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Sengupta A, Tudor JC, Cusmano D, Baur JA, Abel T, Weljie AM. Sleep deprivation and aging are metabolically linked across tissues. Sleep 2023; 46:zsad246. [PMID: 37738102 DOI: 10.1093/sleep/zsad246] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Revised: 08/21/2023] [Indexed: 09/24/2023] Open
Abstract
STUDY OBJECTIVES Insufficient sleep is a concerning hallmark of modern society because sleep deprivation (SD) is a risk factor for neurodegenerative and cardiometabolic disorders. SD imparts an aging-like effect on learning and memory, although little is known about possible common molecular underpinnings of SD and aging. Here, we examine this question by profiling metabolic features across different tissues after acute SD in young adult and aged mice. METHODS Young adult and aged mice were subjected to acute SD for 5 hours. Blood plasma, hippocampus, and liver samples were subjected to UPLC-MS/MS-based metabolic profiling. RESULTS SD preferentially impacts peripheral plasma and liver profiles (e.g. ketone body metabolism) whereas the hippocampus is more impacted by aging. We further demonstrate that aged animals exhibit SD-like metabolic features at baseline. Hepatic alterations include parallel changes in nicotinamide metabolism between aging and SD in young animals. Overall, metabolism in young adult animals is more impacted by SD, which in turn induces aging-like features. A set of nine metabolites was classified (79% correct) based on age and sleep status across all four groups. CONCLUSIONS Our metabolic observations demonstrate striking parallels to previous observations in studies of learning and memory and define a molecular metabolic signature of sleep loss and aging.
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Affiliation(s)
- Arjun Sengupta
- Department of Pharmacology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Jennifer C Tudor
- Department of Biology, University of Pennsylvania, Philadelphia, PA, USA
- Current affiliation: Department of Biology, Saint Joseph's University, Philadelphia, PA, USA
| | - Danielle Cusmano
- Department of Biology, University of Pennsylvania, Philadelphia, PA, USA
| | - Joseph A Baur
- Department of Physiology and Institute for Diabetes, Obesity, and Metabolism, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Ted Abel
- Department of Biology, University of Pennsylvania, Philadelphia, PA, USA
- Current Affiliation: Iowa Neuroscience Institute, Department of Neuroscience and Pharmacology, Carver College of Medicine, University of Iowa, 2312 PBDB, Iowa City, IA, USA
| | - Aalim M Weljie
- Department of Pharmacology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
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2
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Zhai Q, Zhang Y, Ye M, Zhu S, Sun J, Wang Y, Deng B, Ma D, Wang Q. Reducing complement activation during sleep deprivation yields cognitive improvement by dexmedetomidine. Br J Anaesth 2023; 131:542-555. [PMID: 37517957 DOI: 10.1016/j.bja.2023.04.044] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Revised: 04/24/2023] [Accepted: 04/25/2023] [Indexed: 08/01/2023] Open
Abstract
BACKGROUND Sleep loss and its associated conditions (e.g. cognitive deficits) represent a large societal burden, but the underlying mechanisms of these cognitive deficits remain unknown. This study assessed the effect of dexmedetomidine (DEX) on cognitive decline induced by sleep loss. METHODS C57BL/6 mice were subjected to chronic sleep restriction (CSR) for 20 h (5 pm-1 pm the next day) daily for 7 days, and cognitive tests were subsequently carried out. The neuromolecular and cellular changes that occurred in the presence and absence of DEX (100 μg kg-1, i.v., at 1 pm and 3 pm every day) were also investigated. RESULTS CSR mice displayed a decline in learning and memory by 12% (P<0.05) in the Y-maze and by 18% (P<0.01) in the novel object recognition test; these changes were associated with increases in microglial activation, CD68+ microglial phagosome counts, astrocyte-derived complement C3 secretion, and microglial C3a receptor expression (all P<0.05). Synapse elimination, as indicated by a 66% decrease in synaptophysin expression (P=0.0004) and a 45% decrease in postsynaptic density protein-95 expression (P=0.0003), was associated with the occurrence of cognitive deficits. DEX activated astrocytic α2A adrenoceptors and inhibited astrocytic complement C3 release to attenuate synapse elimination through microglial phagocytosis. DEX restored synaptic connections and reversed cognitive deficits induced by CSR. CONCLUSIONS The results demonstrate that complement pathway activation associated with synapse elimination contributes to sleep loss-related cognitive deficits and that dexmedetomidine protects against sleep deprivation-induced complement activation. Dexmedetomidine holds potential for preventing cognitive deficits associated with sleep loss, which warrants further study.
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Affiliation(s)
- Qian Zhai
- Department of Anaesthesiology and Center for Brain Science, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Ying Zhang
- Department of Anaesthesiology and Center for Brain Science, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Mao Ye
- Department of Anaesthesiology and Center for Brain Science, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Shan Zhu
- Department of Anaesthesiology and Center for Brain Science, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Jianyu Sun
- Department of Anaesthesiology and Center for Brain Science, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Yue Wang
- Department of Anaesthesiology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Bin Deng
- Department of Anaesthesiology and Center for Brain Science, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Daqing Ma
- Division of Anaesthetics, Pain Medicine and Intensive Care, Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, Chelsea & Westminster Hospital, London, UK; Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, China.
| | - Qiang Wang
- Department of Anaesthesiology and Center for Brain Science, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China.
