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Chen J, Peng G, Sun B. Alzheimer's disease and sleep disorders: A bidirectional relationship. Neuroscience 2024; 557:12-23. [PMID: 39137870 DOI: 10.1016/j.neuroscience.2024.08.008] [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: 06/16/2024] [Revised: 07/30/2024] [Accepted: 08/07/2024] [Indexed: 08/15/2024]
Abstract
Alzheimer's disease (AD) is the most prevalent dementia, pathologically featuring abnormal accumulation of amyloid-β (Aβ) and hyperphosphorylated tau, while sleep, divided into rapid eye movement sleep (REM) and nonrapid eye movement sleep (NREM), plays a key role in consolidating social and spatial memory. Emerging evidence has revealed that sleep disorders such as circadian disturbances and disruption of neuronal rhythm activity are considered as both candidate risks and consequence of AD, suggesting a bidirectional relationship between sleep and AD. This review will firstly grasp basic knowledge of AD pathogenesis, then highlight macrostructural and microstructural alteration of sleep along with AD progression, explain the interaction between accumulation of Aβ and hyperphosphorylated tau, which are two critical neuropathological processes of AD, as well as neuroinflammation and sleep, and finally introduce several methods of sleep enhancement as strategies to reduce AD-associated neuropathology. Although theories about the bidirectional relationship and relevant therapeutic methods in mice have been well developed in recent years, the knowledge in human is still limited. More studies on how to effectively ameliorate AD pathology in patients by sleep enhancement and what specific roles of sleep play in AD are needed.
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Affiliation(s)
- Junhua Chen
- Chu Kochen Honors College of Zhejiang University, Hangzhou, Zhejiang 310058, China.
| | - Guoping Peng
- Department of Neurology, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang 310003, China.
| | - Binggui Sun
- Department of Anesthesiology of the Children's Hospital and School of Brain Science and Brain Medicine, Zhejiang University School of Medicine and National Clinical Research Center for Child Health, Zhejiang University, Hangzhou, Zhejiang Province 310058, China; NHC and CAMS Key Laboratory of Medical Neurobiology, School of Brain Science and Brain Medicine, Zhejiang University Hangzhou, Zhejiang Province 310058, China.
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2
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Kegyes-Brassai AC, Pierson-Bartel R, Bolla G, Kamondi A, Horvath AA. Disruption of sleep macro- and microstructure in Alzheimer's disease: overlaps between neuropsychology, neurophysiology, and neuroimaging. GeroScience 2024:10.1007/s11357-024-01357-z. [PMID: 39333449 DOI: 10.1007/s11357-024-01357-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2024] [Accepted: 09/14/2024] [Indexed: 09/29/2024] Open
Abstract
Alzheimer's disease (AD) is the leading cause of dementia, often associated with impaired sleep quality and disorganized sleep structure. This study aimed to characterize changes in sleep macrostructure and K-complex density in AD, in relation to neuropsychological performance and brain structural changes. We enrolled 30 AD and 30 healthy control participants, conducting neuropsychological exams, brain MRI, and one-night polysomnography. AD patients had significantly reduced total sleep time (TST), sleep efficiency, and relative durations of non-rapid eye movement (NREM) stages 2 (S2), 3 (S3), and rapid eye movement (REM) sleep (p < 0.01). K-complex (KC) density during the entire sleep period and S2 (p < 0.001) was significantly decreased in AD. We found strong correlations between global cognitive performance and relative S3 (p < 0.001; r = 0.86) and REM durations (p < 0.001; r = 0.87). TST and NREM stage 1 (S1) durations showed a moderate negative correlation with amygdaloid and hippocampal volumes (p < 0.02; r = 0.51-0.55), while S3 and REM sleep had a moderate positive correlation with cingulate cortex volume (p < 0.02; r = 0.45-0.61). KC density strongly correlated with global cognitive function (p < 0.001; r = 0.66) and the thickness of the anterior cingulate cortex (p < 0.05; r = 0.45-0.47). Our results indicate significant sleep organization changes in AD, paralleling cognitive decline. Decreased slow wave sleep and KCs are strongly associated with cingulate cortex atrophy. Since sleep changes are prominent in early AD, they may serve as prognostic markers or therapeutic targets.
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Affiliation(s)
| | | | - Gergo Bolla
- School of PhD Studies, Semmelweis University, Budapest, Hungary
- Neurocognitive Research Centre, Nyírő Gyula National Institute of Psychiatry, and Addictology, Budapest, Hungary
| | - Anita Kamondi
- Neurocognitive Research Centre, Nyírő Gyula National Institute of Psychiatry, and Addictology, Budapest, Hungary
- Department of Neurosurgery and Neurointervention, Semmelweis University, Budapest, Hungary
- Department of Neurology, Semmelweis University, Budapest, Hungary
| | - Andras Attila Horvath
- Neurocognitive Research Centre, Nyírő Gyula National Institute of Psychiatry, and Addictology, Budapest, Hungary
- Department of Anatomy Histology and Embryology, Semmelweis University, Budapest, Hungary
- HUN-REN Research Centre for Natural Sciences, Budapest, Hungary
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3
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Deng S, Hu Y, Chen S, Xue Y, Yao D, Sun Q, Nedergaard M, Wang W, Ding F. Chronic sleep fragmentation impairs brain interstitial clearance in young wildtype mice. J Cereb Blood Flow Metab 2024; 44:1515-1531. [PMID: 38639025 PMCID: PMC11418708 DOI: 10.1177/0271678x241230188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Revised: 10/06/2023] [Accepted: 12/27/2023] [Indexed: 04/20/2024]
Abstract
Accumulating evidence shows that most chronic neurological diseases have a link with sleep disturbances, and that patients with chronically poor sleep undergo an accelerated cognitive decline. Indeed, a single-night of sleep deprivation may increase metabolic waste levels in cerebrospinal fluid. However, it remains unknown how chronic sleep disturbances in isolation from an underlying neurological disease may affect the glymphatic system. Clearance of brain interstitial waste by the glymphatic system occurs primarily during sleep, driven by multiple oscillators including arterial pulsatility, and vasomotion. Herein, we induced sleep fragmentation in young wildtype mice and assessed the effects on glymphatic activity and cognitive functions. Chronic sleep fragmentation reduced glymphatic function and impaired cognitive functions in healthy mice. A mechanistic analysis showed that the chronic sleep fragmentation suppressed slow vasomotion, without altering cardiac-driven pulsations. Taken together, results of this study document that chronic sleep fragmentation suppresses brain metabolite clearance and impairs cognition, even in the absence of disease.
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Affiliation(s)
- Saiyue Deng
- Department of Pharmacology, School of Basic Medical Sciences, Shanghai Medical College, Fudan University, Shanghai, 200032, China
- Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Yusi Hu
- Department of Pharmacology, School of Basic Medical Sciences, Shanghai Medical College, Fudan University, Shanghai, 200032, China
| | - Simiao Chen
- Department of Rehabilitation Medicine, First Affiliated Hospital, Zhejiang University, Hangzhou, 310003, China
| | - Yang Xue
- Department of Neurology, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, 200032, China
| | - Di Yao
- Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Qian Sun
- Department of Pharmacology, School of Basic Medical Sciences, Shanghai Medical College, Fudan University, Shanghai, 200032, China
| | - Maiken Nedergaard
- Division of Glial Disease and Therapeutics, Center for Translational Neuromedicine, Department of Neurology, University of Rochester Medical Center, Rochester, NY, 14642, United States
- Division of Glial Disease and Therapeutics, Center for Translational Neuromedicine, University of Copenhagen, Copenhagen 2200, Denmark
| | - Wei Wang
- Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Fengfei Ding
- Department of Pharmacology, School of Basic Medical Sciences, Shanghai Medical College, Fudan University, Shanghai, 200032, China
- Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
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4
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Borges CR, Poyares DLR, Studart-Neto A, Coutinho AM, Cassimiro L, Avolio I, Piovezan R, Trés ES, Teixeira TBM, Barbosa BJAP, Tufik S, Brucki SMD. Amyloid profile is associated with sleep quality in preclinical but not in prodromal Alzheimer's disease older adults. Sleep Med 2024; 121:359-364. [PMID: 39079370 DOI: 10.1016/j.sleep.2024.07.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2024] [Revised: 07/11/2024] [Accepted: 07/23/2024] [Indexed: 08/19/2024]
Abstract
BACKGROUND Few studies have assessed whether neuropathological markers of AD in the preclinical and prodromal stages are associated with polysomnographic changes and obstructive sleep apnea (OSA). METHODS This was a cross-sectional, case-control study of older adults (≥60 years) without relevant clinical and psychiatric comorbidities selected randomly from a cohort of individuals without dementia in a tertiary university hospital in São Paulo, Brazil. They underwent neuropsychological evaluation for clinical diagnosis and were allocated into two samples: cognitively unimpaired (CU) and mild cognitive impairment (MCI). Also, they underwent PET-PiB to determine the amyloid profile and all-night in-lab polysomnography. For each sample, we compared polysomnographic parameters according to the amyloid profile (A+ vs A-). RESULTS We allocated 67 participants (mean age 73 years, SD 10,1), 70 % females, 14 ± 5 years of education, into two samples: CU (n = 28, 42.4 %) and MCI (n = 39, 57.6 %). In the CU sample, the group A+ (n = 9) showed worse sleep parameters than A- (n = 19) (lower total sleep time (p = 0.007), and sleep efficiency (p = 0.005); higher sleep onset latency (p = 0.025), wake time after sleep onset (p = 0.011), and arousal index (AI) (p = 0.007)), and changes in sleep structure: higher %N1 (p = 0.005), and lower %REM (p = 0.006). In the MCI sample, MCI A-had higher AI (p = 0.013), respiratory disturbance index (p = 0.025, controlled for age), and higher rates of severe OSA than A+. DISCUSSION The amyloid profile was associated with polysomnographic markers of worse sleep quality in individuals with preclinical AD but not with prodromal AD, probably due to the higher frequencies of severe OSA.
