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Krugliakova E, Karpovich A, Stieglitz L, Huwiler S, Lustenberger C, Imbach L, Bujan B, Jedrysiak P, Jacomet M, Baumann CR, Fattinger S. Exploring the local field potential signal from the subthalamic nucleus for phase-targeted auditory stimulation in Parkinson's disease. Brain Stimul 2024; 17:769-779. [PMID: 38906529 DOI: 10.1016/j.brs.2024.06.007] [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: 11/13/2023] [Revised: 05/26/2024] [Accepted: 06/12/2024] [Indexed: 06/23/2024] Open
Abstract
BACKGROUND Enhancing slow waves, the electrophysiological (EEG) manifestation of non-rapid eye movement (NREM) sleep, could potentially benefit patients with Parkinson's disease (PD) by improving sleep quality and slowing disease progression. Phase-targeted auditory stimulation (PTAS) is an approach to enhance slow waves, which are detected in real-time in the surface EEG signal. OBJECTIVE We aimed to test whether the local-field potential of the subthalamic nucleus (STN-LFP) can be used to detect frontal slow waves and assess the electrophysiological changes related to PTAS. METHODS We recruited patients diagnosed with PD and undergoing Percept™ PC neurostimulator (Medtronic) implantation for deep brain stimulation of STN (STN-DBS) in a two-step surgery. Patients underwent three full-night recordings, including one between-surgeries recording and two during rehabilitation, one with DBS+ (on) and one with DBS- (off). Surface EEG and STN-LFP signals from Percept PC were recorded simultaneously, and PTAS was applied during sleep in all three recording sessions. RESULTS Our results show that during NREM sleep, slow waves of the cortex and STN are time-locked. PTAS application resulted in power and coherence changes, which can be detected in STN-LFP. CONCLUSION Our findings suggest the feasibility of implementing PTAS using solely STN-LFP signal for slow wave detection, thus without a need for an external EEG device alongside the implanted neurostimulator. Moreover, we propose options for more efficient STN-LFP signal preprocessing, including different referencing and filtering to enhance the reliability of cortical slow wave detection in STN-LFP recordings.
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Affiliation(s)
- Elena Krugliakova
- Department of Neurology, Clinical Neuroscience Center, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Artyom Karpovich
- Department of Neurology, Clinical Neuroscience Center, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Lennart Stieglitz
- Department of Neurosurgery, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Stephanie Huwiler
- Neural Control of Movement Lab, Institute of Human Movement Sciences and Sport, Department of Health Sciences and Technology, ETH Zurich, Zurich, Switzerland
| | - Caroline Lustenberger
- Neural Control of Movement Lab, Institute of Human Movement Sciences and Sport, Department of Health Sciences and Technology, ETH Zurich, Zurich, Switzerland
| | - Lukas Imbach
- Swiss Epilepsy Center, Clinic Lengg, Zurich, Switzerland
| | - Bartosz Bujan
- Neurorehabilitation, Clinic Lengg, Zurich, Switzerland
| | | | - Maria Jacomet
- Department of Neurology, Clinical Neuroscience Center, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Christian R Baumann
- Department of Neurology, Clinical Neuroscience Center, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Sara Fattinger
- Department of Neurology, Clinical Neuroscience Center, University Hospital Zurich, University of Zurich, Zurich, Switzerland.
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2
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Kawada T. Slow-wave sleep and subsequent risk of dementia. J Clin Sleep Med 2024; 20:1021. [PMID: 38415748 PMCID: PMC11145055 DOI: 10.5664/jcsm.11068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2024] [Revised: 02/06/2024] [Accepted: 02/08/2024] [Indexed: 02/29/2024]
Affiliation(s)
- Tomoyuki Kawada
- Department of Hygiene and Public Health, Nippon Medical School, Tokyo, Japan
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Zeller CJ, Wunderlin M, Wicki K, Teunissen CE, Nissen C, Züst MA, Klöppel S. Multi-night acoustic stimulation is associated with better sleep, amyloid dynamics, and memory in older adults with cognitive impairment. GeroScience 2024:10.1007/s11357-024-01195-z. [PMID: 38744792 DOI: 10.1007/s11357-024-01195-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2024] [Accepted: 05/07/2024] [Indexed: 05/16/2024] Open
Abstract
Sleep is a potential early, modifiable risk factor for cognitive decline and dementia. Impaired slow wave sleep (SWS) is pronounced in individuals with cognitive impairment (CI). Cognitive decline and impairments of SWS are bi-directionally linked in a vicious cycle. SWS can be enhanced non-invasively using phase-locked acoustic stimulation (PLAS), potentially breaking this vicious cycle. Eighteen healthy older adults (HC, agemean±sd, 68.3 ± 5.1) and 16 older adults (agemean±sd, 71.9 ± 3.9) with CI (Montreal Cognitive Assessment ≤ 25) underwent one baseline (sham-PLAS) night and three consecutive stimulation nights (real-PLAS). EEG responses and blood-plasma amyloid beta Aβ42/Aβ40 ratio were measured pre- and post-intervention, as was episodic memory. The latter was again evaluated 1 week and 3 months after the intervention. In both groups, PLAS induced a significant electrophysiological response in both voltage- and time-frequency analyses, and memory performance improved in association with the magnitude of this response. In the CI group, both electrophysiological and associated memory effects were delayed compared to the healthy group. After 3 intervention nights, electrophysiological response to PLAS was no longer different between CI and HC groups. Only in the CI sample, stronger electrophysiological responses were significantly associated with improving post-intervention Aβ42/Aβ40 ratios. PLAS seems to improve SWS electrophysiology, memory, and amyloid dynamics in older adults with CI. However, effects on memory require more time to unfold compared to healthy older adults. This indicates that PLAS may become a potential tool to ameliorate cognitive decline, but longer interventions are necessary to compensate for declining brain integrity. This study was pre-registered (clinicaltrials.gov: NCT04277104).