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Chen P, Ban W, Wang W, You Y, Yang Z. The Devastating Effects of Sleep Deprivation on Memory: Lessons from Rodent Models. Clocks Sleep 2023; 5:276-294. [PMID: 37218868 DOI: 10.3390/clockssleep5020022] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 05/11/2023] [Accepted: 05/11/2023] [Indexed: 05/24/2023] Open
Abstract
In this narrative review article, we discuss the role of sleep deprivation (SD) in memory processing in rodent models. Numerous studies have examined the effects of SD on memory, with the majority showing that sleep disorders negatively affect memory. Currently, a consensus has not been established on which damage mechanism is the most appropriate. This critical issue in the neuroscience of sleep remains largely unknown. This review article aims to elucidate the mechanisms that underlie the damaging effects of SD on memory. It also proposes a scientific solution that might explain some findings. We have chosen to summarize literature that is both representative and comprehensive, as well as innovative in its approach. We examined the effects of SD on memory, including synaptic plasticity, neuritis, oxidative stress, and neurotransmitters. Results provide valuable insights into the mechanisms by which SD impairs memory function.
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Affiliation(s)
- Pinqiu Chen
- Institute of Medicinal Plant Development, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100193, China
- Key Laboratory of Molecular Pharmacology and Drug Evaluation, Ministry of Education, School of Pharmacy, Yantai University, Yantai 264005, China
| | - Weikang Ban
- Institute of Medicinal Plant Development, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100193, China
| | - Wenyan Wang
- Key Laboratory of Molecular Pharmacology and Drug Evaluation, Ministry of Education, School of Pharmacy, Yantai University, Yantai 264005, China
| | - Yuyang You
- School of Automation, Beijing Institute of Technology, Beijing 100081, China
| | - Zhihong Yang
- Institute of Medicinal Plant Development, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100193, China
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4
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Subjective and objective sleep quality does not predict behavioural episodic foresight in younger or older adults. Sci Rep 2023; 13:1056. [PMID: 36658258 PMCID: PMC9852464 DOI: 10.1038/s41598-023-28183-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Accepted: 01/13/2023] [Indexed: 01/20/2023] Open
Abstract
Episodic foresight refers to one's capacity to use imagined scenarios to guide future-directed behaviors. It is important in facilitating complex activities of daily living, such as managing finances. Broader literature shows that older adults perform more poorly on tests of episodic foresight relative to their younger counterparts. At the same time, age-related changes in sleep often contribute to age-related decline in other cognitive abilities known to support episodic foresight, such as memory. No study to date has tested whether sleep quality is associated with episodic foresight when it is measured behaviorally; or whether this relationship is moderated by age. To address this, in the present study healthy younger (n = 39) and older (n = 41) adults were asked to wear an actigraphy watch and self-report their sleep quality for seven nights. Participants then completed the virtual-week foresight task-a behavioral assessment of episodic foresight. Neither objective or subjective sleep quality predicted episodic foresight outcomes, and this was not moderated by age group. Bayesian analyses provided evidence in favour of the null hypotheses. These results suggest that sleep quality (at least in healthy adult populations) may not be linked to episodic foresight.
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5
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Muacevic A, Adler JR, Wu L, Wang C, Lin X, Li X. Electrophysiological Mechanism of Attention of Sleep Deprivation: Evidence From Event-Related Potentials (ERP) Data. Cureus 2023; 15:e33464. [PMID: 36751208 PMCID: PMC9899587 DOI: 10.7759/cureus.33464] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/06/2023] [Indexed: 01/09/2023] Open
Abstract
INTRODUCTION The purpose of this study is to investigate the effects of sleep deprivation on individual attentional function and related electrophysiological mechanisms. METHODS Twenty healthy men who were deprived of sleep for 24 h were evaluated by selective attention test, persistent attention test, and event-related potentials (ERP) experiment. RESULTS After 24 h of sleep deprivation, the subjects' selective attention decreased, mainly manifested as prolonged response time, decreased motion stability, increased rate of neglect error, decreased sustained attention, prolonged latency of P300 at Cz (p=0.001), and decreased amplitude (p=0.000). CONCLUSION After 24 h of sleep deprivation, the attentional ability decreased significantly, and behavioral and ERP indicators showed certain changes.
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Lin JH, Chen XH, Wu Y, Cao YB, Chen HJ, Huang NX. Altered isotropic volume fraction in gray matter after sleep deprivation and its association with visuospatial memory: A neurite orientation dispersion and density imaging study. Front Neurosci 2023; 17:1144802. [PMID: 37034160 PMCID: PMC10076534 DOI: 10.3389/fnins.2023.1144802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2023] [Accepted: 03/06/2023] [Indexed: 04/11/2023] Open
Abstract
Background and aims Diffusion magnetic resonance imaging (dMRI) studies have revealed microstructural abnormalities in white matter resulting from sleep deprivation (SD). This study aimed to adopt neurite orientation dispersion and density imaging (NODDI) to investigate the effect of SD on gray matter (GM) microstructural properties and its association to visuospatial memory (VSM). Methods Twenty-four healthy women underwent two sessions of dMRI scanning and visuospatial ability assessment by Complex Figure Test (CFT), once during rested wakefulness (RW) and once after 24 h of SD. We calculated NODDI metrics, including intracellular volume fraction (ICVF), orientation dispersion index (ODI), and isotropic volume fraction (ISO). Differences in NODDI-related metrics between RW and SD were determined using a voxel-wise paired t-test. We identified an association between NODDI metrics and CFT results using Spearman's correlation coefficient. Results Sleep deprivation worsened subjects' performance in the delayed-CFT trial. We observed no significant difference in ICVF and ODI between RW and SD. After SD, subjects showed decreases in ISO, primarily in the prefrontal cortex and temporal lobe, while exhibiting ISO increases in the anterior and posterior cerebellar lobe and cerebellar vermis. Furthermore, ISO change in the left superior, middle and inferior frontal gyrus was significantly correlated with completion time change in delayed-CFT trial performance. Conclusion Our results suggested that SD hardly affected the density and spatial organization of neurites in GM, but the extra-neurite water molecule diffusion process was affected (perhaps resulting from neuroinflammation), which contributed to VSM dysfunction.
