia, anxiety-specific anxious arousal, and the common internalizing factor, general distress, and test whether these internalizing symptoms interact with sleep to influence memory for emotional and neutral information. Healthy adults (N = 281) encoded scenes featuring either negative objects (e.g., a vicious looking snake) or neutral objects (e.g., a chipmunk) placed on neutral backgrounds (e.g., an outdoor scene). After a 12-hour period of daytime wakefulness (n = 140) or nocturnal sleep (n = 141), participants judged whether objects and backgrounds were the same, similar, or new compared with what they viewed during encoding. Participants also completed the mini version of the Mood and Anxiety Symptom Questionnaire. Higher anxious arousal predicted worse memory across all stimuli features, but only after a day spent being awake-not following a night of sleep. No significant effects were found for general distress and anhedonia in either the sleep or wake condition. In this study, internalizing symptoms were not associated with enhanced emotional memory. Instead, memory performance specifically in individuals with higher anxious arousal was impaired overall, regardless of emotional valence, but this was only the case when the retention interval spanned wakefulness (i.e., not when it spanned sleep). This suggests that sleep may confer a protective effect on general memory impairments associated with anxiety.
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Affiliation(s)
- Xinran Niu
- Department of Psychology, University of Notre Dame, E466 Corbett Family Hall, Notre Dame, IN, 46556, USA
| | - Mia F Utayde
- Department of Psychology, University of Notre Dame, E466 Corbett Family Hall, Notre Dame, IN, 46556, USA
| | - Kristin E G Sanders
- Department of Psychology, University of Notre Dame, E466 Corbett Family Hall, Notre Dame, IN, 46556, USA
| | - Tony J Cunningham
- The Center for Sleep & Cognition, Harvard Medical School & Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Guangjian Zhang
- Department of Psychology, University of Notre Dame, E466 Corbett Family Hall, Notre Dame, IN, 46556, USA
| | | | - Jessica D Payne
- Department of Psychology, University of Notre Dame, E466 Corbett Family Hall, Notre Dame, IN, 46556, USA.
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2
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Mana L, Schwartz-Pallejà M, Vila-Vidal M, Deco G. Overview on cognitive impairment in psychotic disorders: From impaired microcircuits to dysconnectivity. Schizophr Res 2024; 269:132-143. [PMID: 38788432 DOI: 10.1016/j.schres.2024.05.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2024] [Revised: 05/09/2024] [Accepted: 05/13/2024] [Indexed: 05/26/2024]
Abstract
Schizophrenia's cognitive deficits, often overshadowed by positive symptoms, significantly contribute to the disorder's morbidity. Increasing attention highlights these deficits as reflections of neural circuit dysfunction across various cortical regions. Numerous connectivity alterations linked to cognitive symptoms in psychotic disorders have been reported, both at the macroscopic and microscopic level, emphasizing the potential role of plasticity and microcircuits impairment during development and later stages. However, the heterogeneous clinical presentation of cognitive impairment and diverse connectivity findings pose challenges in summarizing them into a cohesive picture. This review aims to synthesize major cognitive alterations, recent insights into network structural and functional connectivity changes and proposed mechanisms and microcircuit alterations underpinning these symptoms, particularly focusing on neurodevelopmental impairment, E/I balance, and sleep disturbances. Finally, we will also comment on some of the most recent and promising therapeutic approaches that aim to target these mechanisms to address cognitive symptoms. Through this comprehensive exploration, we strive to provide an updated and nuanced overview of the multiscale connectivity impairment underlying cognitive impairment in psychotic disorders.
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Affiliation(s)
- L Mana
- Center for Brain and Cognition, Computational Neuroscience Group, Department of Information and Communication Technologies, Universitat Pompeu Fabra, Roc Boronat 138, Barcelona 08018, Spain.
| | - M Schwartz-Pallejà
- Center for Brain and Cognition, Computational Neuroscience Group, Department of Information and Communication Technologies, Universitat Pompeu Fabra, Roc Boronat 138, Barcelona 08018, Spain; Department of Experimental and Health Science, Universitat Pompeu Fabra, Roc Boronat 138, Barcelona 08018, Spain; Eurecat, Technology Center of Catalonia, Multimedia Technologies, Barcelona, Spain.
| | - M Vila-Vidal
- Center for Brain and Cognition, Computational Neuroscience Group, Department of Information and Communication Technologies, Universitat Pompeu Fabra, Roc Boronat 138, Barcelona 08018, Spain; Computational Biology and Complex Systems Group, Department of Physics, Universitat Politècnica de Catalunya, Barcelona, Spain.
| | - G Deco
- Center for Brain and Cognition, Computational Neuroscience Group, Department of Information and Communication Technologies, Universitat Pompeu Fabra, Roc Boronat 138, Barcelona 08018, Spain; Institució Catalana de la Recerca i Estudis Avançats (ICREA), Passeig Lluís Companys 23, Barcelona 08010, Spain.
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3
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Samona EA, Chowdury A, Kopchick J, Thomas P, Rajan U, Khatib D, Zajac-Benitez C, Amirsadri A, Haddad L, Stanley JA, Diwadkar VA. The importance of covert memory consolidation in schizophrenia: Dysfunctional network profiles of the hippocampus and the dorsolateral prefrontal cortex. Psychiatry Res Neuroimaging 2024; 340:111805. [PMID: 38447230 PMCID: PMC11188056 DOI: 10.1016/j.pscychresns.2024.111805] [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: 05/31/2023] [Revised: 01/24/2024] [Accepted: 02/20/2024] [Indexed: 03/08/2024]
Abstract
Altered brain network profiles in schizophrenia (SCZ) during memory consolidation are typically observed during task-active periods such as encoding or retrieval. However active processes are also sub served by covert periods of memory consolidation. These periods are active in that they allow memories to be recapitulated even in the absence of overt sensorimotor processing. It is plausible that regions central to memory formation like the dlPFC and the hippocampus, exert network signatures during covert periods. Are these signatures altered in patients? The question is clinically relevant because real world learning and memory is facilitated by covert processing, and may be impaired in schizophrenia. Here, we compared network signatures of the dlPFC and the hippocampus during covert periods of a learning and memory task. Because behavioral proficiency increased non-linearly, functional connectivity of the dlPFC and hippocampus [psychophysiological interaction (PPI)] was estimated for each of the Early (linear increases in performance) and Late (asymptotic performance) covert periods. During Early periods, we observed hypo-modulation by the hippocampus but hyper-modulation by dlPFC. Conversely, during Late periods, we observed hypo-modulation by both the dlPFC and the hippocampus. We stitch these results into a conceptual model of network deficits during covert periods of memory consolidation.
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Affiliation(s)
- Elias A Samona
- Department of Psychiatry & Behavioral Neurosciences, Wayne State University School of Medicine, Detroit, MI, United States
| | - Asadur Chowdury
- Department of Psychiatry & Behavioral Neurosciences, Wayne State University School of Medicine, Detroit, MI, United States
| | - John Kopchick
- Department of Psychiatry & Behavioral Neurosciences, Wayne State University School of Medicine, Detroit, MI, United States
| | - Patricia Thomas
- Department of Psychiatry & Behavioral Neurosciences, Wayne State University School of Medicine, Detroit, MI, United States
| | - Usha Rajan
- Department of Psychiatry & Behavioral Neurosciences, Wayne State University School of Medicine, Detroit, MI, United States
| | - Dalal Khatib
- Department of Psychiatry & Behavioral Neurosciences, Wayne State University School of Medicine, Detroit, MI, United States
| | - Caroline Zajac-Benitez
- Department of Psychiatry & Behavioral Neurosciences, Wayne State University School of Medicine, Detroit, MI, United States
| | - Alireza Amirsadri
- Department of Psychiatry & Behavioral Neurosciences, Wayne State University School of Medicine, Detroit, MI, United States
| | - Luay Haddad
- Department of Psychiatry & Behavioral Neurosciences, Wayne State University School of Medicine, Detroit, MI, United States
| | - Jeffrey A Stanley
- Department of Psychiatry & Behavioral Neurosciences, Wayne State University School of Medicine, Detroit, MI, United States
| | - Vaibhav A Diwadkar
- Department of Psychiatry & Behavioral Neurosciences, Wayne State University School of Medicine, Detroit, MI, United States.
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4
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Baran B, Lee EE. Age-Related Changes in Sleep and Its Implications for Cognitive Decline in Aging Persons With Schizophrenia: A Critical Review. Schizophr Bull 2024:sbae059. [PMID: 38713085 DOI: 10.1093/schbul/sbae059] [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] [Indexed: 05/08/2024]
Abstract
BACKGROUND AND HYPOTHESIS Cognitive impairment is a core feature of schizophrenia that worsens with aging and interferes with quality of life. Recent work identifies sleep as an actionable target to alleviate cognitive deficits. Cardinal non-rapid eye movement (NREM) sleep oscillations such as sleep spindles and slow oscillations are critical for cognition. People living with schizophrenia (PLWS) and their first-degree relatives have a specific reduction in sleep spindles and an abnormality in their temporal coordination with slow oscillations that predict impaired memory consolidation. While NREM oscillatory activity is reduced in typical aging, it is not known how further disruption in these oscillations contributes to cognitive decline in older PLWS. Another understudied risk factor for cognitive deficits among older PLWS is obstructive sleep apnea (OSA) which may contribute to cognitive decline. STUDY DESIGN We conducted a narrative review to examine the published literature on aging, OSA, and NREM sleep oscillations in PLWS. STUDY RESULTS Spindles are propagated via thalamocortical feedback loops, and this circuitry shows abnormal hyperconnectivity in schizophrenia as revealed by structural and functional MRI studies. While the risk and severity of OSA increase with age, older PLWS are particularly vulnerable to OSA-related cognitive deficits because OSA is often underdiagnosed and undertreated, and OSA adds further damage to the circuitry that generates NREM sleep oscillations. CONCLUSIONS We highlight the critical need to study NREM sleep in older PWLS and propose that identifying and treating OSA in older PLWS will provide an avenue to potentially mitigate and prevent cognitive decline.
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Affiliation(s)
- Bengi Baran
- Department of Psychological and Brain Sciences, University of Iowa, Iowa City, IA, USA
- Department of Psychiatry, Carver College of Medicine, University of Iowa, Iowa City, IA, USA
- Iowa Neuroscience Institute, Carver College of Medicine, University of Iowa, Iowa City, IA, USA
| | - Ellen E Lee
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
- Desert-Pacific Mental Illness Research Education and Clinical Center, Veterans Affairs San Diego Healthcare System, San Diego, CA, USA
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5
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Castelnovo A, Casetta C, Cavallotti S, Marcatili M, Del Fabro L, Canevini MP, Sarasso S, D'Agostino A. Proof-of-concept evidence for high-density EEG investigation of sleep slow wave traveling in First-Episode Psychosis. Sci Rep 2024; 14:6826. [PMID: 38514761 PMCID: PMC10958040 DOI: 10.1038/s41598-024-57476-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Accepted: 03/18/2024] [Indexed: 03/23/2024] Open
Abstract
Schizophrenia is thought to reflect aberrant connectivity within cortico-cortical and reentrant thalamo-cortical loops, which physiologically integrate and coordinate the function of multiple cortical and subcortical structures. Despite extensive research, reliable biomarkers of such "dys-connectivity" remain to be identified at the onset of psychosis, and before exposure to antipsychotic drugs. Because slow waves travel across the brain during sleep, they represent an ideal paradigm to study pathological conditions affecting brain connectivity. Here, we provide proof-of-concept evidence for a novel approach to investigate slow wave traveling properties in First-Episode Psychosis (FEP) with high-density electroencephalography (EEG). Whole-night sleep recordings of 5 drug-naïve FEP and 5 age- and gender-matched healthy control subjects were obtained with a 256-channel EEG system. One patient was re-recorded after 6 months and 3 years of continuous clozapine treatment. Slow wave detection and traveling properties were obtained with an open-source toolbox. Slow wave density and slow wave traveled distance (measured as the line of longest displacement) were significantly lower in patients (p < 0.05). In the patient who was tested longitudinally during effective clozapine treatment, slow wave density normalized, while traveling distance only partially recovered. These preliminary findings suggest that slow wave traveling could be employed in larger samples to detect cortical "dys-connectivity" at psychosis onset.
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Affiliation(s)
- Anna Castelnovo
- Sleep Medicine Unit, Neurocenter of Italian Switzerland, Ente Ospedaliero Cantonale (EOC), Via Tesserete 46, 6900, Lugano, Switzerland.
- Faculty of Biomedical Sciences, University of Italian Switzerland, Lugano, Switzerland.
