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Pan Q, Li H, Gan X, Chen X, Liu X, Li J. Correlation between cognitive impairment and serum markers in patients with obstructive sleep apnea-hypopnea syndrome. Sleep Breath 2024; 28:683-690. [PMID: 37917283 DOI: 10.1007/s11325-023-02942-w] [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: 04/10/2023] [Revised: 10/05/2023] [Accepted: 10/18/2023] [Indexed: 11/04/2023]
Abstract
BACKGROUND Previous studies have revealed that sleep structure and hypoxemia are two important environmental factors for cognitive impairment in patients with obstructive sleep apnea-hypopnea syndrome (OSAHS). We hypothesized that the pathophysiological mechanisms between these two factors may also be involved in cognitive impairment in patients with OSAHS. Previous studies have suggested that alterations in serum glucose and lipid metabolism, inflammatory responses, and astrocyte markers not only contribute to sleep structural disorders in OSAHS but also affect the occurrence and development of this disease. Therefore, we hypothesized that alterations in the abovementioned indicators may be involved in cognitive impairment in OSAHS. Additionally, obesity is an important risk factor for OSAHS. This study therefore aimed to explore the correlation between serum indicators and cognitive impairment in patients with OSAHS. METHODS Patients with OSAHS who underwent polysomnography in our hospital were recruited in this study. The overall cognitive function of patients were evaluated using the Mini mental State Examination (MMSE). Blood biochemical indicators such as glucose (GLU), triglycerides (TG), and triglyceride glucose (TyG) index were measured. Enzyme-linked immunosorbent assay (ELISA) was used to determine the levels of serum glucagon-like peptide-1 receptor (GLP-1R), fibroblast growth factor 21 (FGF21), S100 calcium binding protein B (S100B), brain derived neurotrophic factor (BDNF), inflammatory factors such as C-reactive protein (CRP), tumor necrosis factor-α (TNFα), interleukin-4 (IL-4), interleukin-1β (IL-1β), and interleukin-6 (IL-6). Spearman correlation analysis was used to determine if the indicator was related to cognitive function, and backward linear regression analysis was used to identify the main risk factors for cognitive impairment in non-obese and obese patients with OSAHS. RESULTS Among 34 patients, 19 were non-obese and 15 were obese. Obese patients exhibited higher AHI compared to non-obese individuals, and the difference was statistically significant (p < 0.05). In non-obese patients, Spearman correlation analysis revealed a negative correlation between serum GLU, IL-4, and MMSE scores (p < 0.05); IL-6 was positively correlated with MMSE (p < 0.05). In addition, GLU and IL-6 were independently correlated with MMSE in non-obese patients (p < 0.05). In obese patients, serum TG and TyG were positively correlated with MMSE scores (p < 0.05); age, BMI, and IL-4 were negatively correlated with MMSE scores (p < 0.05). In addition, age and IL-4 were independently correlated with MMSE in obese patients (p < 0.05). CONCLUSIONS Our data suggested that GLU and IL-6 were independently correlated with cognitive impairment in non-obese patients with OSAHS; age and IL-4 were independently correlated with cognitive impairment in obese patients. Early detection of this difference in heterogeneity may provide theoretical support for future investigations in prevention and treatment of cognitive impairment in patients with OSAHS.
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Affiliation(s)
- Qiyuan Pan
- Department of Neurology, The First People's Hospital of Zaoyang City, Zaoyang, 441200, Hubei Province, China
| | - Hanqing Li
- Department of Stomatology, The First People's Hospital of Zaoyang City, Zaoyang, 441200, Hubei Province, China
| | - Xieyu Gan
- Department of Neurology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, 400010, China
| | - Xin Chen
- Department of Neurology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, 400010, China
| | - Xirui Liu
- Department of Neurology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, 400010, China
| | - Jinfang Li
- Department of Neurology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, 400010, China.
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Sochal M, Binienda A, Tarasiuk A, Gabryelska A, Białasiewicz P, Ditmer M, Turkiewicz S, Karuga FF, Fichna J, Wysokiński A. The Relationship between Sleep Parameters Measured by Polysomnography and Selected Neurotrophic Factors. J Clin Med 2024; 13:893. [PMID: 38337587 PMCID: PMC10856018 DOI: 10.3390/jcm13030893] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2024] [Revised: 01/24/2024] [Accepted: 02/01/2024] [Indexed: 02/12/2024] Open
Abstract
BACKGROUND The molecular underpinnings of insufficient sleep remain underexplored, with disruptions in the neurotrophic signaling pathway emerging as a potential explanation. Neurotrophins (NTs), including brain-derived neurotrophic factor (BDNF), neurotrophin-3 (NT3), neurotrophin 4 (NT4), and glial-cell-line-derived growth factor (GDNF), play crucial roles in nerve cell growth and repair. However, their associations with sleep patterns are poorly understood. This study aimed to investigate the relationship between the chosen neurotrophins and objective sleep parameters. METHODS The study involved 81 participants subjected to polysomnography (PSG). Blood samples were collected after PSG. The mRNA expression and serum protein concentrations of BDNF, GDNF, NT3, and NT4 were measured using real-time quantitative reverse-transcription PCR (qRT-PCR) or enzyme-linked immunosorbent assay (ELISA) methods, respectively. RESULTS BDNF and NT3 proteins were negatively correlated with NREM events, while NT4 protein positively correlated with REM events. Electroencephalography power analysis revealed BDNF protein's negative correlation with delta waves during rapid eye movement and non-rapid eye movement sleep. CONCLUSION The study highlights associations between neurotrophins and sleep, emphasizing BDNF's role in regulating NREM and REM sleep. The EEG power analysis implicated BDNF in delta wave modulation, shedding light on potential neurotrophic mechanisms underlying sleep effects on cognitive and mood processes.
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Affiliation(s)
- Marcin Sochal
- Department of Sleep Medicine and Metabolic Disorders, Medical University of Lodz, 90-419 Lodz, Poland; (A.G.); (P.B.); (S.T.); (F.F.K.)
| | - Agata Binienda
- Department of Biochemistry, Medical University of Lodz, 92-215 Lodz, Poland; (A.B.); (A.T.); (J.F.)
| | - Aleksandra Tarasiuk
- Department of Biochemistry, Medical University of Lodz, 92-215 Lodz, Poland; (A.B.); (A.T.); (J.F.)
| | - Agata Gabryelska
- Department of Sleep Medicine and Metabolic Disorders, Medical University of Lodz, 90-419 Lodz, Poland; (A.G.); (P.B.); (S.T.); (F.F.K.)
| | - Piotr Białasiewicz
- Department of Sleep Medicine and Metabolic Disorders, Medical University of Lodz, 90-419 Lodz, Poland; (A.G.); (P.B.); (S.T.); (F.F.K.)
| | - Marta Ditmer
- Department of Sleep Medicine and Metabolic Disorders, Medical University of Lodz, 90-419 Lodz, Poland; (A.G.); (P.B.); (S.T.); (F.F.K.)