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Affiliation(s)
- Jia-Hui Lin
- Department of Radiology, Fujian Medical University Union Hospital, Fuzhou, China
| | - Xu-Hui Chen
- Department of Radiology, Fujian Medical University Union Hospital, Fuzhou, China
| | - Ye Wu
- School of Computer Science and Engineering, Nanjing University of Science and Technology, Nanjing, China
| | - Yun-Bin Cao
- Department of Radiology, Fujian Medical University Union Hospital, Fuzhou, China
| | - Hua-Jun Chen
- Department of Radiology, Fujian Medical University Union Hospital, Fuzhou, China
- *Correspondence: Hua-Jun Chen,
| | - Nao-Xin Huang
- Department of Radiology, Fujian Medical University Union Hospital, Fuzhou, China
- Nao-Xin Huang,
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Almarzouki AF, Mandili RL, Salloom J, Kamal LK, Alharthi O, Alharthi S, Khayyat N, Baglagel AM. The Impact of Sleep and Mental Health on Working Memory and Academic Performance: A Longitudinal Study. Brain Sci 2022; 12:1525. [PMID: 36358451 PMCID: PMC9688482 DOI: 10.3390/brainsci12111525] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2022] [Revised: 11/01/2022] [Accepted: 11/07/2022] [Indexed: 04/06/2024] Open
Abstract
Sleep and mental health can affect cognition and academic performance. The present study aimed to investigate the relationships between sleep, mental health, working memory, and academic performance. We collected demographic data from university students during the non-academic summer period and the academic term. We also measured academic performance (GPA), sleep (PSQI), depression (PHQ-9), anxiety (GAD-7), and disordered social media use (SMDS). Working memory was assessed by the Cambridge Neuropsychological Test Automated Battery (CANTAB). We assessed 83 students (42.2% male) with a mean age of 21 years. Compared to the non-academic summer period, students had significantly worse sleep and distress scores in the academic term. Anxiety, depression, and distress scores were significantly correlated with worse sleep quality. Despite worse mental health and sleep in the academic term, working memory improved compared to the non-academic summer period and was also correlated with a higher GPA. However, a higher GPA was significantly associated with longer sleep latency, increased sleep disturbances, and increased use of sleep medication. Students experiencing poor sleep suffered from poor mental health, although they maintained high GPA and working memory scores. Cognitive resilience, including higher working memory, may mask poor sleep quality and mental health among university students.
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Affiliation(s)
- Abeer F. Almarzouki
- Department of Physiology, Faculty of Medicine, King Abdulaziz University, Jeddah 21589, Saudi Arabia
| | - Rahaf L. Mandili
- Faculty of Medicine, King Abdulaziz University, Jeddah 21589, Saudi Arabia
| | - Joud Salloom
- Faculty of Medicine, King Abdulaziz University, Jeddah 21589, Saudi Arabia
| | - Lujain K. Kamal
- Faculty of Medicine, King Abdulaziz University, Jeddah 21589, Saudi Arabia
| | - Omimah Alharthi
- Faculty of Medicine, King Abdulaziz University, Jeddah 21589, Saudi Arabia
| | - Samah Alharthi
- Faculty of Medicine, King Abdulaziz University, Jeddah 21589, Saudi Arabia
| | - Nusaiba Khayyat
- Faculty of Medicine, King Abdulaziz University, Jeddah 21589, Saudi Arabia
| | - Alaa M. Baglagel
- Faculty of Medicine, King Abdulaziz University, Jeddah 21589, Saudi Arabia
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8
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Dzierzewski JM, Perez E, Ravyts SG, Dautovich N. Sleep and Cognition: A Narrative Review Focused on Older Adults. Sleep Med Clin 2022; 17:205-222. [PMID: 35659074 DOI: 10.1016/j.jsmc.2022.02.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
Little is known regarding sleep's association with the traditional developmental course of late-life cognitive functioning. As the number of older adults increases worldwide, an enhanced understanding of age-related changes in sleep and cognition is necessary to slow decline and promote optimal aging. This review synthesizes the extant literature on sleep and cognitive function in healthy older adults, older adults with insomnia, and older adults with sleep apnea, incorporating information on the potential promising effects of treating poor sleep on cognitive outcomes in older adults. Unifying theories of the sleep-cognition association, possible mechanisms of action, and important unanswered questions are identified.
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Affiliation(s)
- Joseph M Dzierzewski
- Department of Psychology, Virginia Commonwealth University, 806 West Franklin Street, Room 306, Box 842018, Richmond, VA 23284-2018, USA.
| | - Elliottnell Perez
- Department of Psychology, Virginia Commonwealth University, Box 842018, Richmond, VA 23284-2018, USA
| | - Scott G Ravyts
- Department of Psychology, Virginia Commonwealth University, Box 842018, Richmond, VA 23284-2018, USA
| | - Natalie Dautovich
- Department of Psychology, Virginia Commonwealth University, 800 West Franklin Street, Room 203, Box 842018, Richmond, VA 23284-2018, USA
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9
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Nishida M, Chiba T, Murata Y, Shioda K. Effects of Sleep Restriction on Self-Reported Putting Performance in Golf. Percept Mot Skills 2022; 129:833-850. [PMID: 35414325 DOI: 10.1177/00315125221087027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
In the present study, we aimed to explore the effects of sleep restriction (SR) on self-reported golf putting skills. Eleven collegiate golfers participated in a self-reported, counterbalanced experimental study under two conditions: (a) a SR condition in which sleep on the night prior to putting was restricted to 4-5 hours, and (b) a habitual normal sleep (NS) condition on the night before the putting test. Following each sleep condition, participants engaged in ten consecutive putting tests at 7 am, 11 am, and 3 pm. Participants reported their subjective sleepiness before each time frame, and their chronotype, defined as their individual circadian preference, was scored based on a morningness-eveningness questionnaire (MEQ). Participants restricted sleep to an average period of 267.6 minutes/night (SD = 51.2) in the SR condition and 426.2 (SD =38.0) minutes/night in the NS condition. A two-way analysis of variance revealed a significant main effect of the sleep condition on the lateral displacement of putts from the target (lateral misalignment) (p = 0.002). In addition, there was a significant main effect of time on distance from the target (distance misalignment) (p = 0.017), indicating less accuracy of putting in the SR condition. In the SR condition, the MEQ score was positively correlated with distance misalignment at 3 pm (ρ = 0.650, p = 0.030), suggesting that morningness types are susceptible to the effects of SR on putting performance. Our findings suggest that golfers should obtain sufficient sleep to optimize putting performance.