- University Hospital of Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland.
| | - Cecilia Casetta
- Department of Mental Health and Addiction, ASST Santi Paolo e Carlo, Via A. Di Rudinì 8, 20142, Milan, Italy
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Simone Cavallotti
- Department of Mental Health and Addiction, ASST Santi Paolo e Carlo, Via A. Di Rudinì 8, 20142, Milan, Italy
| | - Matteo Marcatili
- Psychiatric Department, ASST Monza, San Gerardo Hospital, Monza, Italy
| | - Lorenzo Del Fabro
- Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy
- Department of Neurosciences and Mental Health, IRCCS Fondazione Ca' Granda Ospedale Maggiore Policlinico, University of Milan, Milan, Italy
| | - Maria Paola Canevini
- Department of Mental Health and Addiction, ASST Santi Paolo e Carlo, Via A. Di Rudinì 8, 20142, Milan, Italy
- Department of Health Sciences, Università degli Studi di Milano, Milan, Italy
| | - Simone Sarasso
- Department of Biomedical and Clinical Sciences "L. Sacco", Università degli Studi di Milano, Via G.B. Grassi 74, 20157, Milan, Italy.
| | - Armando D'Agostino
- Department of Mental Health and Addiction, ASST Santi Paolo e Carlo, Via A. Di Rudinì 8, 20142, Milan, Italy.
- Department of Health Sciences, Università degli Studi di Milano, Milan, Italy.
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6
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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.
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Affiliation(s)
- Ahmad Mayeli
- Department of Psychiatry, University of Pittsburgh, USA
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7
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Niu X, Utayde MF, Sanders KEG, Denis D, Kensinger EA, Payne JD. Age-related positivity effect in emotional memory consolidation from middle age to late adulthood. Front Behav Neurosci 2024; 18:1342589. [PMID: 38328467 PMCID: PMC10847278 DOI: 10.3389/fnbeh.2024.1342589] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Accepted: 01/08/2024] [Indexed: 02/09/2024] Open
Abstract
Background While younger adults are more likely to attend to, process, and remember negative relative to positive information, healthy older adults show the opposite pattern. The current study evaluates when, exactly, this positivity shift begins, and how it influences memory performance for positive, negative, and neutral information. Methods A total of 274 healthy early middle-aged (35-47), late middle-aged (48-59), and older adults (>59) viewed scenes consisting of a negative, positive, or a neutral object placed on a plausible neutral background, and rated each scene for its valence and arousal. After 12 h spanning a night of sleep (n = 137) or a day of wakefulness (n = 137), participants completed an unexpected memory test during which they were shown objects and backgrounds separately and indicated whether the scene component was the "same," "similar," or "new" to what they viewed during the study session. Results and conclusions We found that both late middle-aged and older adults rated positive and neutral scenes more positively compared to early middle-aged adults. However, only older adults showed better memory for positive objects relative to negative objects, and a greater positive memory trade-off magnitude (i.e., remembering positive objects at the cost of their associated neutral backgrounds) than negative memory trade-off magnitude (i.e., remembering negative objects at the cost of their associated neutral backgrounds). Our findings suggest that while the positivity bias may not emerge in memory until older adulthood, a shift toward positivity in terms of processing may begin in middle age.
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Affiliation(s)
- Xinran Niu
- Sleep, Stress, and Memory Lab, Department of Psychology, University of Notre Dame, Notre Dame, IN, United States
| | - Mia F. Utayde
- Sleep, Stress, and Memory Lab, Department of Psychology, University of Notre Dame, Notre Dame, IN, United States
| | - Kristin E. G. Sanders
- Sleep, Stress, and Memory Lab, Department of Psychology, University of Notre Dame, Notre Dame, IN, United States
| | - Dan Denis
- Department of Psychology, University of York, York, United Kingdom
| | - Elizabeth A. Kensinger
- Cognitive and Affective Neuroscience Laboratory, Department of Psychology and Neuroscience, Boston College, Chestnut Hill, MA, United States
| | - Jessica D. Payne
- Sleep, Stress, and Memory Lab, Department of Psychology, University of Notre Dame, Notre Dame, IN, United States
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8
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Denis D, Baran B, Mylonas D, Spitzer C, Raymond N, Talbot C, Kohnke E, Stickgold R, Keshavan M, Manoach DS. NREM sleep oscillations and their relations with sleep-dependent memory consolidation in early course psychosis and first-degree relatives. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2023:2023.10.30.564703. [PMID: 37961668 PMCID: PMC10634996 DOI: 10.1101/2023.10.30.564703] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2023]
Abstract
Sleep spindles are believed to mediate sleep-dependent memory consolidation, particularly when coupled to neocortical slow oscillations. Schizophrenia is characterized by a deficit in sleep spindles that correlates with reduced overnight memory consolidation. Here, we examined sleep spindle activity, slow oscillation-spindle coupling, and both motor procedural and verbal declarative memory consolidation in early course, minimally medicated psychosis patients and non-psychotic first-degree relatives. Using a four-night experimental procedure, we observed significant deficits in spindle density and amplitude in patients relative to controls that were driven by individuals with schizophrenia. Schizophrenia patients also showed reduced sleep-dependent consolidation of motor procedural memory, which correlated with spindle density. Contrary to expectations, there were no group differences in the consolidation of declarative memory on a word pairs task. Nor did the relatives of patients differ in spindle activity or memory consolidation compared with controls, however increased consistency in the timing of SO-spindle coupling were seen in both patient and relatives. Our results extend prior work by demonstrating correlated deficits in sleep spindles and sleep-dependent motor procedural memory consolidation in early course, minimally medicated patients with schizophrenia, but not in first-degree relatives. This is consistent with other work in suggesting that impaired sleep-dependent memory consolidation has some specificity for schizophrenia and is a core feature rather than reflecting the effects of medication or chronicity.
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Affiliation(s)
- Dan Denis
- Department of Psychology, University of York, York, UK
| | - Bengi Baran
- Department of Psychological and Brain Sciences, University of Iowa, Iowa City, IA, USA
- Department of Psychiatry, University of Iowa, Iowa City, IA, USA
| | - Dimitrios Mylonas
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
- Athinoula A. Martinos Center for Biomedical Imaging, Charlestown, MA, USA
| | | | | | - Christine Talbot
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
| | - Erin Kohnke
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
| | - Robert Stickgold
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
- Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Matcheri Keshavan
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
- Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Dara S Manoach
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
- Athinoula A. Martinos Center for Biomedical Imaging, Charlestown, MA, USA
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9
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Kumral D, Matzerath A, Leonhart R, Schönauer M. Spindle-dependent memory consolidation in healthy adults: A meta-analysis. Neuropsychologia 2023; 189:108661. [PMID: 37597610 DOI: 10.1016/j.neuropsychologia.2023.108661] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Revised: 06/23/2023] [Accepted: 08/12/2023] [Indexed: 08/21/2023]
Abstract
Accumulating evidence suggests a central role for sleep spindles in the consolidation of new memories. However, no meta-analysis of the association between sleep spindles and memory performance has been conducted so far. Here, we report meta-analytical evidence for spindle-memory associations and investigate how multiple factors, including memory type, spindle type, spindle characteristics, and EEG topography affect this relationship. The literature search yielded 53 studies reporting 1427 effect sizes, resulting in a small to moderate effect for the average association. We further found that spindle-memory associations were significantly stronger for procedural memory than for declarative memory. Neither spindle types nor EEG scalp topography had an impact on the strength of the spindle-memory relation, but we observed a distinct functional role of global and fast sleep spindles, especially for procedural memory. We also found a moderation effect of spindle characteristics, with power showing the largest effect sizes. Collectively, our findings suggest that sleep spindles are involved in learning, thereby representing a general physiological mechanism for memory consolidation.
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Affiliation(s)
- Deniz Kumral
- Institute of Psychology, Neuropsychology, University of Freiburg, Freiburg Im Breisgau, Germany; Department of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany.
| | - Alina Matzerath
- Institute of Psychology, Neuropsychology, University of Freiburg, Freiburg Im Breisgau, Germany
| | - Rainer Leonhart
- Institute of Psychology, Social Psychology and Methodology, University of Freiburg, Freiburg Im Breisgau, Germany
| | - Monika Schönauer
- Institute of Psychology, Neuropsychology, University of Freiburg, Freiburg Im Breisgau, Germany; Bernstein Center Freiburg, Freiburg Im Breisgau, Germany
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10
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Halonen R, Luokkala S, Kuula L, Antila M, Pesonen AK. Right-lateralized sleep spindles are associated with neutral over emotional bias in picture recognition: An overnight study. COGNITIVE, AFFECTIVE & BEHAVIORAL NEUROSCIENCE 2023; 23:1445-1459. [PMID: 37308745 PMCID: PMC10260275 DOI: 10.3758/s13415-023-01113-4] [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] [Accepted: 05/10/2023] [Indexed: 06/14/2023]
Abstract
Sleep is especially important for emotional memories, although the mechanisms for prioritizing emotional content are insufficiently known. As during waking, emotional processing during sleep may be hemispherically asymmetric; right-lateralized rapid-eye movement (REM) sleep theta (~4-7 Hz) is reportedly associated with emotional memory retention. No research exists on lateralized non-REM sleep oscillations. However, sleep spindles, especially when coupled with slow oscillations (SOs), facilitate off-line memory consolidation.Our primary goal was to examine how the lateralization (right-to-left contrast) of REM theta, sleep spindles, and SO-spindle coupling is associated with overnight recognition memory in a task consisting of neutral and emotionally aversive pictures. Thirty-two healthy adults encoded 150 target pictures before overnight sleep. The recognition of target pictures among foils (discriminability, d') was tested immediately, 12 hours, and 24 hours after encoding.Recognition discriminability between targets and foils was similar for neutral and emotional pictures in immediate and 12-h retrievals. After 24 hours, emotional pictures were less accurately discriminated (p < 0.001). Emotional difference at 24-h retrieval was associated with right-to-left contrast in frontal fast spindle density (p < 0.001). The lateralization of SO-spindle coupling was associated with higher neutral versus emotional difference across all retrievals (p = 0.004).Our findings contribute to a largely unstudied area in sleep-related memory research. Hemispheric asymmetry in non-REM sleep oscillations may contribute to how neutral versus emotional information is processed. This is presumably underlain by both mechanistic offline memory consolidation and a trait-like cognitive/affective bias that influences memory encoding and retrieval. Methodological choices and participants' affective traits are likely involved.
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Affiliation(s)
- Risto Halonen
- SleepWell Research Program, Research Program Unit, Faculty of Medicine, University of Helsinki, P.O. Box 21, 00014, Helsinki, Finland
| | - Sanni Luokkala
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, P.O. Box 21, 00014, Helsinki, Finland
| | - Liisa Kuula
- SleepWell Research Program, Research Program Unit, Faculty of Medicine, University of Helsinki, P.O. Box 21, 00014, Helsinki, Finland
| | - Minea Antila
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, P.O. Box 21, 00014, Helsinki, Finland
| | - Anu-Katriina Pesonen
- SleepWell Research Program, Research Program Unit, Faculty of Medicine, University of Helsinki, P.O. Box 21, 00014, Helsinki, Finland.
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11
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O'Hora KP, Schleifer CH, Bearden CE. Sleep in 22q11.2 Deletion Syndrome: Current Findings, Challenges, and Future Directions. Curr Psychiatry Rep 2023; 25:479-491. [PMID: 37721640 PMCID: PMC10627929 DOI: 10.1007/s11920-023-01444-6] [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] [Accepted: 07/28/2023] [Indexed: 09/19/2023]
Abstract
PURPOSE OF REVIEW To summarize current literature available on sleep in 22q11.2 Deletion Syndrome (22q11.2DS; Velocardiofacial or DiGeorge Syndrome), a neurogenetic disorder caused by a hemizygous deletion in a genomic region critical for neurodevelopment. Due to the greatly increased risk of developmental psychiatric disorders (e.g., autism and schizophrenia) in 22q11.2DS, this review focuses on clinical correlates of sleep disturbances and potential neurobiological underpinnings of these relationships. RECENT FINDINGS Sleep disturbances are widely prevalent in 22q11.2DS and are associated with worse behavioral, psychiatric, and physical health outcomes. There are reports of sleep architecture and sleep neurophysiology differences, but the literature is limited by logistical challenges posed by objective sleep measures, resulting in small study samples to date. Sleep disturbances in 22q11.2DS are prevalent and have a substantial impact on well-being. Further investigation of sleep in 22q11.2DS utilizing multimodal sleep assessments has the potential to provide new insight into neurobiological mechanisms and a potential trans-diagnostic treatment target in 22q11.2DS.