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Affiliation(s)
- Céline J Zeller
- University Hospital of Old Age Psychiatry and Psychotherapy, University of Bern, 3000, Bern 60, Switzerland
- Graduate School for Health Sciences, University of Bern, 3012, Bern, Switzerland
| | - Marina Wunderlin
- University Hospital of Old Age Psychiatry and Psychotherapy, University of Bern, 3000, Bern 60, Switzerland
| | - Korian Wicki
- University Hospital of Old Age Psychiatry and Psychotherapy, University of Bern, 3000, Bern 60, Switzerland
- Graduate School for Health Sciences, University of Bern, 3012, Bern, Switzerland
| | - Charlotte E Teunissen
- Neurochemistry Laboratory, Department of Clinical Chemistry, Amsterdam Neuroscience, Amsterdam UMC, Vrije Universiteit Amsterdam, 1081 HV, Amsterdam, Netherlands
| | - Christoph Nissen
- Division of Psychiatric Specialties, Department of Psychiatry, Geneva University Hospitals (HUG), 1201, Geneva, Switzerland
- Department of Psychiatry, University of Geneva, 1201, Geneva, Switzerland
| | - Marc A Züst
- University Hospital of Old Age Psychiatry and Psychotherapy, University of Bern, 3000, Bern 60, Switzerland.
| | - Stefan Klöppel
- University Hospital of Old Age Psychiatry and Psychotherapy, University of Bern, 3000, Bern 60, Switzerland
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4
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Studler M, Gianotti LRR, Lobmaier J, Maric A, Knoch D. Human Prosocial Preferences Are Related to Slow-Wave Activity in Sleep. J Neurosci 2024; 44:e0885232024. [PMID: 38467433 PMCID: PMC11007317 DOI: 10.1523/jneurosci.0885-23.2024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Revised: 12/27/2023] [Accepted: 01/03/2024] [Indexed: 03/13/2024] Open
Abstract
Prosocial behavior is crucial for the smooth functioning of the society. Yet, individuals differ vastly in the propensity to behave prosocially. Here, we try to explain these individual differences under normal sleep conditions without any experimental modulation of sleep. Using a portable high-density EEG, we measured the sleep data in 54 healthy adults (28 females) during a normal night's sleep at the participants' homes. To capture prosocial preferences, participants played an incentivized public goods game in which they faced real monetary consequences. The whole-brain analyses showed that a higher relative slow-wave activity (SWA, an indicator of sleep depth) in a cluster of electrodes over the right temporoparietal junction (TPJ) was associated with increased prosocial preferences. Source localization and current source density analyses further support these findings. Recent sleep deprivation studies imply that sleeping enough makes us more prosocial; the present findings suggest that it is not only sleep duration, but particularly sufficient sleep depth in the TPJ that is positively related to prosociality. Because the TPJ plays a central role in social cognitive functions, we speculate that sleep depth in the TPJ, as reflected by relative SWA, might serve as a dispositional indicator of social cognition ability, which is reflected in prosocial preferences. These findings contribute to the emerging framework explaining the link between sleep and prosocial behavior by shedding light on the underlying mechanisms.
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Affiliation(s)
- Mirjam Studler
- Department of Social Neuroscience and Social Psychology, Institute of Psychology, University of Bern, Bern 3012, Switzerland
| | - Lorena R R Gianotti
- Department of Social Neuroscience and Social Psychology, Institute of Psychology, University of Bern, Bern 3012, Switzerland
| | - Janek Lobmaier
- Department of Social Neuroscience and Social Psychology, Institute of Psychology, University of Bern, Bern 3012, Switzerland
| | - Angelina Maric
- Department of Neurology, University Hospital Zurich, University of Zurich, Zurich 8091, Switzerland
| | - Daria Knoch
- Department of Social Neuroscience and Social Psychology, Institute of Psychology, University of Bern, Bern 3012, Switzerland
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Jafarzadeh Esfahani M, Sikder N, Ter Horst R, Daraie AH, Appel K, Weber FD, Bevelander KE, Dresler M. Citizen neuroscience: Wearable technology and open software to study the human brain in its natural habitat. Eur J Neurosci 2024; 59:948-965. [PMID: 38328991 DOI: 10.1111/ejn.16227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2023] [Revised: 11/09/2023] [Accepted: 11/30/2023] [Indexed: 02/09/2024]
Abstract
Citizen science allows the public to participate in various stages of scientific research, including study design, data acquisition, and data analysis. Citizen science has a long history in several fields of the natural sciences, and with recent developments in wearable technology, neuroscience has also become more accessible to citizen scientists. This development was largely driven by the influx of minimal sensing systems in the consumer market, allowing more do-it-yourself (DIY) and quantified-self (QS) investigations of the human brain. While most subfields of neuroscience require sophisticated monitoring devices and laboratories, the study of sleep characteristics can be performed at home with relevant noninvasive consumer devices. The strong influence of sleep quality on waking life and the accessibility of devices to measure sleep are two primary reasons citizen scientists have widely embraced sleep research. Their involvement has evolved from solely contributing to data collection to engaging in more collaborative or autonomous approaches, such as instigating ideas, formulating research inquiries, designing research protocols and methodology, acting upon their findings, and disseminating results. In this article, we introduce the emerging field of citizen neuroscience, illustrating examples of such projects in sleep research. We then provide overviews of the wearable technologies for tracking human neurophysiology and various open-source software used to analyse them. Finally, we discuss the opportunities and challenges in citizen neuroscience projects and suggest how to improve the study of the human brain outside the laboratory.
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Affiliation(s)
| | - Niloy Sikder
- Donders Institute for Brain, Behaviour, and Cognition, Radboudumc, Nijmegen, The Netherlands
- Faculty of Technology and Bionics, Rhine-Waal University of Applied Sciences, Kleve, Germany
| | - Rob Ter Horst
- CeMM Research Center for Molecular Medicine of the Austrian Academy of Sciences, Vienna, Austria
| | - Amir Hossein Daraie
- Donders Institute for Brain, Behaviour, and Cognition, Radboudumc, Nijmegen, The Netherlands
- Department of Biomedical Engineering, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | | | - Frederik D Weber
- Donders Institute for Brain, Behaviour, and Cognition, Radboudumc, Nijmegen, The Netherlands
- Department of Sleep and Cognition, Netherlands Institute for Neuroscience, an institute of the Royal Netherlands Academy of Arts and Sciences, Amsterdam, The Netherlands
| | - Kirsten E Bevelander
- Behavioural Science Institute, Radboud University, Nijmegen, The Netherlands
- Primary and Community Care, Radboud University and Medical Center, Nijmegen, The Netherlands
| | - Martin Dresler
- Donders Institute for Brain, Behaviour, and Cognition, Radboudumc, Nijmegen, The Netherlands
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Parsaei M, Amanollahi M, TaghaviZanjani F, Khanmohammadi S, Jameie M, Naser Moghadasi A. Effects of non-pharmacological interventions on gait and balance of persons with Multiple Sclerosis: A narrative review. Mult Scler Relat Disord 2024; 82:105415. [PMID: 38211505 DOI: 10.1016/j.msard.2023.105415] [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: 09/16/2023] [Revised: 12/15/2023] [Accepted: 12/27/2023] [Indexed: 01/13/2024]
Abstract
BACKGROUND Multiple Sclerosis (MS) is among the most common reasons for disability in young adults. Mobility impairment, primarily related to gait and balance, is ranked as the preeminent concern among persons with MS (PwMS). Gait and balance dysfunction can directly affect the quality of life and activities of daily life in PwMS, hence the importance of effective treatment strategies. Previous studies have demonstrated the positive effect of various non-pharmacological rehabilitation methods, including physiotherapy and electrical stimulation, on gait and mobility in PwMS. Non-pharmacological methods can be tailored to the individual needs and abilities of each patient, allowing healthcare providers to create personalized training programs. Furthermore, these methods typically result in minimal or no side effects. PURPOSE This review provides a comprehensive overview of an array of non-pharmacological treatment approaches aimed at enhancing ambulatory performance in PwMS. METHODS We performed a narrative review of the original papers available in PubMed, investigating the effects of different nonmedical approaches on the gait and balance performance of the PwMS. Reviewed treatment approaches include "exercise, physical rehabilitation, dual-task (DT) rehabilitation, robot-assisted rehabilitation, virtual reality-assisted rehabilitation, game training, electrical stimulation devices, auditory stimulation, visual feedback, and shoe insoles". RESULTS AND CONCLUSIONS Eighty articles were meticulously reviewed. Our study highlights the positive effects of non-pharmacological interventions on patients' quality of life, reducing disability, fatigue, and muscle spasticity. While some methods, including exercise and physiotherapy, showed substantial promise, further research is needed to evaluate whether visual biofeedback and auditory stimulation are preferable over conventional approaches. Additionally, approaches such as functional electrical stimulation, non-invasive brain stimulation, and shoe insoles demonstrate substantial short-term benefits, prompting further investigation into their long-term effects. Non-pharmacological interventions can serve as a valuable complement to medication-based approaches.
