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Beaugrand M, Jaramillo V, Markovic A, Huber R, Kohler M, Schoch SF, Kurth S. Lack of association between behavioral development and simplified topographical markers of the sleep EEG in infancy. Neurobiol Sleep Circadian Rhythms 2023; 15:100098. [PMID: 37424705 PMCID: PMC10329166 DOI: 10.1016/j.nbscr.2023.100098] [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: 03/22/2023] [Revised: 06/07/2023] [Accepted: 06/07/2023] [Indexed: 07/11/2023] Open
Abstract
The sleep EEG mirrors neuronal connectivity, especially during development when the brain undergoes substantial rewiring. As children grow, the slow-wave activity (SWA; 0.75-4.25 Hz) spatial distribution in their sleep EEG changes along a posterior-to-anterior gradient. Topographical SWA markers have been linked to critical neurobehavioral functions, such as motor skills, in school-aged children. However, the relationship between topographical markers in infancy and later behavioral outcomes is still unclear. This study aims to explore reliable indicators of neurodevelopment in infants by analyzing their sleep EEG patterns. Thirty-one 6-month-old infants (15 female) underwent high-density EEG recordings during nighttime sleep. We defined markers based on the topographical distribution of SWA and theta activity, including central/occipital and frontal/occipital ratios and an index derived from local EEG power variability. Linear models were applied to test whether markers relate to concurrent, later, or retrospective behavioral scores, assessed by the parent-reported Ages & Stages Questionnaire at ages 3, 6, 12, and 24 months. Results indicate that the topographical markers of the sleep EEG power in infants were not significantly linked to behavioral development at any age. Further research, such as longitudinal sleep EEG in newborns, is needed to better understand the relationship between these markers and behavioral development and assess their predictive value for individual differences.
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Affiliation(s)
| | - Valeria Jaramillo
- University of Surrey, School of Psychology, Guildford, United Kingdom
| | - Andjela Markovic
- University of Fribourg, Department of Psychology, Fribourg, Switzerland
- University Hospital Zurich, Department of Pulmonology, Zurich, Switzerland
| | - Reto Huber
- Center of Competence Sleep & Health Zurich, University of Zurich, Zurich, Switzerland
- Child Development Center, University Children's Hospital Zurich, Zurich, Switzerland
- Department of Child and Adolescent Psychiatry and Psychotherapy, Psychiatric Hospital, Switzerland
| | - Malcolm Kohler
- University Hospital Zurich, Department of Pulmonology, Zurich, Switzerland
- Center of Competence Sleep & Health Zurich, University of Zurich, Zurich, Switzerland
| | - Sarah F. Schoch
- University Hospital Zurich, Department of Pulmonology, Zurich, Switzerland
- Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Centre, Nijmegen, the Netherlands
| | - Salome Kurth
- University of Fribourg, Department of Psychology, Fribourg, Switzerland
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Dimitriades ME, Markovic A, Gefferie SR, Buckley A, Driver DI, Rapoport JL, Nosadini M, Rostasy K, Sartori S, Suppiej A, Kurth S, Franscini M, Walitza S, Huber R, Tarokh L, Bölsterli BK, Gerstenberg M. Sleep spindles across youth affected by schizophrenia or anti- N-methyl-D-aspartate-receptor encephalitis. Front Psychiatry 2023; 14:1055459. [PMID: 37377467 PMCID: PMC10292628 DOI: 10.3389/fpsyt.2023.1055459] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Accepted: 05/19/2023] [Indexed: 06/29/2023] Open
Abstract