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Affiliation(s)
- Conrado Regis Borges
- Universidade de São Paulo - Faculdade de Medicina, R. Dr.Enéas de Carvalho Aguiar, 255, São Paulo (SP), Brazil.
| | - Dalva L R Poyares
- Universidade Federal de São Paulo - Escola Paulista de Medicina, R. Botucatu, 862, São Paulo (SP), Brazil
| | - Adalberto Studart-Neto
- Universidade de São Paulo - Faculdade de Medicina, R. Dr.Enéas de Carvalho Aguiar, 255, São Paulo (SP), Brazil
| | - Artur M Coutinho
- Universidade de São Paulo - Faculdade de Medicina, R. Dr.Enéas de Carvalho Aguiar, 255, São Paulo (SP), Brazil
| | - Luciana Cassimiro
- Universidade de São Paulo - Faculdade de Medicina, R. Dr.Enéas de Carvalho Aguiar, 255, São Paulo (SP), Brazil
| | - Isabela Avolio
- Universidade de São Paulo - Faculdade de Medicina, R. Dr.Enéas de Carvalho Aguiar, 255, São Paulo (SP), Brazil
| | - Ronaldo Piovezan
- Universidade Federal de São Paulo - Escola Paulista de Medicina, R. Botucatu, 862, São Paulo (SP), Brazil
| | - Eduardo S Trés
- Universidade de São Paulo - Faculdade de Medicina, R. Dr.Enéas de Carvalho Aguiar, 255, São Paulo (SP), Brazil
| | - Thiago B M Teixeira
- Universidade de São Paulo - Faculdade de Medicina, R. Dr.Enéas de Carvalho Aguiar, 255, São Paulo (SP), Brazil
| | - Breno J A P Barbosa
- Universidade de São Paulo - Faculdade de Medicina, R. Dr.Enéas de Carvalho Aguiar, 255, São Paulo (SP), Brazil
| | - Sergio Tufik
- Universidade Federal de São Paulo - Escola Paulista de Medicina, R. Botucatu, 862, São Paulo (SP), Brazil
| | - Sonia M D Brucki
- Universidade de São Paulo - Faculdade de Medicina, R. Dr.Enéas de Carvalho Aguiar, 255, São Paulo (SP), Brazil
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5
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McGregor JN, Farris CA, Ensley S, Schneider A, Fosque LJ, Wang C, Tilden EI, Liu Y, Tu J, Elmore H, Ronayne KD, Wessel R, Dyer EL, Bhaskaran-Nair K, Holtzman DM, Hengen KB. Failure in a population: Tauopathy disrupts homeostatic set-points in emergent dynamics despite stability in the constituent neurons. Neuron 2024:S0896-6273(24)00578-6. [PMID: 39241778 DOI: 10.1016/j.neuron.2024.08.006] [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: 09/06/2023] [Revised: 06/24/2024] [Accepted: 08/09/2024] [Indexed: 09/09/2024]
Abstract
Homeostatic regulation of neuronal activity is essential for robust computation; set-points, such as firing rate, are actively stabilized to compensate for perturbations. The disruption of brain function central to neurodegenerative disease likely arises from impairments of computationally essential set-points. Here, we systematically investigated the effects of tau-mediated neurodegeneration on all known set-points in neuronal activity. We continuously tracked hippocampal neuronal activity across the lifetime of a mouse model of tauopathy. We were unable to detect effects of disease in measures of single-neuron firing activity. By contrast, as tauopathy progressed, there was disruption of network-level neuronal activity, quantified by measuring neuronal pairwise interactions and criticality, a homeostatically controlled, ideal computational regime. Deviations in criticality correlated with symptoms, predicted underlying anatomical pathology, occurred in a sleep-wake-dependent manner, and could be used to reliably classify an animal's genotype. This work illustrates how neurodegeneration may disrupt the computational capacity of neurobiological systems.
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Affiliation(s)
- James N McGregor
- Department of Biology, Washington University in Saint Louis, St. Louis, MO, USA
| | - Clayton A Farris
- Department of Biology, Washington University in Saint Louis, St. Louis, MO, USA
| | - Sahara Ensley
- Department of Biology, Washington University in Saint Louis, St. Louis, MO, USA
| | - Aidan Schneider
- Department of Biology, Washington University in Saint Louis, St. Louis, MO, USA
| | - Leandro J Fosque
- Department of Biology, Washington University in Saint Louis, St. Louis, MO, USA
| | - Chao Wang
- Department of Neurology, Hope Center for Neurological Disorders, Knight Alzheimer's Disease Research Center, Washington University in Saint Louis, St. Louis, MO, USA; Institute for Brain Science and Disease, Chongqing Medical University, Chongqing 400016, China
| | - Elizabeth I Tilden
- Department of Neuroscience, Washington University in Saint Louis, St. Louis, MO, USA
| | - Yuqi Liu
- Department of Biology, Washington University in Saint Louis, St. Louis, MO, USA
| | - Jianhong Tu
- Department of Biology, Washington University in Saint Louis, St. Louis, MO, USA
| | - Halla Elmore
- Department of Biology, Washington University in Saint Louis, St. Louis, MO, USA
| | - Keenan D Ronayne
- Department of Biology, Washington University in Saint Louis, St. Louis, MO, USA
| | - Ralf Wessel
- Department of Physics, Washington University in Saint Louis, St. Louis, MO, USA
| | - Eva L Dyer
- Coulter Department of Biomedical Engineering, Georgia Institute of Technology, Atlanta, GA, USA
| | | | - David M Holtzman
- Department of Neurology, Hope Center for Neurological Disorders, Knight Alzheimer's Disease Research Center, Washington University in Saint Louis, St. Louis, MO, USA
| | - Keith B Hengen
- Department of Biology, Washington University in Saint Louis, St. Louis, MO, USA.
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6
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Daniels AJ, McDade E, Llibre-Guerra JJ, Xiong C, Perrin RJ, Ibanez L, Supnet-Bell C, Cruchaga C, Goate A, Renton AE, Benzinger TL, Gordon BA, Hassenstab J, Karch C, Popp B, Levey A, Morris J, Buckles V, Allegri RF, Chrem P, Berman SB, Chhatwal JP, Farlow MR, Fox NC, Day GS, Ikeuchi T, Jucker M, Lee JH, Levin J, Lopera F, Takada L, Sosa AL, Martins R, Mori H, Noble JM, Salloway S, Huey E, Rosa-Neto P, Sánchez-Valle R, Schofield PR, Roh JH, Bateman RJ. 15 Years of Longitudinal Genetic, Clinical, Cognitive, Imaging, and Biochemical Measures in DIAN. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2024:2024.08.08.24311689. [PMID: 39148846 PMCID: PMC11326320 DOI: 10.1101/2024.08.08.24311689] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 08/17/2024]
Abstract
This manuscript describes and summarizes the Dominantly Inherited Alzheimer Network Observational Study (DIAN Obs), highlighting the wealth of longitudinal data, samples, and results from this human cohort study of brain aging and a rare monogenic form of Alzheimer's disease (AD). DIAN Obs is an international collaborative longitudinal study initiated in 2008 with support from the National Institute on Aging (NIA), designed to obtain comprehensive and uniform data on brain biology and function in individuals at risk for autosomal dominant AD (ADAD). ADAD gene mutations in the amyloid protein precursor (APP), presenilin 1 (PSEN1), or presenilin 2 (PSEN2) genes are deterministic causes of ADAD, with virtually full penetrance, and a predictable age at symptomatic onset. Data and specimens collected are derived from full clinical assessments, including neurologic and physical examinations, extensive cognitive batteries, structural and functional neuro-imaging, amyloid and tau pathological measures using positron emission tomography (PET), flurordeoxyglucose (FDG) PET, cerebrospinal fluid and blood collection (plasma, serum, and whole blood), extensive genetic and multi-omic analyses, and brain donation upon death. This comprehensive evaluation of the human nervous system is performed longitudinally in both mutation carriers and family non-carriers, providing one of the deepest and broadest evaluations of the human brain across decades and through AD progression. These extensive data sets and samples are available for researchers to address scientific questions on the human brain, aging, and AD.
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Affiliation(s)
- Alisha J. Daniels
- Washington University School of Medicine, St Louis, St Louis, MO, USA
| | - Eric McDade
- Washington University School of Medicine, St Louis, St Louis, MO, USA
| | | | - Chengjie Xiong
- Washington University School of Medicine, St Louis, St Louis, MO, USA
| | - Richard J. Perrin
- Washington University School of Medicine, St Louis, St Louis, MO, USA
| | - Laura Ibanez
- Washington University School of Medicine, St Louis, St Louis, MO, USA
| | | | - Carlos Cruchaga
- Washington University School of Medicine, St Louis, St Louis, MO, USA
| | - Alison Goate
- Icahn School of Medicine at Mount Sinai, New York, NY USA
| | - Alan E. Renton
- Icahn School of Medicine at Mount Sinai, New York, NY USA
| | | | - Brian A. Gordon
- Washington University School of Medicine, St Louis, St Louis, MO, USA
| | - Jason Hassenstab
- Washington University School of Medicine, St Louis, St Louis, MO, USA
| | - Celeste Karch
- Washington University School of Medicine, St Louis, St Louis, MO, USA
| | - Brent Popp
- Washington University School of Medicine, St Louis, St Louis, MO, USA
| | - Allan Levey
- Goizueta Alzheimer’s Disease Research Center, Emory University, Atlanta, GA, USA
| | - John Morris
- Washington University School of Medicine, St Louis, St Louis, MO, USA
| | - Virginia Buckles
- Washington University School of Medicine, St Louis, St Louis, MO, USA
| | | | - Patricio Chrem
- Institute of Neurological Research FLENI, Buenos Aires, Argentina
| | | | - Jasmeer P. Chhatwal
- Massachusetts General and Brigham & Women’s Hospitals, Harvard Medical School, Boston MA, USA
| | | | - Nick C. Fox
- UK Dementia Research Institute at University College London, London, United Kingdom
- University College London, London, United Kingdom
| | | | - Takeshi Ikeuchi
- Brain Research Institute, Niigata University, Niigata, Japan
| | - Mathias Jucker
- Hertie Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany
- DZNE, German Center for Neurodegenerative Diseases, Tübingen, Germany
| | | | - Johannes Levin
- DZNE, German Center for Neurodegenerative Diseases, Munich, Germany
- Ludwig-Maximilians-Universität München, Munich, Germany
| | | | | | - Ana Luisa Sosa
- Instituto Nacional de Neurologia y Neurocirugla Innn, Mexico City, Mexico
| | - Ralph Martins
- Edith Cowan University, Western Australia, Australia
| | | | - James M. Noble
- Taub Institute for Research on Alzheimer’s Disease and the Aging Brain, Department of Neurology, and GH Sergievsky Center, Columbia University Irving Medical Center, New York, NY, USA
| | | | - Edward Huey
- Brown University, Butler Hospital, Providence, RI, USA
| | - Pedro Rosa-Neto
- Centre de Recherche de L’hopital Douglas and McGill University, Montreal, Quebec
| | - Raquel Sánchez-Valle
- Hospital Clínic de Barcelona. IDIBAPS. University of Barcelona, Barcelona, Spain
| | - Peter R. Schofield
- Neuroscience Research Australia, Sydney, NSW, Australia
- School of Biomedical Sciences, University of New South Wales, Sydney, NSW, Australia
| | - Jee Hoon Roh
- Korea University, Korea University Anam Hospital, Seoul, South Korea
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Kalantari N, Daneault V, Blais H, André C, Sanchez E, Lina JM, Arbour C, Gilbert D, Carrier J, Gosselin N. Cerebral Gray Matter May Not Explain Sleep Slow-Wave Characteristics after Severe Brain Injury. J Neurosci 2024; 44:e1306232024. [PMID: 38844342 PMCID: PMC11308330 DOI: 10.1523/jneurosci.1306-23.2024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Revised: 04/24/2024] [Accepted: 04/26/2024] [Indexed: 08/09/2024] Open
Abstract
Sleep slow waves are the hallmark of deeper non-rapid eye movement sleep. It is generally assumed that gray matter properties predict slow-wave density, morphology, and spectral power in healthy adults. Here, we tested the association between gray matter volume (GMV) and slow-wave characteristics in 27 patients with moderate-to-severe traumatic brain injury (TBI, 32.0 ± 12.2 years old, eight women) and compared that with 32 healthy controls (29.2 ± 11.5 years old, nine women). Participants underwent overnight polysomnography and cerebral MRI with a 3 Tesla scanner. A whole-brain voxel-wise analysis was performed to compare GMV between groups. Slow-wave density, morphology, and spectral power (0.4-6 Hz) were computed, and GMV was extracted from the thalamus, cingulate, insula, precuneus, and orbitofrontal cortex to test the relationship between slow waves and gray matter in regions implicated in the generation and/or propagation of slow waves. Compared with controls, TBI patients had significantly lower frontal and temporal GMV and exhibited a subtle decrease in slow-wave frequency. Moreover, higher GMV in the orbitofrontal cortex, insula, cingulate cortex, and precuneus was associated with higher slow-wave frequency and slope, but only in healthy controls. Higher orbitofrontal GMV was also associated with higher slow-wave density in healthy participants. While we observed the expected associations between GMV and slow-wave characteristics in healthy controls, no such associations were observed in the TBI group despite lower GMV. This finding challenges the presumed role of GMV in slow-wave generation and morphology.