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Affiliation(s)
- Mohammadamin Parsaei
- Maternal, Fetal, and Neonatal Research Center, Family Health Research Institute, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
| | - Mobina Amanollahi
- School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | | | | | - Melika Jameie
- Neuroscience Research Center, Iran University of Medical Sciences, Tehran, Iran; Iranian Center of Neurological Research, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran.
| | - Abdorreza Naser Moghadasi
- Multiple Sclerosis Research Center, Neuroscience Institute, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran.
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7
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Van den Bulcke L, Peeters AM, Heremans E, Davidoff H, Borzée P, De Vos M, Emsell L, Van den Stock J, De Roo M, Tournoy J, Buyse B, Vandenbulcke M, Van Audenhove C, Testelmans D, Van Den Bossche M. Acoustic stimulation as a promising technique to enhance slow-wave sleep in Alzheimer's disease: results of a pilot study. J Clin Sleep Med 2023; 19:2107-2112. [PMID: 37593850 PMCID: PMC10692948 DOI: 10.5664/jcsm.10778] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 08/16/2023] [Accepted: 08/16/2023] [Indexed: 08/19/2023]
Abstract
STUDY OBJECTIVES Sleep disturbances are common in people with Alzheimer's disease (AD), and a reduction in slow-wave activity is the most striking underlying change. Acoustic stimulation has emerged as a promising approach to enhance slow-wave activity in healthy adults and people with amnestic mild cognitive impairment. In this phase 1 study we investigated, for the first time, the feasibility of acoustic stimulation in AD and piloted the effect on slow-wave sleep (SWS). METHODS Eleven adults with mild to moderate AD first wore the DREEM 2 headband for 2 nights to establish a baseline registration. Using machine learning, the DREEM 2 headband automatically scores sleep stages in real time. Subsequently, the participants wore the headband for 14 consecutive "stimulation nights" at home. During these nights, the device applied phase-locked acoustic stimulation of 40-dB pink noise delivered over 2 bone-conductance transducers targeted to the up-phase of the delta wave or SHAM, if it detected SWS in sufficiently high-quality data. RESULTS Results of the DREEM 2 headband algorithm show a significant average increase in SWS (minutes) [t(3.17) = 33.57, P = .019] between the beginning and end of the intervention, almost twice as much time was spent in SWS. Consensus scoring of electroencephalography data confirmed this trend of more time spent in SWS [t(2.4) = 26.07, P = .053]. CONCLUSIONS Our phase 1 study provided the first evidence that targeted acoustic stimuli is feasible and could increase SWS in AD significantly. Future studies should further test and optimize the effect of stimulation on SWS in AD in a large randomized controlled trial. CITATION Van den Bulcke L, Peeters A-M, Heremans E, et al. Acoustic stimulation as a promising technique to enhance slow-wave sleep in Alzheimer's disease: results of a pilot study. J Clin Sleep Med. 2023;19(12):2107-2112.
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Affiliation(s)
- Laura Van den Bulcke
- Geriatric Psychiatry, University Psychiatric Center KU Leuven, Leuven, Belgium
- Neuropsychiatry, Research Group Psychiatry, Department of Neurosciences, Leuven Brain Institute, KU Leuven, Leuven, Belgium
| | - Anne-Marie Peeters
- Geriatric Psychiatry, University Psychiatric Center KU Leuven, Leuven, Belgium
- Neuropsychiatry, Research Group Psychiatry, Department of Neurosciences, Leuven Brain Institute, KU Leuven, Leuven, Belgium
| | | | - Hannah Davidoff
- Department of Electrical Engineering (ESAT), KU Leuven, Leuven, Belgium
- CSH (Circuits and Systems for Health) - imec, Heverlee, Belgium
| | - Pascal Borzée
- Department of Pneumology, University Hospitals Leuven, Leuven, Belgium
| | - Maarten De Vos
- Department of Electrical Engineering (ESAT), KU Leuven, Leuven, Belgium
- Department of Development and Regeneration, Faculty of Medicine, KU Leuven, Leuven, Belgium
| | - Louise Emsell
- Geriatric Psychiatry, University Psychiatric Center KU Leuven, Leuven, Belgium
- Neuropsychiatry, Research Group Psychiatry, Department of Neurosciences, Leuven Brain Institute, KU Leuven, Leuven, Belgium
- Translational MRI, Department of Imaging and Pathology, KU Leuven, Leuven, Belgium
| | - Jan Van den Stock
- Geriatric Psychiatry, University Psychiatric Center KU Leuven, Leuven, Belgium
- Neuropsychiatry, Research Group Psychiatry, Department of Neurosciences, Leuven Brain Institute, KU Leuven, Leuven, Belgium
| | - Maaike De Roo
- Department of Geriatric Medicine, University Hospitals Leuven, Leuven, Belgium
- Department of Public Health and Primary Care, KU Leuven, Leuven, Belgium
| | - Jos Tournoy
- Department of Geriatric Medicine, University Hospitals Leuven, Leuven, Belgium
- Department of Public Health and Primary Care, KU Leuven, Leuven, Belgium
| | - Bertien Buyse
- Department of Pneumology, University Hospitals Leuven, Leuven, Belgium
- Laboratory of Respiratory Diseases and Thoracic Surgery (BREATHE), Department of Chronic Diseases and Metabolism, KU Leuven, Leuven, Belgium
| | - Mathieu Vandenbulcke
- Geriatric Psychiatry, University Psychiatric Center KU Leuven, Leuven, Belgium
- Neuropsychiatry, Research Group Psychiatry, Department of Neurosciences, Leuven Brain Institute, KU Leuven, Leuven, Belgium
| | - Chantal Van Audenhove
- Department of Public Health and Primary Care, KU Leuven, Leuven, Belgium
- LUCAS, Center for Care Research and Consultancy, KU Leuven, Leuven, Belgium
| | - Dries Testelmans
- Department of Pneumology, University Hospitals Leuven, Leuven, Belgium
- Laboratory of Respiratory Diseases and Thoracic Surgery (BREATHE), Department of Chronic Diseases and Metabolism, KU Leuven, Leuven, Belgium
| | - Maarten Van Den Bossche
- Geriatric Psychiatry, University Psychiatric Center KU Leuven, Leuven, Belgium
- Neuropsychiatry, Research Group Psychiatry, Department of Neurosciences, Leuven Brain Institute, KU Leuven, Leuven, Belgium
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Wunderlin M, Zeller CJ, Senti SR, Fehér KD, Suppiger D, Wyss P, Koenig T, Teunissen CE, Nissen C, Klöppel S, Züst MA. Acoustic stimulation during sleep predicts long-lasting increases in memory performance and beneficial amyloid response in older adults. Age Ageing 2023; 52:afad228. [PMID: 38163288 PMCID: PMC10758173 DOI: 10.1093/ageing/afad228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Indexed: 01/03/2024] Open