Background Sleep disturbances are intertwined with the progression and pathophysiology of psychotic symptoms in schizophrenia. Reductions in sleep spindles, a major electrophysiological oscillation during non-rapid eye movement sleep, have been identified in patients with schizophrenia as a potential biomarker representing the impaired integrity of the thalamocortical network. Altered glutamatergic neurotransmission within this network via a hypofunction of the N-methyl-D-aspartate receptor (NMDAR) is one of the hypotheses at the heart of schizophrenia. This pathomechanism and the symptomatology are shared by anti-NMDAR encephalitis (NMDARE), where antibodies specific to the NMDAR induce a reduction of functional NMDAR. However, sleep spindle parameters have yet to be investigated in NMDARE and a comparison of these rare patients with young individuals with schizophrenia and healthy controls (HC) is lacking. This study aims to assess and compare sleep spindles across young patients affected by Childhood-Onset Schizophrenia (COS), Early-Onset Schizophrenia, (EOS), or NMDARE and HC. Further, the potential relationship between sleep spindle parameters in COS and EOS and the duration of the disease is examined. Methods Sleep EEG data of patients with COS (N = 17), EOS (N = 11), NMDARE (N = 8) aged 7-21 years old, and age- and sex-matched HC (N = 36) were assessed in 17 (COS, EOS) or 5 (NMDARE) electrodes. Sleep spindle parameters (sleep spindle density, maximum amplitude, and sigma power) were analyzed. Results Central sleep spindle density, maximum amplitude, and sigma power were reduced when comparing all patients with psychosis to all HC. Between patient group comparisons showed no differences in central spindle density but lower central maximum amplitude and sigma power in patients with COS compared to patients with EOS or NMDARE. Assessing the topography of spindle density, it was significantly reduced over 15/17 electrodes in COS, 3/17 in EOS, and 0/5 in NMDARE compared to HC. In the pooled sample of COS and EOS, a longer duration of illness was associated with lower central sigma power. Conclusions Patients with COS demonstrated more pronounced impairments of sleep spindles compared to patients with EOS and NMDARE. In this sample, there is no strong evidence that changes in NMDAR activity are related to spindle deficits.
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Affiliation(s)
- Maria E. Dimitriades
- Child Development Center, University Children's Hospital Zurich, Zurich, Switzerland
- Children's Research Center, University Children's Hospital Zurich, Zurich, Switzerland
| | - Andjela Markovic
- Department of Pulmonology, University Hospital Zurich, Zurich, Switzerland
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
- Department of Psychology, University of Fribourg, Fribourg, Switzerland
| | - Silvano R. Gefferie
- Stichting Epilepsie Instellingen Nederland, Heemstede, Netherlands
- Department of Neurology, Leiden University Medical Center, Leiden, Netherlands
| | - Ashura Buckley
- Pediatrics and Neurodevelopmental Neuroscience, National Institute of Mental Health, Bethesda, MD, United States
| | - David I. Driver
- Child Psychiatry Branch, National Institute of Mental Health, Bethesda, MD, United States
| | - Judith L. Rapoport
- Child Psychiatry Branch, National Institute of Mental Health, Bethesda, MD, United States
| | - Margherita Nosadini
- Paediatric Neurology and Neurophysiology Unit, Department of Women's and Children's Health, University Hospital of Padova, Padova, Italy
- Neuroimmunology Group, Paediatric Research Institute Città della Speranza, Padova, Italy
| | - Kevin Rostasy
- Department of Pediatric Neurology, Children's Hospital Datteln, Witten/Herdecke University, Datteln, Germany
| | - Stefano Sartori
- Paediatric Neurology and Neurophysiology Unit, Department of Women's and Children's Health, University Hospital of Padova, Padova, Italy
- Neuroimmunology Group, Paediatric Research Institute Città della Speranza, Padova, Italy
| | - Agnese Suppiej
- Department of Medical Sciences, Pediatric Section, University of Ferrara, Ferrara, Italy
| | - Salome Kurth