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Affiliation(s)
- Kathleen P O'Hora
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California, 760 Westwood Plaza, Los Angeles, CA, 90095, USA
- Neuroscience Interdepartmental Program, University of California, Los Angeles, CA, USA
| | - Charles H Schleifer
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California, 760 Westwood Plaza, Los Angeles, CA, 90095, USA
- Neuroscience Interdepartmental Program, University of California, Los Angeles, CA, USA
- David Geffen School of Medicine, University of California, Los Angeles, CA, USA
| | - Carrie E Bearden
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California, 760 Westwood Plaza, Los Angeles, CA, 90095, USA.
- Department of Psychology, University of California, Los Angeles, CA, USA.
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12
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Yazdanbakhsh A, Barbas H, Zikopoulos B. Sleep spindles in primates: Modeling the effects of distinct laminar thalamocortical connectivity in core, matrix, and reticular thalamic circuits. Netw Neurosci 2023; 7:743-768. [PMID: 37397882 PMCID: PMC10312265 DOI: 10.1162/netn_a_00311] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Accepted: 03/01/2023] [Indexed: 10/16/2023] Open
Abstract
Sleep spindles are associated with the beginning of deep sleep and memory consolidation and are disrupted in schizophrenia and autism. In primates, distinct core and matrix thalamocortical (TC) circuits regulate sleep spindle activity through communications that are filtered by the inhibitory thalamic reticular nucleus (TRN); however, little is known about typical TC network interactions and the mechanisms that are disrupted in brain disorders. We developed a primate-specific, circuit-based TC computational model with distinct core and matrix loops that can simulate sleep spindles. We implemented novel multilevel cortical and thalamic mixing, and included local thalamic inhibitory interneurons, and direct layer 5 projections of variable density to TRN and thalamus to investigate the functional consequences of different ratios of core and matrix node connectivity contribution to spindle dynamics. Our simulations showed that spindle power in primates can be modulated based on the level of cortical feedback, thalamic inhibition, and engagement of model core versus matrix, with the latter having a greater role in spindle dynamics. The study of the distinct spatial and temporal dynamics of core-, matrix-, and mix-generated sleep spindles establishes a framework to study disruption of TC circuit balance underlying deficits in sleep and attentional gating seen in autism and schizophrenia.
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Affiliation(s)
- Arash Yazdanbakhsh
- Computational Neuroscience and Vision Lab, Department of Psychological and Brain Sciences, Boston University, Boston, MA, USA
- Graduate Program for Neuroscience, Boston University, Boston, MA, USA
- Center for Systems Neuroscience, Boston, MA, USA
| | - Helen Barbas
- Graduate Program for Neuroscience, Boston University, Boston, MA, USA
- Center for Systems Neuroscience, Boston, MA, USA
- Neural Systems Laboratory, Program in Human Physiology, Department of Health Sciences, College of Health and Rehabilitation Sciences (Sargent College), Boston University, Boston, MA, USA
- Department of Anatomy and Neurobiology, Boston University School of Medicine, Boston University, Boston, MA, USA
| | - Basilis Zikopoulos
- Graduate Program for Neuroscience, Boston University, Boston, MA, USA
- Center for Systems Neuroscience, Boston, MA, USA
- Department of Anatomy and Neurobiology, Boston University School of Medicine, Boston University, Boston, MA, USA
- Human Systems Neuroscience Laboratory, Program in Human Physiology, Department of Health Sciences, College of Health and Rehabilitation Sciences (Sargent College), Boston University, Boston, MA, USA
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13
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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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14
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The Feature of Sleep Spindle Deficits in Patients With Schizophrenia With and Without Auditory Verbal Hallucinations. BIOLOGICAL PSYCHIATRY. COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2023; 8:331-342. [PMID: 34380082 DOI: 10.1016/j.bpsc.2021.07.013] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Revised: 06/10/2021] [Accepted: 07/29/2021] [Indexed: 02/07/2023]
Abstract
BACKGROUND Previous sleep electroencephalography studies have detected abnormalities in sleep architecture and sleep spindle deficits in schizophrenia (SCZ), but the consistency of these results was not robust, which might be due to the small sample size and the influence of clinical factors such as the various medication therapies and symptom heterogeneity. This study aimed to regard auditory verbal hallucinations (AVHs) as a pointcut to downscale the heterogeneity of SCZ and explore whether some sleep architecture and spindle parameters were more severely impaired in SCZ patients with AVHs compared with those without AVHs. METHODS A total of 90 SCZ patients with AVHs, 92 SCZ patients without AVHs, and 91 healthy control subjects were recruited, and parameters of sleep architecture and spindle activities were compared between groups. The correlation between significant sleep parameters and clinical indicators was analyzed. RESULTS Deficits of sleep spindle activities at prefrontal electrodes and intrahemispheric spindle coherence were observed in both AVH and non-AVH groups, several of which were more serious in the AVH group. In addition, deficits of spindle activities at central and occipital electrodes and interhemispheric spindle coherence mainly manifested accompanying AVH symptoms, most of which were retained in the medication-naive first-episode patients, and were associated with Auditory Hallucination Rating Scale scores. CONCLUSIONS Our results suggest that the underlying mechanism of spindle deficits might be different between SCZ patients with and without AVHs. In the future, the sleep feature of SCZ patients with different symptoms and the influence of clinical factors, such as medication therapy, should be further illustrated.
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15
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Sleep spindles, stress and PTSD: The state of the science and future directions. Neurobiol Stress 2023; 23:100516. [PMID: 36861030 PMCID: PMC9969071 DOI: 10.1016/j.ynstr.2023.100516] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2022] [Revised: 01/16/2023] [Accepted: 01/17/2023] [Indexed: 01/27/2023] Open
Abstract
Sleep spindles are a signature feature of non-REM (NREM) sleep, with demonstrated relationships to sleep maintenance and learning and memory. Because PTSD is characterized by disturbances in sleep maintenance and in stress learning and memory, there is now a growing interest in examining the role of sleep spindles in the neurobiology of PTSD. This review provides an overview of methods for measuring and detecting sleep spindles as they pertain to human PTSD and stress research, presents a critical review of early findings examining sleep spindles in PTSD and stress neurobiology, and proposes several directions for future research. In doing so, this review underscores the extensive heterogeneity in sleep spindle measurement and detection methods, the wide range of spindle features that may be and have been examined, the many persisting unknowns about the clinical and functional relevance of those features, and the problems considering PTSD as a homogeneous group in between-group comparisons. This review also highlights the progress that has been made in this field and underscores the strong rationale for ongoing work in this area.
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16
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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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17
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Perrottelli A, Giordano GM, Brando F, Giuliani L, Pezzella P, Mucci A, Galderisi S. Unveiling the Associations between EEG Indices and Cognitive Deficits in Schizophrenia-Spectrum Disorders: A Systematic Review. Diagnostics (Basel) 2022; 12:diagnostics12092193. [PMID: 36140594 PMCID: PMC9498272 DOI: 10.3390/diagnostics12092193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Revised: 09/05/2022] [Accepted: 09/06/2022] [Indexed: 11/16/2022] Open
Abstract
Cognitive dysfunctions represent a core feature of schizophrenia-spectrum disorders due to their presence throughout different illness stages and their impact on functioning. Abnormalities in electrophysiology (EEG) measures are highly related to these impairments, but the use of EEG indices in clinical practice is still limited. A systematic review of articles using Pubmed, Scopus and PsychINFO was undertaken in November 2021 to provide an overview of the relationships between EEG indices and cognitive impairment in schizophrenia-spectrum disorders. Out of 2433 screened records, 135 studies were included in a qualitative review. Although the results were heterogeneous, some significant correlations were identified. In particular, abnormalities in alpha, theta and gamma activity, as well as in MMN and P300, were associated with impairments in cognitive domains such as attention, working memory, visual and verbal learning and executive functioning during at-risk mental states, early and chronic stages of schizophrenia-spectrum disorders. The review suggests that machine learning approaches together with a careful selection of validated EEG and cognitive indices and characterization of clinical phenotypes might contribute to increase the use of EEG-based measures in clinical settings.
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18
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Donnelly NA, Bartsch U, Moulding HA, Eaton C, Marston H, Hall JH, Hall J, Owen MJ, van den Bree MBM, Jones MW. Sleep EEG in young people with 22q11.2 deletion syndrome: A cross-sectional study of slow-waves, spindles and correlations with memory and neurodevelopmental symptoms. eLife 2022; 11:75482. [PMID: 36039635 PMCID: PMC9477499 DOI: 10.7554/elife.75482] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Accepted: 08/12/2022] [Indexed: 11/20/2022] Open
Abstract
Background Young people living with 22q11.2 Deletion Syndrome (22q11.2DS) are at increased risk of schizophrenia, intellectual disability, attention-deficit hyperactivity disorder (ADHD) and autism spectrum disorder (ASD). In common with these conditions, 22q11.2DS is also associated with sleep problems. We investigated whether abnormal sleep or sleep-dependent network activity in 22q11.2DS reflects convergent, early signatures of neural circuit disruption also evident in associated neurodevelopmental conditions. Methods In a cross-sectional design, we recorded high-density sleep EEG in young people (6-20 years) with 22q11.2DS (n=28) and their unaffected siblings (n=17), quantifying associations between sleep architecture, EEG oscillations (spindles and slow waves) and psychiatric symptoms. We also measured performance on a memory task before and after sleep. Results 22q11.2DS was associated with significant alterations in sleep architecture, including a greater proportion of N3 sleep and lower proportions of N1 and REM sleep than in siblings. During sleep, deletion carriers showed broadband increases in EEG power with increased slow-wave and spindle amplitudes, increased spindle frequency and density, and stronger coupling between spindles and slow-waves. Spindle and slow-wave amplitudes correlated positively with overnight memory in controls, but negatively in 22q11.2DS. Mediation analyses indicated that genotype effects on anxiety, ADHD and ASD were partially mediated by sleep EEG measures. Conclusions This study provides a detailed description of sleep neurophysiology in 22q11.2DS, highlighting alterations in EEG signatures of sleep which have been previously linked to neurodevelopment, some of which were associated with psychiatric symptoms. Sleep EEG features may therefore reflect delayed or compromised neurodevelopmental processes in 22q11.2DS, which could inform our understanding of the neurobiology of this condition and be biomarkers for neuropsychiatric disorders. Funding This research was funded by a Lilly Innovation Fellowship Award (UB), the National Institute of Mental Health (NIMH 5UO1MH101724; MvdB), a Wellcome Trust Institutional Strategic Support Fund (ISSF) award (MvdB), the Waterloo Foundation (918-1234; MvdB), the Baily Thomas Charitable Fund (2315/1; MvdB), MRC grant Intellectual Disability and Mental Health: Assessing Genomic Impact on Neurodevelopment (IMAGINE) (MR/L011166/1; JH, MvdB and MO), MRC grant Intellectual Disability and Mental Health: Assessing Genomic Impact on Neurodevelopment 2 (IMAGINE-2) (MR/T033045/1; MvdB, JH and MO); Wellcome Trust Strategic Award 'Defining Endophenotypes From Integrated Neurosciences' Wellcome Trust (100202/Z/12/Z MO, JH). NAD was supported by a National Institute for Health Research Academic Clinical Fellowship in Mental Health and MWJ by a Wellcome Trust Senior Research Fellowship in Basic Biomedical Science (202810/Z/16/Z). CE and HAM were supported by Medical Research Council Doctoral Training Grants (C.B.E. 1644194, H.A.M MR/K501347/1). HMM and UB were employed by Eli Lilly & Co during the study; HMM is currently an employee of Boehringer Ingelheim Pharma GmbH & Co KG. The views and opinions expressed are those of the author(s), and not necessarily those of the NHS, the NIHR or the Department of Health funders.