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Affiliation(s)
- Masaki Nishida
- Faculty of Sport Sciences, 13148Waseda University, Saitama, Japan.,Sleep Research Institute,13148Waseda University, Tokyo, Japan
| | - Taishi Chiba
- Faculty of Sport Sciences, 13148Waseda University, Saitama, Japan
| | - Yusuke Murata
- Sleep Research Institute,13148Waseda University, Tokyo, Japan
| | - Kohei Shioda
- Sleep Research Institute,13148Waseda University, Tokyo, Japan.,Faculty of Human Sciences, 91995Kanazawa Seiryo University, Ishikawa, Japan
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10
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Jurgelis M, Boardman JM, Coxon JP, Drummond SPA, Chong TTJ. Sleep Restriction Reduces Cognitive but Not Physical Motivation. Nat Sci Sleep 2022; 14:2001-2012. [PMID: 36394069 PMCID: PMC9642807 DOI: 10.2147/nss.s368335] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Accepted: 09/13/2022] [Indexed: 11/06/2022] Open
Abstract
PURPOSE Motivation is an important driver of behaviour, and several frameworks distinguish the willingness of individuals to invest cognitive versus physical effort to achieve a goal. One outstanding question is whether sleep loss lowers motivation within specific domains of effort, or has a global effect on motivation across multiple domains. Here, we investigated the effects of sleep restriction on the motivation to invest cognitive or physical effort in return for reward. MATERIALS AND METHODS 24 healthy young adults (11 females) completed an effort-based decision-making task over two laboratory sessions - once while sleep restricted (three consecutive nights with a three-hour sleep opportunity), and the other while fully rested (nine-hour sleep opportunity on each night). In an initial reinforcement phase, participants were trained to ceiling performance across six levels of effort on separate cognitively and physically demanding tasks. Then, in the critical decision-making phase, participants revealed their preference for how much cognitive or physical effort they would be willing to invest for reward. RESULTS Sleep restriction reduced the willingness to exert cognitive effort, but spared motivation in the physical domain. Furthermore, the reduction in cognitive motivation appeared to be a primary motivational deficit, which could not be attributed to differences in reward-likelihood of different levels of effort or the temporal structure of the task. CONCLUSION The results suggest that sleep restriction has a selective effect on cognitive over physical motivation, which has significant implications for real-world settings in which individuals must maintain high levels of cognitive motivation in the face of chronic sleep loss.
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Affiliation(s)
- Mindaugas Jurgelis
- Turner Institute for Brain and Mental Health, Monash University, Melbourne, Victoria, 3800, Australia.,School of Psychological Sciences, Monash University, Melbourne, Victoria, 3800, Australia
| | - Johanna M Boardman
- Turner Institute for Brain and Mental Health, Monash University, Melbourne, Victoria, 3800, Australia.,School of Psychological Sciences, Monash University, Melbourne, Victoria, 3800, Australia
| | - James P Coxon
- Turner Institute for Brain and Mental Health, Monash University, Melbourne, Victoria, 3800, Australia.,School of Psychological Sciences, Monash University, Melbourne, Victoria, 3800, Australia
| | - Sean P A Drummond
- Turner Institute for Brain and Mental Health, Monash University, Melbourne, Victoria, 3800, Australia.,School of Psychological Sciences, Monash University, Melbourne, Victoria, 3800, Australia
| | - Trevor T J Chong
- Turner Institute for Brain and Mental Health, Monash University, Melbourne, Victoria, 3800, Australia.,School of Psychological Sciences, Monash University, Melbourne, Victoria, 3800, Australia.,Department of Neurology, Alfred Health, Melbourne, Victoria, 3004, Australia.,Department of Clinical Neurosciences, St Vincent's Hospital, Melbourne, Victoria, 3065, Australia
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11
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Serrano DM, Rufino KA, Tran JK, Vujanovic AA. The Association of Sleep Disturbance and Suicide Risk Among Firefighters: Exploring Emotion Regulation Dimensions. Arch Suicide Res 2021; 27:179-191. [PMID: 34586973 DOI: 10.1080/13811118.2021.1982093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
AIM This study explored the extent to which emotion regulation dimensions statistically mediate the association between sleep disturbance and suicide risk among firefighters. METHOD Participants were 865 firefighters working for a fire department in an urban area in the southern U.S. Bootstrapping was used to test the indirect effects of sleep disturbance on suicide risk through emotion regulation dimensions, after controlling for depression and trauma exposure. RESULTS The effect of sleep disturbance on suicide risk was significantly statistically mediated by emotion regulation difficulties (β= .09, SE = .02, 95% CI: .05, .14). Moreover, each of the five dimensions of emotion regulation difficulties significantly statistically mediated this association, with difficulties in engaging in goal-direct behavior (β = .09, SE = .02, 95% CI: .05, .14) and lack of strategies to reduce distress demonstrating the strongest indirect effects (β = .07, SE = .02, 95% CI: .04, .11), after accounting for depression and trauma exposure. CONCLUSION Results suggest that suicide interventions for firefighters who suffer from sleep disturbance should focus on the development of emotion regulation strategies.
