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Yuan D, Zhou Z, Song M, Zhang Y, Zhang Y, Ren P, Chen Z, Fu Y. Role of GABA B receptors in cognition and EEG activity in aged APP and PS1 transgenic mice. Neurochem Int 2024; 175:105718. [PMID: 38490487 DOI: 10.1016/j.neuint.2024.105718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Revised: 02/27/2024] [Accepted: 03/04/2024] [Indexed: 03/17/2024]
Abstract
Alzheimer's disease (AD) is the most common cause of dementia in the elderly. Recent evidence suggests that gamma-aminobutyric acid B (GABAB) receptor-mediated inhibition is a major contributor to AD pathobiology, and GABAB receptors have been hypothesized to be a potential target for AD treatment. The aim of this study is to determine how GABAB regulation alters cognitive function and brain activity in an AD mouse model. Early, middle and late stage (8-23 months) amyloid precursor protein (APP) and presenilin 1 (PS1) transgenic mice were used for the study. The GABAB agonist baclofen (1 and 2.5 mg/kg, i. p.) and the antagonist phaclofen (0.5 mg/kg, i. p.) were used. Primarily, we found that GABAB activation was able to improve spatial and/or working memory performance in early and late stage AD animals. In addition, GABAB activation and inhibition could regulate global and local EEG oscillations in AD animals, with activation mainly regulating low-frequency activity (delta-theta bands) and inhibition mainly regulating mid- and high-frequency activity (alpha-gamma bands), although the regulated magnitude at some frequencies was reduced in AD. The cognitive improvements in AD animals may be explained by the reduced EEG activity in the theta frequency band (2-4 Hz). This study provides evidence for a potential therapeutic effect of baclofen in the elderly AD brain and for GABAB receptor-mediated inhibition as a potential therapeutic target for AD.
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Affiliation(s)
- Dong Yuan
- Medical School, Kunming University of Science & Technology, Kunming, Yunnan, 650500, China
| | - Zheng Zhou
- Medical School, Kunming University of Science & Technology, Kunming, Yunnan, 650500, China
| | - Meihui Song
- Medical School, Kunming University of Science & Technology, Kunming, Yunnan, 650500, China
| | - Yunfan Zhang
- Medical School, Kunming University of Science & Technology, Kunming, Yunnan, 650500, China
| | - Yunbin Zhang
- Medical School, Kunming University of Science & Technology, Kunming, Yunnan, 650500, China
| | - Ping Ren
- Department of Geriatric Psychiatry, Shenzhen Mental Health Center, Shenzhen Kangning Hospital, Shenzhen, Guangdong, 518020, China
| | - Zhuangfei Chen
- Medical School, Kunming University of Science & Technology, Kunming, Yunnan, 650500, China
| | - Yu Fu
- Medical School, Kunming University of Science & Technology, Kunming, Yunnan, 650500, China.
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2
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Wilckens KA, Mayeli A, Stepan ME, Peng CW, Habte RF, Sharma K, Janssen SA, Applegate SL, Wallace ML, Buysse DJ, Ferrarelli F. High frequency transcranial magnetic stimulation increases slow-wave activity during subsequent sleep in older adults with cognitive complaints. Brain Stimul 2024; 17:362-364. [PMID: 38490473 PMCID: PMC11215801 DOI: 10.1016/j.brs.2024.03.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2024] [Accepted: 03/04/2024] [Indexed: 03/17/2024] Open
Affiliation(s)
- Kristine A Wilckens
- Department of Psychiatry, University of Pittsburgh, School of Medicine, Pittsburgh, PA, 15206, USA.
| | - Ahmad Mayeli
- Department of Psychiatry, University of Pittsburgh, School of Medicine, Pittsburgh, PA, 15206, USA
| | - Michelle E Stepan
- Department of Psychiatry, University of Pittsburgh, School of Medicine, Pittsburgh, PA, 15206, USA
| | - Christine W Peng
- Department of Psychiatry, University of Pittsburgh, School of Medicine, Pittsburgh, PA, 15206, USA
| | - Rima F Habte
- Department of Psychiatry, University of Pittsburgh, School of Medicine, Pittsburgh, PA, 15206, USA
| | - Kamakashi Sharma
- Department of Psychiatry, University of Pittsburgh, School of Medicine, Pittsburgh, PA, 15206, USA
| | - Sabine A Janssen
- Department of Psychiatry, University of Pittsburgh, School of Medicine, Pittsburgh, PA, 15206, USA
| | - Savannah L Applegate
- Department of Psychiatry, University of Pittsburgh, School of Medicine, Pittsburgh, PA, 15206, USA
| | - Meredith L Wallace
- Department of Psychiatry, University of Pittsburgh, School of Medicine, Pittsburgh, PA, 15206, USA
| | - Daniel J Buysse
- Department of Psychiatry, University of Pittsburgh, School of Medicine, Pittsburgh, PA, 15206, USA
| | - Fabio Ferrarelli
- Department of Psychiatry, University of Pittsburgh, School of Medicine, Pittsburgh, PA, 15206, USA
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3
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Ferini-Strambi L, Liguori C, Lucey BP, Mander BA, Spira AP, Videnovic A, Baumann C, Franco O, Fernandes M, Gnarra O, Krack P, Manconi M, Noain D, Saxena S, Kallweit U, Randerath W, Trenkwalder C, Rosenzweig I, Iranzo A, Bradicich M, Bassetti C. Role of sleep in neurodegeneration: the consensus report of the 5th Think Tank World Sleep Forum. Neurol Sci 2024; 45:749-767. [PMID: 38087143 DOI: 10.1007/s10072-023-07232-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Accepted: 11/26/2023] [Indexed: 01/18/2024]
Abstract
Sleep abnormalities may represent an independent risk factor for neurodegeneration. An international expert group convened in 2021 to discuss the state-of-the-science in this domain. The present article summarizes the presentations and discussions concerning the importance of a strategy for studying sleep- and circadian-related interventions for early detection and prevention of neurodegenerative diseases. An international expert group considered the current state of knowledge based on the most relevant publications in the previous 5 years; discussed the current challenges in the field of relationships among sleep, sleep disorders, and neurodegeneration; and identified future priorities. Sleep efficiency and slow wave activity during non-rapid eye movement (NREM) sleep are decreased in cognitively normal middle-aged and older adults with Alzheimer's disease (AD) pathology. Sleep deprivation increases amyloid-β (Aβ) concentrations in the interstitial fluid of experimental animal models and in cerebrospinal fluid in humans, while increased sleep decreases Aβ. Obstructive sleep apnea (OSA) is a risk factor for dementia. Studies indicate that positive airway pressure (PAP) treatment should be started in patients with mild cognitive impairment or AD and comorbid OSA. Identification of other measures of nocturnal hypoxia and sleep fragmentation could better clarify the role of OSA as a risk factor for neurodegeneration. Concerning REM sleep behavior disorder (RBD), it will be crucial to identify the subset of RBD patients who will convert to a specific neurodegenerative disorder. Circadian sleep-wake rhythm disorders (CSWRD) are strong predictors of caregiver stress and institutionalization, but the absence of recommendations or consensus statements must be considered. Future priorities include to develop and validate existing and novel comprehensive assessments of CSWRD in patients with/at risk for dementia. Strategies for studying sleep-circadian-related interventions for early detection/prevention of neurodegenerative diseases are required. CSWRD evaluation may help to identify additional biomarkers for phenotyping and personalizing treatment of neurodegeneration.
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Affiliation(s)
- Luigi Ferini-Strambi
- Sleep Disorders Center, Division of Neuroscience, Università Vita-Salute San Raffaele, Milan, Italy.
| | - Claudio Liguori
- Sleep Medicine Center, University of Rome Tor Vergata, Rome, Italy
| | - Brendan P Lucey
- Department of Neurology, Washington University School of Medicine, St Louis, MO, USA
| | - Bryce A Mander
- Department of Psychiatry and Human Behavior, University of California, Irvine, CA, USA
| | - Adam P Spira
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Aleksandar Videnovic
- Department of Neurology, Division of Sleep Medicine, Massachussets General Hospital, Harvard Medical School, Boston, MA, USA
| | - Christian Baumann
- Department of Neurology, University Hospital Zurich, Zurich, Switzerland
| | - Oscar Franco
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
| | | | - Oriella Gnarra
- Department of Neurology, University of Bern, Bern, Switzerland
| | - Paul Krack
- Department of Neurology, University of Bern, Bern, Switzerland
| | - Mauro Manconi
- Sleep Medicine Unit, Faculty of Biomedical Sciences, Neurocenter of the Southern Switzerland, Regional Hospital of Lugano, Università Della Svizzera Italiana, Lugano, Switzerland
| | - Daniela Noain
- Department of Neurology, University of Bern, Bern, Switzerland
| | - Smita Saxena
- Department of Neurology, University of Bern, Bern, Switzerland
| | - Ulf Kallweit
- Clinical Sleep and Neuroimmunology, University Witten/Herdecke, Witten, Germany
| | | | - C Trenkwalder
- Department of Neurosurgery, Paracelsus-Elena Klinik, University Medical Center, KasselGoettingen, Germany
| | - Ivana Rosenzweig
- Sleep and Brain Plasticity Centre, Department of Neuroimaging, King's College London, London, UK
| | - Alex Iranzo
- Sleep Center, Neurology Service, Hospital Clinic de Barcelona, Barcelona, IDIBAPS, CIBERNED, Barcelona, Spain
| | - Matteo Bradicich
- Department of Pulmonology and Sleep Disorders Centre, University Hospital Zurich, Zurich, Switzerland
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Kim SJ, Lee JH, Jang JW, Jung HS, Suh IB. Abnormalities of Rest-Activity and Light Exposure Rhythms Associated with Cognitive Function in Patients with Mild Cognitive Impairment (MCI). J Circadian Rhythms 2023; 21:4. [PMID: 38162255 PMCID: PMC10756154 DOI: 10.5334/jcr.227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Accepted: 10/05/2023] [Indexed: 01/03/2024] Open
Abstract
We aimed to examine the difference in rest-activity rhythm (RAR) and light exposure rhythm (LER) between patients with mild cognitive impairment (MCI) and normal controls (NC), and to verify their relationships with cognitive functions. The neuropsychological battery was administered to participants above 50 years old. The MCI diagnosis was made according to Petersen's criteria. Ten patients with MCI (77.90 ± 6.95 years) and eight NC (74.75 ± 5.06 years) were studied. Actigraphy (Actiwatch 2; Philips Respironics) was recorded at home for 5 days. RAR and LER variables, including interdaily stability (IS), intradaily variability (IV) and relative amplitude, were calculated using nonparametric analyses. The associations between cognitive performance and RAR and LER variables were explored using generalized linear models. There were no significant differences in RAR or LER variables between MCI and NC. There was a significant main effect of RAR-IS on the Stroop Color and Word Test (SCWT), indicating a positive relationship between RAR stability and SCWT performance. There was a significant group by RAR-IS interaction on Trail Making Test-A, indicating a negative relationship in MCI compared to NC. There was a significant group by LER-IV interaction on the Boston Naming Test, indicating a positive relationship in MCI compared to NC. There was no disruption in RAR and LER in patients with MCI. Our study showed that circadian rhythm abnormality was associated with a decline in executive function. However, circadian rhythm abnormality was not associated with declines in processing speed and language function in patients with MCI, implying an altered pathophysiology compared to NC.
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Affiliation(s)
- Seong Jae Kim
- Department of Psychiatry, Chosun University College of Medicine, Gwangju, South Korea
- Department of Psychiatry, Chosun University Hospital, Gwangju, South Korea
| | - Jung Hie Lee
- Department of Psychiatry, Kangwon National University School of Medicine, Chuncheon, South Korea
- Department of Psychiatry, Gwanggyo Good Sleep Clinic, Suwon, South Korea
| | - Jae-Won Jang
- Department of Neurology, Kangwon National University School of Medicine, Chuncheon, South Korea
| | - Hee Seo Jung
- Department of Psychiatry, Kangwon National University Hospital, Chuncheon, South Korea
| | - In Bum Suh
- Department of Laboratory Medicine, Kangwon National University School of Medicine, Chuncheon, South Korea
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5
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Shin JW. Neuroprotective effects of melatonin in neurodegenerative and autoimmune central nervous system diseases. ENCEPHALITIS 2023; 3:44-53. [PMID: 37469673 PMCID: PMC10295826 DOI: 10.47936/encephalitis.2022.00094] [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: 10/11/2022] [Revised: 11/24/2022] [Accepted: 12/15/2022] [Indexed: 07/21/2023] Open
Abstract
The suprachiasmatic nucleus (SCN) in the anterior hypothalamus is the major circadian pacemaker in humans. Melatonin is a key hormone secreted by the pineal gland in response to darkness. Light-induced stimuli are transmitted along the retinohypothalamic tract to the SCN. Activation of the SCN inhibits the production of melatonin by the pineal gland through a complex neural pathway passing through the superior cervical ganglion. Accordingly, when light is unavailable, the pineal gland secretes melatonin. The circadian rhythm modulates sleep-wake cycles as well as many physiological functions of the endocrine system, including core body temperature, pulse rate, oxygen consumption, hormone levels, metabolism, and gastrointestinal function. In neurodegenerative disorders, the sleep-wake cycle is disrupted and circadian regulation is altered, which accelerates disease progression, further disrupting circadian regulation and setting up a vicious cycle. Melatonin plays a critical role in the regulation of circadian rhythms and is a multifunctional pleiotropic agent with broad neuroprotective effects in neurodegenerative disorders, viral or autoimmune diseases, and cancer. In this review, I discuss the neuroprotective functions of melatonin in circadian regulation and its roles in promoting anti-inflammatory activity, enhancing immune system functions, and preventing alterations in glucose metabolism and mitochondrial dysfunction in neurodegenerative disorders and autoimmune central nervous system diseases.