- Department of Psychology, University of Fribourg, Fribourg, Switzerland
| | - Maurizia Franscini
- Department of Child and Adolescent Psychiatry and Psychotherapy, Psychiatric University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Susanne Walitza
- Department of Child and Adolescent Psychiatry and Psychotherapy, Psychiatric University Hospital Zurich, University of Zurich, Zurich, Switzerland
- Neuroscience Center Zurich, University of Zurich and Swiss Federal Institute of Technology Zurich, Zurich, Switzerland
- Zurich Center for Integrative Human Physiology, University of Zurich, Zurich, Switzerland
| | - Reto Huber
- Child Development Center, University Children's Hospital Zurich, Zurich, Switzerland
- Children's Research Center, University Children's Hospital Zurich, Zurich, Switzerland
- Department of Child and Adolescent Psychiatry and Psychotherapy, Psychiatric University Hospital Zurich, University of Zurich, Zurich, Switzerland
- Neuroscience Center Zurich, University of Zurich and Swiss Federal Institute of Technology Zurich, Zurich, Switzerland
| | - Leila Tarokh
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
- Translational Research Center, University Hospital of Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Bigna K. Bölsterli
- Child Development Center, University Children's Hospital Zurich, Zurich, Switzerland
- Children's Research Center, University Children's Hospital Zurich, Zurich, Switzerland
- Department of Pediatric Neurology, University Children's Hospital Zurich, Zurich, Switzerland
- Department of Pediatric Neurology, Children's Hospital of Eastern Switzerland, St. Gallen, Switzerland
| | - Miriam Gerstenberg
- Children's Research Center, University Children's Hospital Zurich, Zurich, Switzerland
- Department of Child and Adolescent Psychiatry and Psychotherapy, Psychiatric University Hospital Zurich, University of Zurich, Zurich, Switzerland
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Markovic A, Schoch SF, Huber R, Kohler M, Kurth S. The sleeping brain's connectivity and family environment: characterizing sleep EEG coherence in an infant cohort. Sci Rep 2023; 13:2055. [PMID: 36739318 PMCID: PMC9899221 DOI: 10.1038/s41598-023-29129-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Accepted: 01/31/2023] [Indexed: 02/06/2023] Open
Abstract
Brain connectivity closely reflects brain function and behavior. Sleep EEG coherence, a measure of brain's connectivity during sleep, undergoes pronounced changes across development under the influence of environmental factors. Yet, the determinants of the developing brain's sleep EEG coherence from the child's family environment remain unknown. After characterizing high-density sleep EEG coherence in 31 healthy 6-month-old infants by detecting strongly synchronized clusters through a data-driven approach, we examined the association of sleep EEG coherence from these clusters with factors from the infant's family environment. Clusters with greatest coherence were observed over the frontal lobe. Higher delta coherence over the left frontal cortex was found in infants sleeping in their parents' room, while infants sleeping in a room shared with their sibling(s) showed greater delta coherence over the central parts of the frontal cortex, suggesting a link between local brain connectivity and co-sleeping. Finally, lower occipital delta coherence was associated with maternal anxiety regarding their infant's sleep. These interesting links between sleep EEG coherence and family factors have the potential to serve in early health interventions as a new set of targets from the child's immediate environment.
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Affiliation(s)
- Andjela Markovic
- Department of Psychology, University of Fribourg, Fribourg, Switzerland. .,Department of Pulmonology, University Hospital Zurich, Zurich, Switzerland. .,University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland.