| | - Szymon Turkiewicz
- Department of Sleep Medicine and Metabolic Disorders, Medical University of Lodz, 90-419 Lodz, Poland; (A.G.); (P.B.); (S.T.); (F.F.K.)
| | - Filip Franciszek Karuga
- Department of Sleep Medicine and Metabolic Disorders, Medical University of Lodz, 90-419 Lodz, Poland; (A.G.); (P.B.); (S.T.); (F.F.K.)
| | - Jakub Fichna
- Department of Biochemistry, Medical University of Lodz, 92-215 Lodz, Poland; (A.B.); (A.T.); (J.F.)
| | - Adam Wysokiński
- Department of Old Age Psychiatry and Psychotic Disorders, Medical University of Lodz, 92-216 Lodz, Poland;
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Gabryelska A, Turkiewicz S, Ditmer M, Gajewski A, Białasiewicz P, Strzelecki D, Chałubiński M, Sochal M. Evaluation of the Continuous Positive Airway Pressure Effect on Neurotrophins' Gene Expression and Protein Levels. Int J Mol Sci 2023; 24:16599. [PMID: 38068919 PMCID: PMC10706617 DOI: 10.3390/ijms242316599] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2023] [Revised: 11/18/2023] [Accepted: 11/20/2023] [Indexed: 12/18/2023] Open
Abstract
Neurotrophins (NT) might be associated with the pathophysiology of obstructive sleep apnea (OSA) due to concurrent intermittent hypoxia and sleep fragmentation. Such a relationship could have implications for the health and overall well-being of patients; however, the literature on this subject is sparse. This study investigated the alterations in the serum protein concentration and the mRNA expression of the brain-derived neurotrophic factor (BDNF), glial cell line-derived neurotrophic factor (GDNF), neurotrophin-3 (NTF3), and neurotrophin-4 (NTF4) proteins following a single night of continuous positive airway pressure (CPAP) therapy. This study group consisted of 30 patients with OSA. Venous blood was collected twice after a diagnostic polysomnography (PSG) and PSG with CPAP treatment. Gene expression was assessed with a quantitative real-time polymerase chain reaction. An enzyme-linked immunosorbent assay was used to determine the protein concentrations. After CPAP treatment, BDNF, proBDNF, GDNF, and NTF4 protein levels decreased (p = 0.002, p = 0.003, p = 0.047, and p = 0.009, respectively), while NTF3 increased (p = 0.001). Sleep latency was correlated with ΔPSG + CPAP/PSG gene expression for BDNF (R = 0.387, p = 0.038), NTF3 (R = 0.440, p = 0.019), and NTF4 (R = 0.424, p = 0.025). OSA severity parameters were not associated with protein levels or gene expressions. CPAP therapy could have an impact on the posttranscriptional stages of NT synthesis. The expression of different NTs appears to be connected with sleep architecture but not with OSA severity.
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Affiliation(s)
- Agata Gabryelska
- Department of Sleep Medicine and Metabolic Disorders, Medical University of Lodz, 90-419 Lodz, Poland
| | - Szymon Turkiewicz
- Department of Sleep Medicine and Metabolic Disorders, Medical University of Lodz, 90-419 Lodz, Poland
| | - Marta Ditmer
- Department of Sleep Medicine and Metabolic Disorders, Medical University of Lodz, 90-419 Lodz, Poland
| | - Adrian Gajewski
- Department of Immunology and Allergy, Medical University of Lodz, 90-419 Lodz, Poland
| | - Piotr Białasiewicz
- Department of Sleep Medicine and Metabolic Disorders, Medical University of Lodz, 90-419 Lodz, Poland
| | - Dominik Strzelecki
- Department of Affective and Psychotic Disorders, Medical University of Lodz, 90-419 Lodz, Poland
| | - Maciej Chałubiński
- Department of Immunology and Allergy, Medical University of Lodz, 90-419 Lodz, Poland
| | - Marcin Sochal
- Department of Sleep Medicine and Metabolic Disorders, Medical University of Lodz, 90-419 Lodz, Poland
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Yeo BSY, Koh JH, Ng ACW, Loh S, See A, Seow DCC, Toh ST. The association of obstructive sleep apnea with blood and cerebrospinal fluid biomarkers of Alzheimer's dementia - A systematic review and meta-analysis. Sleep Med Rev 2023; 70:101790. [PMID: 37245474 DOI: 10.1016/j.smrv.2023.101790] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Revised: 04/19/2023] [Accepted: 05/07/2023] [Indexed: 05/30/2023]
Abstract
Alzheimer's disease (AD) is the most common type of dementia and is characterized by the aggregation of extracellular amyloid-beta and intracellular hyperphosphorylation of tau proteins. Obstructive Sleep Apnea (OSA) is associated with increased AD risk. We hypothesize that OSA is associated with higher levels of AD biomarkers. The study aims to conduct a systematic review and meta-analysis of the association between OSA and levels of blood and cerebrospinal fluid biomarkers of AD. Two authors independently searched PubMed, Embase, and Cochrane Library for studies comparing blood and cerebrospinal fluid levels of dementia biomarkers between patients with OSA and healthy controls. Meta-analyses of the standardized mean difference were conducted using random-effects models. From 18 studies with 2804 patients, meta-analysis found that cerebrospinal fluid amyloid beta-40 (SMD:-1.13, 95%CI:-1.65 to -0.60), blood total amyloid beta (SMD:0.68, 95%CI: 0.40 to 0.96), blood amyloid beta-40 (SMD:0.60, 95%CI: 0.35 to 0.85), blood amyloid beta-42 (SMD:0.80, 95%CI: 0.38 to 1.23) and blood total-tau (SMD: 0.664, 95% CI: 0.257 to 1.072, I2 = 82, p<0.01, 7 studies) were significantly higher in OSA patients compared with healthy controls. These findings suggest that OSA is associated with an elevation of some biomarkers of AD.
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Affiliation(s)
- Brian Sheng Yep Yeo
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Jin Hean Koh
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Adele Chin Wei Ng
- Department of Otorhinolaryngology-Head and Neck Surgery, Singapore General Hospital, Singapore
| | - Shaun Loh
- Department of Otorhinolaryngology-Head and Neck Surgery, Singapore General Hospital, Singapore; SingHealth Duke-NUS Sleep Centre, Singapore
| | - Anna See
- Department of Otorhinolaryngology-Head and Neck Surgery, Singapore General Hospital, Singapore; SingHealth Duke-NUS Sleep Centre, Singapore
| | - Dennis Chuen Chai Seow
- Department of Geriatric Medicine, Singapore General Hospital, Singapore; SingHealth Duke-NUS Centre of Memory and Cognitive Disorders, Singapore
| | - Song Tar Toh
- Department of Otorhinolaryngology-Head and Neck Surgery, Singapore General Hospital, Singapore; SingHealth Duke-NUS Sleep Centre, Singapore.
