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Lima Santos JP, Hayes R, Franzen PL, Goldstein TR, Hasler BP, Buysse DJ, Siegle GJ, Dahl RE, Forbes EE, Ladouceur CD, McMakin DL, Ryan ND, Silk JS, Jalbrzikowski M, Soehner AM. The association between cortical gyrification and sleep in adolescents and young adults. Sleep 2024; 47:zsad282. [PMID: 37935899 PMCID: PMC10782503 DOI: 10.1093/sleep/zsad282] [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: 06/23/2023] [Revised: 10/06/2023] [Indexed: 11/09/2023] Open
Abstract
STUDY OBJECTIVES Healthy sleep is important for adolescent neurodevelopment, and relationships between brain structure and sleep can vary in strength over this maturational window. Although cortical gyrification is increasingly considered a useful index for understanding cognitive and emotional outcomes in adolescence, and sleep is also a strong predictor of such outcomes, we know relatively little about associations between cortical gyrification and sleep. We aimed to identify developmentally invariant (stable across age) or developmentally specific (observed only during discrete age intervals) gyrification-sleep relationships in young people. METHODS A total of 252 Neuroimaging and Pediatric Sleep Databank participants (9-26 years; 58.3% female) completed wrist actigraphy and a structural MRI scan. Local gyrification index (lGI) was estimated for 34 bilateral brain regions. Naturalistic sleep characteristics (duration, timing, continuity, and regularity) were estimated from wrist actigraphy. Regularized regression for feature selection was used to examine gyrification-sleep relationships. RESULTS For most brain regions, greater lGI was associated with longer sleep duration, earlier sleep timing, lower variability in sleep regularity, and shorter time awake after sleep onset. lGI in frontoparietal network regions showed associations with sleep patterns that were stable across age. However, in default mode network regions, lGI was only associated with sleep patterns from late childhood through early-to-mid adolescence, a period of vulnerability for mental health disorders. CONCLUSIONS We detected both developmentally invariant and developmentally specific ties between local gyrification and naturalistic sleep patterns. Default mode network regions may be particularly susceptible to interventions promoting more optimal sleep during childhood and adolescence.
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Affiliation(s)
| | - Rebecca Hayes
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
| | - Peter L Franzen
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
| | - Tina R Goldstein
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
| | - Brant P Hasler
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA, USA
- Department of Clinical and Translational Science Institute, University of Pittsburgh, Pittsburgh, PA, USA
| | - Daniel J Buysse
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
- Department of Clinical and Translational Science Institute, University of Pittsburgh, Pittsburgh, PA, USA
| | - Greg J Siegle
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
- Department of Clinical and Translational Science Institute, University of Pittsburgh, Pittsburgh, PA, USA
| | - Ronald E Dahl
- School of Public Health, University of California, Berkeley, Berkeley, CA, USA
| | - Erika E Forbes
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA, USA
- Department of Clinical and Translational Science Institute, University of Pittsburgh, Pittsburgh, PA, USA
- Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | | | - Dana L McMakin
- Department of Psychology, Florida International University, Miami, FL, USA
| | - Neal D Ryan
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
| | - Jennifer S Silk
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA, USA
| | - Maria Jalbrzikowski
- Department of Psychiatry and Behavioral Sciences, Boston Children’s Hospital, Boston, MA, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Adriane M Soehner
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
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Keenan L, Bramham J, Downes M. Parent-Report Sleep Disturbances and Everyday Executive Functioning Difficulties in Children with Tourette Syndrome. Dev Neuropsychol 2024; 49:39-60. [PMID: 38224316 DOI: 10.1080/87565641.2023.2300428] [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: 07/25/2023] [Accepted: 12/22/2023] [Indexed: 01/16/2024]
Abstract
There is an increasing need to identify and treat sleep disturbances in Tourette syndrome (TS), a neurodevelopmental condition characterized by tics. This study explored sleep, tics, and executive functioning in children with TS (n=136) and neurotypical controls (n=101) through parent-report scales and open-ended questions. 85% of children with TS scored in the clinical range for a sleep disorder. Higher tic severity predicted increased sleep disturbances and executive difficulties. Qualitative insights indicated a bidirectional link between sleep and tics, which warrants consideration in clinical settings. Further research is needed to explore causal links.