Abstract
BACKGROUND Sleep and neurodegeneration are assumed to be locked in a bi-directional vicious cycle. Improving sleep could break this cycle and help to prevent neurodegeneration. We tested multi-night phase-locked acoustic stimulation (PLAS) during slow wave sleep (SWS) as a non-invasive method to improve SWS, memory performance and plasma amyloid levels. METHODS 32 healthy older adults (agemean: 68.9) completed a between-subject sham-controlled three-night intervention, preceded by a sham-PLAS baseline night. RESULTS PLAS induced increases in sleep-associated spectral-power bands as well as a 24% increase in slow wave-coupled spindles, known to support memory consolidation. There was no significant group-difference in memory performance or amyloid-beta between the intervention and control group. However, the magnitude of PLAS-induced physiological responses were associated with memory performance up to 3 months post intervention and beneficial changes in plasma amyloid. Results were exclusive to the intervention group. DISCUSSION Multi-night PLAS is associated with long-lasting benefits in memory and metabolite clearance in older adults, rendering PLAS a promising tool to build upon and develop long-term protocols for the prevention of cognitive decline.
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Affiliation(s)
- Marina Wunderlin
- University Hospital of Old Age Psychiatry and Psychotherapy, University of Bern, 3000 Bern, Switzerland
- Graduate School for Health Sciences, University of Bern, 3012 Bern, Switzerland
| | - Céline Jacqueline Zeller
- University Hospital of Old Age Psychiatry and Psychotherapy, University of Bern, 3000 Bern, Switzerland
- Graduate School for Health Sciences, University of Bern, 3012 Bern, Switzerland
| | - Samira Rafaela Senti
- University Hospital of Old Age Psychiatry and Psychotherapy, University of Bern, 3000 Bern, Switzerland
| | - Kristoffer Daniel Fehér
- University Hospital of Psychiatry and Psychotherapy, University of Bern, 3000 Bern, Switzerland
| | - Debora Suppiger
- Department of Neonatology, University Hospital Zurich and University of Zurich, 8006 Zürich, Switzerland
| | - Patric Wyss
- University Hospital of Old Age Psychiatry and Psychotherapy, University of Bern, 3000 Bern, Switzerland
| | - Thomas Koenig
- University Hospital of Psychiatry and Psychotherapy, University of Bern, 3000 Bern, Switzerland
| | - Charlotte Elisabeth Teunissen
- Neurochemistry Laboratory, Department of Clinical Chemistry, Amsterdam Neuroscience, Neurodegeneration, Amsterdam UMC, Vrije Universiteit Amsterdam, 1081 HV Amsterdam, Netherlands
| | - Christoph Nissen
- University Hospital of Psychiatry and Psychotherapy, University of Bern, 3000 Bern, Switzerland
- Division of Psychiatric Specialties, Geneva University Hospitals (HUG), 1205 Geneva, Switzerland
| | - Stefan Klöppel
- University Hospital of Old Age Psychiatry and Psychotherapy, University of Bern, 3000 Bern, Switzerland
| | - Marc Alain Züst
- University Hospital of Old Age Psychiatry and Psychotherapy, University of Bern, 3000 Bern, Switzerland
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Huwiler S, Carro-Domínguez M, Stich FM, Sala R, Aziri F, Trippel A, Ryf T, Markendorf S, Niederseer D, Bohm P, Stoll G, Laubscher L, Thevan J, Spengler CM, Gawinecka J, Osto E, Huber R, Wenderoth N, Schmied C, Lustenberger C. Auditory stimulation of sleep slow waves enhances left ventricular function in humans. Eur Heart J 2023; 44:4288-4291. [PMID: 37794725 PMCID: PMC10590124 DOI: 10.1093/eurheartj/ehad630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/06/2023] Open
Affiliation(s)
- Stephanie Huwiler
- Neural Control of Movement Lab, Institute of Human Movement Sciences and Sport, Department of Health Sciences and Technology, ETH Zurich, Zurich 8092, Switzerland
| | - Manuel Carro-Domínguez
- Neural Control of Movement Lab, Institute of Human Movement Sciences and Sport, Department of Health Sciences and Technology, ETH Zurich, Zurich 8092, Switzerland
| | - Fabia M Stich
- Neural Control of Movement Lab, Institute of Human Movement Sciences and Sport, Department of Health Sciences and Technology, ETH Zurich, Zurich 8092, Switzerland
| | - Rossella Sala
- Neural Control of Movement Lab, Institute of Human Movement Sciences and Sport, Department of Health Sciences and Technology, ETH Zurich, Zurich 8092, Switzerland
| | - Florent Aziri
- Neural Control of Movement Lab, Institute of Human Movement Sciences and Sport, Department of Health Sciences and Technology, ETH Zurich, Zurich 8092, Switzerland
| | - Anna Trippel
- Neural Control of Movement Lab, Institute of Human Movement Sciences and Sport, Department of Health Sciences and Technology, ETH Zurich, Zurich 8092, Switzerland
| | - Tabea Ryf
- Department of Cardiology, University Heart Center Zurich, University of Zurich, Zurich 8091, Switzerland
| | - Susanne Markendorf
- Department of Cardiology, University Heart Center Zurich, University of Zurich, Zurich 8091, Switzerland
| | - David Niederseer
- Department of Cardiology, University Heart Center Zurich, University of Zurich, Zurich 8091, Switzerland
| | - Philipp Bohm
- Department of Cardiology, University Heart Center Zurich, University of Zurich, Zurich 8091, Switzerland
| | - Gloria Stoll
- Neural Control of Movement Lab, Institute of Human Movement Sciences and Sport, Department of Health Sciences and Technology, ETH Zurich, Zurich 8092, Switzerland
| | - Lily Laubscher
- Neural Control of Movement Lab, Institute of Human Movement Sciences and Sport, Department of Health Sciences and Technology, ETH Zurich, Zurich 8092, Switzerland
| | - Jeivicaa Thevan
- Institute of Clinical Chemistry, University Hospital Zurich, University of Zurich, Zurich 8091, Switzerland
| | - Christina M Spengler
- Exercise Physiology Lab, Institute of Human Movement Sciences and Sport, Department of Health Sciences and Technology, ETH Zurich, Zurich 8092, Switzerland
- Zurich Center for Integrative Human Physiology (ZIHP), University of Zurich, Zurich 8057, Switzerland
| | - Joanna Gawinecka
- Institute of Clinical Chemistry, University Hospital Zurich, University of Zurich, Zurich 8091, Switzerland
| | - Elena Osto
- Institute of Clinical Chemistry, University Hospital Zurich, University of Zurich, Zurich 8091, Switzerland
| | - Reto Huber
- Center of Competence Sleep & Health Zurich, University of Zurich, Zurich 8006, Switzerland
- Neuroscience Center Zurich (ZNZ), University of Zurich, ETH Zurich, Zurich 8057, Switzerland
- Child Development Centre, University Children’s Hospital, University of Zurich, Zurich 8032, Switzerland