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Molecular Pathology, Oxidative Stress, and Biomarkers in Obstructive Sleep Apnea. Int J Mol Sci 2023; 24:ijms24065478. [PMID: 36982552 PMCID: PMC10058074 DOI: 10.3390/ijms24065478] [Citation(s) in RCA: 19] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2023] [Revised: 03/06/2023] [Accepted: 03/10/2023] [Indexed: 03/18/2023] Open
Abstract
Obstructive sleep apnea syndrome (OSAS) is characterized by intermittent hypoxia (IH) during sleep due to recurrent upper airway obstruction. The derived oxidative stress (OS) leads to complications that do not only concern the sleep-wake rhythm but also systemic dysfunctions. The aim of this narrative literature review is to investigate molecular alterations, diagnostic markers, and potential medical therapies for OSAS. We analyzed the literature and synthesized the evidence collected. IH increases oxygen free radicals (ROS) and reduces antioxidant capacities. OS and metabolic alterations lead OSAS patients to undergo endothelial dysfunction, osteoporosis, systemic inflammation, increased cardiovascular risk, pulmonary remodeling, and neurological alterations. We treated molecular alterations known to date as useful for understanding the pathogenetic mechanisms and for their potential application as diagnostic markers. The most promising pharmacological therapies are those based on N-acetylcysteine (NAC), Vitamin C, Leptin, Dronabinol, or Atomoxetine + Oxybutynin, but all require further experimentation. CPAP remains the approved therapy capable of reversing most of the known molecular alterations; future drugs may be useful in treating the remaining dysfunctions.
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Gabryelska A, Turkiewicz S, Ditmer M, Sochal M. Neurotrophins in the Neuropathophysiology, Course, and Complications of Obstructive Sleep Apnea-A Narrative Review. Int J Mol Sci 2023; 24:ijms24031808. [PMID: 36768132 PMCID: PMC9916304 DOI: 10.3390/ijms24031808] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2022] [Revised: 12/04/2022] [Accepted: 01/11/2023] [Indexed: 01/18/2023] Open
Abstract
Obstructive sleep apnea (OSA) is a disorder characterized by chronic intermittent hypoxia and sleep fragmentation due to recurring airway collapse during sleep. It is highly prevalent in modern societies, and due to its pleiotropic influence on the organism and numerous sequelae, it burdens patients and physicians. Neurotrophins (NTs), proteins that modulate the functioning and development of the central nervous system, such as brain-derived neurotrophic factor (BDNF), have been associated with OSA, primarily due to their probable involvement in offsetting the decline in cognitive functions which accompanies OSA. However, NTs influence multiple aspects of biological functioning, such as immunity. Thus, extensive evaluation of their role in OSA might enlighten the mechanism behind some of its elusive features, such as the increased risk of developing an immune-mediated disease or the association of OSA with cardiovascular diseases. In this review, we examine the interactions between NTs and OSA and discuss their contribution to OSA pathophysiology, complications, as well as comorbidities.
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Jiang Y, Yue R, Liu G, Liu J, Peng B, Yang M, Zhao L, Li Z. Garlic ( Allium sativum L.) in diabetes and its complications: Recent advances in mechanisms of action. Crit Rev Food Sci Nutr 2022; 64:5290-5340. [PMID: 36503329 DOI: 10.1080/10408398.2022.2153793] [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] [Indexed: 12/14/2022]
Abstract
Diabetes mellitus (DM) is a metabolic disease characterized by chronic hyperglycemia and impaired islet secretion that places a heavy burden on the global health care system due to its high incidence rate, long disease course and many complications. Fortunately, garlic (Allium sativum L.), a well-known medicinal plant and functional food without the toxicity and side effects of conventional drugs, has shown positive effects in the treatment of diabetes and its complications. With interdisciplinary development and in-depth exploration, we offer a clear and comprehensive summary of the research from the past ten years, focusing on the mechanisms and development processes of garlic in the treatment of diabetes and its complications, aiming to provide a new perspective for the treatment of diabetes and promote the efficient development of this field.
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Affiliation(s)
- Yayi Jiang
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Rensong Yue
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Guojie Liu
- School of Chemical Engineering, Sichuan University, Chengdu, China
| | - Jun Liu
- People's Hospital of NanJiang, Bazhong, China
| | - Bo Peng
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Maoyi Yang
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Lianxue Zhao
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Zihan Li
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
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Khalaji A, Behnoush AH, Shobeiri P, Saeedian B, Teixeira AL, Rezaei N. Association between brain-derived neurotrophic factor levels and obstructive sleep apnea: a systematic review and meta-analysis. Sleep Breath 2022; 27:829-841. [DOI: 10.1007/s11325-022-02707-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Revised: 08/31/2022] [Accepted: 09/09/2022] [Indexed: 11/30/2022]
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Feng Y, Ma L, Chen X, Zhang Y, Cao Z, Yuan Y, Xie Y, Liu H, Shi Y, Ren X. Relationship between serum brain-derived neurotrophic factor and cognitive impairment in children with sleep-disordered breathing. Front Pediatr 2022; 10:1027894. [PMID: 36683819 PMCID: PMC9849753 DOI: 10.3389/fped.2022.1027894] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Accepted: 12/09/2022] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND As an important neuroprotective factor, the brain-derived neurotrophic factor (BDNF) may have a key role in cognitive impairment in children with sleep-disordered breathing (SDB). The main aim of this study was to compare the levels of BDNF and tyrosine kinase receptor B (TrkB) in normal children and those with obstructive sleep apnea (OSA) and primary snoring (PS) and to explore a possible link between BDNF/TrkB, inflammation, and SDB with cognitive impairment in children. METHODS A total of 44 OSA children and 35 PS children who completed polysomnography between October 2017 and October 2019 were enrolled. At the same time, 40 healthy children during the same period were included as a control. Enzyme-linked immunosorbent assay was used to measure serum indices of BDNF, TrkB, interleukin-1beta (IL-1β), and tumor necrosis factor-alpha (TNF-α). Correlation and pooled analyses were performed between the cognitive scores and four serological indicators. Logistic regression was used to analyze the risk factors for cognitive impairment. RESULTS Significant differences were found in serum BDNF, TrkB, IL-1β, and TNF-α between the three groups (all P < 0.01). The serum BDNF and TrkB in the OSA and PS groups were lower than those in the control group, whereas the serum IL-1β and TNF-α were higher than those in the control group (all P < 0.05). Moreover, among these four indices, the strongest correlation was found between BDNF and the Chinese Wechsler Intelligence Scale (all P < 0.05). Logistic regression analysis revealed a correlation between OSA status, TrkB, and course of mouth breathing and cognitive status. CONCLUSION The levels of serum BDNF and TrkB were related to cognitive impairment in children with SDB. Also, BDNF and TrkB could be used as noninvasive and objective candidate markers and predictive indices of cognitive impairment in children with SDB.