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Affiliation(s)
- Jung-Won Shin
- Department of Neurology, Bundang CHA Medical Center, CHA University, Seongnam, Korea
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6
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Soula M, Martín-Ávila A, Zhang Y, Dhingra A, Nitzan N, Sadowski MJ, Gan WB, Buzsáki G. Forty-hertz light stimulation does not entrain native gamma oscillations in Alzheimer's disease model mice. Nat Neurosci 2023; 26:570-578. [PMID: 36879142 PMCID: PMC10839995 DOI: 10.1038/s41593-023-01270-2] [Citation(s) in RCA: 47] [Impact Index Per Article: 47.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Accepted: 01/31/2023] [Indexed: 03/08/2023]
Abstract
There is a demand for noninvasive methods to ameliorate disease. We investigated whether 40-Hz flickering light entrains gamma oscillations and suppresses amyloid-β in the brains of APP/PS1 and 5xFAD mouse models of Alzheimer's disease. We used multisite silicon probe recording in the visual cortex, entorhinal cortex or the hippocampus and found that 40-Hz flickering simulation did not engage native gamma oscillations in these regions. Additionally, spike responses in the hippocampus were weak, suggesting 40-Hz light does not effectively entrain deep structures. Mice avoided 40-Hz flickering light, associated with elevated cholinergic activity in the hippocampus. We found no reliable changes in plaque count or microglia morphology by either immunohistochemistry or in vivo two-photon imaging following 40-Hz stimulation, nor reduced levels of amyloid-β 40/42. Thus, visual flicker stimulation may not be a viable mechanism for modulating activity in deep structures.
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Affiliation(s)
- Marisol Soula
- Neuroscience Institute, Langone Medical Center, New York University, New York, NY, USA
| | - Alejandro Martín-Ávila
- Department of Physiology and Neuroscience, Langone Medical Center, New York University, New York, NY, USA
- Skirball Institute of Biomolecular Medicine, Langone Medical Center, New York University, New York, NY, USA
| | - Yiyao Zhang
- Neuroscience Institute, Langone Medical Center, New York University, New York, NY, USA
| | - Annika Dhingra
- Neuroscience Institute, Langone Medical Center, New York University, New York, NY, USA
| | - Noam Nitzan
- Neuroscience Institute, Langone Medical Center, New York University, New York, NY, USA
| | - Martin J Sadowski
- Department of Neurology and Psychiatry, Langone Medical Center, New York University, New York, NY, USA
- Department of Biochemistry and Molecular Pharmacology, Langone Medical Center, New York University, New York, NY, USA
| | - Wen-Biao Gan
- Skirball Institute of Biomolecular Medicine, Langone Medical Center, New York University, New York, NY, USA
| | - György Buzsáki
- Neuroscience Institute, Langone Medical Center, New York University, New York, NY, USA.
- Department of Physiology and Neuroscience, Langone Medical Center, New York University, New York, NY, USA.
- Department of Neurology and Psychiatry, Langone Medical Center, New York University, New York, NY, USA.
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Sanfilippo C, Giuliano L, Castrogiovanni P, Imbesi R, Ulivieri M, Fazio F, Blennow K, Zetterberg H, Di Rosa M. Sex, Age, and Regional Differences in CHRM1 and CHRM3 Genes Expression Levels in the Human Brain Biopsies: Potential Targets for Alzheimer's Disease-related Sleep Disturbances. Curr Neuropharmacol 2023; 21:740-760. [PMID: 36475335 PMCID: PMC10207911 DOI: 10.2174/1570159x21666221207091209] [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: 11/11/2021] [Revised: 03/06/2022] [Accepted: 04/19/2022] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Cholinergic hypofunction and sleep disturbance are hallmarks of Alzheimer's disease (AD), a progressive disorder leading to neuronal deterioration. Muscarinic acetylcholine receptors (M1-5 or mAChRs), expressed in hippocampus and cerebral cortex, play a pivotal role in the aberrant alterations of cognitive processing, memory, and learning, observed in AD. Recent evidence shows that two mAChRs, M1 and M3, encoded by CHRM1 and CHRM3 genes, respectively, are involved in sleep functions and, peculiarly, in rapid eye movement (REM) sleep. METHODS We used twenty microarray datasets extrapolated from post-mortem brain tissue of nondemented healthy controls (NDHC) and AD patients to examine the expression profile of CHRM1 and CHRM3 genes. Samples were from eight brain regions and stratified according to age and sex. RESULTS CHRM1 and CHRM3 expression levels were significantly reduced in AD compared with ageand sex-matched NDHC brains. A negative correlation with age emerged for both CHRM1 and CHRM3 in NDHC but not in AD brains. Notably, a marked positive correlation was also revealed between the neurogranin (NRGN) and both CHRM1 and CHRM3 genes. These associations were modulated by sex. Accordingly, in the temporal and occipital regions of NDHC subjects, males expressed higher levels of CHRM1 and CHRM3, respectively, than females. In AD patients, males expressed higher levels of CHRM1 and CHRM3 in the temporal and frontal regions, respectively, than females. CONCLUSION Thus, substantial differences, all strictly linked to the brain region analyzed, age, and sex, exist in CHRM1 and CHRM3 brain levels both in NDHC subjects and in AD patients.
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Affiliation(s)
- Cristina Sanfilippo
- Department G.F. Ingrassia, Section of Neurosciences, University of Catania, Catania, Italy
| | - Loretta Giuliano
- Department G.F. Ingrassia, Section of Neurosciences, University of Catania, Catania, Italy
| | - Paola Castrogiovanni
- Department of Biomedical and Biotechnological Sciences, Human Anatomy and Histology Section, School of Medicine, University of Catania, Italy
| | - Rosa Imbesi
- Department of Biomedical and Biotechnological Sciences, Human Anatomy and Histology Section, School of Medicine, University of Catania, Italy
| | - Martina Ulivieri
- Department of Psychiatry, Health Science, University of California San Diego, San Diego La Jolla, CA, USA
| | - Francesco Fazio
- Department of Psychiatry, Health Science, University of California San Diego, San Diego La Jolla, CA, USA
| | - Kaj Blennow
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden
- Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden
| | - Henrik Zetterberg
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden
- Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden
- UK Dementia Research Institute at UCL, London, United Kingdom
- Department of Neurodegenerative Disease, UCL Institute of Neurology, London, United Kingdom
| | - Michelino Di Rosa
- Department of Biomedical and Biotechnological Sciences, Human Anatomy and Histology Section, School of Medicine, University of Catania, Italy
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Roberts R, Wall MJ, Braren I, Dhillon K, Evans A, Dunne J, Nyakupinda S, Huckstepp RTR. An Improved Model of Moderate Sleep Apnoea for Investigating Its Effect as a Comorbidity on Neurodegenerative Disease. Front Aging Neurosci 2022; 14:861344. [PMID: 35847678 PMCID: PMC9278434 DOI: 10.3389/fnagi.2022.861344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Accepted: 04/19/2022] [Indexed: 11/25/2022] Open
Abstract
Sleep apnoea is a highly prevalent disease that often goes undetected and is associated with poor clinical prognosis, especially as it exacerbates many different disease states. However, most animal models of sleep apnoea (e.g., intermittent hypoxia) have recently been dispelled as physiologically unrealistic and are often unduly severe. Owing to a lack of appropriate models, little is known about the causative link between sleep apnoea and its comorbidities. To overcome these problems, we have created a more realistic animal model of moderate sleep apnoea by reducing the excitability of the respiratory network. This has been achieved through controlled genetically mediated lesions of the preBötzinger complex (preBötC), the inspiratory oscillator. This novel model shows increases in sleep disordered breathing with alterations in breathing during wakefulness (decreased frequency and increased tidal volume) as observed clinically. The increase in dyspnoeic episodes leads to reduction in REM sleep, with all lost active sleep being spent in the awake state. The increase in hypoxic and hypercapnic insults induces both systemic and neural inflammation. Alterations in neurophysiology, an inhibition of hippocampal long-term potentiation (LTP), is reflected in deficits in both long- and short-term spatial memory. This improved model of moderate sleep apnoea may be the key to understanding why this disorder has such far-reaching and often fatal effects on end-organ function.
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Affiliation(s)
- Reno Roberts
- School of Life Sciences, University of Warwick, Coventry, United Kingdom
| | - Mark J. Wall
- School of Life Sciences, University of Warwick, Coventry, United Kingdom
| | - Ingke Braren
- University Medical Center Eppendorf, Vector Facility, Institute for Experimental Pharmacology and Toxikology, Hamburg, Germany
| | - Karendeep Dhillon
- School of Life Sciences, University of Warwick, Coventry, United Kingdom
| | - Amy Evans
- School of Life Sciences, University of Warwick, Coventry, United Kingdom
| | - Jack Dunne
- School of Life Sciences, University of Warwick, Coventry, United Kingdom
| | | | - Robert T. R. Huckstepp
- School of Life Sciences, University of Warwick, Coventry, United Kingdom
- *Correspondence: Robert T. R. Huckstepp
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9
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Sleep deficiency as a driver of cellular stress and damage in neurological disorders. Sleep Med Rev 2022; 63:101616. [PMID: 35381445 PMCID: PMC9177816 DOI: 10.1016/j.smrv.2022.101616] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Revised: 02/17/2022] [Accepted: 02/18/2022] [Indexed: 12/23/2022]
Abstract
Neurological disorders encompass an extremely broad range of conditions, including those that present early in development and those that progress slowly or manifest with advanced age. Although these disorders have distinct underlying etiologies, the activation of shared pathways, e.g., integrated stress response (ISR) and the development of shared phenotypes (sleep deficits) may offer clues toward understanding some of the mechanistic underpinnings of neurologic dysfunction. While it is incontrovertibly complex, the relationship between sleep and persistent stress in the brain has broad implications in understanding neurological disorders from development to degeneration. The convergent nature of the ISR could be a common thread linking genetically distinct neurological disorders through the dysregulation of a core cellular homeostasis pathway.
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Dunn T, Howlett SE, Stanojevic S, Shehzad A, Stanley J, Rockwood K. Patterns of Symptom Tracking by Caregivers and Patients With Dementia and Mild Cognitive Impairment: Cross-sectional Study. J Med Internet Res 2022; 24:e29219. [PMID: 35084341 PMCID: PMC8832273 DOI: 10.2196/29219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Revised: 08/13/2021] [Accepted: 12/02/2021] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Individuals with dementia and mild cognitive impairment (MCI) experience a wide variety of symptoms and challenges that trouble them. To address this heterogeneity, numerous standardized tests are used for diagnosis and prognosis. myGoalNav Dementia is a web-based tool that allows individuals with impairments and their caregivers to identify and track outcomes of greatest importance to them, which may be a less arbitrary and more sensitive way of capturing meaningful change. OBJECTIVE We aim to explore the most frequent and important symptoms and challenges reported by caregivers and people with dementia and MCI and how this varies according to disease severity. METHODS This cross-sectional study involved 3909 web-based myGoalNav users (mostly caregivers of people with dementia or MCI) who completed symptom profiles between 2006 and 2019. To make a symptom profile, users selected their most personally meaningful or troublesome dementia-related symptoms to track over time. Users were also asked to rank their chosen symptoms from least to most important, which we called the symptom potency. As the stage of disease for these web-based users was unknown, we applied a supervised staging algorithm, previously trained on clinician-derived data, to classify each profile into 1 of 4 stages: MCI and mild, moderate, and severe dementia. Across these stages, we compared symptom tracking frequency, symptom potency, and the relationship between frequency and potency. RESULTS Applying the staging algorithm to the 3909 user profiles resulted in 917 (23.46%) MCI, 1596 (40.83%) mild dementia, 514 (13.15%) moderate dementia, and 882 (22.56%) severe dementia profiles. We found that the most frequent symptoms in MCI and mild dementia profiles were similar and comprised early hallmarks of dementia (eg, recent memory and language difficulty). As the stage increased to moderate and severe, the most frequent symptoms were characteristic of loss of independent function (eg, incontinence) and behavioral problems (eg, aggression). The most potent symptoms were similar between stages and generally reflected disruptions in everyday life (eg, problems with hobbies or games, travel, and looking after grandchildren). Symptom frequency was negatively correlated with potency at all stages, and the strength of this relationship increased with increasing disease severity. CONCLUSIONS Our results emphasize the importance of patient-centricity in MCI and dementia studies and illustrate the valuable real-world evidence that can be collected with digital tools. Here, the most frequent symptoms across the stages reflected our understanding of the typical disease progression. However, the symptoms that were ranked as most personally important by users were generally among the least frequently selected. Through individualization, patient-centered instruments such as myGoalNav can complement standardized measures by capturing these infrequent but potent outcomes.