- Department of Child and Adolescent Psychiatry and Psychotherapy, Psychiatric Hospital Zurich, University of Zurich, Zurich 8032, Switzerland
| | - Nicole Wenderoth
- Neural Control of Movement Lab, Institute of Human Movement Sciences and Sport, Department of Health Sciences and Technology, ETH Zurich, Zurich 8092, Switzerland
- Neuroscience Center Zurich (ZNZ), University of Zurich, ETH Zurich, Zurich 8057, Switzerland
- Future Health Technologies, Singapore-ETH Center, Campus for Research Excellence and Technological Enterprise (CREATE), Singapore 138602, Singapore
| | - Christian Schmied
- Department of Cardiology, University Heart Center Zurich, University of Zurich, Zurich 8091, Switzerland
| | - Caroline Lustenberger
- Neural Control of Movement Lab, Institute of Human Movement Sciences and Sport, Department of Health Sciences and Technology, ETH Zurich, Zurich 8092, Switzerland
- Center of Competence Sleep & Health Zurich, University of Zurich, Zurich 8006, Switzerland
- Neuroscience Center Zurich (ZNZ), University of Zurich, ETH Zurich, Zurich 8057, Switzerland
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10
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Esfahani MJ, Farboud S, Ngo HVV, Schneider J, Weber FD, Talamini LM, Dresler M. Closed-loop auditory stimulation of sleep slow oscillations: Basic principles and best practices. Neurosci Biobehav Rev 2023; 153:105379. [PMID: 37660843 DOI: 10.1016/j.neubiorev.2023.105379] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Revised: 08/25/2023] [Accepted: 08/30/2023] [Indexed: 09/05/2023]
Abstract
Sleep is essential for our physical and mental well-being. During sleep, despite the paucity of overt behavior, our brain remains active and exhibits a wide range of coupled brain oscillations. In particular slow oscillations are characteristic for sleep, however whether they are directly involved in the functions of sleep, or are mere epiphenomena, is not yet fully understood. To disentangle the causality of these relationships, experiments utilizing techniques to detect and manipulate sleep oscillations in real-time are essential. In this review, we first overview the theoretical principles of closed-loop auditory stimulation (CLAS) as a method to study the role of slow oscillations in the functions of sleep. We then describe technical guidelines and best practices to perform CLAS and analyze results from such experiments. We further provide an overview of how CLAS has been used to investigate the causal role of slow oscillations in various sleep functions. We close by discussing important caveats, open questions, and potential topics for future research.
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Affiliation(s)
| | - Soha Farboud
- Donders Institute for Brain, Cognition and Behaviour, Radboud University, the Netherlands
| | - Hong-Viet V Ngo
- Department of Psychology, University of Essex, United Kingdom; Department of Psychology, University of Lübeck, Germany; Center for Brain, Behaviour and Metabolism, University of Lübeck, Germany
| | - Jules Schneider
- Department of Psychiatry and Psychotherapy, University Hospital Carl Gustav Carus, Technische Universität Dresden, Germany; Department of Neurology, University Hospital Carl Gustav Carus, Technische Universität Dresden, Germany
| | - Frederik D Weber
- Donders Institute for Brain, Cognition and Behaviour, Radboudumc, the Netherlands; Department of Sleep and Cognition, Netherlands Institute for Neuroscience, an institute of the Royal Netherlands Academy of Arts and Sciences, Amsterdam, the Netherlands
| | - Lucia M Talamini
- Department of Psychology, University of Amsterdam, Amsterdam, the Netherlands; Amsterdam Brain and Cognition, University of Amsterdam, Amsterdam, the Netherlands
| | - Martin Dresler
- Donders Institute for Brain, Cognition and Behaviour, Radboudumc, the Netherlands.
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11
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Gumussu TC, Da Poian G, Cortesi S, Karlen W. Real-Time Detection of Sleep Arousals with a Head-Mounted Accelerometer. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2023; 2023:1-4. [PMID: 38083461 DOI: 10.1109/embc40787.2023.10340686] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/18/2023]
Abstract
Wearable electroencephalography (EEG) enables real-time interactions with the sleeping brain in real-life settings. An important parameter to monitor during these interactions are sleep arousals, i.e. temporary increases in EEG frequency, that compose sleep dynamics, but are challenging to detect without delay. We describe the development of an EEG- and accelerometer(ACC)-based sensing approach to detect arousals in real-time. We investigated the ability of these sensing modalities to timely and accurately detect arousals. When evaluated on 6 nights of mobile recordings, ACC had a median real-time delay of 2 s and was therefore better suited for an early detection of arousals than EEG (4.7 s). The detection performance was independent of sleep stages, but worked better on longer arousals. Our results demonstrate that a head-mounted ACC might be a cost-effective and easy-to-integrate solution for arousal detection where short delays are important or EEG signals are not available.
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12
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Brain Waste Removal System and Sleep: Photobiomodulation as an Innovative Strategy for Night Therapy of Brain Diseases. Int J Mol Sci 2023; 24:ijms24043221. [PMID: 36834631 PMCID: PMC9965491 DOI: 10.3390/ijms24043221] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Revised: 01/28/2023] [Accepted: 02/02/2023] [Indexed: 02/10/2023] Open
Abstract
Emerging evidence suggests that an important function of the sleeping brain is the removal of wastes and toxins from the central nervous system (CNS) due to the activation of the brain waste removal system (BWRS). The meningeal lymphatic vessels (MLVs) are an important part of the BWRS. A decrease in MLV function is associated with Alzheimer's and Parkinson's diseases, intracranial hemorrhages, brain tumors and trauma. Since the BWRS is activated during sleep, a new idea is now being actively discussed in the scientific community: night stimulation of the BWRS might be an innovative and promising strategy for neurorehabilitation medicine. This review highlights new trends in photobiomodulation of the BWRS/MLVs during deep sleep as a breakthrough technology for the effective removal of wastes and unnecessary compounds from the brain in order to increase the neuroprotection of the CNS as well as to prevent or delay various brain diseases.