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Affiliation(s)
- Yani Feng
- Department of Otorhinolaryngology Head and Neck Surgery, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Lina Ma
- Department of Otorhinolaryngology Head and Neck Surgery, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Xi Chen
- Department of Otorhinolaryngology Head and Neck Surgery, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Yitong Zhang
- Department of Otorhinolaryngology Head and Neck Surgery, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Zine Cao
- Department of Otorhinolaryngology Head and Neck Surgery, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Yuqi Yuan
- Department of Otorhinolaryngology Head and Neck Surgery, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Yushan Xie
- Department of Otorhinolaryngology Head and Neck Surgery, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Haiqin Liu
- Department of Otorhinolaryngology Head and Neck Surgery, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Yewen Shi
- Department of Otorhinolaryngology Head and Neck Surgery, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Xiaoyong Ren
- Department of Otorhinolaryngology Head and Neck Surgery, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
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Pollicina I, Maniaci A, Lechien JR, Iannella G, Vicini C, Cammaroto G, Cannavicci A, Magliulo G, Pace A, Cocuzza S, Di Luca M, Stilo G, Di Mauro P, Bianco MR, Murabito P, Bannò V, La Mantia I. Neurocognitive Performance Improvement after Obstructive Sleep Apnea Treatment: State of the Art. Behav Sci (Basel) 2021; 11:bs11120180. [PMID: 34940115 PMCID: PMC8698492 DOI: 10.3390/bs11120180] [Citation(s) in RCA: 37] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Revised: 12/08/2021] [Accepted: 12/08/2021] [Indexed: 12/16/2022] Open
Abstract
Background: Obstructive Sleep Apnea (OSA) syndrome is a respiratory sleep disorder characterized by partial or complete episodes of upper airway collapse with reduction or complete cessation of airflow. Although the connection remains debated, several mechanisms such as intermittent hypoxemia, sleep deprivation, hypercapnia disruption of the hypothalamic–pituitary–adrenal axis have been associated with poor neurocognitive performance. Different treatments have been proposed to treat OSAS patients as continuous positive airway pressure (CPAP), mandibular advancement devices (MAD), surgery; however, the effect on neurocognitive functions is still debated. This article presents the effect of OSAS treatments on neurocognitive performance by reviewing the literature. Methods: We performed a comprehensive review of the English language over the past 20 years using the following keywords: neurocognitive performance and sleep apnea, neurocognitive improvement and CPAP, OSAS, and cognitive dysfunction. We included in the analysis papers that correlated OSA treatment with neurocognitive performance improvement. All validated tests used to measure different neurocognitive performance improvements were considered. Results: Seventy papers reported neurocognitive Performance improvement in OSA patients after CPAP therapy. Eighty percent of studies found improved executive functions such as verbal fluency or working memory, with partial neural recovery at long-term follow-up. One article compared the effect of MAD, CPAP treatment on cognitive disorders, reporting better improvement of CPAP and MAD than placebo in cognitive function. Conclusions: CPAP treatment seems to improve cognitive defects associated with OSA. Limited studies have evaluated the effects of the other therapies on cognitive function.
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Affiliation(s)
- Isabella Pollicina
- Department of Medical and Surgical Sciences and Advanced Technologies “GF Ingrassia”, ENT Section, University of Catania, 95123 Catania, Italy; (I.P.); antonino.maniaciphd.unict.it (A.M); (S.C.); (M.D.L.); (G.S.); (P.D.M.); (V.B.); (I.L.M.)
| | - Antonino Maniaci
- Department of Human Anatomy and Experimental Oncology, Faculty of Medicine, UMONS Research Institute for Health Sciences and Technology, University of Mons (UMons), 7000 Mons, Belgium; (A.M.); (J.R.L.)
| | - Jerome R. Lechien
- Department of Human Anatomy and Experimental Oncology, Faculty of Medicine, UMONS Research Institute for Health Sciences and Technology, University of Mons (UMons), 7000 Mons, Belgium; (A.M.); (J.R.L.)
- Department of Otorhinolaryngology and Head and Neck Surgery, Foch Hospital, School of Medicine, UFRSimone Veil, Université Versailles Saint-Quentin-en-Yvelines (Paris Saclay University), 91190 Paris, France
- Department of Otorhinolaryngology and Head and Neck Surgery, CHU de Bruxelles, CHU Saint-Pierre, School of Medicine, Université Libre de Bruxelles, 1050 Brussels, Belgium
| | - Giannicola Iannella
- Oral Surgery Unit, Department of Head-Neck Surgery, Otolaryngology, Head-Neck, Morgagni Pierantoni Hospital, 47121 Forli, Italy; (C.V.); (G.C.); (A.C.); (G.M.)
- Department of “Organi di Senso”, University “Sapienza”, 00185 Rome, Italy;
- Correspondence:
| | - Claudio Vicini
- Oral Surgery Unit, Department of Head-Neck Surgery, Otolaryngology, Head-Neck, Morgagni Pierantoni Hospital, 47121 Forli, Italy; (C.V.); (G.C.); (A.C.); (G.M.)
| | - Giovanni Cammaroto
- Oral Surgery Unit, Department of Head-Neck Surgery, Otolaryngology, Head-Neck, Morgagni Pierantoni Hospital, 47121 Forli, Italy; (C.V.); (G.C.); (A.C.); (G.M.)
| | - Angelo Cannavicci
- Oral Surgery Unit, Department of Head-Neck Surgery, Otolaryngology, Head-Neck, Morgagni Pierantoni Hospital, 47121 Forli, Italy; (C.V.); (G.C.); (A.C.); (G.M.)
| | - Giuseppe Magliulo
- Oral Surgery Unit, Department of Head-Neck Surgery, Otolaryngology, Head-Neck, Morgagni Pierantoni Hospital, 47121 Forli, Italy; (C.V.); (G.C.); (A.C.); (G.M.)
| | - Annalisa Pace
- Department of “Organi di Senso”, University “Sapienza”, 00185 Rome, Italy;
| | - Salvatore Cocuzza
- Department of Medical and Surgical Sciences and Advanced Technologies “GF Ingrassia”, ENT Section, University of Catania, 95123 Catania, Italy; (I.P.); antonino.maniaciphd.unict.it (A.M); (S.C.); (M.D.L.); (G.S.); (P.D.M.); (V.B.); (I.L.M.)
| | - Milena Di Luca
- Department of Medical and Surgical Sciences and Advanced Technologies “GF Ingrassia”, ENT Section, University of Catania, 95123 Catania, Italy; (I.P.); antonino.maniaciphd.unict.it (A.M); (S.C.); (M.D.L.); (G.S.); (P.D.M.); (V.B.); (I.L.M.)
| | - Giovanna Stilo
- Department of Medical and Surgical Sciences and Advanced Technologies “GF Ingrassia”, ENT Section, University of Catania, 95123 Catania, Italy; (I.P.); antonino.maniaciphd.unict.it (A.M); (S.C.); (M.D.L.); (G.S.); (P.D.M.); (V.B.); (I.L.M.)