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Affiliation(s)
| | - Susan E Howlett
- Ardea Outcomes, Halifax, NS, Canada
- Department of Pharmacology, Dalhousie University, Halifax, NS, Canada
- Division of Geriatric Medicine, Dalhousie University, Halifax, NS, Canada
| | - Sanja Stanojevic
- Ardea Outcomes, Halifax, NS, Canada
- Department of Community Health and Epidemiology, Dalhousie University, Halifax, NS, Canada
| | | | | | - Kenneth Rockwood
- Ardea Outcomes, Halifax, NS, Canada
- Division of Geriatric Medicine, Dalhousie University, Halifax, NS, Canada
- Geriatric Medicine Research Unit, Nova Scotia Health Authority, Halifax, NS, Canada
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11
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Tseng PT, Zeng BY, Chen YW, Yang CP, Su KP, Chen TY, Wu YC, Tu YK, Lin PY, Carvalho AF, Stubbs B, Matsuoka YJ, Li DJ, Liang CS, Hsu CW, Sun CK, Cheng YS, Yeh PY, Shiue YL. The Dose and Duration-dependent Association between Melatonin Treatment and Overall Cognition in Alzheimer's Dementia: A Network Meta- Analysis of Randomized Placebo-Controlled Trials. Curr Neuropharmacol 2022; 20:1816-1833. [PMID: 35450525 PMCID: PMC9886806 DOI: 10.2174/1570159x20666220420122322] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Revised: 02/18/2022] [Accepted: 04/14/2022] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND While Alzheimer's dementia (AD) has a prevalence as high as 3-32% and is associated with cognitive dysfunction and the risk of institutionalization, no efficacious and acceptable treatments can modify the course of cognitive decline in AD. Potential benefits of exogenous melatonin for cognition have been divergent across trials. OBJECTIVE The current network meta-analysis (NMA) was conducted under the frequentist model to evaluate the potential beneficial effects of exogenous melatonin supplementation on overall cognitive function in participants with AD in comparison to other FDA-approved medications (donepezil, galantamine, rivastigmine, memantine, and Namzaric). METHODS The primary outcome was the changes in the cognitive function [measured by mini-mental state examination (MMSE)] after treatment in patients with Alzheimer's dementia. The secondary outcomes were changes in the quality of life, behavioral disturbance, and acceptability (i.e., drop-out due to any reason and rate of any adverse event reported). RESULTS The current NMA of 50 randomized placebo-controlled trials (RCTs) revealed the medium-term lowdose melatonin to be associated with the highest post-treatment MMSE (mean difference = 1.48 in MMSE score, 95% confidence intervals [95% CIs] = 0.51 to 2.46) and quality of life (standardized mean difference = -0.64, 95% CIs = -1.13 to -0.15) among all of the investigated medications in the participants with AD. Finally, all of the investigated exogenous melatonin supplements were associated with similar acceptability as was the placebo. CONCLUSION The current NMA provides evidence for the potential benefits of exogenous melatonin supplementation, especially medium-term low-dose melatonin, in participants with AD.
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Affiliation(s)
- Ping-Tao Tseng
- Prospect Clinic for Otorhinolaryngology & Neurology, Kaohsiung, Taiwan
- Institute of Biomedical Sciences, National Sun Yat-Sen University, Kaohsiung, Taiwan
- Department of Psychology, College of Medical and Health Science, Asia University, Taichung, Taiwan; Clinical Psychology Center, Asia University Hospital, Taichung, Taiwan
| | - Bing-Yan Zeng
- Department of Internal Medicine, E-DA Dachang Hospital, Kaohsiung, Taiwan
| | - Yen-Wen Chen
- Prospect Clinic for Otorhinolaryngology & Neurology, Kaohsiung, Taiwan
| | - Chun-Pai Yang
- Department of Neurology, Kuang Tien General Hospital, Taichung, Taiwan
- Department of Nutrition, Huangkuang University, Taichung, Taiwan
| | - Kuan-Pin Su
- Department of Psychiatry & Mind-Body Interface Laboratory (MBI-Lab), China Medical University Hospital, Taichung, Taiwan
- College of Medicine, China Medical University, Taichung, Taiwan
- An-Nan Hospital, China Medical University, Tainan, Taiwan
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - Tien-Yu Chen
- Department of Psychiatry, Tri-Service General Hospital; School of Medicine, National Defense Medical Center, Taipei, Taiwan
- Institute of Brain Science, National Yang Ming Chiao Tung University, Taipei112, Taiwan
| | - Yi-Cheng Wu
- Department of Sports Medicine, Landseed International Hospital, Taoyuan, Taiwan
| | - Yu-Kang Tu
- Institute of Epidemiology & Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan
- Department of Dentistry, National Taiwan University Hospital, Taipei, Taiwan
| | - Pao-Yen Lin
- Department of Psychiatry, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
- Institute for Translational Research in Biomedical Sciences, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan
| | - Andre F. Carvalho
- Innovation in Mental and Physical Health and Clinical Treatment (IMPACT) Strategic Research Centre, School of Medicine, Barwon Health, Deakin University, Geelong, VIC, Australia
| | - Brendon Stubbs
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
- Physiotherapy Department, South London and Maudsley NHS Foundation Trust, London, UK
- Faculty of Health, Social Care Medicine and Education, Anglia Ruskin University, Chelmsford, UK
| | - Yutaka J. Matsuoka
- Department of Psychiatry & Mind-Body Interface Laboratory (MBI-Lab), China Medical University Hospital, Taichung, Taiwan
- Former Division Chief of Health Care Research, National Cancer Center, Japan
| | - Dian-Jeng Li
- Department of Addiction Science, Kaohsiung Municipal Kai-Syuan Psychiatric Hospital, Kaohsiung City, Taiwan
| | - Chih-Sung Liang
- Department of Psychiatry, Beitou Branch, Tri-Service General Hospital; School of Medicine, National Defense Medical Center, Taipei, Taiwan
- Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei, Taiwan
| | - Chih-Wei Hsu
- Department of Psychiatry, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Cheuk-Kwan Sun
- Department of Emergency Medicine, E-Da Hospital, I-Shou University School of Medicine for International Students
| | - Yu-Shian Cheng
- Institute of Biomedical Sciences, National Sun Yat-Sen University, Kaohsiung, Taiwan
- Department of Psychiatry, Tsyr-Huey Mental Hospital, Kaohsiung Jen-Ai’s Home, Taiwan
| | - Pin-Yang Yeh
- Department of Psychology, College of Medical and Health Science, Asia University, Taichung, Taiwan; Clinical Psychology Center, Asia University Hospital, Taichung, Taiwan
| | - Yow-Ling Shiue
- Institute of Biomedical Sciences, National Sun Yat-Sen University, Kaohsiung, Taiwan
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12
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Gao F, Liu T, Tuo M, Chi S. The role of orexin in Alzheimer disease: From sleep-wake disturbance to therapeutic target. Neurosci Lett 2021; 765:136247. [PMID: 34530113 DOI: 10.1016/j.neulet.2021.136247] [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: 04/23/2021] [Revised: 08/01/2021] [Accepted: 09/09/2021] [Indexed: 10/20/2022]
Abstract
Accumulating evidence has shown that sleep disturbance is a common symptom in Alzheimer's disease (AD), which is regarded as a modifiable risk factor for AD. Orexin is a key modulator of the sleep-wake cycle and has been found to be dysregulated in AD patients. The increased orexin in cerebrospinal fluid (CSF) is associated with decreased sleep efficiency and REM sleep, as well as cognitive impairment in AD patients. The orexin system has profuse projections to brain regions that are implicated in arousal and cognition and has been found to participate in the progression of AD pathology. Conversely the orexin receptor antagonists are able to consolidate sleep and reduce AD pathology. Therefore, improved understanding of the mechanisms linking orexin system, sleep disturbance and AD could make orexin receptor antagonists a promising target for the prevention or treatment of AD.
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Affiliation(s)
- Fan Gao
- Department of Neurology, the Affiliated Hospital of Qingdao University, Qingdao, China
| | - Tao Liu
- Department of Neurology, the Affiliated Hospital of Qingdao University, Qingdao, China
| | - Miao Tuo
- Department of Neurology, the Affiliated Hospital of Qingdao University, Qingdao, China
| | - Song Chi
- Department of Neurology, the Affiliated Hospital of Qingdao University, Qingdao, China.
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13
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Kaldun JC, Lone SR, Humbert Camps AM, Fritsch C, Widmer YF, Stein JV, Tomchik SM, Sprecher SG. Dopamine, sleep, and neuronal excitability modulate amyloid-β-mediated forgetting in Drosophila. PLoS Biol 2021; 19:e3001412. [PMID: 34613972 PMCID: PMC8523056 DOI: 10.1371/journal.pbio.3001412] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Revised: 10/18/2021] [Accepted: 09/14/2021] [Indexed: 11/18/2022] Open
Abstract
Alzheimer disease (AD) is one of the main causes of age-related dementia and neurodegeneration. However, the onset of the disease and the mechanisms causing cognitive defects are not well understood. Aggregation of amyloidogenic peptides is a pathological hallmark of AD and is assumed to be a central component of the molecular disease pathways. Pan-neuronal expression of Aβ42Arctic peptides in Drosophila melanogaster results in learning and memory defects. Surprisingly, targeted expression to the mushroom bodies, a center for olfactory memories in the fly brain, does not interfere with learning but accelerates forgetting. We show here that reducing neuronal excitability either by feeding Levetiracetam or silencing of neurons in the involved circuitry ameliorates the phenotype. Furthermore, inhibition of the Rac-regulated forgetting pathway could rescue the Aβ42Arctic-mediated accelerated forgetting phenotype. Similar effects are achieved by increasing sleep, a critical regulator of neuronal homeostasis. Our results provide a functional framework connecting forgetting signaling and sleep, which are critical for regulating neuronal excitability and homeostasis and are therefore a promising mechanism to modulate forgetting caused by toxic Aβ peptides.
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Affiliation(s)
- Jenifer C. Kaldun
- Department of Biology, University of Fribourg, Fribourg, Switzerland
| | - Shahnaz R. Lone
- Department of Biology, University of Fribourg, Fribourg, Switzerland
- Department of Animal Sciences, Central University of Punjab, Bathinda, India
| | | | - Cornelia Fritsch
- Department of Biology, University of Fribourg, Fribourg, Switzerland
| | - Yves F. Widmer
- Department of Biology, University of Fribourg, Fribourg, Switzerland
| | - Jens V. Stein
- Department of Medicine, University of Fribourg, Fribourg, Switzerland
| | - Seth M. Tomchik
- Department of Neuroscience, The Scripps Research Institute, Jupiter, Florida, United States of America
| | - Simon G. Sprecher
- Department of Biology, University of Fribourg, Fribourg, Switzerland
- * E-mail:
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14
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D’Atri A, Gorgoni M, Scarpelli S, Cordone S, Alfonsi V, Marra C, Ferrara M, Rossini PM, De Gennaro L. Relationship between Cortical Thickness and EEG Alterations during Sleep in the Alzheimer's Disease. Brain Sci 2021; 11:brainsci11091174. [PMID: 34573195 PMCID: PMC8468220 DOI: 10.3390/brainsci11091174] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Revised: 08/31/2021] [Accepted: 09/01/2021] [Indexed: 02/05/2023] Open
Abstract
Recent evidence showed that EEG activity alterations that occur during sleep are associated with structural, age-related, changes in healthy aging brains, and predict age-related decline in memory performance. Alzheimer's disease (AD) patients show specific EEG alterations during sleep associated with cognitive decline, including reduced sleep spindles during NREM sleep and EEG slowing during REM sleep. We investigated the relationship between these EEG sleep alterations and brain structure changes in a study of 23 AD patients who underwent polysomnographic recording of their undisturbed sleep and 1.5T MRI scans. Cortical thickness measures were correlated with EEG power in the sigma band during NREM sleep and with delta- and beta-power during REM sleep. Thinning in the right precuneus correlated with all the EEG indexes considered in this study. Frontal-central NREM sigma power showed an inverse correlation with thinning of the left entorhinal cortex. Increased delta activity at the frontopolar and temporal regions was significantly associated with atrophy in some temporal, parietal, and frontal cortices, and with mean thickness of the right hemisphere. Our findings revealed an association between sleep EEG alterations and the changes to AD patients' brain structures. Findings also highlight possible compensatory processes involving the sources of frontal-central sleep spindles.