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13
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Zeller CJ, Züst MA, Wunderlin M, Nissen C, Klöppel S. The promise of portable remote auditory stimulation tools to enhance slow-wave sleep and prevent cognitive decline. J Sleep Res 2023:e13818. [PMID: 36631001 DOI: 10.1111/jsr.13818] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Revised: 12/13/2022] [Accepted: 12/14/2022] [Indexed: 01/13/2023]
Abstract
Dementia is the seventh leading cause of mortality, and a major source of disability and dependency in older individuals globally. Cognitive decline (and, to a lesser extent, normal ageing) are associated with sleep fragmentation and loss of slow-wave sleep. Evidence suggests a bidirectional causal link between these losses. Phase-locked auditory stimulation has emerged as a promising non-invasive tool to enhance slow-wave sleep, potentially ameliorating cognitive decline. In laboratory settings, auditory stimulation is usually supervised by trained experts. Different algorithms (simple amplitude thresholds, topographic correlation, sine-wave fitting, phase-locked loop, and phase vocoder) are used to precisely target auditory stimulation to a desired phase of the slow wave. While all algorithms work well in younger adults, the altered sleep physiology of older adults and particularly those with neurodegenerative disorders requires a tailored approach that can adapt to older adults' fragmented sleep and reduced amplitudes of slow waves. Moreover, older adults might require a continuous intervention that is not feasible in laboratory settings. Recently, several auditory stimulation-capable portable devices ('Dreem®', 'SmartSleep®' and 'SleepLoop®') have been developed. We discuss these three devices regarding their potential as tools for science, and as clinical remote-intervention tools to combat cognitive decline. Currently, SleepLoop® shows the most promise for scientific research in older adults due to high transparency and customizability but is not commercially available. Studies evaluating down-stream effects on cognitive abilities, especially in patient populations, are required before a portable auditory stimulation device can be recommended as a clinical preventative remote-intervention tool.
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Affiliation(s)
- Céline J Zeller
- University Hospital of Old Age 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
| | - Christoph Nissen
- University Hospital of Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland.,Division of Psychiatric Specialties, Geneva University Hospitals (HUG), Geneva, Switzerland
| | - Stefan Klöppel
- University Hospital of Old Age Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
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14
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Albrecht JN, Jaramillo V, Huber R, Karlen W, Baumann CR, Brotschi B. Technical feasibility of using auditory phase-targeted stimulation after pediatric severe traumatic brain injury in an intensive care setting. BMC Pediatr 2022; 22:616. [PMID: 36289537 PMCID: PMC9597971 DOI: 10.1186/s12887-022-03667-7] [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: 06/15/2022] [Revised: 09/26/2022] [Accepted: 10/10/2022] [Indexed: 11/24/2022] Open
Abstract
Background Supplementary treatment options after pediatric severe traumatic brain injury (TBI) are needed to improve neurodevelopmental outcome. Evidence suggests enhancement of brain delta waves via auditory phase-targeted stimulation might support neuronal reorganization, however, this method has never been applied in analgosedated patients on the pediatric intensive care unit (PICU). Therefore, we conducted a feasibility study to investigate this approach: In a first recording phase, we examined feasibility of recording over time and in a second stimulation phase, we applied stimulation to address tolerability and efficacy. Methods Pediatric patients (> 12 months of age) with severe TBI were included between May 2019 and August 2021. An electroencephalography (EEG) device capable of automatic delta wave detection and sound delivery through headphones was used to record brain activity and for stimulation (MHSL-SleepBand version 2). Stimulation tolerability was evaluated based on report of nurses, visual inspection of EEG data and clinical signals (heart rate, intracranial pressure), and whether escalation of therapy to reduce intracranial pressure was needed. Stimulation efficacy was investigated by comparing EEG power spectra of active stimulation versus muted stimulation (unpaired t-tests). Results In total, 4 out of 32 TBI patients admitted to the PICU (12.5%) between 4 and 15 years of age were enrolled in the study. All patients were enrolled in the recording phase and the last one also to the stimulation phase. Recordings started within 5 days after insult and lasted for 1–4 days. Overall, 23–88 h of EEG data per patient were collected. In patient 4, stimulation was enabled for 50 min: No signs of patient stress reactions were observed. Power spectrums between active and muted stimulation were not statistically different (all P > .05). Conclusion Results suggests good feasibility of continuously applying devices needed for auditory stimulation over multiple days in pediatric patients with TBI on PICU. Very preliminary evidence suggests good tolerability of auditory stimuli, but efficacy of auditory stimuli to enhance delta waves remains unclear and requires further investigation. However, only low numbers of severe TBI patients could be enrolled in the study and, thus, future studies should consider an international multicentre approach.