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Affiliation(s)
- Lisa Keenan
- School of Psychology, University College Dublin, Dublin, Ireland
| | - Jessica Bramham
- School of Psychology, University College Dublin, Dublin, Ireland
| | - Michelle Downes
- School of Psychology, University College Dublin, Dublin, Ireland
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Hu L, Katz ES, Stamoulis C. Modulatory effects of fMRI acquisition time of day, week and year on adolescent functional connectomes across spatial scales: Implications for inference. Neuroimage 2023; 284:120459. [PMID: 37977408 DOI: 10.1016/j.neuroimage.2023.120459] [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: 06/23/2023] [Revised: 11/06/2023] [Accepted: 11/14/2023] [Indexed: 11/19/2023] Open
Abstract
Metabolic, hormonal, autonomic and physiological rhythms may have a significant impact on cerebral hemodynamics and intrinsic brain synchronization measured with fMRI (the resting-state connectome). The impact of their characteristic time scales (hourly, circadian, seasonal), and consequently scan timing effects, on brain topology in inherently heterogeneous developing connectomes remains elusive. In a cohort of 4102 early adolescents with resting-state fMRI (median age = 120.0 months; 53.1 % females) from the Adolescent Brain Cognitive Development Study, this study investigated associations between scan time-of-day, time-of-week (school day vs weekend) and time-of-year (school year vs summer vacation) and topological properties of resting-state connectomes at multiple spatial scales. On average, participants were scanned around 2 pm, primarily during school days (60.9 %), and during the school year (74.6 %). Scan time-of-day was negatively correlated with multiple whole-brain, network-specific and regional topological properties (with the exception of a positive correlation with modularity), primarily of visual, dorsal attention, salience, frontoparietal control networks, and the basal ganglia. Being scanned during the weekend (vs a school day) was correlated with topological differences in the hippocampus and temporoparietal networks. Being scanned during the summer vacation (vs the school year) was consistently positively associated with multiple topological properties of bilateral visual, and to a lesser extent somatomotor, dorsal attention and temporoparietal networks. Time parameter interactions suggested that being scanned during the weekend and summer vacation enhanced the positive effects of being scanned in the morning. Time-of-day effects were overall small but spatially extensive, and time-of-week and time-of-year effects varied from small to large (Cohen's f ≤ 0.1, Cohen's d<0.82, p < 0.05). Together, these parameters were also positively correlated with temporal fMRI signal variability but only in the left hemisphere. Finally, confounding effects of scan time parameters on relationships between connectome properties and cognitive task performance were assessed using the ABCD neurocognitive battery. Although most relationships were unaffected by scan time parameters, their combined inclusion eliminated associations between properties of visual and somatomotor networks and performance in the Matrix Reasoning and Pattern Comparison Processing Speed tasks. Thus, scan time of day, week and year may impact measurements of adolescent brain's functional circuits, and should be accounted for in studies on their associations with cognitive performance, in order to reduce the probability of incorrect inference.
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Affiliation(s)
- Linfeng Hu
- Department of Pediatrics, Division of Adolescent and Young Adult Medicine, Boston Children's Hospital, Boston, MA 02115, USA; Harvard School of Public Health, Department of Biostatistics, Boston, MA 02115, USA
| | - Eliot S Katz
- Johns Hopkins All Children's Hospital, St. Petersburg, FL 33701, USA
| | - Catherine Stamoulis
- Department of Pediatrics, Division of Adolescent and Young Adult Medicine, Boston Children's Hospital, Boston, MA 02115, USA; Harvard Medical School, Department of Pediatrics, Boston, MA 02115, USA.
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4
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Redline S, Cook K, Chervin RD, Ishman S, Baldassari CM, Mitchell RB, Tapia IE, Amin R, Hassan F, Ibrahim S, Ross K, Elden LM, Kirkham EM, Zopf D, Shah J, Otteson T, Naqvi K, Owens J, Young L, Furth S, Connolly H, Clark CAC, Bakker JP, Garetz S, Radcliffe J, Taylor HG, Rosen CL, Wang R. Adenotonsillectomy for Snoring and Mild Sleep Apnea in Children: A Randomized Clinical Trial. JAMA 2023; 330:2084-2095. [PMID: 38051326 PMCID: PMC10698619 DOI: 10.1001/jama.2023.22114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2023] [Accepted: 10/04/2023] [Indexed: 12/07/2023]
Abstract
Importance The utility of adenotonsillectomy in children who have habitual snoring without frequent obstructive breathing events (mild sleep-disordered breathing [SDB]) is unknown. Objectives To evaluate early adenotonsillectomy compared with watchful waiting and supportive care (watchful waiting) on neurodevelopmental, behavioral, health, and polysomnographic outcomes in children with mild SDB. Design, Setting, and Participants Randomized clinical trial enrolling 459 children aged 3 to 12.9 years with snoring and an obstructive apnea-hypopnea index (AHI) less than 3 enrolled at 7 US academic sleep centers from June 29, 2016, to February 1, 2021, and followed up for 12 months. Intervention Participants were randomized 1:1 to either early adenotonsillectomy (n = 231) or watchful waiting (n = 228). Main Outcomes and Measures The 2 primary outcomes were changes from baseline to 12 months for caregiver-reported Behavior Rating Inventory of Executive Function (BRIEF) Global Executive