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Affiliation(s)
- Nicholas A Donnelly
- Centre for Academic Mental Health, University of Bristol, Bristol, United Kingdom.,Avon and Wiltshire Partnership NHS Mental Health Trust, Avon, United Kingdom
| | - Ullrich Bartsch
- School of Physiology, Pharmacology and Neuroscience, University of Bristol, Bristol, United Kingdom.,Translational Neuroscience, Eli Lilly, Windlesham, United States
| | - Hayley A Moulding
- Medical Research Council Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, United Kingdom
| | - Christopher Eaton
- Medical Research Council Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, United Kingdom
| | - Hugh Marston
- Translational Neuroscience, Eli Lilly, Windlesham, United States
| | - Jessica H Hall
- Medical Research Council Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, United Kingdom
| | - Jeremy Hall
- Medical Research Council Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, United Kingdom
| | - Michael J Owen
- Medical Research Council Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, United Kingdom
| | - Marianne B M van den Bree
- Medical Research Council Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, United Kingdom
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19
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Cunningham TJ, Stickgold R, Kensinger EA. Investigating the effects of sleep and sleep loss on the different stages of episodic emotional memory: A narrative review and guide to the future. Front Behav Neurosci 2022; 16:910317. [PMID: 36105652 PMCID: PMC9466000 DOI: 10.3389/fnbeh.2022.910317] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Accepted: 08/03/2022] [Indexed: 11/29/2022] Open
Abstract
For two decades, sleep has been touted as one of the primary drivers for the encoding, consolidation, retention, and retrieval of episodic emotional memory. Recently, however, sleep’s role in emotional memory processing has received renewed scrutiny as meta-analyses and reviews have indicated that sleep may only contribute a small effect that hinges on the content or context of the learning and retrieval episodes. On the one hand, the strong perception of sleep’s importance in maintaining memory for emotional events may have been exacerbated by publication bias phenomena, such as the “winner’s curse” and “file drawer problem.” On the other hand, it is plausible that there are sets of circumstances that lead to consistent and reliable effects of sleep on emotional memory; these circumstances may depend on factors such as the placement and quality of sleep relative to the emotional experience, the content and context of the emotional experience, and the probes and strategies used to assess memory at retrieval. Here, we review the literature on how sleep (and sleep loss) influences each stage of emotional episodic memory. Specifically, we have separated previous work based on the placement of sleep and sleep loss in relation to the different stages of emotional memory processing: (1) prior to encoding, (2) immediately following encoding during early consolidation, (3) during extended consolidation, separated from initial learning, (4) just prior to retrieval, and (5) post-retrieval as memories may be restructured and reconsolidated. The goals of this review are three-fold: (1) examine phases of emotional memory that sleep may influence to a greater or lesser degree, (2) explicitly identify problematic overlaps in traditional sleep–wake study designs that are preventing the ability to better disentangle the potential role of sleep in the different stages of emotional memory processing, and (3) highlight areas for future research by identifying the stages of emotional memory processing in which the effect of sleep and sleep loss remains under-investigated. Here, we begin the task of better understanding the contexts and factors that influence the relationship between sleep and emotional memory processing and aim to be a valuable resource to facilitate hypothesis generation and promote important future research.
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Affiliation(s)
- Tony J. Cunningham
- Center for Sleep and Cognition, Department of Psychiatry, Beth Israel Deaconess Medical Center, Boston, MA, United States
- Division of Sleep Medicine, Harvard Medical School, Boston, MA, United States
- Department of Psychology and Neuroscience, Boston College, Chestnut Hill, MA, United States
- *Correspondence: Tony J. Cunningham,
| | - Robert Stickgold
- Center for Sleep and Cognition, Department of Psychiatry, Beth Israel Deaconess Medical Center, Boston, MA, United States
- Division of Sleep Medicine, Harvard Medical School, Boston, MA, United States
| | - Elizabeth A. Kensinger
- Department of Psychology and Neuroscience, Boston College, Chestnut Hill, MA, United States
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20
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Katsuki F, Gerashchenko D, Brown RE. Alterations of sleep oscillations in Alzheimer's disease: A potential role for GABAergic neurons in the cortex, hippocampus, and thalamus. Brain Res Bull 2022; 187:181-198. [PMID: 35850189 DOI: 10.1016/j.brainresbull.2022.07.002] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Revised: 06/01/2022] [Accepted: 07/06/2022] [Indexed: 02/07/2023]
Abstract
Sleep abnormalities are widely reported in patients with Alzheimer's disease (AD) and are linked to cognitive impairments. Sleep abnormalities could be potential biomarkers to detect AD since they are often observed at the preclinical stage. Moreover, sleep could be a target for early intervention to prevent or slow AD progression. Thus, here we review changes in brain oscillations observed during sleep, their connection to AD pathophysiology and the role of specific brain circuits. Slow oscillations (0.1-1 Hz), sleep spindles (8-15 Hz) and their coupling during non-REM sleep are consistently reduced in studies of patients and in AD mouse models although the timing and magnitude of these alterations depends on the pathophysiological changes and the animal model studied. Changes in delta (1-4 Hz) activity are more variable. Animal studies suggest that hippocampal sharp-wave ripples (100-250 Hz) are also affected. Reductions in REM sleep amount and slower oscillations during REM are seen in patients but less consistently in animal models. Thus, changes in a variety of sleep oscillations could impact sleep-dependent memory consolidation or restorative functions of sleep. Recent mechanistic studies suggest that alterations in the activity of GABAergic neurons in the cortex, hippocampus and thalamic reticular nucleus mediate sleep oscillatory changes in AD and represent a potential target for intervention. Longitudinal studies of the timing of AD-related sleep abnormalities with respect to pathology and dysfunction of specific neural networks are needed to identify translationally relevant biomarkers and guide early intervention strategies to prevent or delay AD progression.
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Affiliation(s)
- Fumi Katsuki
- VA Boston Healthcare System and Harvard Medical School, Dept. of Psychiatry, West Roxbury, MA 02132, USA.
| | - Dmitry Gerashchenko
- VA Boston Healthcare System and Harvard Medical School, Dept. of Psychiatry, West Roxbury, MA 02132, USA
| | - Ritchie E Brown
- VA Boston Healthcare System and Harvard Medical School, Dept. of Psychiatry, West Roxbury, MA 02132, USA
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21
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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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22
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Kozhemiako N, Wang J, Jiang C, Wang LA, Gai G, Zou K, Wang Z, Yu X, Zhou L, Li S, Guo Z, Law R, Coleman J, Mylonas D, Shen L, Wang G, Tan S, Qin S, Huang H, Murphy M, Stickgold R, Manoach D, Zhou Z, Zhu W, Hal MH, Purcell SM, Pan JQ. Non-rapid eye movement sleep and wake neurophysiology in schizophrenia. eLife 2022; 11:76211. [PMID: 35578829 PMCID: PMC9113745 DOI: 10.7554/elife.76211] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Accepted: 04/11/2022] [Indexed: 12/29/2022] Open
Abstract
Motivated by the potential of objective neurophysiological markers to index thalamocortical function in patients with severe psychiatric illnesses, we comprehensively characterized key non-rapid eye movement (NREM) sleep parameters across multiple domains, their interdependencies, and their relationship to waking event-related potentials and symptom severity. In 72 schizophrenia (SCZ) patients and 58 controls, we confirmed a marked reduction in sleep spindle density in SCZ and extended these findings to show that fast and slow spindle properties were largely uncorrelated. We also describe a novel measure of slow oscillation and spindle interaction that was attenuated in SCZ. The main sleep findings were replicated in a demographically distinct sample, and a joint model, based on multiple NREM components, statistically predicted disease status in the replication cohort. Although also altered in patients, auditory event-related potentials elicited during wake were unrelated to NREM metrics. Consistent with a growing literature implicating thalamocortical dysfunction in SCZ, our characterization identifies independent NREM and wake EEG biomarkers that may index distinct aspects of SCZ pathophysiology and point to multiple neural mechanisms underlying disease heterogeneity. This study lays the groundwork for evaluating these neurophysiological markers, individually or in combination, to guide efforts at treatment and prevention as well as identifying individuals most likely to benefit from specific interventions.
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Affiliation(s)
- Nataliia Kozhemiako
- Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, United States
| | - Jun Wang
- The Affiliated Wuxi Mental Health Center of Nanjing Medical University, Wuxi, China
| | - Chenguang Jiang
- The Affiliated Wuxi Mental Health Center of Nanjing Medical University, Wuxi, China
| | - Lei A Wang
- Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, United States
| | - Guanchen Gai
- The Affiliated Wuxi Mental Health Center of Nanjing Medical University, Wuxi, China
| | - Kai Zou
- The Affiliated Wuxi Mental Health Center of Nanjing Medical University, Wuxi, China
| | - Zhe Wang
- The Affiliated Wuxi Mental Health Center of Nanjing Medical University, Wuxi, China
| | - Xiaoman Yu
- The Affiliated Wuxi Mental Health Center of Nanjing Medical University, Wuxi, China
| | - Lin Zhou
- Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, United States
| | - Shen Li
- Department of Psychiatry, McLean Hospital, Harvard Medical School, Belmont, United States
| | - Zhenglin Guo
- Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, United States
| | - Robert Law
- Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, United States
| | - James Coleman
- Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, United States
| | - Dimitrios Mylonas
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, United States
| | - Lu Shen
- Bio-X Institutes, Shanghai Jiao Tong University, Shanghai, China
| | - Guoqiang Wang
- The Affiliated Wuxi Mental Health Center of Nanjing Medical University, Wuxi, China
| | - Shuping Tan
- Huilong Guan Hospital, Beijing University, Beijing, China
| | - Shengying Qin
- Bio-X Institutes, Shanghai Jiao Tong University, Shanghai, China
| | - Hailiang Huang
- Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, United States.,Analytic and Translational Genetics Unit, Massachusetts General Hospital, Harvard Medical School, Boston, United States
| | - Michael Murphy
- Department of Psychiatry, McLean Hospital, Harvard Medical School, Belmont, United States
| | - Robert Stickgold
- Beth Israel Deaconess Medical Center, Boston, United States.,Department of Psychiatry, Harvard Medical School, Boston, United States
| | - Dara Manoach
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, United States
| | - Zhenhe Zhou
- The Affiliated Wuxi Mental Health Center of Nanjing Medical University, Wuxi, China
| | - Wei Zhu
- The Affiliated Wuxi Mental Health Center of Nanjing Medical University, Wuxi, China
| | - Mei-Hua Hal
- Department of Psychiatry, McLean Hospital, Harvard Medical School, Belmont, United States
| | - Shaun M Purcell
- Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, United States.,Department of Psychiatry, Harvard Medical School, Boston, United States
| | - Jen Q Pan
- Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, United States
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23
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Denis D, Kim SY, Kark SM, Daley RT, Kensinger EA, Payne JD. Slow oscillation-spindle coupling is negatively associated with emotional memory formation following stress. Eur J Neurosci 2022; 55:2632-2650. [PMID: 33511691 DOI: 10.1111/ejn.15132] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Revised: 01/12/2021] [Accepted: 01/17/2021] [Indexed: 01/14/2023]
Abstract
Both stress and sleep enhance emotional memory. They also interact, with the largest effect of sleep on emotional memory being seen when stress occurs shortly before or after encoding. Slow wave sleep (SWS) is critical for long-term episodic memory, facilitated by the temporal coupling of slow oscillations and sleep spindles. Prior work in humans has shown these associations for neutral information in non-stressed participants. Whether coupling interacts with stress to facilitate emotional memory formation is unknown. Here, we addressed this question by reanalyzing an existing dataset of 64 individuals. Participants underwent a psychosocial stressor (32) or comparable control (32) prior to the encoding of 150-line drawings of neutral, positive, and negative images. All participants slept overnight with polysomnography, before being given a surprise memory test the following day. In the stress group, time spent in SWS was positively correlated with memory for images of all valences. Results were driven by those who showed a high cortisol response to the stressor, compared to low responders. The amount of slow oscillation-spindle coupling during SWS was negatively associated with neutral and emotional memory in the stress group only. The association with emotional memory was significantly stronger than for neutral memory within the stress group. These results suggest that stress around the time of initial memory formation impacts the relationship between slow wave sleep and memory.
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Affiliation(s)
- Dan Denis
- Department of Psychology, University of Notre Dame, Notre Dame, IN, USA
| | - Sara Y Kim
- Department of Psychology, University of Notre Dame, Notre Dame, IN, USA
| | - Sarah M Kark
- Department of Neurobiology and Behavior, Center for the Neurobiology of Learning and Memory, University of California, Irvine, Irvine, CA, USA
| | - Ryan T Daley
- Department of Psychology and Neuroscience, Boston College, Chestnut Hill, MA, USA
| | | | - Jessica D Payne
- Department of Psychology, University of Notre Dame, Notre Dame, IN, USA
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24
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Gombos F, Bódizs R, Pótári A, Bocskai G, Berencsi A, Szakács H, Kovács I. Topographical relocation of adolescent sleep spindles reveals a new maturational pattern in the human brain. Sci Rep 2022; 12:7023. [PMID: 35487959 PMCID: PMC9054798 DOI: 10.1038/s41598-022-11098-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Accepted: 04/18/2022] [Indexed: 11/23/2022] Open
Abstract
Current theories of human neural development emphasize the posterior-to-anterior pattern of brain maturation. However, this scenario leaves out significant brain areas not directly involved with sensory input and behavioral control. Suggesting the relevance of cortical activity unrelated to sensory stimulation, such as sleep, we investigated adolescent transformations in the topography of sleep spindles. Sleep spindles are known to be involved in neural plasticity and in adults have a bimodal topography: slow spindles are frontally dominant, while fast spindles have a parietal/precuneal origin. The late functional segregation of the precuneus from the frontoparietal network during adolescence suggests that spindle topography might approach the adult state relatively late in development, and it may not be a result of the posterior-to-anterior maturational pattern. We analyzed the topographical distribution of spindle parameters in HD-EEG polysomnographic sleep recordings of adolescents and found that slow spindle duration maxima traveled from central to anterior brain regions, while fast spindle density, amplitude and frequency peaks traveled from central to more posterior brain regions. These results provide evidence for the gradual posteriorization of the anatomical localization of fast sleep spindles during adolescence and indicate the existence of an anterior-to-posterior pattern of human brain maturation.