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12
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Wang C, Gao WR, Yin J, Wang ZJ, Qi JS, Cai HY, Wu MN. Chronic sleep deprivation exacerbates cognitive and synaptic plasticity impairments in APP/PS1 transgenic mice. Behav Brain Res 2021; 412:113400. [PMID: 34087256 DOI: 10.1016/j.bbr.2021.113400] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Revised: 05/27/2021] [Accepted: 05/30/2021] [Indexed: 01/01/2023]
Abstract
Alzheimer's disease (AD) is a progressive neurodegenerative disorder characterized by cognitive deficits. Sleep deprivation (SD) could lead to memory deficits, and it was a candidate risk factor for AD. However, the effects of chronic SD on the cognitive functions of AD model mice and its possible mechanism are still unclear. In the present study, 8-month-old male APP/PS1 transgenic mice and wild type (WT) littermates were subjected to chronic SD by using the modified multiple platform method (MMPM), with 20 h of SD each day for 21 days. Then, the effects of chronic SD on cognitive functions in APP/PS1 mice were tested by using behavioral tests, the potential mechanisms were investigated by in vivo electrophysiological recording, western blot and immunochemistry. The results showed that chronic SD obviously aggravated the cognitive impairments, exacerbated in vivo hippocampal long-term potentiation (LTP) suppression, reduced the expression level of PSD95, increased amyloid-β (Aβ) protein deposition and overactivated microglia in the hippocampus of APP/PS1 mice. These results indicate that chronic SD exacerbates the cognitive deficits in APP/PS1 mice by accelerating the development of AD pathologies, reducing the expression of PSD95 and aggravating the LTP suppression in hippocampus. At the same time, chronic SD also impaired cognitive functions and synaptic plasticity in WT mice through down-regulating the level of PSD95 and activating microglia. These findings further clarify the electrophysiological and molecular mechanisms of exacerbated cognitive deficits in AD caused by chronic SD.
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Affiliation(s)
- Chun Wang
- Department of Physiology, Key Laboratory of Cellular Physiology, Ministry of Education, Shanxi Medical University, Taiyuan, 030001, China
| | - Wen-Rui Gao
- Department of Physiology, Key Laboratory of Cellular Physiology, Ministry of Education, Shanxi Medical University, Taiyuan, 030001, China
| | - Jing Yin
- Department of Physiology, Key Laboratory of Cellular Physiology, Ministry of Education, Shanxi Medical University, Taiyuan, 030001, China
| | - Zhao-Jun Wang
- Department of Physiology, Key Laboratory of Cellular Physiology, Ministry of Education, Shanxi Medical University, Taiyuan, 030001, China
| | - Jin-Shun Qi
- Department of Physiology, Key Laboratory of Cellular Physiology, Ministry of Education, Shanxi Medical University, Taiyuan, 030001, China
| | - Hong-Yan Cai
- Department of Microbiology and Immunology, Shanxi Medical University, Taiyuan, 030001, China.
| | - Mei-Na Wu
- Department of Physiology, Key Laboratory of Cellular Physiology, Ministry of Education, Shanxi Medical University, Taiyuan, 030001, China.
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13
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Chen PC, Whitehurst LN, Naji M, Mednick SC. Autonomic Activity during a Daytime Nap Facilitates Working Memory Improvement. J Cogn Neurosci 2020; 32:1963-1974. [PMID: 32530384 DOI: 10.1162/jocn_a_01588] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Recent investigations have implicated the parasympathetic branch of the autonomic nervous system in higher-order executive functions. These actions are purported to occur through autonomic nervous system's modulation of the pFC, with parasympathetic activity during wake associated with working memory (WM) ability. Compared with wake, sleep is a period with substantially greater parasympathetic tone. Recent work has reported that sleep may also contribute to improvement in WM. Here, we examined the role of cardiac parasympathetic activity during sleep on WM improvement in healthy young adults. Participants were tested in an operation span task in the morning and evening, and during the intertest period, participants experienced either a nap or wake. We measured high-frequency heart rate variability as an index of cardiac, parasympathetic activity during both wake and sleep. Participants showed the expected boost in parasympathetic activity during nap, compared with wake. Furthermore, parasympathetic activity during sleep, but not wake, was significantly correlated with WM improvement. Together, these results indicate that the natural boost in parasympathetic activity during sleep may benefit gains in prefrontal executive function in young adults. We present a conceptual model illustrating the interaction between sleep, autonomic activity, and prefrontal brain function and highlight open research questions that will facilitate understanding of the factors that contribute to executive abilities in young adults as well as in cognitive aging.
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Bañuelos S, Best J, Huguet G, Prieto-Langarica A, Pyzza PB, Wilson S. Modeling the long term effects of thermoregulation on human sleep. J Theor Biol 2020; 493:110208. [PMID: 32087179 DOI: 10.1016/j.jtbi.2020.110208] [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: 01/18/2019] [Revised: 12/23/2019] [Accepted: 02/19/2020] [Indexed: 11/15/2022]
Abstract
The connection between human sleep and energy exertion has long been regarded as part of the reasoning for the need to sleep. A recent theory proposes that during REM sleep, energy utilized for thermoregulation is diverted to other relevant biological processes. We present a mathematical model of human sleep/wake regulation with thermoregulatory functions to gain quantitative insight into the effects of ambient temperature on sleep quality. Our model extends previous models by incorporating equations for the metabolic processes that control thermoregulation during sleep. We present numerical simulations that provide a quantitative answer for how humans adjust by changing the normal sleep stage progression when it is challenged with ambient temperatures away from thermoneutral. We explore the dynamics for a single night and several nights. Our results indicate that including the effects of temperature is a vital component of modeling sleep.
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Affiliation(s)
- Selenne Bañuelos
- Department of Mathematics, California State University-Channel Islands, Camarillo, CA, United States.
| | - Janet Best
- Department of Mathematics, The Ohio State University, Columbus, OH, United States.
| | - Gemma Huguet
- Departament de Matemàtiques, Universitat Politècnica de Catalunya, Barcelona, Spain.
| | - Alicia Prieto-Langarica
- Department of Mathematics and Statistics, Youngstown State University, Youngstown, OH, United States.
| | - Pamela B Pyzza
- Department of Mathematics and Computer Science, Ohio Wesleyan University, Delaware, OH, United States.
| | - Shelby Wilson
- Department of Biology, University of Maryland, College Park, MD, United States.