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Affiliation(s)
- Narges Kalantari
- Center for Advanced Research in Sleep Medicine, Hôpital du Sacré-Cœur de Montréal, Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Île-de Montréal, Montreal, Quebec H4J 1C5, Canada
- Department of Psychology, Université de Montréal, Montreal, Quebec H2V 2S9, Canada
| | - Véronique Daneault
- Center for Advanced Research in Sleep Medicine, Hôpital du Sacré-Cœur de Montréal, Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Île-de Montréal, Montreal, Quebec H4J 1C5, Canada
- Department of Psychology, Université de Montréal, Montreal, Quebec H2V 2S9, Canada
| | - Hélène Blais
- Center for Advanced Research in Sleep Medicine, Hôpital du Sacré-Cœur de Montréal, Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Île-de Montréal, Montreal, Quebec H4J 1C5, Canada
| | - Claire André
- Center for Advanced Research in Sleep Medicine, Hôpital du Sacré-Cœur de Montréal, Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Île-de Montréal, Montreal, Quebec H4J 1C5, Canada
- Department of Psychology, Université de Montréal, Montreal, Quebec H2V 2S9, Canada
| | - Erlan Sanchez
- Center for Advanced Research in Sleep Medicine, Hôpital du Sacré-Cœur de Montréal, Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Île-de Montréal, Montreal, Quebec H4J 1C5, Canada
- Cognitive Neurology Research Unit, Sunnybrook Research Institute, Toronto, Ontario M4N 3M5, Canada
| | - Jean-Marc Lina
- Center for Advanced Research in Sleep Medicine, Hôpital du Sacré-Cœur de Montréal, Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Île-de Montréal, Montreal, Quebec H4J 1C5, Canada
- Department of Electrical Engineering, École de Technologie Supérieure, Montreal, Quebec H3C 1K3, Canada
| | - Caroline Arbour
- Center for Advanced Research in Sleep Medicine, Hôpital du Sacré-Cœur de Montréal, Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Île-de Montréal, Montreal, Quebec H4J 1C5, Canada
- Faculty of Nursing, Université de Montréal, Montreal, Quebec H3T 1A8, Canada
| | - Danielle Gilbert
- Department of Radiology, Radiation Oncology and Nuclear Medicine, Université de Montréal, Montreal, Quebec H3T 1A4, Canada
- Department of Radiology, Hôpital du Sacré-Coeur de Montréal, Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Île-de Montréal, Montreal, Quebec H4J 1C5, Canada
| | - Julie Carrier
- Center for Advanced Research in Sleep Medicine, Hôpital du Sacré-Cœur de Montréal, Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Île-de Montréal, Montreal, Quebec H4J 1C5, Canada
- Department of Psychology, Université de Montréal, Montreal, Quebec H2V 2S9, Canada
| | - Nadia Gosselin
- Center for Advanced Research in Sleep Medicine, Hôpital du Sacré-Cœur de Montréal, Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Île-de Montréal, Montreal, Quebec H4J 1C5, Canada
- Department of Psychology, Université de Montréal, Montreal, Quebec H2V 2S9, Canada
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8
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Tucker A, Goldberg TE, Kim H. Biomarkers of sleep-wake disturbance as predictors of cognitive decline and accelerated disease progression. Expert Rev Mol Diagn 2024; 24:649-657. [PMID: 39129222 DOI: 10.1080/14737159.2024.2389307] [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: 04/29/2024] [Accepted: 08/02/2024] [Indexed: 08/13/2024]
Abstract
INTRODUCTION In older adults, where sleep disturbances and cognitive impairment are common, mounting evidence suggests a potential connection between sleep and cognitive function, highlighting the significance of utilizing sleep as a biomarker for early detection of cognitive impairment to improve clinical outcomes in a noninvasive, cost-effective manner. AREAS COVERED This review describes the relationship between sleep and cognitive function in older adults, encompassing both subjective and objective measures of sleep quality, duration, architecture, and sleep-disordered breathing. The authors consider the directionality of the associations observed in prospective and cross-sectional studies, exploring whether sleep disturbances precede cognitive decline or vice versa. Furthermore, they discuss the potential bidirectional relationships between sleep and Alzheimer's disease (AD) risks in older adults while also examining the neurodegenerative pathways of this relationship. EXPERT OPINION Routine sleep monitoring in primary care settings has the potential to bolster early detection and treatment of sleep disturbance, and by extension, reduce the risk of dementia. Improving sleep assessment tools, such as wearables, provide scalable alternatives to traditional methods like polysomnography, potentially enabling widespread monitoring of sleep characteristics. Standardized measurement and inclusive participant recruitment are needed to enhance generalizability, while longitudinal studies are essential to understand the interaction between sleep and AD pathology.
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Affiliation(s)
- Aren Tucker
- Brain Aging and Mental Health Division, New York State Psychiatric Institute, New York, NY, USA
| | - Terry E Goldberg
- Brain Aging and Mental Health Division, New York State Psychiatric Institute, New York, NY, USA
- Department of Psychiatry, Columbia University Irving Medical Psychology, New York, NY, USA
- Department of Anesthisiology, Columbia University Irving Medical Psychology, New York, NY, USA
| | - Hyun Kim
- Brain Aging and Mental Health Division, New York State Psychiatric Institute, New York, NY, USA
- Department of Psychiatry, Columbia University Irving Medical Psychology, New York, NY, USA
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Campbell KJ, Jiang P, Olker C, Lin X, Kim SY, Lee CJ, Song EJ, Turek FW, Vitaterna MH. The impacts of sex and the 5xFAD model of Alzheimer's disease on the sleep and spatial learning responses to feeding time. Front Neurol 2024; 15:1430989. [PMID: 39144714 PMCID: PMC11322461 DOI: 10.3389/fneur.2024.1430989] [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: 05/10/2024] [Accepted: 07/16/2024] [Indexed: 08/16/2024] Open
Abstract
Introduction The relationships between the feeding rhythm, sleep and cognition in Alzheimer's disease (AD) are incompletely understood, but meal time could provide an easy-to-implement method of curtailing disease-associated disruptions in sleep and cognition. Furthermore, known sex differences in AD incidence could relate to sex differences in circadian rhythm/sleep/cognition interactions. Methods The 5xFAD transgenic mouse model of AD and non-transgenic wild-type controls were studied. Both female and male mice were used. Food access was restricted each day to either the 12-h light phase (light-fed groups) or the 12-h dark phase (dark-fed groups). Sleep (electroencephalographic/electromyographic) recording and cognitive behavior measures were collected. Results The 5xFAD genotype reduces NREM and REM as well as the number of sleep spindles. In wild-type mice, light-fed groups had disrupted vigilance state amounts, characteristics, and rhythms relative to dark-fed groups. These feeding time differences were reduced in 5xFAD mice. Sex modulates these effects. 5xFAD mice display poorer spatial memory that, in female mice, is curtailed by dark phase feeding. Similarly, female 5xFAD mice have decreased anxiety-associated behavior. These emotional and cognitive measures are correlated with REM amount. Discussion Our study demonstrates that the timing of feeding can alter many aspects of wake, NREM and REM. Unexpectedly, 5xFAD mice are less sensitive to these feeding time effects. 5xFAD mice demonstrate deficits in cognition which are correlated with REM, suggesting that this circadian-timed aspect of sleep may link feeding time and cognition. Sex plays an important role in regulating the impact of feeding time on sleep and cognition in both wild-type and 5xFAD mice, with females showing a greater cognitive response to feeding time than males.
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Affiliation(s)
- Katrina J. Campbell
- Center for Sleep and Circadian Biology, Northwestern University, Evanston, IL, United States
- Department of Neurobiology, Weinberg College of Arts and Sciences, Northwestern University, Evanston, IL, United States
| | - Peng Jiang
- Center for Sleep and Circadian Biology, Northwestern University, Evanston, IL, United States
- Department of Neurobiology, Weinberg College of Arts and Sciences, Northwestern University, Evanston, IL, United States
| | - Christopher Olker
- Center for Sleep and Circadian Biology, Northwestern University, Evanston, IL, United States
- Department of Neurobiology, Weinberg College of Arts and Sciences, Northwestern University, Evanston, IL, United States
| | - Xuanyi Lin
- Center for Sleep and Circadian Biology, Northwestern University, Evanston, IL, United States
- Department of Neurobiology, Weinberg College of Arts and Sciences, Northwestern University, Evanston, IL, United States
| | - Sarah Y. Kim
- Center for Sleep and Circadian Biology, Northwestern University, Evanston, IL, United States
- Department of Neurobiology, Weinberg College of Arts and Sciences, Northwestern University, Evanston, IL, United States
| | - Christopher J. Lee
- Center for Sleep and Circadian Biology, Northwestern University, Evanston, IL, United States
- Department of Neurobiology, Weinberg College of Arts and Sciences, Northwestern University, Evanston, IL, United States
| | - Eun Joo Song
- Center for Sleep and Circadian Biology, Northwestern University, Evanston, IL, United States
- Department of Neurobiology, Weinberg College of Arts and Sciences, Northwestern University, Evanston, IL, United States
| | - Fred W. Turek
- Center for Sleep and Circadian Biology, Northwestern University, Evanston, IL, United States
- Department of Neurobiology, Weinberg College of Arts and Sciences, Northwestern University, Evanston, IL, United States
| | - Martha Hotz Vitaterna
- Center for Sleep and Circadian Biology, Northwestern University, Evanston, IL, United States
- Department of Neurobiology, Weinberg College of Arts and Sciences, Northwestern University, Evanston, IL, United States
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Wang M, Hua Y, Bai Y. A review of the application of exercise intervention on improving cognition in patients with Alzheimer's disease: mechanisms and clinical studies. Rev Neurosci 2024; 0:revneuro-2024-0046. [PMID: 39029521 DOI: 10.1515/revneuro-2024-0046] [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: 03/29/2024] [Accepted: 07/08/2024] [Indexed: 07/21/2024]
Abstract
Alzheimer's disease (AD) is the most common form of dementia, leading to sustained cognitive decline. An increasing number of studies suggest that exercise is an effective strategy to promote the improvement of cognition in AD. Mechanisms of the benefits of exercise intervention on cognitive function may include modulation of vascular factors by affecting cardiovascular risk factors, regulating cardiorespiratory health, and enhancing cerebral blood flow. Exercise also promotes neurogenesis by stimulating neurotrophic factors, affecting neuroplasticity in the brain. Additionally, regular exercise improves the neuropathological characteristics of AD by improving mitochondrial function, and the brain redox status. More and more attention has been paid to the effect of Aβ and tau pathology as well as sleep disorders on cognitive function in persons diagnosed with AD. Besides, there are various forms of exercise intervention in cognitive improvement in patients with AD, including aerobic exercise, resistance exercise, and multi-component exercise. Consequently, the purpose of this review is to summarize the findings of the mechanisms of exercise intervention on cognitive function in patients with AD, and also discuss the application of different exercise interventions in cognitive impairment in AD to provide a theoretical basis and reference for the selection of exercise intervention in cognitive rehabilitation in AD.