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Affiliation(s)
- Aurora D’Atri
- Department of Biotechnological and Applied Clinical Sciences, University of L’Aquila, 67100 L’Aquila, Italy; (A.D.); (M.F.)
| | - Maurizio Gorgoni
- Department of Psychology, University of Rome “Sapienza”, 00185 Rome, Italy; (M.G.); (S.S.); (V.A.)
| | - Serena Scarpelli
- Department of Psychology, University of Rome “Sapienza”, 00185 Rome, Italy; (M.G.); (S.S.); (V.A.)
| | - Susanna Cordone
- UniCamillus, Saint Camillus International University of Health Sciences, 00131 Rome, Italy;
| | - Valentina Alfonsi
- Department of Psychology, University of Rome “Sapienza”, 00185 Rome, Italy; (M.G.); (S.S.); (V.A.)
| | - Camillo Marra
- Memory Clinic-Department of Aging, Neuroscience, Orthopaedic and Head-Neck, IRCCS Foundation Policlinico Universitario Agostino Gemelli, 00168 Rome, Italy;
| | - Michele Ferrara
- Department of Biotechnological and Applied Clinical Sciences, University of L’Aquila, 67100 L’Aquila, Italy; (A.D.); (M.F.)
| | - Paolo Maria Rossini
- Department of Neuroscience & Neurorehabil., IRCCS San Raffaele-Pisana, 00163 Rome, Italy;
| | - Luigi De Gennaro
- Department of Psychology, University of Rome “Sapienza”, 00185 Rome, Italy; (M.G.); (S.S.); (V.A.)
- Correspondence: ; Tel.: +39-0649917647
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15
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Byron N, Semenova A, Sakata S. Mutual Interactions between Brain States and Alzheimer's Disease Pathology: A Focus on Gamma and Slow Oscillations. BIOLOGY 2021; 10:707. [PMID: 34439940 PMCID: PMC8389330 DOI: 10.3390/biology10080707] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Revised: 07/17/2021] [Accepted: 07/21/2021] [Indexed: 12/26/2022]
Abstract
Brain state varies from moment to moment. While brain state can be defined by ongoing neuronal population activity, such as neuronal oscillations, this is tightly coupled with certain behavioural or vigilant states. In recent decades, abnormalities in brain state have been recognised as biomarkers of various brain diseases and disorders. Intriguingly, accumulating evidence also demonstrates mutual interactions between brain states and disease pathologies: while abnormalities in brain state arise during disease progression, manipulations of brain state can modify disease pathology, suggesting a therapeutic potential. In this review, by focusing on Alzheimer's disease (AD), the most common form of dementia, we provide an overview of how brain states change in AD patients and mouse models, and how controlling brain states can modify AD pathology. Specifically, we summarise the relationship between AD and changes in gamma and slow oscillations. As pathological changes in these oscillations correlate with AD pathology, manipulations of either gamma or slow oscillations can modify AD pathology in mouse models. We argue that neuromodulation approaches to target brain states are a promising non-pharmacological intervention for neurodegenerative diseases.
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Affiliation(s)
- Nicole Byron
- Strathclyde Institute of Pharmacy and Biomedical Sciences, University of Strathclyde, 161 Cathedral Street, Glasgow G4 0RE, UK
| | - Anna Semenova
- Strathclyde Institute of Pharmacy and Biomedical Sciences, University of Strathclyde, 161 Cathedral Street, Glasgow G4 0RE, UK
| | - Shuzo Sakata
- Strathclyde Institute of Pharmacy and Biomedical Sciences, University of Strathclyde, 161 Cathedral Street, Glasgow G4 0RE, UK
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16
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Joshi P, Perni M, Limbocker R, Mannini B, Casford S, Chia S, Habchi J, Labbadia J, Dobson CM, Vendruscolo M. Two human metabolites rescue a C. elegans model of Alzheimer's disease via a cytosolic unfolded protein response. Commun Biol 2021; 4:843. [PMID: 34234268 PMCID: PMC8263720 DOI: 10.1038/s42003-021-02218-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2020] [Accepted: 05/11/2021] [Indexed: 02/06/2023] Open
Abstract
Age-related changes in cellular metabolism can affect brain homeostasis, creating conditions that are permissive to the onset and progression of neurodegenerative disorders such as Alzheimer's and Parkinson's diseases. Although the roles of metabolites have been extensively studied with regard to cellular signaling pathways, their effects on protein aggregation remain relatively unexplored. By computationally analysing the Human Metabolome Database, we identified two endogenous metabolites, carnosine and kynurenic acid, that inhibit the aggregation of the amyloid beta peptide (Aβ) and rescue a C. elegans model of Alzheimer's disease. We found that these metabolites act by triggering a cytosolic unfolded protein response through the transcription factor HSF-1 and downstream chaperones HSP40/J-proteins DNJ-12 and DNJ-19. These results help rationalise previous observations regarding the possible anti-ageing benefits of these metabolites by providing a mechanism for their action. Taken together, our findings provide a link between metabolite homeostasis and protein homeostasis, which could inspire preventative interventions against neurodegenerative disorders.
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Affiliation(s)
- Priyanka Joshi
- grid.5335.00000000121885934Yusuf Hamied Department of Chemistry, Centre for Misfolding Diseases, University of Cambridge, Cambridge, UK ,grid.47840.3f0000 0001 2181 7878Present Address: The California Institute for Quantitative Biosciences (QB3-Berkeley), University of California, Berkeley, CA USA
| | - Michele Perni
- grid.5335.00000000121885934Yusuf Hamied Department of Chemistry, Centre for Misfolding Diseases, University of Cambridge, Cambridge, UK
| | - Ryan Limbocker
- grid.5335.00000000121885934Yusuf Hamied Department of Chemistry, Centre for Misfolding Diseases, University of Cambridge, Cambridge, UK ,grid.419884.80000 0001 2287 2270Present Address: Department of Chemistry and Life Science, United States Military Academy, West Point, NY USA
| | - Benedetta Mannini
- grid.5335.00000000121885934Yusuf Hamied Department of Chemistry, Centre for Misfolding Diseases, University of Cambridge, Cambridge, UK
| | - Sam Casford
- grid.5335.00000000121885934Yusuf Hamied Department of Chemistry, Centre for Misfolding Diseases, University of Cambridge, Cambridge, UK
| | - Sean Chia
- grid.5335.00000000121885934Yusuf Hamied Department of Chemistry, Centre for Misfolding Diseases, University of Cambridge, Cambridge, UK
| | - Johnny Habchi
- grid.5335.00000000121885934Yusuf Hamied Department of Chemistry, Centre for Misfolding Diseases, University of Cambridge, Cambridge, UK
| | - Johnathan Labbadia
- grid.83440.3b0000000121901201Department of Genetics, Evolution and Environment, Institute of Healthy Ageing, University College London, London, UK
| | - Christopher M. Dobson
- grid.5335.00000000121885934Yusuf Hamied Department of Chemistry, Centre for Misfolding Diseases, University of Cambridge, Cambridge, UK
| | - Michele Vendruscolo
- grid.5335.00000000121885934Yusuf Hamied Department of Chemistry, Centre for Misfolding Diseases, University of Cambridge, Cambridge, UK
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17
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Sadria M, Layton AT. Aging affects circadian clock and metabolism and modulates timing of medication. iScience 2021; 24:102245. [PMID: 33796837 PMCID: PMC7995490 DOI: 10.1016/j.isci.2021.102245] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Revised: 12/29/2020] [Accepted: 02/25/2021] [Indexed: 02/07/2023] Open
Abstract
Aging is associated with impairments in the circadian rhythms, and with energy deregulation that affects multiple metabolic pathways. The goal of this study is to unravel the complex interactions among aging, metabolism, and the circadian clock. We seek to identify key factors that inform the liver circadian clock of cellular energy status and to reveal the mechanisms by which variations in food intake may disrupt the clock. To address these questions, we develop a comprehensive mathematical model that represents the circadian pathway in the mouse liver, together with the insulin/IGF-1 pathway, mTORC1, AMPK, NAD+, and the NAD+ -consuming factor SIRT1. The model is age-specific and can simulate the liver of a young mouse or an aged mouse. Simulation results suggest that the reduced NAD+ and SIRT1 bioavailability may explain the shortened circadian period in aged rodents. Importantly, the model identifies the dosing schedules for maximizing the efficacy of anti-aging medications.
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Affiliation(s)
- Mehrshad Sadria
- Department of Applied Mathematics, University of Waterloo, Waterloo, ON, Canada
| | - Anita T. Layton
- Department of Applied Mathematics, University of Waterloo, Waterloo, ON, Canada
- Department of Biology, Cheriton School of Computer Science, and School of Pharmacy, University of Waterloo, Waterloo, ON, Canada
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18
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Montaruli A, Castelli L, Mulè A, Scurati R, Esposito F, Galasso L, Roveda E. Biological Rhythm and Chronotype: New Perspectives in Health. Biomolecules 2021; 11:biom11040487. [PMID: 33804974 PMCID: PMC8063933 DOI: 10.3390/biom11040487] [Citation(s) in RCA: 78] [Impact Index Per Article: 26.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Revised: 03/03/2021] [Accepted: 03/16/2021] [Indexed: 12/11/2022] Open
Abstract
The circadian rhythm plays a fundamental role in regulating biological functions, including sleep–wake preference, body temperature, hormonal secretion, food intake, and cognitive and physical performance. Alterations in circadian rhythm can lead to chronic disease and impaired sleep. The circadian rhythmicity in human beings is represented by a complex phenotype. Indeed, over a 24-h period, a person’s preferred time to be more active or to sleep can be expressed in the concept of morningness–eveningness. Three chronotypes are distinguished: Morning, Neither, and Evening-types. Interindividual differences in chronotypes need to be considered to reduce the negative effects of circadian disruptions on health. In the present review, we examine the bi-directional influences of the rest–activity circadian rhythm and sleep–wake cycle in chronic pathologies and disorders. We analyze the concept and the main characteristics of the three chronotypes.
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Affiliation(s)
- Angela Montaruli
- Department of Biomedical Sciences for Health, University of Milan, Via G. Colombo 71, 20133 Milan, Italy; (A.M.); (L.C.); (A.M.); (R.S.); (F.E.); (E.R.)
- IRCCS Istituto Ortopedico Galeazzi, Via R. Galeazzi 4, 20161 Milan, Italy
| | - Lucia Castelli
- Department of Biomedical Sciences for Health, University of Milan, Via G. Colombo 71, 20133 Milan, Italy; (A.M.); (L.C.); (A.M.); (R.S.); (F.E.); (E.R.)
| | - Antonino Mulè
- Department of Biomedical Sciences for Health, University of Milan, Via G. Colombo 71, 20133 Milan, Italy; (A.M.); (L.C.); (A.M.); (R.S.); (F.E.); (E.R.)
| | - Raffaele Scurati
- Department of Biomedical Sciences for Health, University of Milan, Via G. Colombo 71, 20133 Milan, Italy; (A.M.); (L.C.); (A.M.); (R.S.); (F.E.); (E.R.)
| | - Fabio Esposito
- Department of Biomedical Sciences for Health, University of Milan, Via G. Colombo 71, 20133 Milan, Italy; (A.M.); (L.C.); (A.M.); (R.S.); (F.E.); (E.R.)
- IRCCS Istituto Ortopedico Galeazzi, Via R. Galeazzi 4, 20161 Milan, Italy
| | - Letizia Galasso
- Department of Biomedical Sciences for Health, University of Milan, Via G. Colombo 71, 20133 Milan, Italy; (A.M.); (L.C.); (A.M.); (R.S.); (F.E.); (E.R.)
- Correspondence: ; Tel.: +2-5031-4656
| | - Eliana Roveda
- Department of Biomedical Sciences for Health, University of Milan, Via G. Colombo 71, 20133 Milan, Italy; (A.M.); (L.C.); (A.M.); (R.S.); (F.E.); (E.R.)
- IRCCS Istituto Ortopedico Galeazzi, Via R. Galeazzi 4, 20161 Milan, Italy
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19
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Kent BA, Feldman HH, Nygaard HB. Sleep and its regulation: An emerging pathogenic and treatment frontier in Alzheimer's disease. Prog Neurobiol 2021; 197:101902. [PMID: 32877742 PMCID: PMC7855222 DOI: 10.1016/j.pneurobio.2020.101902] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Revised: 07/19/2020] [Accepted: 08/18/2020] [Indexed: 02/07/2023]
Abstract
A majority of patients with Alzheimer's disease (AD) experience some form of sleep disruption, including nocturnal sleep fragmentation, increased daytime napping, decreased slow-wave sleep (SWS, stage N3), and decreased rapid-eye-movement sleep (REM). Clinical studies are investigating whether such sleep disturbances are a consequence of the underlying disease, and whether they also contribute to the clinical and pathological manifestations of AD. Emerging research has provided a direct link between several of these sleep disruptions and AD pathophysiology, suggesting that treating sleep disorders in this population may target basic mechanisms of the disease. Here, we provide a comprehensive review of sleep disturbances associated with the spectrum of AD, ranging from the preclinical stages through dementia. We discuss how sleep interacts with AD pathophysiology and, critically, whether sleep impairments can be targeted to modify the disease course in a subgroup of affected AD patients. Ultimately, larger studies that fully utilize new diagnostic and experimental tools will be required to better define the most relevant sleep disturbance to target in AD, the interventions that best modulate this target symptom, and whether successful early intervention can modify AD risk and prevent dementia.