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15
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Beynel L, Davis SW, Crowell CA, Dannhauer M, Lim W, Palmer H, Hilbig SA, Brito A, Hile C, Luber B, Lisanby SH, Peterchev AV, Cabeza R, Appelbaum LG. Site-Specific Effects of Online rTMS during a Working Memory Task in Healthy Older Adults. Brain Sci 2020; 10:E255. [PMID: 32349366 PMCID: PMC7287855 DOI: 10.3390/brainsci10050255] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Revised: 04/24/2020] [Accepted: 04/27/2020] [Indexed: 12/04/2022] Open
Abstract
The process of manipulating information within working memory is central to many cognitive functions, but also declines rapidly in old age. Improving this process could markedly enhance the health-span in older adults. The current pre-registered, randomized and placebo-controlled study tested the potential of online repetitive transcranial magnetic stimulation (rTMS) applied at 5 Hz over the left lateral parietal cortex to enhance working memory manipulation in healthy elderly adults. rTMS was applied, while participants performed a delayed-response alphabetization task with two individually titrated levels of difficulty. Coil placement and stimulation amplitude were calculated from fMRI activation maps combined with electric field modeling on an individual-subject basis in order to standardize dosing at the targeted cortical location. Contrary to the a priori hypothesis, active rTMS significantly decreased accuracy relative to sham, and only in the hardest difficulty level. When compared to the results from our previous study, in which rTMS was applied over the left prefrontal cortex, we found equivalent effect sizes but opposite directionality suggesting a site-specific effect of rTMS. These results demonstrate engagement of cortical working memory processing using a novel TMS targeting approach, while also providing prescriptions for future studies seeking to enhance memory through rTMS.
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Affiliation(s)
- Lysianne Beynel
- Department of Psychiatry and Behavioral Science, Duke University School of Medicine, 200 Trent Drive, Box 3620 DUMC, Durham, NC 27710, USA; (C.A.C.); (M.D.); (W.L.); (H.P.); (S.A.H.); (A.B.); (C.H.); (S.H.L.); (A.V.P.); (L.G.A.)
| | - Simon W. Davis
- Department of Neurology, Duke University School of Medicine, 3116 N Duke Street, Durham, NC 27704, USA;
- Center for Cognitive Neuroscience, Duke University, 308 Research Drive, Durham, NC 27710, USA;
| | - Courtney A. Crowell
- Department of Psychiatry and Behavioral Science, Duke University School of Medicine, 200 Trent Drive, Box 3620 DUMC, Durham, NC 27710, USA; (C.A.C.); (M.D.); (W.L.); (H.P.); (S.A.H.); (A.B.); (C.H.); (S.H.L.); (A.V.P.); (L.G.A.)
- Center for Cognitive Neuroscience, Duke University, 308 Research Drive, Durham, NC 27710, USA;
| | - Moritz Dannhauer
- Department of Psychiatry and Behavioral Science, Duke University School of Medicine, 200 Trent Drive, Box 3620 DUMC, Durham, NC 27710, USA; (C.A.C.); (M.D.); (W.L.); (H.P.); (S.A.H.); (A.B.); (C.H.); (S.H.L.); (A.V.P.); (L.G.A.)
| | - Wesley Lim
- Department of Psychiatry and Behavioral Science, Duke University School of Medicine, 200 Trent Drive, Box 3620 DUMC, Durham, NC 27710, USA; (C.A.C.); (M.D.); (W.L.); (H.P.); (S.A.H.); (A.B.); (C.H.); (S.H.L.); (A.V.P.); (L.G.A.)
| | - Hannah Palmer
- Department of Psychiatry and Behavioral Science, Duke University School of Medicine, 200 Trent Drive, Box 3620 DUMC, Durham, NC 27710, USA; (C.A.C.); (M.D.); (W.L.); (H.P.); (S.A.H.); (A.B.); (C.H.); (S.H.L.); (A.V.P.); (L.G.A.)
| | - Susan A. Hilbig
- Department of Psychiatry and Behavioral Science, Duke University School of Medicine, 200 Trent Drive, Box 3620 DUMC, Durham, NC 27710, USA; (C.A.C.); (M.D.); (W.L.); (H.P.); (S.A.H.); (A.B.); (C.H.); (S.H.L.); (A.V.P.); (L.G.A.)
| | - Alexandra Brito
- Department of Psychiatry and Behavioral Science, Duke University School of Medicine, 200 Trent Drive, Box 3620 DUMC, Durham, NC 27710, USA; (C.A.C.); (M.D.); (W.L.); (H.P.); (S.A.H.); (A.B.); (C.H.); (S.H.L.); (A.V.P.); (L.G.A.)
| | - Connor Hile
- Department of Psychiatry and Behavioral Science, Duke University School of Medicine, 200 Trent Drive, Box 3620 DUMC, Durham, NC 27710, USA; (C.A.C.); (M.D.); (W.L.); (H.P.); (S.A.H.); (A.B.); (C.H.); (S.H.L.); (A.V.P.); (L.G.A.)
| | - Bruce Luber
- National Institute of Mental Health, 6001 Executive Boulevard, Bethesda, MD 20852, USA;
| | - Sarah H. Lisanby
- Department of Psychiatry and Behavioral Science, Duke University School of Medicine, 200 Trent Drive, Box 3620 DUMC, Durham, NC 27710, USA; (C.A.C.); (M.D.); (W.L.); (H.P.); (S.A.H.); (A.B.); (C.H.); (S.H.L.); (A.V.P.); (L.G.A.)