| | - Sarah F Schoch
- Department of Pulmonology, University Hospital Zurich, Zurich, Switzerland.,Center of Competence Sleep & Health Zurich, University of Zurich, Zurich, Switzerland.,Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Reto Huber
- Center of Competence Sleep & Health Zurich, University of Zurich, Zurich, Switzerland.,Child Development Center, University Children's Hospital Zurich, Zurich, Switzerland.,Department of Child and Adolescent Psychiatry and Psychotherapy, Psychiatric Hospital, University of Zurich, Zurich, Switzerland
| | - Malcolm Kohler
- Department of Pulmonology, University Hospital Zurich, Zurich, Switzerland.,Center of Competence Sleep & Health Zurich, University of Zurich, Zurich, Switzerland
| | - Salome Kurth
- Department of Psychology, University of Fribourg, Fribourg, Switzerland.,Department of Pulmonology, University Hospital Zurich, Zurich, Switzerland.,Center of Competence Sleep & Health Zurich, University of Zurich, Zurich, Switzerland
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4
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Kozhemiako N, Wang J, Jiang C, Wang LA, Gai G, Zou K, Wang Z, Yu X, Zhou L, Li S, Guo Z, Law R, Coleman J, Mylonas D, Shen L, Wang G, Tan S, Qin S, Huang H, Murphy M, Stickgold R, Manoach D, Zhou Z, Zhu W, Hal MH, Purcell SM, Pan JQ. Non-rapid eye movement sleep and wake neurophysiology in schizophrenia. eLife 2022; 11:76211. [PMID: 35578829 PMCID: PMC9113745 DOI: 10.7554/elife.76211] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Accepted: 04/11/2022] [Indexed: 12/29/2022] Open
Abstract
Motivated by the potential of objective neurophysiological markers to index thalamocortical function in patients with severe psychiatric illnesses, we comprehensively characterized key non-rapid eye movement (NREM) sleep parameters across multiple domains, their interdependencies, and their relationship to waking event-related potentials and symptom severity. In 72 schizophrenia (SCZ) patients and 58 controls, we confirmed a marked reduction in sleep spindle density in SCZ and extended these findings to show that fast and slow spindle properties were largely uncorrelated. We also describe a novel measure of slow oscillation and spindle interaction that was attenuated in SCZ. The main sleep findings were replicated in a demographically distinct sample, and a joint model, based on multiple NREM components, statistically predicted disease status in the replication cohort. Although also altered in patients, auditory event-related potentials elicited during wake were unrelated to NREM metrics. Consistent with a growing literature implicating thalamocortical dysfunction in SCZ, our characterization identifies independent NREM and wake EEG biomarkers that may index distinct aspects of SCZ pathophysiology and point to multiple neural mechanisms underlying disease heterogeneity. This study lays the groundwork for evaluating these neurophysiological markers, individually or in combination, to guide efforts at treatment and prevention as well as identifying individuals most likely to benefit from specific interventions.
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Affiliation(s)
- Nataliia Kozhemiako
- Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, United States
| | - Jun Wang
- The Affiliated Wuxi Mental Health Center of Nanjing Medical University, Wuxi, China
| | - Chenguang Jiang
- The Affiliated Wuxi Mental Health Center of Nanjing Medical University, Wuxi, China
| | - Lei A Wang
- Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, United States
| | - Guanchen Gai
- The Affiliated Wuxi Mental Health Center of Nanjing Medical University, Wuxi, China
| | - Kai Zou
- The Affiliated Wuxi Mental Health Center of Nanjing Medical University, Wuxi, China
| | - Zhe Wang
- The Affiliated Wuxi Mental Health Center of Nanjing Medical University, Wuxi, China
| | - Xiaoman Yu
- The Affiliated Wuxi Mental Health Center of Nanjing Medical University, Wuxi, China
| | - Lin Zhou
- Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, United States
| | - Shen Li
- Department of Psychiatry, McLean Hospital, Harvard Medical School, Belmont, United States
| | - Zhenglin Guo
- Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, United States
| | - Robert Law
- Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, United States
| | - James Coleman
- Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, United States
| | - Dimitrios Mylonas
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, United States
| | - Lu Shen
- Bio-X Institutes, Shanghai Jiao Tong University, Shanghai, China
| | - Guoqiang Wang