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Affiliation(s)
- Ferenc Gombos
- Laboratory for Psychological Research, Pázmány Péter Catholic University, 1 Mikszáth Kálmán Sq., Budapest, 1088, Hungary.,Adolescent Development Research Group, Hungarian Academy of Sciences - Pázmány Péter Catholic University, Budapest, 1088, Hungary
| | - Róbert Bódizs
- Institute of Behavioural Sciences, Semmelweis University, Budapest, 1089, Hungary.,National Institute of Clinical Neurosciences, Budapest, 1145, Hungary
| | - Adrián Pótári
- Adolescent Development Research Group, Hungarian Academy of Sciences - Pázmány Péter Catholic University, Budapest, 1088, Hungary
| | - Gábor Bocskai
- Laboratory for Psychological Research, Pázmány Péter Catholic University, 1 Mikszáth Kálmán Sq., Budapest, 1088, Hungary.,Doctoral School of Mental Health Sciences, Semmelweis University, Üllői st. 26, Budapest, 1085, Hungary
| | - Andrea Berencsi
- Adolescent Development Research Group, Hungarian Academy of Sciences - Pázmány Péter Catholic University, Budapest, 1088, Hungary.,Institute for the Methodology of Special Needs Education and Rehabilitation, Bárczi Gusztáv Faculty of Special Needs Education, Eötvös Loránd University, Budapest, 1097, Hungary
| | - Hanna Szakács
- Laboratory for Psychological Research, Pázmány Péter Catholic University, 1 Mikszáth Kálmán Sq., Budapest, 1088, Hungary.,Doctoral School of Mental Health Sciences, Semmelweis University, Üllői st. 26, Budapest, 1085, Hungary
| | - Ilona Kovács
- Laboratory for Psychological Research, Pázmány Péter Catholic University, 1 Mikszáth Kálmán Sq., Budapest, 1088, Hungary. .,Adolescent Development Research Group, Hungarian Academy of Sciences - Pázmány Péter Catholic University, Budapest, 1088, Hungary. .,Institute of Cognitive Neuroscience and Psychology, Research Centre for Natural Sciences, Budapest, 1117, Hungary.
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25
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Leong CWY, Leow JWS, Grunstein RR, Naismith SL, Teh JZ, D’Rozario AL, Saini B. A systematic scoping review of the effects of central nervous system active drugs on sleep spindles and sleep-dependent memory consolidation. Sleep Med Rev 2022; 62:101605. [DOI: 10.1016/j.smrv.2022.101605] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Revised: 01/15/2022] [Accepted: 01/26/2022] [Indexed: 11/26/2022]
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26
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Association of polygenic risk for schizophrenia with fast sleep spindle density depends on pro-cognitive variants. Eur Arch Psychiatry Clin Neurosci 2022; 272:1193-1203. [PMID: 35723738 PMCID: PMC9508216 DOI: 10.1007/s00406-022-01435-3] [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: 01/21/2022] [Accepted: 05/15/2022] [Indexed: 11/14/2022]
Abstract
Cognitive impairment is a common feature in schizophrenia and the strongest prognostic factor for long-term outcome. Identifying a trait associated with the genetic background for cognitive outcome in schizophrenia may aid in a deeper understanding of clinical disease subtypes. Fast sleep spindles may represent such a biomarker as they are strongly genetically determined, associated with cognitive functioning and impaired in schizophrenia and unaffected relatives. We measured fast sleep spindle density in 150 healthy adults and investigated its association with a genome-wide polygenic score for schizophrenia (SCZ-PGS). The association between SCZ-PGS and fast spindle density was further characterized by stratifying it to the genetic background of intelligence. SCZ-PGS was positively associated with fast spindle density. This association mainly depended on pro-cognitive genetic variants. Our results strengthen the evidence for a genetic background of spindle abnormalities in schizophrenia. Spindle density might represent an easily accessible marker for a favourable cognitive outcome which should be further investigated in clinical samples.
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27
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Lai M, Hegde R, Kelly S, Bannai D, Lizano P, Stickgold R, Manoach DS, Keshavan M. Investigating sleep spindle density and schizophrenia: A meta-analysis. Psychiatry Res 2022; 307:114265. [PMID: 34922240 DOI: 10.1016/j.psychres.2021.114265] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Revised: 10/25/2021] [Accepted: 10/31/2021] [Indexed: 11/26/2022]
Abstract
Sleep abnormalities are an early feature of schizophrenia (SZ) characterized by reductions in sleep spindles that are associated with deficits in brain connectivity and cognitive function. This study investigated sleep spindle density (SSD) differences between SZ, first episode psychosis (FEP), and family high-risk (FHR) populations and matched healthy controls (HC) by investigating recent studies via a meta-analysis. We collected experimental, demographic, and methodological metrics from eligible studies across multiple online databases. 14 total studies survived the inclusion and exclusion criteria for a total of 337 patients and relatives and 339 HC. R-Studio was used to run the meta-analysis via the meta and metaphor packages. A heterogeneity score of I2 = 80% was calculated and thus a random effects model was chosen. We report a large effect size for SSD in patients compared to controls. Furthermore, illness duration was significantly associated with SSD. Our next step to understanding sleep spindles would be to investigate SSD's use as a predictor for SZ or attempt to normalize SSD deficits as a therapeutic option.
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Affiliation(s)
- Matthew Lai
- Department of Psychiatry, Beth Israel Deaconess Medical Center and Massachusetts Mental Health Center, Boston, MA, United States
| | - Rachal Hegde
- Department of Psychiatry, Beth Israel Deaconess Medical Center and Massachusetts Mental Health Center, Boston, MA, United States
| | - Sinead Kelly
- Department of Psychiatry, Beth Israel Deaconess Medical Center and Massachusetts Mental Health Center, Boston, MA, United States; Department of Psychiatry, Harvard Medical School, Boston, MA, United States; Department of Psychiatry, Brigham and Women's Hospital, Boston, MA, United States
| | - Deepthi Bannai
- Department of Psychiatry, Beth Israel Deaconess Medical Center and Massachusetts Mental Health Center, Boston, MA, United States
| | - Paulo Lizano
- Department of Psychiatry, Beth Israel Deaconess Medical Center and Massachusetts Mental Health Center, Boston, MA, United States; Department of Psychiatry, Harvard Medical School, Boston, MA, United States
| | - Robert Stickgold
- Department of Psychiatry, Beth Israel Deaconess Medical Center and Massachusetts Mental Health Center, Boston, MA, United States; Department of Psychiatry, Harvard Medical School, Boston, MA, United States
| | - Dara S Manoach
- Department of Psychiatry, Harvard Medical School, Boston, MA, United States; Department of Psychiatry, Massachusetts General Hospital, Boston, MA, United States
| | - Matcheri Keshavan
- Department of Psychiatry, Beth Israel Deaconess Medical Center and Massachusetts Mental Health Center, Boston, MA, United States; Department of Psychiatry, Harvard Medical School, Boston, MA, United States.
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28
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Covering the Gap Between Sleep and Cognition – Mechanisms and Clinical Examples. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2022; 1384:17-29. [PMID: 36217076 DOI: 10.1007/978-3-031-06413-5_2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
A growing number of studies have shown the strong relationship between sleep and different cognitive processes, especially those that involve memory consolidation. Traditionally, these processes were attributed to mechanisms related to the macroarchitecture of sleep, as sleep cycles or the duration of specific stages, such as the REM stage. More recently, the relationship between different cognitive traits and specific waves (sleep spindles or slow oscillations) has been studied. We here present the most important physiological processes induced by sleep, with particular focus on brain electrophysiology. In addition, recent and classical literature were reviewed to cover the gap between sleep and cognition, while illustrating this relationship by means of clinical examples. Finally, we propose that future studies may focus not only on analyzing specific waves, but also on the relationship between their characteristics as potential biomarkers for multiple diseases.
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29
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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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30
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Abstract
Sleep disturbances are commonly observed in schizophrenia, including in chronic, early-course, and first-episode patients. This has generated considerable interest, both in clinical and research endeavors, in characterizing the relationship between disturbed sleep and schizophrenia. Sleep features can be objectively assessed with EEG recordings. Traditionally, EEG studies have focused on sleep architecture, which includes non-REM and REM sleep stages. More recently, numerous studies have investigated alterations in sleep-specific rhythms, including EEG oscillations, such as sleep spindles and slow waves, in individuals with schizophrenia compared with control subjects. In this article, the author reviews state-of-the-art evidence of disturbed sleep in schizophrenia, starting from the relationship between sleep disturbances and clinical symptoms. First, the author presents studies demonstrating abnormalities in sleep architecture and sleep-oscillatory rhythms in schizophrenia and related psychotic disorders, with an emphasis on recent work demonstrating sleep spindles and slow-wave deficits in early-course and first-episode schizophrenia. Next, the author shows how these sleep abnormalities relate to the cognitive impairments in patients diagnosed with schizophrenia and point to dysfunctions in underlying thalamocortical circuits, Ca+ channel activity, and GABA-glutamate neurotransmission. Finally, the author discusses some of the next steps needed to further establish the role of altered sleep in schizophrenia, including the need to investigate sleep abnormalities across the psychotic spectrum and to establish their relationship with circadian disturbances, which in turn will contribute to the development of novel sleep-informed treatment interventions.
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Affiliation(s)
- Fabio Ferrarelli
- Department of Psychiatry, University of Pittsburgh School of Medicine Pittsburgh, PA, 15213
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31
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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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32
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Dehnavi F, Koo-Poeggel PC, Ghorbani M, Marshall L. Spontaneous slow oscillation - slow spindle features predict induced overnight memory retention. Sleep 2021; 44:6277833. [PMID: 34003291 PMCID: PMC8503833 DOI: 10.1093/sleep/zsab127] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Revised: 05/06/2021] [Indexed: 11/13/2022] Open
Abstract
Study Objectives Synchronization of neural activity within local networks and between brain regions is a major contributor to rhythmic field potentials such as the EEG. On the other hand, dynamic changes in microstructure and activity are reflected in the EEG, for instance slow oscillation (SO) slope can reflect synaptic strength. SO-spindle coupling is a measure for neural communication. It was previously associated with memory consolidation, but also shown to reveal strong interindividual differences. In studies, weak electric current stimulation has modulated brain rhythms and memory retention. Here, we investigate whether SO-spindle coupling and SO slope during baseline sleep are associated with (predictive of) stimulation efficacy on retention performance. Methods Twenty-five healthy subjects participated in three experimental sessions. Sleep-associated memory consolidation was measured in two sessions, in one anodal transcranial direct current stimulation oscillating at subjects individual SO frequency (so-tDCS) was applied during nocturnal sleep. The third session was without a learning task (baseline sleep). The dependence on SO-spindle coupling and SO-slope during baseline sleep of so-tDCS efficacy on retention performance were investigated. Results Stimulation efficacy on overnight retention of declarative memories was associated with nesting of slow spindles to SO trough in deep nonrapid eye movement baseline sleep. Steepness and direction of SO slope in baseline sleep were features indicative for stimulation efficacy. Conclusions Findings underscore a functional relevance of activity during the SO up-to-down state transition for memory consolidation and provide support for distinct consolidation mechanisms for types of declarative memories.