- National Institute of Mental Health, 6001 Executive Boulevard, Bethesda, MD 20852, USA;
| | - Angel V. Peterchev
- Department of Psychiatry and Behavioral Science, Duke University School of Medicine, 200 Trent Drive, Box 3620 DUMC, Durham, NC 27710, USA; (C.A.C.); (M.D.); (W.L.); (H.P.); (S.A.H.); (A.B.); (C.H.); (S.H.L.); (A.V.P.); (L.G.A.)
- Department of Biomedical Engineering, Duke University, 305 Teer Engineering Building, Box 90271, Durham, NC 27708, USA
- Department of Electrical and Computer Engineering, Duke University, 305 Teer Engineering Building, Box 90271, Durham, NC 27708, USA
- Department of Neurosurgery, Duke University School of Medicine, 200 Trent Drive, Box 3807 DUMC, Durham, NC 27710, USA
| | - Roberto Cabeza
- Center for Cognitive Neuroscience, Duke University, 308 Research Drive, Durham, NC 27710, USA;
- Department of Psychology & Neuroscience, Duke University, 417 Chapel Drive, Durham, NC 27708, USA
| | - Lawrence G. Appelbaum
- Department of Psychiatry and Behavioral Science, Duke University School of Medicine, 200 Trent Drive, Box 3620 DUMC, Durham, NC 27710, USA; (C.A.C.); (M.D.); (W.L.); (H.P.); (S.A.H.); (A.B.); (C.H.); (S.H.L.); (A.V.P.); (L.G.A.)
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16
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Barkus E. Effects of working memory training on emotion regulation: Transdiagnostic review. Psych J 2020; 9:258-279. [PMID: 32166891 DOI: 10.1002/pchj.353] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2019] [Revised: 10/20/2019] [Accepted: 11/19/2019] [Indexed: 12/18/2022]
Abstract
Working memory training is widely used transdiagnostically to improve cognition. However, more recently, studies using working memory training packages have targeted emotion-regulation outcomes to determine whether far transfer effects can be achieved. A narrative review is conducted of studies that have used standardized computerized working memory training packages across healthy volunteers, affect, anxiety, post-traumatic stress disorder (PTSD), and eating disordered populations with emotion-regulation outcomes. Working memory training has been used in children, adolescents, and adults to improve emotion regulation. Many studies have reported gains in mood as well as emotion-regulation strategies following working memory training, regardless of clinical indication and whether near transfer gains were achieved in cognitive domains. Significant emotion-regulation outcomes include: state and trait anxiety, rumination, brooding, positive appraisal, decreasing maladaptive emotion-regulation strategies, and decreasing intrusive thoughts. It is speculated that these far transfer outcomes from working memory training are possible due to the cognitive and neural overlap between cognitive and affective working memory, and emotion regulation. Working memory training could improve cognitive efficiency, which, in turn, increases the availability of cognitive resources during times when emotion regulation is taxed. Future studies need to consider the role of participant expectancy in predicting outcome measure performance, and including subjective and objective outcomes is paramount to study design. Furthermore, sample sizes require additional attention, given that the current review highlights that individual differences in non-clinical and clinical populations influence the outcomes from working memory training. Working memory training offers a possibility for improving emotion regulation transdiagnostically.
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Affiliation(s)
- Emma Barkus
- School of Psychology, University of Wollongong, Wollongong, Australia
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High-Frequency Repetitive Transcranial Magnetic Stimulation Could Improve Impaired Working Memory Induced by Sleep Deprivation. Neural Plast 2019; 2019:7030286. [PMID: 31915432 PMCID: PMC6930796 DOI: 10.1155/2019/7030286] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2019] [Revised: 11/11/2019] [Accepted: 11/22/2019] [Indexed: 02/07/2023] Open
Abstract
Objective To investigate whether and how the working memory impairment induced by sleep deprivation (SD) could be recovered by using repetitive transcranial magnetic stimulation (rTMS), as well as to clarify the corresponding brain activity changes. Methods Seventeen healthy adults received one session of 5.0 Hz rTMS over the left dorsolateral prefrontal cortex (DLPFC) following 24 hours of SD. Resting state functional magnetic resonance imaging (fMRI) and working memory test were performed during a rested waking period, after SD and rTMS. The amplitude of low-frequency fluctuations (ALFF) was used to detect the spontaneous neural activity changes after both SD and rTMS. The relationship between ALFF and the performance of working memory was also assessed by using correlation analysis. Results After SD, the participants exhibited lower response accuracies and longer reaction times on the working memory tests of letters and numbers. The decreased response accuracy of numbers was significantly improved after rTMS similarly to the state of the rested waking period after a normal night of sleep. ALFF values decreased from the rested waking period state to the state of SD in the brain regions involving the frontal gyrus, precuneus, angular gyrus, and parietal lobe which showed significantly increased ALFF after rTMS. Furthermore, significantly positive correlations were observed between changes of response accuracy and the changes of ALFF value of the inferior frontal gyrus and supramarginal gyrus. Conclusion These results indicate that high-frequency rTMS applied over left DLPFC may contribute to the recovery of the impaired working memory after SD by modulating the neural activity of related brain regions.
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Leong RL, Cheng GHL, Chee MW, Lo JC. The effects of sleep on prospective memory: A systematic review and meta-analysis. Sleep Med Rev 2019; 47:18-27. [DOI: 10.1016/j.smrv.2019.05.006] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2019] [Revised: 05/23/2019] [Accepted: 05/27/2019] [Indexed: 01/10/2023]
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Chang MC, Chun MH. The Effect of Hypnotics on Sleep Quality and Cognitive Function in Patients with Brain Tumors. J Korean Neurosurg Soc 2019; 63:261-267. [PMID: 31533416 PMCID: PMC7054112 DOI: 10.3340/jkns.2019.0057] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2019] [Accepted: 05/19/2019] [Indexed: 02/05/2023] Open
Abstract
Objective We investigated the effect of hypnotics on sleep quality, cognitive function, and depressive mood in patients with insomnia following brain tumor resection.