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Affiliation(s)
- Man Wang
- Department of Rehabilitation Medicine, Huashan Hospital, Fudan University, No. 12 Middle Wulumuqi Road, Jing'an District, Shanghai 200040, China
- Department of Rehabilitation Medicine, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 200233, China
| | - Yan Hua
- Department of Rehabilitation Medicine, Huashan Hospital, Fudan University, No. 12 Middle Wulumuqi Road, Jing'an District, Shanghai 200040, China
| | - Yulong Bai
- Department of Rehabilitation Medicine, Huashan Hospital, Fudan University, No. 12 Middle Wulumuqi Road, Jing'an District, Shanghai 200040, China
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Xu Q, Kim Y, Chung K, Schulz P, Gottlieb A. Prediction of Mild Cognitive Impairment Status: Pilot Study of Machine Learning Models Based on Longitudinal Data From Fitness Trackers. JMIR Form Res 2024; 8:e55575. [PMID: 39024003 PMCID: PMC11294783 DOI: 10.2196/55575] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2023] [Revised: 02/15/2024] [Accepted: 06/08/2024] [Indexed: 07/20/2024] Open
Abstract
BACKGROUND Early signs of Alzheimer disease (AD) are difficult to detect, causing diagnoses to be significantly delayed to time points when brain damage has already occurred and current experimental treatments have little effect on slowing disease progression. Tracking cognitive decline at early stages is critical for patients to make lifestyle changes and consider new and experimental therapies. Frequently studied biomarkers are invasive and costly and are limited for predicting conversion from normal to mild cognitive impairment (MCI). OBJECTIVE This study aimed to use data collected from fitness trackers to predict MCI status. METHODS In this pilot study, fitness trackers were worn by 20 participants: 12 patients with MCI and 8 age-matched controls. We collected physical activity, heart rate, and sleep data from each participant for up to 1 month and further developed a machine learning model to predict MCI status. RESULTS Our machine learning model was able to perfectly separate between MCI and controls (area under the curve=1.0). The top predictive features from the model included peak, cardio, and fat burn heart rate zones; resting heart rate; average deep sleep time; and total light activity time. CONCLUSIONS Our results suggest that a longitudinal digital biomarker differentiates between controls and patients with MCI in a very cost-effective and noninvasive way and hence may be very useful for identifying patients with very early AD who can benefit from clinical trials and new, disease-modifying therapies.
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Affiliation(s)
- Qidi Xu
- McWilliams School of Biomedical Informatics, University of Texas Health Science Center at Houston, Houston, TX, United States
| | - Yejin Kim
- McWilliams School of Biomedical Informatics, University of Texas Health Science Center at Houston, Houston, TX, United States
| | - Karen Chung
- McGovern Medical School, University of Texas Health Science Center at Houston, Houston, TX, United States
| | - Paul Schulz
- McGovern Medical School, University of Texas Health Science Center at Houston, Houston, TX, United States
| | - Assaf Gottlieb
- McWilliams School of Biomedical Informatics, University of Texas Health Science Center at Houston, Houston, TX, United States
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12
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Stankeviciute L, Chhatwal JP, Levin R, Pinilla V, Schultz AP, Redline S, Johnson KA, Sperling RA, Kozhemiako N, Purcell S, Djonlagic I. Amyloid beta-independent sleep markers associated with early regional tau burden and cortical thinning. ALZHEIMER'S & DEMENTIA (AMSTERDAM, NETHERLANDS) 2024; 16:e12616. [PMID: 39077684 PMCID: PMC11284643 DOI: 10.1002/dad2.12616] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/26/2024] [Revised: 04/26/2024] [Accepted: 04/28/2024] [Indexed: 07/31/2024]
Abstract
INTRODUCTION Sleep is crucial for memory consolidation and the clearance of toxic proteins associated with Alzheimer's disease (AD). We examined the association between sleep characteristics and imaging biomarkers of early amyloid beta (Aβ) and tau pathology as well as neurodegeneration in brain regions known to be affected in the incipient stages of AD. METHODS Thirty-nine cognitively unimpaired (CU) participants of the Harvard Aging Brain Study underwent at-home polysomnography as well as tau positron emission tomography (flortaucipir-PET), amyloid PET (Pittsburgh compound B [PiB]-PET), and magnetic resonance imaging-derived assessment of cortical thickness (CT). RESULTS Increased N1 sleep was associated with a higher tau PET signal (β = 0.009, p = 0.001) and lower CT in the temporal composite region of interest (β = -0.017, p = 0.007). Decreased slow-wave sleep (SWS) was associated with higher tau burden in the temporal composite (β = -0.008, p = 0.005) and lower CT (β = 0.008, p = 0.002), even after controlling for global PiB-PET. DISCUSSION In CU older adults, lower SWS and higher N1 sleep were associated with higher tau burden and lower CT in brain regions associated with early tau deposition and vulnerable to AD-related neurodegeneration through mechanisms dissociable from amyloid deposition. Highlights We report the results of an observational study, which leveraged -a well-characterized cohort of healthy aging (Harvard Aging Brain Study) by adding in-home full polysomnograms.By adding at-home polysomnograms to this unique and deeply phenotyped cohort, we examined variations in sleep architecture that are associated with Alzheimer's disease (AD) pathologic changes.Our results confirmed the association of sleep changes with early tau and cortical neurodegenerative changes that were independent of amyloid.The results will be of importance in monitoring sleep-related variations in relation to the natural history of AD pathology and in designing sleep-focused clinical trials.
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Affiliation(s)
- Laura Stankeviciute
- Department of NeurologyBrigham and Women's HospitalBostonMassachusettsUSA
- Barcelonaβeta Brain Research Center (BBRC)Pasqual Maragall FoundationBarcelonaSpain
| | - Jasmeer P. Chhatwal
- Department of NeurologyBrigham and Women's HospitalBostonMassachusettsUSA
- Massachusetts General HospitalBostonMassachusettsUSA
- Harvard Medical SchoolBostonMassachusettsUSA
| | - Raina Levin
- Massachusetts General HospitalBostonMassachusettsUSA
| | | | - Aaron P. Schultz
- Massachusetts General HospitalBostonMassachusettsUSA
- Harvard Medical SchoolBostonMassachusettsUSA
| | - Susan Redline
- Massachusetts General HospitalBostonMassachusettsUSA
- Harvard Medical SchoolBostonMassachusettsUSA
| | - Keith A. Johnson
- Department of NeurologyBrigham and Women's HospitalBostonMassachusettsUSA
- Massachusetts General HospitalBostonMassachusettsUSA
- Harvard Medical SchoolBostonMassachusettsUSA
| | - Reisa A. Sperling
- Department of NeurologyBrigham and Women's HospitalBostonMassachusettsUSA
- Massachusetts General HospitalBostonMassachusettsUSA
- Harvard Medical SchoolBostonMassachusettsUSA
| | - Nataliia Kozhemiako
- Department of NeurologyBrigham and Women's HospitalBostonMassachusettsUSA
- Harvard Medical SchoolBostonMassachusettsUSA
| | - Shaun Purcell
- Department of NeurologyBrigham and Women's HospitalBostonMassachusettsUSA
- Harvard Medical SchoolBostonMassachusettsUSA
| | - Ina Djonlagic
- Department of NeurologyBrigham and Women's HospitalBostonMassachusettsUSA
- Harvard Medical SchoolBostonMassachusettsUSA
- Beth Israel Deaconess Medical CenterBostonMassachusettsUSA
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Mullins AE, Pehel S, Parekh A, Kam K, Bubu OM, Tolbert TM, Rapoport DM, Ayappa I, Varga AW, Osorio RS. The stability of slow-wave sleep and EEG oscillations across two consecutive nights of laboratory polysomnography in cognitively normal older adults. J Sleep Res 2024:e14281. [PMID: 38937887 DOI: 10.1111/jsr.14281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2024] [Revised: 06/07/2024] [Accepted: 06/11/2024] [Indexed: 06/29/2024]
Abstract
Laboratory polysomnography provides gold-standard measures of sleep physiology, but multi-night investigations are resource intensive. We assessed the night-to-night stability via reproducibility metrics for sleep macrostructure and electroencephalography oscillations in a group of cognitively normal adults attending two consecutive polysomnographies. Electroencephalographies were analysed using an automatic algorithm for detection of slow-wave activity, spindle and K-complex densities. Average differences between nights for sleep macrostructure, electroencephalography oscillations and sleep apnea severity were assessed, and test-retest reliability was determined using two-way intraclass correlations. Agreement was calculated using the smallest real differences between nights for all measures. Night 2 polysomnographies showed significantly greater time in bed, total sleep time (6.3 hr versus 6.8 hr, p < 0.001) and percentage of rapid eye movement sleep (17.5 versus 19.7, p < 0.001). Intraclass correlations were low for total sleep time, percentage of rapid eye movement sleep and sleep efficiency, moderate for percentage of slow-wave sleep and percentage of non-rapid eye movement 2 sleep, good for slow-wave activity and K-complex densities, and excellent for spindles and apnea-hypopnea index with hypopneas defined according to 4% oxygen desaturation criteria only. The smallest real difference values were proportionally high for most sleep macrostructure measures, indicating moderate agreement, and proportionally lower for most electroencephalography microstructure variables. Slow waves, K-complexes, spindles and apnea severity indices are highly reproducible across two consecutive nights of polysomnography. In contrast, sleep macrostructure measures all demonstrated poor reproducibility as indicated by low intraclass correlation values and moderate agreement. Although there were average differences in percentage of rapid eye movement sleep and total sleep time, these were numerically small and perhaps functionally or clinically less significant. One night of in-laboratory polysomnography is enough to provide stable, reproducible estimates of an individual's sleep concerning measures of slow-wave activity, spindles, K-complex densities and apnea severity.