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Affiliation(s)
- Brianne A Kent
- Division of Sleep and Circadian Disorders, Brigham and Women's Hospital, Harvard Medical School, Boston, USA; Division of Neurology, University of British Columbia, Vancouver, Canada.
| | - Howard H Feldman
- Division of Neurology, University of British Columbia, Vancouver, Canada; Department of Neurosciences, University of California, San Diego, La Jolla, USA
| | - Haakon B Nygaard
- Division of Neurology, University of British Columbia, Vancouver, Canada
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20
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Light in the Senior Home: Effects of Dynamic and Individual Light Exposure on Sleep, Cognition, and Well-Being. Clocks Sleep 2020; 2:557-576. [PMID: 33327499 PMCID: PMC7768397 DOI: 10.3390/clockssleep2040040] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Revised: 12/04/2020] [Accepted: 12/08/2020] [Indexed: 11/18/2022] Open
Abstract
Disrupted sleep is common among nursing home patients and is associated with cognitive decline and reduced well-being. Sleep disruptions may in part be a result of insufficient daytime light exposure. This pilot study examined the effects of dynamic “circadian” lighting and individual light exposure on sleep, cognitive performance, and well-being in a sample of 14 senior home residents. The study was conducted as a within-subject study design over five weeks of circadian lighting and five weeks of conventional lighting, in a counterbalanced order. Participants wore wrist accelerometers to track rest–activity and light profiles and completed cognitive batteries (National Institute of Health (NIH) toolbox) and questionnaires (depression, fatigue, sleep quality, lighting appraisal) in each condition. We found no significant differences in outcome variables between the two lighting conditions. Individual differences in overall (indoors and outdoors) light exposure levels varied greatly between participants but did not differ between lighting conditions, except at night (22:00–6:00), with maximum light exposure being greater in the conventional lighting condition. Pooled data from both conditions showed that participants with higher overall morning light exposure (6:00–12:00) had less fragmented and more stable rest–activity rhythms with higher relative amplitude. Rest–activity rhythm fragmentation and long sleep duration both uniquely predicted lower cognitive performance.
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21
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Ye E, Sun H, Leone MJ, Paixao L, Thomas RJ, Lam AD, Westover MB. Association of Sleep Electroencephalography-Based Brain Age Index With Dementia. JAMA Netw Open 2020; 3:e2017357. [PMID: 32986106 PMCID: PMC7522697 DOI: 10.1001/jamanetworkopen.2020.17357] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
IMPORTANCE Dementia is an increasing cause of disability and loss of independence in the elderly population yet remains largely underdiagnosed. A biomarker for dementia that can identify individuals with or at risk for developing dementia may help close this diagnostic gap. OBJECTIVE To investigate the association between a sleep electroencephalography-based brain age index (BAI), the difference between chronological age and brain age estimated using the sleep electroencephalogram, and dementia. DESIGN, SETTING, AND PARTICIPANTS In this retrospective cross-sectional study of 9834 polysomnograms, BAI was computed among individuals with previously determined dementia, mild cognitive impairment (MCI), or cognitive symptoms but no diagnosis of MCI or dementia, and among healthy individuals without dementia from August 22, 2008, to June 4, 2018. Data were analyzed from November 15, 2018, to June 24, 2020. EXPOSURE Dementia, MCI, and dementia-related symptoms, such as cognitive change and memory impairment. MAIN OUTCOMES AND MEASURES The outcome measures were the trend in BAI when moving from groups ranging from healthy, to symptomatic, to MCI, to dementia and pairwise comparisons of BAI among these groups. FINDINGS A total of 5144 sleep studies were included in BAI examinations. Patients in these studies had a median (interquartile range) age of 54 (43-65) years, and 3026 (59%) were men. The patients included 88 with dementia, 44 with MCI, 1075 who were symptomatic, and 2336 without dementia. There was a monotonic increase in mean (SE) BAI from the nondementia group to the dementia group (nondementia: 0.20 [0.42]; symptomatic: 0.58 [0.41]; MCI: 1.65 [1.20]; dementia: 4.18 [1.02]; P < .001). CONCLUSIONS AND RELEVANCE These findings suggest that a sleep-state electroencephalography-based BAI shows promise as a biomarker associated with progressive brain processes that ultimately result in dementia.
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Affiliation(s)
- Elissa Ye
- Department of Neurology, Massachusetts General Hospital, Boston
| | - Haoqi Sun
- Department of Neurology, Massachusetts General Hospital, Boston
| | | | - Luis Paixao
- Department of Neurology, Massachusetts General Hospital, Boston
| | - Robert J. Thomas
- Division of Pulmonary, Critical Care and Sleep, Department of Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts
| | - Alice D. Lam
- Department of Neurology, Massachusetts General Hospital, Boston
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Lee YF, Gerashchenko D, Timofeev I, Bacskai BJ, Kastanenka KV. Slow Wave Sleep Is a Promising Intervention Target for Alzheimer's Disease. Front Neurosci 2020; 14:705. [PMID: 32714142 PMCID: PMC7340158 DOI: 10.3389/fnins.2020.00705] [Citation(s) in RCA: 51] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Accepted: 06/11/2020] [Indexed: 12/22/2022] Open
Abstract
Alzheimer's disease (AD) is the major cause of dementia, characterized by the presence of amyloid-beta plaques and neurofibrillary tau tangles. Plaques and tangles are associated with sleep-wake cycle disruptions, including the disruptions in non-rapid eye movement (NREM) slow wave sleep (SWS). Alzheimer's patients spend less time in NREM sleep and exhibit decreased slow wave activity (SWA). Consistent with the critical role of SWS in memory consolidation, reduced SWA is associated with impaired memory consolidation in AD patients. The aberrant SWA can be modeled in transgenic mouse models of amyloidosis and tauopathy. Animal models exhibited slow wave impairments early in the disease progression, prior to the deposition of amyloid-beta plaques, however, in the presence of abundant oligomeric amyloid-beta. Optogenetic rescue of SWA successfully halted the amyloid accumulation and restored intraneuronal calcium levels in mice. On the other hand, optogenetic acceleration of slow wave frequency exacerbated amyloid deposition and disrupted neuronal calcium homeostasis. In this review, we summarize the evidence and the mechanisms underlying the existence of a positive feedback loop between amyloid/tau pathology and SWA disruptions that lead to further accumulations of amyloid and tau in AD. Moreover, since SWA disruptions occur prior to the plaque deposition, SWA disruptions may provide an early biomarker for AD. Finally, we propose that therapeutic targeting of SWA in AD might lead to an effective treatment for Alzheimer's patients.
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Affiliation(s)
- Yee Fun Lee
- Department of Neurology, MassGeneral Institute of Neurodegenerative Diseases, Massachusetts General Hospital and Harvard Medical School, Charlestown, MA, United States
- Department of Anatomy and Neurobiology, Boston University School of Medicine, Boston, MA, United States
| | - Dmitry Gerashchenko
- Harvard Medical School/VA Boston Healthcare System, West Roxbury, MA, United States
| | - Igor Timofeev
- Department of Psychiatry and Neuroscience, School of Medicine, Université Laval, Québec, QC, Canada
- CERVO Brain Research Center, Québec, QC, Canada
| | - Brian J. Bacskai
- Department of Neurology, MassGeneral Institute of Neurodegenerative Diseases, Massachusetts General Hospital and Harvard Medical School, Charlestown, MA, United States
| | - Ksenia V. Kastanenka
- Department of Neurology, MassGeneral Institute of Neurodegenerative Diseases, Massachusetts General Hospital and Harvard Medical School, Charlestown, MA, United States
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Alzheimer's disease: Neurotransmitters of the sleep-wake cycle. Neurosci Biobehav Rev 2019; 105:72-80. [PMID: 31377219 DOI: 10.1016/j.neubiorev.2019.07.019] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2019] [Revised: 05/22/2019] [Accepted: 07/28/2019] [Indexed: 11/22/2022]
Abstract
With aging, our sleeping pattern alters. Elderly often wake unrested because their sleep time and sleep efficacy is reduced. In Alzheimer's disease (AD) patients, these alterations are even more pronounced and may further aggravate cognitive decline. Therefore, sleep disturbances greatly impact self-care ability, caregiver exhaustion and institutionalization rate. Reestablishing an effective sleep-wake cycle in these patients still remains an unresolved challenge, partly because sleep physiology is quite complex and multiple neurotransmitter systems contribute to a single process. Gaining a better understanding of sleep physiology will be crucial for further research. Conjointly, animal models, along with a multidisciplinary approach, will be of great value to establish a common ground between AD and sleep disturbances and work towards a potential therapeutic application.
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Sleep architecture changes in the APP23 mouse model manifest at onset of cognitive deficits. Behav Brain Res 2019; 373:112089. [PMID: 31325518 DOI: 10.1016/j.bbr.2019.112089] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2019] [Revised: 06/26/2019] [Accepted: 07/16/2019] [Indexed: 01/16/2023]
Abstract
Alzheimer's disease (AD), which accounts for most of the dementia cases, is, aside from cognitive deterioration, often characterized by the presence of non-cognitive symptoms such as activity and sleep disturbances. AD patients typically experience increased sleep fragmentation, excessive daytime sleepiness and night-time insomnia. Here, we sought to investigate the link between sleep architecture, cognition and amyloid pathology in the APP23 amyloidosis mouse model for AD. By means of polysomnographic recordings the sleep-wake cycle of freely-moving APP23 and wild-type (WT) littermates of 3, 6 and 12 months of age was examined. In addition, ambulatory cage activity was assessed by interruption of infrared beams surrounding the home cage. To assess visuo-spatial learning and memory a hidden-platform Morris-type Water Maze (MWM) experiment was performed. We found that sleep architecture is only slightly altered at early stages of pathology, but significantly deteriorates from 12 months of age, when amyloid plaques become diffusely present. APP23 mice of 12 months old had quantitative reductions of NREM and REM sleep and were more awake during the dark phase compared to WT littermates. These findings were confirmed by increased ambulatory cage activity during that phase of the light-dark cycle. No quantitative differences in sleep parameters were observed during the light phase. However, during this light phase, the sleep pattern of APP23 mice was more fragmented from 6 months of age, the point at which also cognitive abilities started to be affected in the MWM. Sleep time also positively correlated with MWM performance. We also found that spectral components in the EEG started to alter at the age of 6 months. To conclude, our results indicate that sleep architectural changes arise around the time the first amyloid plaques start to form and cognitive deterioration becomes apparent. These changes start subtle, but gradually worsen with age, adequately mimicking the clinical condition.
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Abstract
This article focuses on irregular sleep-wake rhythm disorder (ISWRD) and its associations with several other comorbidities. Irregular sleep-wake rhythm disorder is a circadian disorder characterized by a lack of a clear sleep-wake pattern. The disorder has yet to be fully understood from pathophysiologic perspective. Treatments are available, but there is a need for development of novel interventions. The goal of this article is to focus on multiple aspects of ISWRD.
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Affiliation(s)
- Temitayo Oyegbile
- Georgetown University, MedStar St. Mary's Sleep Lab, Georgetown University Medical Center, 3800 Reservoir Road, Washington, DC 20007, USA.
| | - Aleksandar Videnovic
- MGH Neurological Clinical Research Institute, 165 Cambridge Street, Suite 600, Boston, MA 02114, USA
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Shang B, Yin H, Jia Y, Zhao J, Meng X, Chen L, Liu P. Nonpharmacological interventions to improve sleep in nursing home residents: A systematic review. Geriatr Nurs 2019; 40:405-416. [DOI: 10.1016/j.gerinurse.2019.01.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2018] [Revised: 01/11/2019] [Accepted: 01/17/2019] [Indexed: 12/31/2022]
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Cordone S, Annarumma L, Rossini PM, De Gennaro L. Sleep and β-Amyloid Deposition in Alzheimer Disease: Insights on Mechanisms and Possible Innovative Treatments. Front Pharmacol 2019; 10:695. [PMID: 31281257 PMCID: PMC6595048 DOI: 10.3389/fphar.2019.00695] [Citation(s) in RCA: 77] [Impact Index Per Article: 15.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2019] [Accepted: 05/28/2019] [Indexed: 02/05/2023] Open
Abstract
The growing interest in the preclinical stage of Alzheimer's disease (AD) led investigators to identify modifiable risk and predictive factors useful to design early intervention strategies. The preclinical stage of AD is characterized by β-amyloid (Aβ) aggregation into amyloid plaques and tau phosphorylation and aggregation into neurofibrillary tangles. There is a consensus on the importance of sleep within this context: the bidirectional relationship between sleep and AD pathology is supported by growing evidence that proved that the occurrence of sleep changes starting from the preclinical stage of AD, many years before the onset of cognitive decline. Hence, we review the most recent studies on sleep disturbances related to Aβ and the effects of sleep deprivation on Aβ accumulation in animal and human models. We also discuss evidence on the role of sleep in clearing the brain of toxic metabolic by-products, with original findings of the clearance activity of the glymphatic system stimulated by sleep. Furthermore, starting from new recent advances about the relationship between slow-wave sleep (SWS) and Aβ burden, we review the results of recent electroencephalographic (EEG) studies in order to clarify the possible role of SWS component disruption as a novel mechanistic pathway through which Aβ pathology may contribute to cognitive decline and, conversely, the eventual useful role of SWS in facilitating Aβ clearance. Finally, we discuss some promising innovative, effective, low-risk, non-invasive interventions, although empirical evidence on the efficacy of sleep interventions in improving the course of AD is at the very beginning.