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Affiliation(s)
- Fereshteh Dehnavi
- Department of Electrical Engineering, Ferdowsi University of Mashhad, Mashhad, Iran
| | - Ping Chai Koo-Poeggel
- Institute of Experimental and Clinical Pharmacology and Toxicology, University of Lübeck, Ratzeburger Allee, Lübeck, Germany.,Center of Brain, Behavior and Metabolism, University of Lübeck, Lübeck
| | - Maryam Ghorbani
- Department of Electrical Engineering, Ferdowsi University of Mashhad, Mashhad, Iran.,Rayan Center for Neuroscience and Behavior, Ferdowsi University of Mashhad, Mashhad, Iran
| | - Lisa Marshall
- Institute of Experimental and Clinical Pharmacology and Toxicology, University of Lübeck, Ratzeburger Allee, Lübeck, Germany.,Center of Brain, Behavior and Metabolism, University of Lübeck, Lübeck
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33
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Geiser T, Hertenstein E, Fehér K, Maier JG, Schneider CL, Züst MA, Wunderlin M, Mikutta C, Klöppel S, Nissen C. Targeting Arousal and Sleep through Noninvasive Brain Stimulation to Improve Mental Health. Neuropsychobiology 2021; 79:284-292. [PMID: 32408296 DOI: 10.1159/000507372] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2020] [Accepted: 03/14/2020] [Indexed: 01/29/2023]
Abstract
Arousal and sleep represent fundamental physiological domains, and alterations in the form of insomnia (difficulty falling or staying asleep) or hypersomnia (increased propensity for falling asleep or increased sleep duration) are prevalent clinical problems. Current first-line treatments include psychotherapy and pharmacotherapy. Despite significant success, a number of patients do not benefit sufficiently. Progress is limited by an incomplete understanding of the -neurobiology of insomnia and hypersomnia. This work summarizes current concepts of the regulation of arousal and sleep and its modulation through noninvasive brain stimulation (NIBS), including transcranial magnetic, current, and auditory stimulation. Particularly, we suggest: (1) characterization of patients with sleep problems - across diagnostic entities of mental disorders - based on specific alterations of sleep, including alterations of sleep slow waves, sleep spindles, cross-frequency coupling of brain oscillations, local sleep-wake regulation, and REM sleep and (2) targeting these with specific NIBS techniques. While evidence is accumulating that the modulation of specific alterations of sleep through NIBS is feasible, it remains to be tested whether this translates to clinically relevant effects and new treatment developments.
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Affiliation(s)
- Tim Geiser
- University Hospital of Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Elisabeth Hertenstein
- University Hospital of Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Kristoffer Fehér
- University Hospital of Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Jonathan G Maier
- University Hospital of Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Carlotta L Schneider
- University Hospital of Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Marc A Züst
- University Hospital of Old Age Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Marina Wunderlin
- University Hospital of Old Age Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Christian Mikutta
- University Hospital of Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland.,Privatklinik Meiringen, Meiringen, Switzerland
| | - Stefan Klöppel
- University Hospital of Old Age Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Christoph Nissen
- University Hospital of Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland,
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34
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Rentschler KM, Baratta AM, Ditty AL, Wagner NTJ, Wright CJ, Milosavljevic S, Mong JA, Pocivavsek A. Prenatal Kynurenine Elevation Elicits Sex-Dependent Changes in Sleep and Arousal During Adulthood: Implications for Psychotic Disorders. Schizophr Bull 2021; 47:1320-1330. [PMID: 33823027 PMCID: PMC8379538 DOI: 10.1093/schbul/sbab029] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Dysregulation of the kynurenine pathway (KP) of tryptophan catabolism has been implicated in psychotic disorders, including schizophrenia and bipolar disorder. Kynurenic acid (KYNA) is a KP metabolite synthesized by kynurenine aminotransferases (KATs) from its biological precursor kynurenine and acts as an endogenous antagonist of N-methyl-D-aspartate and α7-nicotinic acetylcholine receptors. Elevated KYNA levels found in postmortem brain tissue and cerebrospinal fluid of patients are hypothesized to play a key role in the etiology of cognitive symptoms observed in psychotic disorders. Sleep plays an important role in memory consolidation, and sleep disturbances are common among patients. Yet, little is known about the effect of altered KP metabolism on sleep-wake behavior. We presently utilized a well-established experimental paradigm of embryonic kynurenine (EKyn) exposure wherein pregnant dams are fed a diet laced with kynurenine the last week of gestation and hypothesized disrupted sleep-wake behavior in adult offspring. We examined sleep behavior in adult male and female offspring using electroencephalogram and electromyogram telemetry and determined sex differences in sleep and arousal in EKyn offspring. EKyn males displayed reduced rapid eye movement sleep, while female EKyn offspring were hyperaroused compared to controls. We determined that EKyn males maintain elevated brain KYNA levels, while KYNA levels were unchanged in EKyn females, yet the activity levels of KAT I and KAT II were reduced. Our findings indicate that elevated prenatal kynurenine exposure elicits sex-specific changes in sleep-wake behavior, arousal, and KP metabolism.
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Affiliation(s)
- Katherine M Rentschler
- Department of Pharmacology, Physiology, and Neuroscience, University of South Carolina School of Medicine, Columbia, SC, USA
| | | | - Audrey L Ditty
- Department of Pharmacology, Physiology, and Neuroscience, University of South Carolina School of Medicine, Columbia, SC, USA
| | - Nathan T J Wagner
- Department of Pharmacology, Physiology, and Neuroscience, University of South Carolina School of Medicine, Columbia, SC, USA
| | - Courtney J Wright
- Department of Pharmacology, Physiology, and Neuroscience, University of South Carolina School of Medicine, Columbia, SC, USA
| | - Snezana Milosavljevic
- Department of Pharmacology, Physiology, and Neuroscience, University of South Carolina School of Medicine, Columbia, SC, USA
| | - Jessica A Mong
- Department of Pharmacology, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Ana Pocivavsek
- Department of Pharmacology, Physiology, and Neuroscience, University of South Carolina School of Medicine, Columbia, SC, USA,To whom correspondence should be addressed; tel: (803) 216–3509, fax: 803-216-3538, e-mail:
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35
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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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Clarke L, Chisholm K, Cappuccio FP, Tang NKY, Miller MA, Elahi F, Thompson AD. Sleep disturbances and the At Risk Mental State: A systematic review and meta-analysis. Schizophr Res 2021; 227:81-91. [PMID: 32646803 DOI: 10.1016/j.schres.2020.06.027] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/29/2020] [Revised: 06/14/2020] [Accepted: 06/20/2020] [Indexed: 11/28/2022]
Abstract
AIMS To synthesise and investigate how sleep disturbances relate to psychotic symptoms, functioning and Quality of Life (QoL) in At Risk Mental State (ARMS) youth. METHOD A comprehensive search of six databases (MEDLINE, PsycINFO, Embase, CINAHL, Web of Science and CENTRAL) was conducted. Eligible studies provided data on sleep disturbances or disorders in ARMS patients. RESULTS Sixteen studies met the inclusion criteria (n = 1962 ARMS patients) including 7 cross-sectional studies, 2 RCT's and 7 cohort studies. Narrative synthesis revealed that self-reported sleep (e.g., general disturbances, fragmented night time sleep and nightmares) was poorer among ARMS patients compared to healthy controls. In the limited studies (n = 4) including objective measurements of sleep disturbances, ARMS patients experienced higher levels of movement during sleep, more daytime naps and increased sleep latency compared to controls. Furthermore, sleep disturbances were associated with attenuated psychotic symptoms and functional outcomes cross-sectionally and longitudinally. Only one study investigated the relationship between sleep and QoL. The exploratory meta-analysis revealed a significant difference in self-reported sleep disturbances measured by the PSQI (mean difference in score: 3.30 (95% CI 1.87, 4.74), p < 0.00001) and SIPS (mean difference in score: 1.58 (95% CI 0.80, 2.35), p < 0.00001) of ARMS patients compared to control groups. CONCLUSIONS ARMS individuals report impaired sleep quality and reduced sleep quantity compared to healthy controls. However, further research is needed to explore the longitudinal relationship between sleep disruptions and QoL in early psychosis. Significant variations in how sleep is measured across studies highlight a need to assess disturbances to sleep using robust and consistent approaches in this patient group.
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Affiliation(s)
- Latoya Clarke
- Mental Health and Wellbeing Division, Warwick Medical School, University of Warwick, Coventry, UK.
| | | | - Francesco P Cappuccio
- Mental Health and Wellbeing Division, Warwick Medical School, University of Warwick, Coventry, UK
| | - Nicole K Y Tang
- Department of Psychology, University of Warwick, Coventry, UK
| | - Michelle A Miller
- Mental Health and Wellbeing Division, Warwick Medical School, University of Warwick, Coventry, UK
| | - Farah Elahi
- Mental Health and Wellbeing Division, Warwick Medical School, University of Warwick, Coventry, UK
| | - Andrew D Thompson
- Mental Health and Wellbeing Division, Warwick Medical School, University of Warwick, Coventry, UK
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Davidson P, Jönsson P, Carlsson I, Pace-Schott E. Does Sleep Selectively Strengthen Certain Memories Over Others Based on Emotion and Perceived Future Relevance? Nat Sci Sleep 2021; 13:1257-1306. [PMID: 34335065 PMCID: PMC8318217 DOI: 10.2147/nss.s286701] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Accepted: 03/24/2021] [Indexed: 12/12/2022] Open
Abstract
Sleep has been found to have a beneficial effect on memory consolidation. It has furthermore frequently been suggested that sleep does not strengthen all memories equally. The first aim of this review paper was to examine whether sleep selectively strengthens emotional declarative memories more than neutral ones. We examined this first by reviewing the literature focusing on sleep/wake contrasts, and then the literature on whether any specific factors during sleep preferentially benefit emotional memories, with a special focus on the often-suggested claim that rapid eye movement sleep primarily consolidates emotional memories. A second aim was to examine if sleep preferentially benefits memories based on other cues of future relevance such as reward, test-expectancy or different instructions during encoding. Once again, we first focused on studies comparing sleep and wake groups, and then on studies examining the contributions of specific factors during sleep (for each future relevance paradigm, respectively). The review revealed that although some support exists that sleep is more beneficial for certain kinds of memories based on emotion or other cues of future relevance, the majority of studies does not support such an effect. Regarding specific factors during sleep, our review revealed that no sleep variable has reliably been found to be specifically associated with the consolidation of certain kinds of memories over others based on emotion or other cues of future relevance.
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Affiliation(s)
- Per Davidson
- Department of Psychology, Lund University, Lund, Sweden.,Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA.,Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Peter Jönsson
- School of Education and Environment, Centre for Psychology, Kristianstad University, Kristianstad, Sweden
| | | | - Edward Pace-Schott
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA.,Department of Psychiatry, Harvard Medical School, Boston, MA, USA.,Athinoula A. Martinos Center for Biomedical Imaging, Charlestown, MA, USA
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Au CH, Harvey CJ. Systematic review: the relationship between sleep spindle activity with cognitive functions, positive and negative symptoms in psychosis. Sleep Med X 2020; 2:100025. [PMID: 33870177 PMCID: PMC8041130 DOI: 10.1016/j.sleepx.2020.100025] [Citation(s) in RCA: 8] [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: 07/08/2020] [Revised: 08/07/2020] [Accepted: 08/19/2020] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Sleep disturbances are associated with worse cognitive and psychotic symptoms in individuals with schizophrenia. Growing literature reveals sleep spindle deficits in schizophrenia may be an endophenotype reflecting a dysfunctional thalamo-thalamic reticular nucleus-cortical circuit. Since thalamic functions link to cognitive, positive and negative symptoms, it is possible that sleep spindle activity is associated with these symptoms. The primary objectives of this systematic review were to assess the associations of sleep spindle activity in psychotic patients with 1) cognitive functions; and 2) positive and negative symptom severity. A secondary objective was to examine which spindle parameter would be the most consistent parameter correlating with cognitive functions, and positive and negative symptoms. METHOD Observational studies reporting an association between sleep spindle activity and cognitive functions, positive and negative symptoms in patients with psychotic disorders were considered eligible. We developed a comprehensive electronic search strategy to identify peer-reviewed studies in Pubmed, Embase, PsycINFO and CINAHL covering all dates up to the search date in May 2020 with no language restriction. The references of published articles were hand-searched for additional materials. The authors of published articles were contacted for newer or unpublished data. Risk of bias was assessed by Appraisal of Cross-sectional Studies (AXIS). RESULTS A total 11 cross-sectional studies (n = 255) with low-to-moderate quality, were selected for the systematic review. 8 of them addressed the association between sleep spindle activity and cognitive functions (n = 193), of which 6 studies reported positive correlations (r only reported in 4 studies, from 0.45 to 0.75). Out of multiple cognitive domains, we have only found attention/cognitive processing speed to have a more consistent positive association with sleep spindle activity. On the other hand, 8 studies investigated the relationship between sleep spindle and positive/negative symptom severity (n = 190), but findings were inconsistent. Spindle density is the most consistent parameter correlating with cognitive functions, while the best spindle parameter for correlating with positive and negative symptom severity cannot be identified due to mixed results. DISCUSSION This systematic review confirms the linkage between sleep spindle activity and cognitive functions. However, included studies had small sample sizes, with high risks of sampling and response bias. Moreover, confounders were often not controlled. The heterogeneous report of spindle parameters and use of cognitive assessment tools rendered meta-analysis infeasible. It is necessary to examine the longitudinal change of sleep spindle activity with the course of illness, as well as the effect of sleep spindle enhancing agents on cognitive function.