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Affiliation(s)
- Anna E Mullins
- Mount Sinai Integrative Sleep Center, Division of Pulmonary, Critical Care, and Sleep Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Shayna Pehel
- Center for Sleep and Brain Health, Department of Psychiatry, NYU Grossman School of Medicine, New York, New York, USA
| | - Ankit Parekh
- Mount Sinai Integrative Sleep Center, Division of Pulmonary, Critical Care, and Sleep Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Korey Kam
- Mount Sinai Integrative Sleep Center, Division of Pulmonary, Critical Care, and Sleep Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Omonigho M Bubu
- Center for Sleep and Brain Health, Department of Psychiatry, NYU Grossman School of Medicine, New York, New York, USA
| | - Thomas M Tolbert
- Mount Sinai Integrative Sleep Center, Division of Pulmonary, Critical Care, and Sleep Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - David M Rapoport
- Mount Sinai Integrative Sleep Center, Division of Pulmonary, Critical Care, and Sleep Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Indu Ayappa
- Mount Sinai Integrative Sleep Center, Division of Pulmonary, Critical Care, and Sleep Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Andrew W Varga
- Mount Sinai Integrative Sleep Center, Division of Pulmonary, Critical Care, and Sleep Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Ricardo S Osorio
- Center for Sleep and Brain Health, Department of Psychiatry, NYU Grossman School of Medicine, New York, New York, USA
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Gaeta AM, Quijada-López M, Barbé F, Vaca R, Pujol M, Minguez O, Sánchez-de-la-Torre M, Muñoz-Barrutia A, Piñol-Ripoll G. Predicting Alzheimer's disease CSF core biomarkers: a multimodal Machine Learning approach. Front Aging Neurosci 2024; 16:1369545. [PMID: 38988328 PMCID: PMC11233742 DOI: 10.3389/fnagi.2024.1369545] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2024] [Accepted: 06/04/2024] [Indexed: 07/12/2024] Open
Abstract
Introduction Alzheimer's disease (AD) is a progressive neurodegenerative disorder. Current core cerebrospinal fluid (CSF) AD biomarkers, widely employed for diagnosis, require a lumbar puncture to be performed, making them impractical as screening tools. Considering the role of sleep disturbances in AD, recent research suggests quantitative sleep electroencephalography features as potential non-invasive biomarkers of AD pathology. However, quantitative analysis of comprehensive polysomnography (PSG) signals remains relatively understudied. PSG is a non-invasive test enabling qualitative and quantitative analysis of a wide range of parameters, offering additional insights alongside other biomarkers. Machine Learning (ML) gained interest for its ability to discern intricate patterns within complex datasets, offering promise in AD neuropathology detection. Therefore, this study aims to evaluate the effectiveness of a multimodal ML approach in predicting core AD CSF biomarkers. Methods Mild-moderate AD patients were prospectively recruited for PSG, followed by testing of CSF and blood samples for biomarkers. PSG signals underwent preprocessing to extract non-linear, time domain and frequency domain statistics quantitative features. Multiple ML algorithms were trained using four subsets of input features: clinical variables (CLINVAR), conventional PSG parameters (SLEEPVAR), quantitative PSG signal features (PSGVAR) and a combination of all subsets (ALL). Cross-validation techniques were employed to evaluate model performance and ensure generalizability. Regression models were developed to determine the most effective variable combinations for explaining variance in the biomarkers. Results On 49 subjects, Gradient Boosting Regressors achieved the best results in estimating biomarkers levels, using different loss functions for each biomarker: least absolute deviation (LAD) for the Aβ42, least squares (LS) for p-tau and Huber for t-tau. The ALL subset demonstrated the lowest training errors for all three biomarkers, albeit with varying test performance. Specifically, the SLEEPVAR subset yielded the best test performance in predicting Aβ42, while the ALL subset most accurately predicted p-tau and t-tau due to the lowest test errors. Conclusions Multimodal ML can help predict the outcome of CSF biomarkers in early AD by utilizing non-invasive and economically feasible variables. The integration of computational models into medical practice offers a promising tool for the screening of patients at risk of AD, potentially guiding clinical decisions.
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Affiliation(s)
- Anna Michela Gaeta
- Servicio de Neumología, Hospital Universitario Severo Ochoa, Leganés, Spain
| | - María Quijada-López
- Departamento de Bioingeniería, Universidad Carlos III de Madrid, Leganés, Spain
| | - Ferran Barbé
- Group of Translational Research in Respiratory Medicine, Hospital Universitari Arnau de Vilanova and Santa Maria, Institut de Recerca Biomedica de Lleida (IRBLleida), Lleida, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Madrid, Spain
| | - Rafaela Vaca
- Group of Translational Research in Respiratory Medicine, Hospital Universitari Arnau de Vilanova and Santa Maria, Institut de Recerca Biomedica de Lleida (IRBLleida), Lleida, Spain
| | - Montse Pujol
- Unitat Trastorns Cognitius, Clinical Neuroscience Research, Institut de Recerca Biomedica de Lleida (IRBLleida), Hospital Universitari Santa Maria, Lleida, Spain
| | - Olga Minguez
- Group of Translational Research in Respiratory Medicine, Hospital Universitari Arnau de Vilanova and Santa Maria, Institut de Recerca Biomedica de Lleida (IRBLleida), Lleida, Spain
| | - Manuel Sánchez-de-la-Torre
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Madrid, Spain
- Group of Precision Medicine in Chronic Diseases, Hospital Nacional de Parapléjicos, IDISCAM, Department of Nursing, Physiotherapy and Occupational Therapy, Faculty of Physiotherapy and Nursing, University of Castilla-La Mancha, Toledo, Spain
| | - Arrate Muñoz-Barrutia
- Departamento de Bioingeniería, Universidad Carlos III de Madrid, Leganés, Spain
- Departamento de Bioingegneria, Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
| | - Gerard Piñol-Ripoll
- Unitat Trastorns Cognitius, Clinical Neuroscience Research, Institut de Recerca Biomedica de Lleida (IRBLleida), Hospital Universitari Santa Maria, Lleida, Spain
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Wang J, Huffman D, Ajwad A, McLouth CJ, Bachstetter A, Kohler K, Murphy MP, O'Hara BF, Duncan MJ, Sunderam S. Thermoneutral temperature exposure enhances slow-wave sleep with a correlated improvement in amyloid pathology in a triple-transgenic mouse model of Alzheimer's disease. Sleep 2024; 47:zsae078. [PMID: 38512801 DOI: 10.1093/sleep/zsae078] [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: 08/02/2023] [Revised: 01/14/2024] [Indexed: 03/23/2024] Open
Abstract
Accumulation of amyloid-β (Aβ) plays an important role in Alzheimer's disease (AD) pathology. There is growing evidence that disordered sleep may accelerate AD pathology by impeding the physiological clearance of Aβ from the brain that occurs in normal sleep. Therapeutic strategies for improving sleep quality may therefore help slow disease progression. It is well documented that the composition and dynamics of sleep are sensitive to ambient temperature. We therefore compared Aβ pathology and sleep metrics derived from polysomnography in 12-month-old female 3xTg-AD mice (n = 8) exposed to thermoneutral temperatures during the light period over 4 weeks to those of age- and sex-matched controls (n = 8) that remained at normal housing temperature (22°C) during the same period. The treated group experienced greater proportions of slow wave sleep (SWS)-i.e. epochs of elevated 0.5-2 Hz EEG slow wave activity during non-rapid eye movement (NREM) sleep-compared to controls. Assays performed on mouse brain tissue harvested at the end of the experiment showed that exposure to thermoneutral temperatures significantly reduced levels of DEA-soluble (but not RIPA- or formic acid-soluble) Aβ40 and Aβ42 in the hippocampus, though not in the cortex. With both groups pooled together and without regard to treatment condition, NREM sleep continuity and any measure of SWS within NREM at the end of the treatment period were inversely correlated with DEA-soluble Aβ40 and Aβ42 levels, again in the hippocampus but not in the cortex. These findings suggest that experimental manipulation of SWS could offer useful clues into the mechanisms and treatment of AD.
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Affiliation(s)
- Jun Wang
- F. Joseph Halcomb III, MD, Department of Biomedical Engineering, University of Kentucky, Lexington, KY, USA
| | - Dillon Huffman
- F. Joseph Halcomb III, MD, Department of Biomedical Engineering, University of Kentucky, Lexington, KY, USA
| | - Asma'a Ajwad
- F. Joseph Halcomb III, MD, Department of Biomedical Engineering, University of Kentucky, Lexington, KY, USA
- Department of Physiology, University of Diyala College of Medicine, Diyala, Iraq
| | | | - Adam Bachstetter
- Department of Neuroscience, University of Kentucky, Lexington, KY, USA
| | - Katarina Kohler
- Department of Molecular and Cellular Biochemistry, University of Kentucky, Lexington, KY, USA
| | - M Paul Murphy
- Department of Molecular and Cellular Biochemistry, University of Kentucky, Lexington, KY, USA
| | - Bruce F O'Hara
- Department of Biology, University of Kentucky, Lexington, KY, USA
| | - Marilyn J Duncan
- Department of Neuroscience, University of Kentucky, Lexington, KY, USA
| | - Sridhar Sunderam
- F. Joseph Halcomb III, MD, Department of Biomedical Engineering, University of Kentucky, Lexington, KY, USA
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Elliott JE, Ligman BR, Bryant-Ekstrand MD, Keil AT, Powers K, Olivo C, Neilson LE, Postuma RB, Pelletier A, Gagnon JF, Gan-Or Z, Yu E, Liu L, St Louis EK, Forsberg LK, Fields JA, Ross OA, Huddleston DE, Bliwise DL, Avidan AY, Howell MJ, Schenck CH, McLeland J, Criswell SR, Videnovic A, During EH, Miglis MG, Shprecher DR, Lee-Iannotti JK, Boeve BF, Ju YES, Lim MM. Comorbid neurotrauma increases neurodegenerative-relevant cognitive, motor, and autonomic dysfunction in patients with rapid eye movement sleep behavior disorder: a substudy of the North American Prodromal Synucleinopathy Consortium. Sleep 2024; 47:zsae007. [PMID: 38181205 DOI: 10.1093/sleep/zsae007] [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: 10/11/2023] [Revised: 12/13/2023] [Indexed: 01/07/2024] Open
Abstract
STUDY OBJECTIVES Rapid eye movement sleep behavior disorder (RBD) is strongly associated with phenoconversion to an overt synucleinopathy, e.g. Parkinson's disease (PD), Lewy body dementia, and related disorders. Comorbid traumatic brain injury (TBI) and posttraumatic stress disorder (PTSD)-henceforth "neurotrauma" (NT)-increase the odds of RBD by ~2.5-fold and are associated with an increased rate of service-connected PD in Veterans. Thus, RBD and NT are both independently associated with PD; however, it is unclear how NT influences neurological function in patients with RBD. METHODS Participants ≥18 years with overnight polysomnogram-confirmed RBD were enrolled between 8/2018 to 4/2021 through the North American Prodromal Synucleinopathy Consortium. Standardized assessments for RBD, TBI, and PTSD history, as well as cognitive, motor, sensory, and autonomic function, were completed. This cross-sectional analysis compared cases (n = 24; RBD + NT) to controls (n = 96; RBD), matched for age (~60 years), sex (15% female), and years of education (~15 years). RESULTS RBD + NT reported earlier RBD symptom onset (37.5 ± 11.9 vs. 52.2 ± 15.1 years of age) and a more severe RBD phenotype. Similarly, RBD + NT reported more severe anxiety and depression, greater frequency of hypertension, and significantly worse cognitive, motor, and autonomic function compared to RBD. No differences in olfaction or color vision were observed. CONCLUSIONS This cross-sectional, matched case:control study shows individuals with RBD + NT have significantly worse neurological measures related to common features of an overt synucleinopathy. Confirmatory longitudinal studies are ongoing; however, these results suggest RBD + NT may be associated with more advanced neurological symptoms related to an evolving neurodegenerative process.