Composite (GEC) T score, a measure of executive function; and a computerized test of attention, the Go/No-go (GNG) test d-prime signal detection score, reflecting the probability of response to target vs nontarget stimuli. Twenty-two secondary outcomes included 12-month changes in neurodevelopmental, behavioral, quality of life, sleep, and health outcomes. Results Of the 458 participants in the analyzed sample (231 adenotonsillectomy and 237 watchful waiting; mean age, 6.1 years; 230 female [50%]; 123 Black/African American [26.9%]; 75 Hispanic [16.3%]; median AHI, 0.5 [IQR, 0.2-1.1]), 394 children (86%) completed 12-month follow-up visits. There were no statistically significant differences in change from baseline between the 2 groups in executive function (BRIEF GEC T-scores: -3.1 for adenotonsillectomy vs -1.9 for watchful waiting; difference, -0.96 [95% CI, -2.66 to 0.74]) or attention (GNG d-prime scores: 0.2 for adenotonsillectomy vs 0.1 for watchful waiting; difference, 0.05 [95% CI, -0.18 to 0.27]) at 12 months. Behavioral problems, sleepiness, symptoms, and quality of life each improved more with adenotonsillectomy than with watchful waiting. Adenotonsillectomy was associated with a greater 12-month decline in systolic and diastolic blood pressure percentile levels (difference in changes, -9.02 [97% CI, -15.49 to -2.54] and -6.52 [97% CI, -11.59 to -1.45], respectively) and less progression of the AHI to greater than 3 events/h (1.3% of children in the adenotonsillectomy group compared with 13.2% in the watchful waiting group; difference, -11.2% [97% CI, -17.5% to -4.9%]). Six children (2.7%) experienced a serious adverse event associated with adenotonsillectomy. Conclusions In children with mild SDB, adenotonsillectomy, compared with watchful waiting, did not significantly improve executive function or attention at 12 months. However, children with adenotonsillectomy had improved secondary outcomes, including behavior, symptoms, and quality of life and decreased blood pressure, at 12-month follow-up. Trial Registration ClinicalTrials.gov Identifier: NCT02562040.
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Affiliation(s)
- Susan Redline
- Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts
| | - Kaitlyn Cook
- Program in Statistical and Data Sciences, Smith College, Northampton, Massachusetts
- Department of Population Medicine, Harvard Pilgrim Health Care Institute and Harvard Medical School, Boston, Massachusetts
| | - Ronald D. Chervin
- Sleep Disorders Center and Department of Neurology, University of Michigan, Ann Arbor
| | - Stacey Ishman
- Department of Otolaryngology, Head and Neck Surgery, University of Cincinnati College of Medicine, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio
| | - Cristina M. Baldassari
- Department of Otolaryngology, Eastern Virginia Medical School, Children’s Hospital of The King’s Daughters, Norfolk
| | - Ron B. Mitchell
- Departments of Otolaryngology-Head and Neck Surgery and Neurology Sleep Disorders Center, UT Southwestern Medical Center, Children’s Medical Center, Dallas
| | - Ignacio E. Tapia
- Department of Pediatrics, Children’s Hospital of Philadelphia, Perelman School of Medicine, University of Pennsylvania, Philadelphia
| | - Raouf Amin
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio
| | - Fauziya Hassan
- Sleep Disorders Center and Department of Pediatrics and Communicable Diseases, University of Michigan, Ann Arbor
| | - Sally Ibrahim
- Department of Pediatrics, University Hospitals Rainbow Babies & Children’s Hospital, Cleveland, Ohio
| | - Kristie Ross
- Department of Pediatrics, University Hospitals Rainbow Babies & Children’s Hospital, Cleveland, Ohio
| | - Lisa M. Elden
- Division of Pediatric Otolaryngology, Children’s Hospital of Philadelphia, Perelman School of Medicine, University of Pennsylvania, Philadelphia
| | - Erin M. Kirkham
- Department of Otolaryngology–Head and Neck Surgery, University of Michigan, Ann Arbor
| | - David Zopf
- Department of Otolaryngology–Head and Neck Surgery, University of Michigan, Ann Arbor
| | - Jay Shah
- Department of Otolaryngology, University Hospitals Rainbow Babies
- University Hospitals Rainbow Babies & Children’s Hospital, Case Western Reserve University, Cleveland, Ohio
| | - Todd Otteson
- Department of Otolaryngology, University Hospitals Rainbow Babies
- University Hospitals Rainbow Babies & Children’s Hospital, Case Western Reserve University, Cleveland, Ohio
| | - Kamal Naqvi
- Department of Pediatrics, UT Southwestern Medical Center, Dallas
| | - Judith Owens
- Department of Neurology, Boston Children’s Hospital, Harvard Medical School, Boston, Massachusetts
| | - Lisa Young
- Department of Pediatrics, Children’s Hospital of Philadelphia, Perelman School of Medicine, University of Pennsylvania, Philadelphia
| | - Susan Furth
- Department of Pediatrics, Children’s Hospital of Philadelphia, Perelman School of Medicine, University of Pennsylvania, Philadelphia
| | - Heidi Connolly
- Department of Pediatrics, University of Rochester, Rochester, New York
| | - Caron A. C. Clark
- Department of Educational Psychology, University of Nebraska-Lincoln
| | - Jessie P. Bakker
- Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts
| | - Susan Garetz
- Department of Otolaryngology–Head and Neck Surgery and Department of Neurology-Sleep Disorders Center, University of Michigan, Ann Arbor
| | - Jerilynn Radcliffe
- Department of Pediatrics, Children’s Hospital of Philadelphia, Perelman School of Medicine, University of Pennsylvania, Philadelphia
| | - H. Gerry Taylor
- Abigail Wexner Research Institute at Nationwide Children’s Hospital and The Ohio State University, Columbus
| | - Carol L. Rosen
- Case Western Reserve University School of Medicine, Department of Pediatrics, Cleveland, Ohio
| | - Rui Wang
- Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts
- Department of Population Medicine, Harvard Pilgrim Health Care Institute and Harvard Medical School, Boston, Massachusetts
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
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5
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Han H, Weng Y, Liang H, Yi C, Lin K, Wu H, Xiao J, Han C. Persistent neuroinflammation of the right insular cortex in children with juvenile idiopathic arthritis: a proton MRS study. Clin Rheumatol 2023; 42:3059-3066. [PMID: 37442888 DOI: 10.1007/s10067-023-06680-y] [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: 02/10/2023] [Revised: 06/01/2023] [Accepted: 06/16/2023] [Indexed: 07/15/2023]
Abstract
OBJECTIVE The aim of this study of children with juvenile idiopathic arthritis (JIA) was to use proton magnetic resonance spectroscopy (1H-MRS) to compare the levels of five neurometabolites in the right and left insular cortexes of subjects in three groups: JIA-active, JIA-inactive, and healthy controls (HCs). METHODS Two inflammation markers and five psychometric scores were determined. 1H-MRS was used to measure the levels of total N-acetylaspartate (NAA), total choline (Cho), myo-inositol (mI), and glutamate (Glu), and the complex of glutamine and glutamate (Glx) relative to total creatine (tCr) in the right and left insular cortexes of participants. RESULTS Intra-group comparisons indicated that each group had higher levels of NAA/tCr, Glu/tCr, Glx/tCr, and mI/tCr in the right insula, and higher levels of Cho/tCr in the left insula. Inter-group comparisons of the right insula indicated that the JIA-active and JIA-inactive groups had higher levels of Cho/tCr than the HC group, but none of the other inter-group differences were statistically significant. The score of the Sleep Disturbance Scale for Children (SDCD) had an inverse correlation with the level of Cho/tCr in the right insular cortex of patients in the JIA-inactive group. CONCLUSIONS Relative to the HC group, the right insular cortex of subjects in the JIA-active and the JIA-inactive groups had greater levels of Cho/tCr, suggesting increased inflammation in this region. The Cho/tCr level in the right insular cortex had an inverse correlation with SDCD score in the JIA-inactive group. Key Points • Healthy controls and JIA patients had higher levels of tNAA/tCr, Glu/tCr, Glx/tCr, and mI/tCr in the right insula, and higher levels of Cho/tCr in the left insula. • A greater level of Cho/tCr in the right insula of JIA-active and JIA-inactive patients indicated neuroinflammation in this region. • The Cho/tCr level in the right insular cortex had an inverse correlation with SDCD score in the JIA-inactive group.
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Affiliation(s)
- Haiwei Han
- Department of Radiology, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China
| | - Yifei Weng
- Department of Radiology, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China
| | - Hongyan Liang
- Department of Radiology, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China
| | - Cuili Yi
- Department of Pediatrics, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China
| | - Kezhao Lin
- Department of Pediatrics, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China
| | - Hua Wu
- Department of Nuclear Medicine and Minnan PET Center, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, 55 Zhenhai Road, Siming District, Xiammen, 361003, Fujian Province, China
| | - Jihong Xiao
- Department of Pediatrics, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China.
| | - Chengkun Han
- Department of Radiology, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China.
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Donnici C, Tomfohr-Madsen L, Long X, Manning KY, Giesbrecht G, Lebel C. Prenatal depressive symptoms are associated with altered structural brain networks in infants and moderated by infant sleep. J Affect Disord 2023; 339:118-126. [PMID: 37390922 PMCID: PMC10303328 DOI: 10.1016/j.jad.2023.06.054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Accepted: 06/26/2023] [Indexed: 07/02/2023]
Abstract
BACKGROUND The prevalence of prenatal depressive symptoms has more than doubled during the COVID-19 pandemic, raising substantial concerns about child outcomes including sleep problems and altered brain development. The objective of this work was to determine relationships between prenatal depressive symptoms, infant brain network structure, and infant sleep. METHODS Pregnant individuals were recruited as part of the Pregnancy during the Pandemic (PdP) study. Maternal depressive symptoms were measured in pregnancy and postpartum. When infants of those participants were 3 months of age (n=66; 26 females), infants underwent diffusion magnetic resonance imaging and infant sleep was evaluated. Using tractography, we calculated structural connectivity matrices for the default mode (DMN) and limbic networks. We examined associations between graph theory metrics of infant brain networks and prenatal maternal depressive symptoms, with infant sleep as a moderator. RESULTS Prenatal depressive symptoms were negatively related to average DMN clustering coefficient and local efficiency in infant brains. Infant sleep duration was related to DMN global efficiency and moderated the relationship between prenatal depressive symptoms and density of limbic connections such that infants who slept less had a more negative relationship between prenatal depressive symptoms and local brain connectivity. CONCLUSIONS Prenatal depressive symptoms appear to impact early topological development in brain networks important for emotion regulation. In the limbic network, sleep duration moderated this relationship, suggesting sleep may play a role in infant brain network development.