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The effects of eszopiclone on sleep spindles and memory consolidation in schizophrenia: a randomized clinical trial. Neuropsychopharmacology 2020; 45:2189-2197. [PMID: 32919407 PMCID: PMC7785021 DOI: 10.1038/s41386-020-00833-2] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Revised: 08/15/2020] [Accepted: 08/20/2020] [Indexed: 12/16/2022]
Abstract
Sleep spindles, defining oscillations of stage 2 non-rapid eye movement sleep (N2), mediate memory consolidation. Schizophrenia is characterized by reduced spindle activity that correlates with impaired sleep-dependent memory consolidation. In a small, randomized, placebo-controlled pilot study of schizophrenia, eszopiclone (Lunesta®), a nonbenzodiazepine sedative hypnotic, increased N2 spindle density (number/minute) but did not significantly improve memory. This larger double-blind crossover study that included healthy controls investigated whether eszopiclone could both increase N2 spindle density and improve memory. Twenty-six medicated schizophrenia outpatients and 29 healthy controls were randomly assigned to have a placebo or eszopiclone (3 mg) sleep visit first. Each visit involved two consecutive nights of high density polysomnography with training on the Motor Sequence Task (MST) on the second night and testing the following morning. Patients showed a widespread reduction of spindle density and, in both groups, eszopiclone increased spindle density but failed to enhance sleep-dependent procedural memory consolidation. Follow-up analyses revealed that eszopiclone also affected cortical slow oscillations: it decreased their amplitude, increased their duration, and rendered their phase locking with spindles more variable. Regardless of group or visit, the density of coupled spindle-slow oscillation events predicted memory consolidation significantly better than spindle density alone, suggesting that they are a better biomarker of memory consolidation. In conclusion, sleep oscillations are promising targets for improving memory consolidation in schizophrenia, but enhancing spindles is not enough. Effective therapies also need to preserve or enhance cortical slow oscillations and their coordination with thalamic spindles, an interregional dialog that is necessary for sleep-dependent memory consolidation.
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40
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Markovic A, Buckley A, Driver DI, Dillard-Broadnax D, Gochman PA, Hoedlmoser K, Rapoport JL, Tarokh L. Sleep spindle activity in childhood onset schizophrenia: Diminished and associated with clinical symptoms. Schizophr Res 2020; 223:327-336. [PMID: 32980206 PMCID: PMC7704640 DOI: 10.1016/j.schres.2020.08.022] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2019] [Revised: 05/24/2020] [Accepted: 08/25/2020] [Indexed: 12/21/2022]
Abstract
Neuroimaging studies of childhood onset schizophrenia (COS), a rare yet severe form of schizophrenia with an onset before the age of 13 years, have shown continuity with adult onset schizophrenia. Previous research in adult patients has shown reduced sleep spindle activity, transient oscillations in the sleep electroencephalogram (EEG) generated through thalamocortical loops. The current study examines sleep spindle activity in patients with COS. Seventeen children and adolescents with COS (16 years ±6.6) underwent overnight sleep EEG recordings. Sleep spindle activity was compared between patients with COS and age and gender matched controls and correlated with clinical symptom severity. We found pronounced deficits in sleep spindle amplitude, duration, density and frequency in patients with COS (effect size = 0.61 to 1.96; dependent on metric and EEG derivation). Non-rapid eye movement (NREM) sleep EEG power and coherence in the sigma band (11-16 Hz) corresponding to spindle activity were also markedly diminished in patients with COS as compared to controls. Furthermore, the degree of deficit in power and coherence of spindles was strongly associated with clinician rated hallucinations and positive symptoms over widespread cortical regions. Our finding of diminished spindle activity and its association with hallucinations likely reflect dysfunction of the thalamocortical circuits in children and adolescents with COS. Given the relative ease of sleep EEG recordings in vulnerable populations, this study highlights the potential of such recordings to characterize brain function in schizophrenia.
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Affiliation(s)
- Andjela Markovic
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Switzerland; Graduate School for Health Sciences, University of Bern, Switzerland
| | - Ashura Buckley
- National Institute of Mental Health, National Institutes of Health, Bethesda, MD, United States of America
| | - David I Driver
- National Institute of Mental Health, National Institutes of Health, Bethesda, MD, United States of America
| | - Diane Dillard-Broadnax
- National Institute of Mental Health, National Institutes of Health, Bethesda, MD, United States of America
| | - Peter A Gochman
- National Institute of Mental Health, National Institutes of Health, Bethesda, MD, United States of America
| | - Kerstin Hoedlmoser
- Laboratory for Sleep, Cognition and Consciousness Research, Department of Psychology, Centre for Cognitive Neuroscience, University of Salzburg, Austria
| | - Judith L Rapoport
- National Institute of Mental Health, National Institutes of Health, Bethesda, MD, United States of America
| | - Leila Tarokh
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Switzerland.
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41
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Sleep-related memory consolidation in the psychosis spectrum phenotype. Neurobiol Learn Mem 2020; 174:107273. [PMID: 32659349 DOI: 10.1016/j.nlm.2020.107273] [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] [Received: 01/29/2020] [Revised: 05/19/2020] [Accepted: 07/03/2020] [Indexed: 11/23/2022]
Abstract
Sleep and memory processing impairments range from mild to severe in the psychosis spectrum. Relationships between memory processing and sleep characteristics have been described for schizophrenia, including unaffected first-degree relatives, but they are less clear across other high-risk groups within the psychosis spectrum. In this study, we investigated high-risk individuals with accumulated risk-factors for psychosis and subthreshold symptoms. Out of 1898 screened individuals, 44 age- and sex-matched participants were sub-grouped into those with substantial environmental risk factors for psychosis and subthreshold psychotic symptoms (high-risk group) and those without these phenotypes (low-risk controls). Four groups (high/low risk, morning/evening training) were trained and tested in the laboratory for sustained attention, motor skill memory (finger-tapping task) and declarative memory (word-pair learning task) immediately after training, again after a night of EEG-recorded sleep at home or a period of daytime wakefulness, and again after 24 h from training. No differences in sustained attention or in memory consolidation of declarative and motor skill memory were found between groups for any time period tested. However, a group difference was found for rapid-eye movement (REM) sleep in relation to motor skill memory: the longer the total sleep time, particularly longer REM sleep, the greater the performance gain, which occurred only in high-risk individuals. In conclusion, our results suggest a gain in motor skill performance with sufficient sleep opportunity for longer REM sleep in high-risk individuals with subthreshold psychotic symptoms. Declarative memory did not benefit from sleep consolidation above or beyond that of the control group.
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Zhang Y, Quiñones GM, Ferrarelli F. Sleep spindle and slow wave abnormalities in schizophrenia and other psychotic disorders: Recent findings and future directions. Schizophr Res 2020; 221:29-36. [PMID: 31753592 PMCID: PMC7231641 DOI: 10.1016/j.schres.2019.11.002] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2019] [Revised: 10/31/2019] [Accepted: 11/03/2019] [Indexed: 12/27/2022]
Abstract
Sleep spindles and slow waves are the two main oscillatory activities occurring during NREM sleep. Slow waves are ∼1 Hz, high amplitude, negative-positive deflections that are primarily generated and coordinated within the cortex, whereas sleep spindles are 12-16 Hz, waxing and waning oscillations that are initiated within the thalamus and regulated by thalamo-cortical circuits. In healthy subjects, these oscillations are thought to be responsible for the restorative aspects of sleep and have been increasingly shown to be involved in learning, memory and plasticity. Furthermore, deficits in sleep spindles and, to lesser extent, slow waves have been reported in both chronic schizophrenia (SCZ) and early course psychosis patients. In this article, we will first describe sleep spindle and slow wave characteristics, including their putative functional roles in the healthy brain. We will then review electrophysiological, genetic, and cognitive studies demonstrating spindle and slow wave impairments in SCZ and other psychotic disorders, with particularly emphasis on recent findings in early course patients. Finally, we will discuss how future work, including sleep studies in individuals at clinical high risk for psychosis, may help position spindles and slow waves as candidate biomarkers, as well as novel treatment targets, for SCZ and related psychotic disorders.
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Affiliation(s)
- Yingyi Zhang
- Department of Psychiatry, University of Pittsburgh, USA
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Fröhlich F, Lustenberger C. Neuromodulation of sleep rhythms in schizophrenia: Towards the rational design of non-invasive brain stimulation. Schizophr Res 2020; 221:71-80. [PMID: 32354662 PMCID: PMC7316586 DOI: 10.1016/j.schres.2020.04.003] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2019] [Revised: 04/01/2020] [Accepted: 04/03/2020] [Indexed: 02/01/2023]
Abstract
Brain function critically depends on oscillatory synchronization of neuronal populations both during wake and sleep. Originally, neural oscillations have been discounted as an epiphenomenon. More recently, specific deficits in the structure of brain oscillations have been linked to psychiatric diseases. For example, schizophrenia is hallmarked by abnormalities in different brain oscillations. Key sleep rhythms during NEM sleep such as sleep spindles, which are implicated in memory consolidation and are related to cognitive functions, are strongly diminished in these patients compared to healthy controls. To date, it remains unclear whether these reductions in sleep oscillations are causal for the functional impairments observed in schizophrenia. The application of non-invasive brain stimulation permits the causal examination of brain network dynamics and will help to establish the causal association of sleep oscillations and symptoms of schizophrenia. To accomplish this, stimulation paradigms that selectively engage specific network targets such as sleep spindles or slow waves are needed. We propose that the successful development and application of these non-invasive brain stimulation approaches will require rational design that takes network dynamics and neuroanatomical information into account. The purpose of this article is to prepare the grounds for the next steps towards such rational design of non-invasive stimulation, with a special focus on electrical and auditory stimulation. First, we briefly summarize the deficits in network dynamics during sleep in schizophrenia. Then, we discuss today's and tomorrow's non-invasive brain stimulation modalities to engage these network targets.
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Affiliation(s)
- Flavio Fröhlich
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; Carolina Center for Neurostimulation, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; Department of Cell Biology and Physiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; Neuroscience Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; Department of Neurology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; Department of Biomedical Engineering, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
| | - Caroline Lustenberger
- Neural Control of Movement Lab, Institute of Movement Sciences and Sport, Department of Health Sciences and Technology, ETH Zurich, 8092 Zurich, Switzerland.
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Gerstenberg M, Furrer M, Tesler N, Franscini M, Walitza S, Huber R. Reduced sleep spindle density in adolescent patients with early-onset schizophrenia compared to major depressive disorder and healthy controls. Schizophr Res 2020; 221:20-28. [PMID: 31924372 DOI: 10.1016/j.schres.2019.11.060] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2019] [Revised: 11/27/2019] [Accepted: 11/30/2019] [Indexed: 10/25/2022]
Abstract
OBJECTIVES During adolescence schizophrenia and major depressive disorder (MDD) increasingly emerge. Overlapping symptomatology during first presentation challenges the diagnostic process. Reduced sleep spindle density (SSD) was suggested as a biomarker in adults, discerning patients with schizophrenia from patients with depression or healthy controls (HC). We aimed to compare SSD in early-onset schizophrenia (EOS), with MDD, and HC, and to analyse associations of SSD with symptomatology and neurocognitive measures. METHODS Automatic sleep spindle detection was performed on all-night high-density EEG (128 electrodes) data of 12 EOS, 19 MDD, and 57 HC (age range 9.8-19), allowing an age- and sex-matching of 1:2 (patients vs. HC). Severity of current symptoms and neurocognitive variables were assessed in all patients. RESULTS SSD was defined between 13.75 and 14.50 Hz as within this frequency range SSD differed between EOS vs. HC in bin by bin analyses (12-15 Hz). In EOS, SSD was lower over 27 centro-temporal electrodes compared to HC and over 9 central electrodes compared to MDD. Reduced SSD in EOS compared to MDD and HC was accompanied by a high variability of SSD in all adolescents. SSD did not differ between MDD and HC. In the pooled sample of patients, lower SSD was associated with more severe Positive and Negative Symptoms Scale total score, more impaired memory consolidation and processing speed. CONCLUSION A high variability of SSD in all adolescents may reflect the evolving character of SSD. The association of reduced SSD with the symptom dimension of impaired cognition cuts across diagnostical entities.