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Affiliation(s)
- Jonathan E Elliott
- VA Portland Health Care System, Research Service, Portland, OR, USA
- Oregon Health and Science University, Department of Neurology, Portland, OR, USA
| | | | | | - Allison T Keil
- VA Portland Health Care System, Research Service, Portland, OR, USA
- McGill University, Montreal Neurological Institute and Department of Neurology and Neurosurgery, Montréal, QC, Canada
| | - Katherine Powers
- VA Portland Health Care System, Research Service, Portland, OR, USA
| | - Cosette Olivo
- VA Portland Health Care System, Research Service, Portland, OR, USA
| | - Lee E Neilson
- VA Portland Health Care System, Research Service, Portland, OR, USA
- Oregon Health and Science University, Department of Neurology, Portland, OR, USA
| | - Ronald B Postuma
- McGill University, Montreal Neurological Institute and Department of Neurology and Neurosurgery, Montréal, QC, Canada
- Université du Québec à Montréal, Département of Psychology, Montréal, QC, Canada
- Hôpital du Sacré-Coeur de Montréal, Center for Advanced Research in Sleep Medicine, Montréal, QC, Canada
- Research Institute of the McGill University Health Centre, Montreal, QC, Canada
| | - Amélie Pelletier
- Hôpital du Sacré-Coeur de Montréal, Center for Advanced Research in Sleep Medicine, Montréal, QC, Canada
- Research Institute of the McGill University Health Centre, Montreal, QC, Canada
| | - Jean-François Gagnon
- Université du Québec à Montréal, Département of Psychology, Montréal, QC, Canada
- Hôpital du Sacré-Coeur de Montréal, Center for Advanced Research in Sleep Medicine, Montréal, QC, Canada
| | - Ziv Gan-Or
- McGill University, Montreal Neurological Institute and Department of Neurology and Neurosurgery, Montréal, QC, Canada
- McGill University, Department of Human Genetics, Montréal, QC, Canada
| | - Eric Yu
- McGill University, Montreal Neurological Institute and Department of Neurology and Neurosurgery, Montréal, QC, Canada
- McGill University, Department of Human Genetics, Montréal, QC, Canada
| | - Lang Liu
- McGill University, Montreal Neurological Institute and Department of Neurology and Neurosurgery, Montréal, QC, Canada
- McGill University, Department of Human Genetics, Montréal, QC, Canada
| | | | | | | | - Owen A Ross
- Mayo Clinic, Neurology and Medicine, Rochester, MN, USA
| | | | | | - Alon Y Avidan
- University of California Los Angeles, Neurology, Sleep Disorders Center, Los Angeles, CA, USA
| | - Michael J Howell
- University of Minnesota Medical Center, Department of Neurology, Minneapolis, MN, USA
- Hennepin County Medical Center, Minnesota Regional Sleep Disorders Center, Minneapolis, MN, USA
| | - Carlos H Schenck
- University of Minnesota Medical Center, Department of Neurology, Minneapolis, MN, USA
| | - Jennifer McLeland
- Washington University School of Medicine, Department of Neurology, Saint Louis, MO, USA
| | | | - Aleksandar Videnovic
- Massachusetts General Hospital, Movement Disorders Unit, Division of Sleep Medicine, Boston, MA, USA
- Harvard Medical School, Neurological Clinical Research Institute, Boston, MA, USA
| | - Emmanuel H During
- Stanford University, Psychiatry and Behavioral Sciences, Redwood City, CA, USA
- Stanford University, Neurology and Neurological Sciences, Palo Alto, CA, USA
- Mt Sinai School of Medicine, Department of Neurology, New York, NY, USA
| | - Mitchell G Miglis
- Stanford University, Psychiatry and Behavioral Sciences, Redwood City, CA, USA
- Stanford University, Neurology and Neurological Sciences, Palo Alto, CA, USA
| | - David R Shprecher
- Banner University Medical Center, Department of Neurology, Phoenix, AZ, USA
| | | | - Bradley F Boeve
- Mayo Clinic, Neurology and Medicine, Rochester, MN, USA
- NAPS Consortium Co-principal Investigators
| | - Yo-El S Ju
- Washington University School of Medicine, Department of Neurology, Saint Louis, MO, USA
- NAPS Consortium Co-principal Investigators
| | - Miranda M Lim
- Oregon Health and Science University, Department of Neurology, Portland, OR, USA
- Oregon Health and Science University, Department of Behavioral Neuroscience; Department of Pulmonary and Critical Care Medicine; Oregon Institute of Occupational Health Sciences, Portland, OR, USA
- VA Portland Health Care System, Mental Illness Research Education and Clinical Center; Neurology; National Center for Rehabilitative Auditory Research, Portland, OR, USA
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Ourry V, Binette AP, St-Onge F, Strikwerda-Brown C, Chagnot A, Poirier J, Breitner J, Arenaza-Urquijo EM, Rabin JS, Buckley R, Gonneaud J, Marchant NL, Villeneuve S. How Do Modifiable Risk Factors Affect Alzheimer's Disease Pathology or Mitigate Its Effect on Clinical Symptom Expression? Biol Psychiatry 2024; 95:1006-1019. [PMID: 37689129 DOI: 10.1016/j.biopsych.2023.09.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Revised: 08/11/2023] [Accepted: 09/03/2023] [Indexed: 09/11/2023]
Abstract
Epidemiological studies show that modifiable risk factors account for approximately 40% of the population variability in risk of developing dementia, including sporadic Alzheimer's disease (AD). Recent findings suggest that these factors may also modify disease trajectories of people with autosomal-dominant AD. With positron emission tomography imaging, it is now possible to study the disease many years before its clinical onset. Such studies can provide key knowledge regarding pathways for either the prevention of pathology or the postponement of its clinical expression. The former "resistance pathway" suggests that modifiable risk factors could affect amyloid and tau burden decades before the appearance of cognitive impairment. Alternatively, the resilience pathway suggests that modifiable risk factors may mitigate the symptomatic expression of AD pathology on cognition. These pathways are not mutually exclusive and may appear at different disease stages. Here, in a narrative review, we present neuroimaging evidence that supports both pathways in sporadic AD and autosomal-dominant AD. We then propose mechanisms for their protective effect. Among possible mechanisms, we examine neural and vascular mechanisms for the resistance pathway. We also describe brain maintenance and functional compensation as bases for the resilience pathway. Improved mechanistic understanding of both pathways may suggest new interventions.
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Affiliation(s)
- Valentin Ourry
- Department of Psychiatry, Faculty of Medicine, McGill University, Montreal, Quebec, Canada; Douglas Mental Health University Institute, Montreal, Quebec, Canada.
| | - Alexa Pichet Binette
- Department of Psychiatry, Faculty of Medicine, McGill University, Montreal, Quebec, Canada; Douglas Mental Health University Institute, Montreal, Quebec, Canada; Clinical Memory Research Unit, Department of Clinical Sciences, Lunds Universitet, Malmö, Sweden
| | - Frédéric St-Onge
- Department of Psychiatry, Faculty of Medicine, McGill University, Montreal, Quebec, Canada; Douglas Mental Health University Institute, Montreal, Quebec, Canada; Integrated Program in Neuroscience, Faculty of Medicine, McGill University, Montreal, Quebec, Canada
| | - Cherie Strikwerda-Brown
- Department of Psychiatry, Faculty of Medicine, McGill University, Montreal, Quebec, Canada; Douglas Mental Health University Institute, Montreal, Quebec, Canada; School of Psychological Science, The University of Western Australia, Perth, Western Australia, Australia
| | - Audrey Chagnot
- UK Dementia Research Institute, Edinburgh Medical School, University of Edinburgh, Edinburgh, United Kingdom; Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, United Kingdom
| | - Judes Poirier
- Department of Psychiatry, Faculty of Medicine, McGill University, Montreal, Quebec, Canada; Douglas Mental Health University Institute, Montreal, Quebec, Canada
| | - John Breitner
- Department of Psychiatry, Faculty of Medicine, McGill University, Montreal, Quebec, Canada; Douglas Mental Health University Institute, Montreal, Quebec, Canada
| | - Eider M Arenaza-Urquijo
- Environment and Health over the Lifecourse Programme, Barcelona Institute for Global Health (ISGlobal), Barcelona, Spain; Department of Radiology, Mayo Clinic, Rochester, Minnesota
| | - Jennifer S Rabin
- Division of Neurology, Department of Medicine, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada; Harquail Centre for Neuromodulation, Hurvitz Brain Sciences Program, Sunnybrook Research Institute, University of Toronto, Toronto, Ontario, Canada; Rehabilitation Sciences Institute, University of Toronto, Toronto, Ontario, Canada
| | - Rachel Buckley
- Melbourne School of Psychological Sciences University of Melbourne, Parkville, Victoria, Australia; Department of Neurology, Massachusetts General Hospital, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts; Center for Alzheimer Research and Treatment, Department of Neurology, Brigham and Women's Hospital, Boston, Massachusetts
| | - Julie Gonneaud
- Normandie University, UNICAEN, INSERM, U1237, PhIND "Physiopathology and Imaging of Neurological Disorders," Institut Blood and Brain @ Caen-Normandie, GIP Cyceron, Caen, France
| | - Natalie L Marchant
- Division of Psychiatry, University College London, London, United Kingdom
| | - Sylvia Villeneuve
- Department of Psychiatry, Faculty of Medicine, McGill University, Montreal, Quebec, Canada; Douglas Mental Health University Institute, Montreal, Quebec, Canada; McConnell Brain Imaging Center, Montreal Neurological Institute, McGill University, Montreal, Quebec, Canada.