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Affiliation(s)
- Claire Donnici
- Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Lianne Tomfohr-Madsen
- Department of Pediatrics, University of Calgary, Calgary, AB, Canada; Department of Psychology, University of Calgary, Calgary, AB, Canada; Alberta Children's Hospital Research Institute, Calgary, AB, Canada; Libin Cardiovascular Institute, University of Calgary, Calgary, AB, Canada; Faculty of Education, University of British Columbia, Vancouver, BC, Canada
| | - Xiangyu Long
- Alberta Children's Hospital Research Institute, Calgary, AB, Canada; Hotchkiss Brain Institute, Calgary, AB, Canada; Department of Radiology, University of Calgary, Calgary, AB, Canada
| | - Kathryn Y Manning
- Alberta Children's Hospital Research Institute, Calgary, AB, Canada; Hotchkiss Brain Institute, Calgary, AB, Canada; Department of Radiology, University of Calgary, Calgary, AB, Canada
| | - Gerald Giesbrecht
- Cumming School of Medicine, University of Calgary, Calgary, AB, Canada; Department of Pediatrics, University of Calgary, Calgary, AB, Canada; Alberta Children's Hospital Research Institute, Calgary, AB, Canada; Department of Community Health Sciences, University of Calgary, Calgary, AB, Canada
| | - Catherine Lebel
- Alberta Children's Hospital Research Institute, Calgary, AB, Canada; Hotchkiss Brain Institute, Calgary, AB, Canada; Department of Radiology, University of Calgary, Calgary, AB, Canada.
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7
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Li W, Li C, Liu T, Wang Y, Ma X, Xiao X, Zhang Q, Qu J. Self-reported sleep disorders and the risk of all cancer types: evidence from the Kailuan Cohort study. Public Health 2023; 223:209-216. [PMID: 37677850 DOI: 10.1016/j.puhe.2023.08.007] [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: 03/13/2023] [Revised: 06/18/2023] [Accepted: 08/03/2023] [Indexed: 09/09/2023]
Abstract
OBJECTIVES Previous studies that focussed on sleep disturbance have primarily examined specific aspects of sleep disorders rather than considering overall sleep quality. We aimed to investigate different sleep disorders and their combination as risk factors for different types of cancer. STUDY DESIGN Prospective cohort study. METHODS In this prospective cohort study, we included 78,232 participants. A self-reported questionnaire was used to address insomnia, daytime sleepiness, snoring, and sleep duration. Overall sleep quality was evaluated by summarising these four sleep parameters. Cox proportional hazards analysis was used to estimate the hazard ratios and their 95% confidence intervals for determining the effect of the overall sleep-quality score and its components on the risk of incident cancer. RESULTS During a median follow-up of 5.67 years, 1266 participants were diagnosed with incident cancer. Compared to participants in the best sleep-quality score group, participants in the worst sleep-quality score group had a higher subsequent risk of overall cancer, and colorectal, breast, uterine or uterine cervical, prostatic, kidney, and bladder cancer. Participants with insomnia and snoring status had an elevated risk of head and neck, breast, uterine or uterine cervical, prostatic, kidney, bladder cancer, and lymphoma. CONCLUSIONS Poor overall sleep-quality scores as well as poor scores for the scale's components, including insomnia and snoring status, elevated the risk of overall and several specific-site cancers. TRIAL REGISTRATION Kailuan Study, ChiCTR2000029767. Registered 12 February, 2020-Retrospectively registered, https://www.chictr.org.cn/showprojEN.html?proj=48316.
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Affiliation(s)
- W Li
- Department of General Surgery, Aerospace Centre Hospital, Beijing, 100038, China
| | - C Li
- Department of Oncology, Dazu Hospital of Chongqing Medical University, Chongqing, 402360, China
| | - T Liu
- Department of Gastrointestinal Surgery/Clinical Nutrition, Capital Medical University Affiliated Beijing Shijitan Hospital, Beijing, 100038, China
| | - Y Wang
- Department of Hepatological Surgery, Kailuan General Hospital, Tangshan, 063000, China
| | - X Ma
- Department of Hepatological Surgery, Kailuan General Hospital, Tangshan, 063000, China
| | - X Xiao
- Department of Gynecology, Aerospace Center Hospital, 100038, China.
| | - Q Zhang
- Department of General Surgery, Kailuan General Hospital, Tangshan, 063000, China.
| | - J Qu
- Department of General Surgery, Aerospace Centre Hospital, Beijing, 100038, China.