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Affiliation(s)
- Miriam Gerstenberg
- Department of Child and Adolescent Psychiatry and Psychotherapy, Psychiatric University Hospital Zurich, Switzerland.
| | - Melanie Furrer
- Child Development Center, University Children's Hospital Zurich, Zurich, Switzerland
| | - Noemi Tesler
- Child Development Center, University Children's Hospital Zurich, Zurich, Switzerland; Center for Integrative Human Physiology, University of Zurich, Zurich, Switzerland
| | - Maurizia Franscini
- Department of Child and Adolescent Psychiatry and Psychotherapy, Psychiatric University Hospital Zurich, Switzerland
| | - Susanne Walitza
- Department of Child and Adolescent Psychiatry and Psychotherapy, Psychiatric University Hospital Zurich, Switzerland; Center for Integrative Human Physiology, University of Zurich, Zurich, Switzerland; Neuroscience Center Zurich, University of Zurich, Zurich, Switzerland
| | - Reto Huber
- Department of Child and Adolescent Psychiatry and Psychotherapy, Psychiatric University Hospital Zurich, Switzerland; Child Development Center, University Children's Hospital Zurich, Zurich, Switzerland; Center for Integrative Human Physiology, University of Zurich, Zurich, Switzerland; Neuroscience Center Zurich, University of Zurich, Zurich, Switzerland
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Schäfer SK, Wirth BE, Staginnus M, Becker N, Michael T, Sopp MR. Sleep's impact on emotional recognition memory: A meta-analysis of whole-night, nap, and REM sleep effects. Sleep Med Rev 2020; 51:101280. [DOI: 10.1016/j.smrv.2020.101280] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2019] [Revised: 12/23/2019] [Accepted: 01/02/2020] [Indexed: 01/03/2023]
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Sleep spindles and psychopathology. Sleep Med 2020; 77:365-366. [PMID: 32564918 DOI: 10.1016/j.sleep.2020.05.003] [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: 11/24/2022]
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Markovic A, Buckley A, Driver DI, Dillard-Broadnax D, Gochman PA, Hoedlmoser K, Rapoport JL, Tarokh L. Sleep neurophysiology in childhood onset schizophrenia. J Sleep Res 2020; 30:e13039. [PMID: 32350968 DOI: 10.1111/jsr.13039] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2019] [Revised: 02/21/2020] [Accepted: 03/13/2020] [Indexed: 12/01/2022]
Abstract
Altered sleep neurophysiology has consistently been reported in adult patients with schizophrenia. Converging evidence suggests that childhood onset schizophrenia (COS), a rare but severe form of schizophrenia, is continuous with adult onset schizophrenia. The aim of the current study was to characterize sleep neurophysiology in COS. An overnight sleep electroencephalogram (EEG) was recorded in 17 children and adolescents with COS (16 years ± 6.6) and 17 age and gender-matched controls. Non-rapid eye movement (NREM) and rapid eye movement (REM) sleep EEG power and coherence for the frequency bands delta (1.6-4.8 Hz), theta (5-8.4 Hz), alpha (8.6-11 Hz), beta 1 (16.4-20.2 Hz) and beta 2 (20.4-24.2 Hz) were compared between COS patients and controls. COS patients exhibited significant and widespread deficits in beta power during NREM and REM sleep. With regard to coherence, we found increases in COS patients across brain regions, frequency bands and sleep states. This study demonstrates the utility of the sleep EEG for studying vulnerable populations and its potential to aid diagnosis.
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Affiliation(s)
- Andjela Markovic
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland.,Graduate School for Health Sciences, University of Bern, Bern, Switzerland
| | - Ashura Buckley
- National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland
| | - David I Driver
- Child Psychiatry Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland
| | - Diane Dillard-Broadnax
- Child Psychiatry Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland
| | - Peter A Gochman
- Child Psychiatry Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland
| | - Kerstin Hoedlmoser
- Laboratory for Sleep, Cognition and Consciousness Research, Department of Psychology, Centre for Cognitive Neuroscience, University of Salzburg, Salzburg, Austria
| | - Judith L Rapoport
- Child Psychiatry Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland
| | - Leila Tarokh
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
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Göder R, Bares S, Vogel C, Böttcher H, Drews HJ, Lechinger J, Jauch-Chara K, Weinhold S. Psychotic-like experiences in patients with insomnia or sleep apnea: associations with sleep parameters. Sleep Med 2020; 77:367-373. [PMID: 32819820 DOI: 10.1016/j.sleep.2020.04.015] [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] [Received: 02/28/2020] [Revised: 04/08/2020] [Accepted: 04/16/2020] [Indexed: 01/01/2023]
Abstract
OBJECTIVES There are strong links between sleep and psychotic-like experiences (PLE), such as magical ideations or persecutory ideas. Sleep disturbances seem to play an important role in the occurrence of such symptoms, but studies investigating PLE in patients with sleep disorders are lacking. METHODS We studied 24 subjects with insomnia disorder (41 ± 13 years) and 47 participants with obstructive sleep apnea (OSA, 47 ± 11 years) in the sleep laboratory and 33 healthy controls. Sleep in patients with sleep disorders was recorded and scored according to standard criteria of the American Academy of Sleep Medicine. PLE were measured by the Magical Ideation Scale (MIS, short form with 10 items) and by the Peters et al., Delusions Inventory (PDI, 21 items). Additionally, cognitive tests and further psychological self-rating tests such as the Beck Depression Inventory (BDI) and the Pittsburgh Sleep Quality Index (PSQI) were administered. RESULTS Patients with insomnia had significantly higher scores of magical and delusional ideations compared to healthy controls. Sleep apnea patients showed a tendency of a higher score of delusional beliefs in comparison to controls. Magical ideations in insomnia subjects were significantly negatively correlated with the number of sleep spindles. In a subgroup of insomnia patients without antidepressants, delusional beliefs were negatively associated with rapid eye movement (REM)-sleep. CONCLUSIONS As there are indications that diminutions of sleep spindles are a biomarker for dysfunctional thalamo-cortical circuits underlying the neuropathology of psychosis, we conclude that there might be a sub-group of insomnia patients with fewer sleep spindles which is more vulnerable to developing a psychotic disorder in the future.
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Affiliation(s)
- Robert Göder
- Department of Psychiatry and Psychotherapy, University Hospital Schleswig-Holstein, Kiel, Germany.
| | - Sarah Bares
- Department of Psychiatry and Psychotherapy, University Hospital Schleswig-Holstein, Kiel, Germany
| | - Charlotte Vogel
- Department of Psychiatry and Psychotherapy, University Hospital Schleswig-Holstein, Kiel, Germany
| | - Heidi Böttcher
- Department of Psychiatry and Psychotherapy, University Hospital Schleswig-Holstein, Kiel, Germany
| | - Henning Johannes Drews
- Department of Psychiatry and Psychotherapy, University Hospital Schleswig-Holstein, Kiel, Germany
| | - Julia Lechinger
- Department of Psychiatry and Psychotherapy, University Hospital Schleswig-Holstein, Kiel, Germany
| | - Kamila Jauch-Chara
- Department of Psychiatry and Psychotherapy, University Hospital Schleswig-Holstein, Kiel, Germany
| | - Sara Weinhold
- Department of Psychiatry and Psychotherapy, University Hospital Schleswig-Holstein, Kiel, Germany
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49
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Ghoshal A, Uygun DS, Yang L, McNally JM, Lopez-Huerta VG, Arias-Garcia MA, Baez-Nieto D, Allen A, Fitzgerald M, Choi S, Zhang Q, Hope JM, Yan K, Mao X, Nicholson TB, Imaizumi K, Fu Z, Feng G, Brown RE, Strecker RE, Purcell SM, Pan JQ. Effects of a patient-derived de novo coding alteration of CACNA1I in mice connect a schizophrenia risk gene with sleep spindle deficits. Transl Psychiatry 2020; 10:29. [PMID: 32066662 PMCID: PMC7026444 DOI: 10.1038/s41398-020-0685-1] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2019] [Revised: 10/25/2019] [Accepted: 11/06/2019] [Indexed: 11/09/2022] Open
Abstract
CACNA1I, a schizophrenia risk gene, encodes a subtype of voltage-gated T-type calcium channel CaV3.3. We previously reported that a patient-derived missense de novo mutation (R1346H) of CACNA1I impaired CaV3.3 channel function. Here, we generated CaV3.3-RH knock-in animals, along with mice lacking CaV3.3, to investigate the biological impact of R1346H (RH) variation. We found that RH mutation altered cellular excitability in the thalamic reticular nucleus (TRN), where CaV3.3 is abundantly expressed. Moreover, RH mutation produced marked deficits in sleep spindle occurrence and morphology throughout non-rapid eye movement (NREM) sleep, while CaV3.3 haploinsufficiency gave rise to largely normal spindles. Therefore, mice harboring the RH mutation provide a patient derived genetic model not only to dissect the spindle biology but also to evaluate the effects of pharmacological reagents in normalizing sleep spindle deficits. Importantly, our analyses highlighted the significance of characterizing individual spindles and strengthen the inferences we can make across species over sleep spindles. In conclusion, this study established a translational link between a genetic allele and spindle deficits during NREM observed in schizophrenia patients, representing a key step toward testing the hypothesis that normalizing spindles may be beneficial for schizophrenia patients.
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Affiliation(s)
- Ayan Ghoshal
- Stanley Center for Psychiatric Research, Broad Institute, Cambridge, MA USA
| | - David S. Uygun
- Department of Psychiatry, VA Boston Healthcare System & Harvard Medical School, Boston, MA USA
| | - Lingling Yang
- Stanley Center for Psychiatric Research, Broad Institute, Cambridge, MA USA
| | - James M. McNally
- Department of Psychiatry, VA Boston Healthcare System & Harvard Medical School, Boston, MA USA
| | - Violeta G. Lopez-Huerta
- Stanley Center for Psychiatric Research, Broad Institute, Cambridge, MA USA
- McGovern Institute for Brain Research, MIT, Cambridge, MA USA
- Present Address: Department of Neurodevelopment and Physiology, Institute of Cellular Physiology, National Autonomous University of Mexico, Mexico City, Mexico
| | - Mario A. Arias-Garcia
- Stanley Center for Psychiatric Research, Broad Institute, Cambridge, MA USA
- McGovern Institute for Brain Research, MIT, Cambridge, MA USA
- Present Address: Department of Neurodevelopment and Physiology, Institute of Cellular Physiology, National Autonomous University of Mexico, Mexico City, Mexico
| | - David Baez-Nieto
- Stanley Center for Psychiatric Research, Broad Institute, Cambridge, MA USA
| | - Andrew Allen
- Stanley Center for Psychiatric Research, Broad Institute, Cambridge, MA USA
| | - Megan Fitzgerald
- Stanley Center for Psychiatric Research, Broad Institute, Cambridge, MA USA
| | - Soonwook Choi
- Stanley Center for Psychiatric Research, Broad Institute, Cambridge, MA USA
- McGovern Institute for Brain Research, MIT, Cambridge, MA USA
| | - Qiangge Zhang
- McGovern Institute for Brain Research, MIT, Cambridge, MA USA
| | - Jen M. Hope
- Stanley Center for Psychiatric Research, Broad Institute, Cambridge, MA USA
| | - Karena Yan
- Stanley Center for Psychiatric Research, Broad Institute, Cambridge, MA USA
| | - Xiaohong Mao
- Novartis Institutes for BioMedical Research, 181 Mass Ave., Cambridge, MA 02139 USA
| | - Thomas B. Nicholson
- Novartis Institutes for BioMedical Research, 181 Mass Ave., Cambridge, MA 02139 USA
| | | | - Zhanyan Fu
- Stanley Center for Psychiatric Research, Broad Institute, Cambridge, MA USA
- McGovern Institute for Brain Research, MIT, Cambridge, MA USA
| | - Guoping Feng
- Stanley Center for Psychiatric Research, Broad Institute, Cambridge, MA USA
- McGovern Institute for Brain Research, MIT, Cambridge, MA USA
| | - Ritchie E. Brown
- Department of Psychiatry, VA Boston Healthcare System & Harvard Medical School, Boston, MA USA
| | - Robert E. Strecker
- Department of Psychiatry, VA Boston Healthcare System & Harvard Medical School, Boston, MA USA
| | - Shaun M. Purcell
- Brigham and Women’s Hospital, Harvard Medical School, Boston, MA USA
| | - Jen Q. Pan
- Stanley Center for Psychiatric Research, Broad Institute, Cambridge, MA USA
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50
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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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