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18
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Rios RL, Green M, Smith SK, Kafashan M, Ching S, Farber NB, Lin N, Lucey BP, Reynolds CF, Lenze EJ, Palanca BJA. Propofol enhancement of slow wave sleep to target the nexus of geriatric depression and cognitive dysfunction: protocol for a phase I open label trial. BMJ Open 2024; 14:e087516. [PMID: 38816055 PMCID: PMC11138309 DOI: 10.1136/bmjopen-2024-087516] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2024] [Accepted: 04/26/2024] [Indexed: 06/01/2024] Open
Abstract
INTRODUCTION Late-life treatment-resistant depression (LL-TRD) is common and increases risk for accelerated ageing and cognitive decline. Impaired sleep is common in LL-TRD and is a risk factor for cognitive decline. Slow wave sleep (SWS) has been implicated in key processes including synaptic plasticity and memory. A deficiency in SWS may be a core component of depression pathophysiology. The anaesthetic propofol can induce electroencephalographic (EEG) slow waves that resemble SWS. Propofol may enhance SWS and oral antidepressant therapy, but relationships are unclear. We hypothesise that propofol infusions will enhance SWS and improve depression in older adults with LL-TRD. This hypothesis has been supported by a recent small case series. METHODS AND ANALYSIS SWIPED (Slow Wave Induction by Propofol to Eliminate Depression) phase I is an ongoing open-label, single-arm trial that assesses the safety and feasibility of using propofol to enhance SWS in older adults with LL-TRD. The study is enrolling 15 English-speaking adults over age 60 with LL-TRD. Participants will receive two propofol infusions 2-6 days apart. Propofol infusions are individually titrated to maximise the expression of EEG slow waves. Preinfusion and postinfusion sleep architecture are evaluated through at-home overnight EEG recordings acquired using a wireless headband equipped with dry electrodes. Sleep EEG recordings are scored manually. Key EEG measures include sleep slow wave activity, SWS duration and delta sleep ratio. Longitudinal changes in depression, suicidality and anhedonia are assessed. Assessments are performed prior to the first infusion and up to 10 weeks after the second infusion. Cognitive ability is assessed at enrolment and approximately 3 weeks after the second infusion. ETHICS AND DISSEMINATION The study was approved by the Washington University Human Research Protection Office. Recruitment began in November 2022. Dissemination plans include presentations at scientific conferences, peer-reviewed publications and mass media. Positive results will lead to a larger phase II randomised placebo-controlled trial. TRIAL REGISTRATION NUMBER NCT04680910.
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Affiliation(s)
- Rachel Lynn Rios
- Department of Anesthesiology, Washington University School of Medicine in St. Louis, St Louis, Missouri, USA
| | - Michael Green
- Department of Anesthesiology, Washington University School of Medicine in St. Louis, St Louis, Missouri, USA
| | - S Kendall Smith
- Department of Anesthesiology, Washington University School of Medicine in St. Louis, St Louis, Missouri, USA
- Center on Biological Rhythms and Sleep, Washington University School of Medicine in St. Louis, St. Louis, Missouri, USA
| | - MohammadMehdi Kafashan
- Department of Anesthesiology, Washington University School of Medicine in St. Louis, St Louis, Missouri, USA
- Center on Biological Rhythms and Sleep, Washington University School of Medicine in St. Louis, St. Louis, Missouri, USA
| | - ShiNung Ching
- Department of Electrical & Systems Engineering, Washington University in St. Louis, St Louis, Missouri, USA
| | - Nuri B Farber
- Department of Psychiatry, Washington University School of Medicine in St. Louis, St Louis, Missouri, USA
| | - Nan Lin
- Department of Biostatistics and Data Science, Washington University in St Louis, St Louis, Missouri, USA
| | - Brendan P Lucey
- Center on Biological Rhythms and Sleep, Washington University School of Medicine in St. Louis, St. Louis, Missouri, USA
- Department of Neurology, Washington University School of Medicine in St. Louis, St. Louis, Missouri, USA
| | - Charles F Reynolds
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Eric J Lenze
- Department of Anesthesiology, Washington University School of Medicine in St. Louis, St Louis, Missouri, USA
- Department of Psychiatry, Washington University School of Medicine in St. Louis, St Louis, Missouri, USA
| | - Ben Julian Agustin Palanca
- Department of Anesthesiology, Washington University School of Medicine in St. Louis, St Louis, Missouri, USA
- Center on Biological Rhythms and Sleep, Washington University School of Medicine in St. Louis, St. Louis, Missouri, USA
- Department of Psychiatry, Washington University School of Medicine in St. Louis, St Louis, Missouri, USA
- Division of Biology and Biomedical Sciences, Washington University School of Medicine in St. Louis, St. Louis, Missouri, USA
- Department of Biomedical Engineering, Washington University in St. Louis, St. Louis, Missouri, USA
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19
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Ouyang M, Chen T, Chen J, Liu C, Luo H, Yang S, Liao W. The association between sleep duration, bedtime, and cognitive ability in Chinese adults: Evidence from the China family panel studies. Heliyon 2024; 10:e30009. [PMID: 38737242 PMCID: PMC11088265 DOI: 10.1016/j.heliyon.2024.e30009] [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: 11/18/2023] [Revised: 04/09/2024] [Accepted: 04/18/2024] [Indexed: 05/14/2024] Open
Abstract
Introduction Dementia is marked by a steady decline or worsening in cognitive abilities, affecting memory, logic, and social competencies. While many studies suggest a potential link between the amount of sleep and dementia risk, the outcomes are not yet consistent. This research delved into the relationship between sleep length and bedtime on cognitive abilities using an extensive dataset from the China Family Panel Studies (CFPS) from 2014 to 2020. Methods Data from 175,702 observations were collected, including cognitive function test data from 22,848 participants. Various cognitive tests were used to assess cognitive function. Restricted cubic spline (RCS) models were used for data analysis. Results The optimal sleep duration for cognitive function was found to be 6-7 h, and the optimal bedtime was generally between 22:00-23:00. Longitudinal analysis revealed that sleep duration four years prior had a significant impact on current cognitive function. After accounting for various factors, those who slept for 7-8 h and over 8 h displayed lower cognitive function scores. Conversely, individuals sleeping less than 6 h had higher scores on the Vocabulary Test. Bedtime before 22:00 was associated with lower scores on the Vocabulary Test and Mathematical Test. Subgroup analyses based on age, gender, and urban residence showed variations in optimal sleep duration for different populations. Propensity Score Matching (PSM) analysis supported the findings. Conclusions Maintaining a sleep duration of 6-7 h and a regular bedtime between 22:00-23:00 is important for optimizing cognitive performance.
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Affiliation(s)
- Mengqian Ouyang
- Department of Economics, Guangdong Institute of Public Administration, Guangzhou, China
| | - Tao Chen
- Structural Cardiology, Affiliated Hospital of Guangdong Medical University, Zhanjiang, China
| | - Jiawei Chen
- Department of Neurology, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Chongxu Liu
- Department of Neurology, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Haoyu Luo
- Department of Neurology, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Shaoqing Yang
- Department of Neurology, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Wang Liao
- Department of Neurology, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
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20
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Pierson SR, Kolling LJ, James TD, Pushpavathi SG, Marcinkiewcz CA. Serotonergic dysfunction may mediate the relationship between alcohol consumption and Alzheimer's disease. Pharmacol Res 2024; 203:107171. [PMID: 38599469 PMCID: PMC11088857 DOI: 10.1016/j.phrs.2024.107171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Revised: 03/14/2024] [Accepted: 04/02/2024] [Indexed: 04/12/2024]
Abstract
The impact of Alzheimer's disease (AD) and its related dementias is rapidly expanding, and its mitigation remains an urgent social and technical challenge. To date there are no effective treatments or interventions for AD, but recent studies suggest that alcohol consumption is correlated with the risk of developing dementia. In this review, we synthesize data from preclinical, clinical, and epidemiological models to evaluate the combined role of alcohol consumption and serotonergic dysfunction in AD, underscoring the need for further research on this topic. We first discuss the limitations inherent to current data-collection methods, and how neuropsychiatric symptoms common among AD, alcohol use disorder, and serotonergic dysfunction may mask their co-occurrence. We additionally describe how excess alcohol consumption may accelerate the development of AD via direct effects on serotonergic function, and we explore the roles of neuroinflammation and proteostasis in mediating the relationship between serotonin, alcohol consumption, and AD. Lastly, we argue for a shift in current research to disentangle the pathogenic effects of alcohol on early-affected brainstem structures in AD.
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Affiliation(s)
- Samantha R Pierson
- Department of Neuroscience and Pharmacology, University of Iowa, United States
| | - Louis J Kolling
- Department of Neuroscience and Pharmacology, University of Iowa, United States
| | - Thomas D James
- Department of Neuroscience and Pharmacology, University of Iowa, United States
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21
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Sauers SC, Toedebusch CD, Richardson R, Spira AP, Morris JC, Holtzman DM, Lucey BP. Midpoint of sleep is associated with sleep quality in older adults with and without symptomatic Alzheimer's disease. SLEEP ADVANCES : A JOURNAL OF THE SLEEP RESEARCH SOCIETY 2024; 5:zpae023. [PMID: 38711547 PMCID: PMC11071685 DOI: 10.1093/sleepadvances/zpae023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Revised: 03/27/2024] [Indexed: 05/08/2024]
Abstract
Introduction Disrupted sleep is common in individuals with Alzheimer's disease (AD) and may be a marker for AD risk. The timing of sleep affects sleep-wake activity and is also associated with AD, but little is known about links between sleep architecture and the midpoint of sleep in older adults. In this study, we tested if the midpoint of sleep is associated with different measures of sleep architecture, AD biomarkers, and cognitive status among older adults with and without symptomatic AD. Methods Participants (N = 243) with a mean age of 74 underwent standardized cognitive assessments, measurement of CSF AD biomarkers, and sleep monitoring via single-channel EEG, actigraphy, a home sleep apnea test, and self-reported sleep logs. The midpoint of sleep was defined by actigraphy. Results A later midpoint of sleep was associated with African-American race and greater night-to-night variability in the sleep midpoint. After adjusting for multiple potential confounding factors, a later sleep midpoint was associated with longer rapid-eye movement (REM) onset latency, decreased REM sleep time, more actigraphic awakenings at night, and higher < 2 Hz non-REM slow-wave activity. Conclusions Noninvasive in vivo markers of brain function, such as sleep, are needed to track both future risk of cognitive impairment and response to interventions in older adults at risk for AD. Sleep timing is associated with multiple other sleep measures and may affect their utility as markers of AD. The midpoint of sleep may be changed through behavioral intervention and should be taken into account when using sleep as a marker for AD risk.