| | - Paola Di Mauro
- Department of Medical and Surgical Sciences and Advanced Technologies “GF Ingrassia”, ENT Section, University of Catania, 95123 Catania, Italy; (I.P.); antonino.maniaciphd.unict.it (A.M); (S.C.); (M.D.L.); (G.S.); (P.D.M.); (V.B.); (I.L.M.)
| | - Maria Rita Bianco
- Otolaryngology, Department of Health Science, University Magna Graecia of Catanzaro, Viale Europa, Germaneto, 88100 Catanzaro, Italy;
| | - Paolo Murabito
- Department of Surgery and Medical and Surgical Specialties—Section of Anaesthesiology and Intensive Care, University of Catania (Italy), 95123 Catania, Italy;
| | - Vittoria Bannò
- Department of Medical and Surgical Sciences and Advanced Technologies “GF Ingrassia”, ENT Section, University of Catania, 95123 Catania, Italy; (I.P.); antonino.maniaciphd.unict.it (A.M); (S.C.); (M.D.L.); (G.S.); (P.D.M.); (V.B.); (I.L.M.)
| | - Ignazio La Mantia
- Department of Medical and Surgical Sciences and Advanced Technologies “GF Ingrassia”, ENT Section, University of Catania, 95123 Catania, Italy; (I.P.); antonino.maniaciphd.unict.it (A.M); (S.C.); (M.D.L.); (G.S.); (P.D.M.); (V.B.); (I.L.M.)
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11
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Piotrowicz Z, Chalimoniuk M, Płoszczyca K, Czuba M, Langfort J. Exercise-Induced Elevated BDNF Level Does Not Prevent Cognitive Impairment Due to Acute Exposure to Moderate Hypoxia in Well-Trained Athletes. Int J Mol Sci 2020; 21:ijms21155569. [PMID: 32759658 PMCID: PMC7432544 DOI: 10.3390/ijms21155569] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Revised: 07/30/2020] [Accepted: 07/31/2020] [Indexed: 12/12/2022] Open
Abstract
Exposure to acute hypoxia causes a detrimental effect on the brain which is also manifested by a decrease in the ability to perform psychomotor tasks. Conversely, brain-derived neurotrophic factor (BDNF), whose levels are elevated in response to exercise, is a well-known factor in improving cognitive function. Therefore, the aim of our study was to investigate whether the exercise under hypoxic conditions affects psychomotor performance. For this purpose, 11 healthy young athletes performed a graded cycloergometer exercise test to volitional exhaustion under normoxia and acute mild hypoxia (FiO2 = 14.7%). Before, immediately after exercise and after a period of recovery, choice reaction time (CRT) and number of correct reactions (NCR) in relation to changes in serum BDNF were examined. Additionally, other selected factors which may modify BDNF production, i.e., cortisol (C), nitrite, catecholamines (adrenalin-A, noradrenaline-NA, dopamine-DA, serotonin-5-HT) and endothelin-1 (ET-1), were also measured. Exercise in hypoxic conditions extended CRT by 13.8% (p < 0.01) and decreased NCR (by 11.5%) compared to rest (p < 0.05). During maximal workload, NCR was lower by 9% in hypoxia compared to normoxia (p < 0.05). BDNF increased immediately after exercise in normoxia (by 29.3%; p < 0.01), as well as in hypoxia (by 50.0%; p < 0.001). There were no differences in BDNF between normoxia and hypoxia. Considering the fact that similar levels of BDNF were seen in both conditions but cognitive performance was suppressed in hypoxia, acute elevation of BDNF did not compensate for hypoxia-induced cognition impairment. Moreover, neither potentially negative effects of C nor positive effects of A, DA and NO on the brain were observed in our study.
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Affiliation(s)
- Zofia Piotrowicz
- Institute of Sport Sciences, The Jerzy Kukuczka Academy of Physical Education, 40-065 Katowice, Poland;
- Correspondence:
| | - Małgorzata Chalimoniuk
- Department of Tourism and Health in Biała Podlaska, The Józef Piłsudski University of Physical Education, 00-968 Warsaw, Poland;
| | - Kamila Płoszczyca
- Department of Kinesiology, Institute of Sport, 01-982 Warsaw, Poland; (K.P.); (M.C.)
| | - Miłosz Czuba
- Department of Kinesiology, Institute of Sport, 01-982 Warsaw, Poland; (K.P.); (M.C.)
- Faculty of Health Sciences, Jan Dlugosz University, 42-200 Czestochowa, Poland
| | - Józef Langfort
- Institute of Sport Sciences, The Jerzy Kukuczka Academy of Physical Education, 40-065 Katowice, Poland;
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12
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Flores KR, Viccaro F, Aquilini M, Scarpino S, Ronchetti F, Mancini R, Di Napoli A, Scozzi D, Ricci A. Protective role of brain derived neurotrophic factor (BDNF) in obstructive sleep apnea syndrome (OSAS) patients. PLoS One 2020; 15:e0227834. [PMID: 31951637 PMCID: PMC6968866 DOI: 10.1371/journal.pone.0227834] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2019] [Accepted: 12/30/2019] [Indexed: 02/06/2023] Open
Abstract
Obstructive sleep apnea syndrome (OSAS) is a common disorder characterized by repeated episodes of upper airways collapse during the sleep. The following intermittent hypoxia triggers a state of chronic inflammation, which also interests the nervous system leading to neuronal damage and increased risk of cognitive impairment. Brain derived neurotrophic factor (BDNF) is a growth factor often associated with neuroplasticity and neuroprotection whose levels increase in several condition associated with neuronal damage. However, whether patients affected by OSAS have altered BDNF levels and whether such alteration may be reflective of their cognitive impairment is still controversial. Here we show that, when compared to healthy control volunteers, OSAS patients have increased serum levels of BDNF. Moreover, OSAS patients with the higher levels of BDNF also have reduced neurocognitive impairment as measured by The Montreal Cognitive Assessment (MoCA) questionnaire. Treatment with standard non-invasive mechanical ventilation (CPAP) also was able to ameliorate the level of cognitive impairment. Altogether our results indicate that BDNF levels represent a neuroprotective response to intermittent hypoxia in OSAS patients.