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Subotic-Kerry M, Werner-Seidler A, Corkish B, Batterham PJ, Sicouri G, Hudson J, Christensen H, O'Dea B, Li SH. Protocol for a randomised controlled trial evaluating the effect of a CBT-I smartphone application (Sleep Ninja®) on insomnia symptoms in children. BMC Psychiatry 2023; 23:684. [PMID: 37730577 PMCID: PMC10510253 DOI: 10.1186/s12888-023-05185-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Accepted: 09/12/2023] [Indexed: 09/22/2023] Open
Abstract
BACKGROUND Sleep is necessary for healthy development and mental wellbeing. Despite this, many children do not get the recommended duration of sleep each night, and many experience sleep problems. Although treatable, existing interventions for sleep disturbance are time-consuming, burdensome for families, and focus on providing behavioural strategies to parents rather than upskilling children directly. To address this gap, we modified Sleep Ninja®, an evidence-based cognitive behavioural therapy for insomnia (CBT-I) smartphone app for adolescent sleep disturbance, to be appropriate for 10 to 12 year olds. Here, we describe the protocol for a randomised controlled trial to evaluate the effect of Sleep Ninja on insomnia and other outcomes, including depression, anxiety, sleep quality, and daytime sleepiness, and explore effects on the emergence of Major Depressive Disorder (MDD), compared to an active control group. METHODS We aim to recruit 214 children aged 10 to 12 years old experiencing disturbed sleep. Participants will be screened for inclusion, complete the baseline assessment, and then be randomly allocated to receive Sleep Ninja, or digital psychoeducation flyers (active control) for 6-weeks. The primary outcome, insomnia symptoms, along with depression, anxiety, sleep quality, and daytime sleepiness will be assessed at 6-weeks (primary endpoint), 3-months, and 9-months post-baseline (secondary and tertiary endpoints, respectively). A mixed model repeated measures analytic approach will be used to conduct intention-to-treat analyses to determine whether reductions in insomnia and secondary outcomes are greater for those receiving Sleep Ninja relative to the control condition at the primary and secondary endpoints. The difference in relative risk for MDD onset will be explored at 9-months and compared between conditions. DISCUSSION This is the first clinical trial examining the effects of a CBT-I smartphone app in children experiencing sleep disturbance. Results will provide empirical evidence about the effects of Sleep Ninja on insomnia and other mental health outcomes. TRIAL REGISTRATION Australian New Zealand Clinical Trials Registry (ACTRN12623000587606). UNIVERSAL TRIAL NUMBER U1111-1294-4167.
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Affiliation(s)
- M Subotic-Kerry
- Black Dog Institute, University of New South Wales, Sydney, NSW, Australia
| | - A Werner-Seidler
- Black Dog Institute and School of Psychology, University of New South Wales, Sydney, NSW, Australia
| | - B Corkish
- Black Dog Institute, University of New South Wales, Sydney, NSW, Australia
| | - P J Batterham
- Centre for Mental Health Research, Australian National University, Canberra, Australia
| | - G Sicouri
- Black Dog Institute and School of Psychology, University of New South Wales, Sydney, NSW, Australia
| | - J Hudson
- Black Dog Institute and School of Psychology, University of New South Wales, Sydney, NSW, Australia
| | - H Christensen
- Faculty of Medicine and Health, University of New South Wales, Sydney, NSW, Australia
| | - B O'Dea
- Black Dog Institute, University of New South Wales, Sydney, NSW, Australia
| | - S H Li
- Black Dog Institute and School of Psychology, University of New South Wales, Sydney, NSW, Australia.
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Santos JPL, Hayes R, Franzen PL, Goldstein TR, Hasler BP, Buysse DJ, Siegle GJ, Dahl RE, Forbes EE, Ladouceur CD, McMakin DL, Ryan ND, Silk JS, Jalbrzikowski M, Soehner AM. The association between cortical gyrification and sleep in adolescents and young adults. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2023:2023.09.15.557966. [PMID: 37745609 PMCID: PMC10516006 DOI: 10.1101/2023.09.15.557966] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/26/2023]
Abstract
Study objectives Healthy sleep is important for adolescent neurodevelopment, and relationships between brain structure and sleep can vary in strength over this maturational window. Although cortical gyrification is increasingly considered a useful index for understanding cognitive and emotional outcomes in adolescence, and sleep is also a strong predictor of such outcomes, we know relatively little about associations between cortical gyrification and sleep. Methods Using Local gyrification index (lGI) of 34 bilateral brain regions and regularized regression for feature selection, we examined gyrification-sleep relationships in the Neuroimaging and Pediatric Sleep databank (252 participants; 9-26 years; 58.3% female) and identified developmentally invariant (stable across age) or developmentally specific (observed only during discrete age intervals) brain-sleep associations. Naturalistic sleep characteristics (duration, timing, continuity, and regularity) were estimated from wrist actigraphy. Results For most brain regions, greater lGI was associated with longer sleep duration, earlier sleep timing, lower variability in sleep regularity, and shorter time awake after sleep onset. lGI in frontoparietal network regions showed associations with sleep patterns that were stable across age. However, in default mode network regions, lGI was only associated with sleep patterns from late childhood through early-to-mid adolescence, a period of vulnerability for mental health disorders. Conclusions We detected both developmentally invariant and developmentally specific ties between local gyrification and naturalistic sleep patterns. Default mode network regions may be particularly susceptible to interventions promoting more optimal sleep during childhood and adolescence.