Methods From patients who underwent brain tumor resection, we recruited 10 patients with insomnia who received hypnotics for more than 1 week during a 3-week follow-up period (insomnia group). We also recruited 12 control patients with brain tumors but without insomnia (control group). We evaluated sleep quality at baseline and 3 weeks later using the Insomnia Severity Index (ISI), the Pittsburgh Sleep Quality Index (PSQI), the Stanford Sleepiness Scale (SSS), and the Epworth Sleepiness Scale (ESS) and investigated cognitive function and depression using the Computerized Neuropsychological Test and the Beck Depression Inventory (BDI).
Results At baseline, SSS, ISI, PSQI, and BDI scores were significantly higher and visual continuous performance test (VCPT) and auditory continuous performance test (ACPT) scores were significantly lower in the insomnia than in the control group. Three weeks later, the patients who had received hypnotics had significantly higher ISI, PSQI, ESS, VCPT, ACPT, visual span forward and backward, and visual recognition test scores, and significantly lower BDI scores.
Conclusion Quality of sleep in patients with insomnia following brain tumor resection was initially poor but improved significantly after taking hypnotic medication. Further, the hypnotic medications appeared to contribute to the amelioration of cognitive impairments and depressive moods in patients who previously underwent brain tumor resection. We thus recommend the use of hypnotics for patients with brain tumors with insomnia.
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Affiliation(s)
- Min Cheol Chang
- Department of Rehabilitation Medicine, College of Medicine, Yeungnam University, Daegu, Korea
| | - Min Ho Chun
- Department of Rehabilitation Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
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21
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Marriott BP, Turner TH, Hibbeln JR, Pregulman M, Newman J, Johnson KB, Malek AM, Malcolm RJ, Burbelo GA, Wissman JW. Design and methods for the Ranger Resilience and Improved Performance on Phospholipid bound Omega-3's (RRIPP-3 study). Contemp Clin Trials Commun 2019; 15:100359. [PMID: 31080908 PMCID: PMC6503132 DOI: 10.1016/j.conctc.2019.100359] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2018] [Revised: 03/20/2019] [Accepted: 04/05/2019] [Indexed: 12/13/2022] Open
Abstract
Intake of nutrients fundamental for optimal neuronal function is of increasing interest. The potential importance of omega-3 highly unsaturated fatty acids (HUFAs) for optimizing emotional states, cognitive function, and mental health has been demonstrated in observational studies and randomized controlled trials. Omega-3 (HUFAs), specifically EPA (eicosapentaenoic acid) and docosahexaenoic acid (DHA), are concentrated in neural tissues and are essential for neural function, normative neurodevelopment, neurotransmitter, and neural immune functions. Omega-3 HUFAs must be obtained from the diet, predominantly from marine sources such as fish and other seafood. HUFAs also can be found in a variety of dietary supplements (omega-3 fatty acid esters, fish oil and krill oil). As dietary supplements, omega-3 HUFAs (fatty acid esters, fish and krill oils) differ substantially in their physicochemical properties and nutrient content. Here we present the design and methods for the Ranger Resilience and Improved Performance on Phospholipid bound Omega-3's (RRIPP-3) study. RRIPP-3 was a double blind, randomized, controlled trial among individuals in the United States (US) Army Infantry Basic Officer Leaders Course (IBOLC) and following US Ranger School training (RC) at Fort Benning, GA of omega-3 HUFA on krill oil versus placebo supplementation. The RRIPP-3 study sought to determine if krill oil supplementation with omega-3 HUFAs supports aspects of cognitive functioning critical to battlefield success when measured immediately after an intense combat simulation. Sub-analyses addressed basic improvements in IBOLC performance. We also describe additional outcome measures critical for interpretation of the study results, such as diet and other dietary supplement use.
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Affiliation(s)
- Bernadette P Marriott
- Nutrition Section, Division of Gastroenterology and Hepatology, Department of Medicine, and Military Division, Department of Psychiatry and Behavioral Sciences, College of Medicine, Medical University of South Carolina, 114 Doughty Street, Ste. 630D, MSC774, Charleston, SC, 29425, USA
| | - Travis H Turner
- Department of Neurology, College of Medicine, Medical University of South Carolina, 96 Jonathan Lucas Street, Suite 301 CSB, Charleston, SC, 29425, USA
| | - Joseph R Hibbeln
- Acting Chief, Section on Nutritional Neurosciences, LMBB, NIAAA, NIH, 5625 Fishers Lane, Rm 3N-07, MSC 9410, Bethesda, MD, 20892, USA
| | - Marcie Pregulman
- Nutrition Section, Division of Gastroenterology and Hepatology, Department of Medicine, College of Medicine, Medical University of South Carolina, 114 Doughty Street, Ste. 630D, MSC774, Charleston, SC 29425, USA
| | - Jill Newman
- Nutrition Section, Division of Gastroenterology and Hepatology, Department of Medicine, College of Medicine, Medical University of South Carolina, 114 Doughty Street, Ste. 630D, MSC774, Charleston, SC 29425, USA
| | - Kristen B Johnson
- Nutrition Section, Division of Gastroenterology and Hepatology, Department of Medicine, College of Medicine, Medical University of South Carolina, 114 Doughty Street, Ste. 630D, MSC774, Charleston, SC 29425, USA
| | - Angela M Malek
- Department of Public Health Sciences, Medical University of South Carolina, 135 Cannon Street, Ste. 303C, Charleston, SC, 29425, USA
| | - Robert J Malcolm
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, 67 President Street, Charleston, SC, 29425, USA
| | | | - Jeffrey W Wissman
- Maneuver Center of Excellence, Infantry Basic Officers Leader Course, Fort Benning, GA, 31905, USA
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