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Affiliation(s)
- Krisstopher Richard Flores
- Department of Clinical and Molecular Medicine, Division of Respiratory Diseases, Sant’Andrea Hospital, Sapienza University, Rome, Italy
| | - Fausta Viccaro
- Department of Clinical and Molecular Medicine, Division of Respiratory Diseases, Sant’Andrea Hospital, Sapienza University, Rome, Italy
| | - Mauro Aquilini
- Department of Clinical and Molecular Medicine, Division of Respiratory Diseases, Sant’Andrea Hospital, Sapienza University, Rome, Italy
| | - Stefania Scarpino
- Department of Clinical and Molecular Medicine, Division of Respiratory Diseases, Sant’Andrea Hospital, Sapienza University, Rome, Italy
| | - Francesco Ronchetti
- Department of Clinical and Molecular Medicine, Division of Respiratory Diseases, Sant’Andrea Hospital, Sapienza University, Rome, Italy
| | - Rita Mancini
- Department of Clinical and Molecular Medicine, Division of Respiratory Diseases, Sant’Andrea Hospital, Sapienza University, Rome, Italy
| | - Arianna Di Napoli
- Department of Clinical and Molecular Medicine, Division of Respiratory Diseases, Sant’Andrea Hospital, Sapienza University, Rome, Italy
| | - Davide Scozzi
- Department of Surgery, Washington University School of Medicine, St. Louis, Missouri, United States of America
| | - Alberto Ricci
- Department of Clinical and Molecular Medicine, Division of Respiratory Diseases, Sant’Andrea Hospital, Sapienza University, Rome, Italy
- * E-mail:
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13
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Zaki NFW, Saleh E, Elwasify M, Mahmoud E, Zaki J, Spence DW, BaHammam AS, Pandi-Perumal SR. The association of BDNF gene polymorphism with cognitive impairment in insomnia patients. Prog Neuropsychopharmacol Biol Psychiatry 2019; 88:253-264. [PMID: 30076879 DOI: 10.1016/j.pnpbp.2018.07.025] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2018] [Revised: 07/20/2018] [Accepted: 07/29/2018] [Indexed: 02/02/2023]
Abstract
BACKGROUND Reductions in BDNF activity have shown associations with depressed mood. Other evidence has demonstrated that the BDNF Val66Met polymorphism (rs6265) appears to reduce neural plasticity. A limited number of studies have investigated the influence of these genetic polymorphisms in insomnia. The present study sought to confirm the presence of associations between BDNF Val66Met polymorphism (rs6265) occurrence in normal sleepers and those with insomnia. METHOD The study subjects consisted of a patient group (n = 199) complaining of insomnia and a control group (n = 51). Each subject was clinically interviewed using questions taken from the Brief Insomnia Questionnaire. After the interview, the subjects were asked to complete the Insomnia Severity Index, The Hamilton Depression Rating Scale, and the Montreal Cognitive Assessment Test. An overnight polysomnography test was also administered. Blood samples were collected for genetic study. RESULTS The insomnia patients showed a greater prevalence of heterozygous (A/G) VAL/MET polymorphism than the normal controls (p = ≤ 0.0001). This finding confirmed that this genetic polymorphism, which impairs BDNF activity, is an important correlate of disturbed sleep. Further, the finding of significantly greater (p = ≤ 0.0001) depression scores among the insomnia group suggested that BDNF is an important factor in the development of depressive symptoms. CLINICAL IMPLICATIONS The results of the present study indicate that BDNF gene polymorphism plays a prominent role in the variation of symptoms among insomnia patients and, further, that this polymorphism is strongly related to the severity of depression.
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Affiliation(s)
- Nevin F W Zaki
- Sleep Research Unit, Mansoura University, Egypt; Department of Psychiatry, Mansoura University, Egypt.
| | - Elsayed Saleh
- Department of Psychiatry, Mansoura University, Egypt
| | | | | | - John Zaki
- Department 0f Mechanical Engineering, Statistical Consultation Office, Mansoura University, Egypt
| | | | - Ahmed S BaHammam
- University Sleep Disorders Center, College of Medicine, King Saud University, Riyadh, Saudi Arabia
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14
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Becke A, Müller P, Dordevic M, Lessmann V, Brigadski T, Müller NG. Daily Intermittent Normobaric Hypoxia Over 2 Weeks Reduces BDNF Plasma Levels in Young Adults - A Randomized Controlled Feasibility Study. Front Physiol 2018; 9:1337. [PMID: 30327610 PMCID: PMC6174219 DOI: 10.3389/fphys.2018.01337] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2018] [Accepted: 09/04/2018] [Indexed: 12/12/2022] Open
Abstract
Background: The results from animal and human research indicate that acute intermittent hypoxia can enhance brain-derived neurotrophic factor (BDNF) plasma levels and gene expression. As BDNF is known to promote the differentiation of new neurons and the formation of synapses, it has been proposed to mediate adult neuroplasticity. Thus, the present study aimed to analyze the long-term effects of daily intermittent exposure to normobaric hypoxia (simulating high altitude exposure at approximately 4000–5000 m) over 2 weeks on BDNF levels in young adults. Methods: Twenty-eight young adults (age: 19–33 years) were randomized into a hypoxic intervention group (N = 14) or the control group (N = 14). Participants in the intervention group breathed intermittent normobaric hypoxic air at resting conditions (5 min intervals, 80–85% SpO2 measured via a finger pulse oximeter, 12 sessions for 60 min/day for 2 weeks) via a hypoxic generator. BDNF plasma and serum levels were determined at baseline and at 2 weeks after intervention using sandwich ELISAs. Results: After 2 weeks of daily intermittent hypoxic treatment (IHT), we found a significant group x time interaction effect for BDNF plasma levels based on a significant decrease in BDNF levels in the hypoxia group. Conclusion: Our results demonstrate that daily intermittent administration of hypoxic air has a significant effect on BDNF regulation in healthy young adults. Contrary to other results reporting an increase in BDNF levels under hypoxic conditions, the present data suggest that hypoxic treatment using intensive IHT can reduce BDNF plasma levels for at least 2 weeks. This finding indicates that the daily application of hypoxic air is too frequent for the aimed physiological response, namely, an increase in BDNF levels.
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Affiliation(s)
- Andreas Becke
- Institute of Cognitive Neurology and Dementia Research, Otto-von-Guericke-Universität Magdeburg, Magdeburg, Germany.,Neuroprotection Laboratory, German Center for Neurodegenerative Diseases (DZNE), Magdeburg, Germany
| | - Patrick Müller
- Neuroprotection Laboratory, German Center for Neurodegenerative Diseases (DZNE), Magdeburg, Germany
| | - Milos Dordevic
- Neuroprotection Laboratory, German Center for Neurodegenerative Diseases (DZNE), Magdeburg, Germany
| | - Volkmar Lessmann
- Institute of Physiology, Otto-von-Guericke-Universität Magdeburg, Magdeburg, Germany.,Center for Behavioral Brain Sciences, Magdeburg, Germany
| | - Tanja Brigadski
- Institute of Physiology, Otto-von-Guericke-Universität Magdeburg, Magdeburg, Germany.,Informatics and Microsystem Technology, University of Applied Sciences, Kaiserslautern, Kaiserslautern, Germany
| | - Notger G Müller
- Neuroprotection Laboratory, German Center for Neurodegenerative Diseases (DZNE), Magdeburg, Germany.,Center for Behavioral Brain Sciences, Magdeburg, Germany
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15
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Devita M, Montemurro S, Ramponi S, Marvisi M, Villani D, Raimondi MC, Rusconi ML, Mondini S. Obstructive sleep apnea and its controversial effects on cognition. J Clin Exp Neuropsychol 2016; 39:659-669. [PMID: 27845600 DOI: 10.1080/13803395.2016.1253668] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Obstructive sleep apnea syndrome is a sleep disorder that may affect many brain functions. We are interested in the cognitive consequences of the condition with regard to the quality of life of individuals with this disorder. A debate is still underway as to whether cognitive difficulties caused by obstructive sleep apnea actually induce a "pseudodementia" pattern. This work provides a brief overview of the main controversies currently surrounding this issue. We report findings and opinions on structural and cognitive brain changes in individuals affected by obstructive sleep apnea by highlighting the involvement of executive functions and the possible reversibility of signs following-treatment with continuous positive airway pressure. Much research has been done on this issue but, to the best of our knowledge, a review of the present state of the literature evaluating different points of view has not yet been carried out.