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Affiliation(s)
- Susanna Cordone
- Department of Psychology, University of Rome "Sapienza," Rome, Italy
| | | | - Paolo Maria Rossini
- Department of Neurological, Motor and Sensory Sciences, IRCCS San Raffaele Pisana, Rome, Italy.,Institute of Neurology, Catholic University of The Sacred Heart, Rome, Italy
| | - Luigi De Gennaro
- Department of Psychology, University of Rome "Sapienza," Rome, Italy
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Melatonin in Alzheimer’s Disease: A Latent Endogenous Regulator of Neurogenesis to Mitigate Alzheimer’s Neuropathology. Mol Neurobiol 2019; 56:8255-8276. [DOI: 10.1007/s12035-019-01660-3] [Citation(s) in RCA: 58] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2019] [Revised: 05/20/2019] [Accepted: 05/22/2019] [Indexed: 12/15/2022]
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29
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Kourtis LC, Regele OB, Wright JM, Jones GB. Digital biomarkers for Alzheimer's disease: the mobile/ wearable devices opportunity. NPJ Digit Med 2019; 2:9. [PMID: 31119198 PMCID: PMC6526279 DOI: 10.1038/s41746-019-0084-2] [Citation(s) in RCA: 157] [Impact Index Per Article: 31.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2018] [Accepted: 02/01/2019] [Indexed: 12/14/2022] Open
Abstract
Alzheimer's Disease (AD) represents a major and rapidly growing burden to the healthcare ecosystem. A growing body of evidence indicates that cognitive, behavioral, sensory, and motor changes may precede clinical manifestations of AD by several years. Existing tests designed to diagnose neurodegenerative diseases, while well-validated, are often less effective in detecting deviations from normal cognitive decline trajectory in the earliest stages of the disease. In the quest for gold standards for AD assessment, there is a growing interest in the identification of readily accessible digital biomarkers, which harness advances in consumer grade mobile and wearable technologies. Topics examined include a review of existing early clinical manifestations of AD and a path to the respective sensor and mobile/wearable device usage to acquire domain-centric data towards objective, high frequency and passive digital phenotyping.
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Affiliation(s)
- Lampros C. Kourtis
- Clinical & Translational Science Institute, Tufts University Medical Center, 800 Washington St, Boston, MA 02111 USA
- Evidation Health, 167 2nd Ave, San Mateo, CA 94401 USA
- Cambridge Innovation Center, Eli Lilly and Company, 450 Kendall, Cambridge, MA 02142 USA
| | - Oliver B. Regele
- Cambridge Innovation Center, Eli Lilly and Company, 450 Kendall, Cambridge, MA 02142 USA
- Present Address: Massachusetts Institute of Technology, Cambridge, MA USA
| | - Justin M. Wright
- Cambridge Innovation Center, Eli Lilly and Company, 450 Kendall, Cambridge, MA 02142 USA
- Present Address: Novartis Pharmaceuticals, East Hanover, NJ USA
| | - Graham B. Jones
- Clinical & Translational Science Institute, Tufts University Medical Center, 800 Washington St, Boston, MA 02111 USA
- Present Address: Novartis Pharmaceuticals, East Hanover, NJ USA
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Carnicelli L, Maestri M, Di Coscio E, Tognoni G, Fabbrini M, Schirru A, Giorgi FS, Siciliano G, Bonuccelli U, Bonanni E. A longitudinal study of polysomnographic variables in patients with mild cognitive impairment converting to Alzheimer's disease. J Sleep Res 2019; 28:e12821. [DOI: 10.1111/jsr.12821] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2018] [Revised: 11/27/2018] [Accepted: 12/06/2018] [Indexed: 12/19/2022]
Affiliation(s)
- Luca Carnicelli
- Section of Neurology Department of Clinical and Experimental Medicine University of Pisa and Pisa University Hospital Pisa Italy
| | - Michelangelo Maestri
- Section of Neurology Department of Clinical and Experimental Medicine University of Pisa and Pisa University Hospital Pisa Italy
| | - Elisa Di Coscio
- Section of Neurology Department of Clinical and Experimental Medicine University of Pisa and Pisa University Hospital Pisa Italy
| | - Gloria Tognoni
- Section of Neurology Department of Clinical and Experimental Medicine University of Pisa and Pisa University Hospital Pisa Italy
| | - Monica Fabbrini
- Section of Neurology Department of Clinical and Experimental Medicine University of Pisa and Pisa University Hospital Pisa Italy
| | - Alessandro Schirru
- Section of Neurology Department of Clinical and Experimental Medicine University of Pisa and Pisa University Hospital Pisa Italy
| | - Filippo S. Giorgi
- Section of Neurology Department of Clinical and Experimental Medicine University of Pisa and Pisa University Hospital Pisa Italy
| | - Gabriele Siciliano
- Section of Neurology Department of Clinical and Experimental Medicine University of Pisa and Pisa University Hospital Pisa Italy
| | - Ubaldo Bonuccelli
- Section of Neurology Department of Clinical and Experimental Medicine University of Pisa and Pisa University Hospital Pisa Italy
| | - Enrica Bonanni
- Section of Neurology Department of Clinical and Experimental Medicine University of Pisa and Pisa University Hospital Pisa Italy
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31
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Winsky-Sommerer R, de Oliveira P, Loomis S, Wafford K, Dijk DJ, Gilmour G. Disturbances of sleep quality, timing and structure and their relationship with other neuropsychiatric symptoms in Alzheimer’s disease and schizophrenia: Insights from studies in patient populations and animal models. Neurosci Biobehav Rev 2019; 97:112-137. [DOI: 10.1016/j.neubiorev.2018.09.027] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2017] [Revised: 08/31/2018] [Accepted: 09/30/2018] [Indexed: 02/06/2023]
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Yakovleva OV, Poluektov MG, Lyashenko EA, Levin OS. Sleep and cognitive impairment in neurodegenerative diseases. Zh Nevrol Psikhiatr Im S S Korsakova 2019; 119:89-98. [DOI: 10.17116/jnevro201911904289] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
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Liguori C, Mercuri NB, Nuccetelli M, Izzi F, Bernardini S, Placidi F. Cerebrospinal Fluid Orexin Levels and Nocturnal Sleep Disruption in Alzheimer’s Disease Patients Showing Neuropsychiatric Symptoms. J Alzheimers Dis 2018; 66:993-999. [DOI: 10.3233/jad-180769] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Affiliation(s)
- Claudio Liguori
- Department of Systems Medicine, Sleep Medicine Centre, University of Rome “Tor Vergata”, Rome, Italy
| | - Nicola Biagio Mercuri
- Department of Systems Medicine, Sleep Medicine Centre, University of Rome “Tor Vergata”, Rome, Italy
- IRCCS Fondazione Santa Lucia, Rome, Italy
- Department of Systems Medicine, Neurology Unit, University of Rome “Tor Vergata”, Rome, Italy
| | - Marzia Nuccetelli
- Department of Clinical Biochemistry and Molecular Biology, University of Rome “Tor Vergata”, Rome, Italy
| | - Francesca Izzi
- Department of Systems Medicine, Sleep Medicine Centre, University of Rome “Tor Vergata”, Rome, Italy
| | - Sergio Bernardini
- Department of Clinical Biochemistry and Molecular Biology, University of Rome “Tor Vergata”, Rome, Italy
| | - Fabio Placidi
- Department of Systems Medicine, Sleep Medicine Centre, University of Rome “Tor Vergata”, Rome, Italy
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Katagi A, Miyai N. [Effects of Short-term Nap and Light Physical Exercise on Sleep among Elderly Patients with Mild-to-Moderate Dementia in Communal Living Group Homes]. Nihon Eiseigaku Zasshi 2018; 73:365-372. [PMID: 30270304 DOI: 10.1265/jjh.73.365] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
OBJECTIVES In this study, we examined whether a combined regimen of a short-term nap and a light physical exercise is effective in improving sleep among elderly individuals with mild-to-moderate dementia in communal living group homes. METHODS Twenty-three female residents (aged 87.4±5.6 years) living in two group homes for the elderly with dementia were included in the present study. After undergoing an assessment for eligibility, they were randomly allocated to either the study group (N=11), who participated in the regimen of a short-term nap (<30 min) and light physical exercise for four weeks, or the control group (N=12), who received the usual nursing care without participating in the nap and exercise regimen. The lengths of sleep time and wake time were measured using a sleep monitor with a radiofrequency motion sensor. The frequencies of nocturnal behavioral and psychological symptoms associated with dementia including excitement, violence, night delirium, wandering, and unhygienic behavior were investigated throughout the study period. RESULTS The subjects participating in the nap and physical exercise regimen showed a significant increase in sleep efficacy as well as a reduction in the total nocturnal wake time, whereas no clear change was observed in the control subjects. The frequencies of nocturnal episodes of urination in the study group also decreased during the course of the study. However, there was no significant decrease in the frequencies of nocturnal behavioral or psychological symptoms associated with dementia. CONCLUSIONS The findings of this study suggest that a short-term nap and a light physical exercise may be effective in adjusting the sleep-wake biorhythm in elderly patients with mild-to-moderate dementia and may improve sleep among these individuals.
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Affiliation(s)
- Akiko Katagi
- Graduate School of Health and Nursing Science, Wakayama Medical University
| | - Nobuyuki Miyai
- Graduate School of Health and Nursing Science, Wakayama Medical University
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Cassidy-Eagle E, Siebern A, Unti L, Glassman J, O'Hara R. Neuropsychological Functioning in Older Adults with Mild Cognitive Impairment and Insomnia Randomized to CBT-I or Control Group. Clin Gerontol 2018; 41:136-144. [PMID: 29220627 DOI: 10.1080/07317115.2017.1384777] [Citation(s) in RCA: 44] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
OBJECTIVES Improving the sleep of older adults with mild cognitive impairment (MCI) represents a first step in discovering whether interventions directed at modifying this risk factor also have the potential to alter the cognitive decline trajectory. METHODS A six-session, adapted version of a cognitive behavioral therapy for insomnia (CBT-I) was administered to older adults (N = 28; 14 per group) with MCI across two residential facilities. Participants were randomly assigned to either the sleep intervention or an active control group and completed a neuropsychological battery at three time points (e.g., baseline-T1, post-intervention-T2, 4 month follow-up-T3). RESULTS Results showed a significant improvement in sleep and a change (p < .05) on a key measure of executive functioning sub task of inhibition (Condition 3 of D-KEF Color-Word Interference Test), a positive trend on the inhibition-switching task (p < .10; Condition 4 of D-KEF Color-Word Interference Test), an no change in a measure of verbal memory (HVLT-R Delayed Recall) compared with the active control group. CONCLUSIONS CBT-I is a nonpharmacological intervention that has the potential to cognitively benefit individuals with MCI suffering from comorbid insomnia. CLINICAL IMPLICATIONS Results suggest that a non-pharmacological intervention to improve sleep in older adults with MCI also improve cognitive functioning. Further exploration of the mechanisms underlying these improvements is warranted.