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Affiliation(s)
| | - Rebecca Hayes
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
| | - Peter L Franzen
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
| | - Tina R Goldstein
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
| | - Brant P Hasler
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA, USA
- Department of Clinical and Translational Science Institute, University of Pittsburgh, Pittsburgh, PA, USA
| | - Daniel J Buysse
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
- Department of Clinical and Translational Science Institute, University of Pittsburgh, Pittsburgh, PA, USA
| | - Greg J Siegle
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
- Department of Clinical and Translational Science Institute, University of Pittsburgh, Pittsburgh, PA, USA
| | - Ronald E Dahl
- School of Public Health, University of California, Berkeley, Berkeley, CA, USA
| | - Erika E Forbes
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA, USA
- Department of Clinical and Translational Science Institute, University of Pittsburgh, Pittsburgh, PA, USA
- Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | | | - Dana L McMakin
- Department of Psychology, Florida International University, Miami, FL, USA
| | - Neal D Ryan
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
| | - Jennifer S Silk
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA, USA
| | - Maria Jalbrzikowski
- Department of Psychiatry and Behavioral Sciences, Boston Children's Hospital, Boston, MA, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Adriane M Soehner
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
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Hehr A, Huntley ED, Marusak HA. Getting a Good Night's Sleep: Associations Between Sleep Duration and Parent-Reported Sleep Quality on Default Mode Network Connectivity in Youth. J Adolesc Health 2023; 72:933-942. [PMID: 36872118 PMCID: PMC10198813 DOI: 10.1016/j.jadohealth.2023.01.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Revised: 12/07/2022] [Accepted: 01/04/2023] [Indexed: 03/07/2023]
Abstract
PURPOSE Sleep plays an important role in healthy neurocognitive development, and poor sleep is linked to cognitive and emotional dysfunction. Studies in adults suggest that shorter sleep duration and poor sleep quality may disrupt core neurocognitive networks, particularly the default mode network (DMN)-a network implicated in internal cognitive processing and rumination. Here, we examine the relationships between sleep and within- and between-network resting-state functional connectivity (rs-FC) of the DMN in youth. METHODS This study included 3,798 youth (11.9 ± 0.6 years, 47.5% female) from the Adolescent Brain Cognitive Development cohort. Sleep duration and wake after sleep onset (WASO) were quantified using Fitbit watch recordings, and parent-reported sleep disturbances were measured using the Sleep Disturbance Scale for Children. We focused on rs-FC between the DMN and anticorrelated networks (i.e., dorsal attention network [DAN], frontoparietal network, salience network). RESULTS Both shorter sleep duration and greater sleep disturbances were associated with weaker within-network DMN rs-FC. Shorter sleep duration was also associated with weaker anticorrelation (i.e., higher rs-FC) between the DMN and two anticorrelated networks: the DAN and frontoparietal network. Greater WASO was also associated with DMN-DAN rs-FC, and the effects of WASO on rs-FC were most pronounced among children who slept fewer hours/night. DISCUSSION Together, these data suggest that different aspects of sleep are associated with distinct and interactive alterations in resting-state brain networks. Alterations in core neurocognitive networks may confer increased risk for emotional psychopathology and attention-related vulnerabilities. Our findings contribute to the growing number of studies demonstrating the importance of healthy sleep practices in youth.
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Affiliation(s)
- Aneesh Hehr
- Department of Psychiatry & Behavioral Neurosciences, School of Medicine, Wayne State University, Detroit, Michigan
| | - Edward D Huntley
- Survey Research Center, Institute for Social Research, University of Michigan, Ann Arbor, Michigan
| | - Hilary A Marusak
- Department of Psychiatry & Behavioral Neurosciences, School of Medicine, Wayne State University, Detroit, Michigan; Karmanos Cancer Institute, Detroit, Michigan; Merrill Palmer Skillman Institute for Child and Family Development, Wayne State University, Detroit, Michigan.