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Affiliation(s)
- Maria Devita
- a Department of Human and Social Sciences , University of Bergamo , Bergamo , Italy
| | - Sonia Montemurro
- b Department of General Psychology , University of Padua , Padua , Italy.,c Human Inspired Technology Research Centre , University of Padua , Padua , Italy
| | - Sara Ramponi
- d Internal Medicine Unit , Figlie di S. Camillo , Cremona , Italy
| | - Maurizio Marvisi
- d Internal Medicine Unit , Figlie di S. Camillo , Cremona , Italy.,e Department of Internal Medicine and Pneumology , University of Parma , Parma , Italy
| | - Daniele Villani
- f Neuromotor Rehabilitation Unit , Figlie di S. Camillo , Cremona , Italy
| | | | - Maria Luisa Rusconi
- a Department of Human and Social Sciences , University of Bergamo , Bergamo , Italy
| | - Sara Mondini
- b Department of General Psychology , University of Padua , Padua , Italy.,c Human Inspired Technology Research Centre , University of Padua , Padua , Italy
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16
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Giacobbo BL, Corrêa MS, Vedovelli K, de Souza CEB, Spitza LM, Gonçalves L, Paludo N, Molina RD, da Rosa ED, Argimon IIDL, Bromberg E. Could BDNF be involved in compensatory mechanisms to maintain cognitive performance despite acute sleep deprivation? An exploratory study. Int J Psychophysiol 2015; 99:96-102. [PMID: 26602839 DOI: 10.1016/j.ijpsycho.2015.11.008] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2015] [Revised: 09/01/2015] [Accepted: 11/18/2015] [Indexed: 01/18/2023]
Abstract
BACKGROUND Neuroimaging studies suggest that acute sleep deprivation can lead to adaptations, such as compensatory recruitment of cerebral structures, to maintain cognitive performance despite sleep loss. However, the understanding of the neurochemical alterations related to these adaptations remains incomplete. OBJECTIVE Investigate BDNF levels, cognitive performance and their relations in healthy subjects after acute sleep deprivation. METHODS Nineteen sleep deprived (22.11±3.21years) and twenty control (25.10±4.42years) subjects completed depression, anxiety and sleep quality questionnaires. Sleep deprived group spent a full night awake performing different playful activities to keep themselves from sleeping. Attention, response inhibition capacity and working memory (prefrontal cortex-dependent) were assessed with Stroop and Digit Span tests. Declarative memory (hippocampus-dependent) was assessed with Logical Memory test. Serum BDNF was measured by sandwich ELISA. Data were analyzed with independent samples T-test, ANOVA, ANCOVA and curve estimation regressions. p<0.05 was deemed statistically significant. RESULTS The sleep deprived group showed higher BDNF levels and normal performance on attention, response inhibition capacity and working memory. However, declarative memory was impaired. A sigmoidal relation between BDNF and Stroop Test scores was found. CONCLUSIONS Increased BDNF could be related, at least in part, to the maintenance of normal prefrontal cognitive functions after sleep deprivation. This potential relation should be further investigated.
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Affiliation(s)
- Bruno Lima Giacobbo
- Neurobiology and Developmental Biology Laboratory, Faculty of Biosciences, Pontifical Catholic University of Rio Grande do Sul, Porto Alegre 90619-900, Brazil; National Institute for Translational Medicine (INCT-TM), Porto Alegre, Rio Grande do Sul 90035-003, Brazil
| | - Márcio Silveira Corrêa
- Neurobiology and Developmental Biology Laboratory, Faculty of Biosciences, Pontifical Catholic University of Rio Grande do Sul, Porto Alegre 90619-900, Brazil; National Institute for Translational Medicine (INCT-TM), Porto Alegre, Rio Grande do Sul 90035-003, Brazil
| | - Kelem Vedovelli
- Neurobiology and Developmental Biology Laboratory, Faculty of Biosciences, Pontifical Catholic University of Rio Grande do Sul, Porto Alegre 90619-900, Brazil; Institute of Geriatrics and Gerontology, Pontifical Catholic University of Rio Grande do Sul, Porto Alegre 90619-900, Brazil; National Institute for Translational Medicine (INCT-TM), Porto Alegre, Rio Grande do Sul 90035-003, Brazil
| | - Carlos Eduardo Bruhn de Souza
- Neurobiology and Developmental Biology Laboratory, Faculty of Biosciences, Pontifical Catholic University of Rio Grande do Sul, Porto Alegre 90619-900, Brazil
| | - Letícia Martins Spitza
- Neurobiology and Developmental Biology Laboratory, Faculty of Biosciences, Pontifical Catholic University of Rio Grande do Sul, Porto Alegre 90619-900, Brazil
| | - Lucas Gonçalves
- Neurobiology and Developmental Biology Laboratory, Faculty of Biosciences, Pontifical Catholic University of Rio Grande do Sul, Porto Alegre 90619-900, Brazil
| | - Nathália Paludo
- Neurobiology and Developmental Biology Laboratory, Faculty of Biosciences, Pontifical Catholic University of Rio Grande do Sul, Porto Alegre 90619-900, Brazil
| | - Rachel Dias Molina
- Institute of Geriatrics and Gerontology, Pontifical Catholic University of Rio Grande do Sul, Porto Alegre 90619-900, Brazil
| | - Eduarda Dias da Rosa
- Laboratory of Molecular Psychiatry, Federal University of Rio Grande do Sul, Porto Alegre 90035-003, Brazil
| | - Irani Iracema de Lima Argimon
- Institute of Geriatrics and Gerontology, Pontifical Catholic University of Rio Grande do Sul, Porto Alegre 90619-900, Brazil
| | - Elke Bromberg
- Neurobiology and Developmental Biology Laboratory, Faculty of Biosciences, Pontifical Catholic University of Rio Grande do Sul, Porto Alegre 90619-900, Brazil; National Institute for Translational Medicine (INCT-TM), Porto Alegre, Rio Grande do Sul 90035-003, Brazil.