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Affiliation(s)
- Erin Cassidy-Eagle
- a Department of Psychiatry & Behavioral Sciences , Stanford University School of Medicine , Stanford , California , USA
| | - Allison Siebern
- a Department of Psychiatry & Behavioral Sciences , Stanford University School of Medicine , Stanford , California , USA.,c Fayetteville Veterans Affairs Medical Center , Fayetteville , North Carolina , USA
| | - Lisa Unti
- b ETR , Scotts Valley , California , USA
| | - Jill Glassman
- a Department of Psychiatry & Behavioral Sciences , Stanford University School of Medicine , Stanford , California , USA.,b ETR , Scotts Valley , California , USA
| | - Ruth O'Hara
- a Department of Psychiatry & Behavioral Sciences , Stanford University School of Medicine , Stanford , California , USA.,d Veterans Affairs Palo Alto Health Care System , Sierra Pacific Mental Illness Research Education and Clinical Centers (MIRECC) , Palo Alto , California , USA
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Van Erum J, Van Dam D, De Deyn PP. Sleep and Alzheimer's disease: A pivotal role for the suprachiasmatic nucleus. Sleep Med Rev 2017; 40:17-27. [PMID: 29102282 DOI: 10.1016/j.smrv.2017.07.005] [Citation(s) in RCA: 60] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2017] [Revised: 07/10/2017] [Accepted: 07/24/2017] [Indexed: 10/19/2022]
Abstract
Alzheimer's disease (AD), which accounts for most of the dementia cases, is, aside from cognitive deterioration, often characterized by the presence of non-cognitive symptoms. Society is desperately in need for interventions that alleviate the economic and social burden related to AD. Circadian dysrhythmia, one of these symptoms in particular, immensely decreases the self-care ability of AD patients and is one of the main reasons of caregiver exhaustion. Studies suggest that these circadian disturbances form the root of sleep-wake problems, diagnosed in more than half of AD patients. Sleep abnormalities have generally been considered merely a consequence of AD pathology. Recent evidence suggests that a bidirectional relationship exists between sleep and AD, and that poor sleep might negatively impact amyloid burden, as well as cognition. The suprachiasmatic nucleus (SCN), the main circadian pacemaker, is subjected to several alterations during the course of the disease. Its functional deterioration might fulfill a crucial role in the relation between AD pathophysiology and the development of sleep abnormalities. This review aims to give a concise overview of the anatomy and physiology of the SCN, address how AD pathology precisely impacts the SCN and to what degree these alterations can contribute to the progression of the disease.
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Affiliation(s)
- Jan Van Erum
- Laboratory of Neurochemistry and Behavior, Institute Born-Bunge, Department of Biomedical Sciences, University of Antwerp, Wilrijk, Antwerp, Belgium
| | - Debby Van Dam
- Laboratory of Neurochemistry and Behavior, Institute Born-Bunge, Department of Biomedical Sciences, University of Antwerp, Wilrijk, Antwerp, Belgium; Department of Neurology and Alzheimer Research Center, University of Groningen and University Medical Center Groningen (UMCG), Groningen, The Netherlands
| | - Peter Paul De Deyn
- Laboratory of Neurochemistry and Behavior, Institute Born-Bunge, Department of Biomedical Sciences, University of Antwerp, Wilrijk, Antwerp, Belgium; Department of Neurology and Alzheimer Research Center, University of Groningen and University Medical Center Groningen (UMCG), Groningen, The Netherlands; Department of Neurology, Memory Clinic of Hospital Network Antwerp (ZNA) Middelheim and Hoge Beuken, Antwerp, Belgium.
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38
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Silkis IG. Hypothetical neurochemical mechanisms of paradoxical sleep deficiency in Alzheimer’s disease. NEUROCHEM J+ 2017. [DOI: 10.1134/s181971241702012x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
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39
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Figueiro MG. Light, sleep and circadian rhythms in older adults with Alzheimer's disease and related dementias. Neurodegener Dis Manag 2017; 7:119-145. [PMID: 28534696 PMCID: PMC5836917 DOI: 10.2217/nmt-2016-0060] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2016] [Accepted: 01/11/2017] [Indexed: 02/04/2023] Open
Abstract
Alzheimer's disease and related dementias (ADRD) can cause sleep and behavioral problems that are problematic for ADRD patients and their family caregivers. Light therapy has shown promise as a nonpharmacological treatment, and preliminary studies demonstrate that timed light exposure can consolidate and improve nighttime sleep efficiency, increase daytime wakefulness and reduce evening agitation without the adverse effects of pharmacological solutions. Compliance with light treatment and the accurate measurement of light exposures during treatment, however, have presented barriers for the adoption of light therapy for ADRD. Recent research showing that the circadian system is maximally sensitive to short-wavelength light opens the way for the potential application of lower, more-targeted light intensities to maximize compliance and individualize light dose/timing in therapeutic settings.
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Affiliation(s)
- Mariana G Figueiro
- Lighting Research Center, Rensselaer Polytechnic Institute, 21 Union Street, Troy, NY 12180, USA
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40
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Monje FJ, Cicvaric A, Acevedo Aguilar JP, Elbau I, Horvath O, Diao W, Glat M, Pollak DD. Disrupted Ultradian Activity Rhythms and Differential Expression of Several Clock Genes in Interleukin-6-Deficient Mice. Front Neurol 2017; 8:99. [PMID: 28382017 PMCID: PMC5360714 DOI: 10.3389/fneur.2017.00099] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2016] [Accepted: 02/28/2017] [Indexed: 12/14/2022] Open
Abstract
The characteristics of the cycles of activity and rest stand out among the most intensively investigated aspects of circadian rhythmicity in humans and experimental animals. Alterations in the circadian patterns of activity and rest are strongly linked to cognitive and emotional dysfunctions in severe mental illnesses such as Alzheimer’s disease (AD) and major depression (MDD). The proinflammatory cytokine interleukin 6 (IL-6) has been prominently associated with the pathogenesis of AD and MDD. However, the potential involvement of IL-6 in the modulation of the diurnal rhythms of activity and rest has not been investigated. Here, we set out to study the role of IL-6 in circadian rhythmicity through the characterization of patterns of behavioral locomotor activity in IL-6 knockout (IL-6 KO) mice and wild-type littermate controls. Deletion of IL-6 did not alter the length of the circadian period or the amount of locomotor activity under either light-entrained or free-running conditions. IL-6 KO mice also presented a normal phase shift in response to light exposure at night. However, the temporal architecture of the behavioral rhythmicity throughout the day, as characterized by the quantity of ultradian activity bouts, was significantly impaired under light-entrained and free-running conditions in IL-6 KO. Moreover, the assessment of clock gene expression in the hippocampus, a brain region involved in AD and depression, revealed altered levels of cry1, dec2, and rev-erb-beta in IL-6 KO mice. These data propose that IL-6 participates in the regulation of ultradian activity/rest rhythmicity and clock gene expression in the mammalian brain. Furthermore, we propose IL-6-dependent circadian misalignment as a common pathogenetic principle in some neurodegenerative and neuropsychiatric disorders.
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Affiliation(s)
- Francisco J Monje
- Department of Neurophysiology and Neuropharmacology, Center for Physiology and Pharmacology, Medical University of Vienna , Vienna , Austria
| | - Ana Cicvaric
- Department of Neurophysiology and Neuropharmacology, Center for Physiology and Pharmacology, Medical University of Vienna , Vienna , Austria
| | - Juan Pablo Acevedo Aguilar
- Department of Neurophysiology and Neuropharmacology, Center for Physiology and Pharmacology, Medical University of Vienna , Vienna , Austria
| | - Immanuel Elbau
- Department of Neurophysiology and Neuropharmacology, Center for Physiology and Pharmacology, Medical University of Vienna, Vienna, Austria; Max Planck Institute of Psychiatry, Munich, Germany
| | - Orsolya Horvath
- Department of Neurophysiology and Neuropharmacology, Center for Physiology and Pharmacology, Medical University of Vienna , Vienna , Austria
| | - Weifei Diao
- Department of Neurophysiology and Neuropharmacology, Center for Physiology and Pharmacology, Medical University of Vienna , Vienna , Austria
| | - Micaela Glat
- Department of Neurophysiology and Neuropharmacology, Center for Physiology and Pharmacology, Medical University of Vienna , Vienna , Austria
| | - Daniela D Pollak
- Department of Neurophysiology and Neuropharmacology, Center for Physiology and Pharmacology, Medical University of Vienna , Vienna , Austria
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Associations between Brain Perfusion and Sleep Disturbance in Patients with Alzheimer's Disease. Dement Neurocogn Disord 2017; 16:72-77. [PMID: 30906374 PMCID: PMC6427985 DOI: 10.12779/dnd.2017.16.3.72] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2017] [Revised: 09/10/2017] [Accepted: 09/10/2017] [Indexed: 11/27/2022] Open
Abstract
Background and Purpose Methods Results Conclusions
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Tanev KS, Winokur A, Pitman RK. Sleep Patterns and Neuropsychiatric Symptoms in Hospitalized Patients With Dementia. J Neuropsychiatry Clin Neurosci 2017; 29:248-253. [PMID: 28294708 PMCID: PMC5578477 DOI: 10.1176/appi.neuropsych.16090166] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
The authors examined 28 dementia inpatients receiving treatment as usual. Beginning-to-end differences in neuropsychiatric symptoms and actigraphic sleep patterns were measured. Using a mixed-model, the authors regressed neuropsychiatric symptoms on average sleep minutes (between-subjects effect) and each night's deviation from average (within-subject effect). Sleep did not significantly differ from beginning to end of participation, whereas neuropsychiatric symptoms did. Average sleep minutes predicted average neuropsychiatric symptoms (p=0.002), but each night's deviation from the average did not predict next day's symptoms (p=0.90). These findings raise questions about the immediate benefits of treating sleep-wake disturbances on neuropsychiatric symptoms in hospitalized inpatients with dementias.
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Affiliation(s)
- Kaloyan S. Tanev
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - Andrew Winokur
- Department of Psychiatry, University of Connecticut Health Center, Farmington, CT
| | - Roger K. Pitman
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA
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Shukla M, Govitrapong P, Boontem P, Reiter RJ, Satayavivad J. Mechanisms of Melatonin in Alleviating Alzheimer's Disease. Curr Neuropharmacol 2017; 15:1010-1031. [PMID: 28294066 PMCID: PMC5652010 DOI: 10.2174/1570159x15666170313123454] [Citation(s) in RCA: 120] [Impact Index Per Article: 17.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2016] [Revised: 02/10/2017] [Accepted: 03/09/2017] [Indexed: 02/07/2023] Open
Abstract
Alzheimer's disease (AD) is a chronic, progressive and prevalent neurodegenerative disease characterized by the loss of higher cognitive functions and an associated loss of memory. The thus far "incurable" stigma for AD prevails because of variations in the success rates of different treatment protocols in animal and human studies. Among the classical hypotheses explaining AD pathogenesis, the amyloid hypothesis is currently being targeted for drug development. The underlying concept is to prevent the formation of these neurotoxic peptides which play a central role in AD pathology and trigger a multispectral cascade of neurodegenerative processes post-aggregation. This could possibly be achieved by pharmacological inhibition of β- or γ-secretase or stimulating the nonamyloidogenic α-secretase. Melatonin the pineal hormone is a multifunctioning indoleamine. Production of this amphiphilic molecule diminishes with advancing age and this decrease runs parallel with the progression of AD which itself explains the potential benefits of melatonin in line of development and devastating consequences of the disease progression. Our recent studies have revealed a novel mechanism by which melatonin stimulates the nonamyloidogenic processing and inhibits the amyloidogenic processing of β-amyloid precursor protein (βAPP) by stimulating α -secretases and consequently down regulating both β- and γ-secretases at the transcriptional level. In this review, we discuss and evaluate the neuroprotective functions of melatonin in AD pathogenesis, including its role in the classical hypotheses in cellular and animal models and clinical interventions in AD patients, and suggest that with early detection, melatonin treatment is qualified to be an anti-AD therapy.
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Affiliation(s)
- Mayuri Shukla
- Chulabhorn Graduate Institute, Chulabhorn Royal Academy, 54 Kamphaeng Phet 6 Road, Lak Si, Bangkok10210, Thailand
| | - Piyarat Govitrapong
- Chulabhorn Graduate Institute, Chulabhorn Royal Academy, 54 Kamphaeng Phet 6 Road, Lak Si, Bangkok10210, Thailand
- Research Center for Neuroscience, Institute of Molecular Biosciences, Mahidol University, Salaya, Nakornpathom 73170, Thailand
| | - Parichart Boontem
- Chulabhorn Graduate Institute, Chulabhorn Royal Academy, 54 Kamphaeng Phet 6 Road, Lak Si, Bangkok10210, Thailand
| | - Russel J. Reiter
- Department of Cellular and Structural Biology, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
| | - Jutamaad Satayavivad
- Chulabhorn Research Institute and Chulabhorn Graduate Institute, Chulabhorn Royal Academy, Bangkok10210, Thailand
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Abstract
Sleep disorders are prevalent in Alzheimer's disease (AD) and a major cause of institutionalization. Like AD pathology, sleep abnormalities can appear years before cognitive decline and may be predictive of dementia. A bidirectional relationship between sleep and amyloid β (Aβ) has been well established with disturbed sleep and increased wakefulness leading to increased Aβ production and decreased Aβ clearance; whereas Aβ deposition is associated with increased wakefulness and sleep disturbances. Aβ fluctuates with the sleep-wake cycle and is higher during wakefulness and lower during sleep. This fluctuation is lost with Aβ deposition, likely due to its sequestration into amyloid plaques. As such, Aβ is believed to play a significant role in the development of sleep disturbances in the preclinical and clinical phases of AD. In addition to Aβ, the influence of tau AD pathology is likely important to the sleep disturbances observed in AD. Abnormal tau is the earliest observable AD-like pathology in the brain with abnormal tau phosphorylation in many sleep regulating regions such as the locus coeruleus, dorsal raphe, tuberomammillary nucleus, parabrachial nucleus, and basal forebrain prior to the appearance of amyloid or cortical tau pathology. Furthermore, human tau mouse models exhibit AD-like sleep disturbances and sleep changes are common in other tauopathies including frontotemporal dementia and progressive supranuclear palsy. Together these observations suggest that tau pathology can induce sleep disturbances and may play a large role in the sleep disruption seen in AD. To elucidate the relationship between sleep and AD it will be necessary to not only understand the role of amyloid but also tau and how these two pathologies, together with comorbid pathology such as alpha-synuclein, interact and affect sleep regulation in the brain.