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Affiliation(s)
- Joëlle Ninon Albrecht
- grid.7400.30000 0004 1937 0650Child Development Center, University Children’s Hospital Zurich, University of Zurich (UZH), Zurich, Switzerland ,grid.7400.30000 0004 1937 0650Children’s Research Center, University Children’s Hospital Zurich, University of Zurich (UZH), Zurich, Switzerland
| | - Valeria Jaramillo
- grid.7400.30000 0004 1937 0650Child Development Center, University Children’s Hospital Zurich, University of Zurich (UZH), Zurich, Switzerland ,grid.7400.30000 0004 1937 0650Children’s Research Center, University Children’s Hospital Zurich, University of Zurich (UZH), Zurich, Switzerland ,grid.5475.30000 0004 0407 4824Surrey Sleep Research Centre, Faculty of Health and Medical Sciences, University of Surrey, Guildford, UK ,grid.5475.30000 0004 0407 4824Neuromodulation Laboratory, School of Psychology, University of Surrey, Guildford, UK ,grid.7445.20000 0001 2113 8111Care Research and Technology Centre, UK Dementia Research Institute, at Imperial College, University of Surrey, London, Guildford, UK
| | - Reto Huber
- grid.7400.30000 0004 1937 0650Child Development Center, University Children’s Hospital Zurich, University of Zurich (UZH), Zurich, Switzerland ,grid.7400.30000 0004 1937 0650Children’s Research Center, University Children’s Hospital Zurich, University of Zurich (UZH), Zurich, Switzerland ,grid.7400.30000 0004 1937 0650Department of Child and Adolescent Psychiatry and Psychotherapy, University Hospital of Psychiatry, University of Zurich (UZH), Zurich, Switzerland
| | - Walter Karlen
- grid.5801.c0000 0001 2156 2780Mobile Health Systems Lab, Department of Health Sciences and Technology, ETH Zurich, Zurich, Switzerland ,grid.6582.90000 0004 1936 9748Institute of Biomedical Engineering, University of Ulm, Ulm, Germany
| | - Christian Rainer Baumann
- grid.412004.30000 0004 0478 9977Department of Neurology, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Barbara Brotschi
- grid.7400.30000 0004 1937 0650Children’s Research Center, University Children’s Hospital Zurich, University of Zurich (UZH), Zurich, Switzerland ,grid.7400.30000 0004 1937 0650Department of Neonatology and Paediatric Intensive Care, University Children’s Hospital Zurich, University of Zurich (UZH), Zurich, Switzerland
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15
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Seol J, Lee J, Park I, Tokuyama K, Fukusumi S, Kokubo T, Yanagisawa M, Okura T. Bidirectional associations between physical activity and sleep in older adults: a multilevel analysis using polysomnography. Sci Rep 2022; 12:15399. [PMID: 36100642 PMCID: PMC9470065 DOI: 10.1038/s41598-022-19841-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Accepted: 09/05/2022] [Indexed: 11/09/2022] Open
Abstract
AbstractAlthough recent studies have examined the bidirectional associations between physical activity and sleep parameters, few have focused on older adults utilizing objective assessments, such as polysomnography. This micro-longitudinal observational study included 92 Japanese older adults (aged 65–86 years) who underwent objective evaluations of sleep quality using polysomnography and completed subjective sleep-related questionnaires. Activity levels were assessed using an accelerometer. Polysomnography, subjective sleep-related questionnaires, and accelerometer were administered for 7 consecutive days. Multilevel models (participant-, day-level) were used to examine the temporal associations of objective and subjective sleep parameters with sedentary behavior and physical activity. In the day-level analysis, higher levels of sedentary behavior during daytime were associated with longer rapid eye movement (REM) sleep, shorter REM latency, lower levels of non-REM sleep (stage N3), and reduced delta power during daytime. Higher levels of low-intensity physical activity during daytime were associated with lower levels of REM sleep, longer REM latency, and increased stage N3 sleep in the day-level analysis. Higher levels of moderate-to-vigorous physical activity were associated with increased REM latency. Longer subjective sleep time was associated with increased next-day moderate-to-vigorous physical activity. Thus, low-intensity physical activity may provide objective benefits related to deep sleep parameters in older adults.
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16
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Huwiler S, Carro Dominguez M, Huwyler S, Kiener L, Stich FM, Sala R, Aziri F, Trippel A, Schmied C, Huber R, Wenderoth N, Lustenberger C. Effects of auditory sleep modulation approaches on brain oscillatory and cardiovascular dynamics. Sleep 2022; 45:6632997. [PMID: 35793672 PMCID: PMC9453626 DOI: 10.1093/sleep/zsac155] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Revised: 06/01/2022] [Indexed: 11/14/2022] Open
Abstract
Abstract
Slow waves, the hallmark feature of deep nonrapid eye movement sleep, do potentially drive restorative effects of sleep on brain and body functions. Sleep modulation techniques to elucidate the functional role of slow waves thus have gained large interest. Auditory slow wave stimulation is a promising tool; however, directly comparing auditory stimulation approaches within a night and analyzing induced dynamic brain and cardiovascular effects are yet missing. Here, we tested various auditory stimulation approaches in a windowed, 10 s ON (stimulations) followed by 10 s OFF (no stimulations), within-night stimulation design and compared them to a SHAM control condition. We report the results of three studies and a total of 51 included nights and found a large and global increase in slow-wave activity (SWA) in the stimulation window compared to SHAM. Furthermore, slow-wave dynamics were most pronouncedly increased at the start of the stimulation and declined across the stimulation window. Beyond the changes in brain oscillations, we observed, for some conditions, a significant increase in the mean interval between two heartbeats within a stimulation window, indicating a slowing of the heart rate, and increased heart rate variability derived parasympathetic activity. Those cardiovascular changes were positively correlated with the change in SWA, and thus, our findings provide insight into the potential of auditory slow wave enhancement to modulate cardiovascular restorative conditions during sleep. However, future studies need to investigate whether the potentially increased restorative capacity through slow-wave enhancements translates into a more rested cardiovascular system on a subsequent day.
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Affiliation(s)
- Stephanie Huwiler
- Department of Health Sciences and Technology, Neural Control of Movement Lab, Institute of Human Movement Sciences and Sport, ETH Zurich, Zurich, Switzerland
| | - Manuel Carro Dominguez
- Department of Health Sciences and Technology, Neural Control of Movement Lab, Institute of Human Movement Sciences and Sport, ETH Zurich, Zurich, Switzerland
| | - Silja Huwyler
- Department of Health Sciences and Technology, Neural Control of Movement Lab, Institute of Human Movement Sciences and Sport, ETH Zurich, Zurich, Switzerland
| | - Luca Kiener
- Department of Health Sciences and Technology, Neural Control of Movement Lab, Institute of Human Movement Sciences and Sport, ETH Zurich, Zurich, Switzerland
| | - Fabia M Stich
- Department of Health Sciences and Technology, Neural Control of Movement Lab, Institute of Human Movement Sciences and Sport, ETH Zurich, Zurich, Switzerland
| | - Rossella Sala
- Department of Health Sciences and Technology, Neural Control of Movement Lab, Institute of Human Movement Sciences and Sport, ETH Zurich, Zurich, Switzerland
| | - Florent Aziri
- Department of Health Sciences and Technology, Neural Control of Movement Lab, Institute of Human Movement Sciences and Sport, ETH Zurich, Zurich, Switzerland
| | - Anna Trippel
- Department of Health Sciences and Technology, Neural Control of Movement Lab, Institute of Human Movement Sciences and Sport, ETH Zurich, Zurich, Switzerland
| | - Christian Schmied
- Department of Cardiology, University Heart Center Zurich, University of Zurich, Zurich, Switzerland
| | - Reto Huber
- Center of Competence Sleep and Health Zurich, University of Zurich, Zurich, Switzerland
- Neuroscience Center Zurich (ZNZ), University of Zurich, ETH Zurich, Zurich, Switzerland
- Child Development Centre, University Children’s Hospital, University of Zurich, Zurich, Switzerland
- Department of Child and Adolescent Psychiatry and Psychotherapy, Psychiatric Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Nicole Wenderoth
- Department of Health Sciences and Technology, Neural Control of Movement Lab, Institute of Human Movement Sciences and Sport, ETH Zurich, Zurich, Switzerland
- Neuroscience Center Zurich (ZNZ), University of Zurich, ETH Zurich, Zurich, Switzerland
- Future Health Technologies, Singapore-ETH Center, Campus for Research Excellence and Technological Enterprise (CREATE), Singapore, Singapore
| | - Caroline Lustenberger
- Corresponding author. Caroline Lustenberger, Department of Health Sciences and Technology, Neural Control of Movement Lab, ETH Zurich, Zurich, 8092, Switzerland.