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17
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Chen X, Zhang R, Xiao Y, Dong J, Niu X, Kong W. Reliability and Validity of the Beijing Version of the Montreal Cognitive Assessment in the Evaluation of Cognitive Function of Adult Patients with OSAHS. PLoS One 2015. [PMID: 26208289 PMCID: PMC4514887 DOI: 10.1371/journal.pone.0132361] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
Background The patients with obstructive sleep apnea hypopnea syndrome (OSAHS) tend to develop cognitive deficits, which usually go unrecognized, and can affect their daily life. The Beijing version of the Montreal cognitive assessment (MoCA-BJ), a Chinese version of MoCA, has been used for the assessment of cognitive functions of OSAHS patients in clinical practice. So far, its reliability and validity have not been tested. This study examined the reliability and validity of MoCA-BJ in a cohort of adult OSAHS patients. Methods 152 OSAHS patients, ranging from mild, moderate to severe, 49 primary snoring subjects and 40 normal controls were evaluated for cognitive functions by employing both MoCA-BJ and the Mini Mental State Examination (MMSE). Forty of them were re-tested by MoCA-BJ 14 days after the first test. Internal consistency, test-retest reliability, discriminate and concurrent validity of MoCA-BJ were analyzed. Results Internal consistency reliability by Cronbach’s alpha was adequate (0.73). Intra-class correlation coefficient (ICC), an measure of test-retest reliability, was 0.87 (P<0.001). The total MoCA-BJ scores were significant higher in normal controls than in OSAHS groups (p<0.05). The performances of visuospatial ability in severe OSAHS group were significantly weaker than in normal controls and primary snoring group. The performances of executive ability in severe OSAHS patients were weaker than in normal controls. An optimal cut-off between normal controls and non-normal subjects was at 26 points (total MoCA score). Moreover, cut-off between non-severe and severe OSAHS was at 2 points on visuospatial subscale. Analysis of the correlation between MoCA total scores and MMSE total scores revealed a statistically significant, though relatively weak, correlation (r=0.41, P<0.05). Conclusion In conclusion, our study showed that the Beijing version of the MoCA was reliable and stable. The MoCA-BJ was capable of detecting cognitive dysfunction by visuospatial and total MoCA-BJ score.
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Affiliation(s)
- Xiong Chen
- Department of Otolaryngology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Rui Zhang
- Department of Otolaryngology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Ying Xiao
- Department of Otolaryngology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Jiaqi Dong
- Department of Otolaryngology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xun Niu
- Department of Otolaryngology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Weijia Kong
- Department of Otolaryngology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- * E-mail:
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18
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Chemobrain: a critical review and causal hypothesis of link between cytokines and epigenetic reprogramming associated with chemotherapy. Cytokine 2015; 72:86-96. [PMID: 25573802 DOI: 10.1016/j.cyto.2014.12.006] [Citation(s) in RCA: 127] [Impact Index Per Article: 14.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2014] [Revised: 10/29/2014] [Accepted: 12/08/2014] [Indexed: 01/21/2023]
Abstract
One consequence of modern cancer therapy is chemotherapy related cognitive dysfunction or "chemobrain", the subjective experience of cognitive deficits at any point during or following chemotherapy. Chemobrain, a well-established clinical syndrome, has become an increasing concern because the number of long-term cancer survivors is growing dramatically. There is strong evidence that correlates changes in peripheral cytokines with the development of chemobrain in commonly used chemotherapeutic drugs for different types of cancer. However, the mechanisms by which these cytokines elicit change in the central nervous system are still unclear. In this review, we hypothesize that the administration of chemotherapy agents initiates a cascade of biological changes, with short-lived alterations in the cytokine milieu inducing persistent epigenetic alterations. These epigenetic changes lead to changes in gene expression, alterations in metabolic activity and neuronal transmission that are responsible for generating the subjective experience of cognition. This speculative but testable hypothesis should help to gain a comprehensive understanding of the mechanism underlying cognitive dysfunction in cancer patients. Such knowledge is critical to identify pharmaceutical targets with the potential to prevent and treat cancer-treatment related cognitive dysfunction and similar disorders.
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19
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Li HJ, Dai XJ, Gong HH, Nie X, Zhang W, Peng DC. Aberrant spontaneous low-frequency brain activity in male patients with severe obstructive sleep apnea revealed by resting-state functional MRI. Neuropsychiatr Dis Treat 2015; 11:207-14. [PMID: 25653530 PMCID: PMC4311758 DOI: 10.2147/ndt.s73730] [Citation(s) in RCA: 57] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND The majority of previous neuroimaging studies have demonstrated both structural and functional abnormalities in obstructive sleep apnea (OSA). However, few studies have focused on the regional intensity of spontaneous fluctuations during the resting state and the relationship between the abnormal properties and the behavioral performances. In the present study, we employed the amplitude of low-frequency fluctuation (ALFF) method to explore the local features of spontaneous brain activity in OSA patients (OSAs). METHODS Twenty-five untreated male severe OSAs and 25 age-matched and years-of-education-matched male good sleepers (GSs) were included in this study. The ALFF method was used to assess the local features of spontaneous brain activity. The mean signal values of the altered ALFF areas were analyzed with receiver operating characteristic curve. Partial correlation analysis was used to explore the relationship between the observed mean ALFF values of the different areas and the behavioral performances. RESULTS Compared with GSs, OSAs had significantly higher scores for body mass index, apnea-hypopnea index, arterial oxygen saturation <90%, arousal index, and Epworth Sleepiness Scale (ESS) score; furthermore, OSAs had significantly lower scores for rapid eye movement sleep and in the Montreal Cognitive Assessment (MoCA). Compared with GSs, OSAs showed significant lower-ALFF areas in the cluster of the right precuneus and bilateral posterior cingulate gyrus, as well as a higher-ALFF area in the left inferior frontal gyrus. The area under the curve values of the lower- and higher-ALFF areas were 0.90 and 0.93, respectively. Further diagnostic analysis exhibited that the sensibility and specificity of the two clusters were 80% and 92%, respectively. The mean signal value of the lower-ALFF cluster displayed significant positive correlations with lowest oxygen saturation (r=0.447, P=0.025) and MoCA score (r =0.405, P=0.045). CONCLUSION OSAs may involve in a dysfunction in the default mode network and an adaptive compensatory response in the frontal lobe, which reflect the underlying pathophysiology of cognitive impairment.
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Affiliation(s)
- Hai-Jun Li
- Department of Radiology, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, People's Republic of China
| | - Xi-Jian Dai
- Department of Radiology, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, People's Republic of China ; Department of Imaging and Interventional Radiology, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong Special Administrative Region, People's Republic of China
| | - Hong-Han Gong
- Department of Radiology, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, People's Republic of China
| | - Xiao Nie
- Department of Radiology, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, People's Republic of China
| | - Wei Zhang
- Department of Pneumology, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, People's Republic of China
| | - De-Chang Peng
- Department of Radiology, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, People's Republic of China
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