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Mander BA, Winer JR, Jagust WJ, Walker MP. Sleep: A Novel Mechanistic Pathway, Biomarker, and Treatment Target in the Pathology of Alzheimer's Disease? Trends Neurosci 2016; 39:552-566. [PMID: 27325209 PMCID: PMC4967375 DOI: 10.1016/j.tins.2016.05.002] [Citation(s) in RCA: 290] [Impact Index Per Article: 36.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2016] [Revised: 04/13/2016] [Accepted: 05/10/2016] [Indexed: 12/16/2022]
Abstract
Sleep disruption appears to be a core component of Alzheimer's disease (AD) and its pathophysiology. Signature abnormalities of sleep emerge before clinical onset of AD. Moreover, insufficient sleep facilitates accumulation of amyloid-β (Aβ), potentially triggering earlier cognitive decline and conversion to AD. Building on such findings, this review has four goals: evaluating (i) associations and plausible mechanisms linking non-rapid-eye-movement (NREM) sleep disruption, Aβ, and AD; (ii) a role for NREM sleep disruption as a novel factor linking cortical Aβ to impaired hippocampus-dependent memory consolidation; (iii) the potential diagnostic utility of NREM sleep disruption as a new biomarker of AD; and (iv) the possibility of sleep as a new treatment target in aging, affording preventative and therapeutic benefits.
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Affiliation(s)
- Bryce A Mander
- Sleep and Neuroimaging Laboratory University of California, Berkeley, CA 94720-1650, USA.
| | - Joseph R Winer
- Sleep and Neuroimaging Laboratory University of California, Berkeley, CA 94720-1650, USA
| | - William J Jagust
- Helen Wills Neuroscience Institute, University of California, Berkeley, CA 94720-1650, USA; Molecular Biophysics and Bioimaging Division, Lawrence Berkeley National Laboratory, Berkeley, CA 94720, USA
| | - Matthew P Walker
- Sleep and Neuroimaging Laboratory University of California, Berkeley, CA 94720-1650, USA; Helen Wills Neuroscience Institute, University of California, Berkeley, CA 94720-1650, USA.
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Villa C, Ferini-Strambi L, Combi R. The Synergistic Relationship between Alzheimer's Disease and Sleep Disorders: An Update. J Alzheimers Dis 2016; 46:571-80. [PMID: 25835421 DOI: 10.3233/jad-150138] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
Sleep disorders are frequently reported in Alzheimer's disease (AD), with a significant impact on patients and caregivers and a major risk factor for early institutionalization. Although changes in sleep organization are a hallmark of the normal aging processes, sleep macro- and micro-architectural alterations are more evident in patients affected by AD. Degeneration of neural pathways regulating sleep-wake patterns and sleep architecture may contribute to sleep alterations. In return, several recent studies suggested that common sleep disorders may precede clinical symptoms of dementia and represent risk factors for cognitive decline, through impairment of sleep-dependent memory consolidation processes. Thus, a close relationship between sleep disorders and AD has been largely hypothesized. Here, sleep alterations in AD and its pre-dementia stage, mild cognitive impairment, and their complex interactions are reviewed.
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Affiliation(s)
- Chiara Villa
- Department of Surgery and Translational Medicine, University of Milano-Bicocca, Monza, Italy
| | - Luigi Ferini-Strambi
- Department of Clinical Neurosciences, Sleep Disorders Center, University Vita-Salute San Raffaele, Milan, Italy
| | - Romina Combi
- Department of Surgery and Translational Medicine, University of Milano-Bicocca, Monza, Italy
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Diem SJ, Blackwell TL, Stone KL, Yaffe K, Tranah G, Cauley JA, Ancoli-Israel S, Redline S, Spira AP, Hillier TA, Ensrud KE. Measures of Sleep-Wake Patterns and Risk of Mild Cognitive Impairment or Dementia in Older Women. Am J Geriatr Psychiatry 2016; 24:248-58. [PMID: 26964485 PMCID: PMC4807599 DOI: 10.1016/j.jagp.2015.12.002] [Citation(s) in RCA: 93] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2015] [Revised: 12/03/2015] [Accepted: 12/09/2015] [Indexed: 01/28/2023]
Abstract
OBJECTIVE Sleep disturbances are common in older adults. Little is known about the sleep of cognitively intact older adults and its relationship to subsequent cognitive impairment. The objective of this study was to examine the association between objective sleep-wake measures and risk of incident cognitive impairment. METHODS In this prospective cohort study encompassing four U.S. sites, 1,245 women (mean age: 82.6 years) without dementia participated in the Study of Osteoporotic Fractures and completed actigraphy at the baseline visit and comprehensive cognitive assessment at follow-up. The association between sleep-wake patterns measured by actigraphy and risk of incident mild cognitive impairment (MCI) and dementia was examined. RESULTS A total of 473 women (38%) developed cognitive impairment during an average (SD) follow-up of 4.9 (0.6) years; 290 (23.3%) developed MCI and 183 (14.7%) developed dementia. After controlling for multiple potential confounders, women in the lowest quartile of average sleep efficiency (<74%) had a 1.5-fold higher odds of developing MCI or dementia compared with women in the highest quartile of sleep efficiency (>86%) (odds ratio: Q1 versus Q4 1.53; 95% CI: 1.07, 2.19; Wald χ(2) [1, N = 1,223] = 5.34 for p for trend = 0.03). Longer average sleep latency, but not total sleep time, was also associated with higher odds of developing cognitive impairment. Greater variability in both sleep efficiency and total sleep time was associated with an increased odds of developing MCI or dementia. CONCLUSION Lower average sleep efficiency, longer average sleep latency, and greater variability in sleep efficiency and total sleep time are associated with increased odds of developing cognitive impairment. Further research is needed to explore the mechanisms underlying these associations.
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Affiliation(s)
- Susan J Diem
- Department of Medicine and Division of Epidemiology & Community Health, University of Minnesota, Minneapolis, MN.
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Gibson RH, Gander PH, Dowell AC, Jones LM. Non-pharmacological interventions for managing dementia-related sleep problems within community dwelling pairs: A mixed-method approach. DEMENTIA 2016; 16:967-984. [PMID: 26768728 DOI: 10.1177/1471301215625821] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
Dementia-related sleep problems can be complex and challenging. Environmental interventions which resynchronise the sleep/wake cycle have been trialled with promising results for people with dementia in institutionalised settings. However, there is less research concerning community-dwelling people with dementia and their family carers. This study involved a five-week feasibility study including timed light therapy, exercise and sleep education. Sleep and physical and mental functioning were measured at the beginning and end of the trial using objective measures, standardised questionnaires and structured participant feedback. Of 15 community-dwelling pairs who participated, nine completed the trial. The case studies presented here reveal that it is feasible for this population to use non-pharmacological interventions, with positive outcomes. However, there are also issues that can mask benefits or prevent compliance. The options for treating dementia are limited. Environmental interventions may help manage dementia-related sleep problems and further trials would be worthwhile to improve compliance and evaluate effectiveness.
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Affiliation(s)
| | | | - Anthony C Dowell
- Primary Health Care & General Practice, Otago University, New Zealand
| | - Linda M Jones
- School of Psychology, Massey University, New Zealand
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Waller KL, Mortensen EL, Avlund K, Osler M, Fagerlund B, Lauritzen M, Jennum P. Subjective sleep quality and daytime sleepiness in late midlife and their association with age-related changes in cognition. Sleep Med 2016; 17:165-73. [DOI: 10.1016/j.sleep.2015.01.004] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2014] [Revised: 12/04/2014] [Accepted: 01/05/2015] [Indexed: 12/13/2022]
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La Morgia C, Ross-Cisneros FN, Koronyo Y, Hannibal J, Gallassi R, Cantalupo G, Sambati L, Pan BX, Tozer KR, Barboni P, Provini F, Avanzini P, Carbonelli M, Pelosi A, Chui H, Liguori R, Baruzzi A, Koronyo-Hamaoui M, Sadun AA, Carelli V. Melanopsin retinal ganglion cell loss in Alzheimer disease. Ann Neurol 2015; 79:90-109. [PMID: 26505992 PMCID: PMC4737313 DOI: 10.1002/ana.24548] [Citation(s) in RCA: 269] [Impact Index Per Article: 29.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2014] [Revised: 10/16/2015] [Accepted: 10/16/2015] [Indexed: 12/24/2022]
Abstract
Objective Melanopsin retinal ganglion cells (mRGCs) are photoreceptors driving circadian photoentrainment, and circadian dysfunction characterizes Alzheimer disease (AD). We investigated mRGCs in AD, hypothesizing that they contribute to circadian dysfunction. Methods We assessed retinal nerve fiber layer (RNFL) thickness by optical coherence tomography (OCT) in 21 mild‐moderate AD patients, and in a subgroup of 16 we evaluated rest–activity circadian rhythm by actigraphy. We studied postmortem mRGCs by immunohistochemistry in retinas, and axons in optic nerve cross‐sections of 14 neuropathologically confirmed AD patients. We coimmunostained for retinal amyloid β (Aβ) deposition and melanopsin to locate mRGCs. All AD cohorts were compared with age‐matched controls. Results We demonstrated an age‐related optic neuropathy in AD by OCT, with a significant reduction of RNFL thickness (p = 0.038), more evident in the superior quadrant (p = 0.006). Axonal loss was confirmed in postmortem AD optic nerves. Abnormal circadian function characterized only a subgroup of AD patients. Sleep efficiency was significantly reduced in AD patients (p = 0.001). We also found a significant loss of mRGCs in postmortem AD retinal specimens (p = 0.003) across all ages and abnormal mRGC dendritic morphology and size (p = 0.003). In flat‐mounted AD retinas, Aβ accumulation was remarkably evident inside and around mRGCs. Interpretation We show variable degrees of rest–activity circadian dysfunction in AD patients. We also demonstrate age‐related loss of optic nerve axons and specifically mRGC loss and pathology in postmortem AD retinal specimens, associated with Aβ deposition. These results all support the concept that mRGC degeneration is a contributor to circadian rhythm dysfunction in AD. ANN NEUROL 2016;79:90–109
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Affiliation(s)
- Chiara La Morgia
- IRCCS Institute of Neurological Sciences of Bologna, Bellaria Hospital, Bologna, Italy
- Neurology Unit, Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | | | - Yosef Koronyo
- Department of Neurosurgery and Maxine Dunitz Neurosurgical Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA
| | - Jens Hannibal
- Department of Clinical Biochemistry, Bispebjerg Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Roberto Gallassi
- IRCCS Institute of Neurological Sciences of Bologna, Bellaria Hospital, Bologna, Italy
- Neurology Unit, Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - Gaetano Cantalupo
- Child Neuropsychiatry, Department of Life and Reproduction Sciences, University of Verona, Verona, Italy
| | - Luisa Sambati
- IRCCS Institute of Neurological Sciences of Bologna, Bellaria Hospital, Bologna, Italy
- Neurology Unit, Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - Billy X Pan
- Keck School of Medicine, University of Southern California, Los Angeles, CA
| | - Kevin R Tozer
- Keck School of Medicine, University of Southern California, Los Angeles, CA
| | | | - Federica Provini
- IRCCS Institute of Neurological Sciences of Bologna, Bellaria Hospital, Bologna, Italy
- Neurology Unit, Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - Pietro Avanzini
- Department of Neurosciences, University of Parma, Parma, Italy
| | - Michele Carbonelli
- IRCCS Institute of Neurological Sciences of Bologna, Bellaria Hospital, Bologna, Italy
| | - Annalisa Pelosi
- Department of Neurosciences, University of Parma, Parma, Italy
| | - Helena Chui
- Department of Neurology, Keck School of Medicine, University of Southern California, Los Angeles, CA
| | - Rocco Liguori
- IRCCS Institute of Neurological Sciences of Bologna, Bellaria Hospital, Bologna, Italy
- Neurology Unit, Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - Agostino Baruzzi
- IRCCS Institute of Neurological Sciences of Bologna, Bellaria Hospital, Bologna, Italy
- Neurology Unit, Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - Maya Koronyo-Hamaoui
- Department of Neurosurgery and Maxine Dunitz Neurosurgical Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA
- Department of Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, CA
| | - Alfredo A Sadun
- Doheny Eye Institute, Los Angeles, CA
- Department of Ophthalmology, David Geffen School of Medicine at University of California, Los Angeles, Los Angeles, CA
| | - Valerio Carelli
- IRCCS Institute of Neurological Sciences of Bologna, Bellaria Hospital, Bologna, Italy
- Neurology Unit, Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
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