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17
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Schreiner SJ, Werth E, Ballmer L, Valko PO, Schubert KM, Imbach LL, Baumann CR, Maric A, Baumann-Vogel H. Sleep spindle and slow wave activity in Parkinson disease with excessive daytime sleepiness. Sleep 2022; 46:6649751. [PMID: 35877159 DOI: 10.1093/sleep/zsac165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Revised: 06/17/2022] [Indexed: 11/13/2022] Open
Abstract
Abstract
Study Objectives
Excessive daytime sleepiness (EDS) is a common and devastating symptom in Parkinson disease (PD), but surprisingly most studies showed that EDS is independent from nocturnal sleep disturbance measured with polysomnography. Quantitative electroencephalography (EEG) may reveal additional insights by measuring the EEG hallmarks of non-rapid eye movement (NREM) sleep, namely slow waves and spindles. Here, we tested the hypothesis that EDS in PD is associated with nocturnal sleep disturbance revealed by quantitative NREM sleep EEG markers.
Methods
Patients with PD (n = 130) underwent polysomnography followed by spectral analysis to calculate spindle frequency activity, slow-wave activity (SWA), and overnight SWA decline, which reflects the dissipation of homeostatic sleep pressure. We used the Epworth Sleepiness Scale (ESS) to assess subjective daytime sleepiness and define EDS (ESS > 10). All examinations were part of an evaluation for deep brain stimulation.
Results
Patients with EDS (n = 46) showed reduced overnight decline of SWA (p = 0.036) and reduced spindle frequency activity (p = 0.032) compared with patients without EDS. Likewise, more severe daytime sleepiness was associated with reduced SWA decline (ß= −0.24 p = 0.008) and reduced spindle frequency activity (ß= −0.42, p < 0.001) across all patients. Reduced SWA decline, but not daytime sleepiness, was associated with poor sleep quality and continuity at polysomnography.
Conclusions
Our data suggest that daytime sleepiness in PD patients is associated with sleep disturbance revealed by quantitative EEG, namely reduced overnight SWA decline and reduced spindle frequency activity. These findings could indicate that poor sleep quality, with incomplete dissipation of homeostatic sleep pressure, may contribute to EDS in PD.
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Affiliation(s)
- Simon J Schreiner
- Department of Neurology, University Hospital Zurich, University of Zurich , Zurich , Switzerland
- Clinical Neuroscience Center, University Hospital Zurich, University of Zurich , Zurich , Switzerland
- Sleep and Health Zurich (SHZ), University of Zurich , Zurich , Switzerland
| | - Esther Werth
- Department of Neurology, University Hospital Zurich, University of Zurich , Zurich , Switzerland
- Clinical Neuroscience Center, University Hospital Zurich, University of Zurich , Zurich , Switzerland
- Sleep and Health Zurich (SHZ), University of Zurich , Zurich , Switzerland
| | - Leonie Ballmer
- Department of Neurology, University Hospital Zurich, University of Zurich , Zurich , Switzerland
- Clinical Neuroscience Center, University Hospital Zurich, University of Zurich , Zurich , Switzerland
| | - Philipp O Valko
- Department of Neurology, University Hospital Zurich, University of Zurich , Zurich , Switzerland
- Clinical Neuroscience Center, University Hospital Zurich, University of Zurich , Zurich , Switzerland
- Sleep and Health Zurich (SHZ), University of Zurich , Zurich , Switzerland
| | - Kai M Schubert
- Department of Neurology, University Hospital Zurich, University of Zurich , Zurich , Switzerland
- Clinical Neuroscience Center, University Hospital Zurich, University of Zurich , Zurich , Switzerland
| | - Lukas L Imbach
- Department of Neurology, University Hospital Zurich, University of Zurich , Zurich , Switzerland
- Clinical Neuroscience Center, University Hospital Zurich, University of Zurich , Zurich , Switzerland
- Swiss Epilepsy Center, Klinik Lengg , Zurich , Switzerland
| | - Christian R Baumann
- Department of Neurology, University Hospital Zurich, University of Zurich , Zurich , Switzerland
- Clinical Neuroscience Center, University Hospital Zurich, University of Zurich , Zurich , Switzerland
- Sleep and Health Zurich (SHZ), University of Zurich , Zurich , Switzerland
| | - Angelina Maric
- Department of Neurology, University Hospital Zurich, University of Zurich , Zurich , Switzerland
- Clinical Neuroscience Center, University Hospital Zurich, University of Zurich , Zurich , Switzerland
- Sleep and Health Zurich (SHZ), University of Zurich , Zurich , Switzerland
| | - Heide Baumann-Vogel
- Department of Neurology, University Hospital Zurich, University of Zurich , Zurich , Switzerland
- Clinical Neuroscience Center, University Hospital Zurich, University of Zurich , Zurich , Switzerland
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18
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Ferster ML, Da Poian G, Menachery K, Schreiner SJ, Lustenberger C, Maric A, Huber R, Baumann CR, Karlen W. Benchmarking real-time algorithms for in-phase auditory stimulation of low amplitude slow waves with wearable EEG devices during sleep. IEEE Trans Biomed Eng 2022; 69:2916-2925. [PMID: 35259094 DOI: 10.1109/tbme.2022.3157468] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Auditory stimulation of EEG slow waves (SW) during non-rapid eye movement (NREM) sleep has shown to improve cognitive function when it is delivered at the up-phase of SW. SW enhancement is particularly desirable in subjects with low-amplitude SW such as older adults or patients suffering from neurodegeneration such as Parkinson disease (PD). However, existing algorithms to estimate the up-phase suffer from a poor phase accuracy at low EEG amplitudes and when SW frequencies are not constant. We introduce two novel algorithms for real-time EEG phase estimation on autonomous wearable devices. The algorithms were based on a phase-locked loop (PLL) and, for the first time, a phase vocoder (PV). We compared these phase tracking algorithms with a simple amplitude threshold approach. The optimized algorithms were benchmarked for phase accuracy, the capacity to estimate phase at SW amplitudes between 20 and 60 V, and SW frequencies above 1 Hz on 324 recordings from healthy older adults and PD patients. Furthermore, the algorithms were implemented on a wearable device and the computational efficiency and the performance was evaluated on simulated sleep EEG, as well as prospectively during a recording with a PD patient. All three algorithms delivered more than 70% of the stimulation triggers during the SW up-phase. The PV showed the highest capacity on targeting low-amplitude SW and SW with frequencies above 1 Hz. The testing on real-time hardware revealed that both PV and PLL have marginal impact on microcontroller load, while the efficiency of the PV was 4% lower than the PLL. Active auditory stimulation did not influence the phase tracking. This work demonstrated that phase-accurate auditory stimulation can be delivered during home-based sleep interventions with a wearable device also in populations with low-amplitude SW.
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