- The Affiliated Wuxi Mental Health Center of Nanjing Medical University, Wuxi, China
| | - Shuping Tan
- Huilong Guan Hospital, Beijing University, Beijing, China
| | - Shengying Qin
- Bio-X Institutes, Shanghai Jiao Tong University, Shanghai, China
| | - Hailiang Huang
- Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, United States.,Analytic and Translational Genetics Unit, Massachusetts General Hospital, Harvard Medical School, Boston, United States
| | - Michael Murphy
- Department of Psychiatry, McLean Hospital, Harvard Medical School, Belmont, United States
| | - Robert Stickgold
- Beth Israel Deaconess Medical Center, Boston, United States.,Department of Psychiatry, Harvard Medical School, Boston, United States
| | - Dara Manoach
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, United States
| | - Zhenhe Zhou
- The Affiliated Wuxi Mental Health Center of Nanjing Medical University, Wuxi, China
| | - Wei Zhu
- The Affiliated Wuxi Mental Health Center of Nanjing Medical University, Wuxi, China
| | - Mei-Hua Hal
- Department of Psychiatry, McLean Hospital, Harvard Medical School, Belmont, United States
| | - Shaun M Purcell
- Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, United States.,Department of Psychiatry, Harvard Medical School, Boston, United States
| | - Jen Q Pan
- Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, United States
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Markovic A, Buckley A, Driver DI, Dillard-Broadnax D, Gochman PA, Hoedlmoser K, Rapoport JL, Tarokh L. Sleep spindle activity in childhood onset schizophrenia: Diminished and associated with clinical symptoms. Schizophr Res 2020; 223:327-336. [PMID: 32980206 PMCID: PMC7704640 DOI: 10.1016/j.schres.2020.08.022] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2019] [Revised: 05/24/2020] [Accepted: 08/25/2020] [Indexed: 12/21/2022]
Abstract
Neuroimaging studies of childhood onset schizophrenia (COS), a rare yet severe form of schizophrenia with an onset before the age of 13 years, have shown continuity with adult onset schizophrenia. Previous research in adult patients has shown reduced sleep spindle activity, transient oscillations in the sleep electroencephalogram (EEG) generated through thalamocortical loops. The current study examines sleep spindle activity in patients with COS. Seventeen children and adolescents with COS (16 years ±6.6) underwent overnight sleep EEG recordings. Sleep spindle activity was compared between patients with COS and age and gender matched controls and correlated with clinical symptom severity. We found pronounced deficits in sleep spindle amplitude, duration, density and frequency in patients with COS (effect size = 0.61 to 1.96; dependent on metric and EEG derivation). Non-rapid eye movement (NREM) sleep EEG power and coherence in the sigma band (11-16 Hz) corresponding to spindle activity were also markedly diminished in patients with COS as compared to controls. Furthermore, the degree of deficit in power and coherence of spindles was strongly associated with clinician rated hallucinations and positive symptoms over widespread cortical regions. Our finding of diminished spindle activity and its association with hallucinations likely reflect dysfunction of the thalamocortical circuits in children and adolescents with COS. Given the relative ease of sleep EEG recordings in vulnerable populations, this study highlights the potential of such recordings to characterize brain function in schizophrenia.
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Affiliation(s)
- Andjela Markovic
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Switzerland; Graduate School for Health Sciences, University of Bern, Switzerland
| | - Ashura Buckley
- National Institute of Mental Health, National Institutes of Health, Bethesda, MD, United States of America
| | - David I Driver
- National Institute of Mental Health, National Institutes of Health, Bethesda, MD, United States of America
| | - Diane Dillard-Broadnax
- National Institute of Mental Health, National Institutes of Health, Bethesda, MD, United States of America
| | - Peter A Gochman
- National Institute of Mental Health, National Institutes of Health, Bethesda, MD, United States of America
| | - Kerstin Hoedlmoser
- Laboratory for Sleep, Cognition and Consciousness Research, Department of Psychology, Centre for Cognitive Neuroscience, University of Salzburg, Austria
| | - Judith L Rapoport
- National Institute of Mental Health, National Institutes of Health, Bethesda, MD, United States of America
| | - Leila Tarokh
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Switzerland.
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