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11
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Brooks SJ, Smith C, Stamoulis C. Excess BMI in early adolescence adversely impacts maturating functional circuits supporting high-level cognition and their structural correlates. Int J Obes (Lond) 2023:10.1038/s41366-023-01303-7. [PMID: 37012426 DOI: 10.1038/s41366-023-01303-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/31/2022] [Revised: 03/17/2023] [Accepted: 03/21/2023] [Indexed: 04/05/2023]
Abstract
BACKGROUND/OBJECTIVES Adverse effects of excess BMI (affecting 1 in 5 children in the US) on brain circuits during neurodevelopmentally vulnerable periods are incompletely understood. This study investigated BMI-related alterations in maturating functional networks and their underlying brain structures, and high-level cognition in early adolescence. SUBJECTS/METHODS Cross-sectional resting-state fMRI, structural sMRI, neurocognitive task scores, and BMI from 4922 youth [median (IQR) age = 120.0 (13.0) months, 2572 females (52.25%)] from the Adolescent Brain Cognitive Development (ABCD) cohort were analyzed. Comprehensive topological and morphometric network properties were estimated from fMRI and sMRI, respectively. Cross-validated linear regression models assessed correlations with BMI. Results were reproduced across multiple fMRI datasets. RESULTS Almost 30% of youth had excess BMI, including 736 (15.0%) with overweight and 672 (13.7%) with obesity, and statistically more Black and Hispanic compared to white, Asian and non-Hispanic youth (p < 0.01). Those with obesity or overweight were less physically active, slept less than recommended, snored more frequently, and spent more time using an electronic device (p < 0.01). They also had lower topological efficiency, resilience, connectivity, connectedness and clustering in Default-Mode, dorsal attention, salience, control, limbic, and reward networks (p ≤ 0.04, Cohen's d: 0.07-0.39). Lower cortico-thalamic efficiency and connectivity were estimated only in youth with obesity (p < 0.01, Cohen's d: 0.09-0.19). Both groups had lower cortical thickness, volume and white matter intensity in these networks' constituent structures, particularly anterior cingulate, entorhinal, prefrontal, and lateral occipital cortices (p < 0.01, Cohen's d: 0.12-0.30), which also mediated inverse relationships between BMI and regional functional topologies. Youth with obesity or overweight had lower scores in a task measuring fluid reasoning - a core aspect of cognitive function, which were partially correlated with topological changes (p ≤ 0.04). CONCLUSIONS Excess BMI in early adolescence may be associated with profound aberrant topological alterations in maturating functional circuits and underdeveloped brain structures that adversely impact core aspects of cognitive function.
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Affiliation(s)
- Skylar J Brooks
- Boston Children's Hospital, Department of Pediatrics, Division of Adolescent Medicine, Boston, MA, USA
- University of California Berkeley, Helen Wills Neuroscience Institute, Berkeley, CA, USA
| | - Calli Smith
- Boston Children's Hospital, Department of Pediatrics, Division of Adolescent Medicine, Boston, MA, USA
| | - Catherine Stamoulis
- Boston Children's Hospital, Department of Pediatrics, Division of Adolescent Medicine, Boston, MA, USA.
- Harvard Medical School, Department of Pediatrics, Boston, MA, USA.
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12
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Brooks SJ, Tian L, Parks SM, Stamoulis C. Parental religiosity is associated with changes in youth functional network organization and cognitive performance in early adolescence. Sci Rep 2022; 12:17305. [PMID: 36243789 PMCID: PMC9569366 DOI: 10.1038/s41598-022-22299-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Accepted: 10/12/2022] [Indexed: 01/10/2023] Open
Abstract
Parental religious beliefs and practices (religiosity) may have profound effects on youth, especially in neurodevelopmentally complex periods such as adolescence. In n = 5566 children (median age = 120.0 months; 52.1% females; 71.2% with religious affiliation) from the Adolescent Brain Cognitive Development study, relationships between parental religiosity and non-religious beliefs on family values (data on youth beliefs were not available), topological properties of youth resting-state brain networks, and executive function, inhibitory control, and cognitive flexibility were investigated. Lower caregiver education and family income were associated with stronger parental beliefs (p < 0.01). Strength of both belief types was correlated with lower efficiency, community structure, and robustness of frontoparietal control, temporoparietal, and dorsal attention networks (p < 0.05), and lower Matrix Reasoning scores. Stronger religious beliefs were negatively associated (directly and indirectly) with multiscale properties of salience and default-mode networks, and lower Flanker and Dimensional Card Sort scores, but positively associated with properties of the precuneus. Overall, these effects were small (Cohen's d ~ 0.2 to ~ 0.4). Overlapping neuromodulatory and cognitive effects of parental beliefs suggest that early adolescents may perceive religious beliefs partly as context-independent rules on expected behavior. However, religious beliefs may also differentially affect cognitive flexibility, attention, and inhibitory control and their neural substrates.
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Affiliation(s)
- Skylar J. Brooks
- grid.2515.30000 0004 0378 8438Division of Adolescent Medicine, Department of Pediatrics, Boston Children’s Hospital, Boston, MA USA
| | - Luyao Tian
- grid.2515.30000 0004 0378 8438Division of Adolescent Medicine, Department of Pediatrics, Boston Children’s Hospital, Boston, MA USA ,Massachusetts Institution of Technology, Cambridge, MA USA
| | - Sean M. Parks
- grid.2515.30000 0004 0378 8438Division of Adolescent Medicine, Department of Pediatrics, Boston Children’s Hospital, Boston, MA USA ,Massachusetts Institution of Technology, Cambridge, MA USA
| | - Catherine Stamoulis
- Massachusetts Institution of Technology, Cambridge, MA USA ,grid.38142.3c000000041936754XHarvard Medical School, Boston, MA USA ,grid.2515.30000 0004 0378 8438Department of Pediatrics, Boston Children’s Hospital, 300 Longwood Avenue, Boston, MA 02115 USA
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