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Affiliation(s)
- Scott C Sauers
- Department of Neurology, Washington University School of Medicine, St Louis, MO, USA
| | - Cristina D Toedebusch
- Department of Neurology, Washington University School of Medicine, St Louis, MO, USA
| | - Rachel Richardson
- Department of Neurology, Washington University School of Medicine, St Louis, MO, USA
| | - Adam P Spira
- Department of Mental Health, The Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
- Department of Psychiatry and Behavioral Sciences, The Johns Hopkins School of Medicine, Baltimore, MD, USA
- The Johns Hopkins Center on Aging and Health, Baltimore, MD, USA
| | - John C Morris
- Department of Neurology, Washington University School of Medicine, St Louis, MO, USA
- Knight Alzheimer Disease Research Center, Washington University School of Medicine, St Louis, MO, USA
| | - David M Holtzman
- Department of Neurology, Washington University School of Medicine, St Louis, MO, USA
- Knight Alzheimer Disease Research Center, Washington University School of Medicine, St Louis, MO, USA
- Center on Biological Rhythms and Sleep, Washington University School of Medicine, St Louis, MO, USA
- Hope Center for Neurological Disorders, Washington University School of Medicine, St Louis, MO, USA
| | - Brendan P Lucey
- Department of Neurology, Washington University School of Medicine, St Louis, MO, USA
- Center on Biological Rhythms and Sleep, Washington University School of Medicine, St Louis, MO, USA
- Hope Center for Neurological Disorders, Washington University School of Medicine, St Louis, MO, USA
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22
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Champetier P, André C, Rehel S, Ourry V, Landeau B, Mézenge F, Roquet D, Vivien D, de La Sayette V, Chételat G, Rauchs G. Multimodal neuroimaging correlates of spectral power in NREM sleep delta sub-bands in cognitively unimpaired older adults. Sleep 2024; 47:zsae012. [PMID: 38227830 PMCID: PMC11009032 DOI: 10.1093/sleep/zsae012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Revised: 11/27/2023] [Indexed: 01/18/2024] Open
Abstract
STUDY OBJECTIVES In aging, reduced delta power (0.5-4 Hz) during N2 and N3 sleep has been associated with gray matter (GM) atrophy and hypometabolism within frontal regions. Some studies have also reported associations between N2 and N3 sleep delta power in specific sub-bands and amyloid pathology. Our objective was to better understand the relationships between spectral power in delta sub-bands during N2-N3 sleep and brain integrity using multimodal neuroimaging. METHODS In-home polysomnography was performed in 127 cognitively unimpaired older adults (mean age ± SD: 69.0 ± 3.8 years). N2-N3 sleep EEG power was calculated in delta (0.5-4 Hz), slow delta (0.5-1 Hz), and fast delta (1-4 Hz) frequency bands. Participants also underwent magnetic resonance imaging and Florbetapir-PET (early and late acquisitions) scans to assess GM volume, brain perfusion, and amyloid burden. Amyloid accumulation over ~21 months was also quantified. RESULTS Higher delta power was associated with higher GM volume mainly in fronto-cingular regions. Specifically, slow delta power was positively correlated with GM volume and perfusion in these regions, while the inverse association was observed with fast delta power. Delta power was neither associated with amyloid burden at baseline nor its accumulation over time, whatever the frequency band considered. CONCLUSIONS Our results show that slow delta is particularly associated with preserved brain structure, and highlight the importance of analyzing delta power sub-bands to better understand the associations between delta power and brain integrity. Further longitudinal investigations with long follow-ups are needed to disentangle the associations among sleep, amyloid pathology, and dementia risk in older populations. CLINICAL TRIAL INFORMATION Name: Study in Cognitively Intact Seniors Aiming to Assess the Effects of Meditation Training (Age-Well). URL: https://clinicaltrials.gov/ct2/show/NCT02977819?term=Age-Well&draw=2&rank=1. See STROBE_statement_AGEWELL in supplemental materials. REGISTRATION EudraCT: 2016-002441-36; IDRCB: 2016-A01767-44; ClinicalTrials.gov Identifier: NCT02977819.
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Affiliation(s)
- Pierre Champetier
- Normandie Univ, UNICAEN, INSERM, U1237, PhIND “Physiopathology and Imaging of Neurological Disorders,” NeuroPresage Team, Institut Blood and Brain @ Caen-Normandie, GIP Cyceron, 14000 Caen, France
- Normandie Univ, UNICAEN, PSL Université, EPHE, INSERM, U1077, CHU de Caen, GIP Cyceron, NIMH, 14000 Caen, France
| | - Claire André
- Normandie Univ, UNICAEN, INSERM, U1237, PhIND “Physiopathology and Imaging of Neurological Disorders,” NeuroPresage Team, Institut Blood and Brain @ Caen-Normandie, GIP Cyceron, 14000 Caen, France
| | - Stéphane Rehel
- Normandie Univ, UNICAEN, INSERM, U1237, PhIND “Physiopathology and Imaging of Neurological Disorders,” NeuroPresage Team, Institut Blood and Brain @ Caen-Normandie, GIP Cyceron, 14000 Caen, France
- Normandie Univ, UNICAEN, PSL Université, EPHE, INSERM, U1077, CHU de Caen, GIP Cyceron, NIMH, 14000 Caen, France
| | - Valentin Ourry
- Normandie Univ, UNICAEN, INSERM, U1237, PhIND “Physiopathology and Imaging of Neurological Disorders,” NeuroPresage Team, Institut Blood and Brain @ Caen-Normandie, GIP Cyceron, 14000 Caen, France
- Normandie Univ, UNICAEN, PSL Université, EPHE, INSERM, U1077, CHU de Caen, GIP Cyceron, NIMH, 14000 Caen, France
| | - Brigitte Landeau
- Normandie Univ, UNICAEN, INSERM, U1237, PhIND “Physiopathology and Imaging of Neurological Disorders,” NeuroPresage Team, Institut Blood and Brain @ Caen-Normandie, GIP Cyceron, 14000 Caen, France
| | - Florence Mézenge
- Normandie Univ, UNICAEN, INSERM, U1237, PhIND “Physiopathology and Imaging of Neurological Disorders,” NeuroPresage Team, Institut Blood and Brain @ Caen-Normandie, GIP Cyceron, 14000 Caen, France
| | - Daniel Roquet
- Normandie Univ, UNICAEN, INSERM, U1237, PhIND “Physiopathology and Imaging of Neurological Disorders,” NeuroPresage Team, Institut Blood and Brain @ Caen-Normandie, GIP Cyceron, 14000 Caen, France
| | - Denis Vivien
- Normandie Univ, UNICAEN, INSERM, U1237, PhIND “Physiopathology and Imaging of Neurological Disorders,” NeuroPresage Team, Institut Blood and Brain @ Caen-Normandie, GIP Cyceron, 14000 Caen, France
- Département de Recherche Clinique, CHU Caen-Normandie, Caen, France
| | | | - Gaël Chételat
- Normandie Univ, UNICAEN, INSERM, U1237, PhIND “Physiopathology and Imaging of Neurological Disorders,” NeuroPresage Team, Institut Blood and Brain @ Caen-Normandie, GIP Cyceron, 14000 Caen, France
| | - Géraldine Rauchs
- Normandie Univ, UNICAEN, INSERM, U1237, PhIND “Physiopathology and Imaging of Neurological Disorders,” NeuroPresage Team, Institut Blood and Brain @ Caen-Normandie, GIP Cyceron, 14000 Caen, France
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Van Egroo M, van Someren EJW, Grinberg LT, Bennett DA, Jacobs HIL. Associations of 24-Hour Rest-Activity Rhythm Fragmentation, Cognitive Decline, and Postmortem Locus Coeruleus Hypopigmentation in Alzheimer's Disease. Ann Neurol 2024; 95:653-664. [PMID: 38407546 DOI: 10.1002/ana.26880] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Revised: 01/23/2024] [Accepted: 01/27/2024] [Indexed: 02/27/2024]
Abstract
OBJECTIVE While studies suggested that locus coeruleus (LC) neurodegeneration contributes to sleep-wake dysregulation in Alzheimer's disease (AD), the association between LC integrity and circadian rest-activity patterns remains unknown. Here, we investigated the relationships between 24-hour rest-activity rhythms, cognitive trajectories, and autopsy-derived LC integrity in older adults with and without cortical AD neuropathology. METHODS This retrospective study leveraged multi-modal data from participants of the longitudinal clinical-pathological Rush Memory and Aging Project. Indices of 24-hour rest-activity rhythm fragmentation (intradaily variability) and stability (interdaily stability) were extracted from annual actigraphic recordings, and cognitive trajectories were computed from annual cognitive evaluations. At autopsy, LC neurodegeneration was determined by the presence of hypopigmentation, and cortical AD neuropathology was assessed. Contributions of comorbid pathologies (Lewy bodies, cerebrovascular pathology) were evaluated. RESULTS Among the 388 cases included in the study sample (age at death = 92.1 ± 5.9 years; 273 women), 98 (25.3%) displayed LC hypopigmentation, and 251 (64.7%) exhibited cortical AD neuropathology. Logistic regression models showed that higher rest-activity rhythm fragmentation, measured up to ~7.1 years before death, was associated with increased risk to display LC neurodegeneration at autopsy (odds ratio [OR] = 1.46, 95% confidence interval [CI95%]: 1.16-1.84, pBONF = 0.004), particularly in individuals with cortical AD neuropathology (OR = 1.56, CI95%: 1.15-2.15, pBONF = 0.03) and independently of comorbid pathologies. In addition, longitudinal increases in rest-activity rhythm fragmentation partially mediated the association between LC neurodegeneration and cognitive decline (estimate = -0.011, CI95%: -0.023--0.002, pBONF = 0.03). INTERPRETATION These findings highlight the LC as a neurobiological correlate of sleep-wake dysregulation in AD, and further underscore the clinical relevance of monitoring rest-activity patterns for improved detection of at-risk individuals. ANN NEUROL 2024;95:653-664.
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Affiliation(s)
- Maxime Van Egroo
- Faculty of Health, Medicine and Life Sciences, School for Mental Health and Neuroscience, Alzheimer Centre Limburg, Maastricht University, Maastricht, The Netherlands
| | - Eus J W van Someren
- Department of Sleep and Cognition, Netherlands Institute for Neuroscience, Institute of the Royal Netherlands Academy of Arts and Sciences, Amsterdam, The Netherlands
- Department of Integrative Neurophysiology, Center for Neurogenomics and Cognitive Research, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Department of Psychiatry, Amsterdam UMC, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Lea T Grinberg
- Department of Pathology, LIM-22, University of São Paulo Medical School, São Paulo, Brazil
- Memory and Aging Center, Department of Neurology, and Pathology, University of California, San Francisco, California, USA
- Global Brain Health Institute, University of California, San Francisco, California, USA
| | - David A Bennett
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, Illinois, USA
- Department of Neurological Sciences, Rush University Medical Center, Chicago, Illinois, USA
| | - Heidi I L Jacobs
- Faculty of Health, Medicine and Life Sciences, School for Mental Health and Neuroscience, Alzheimer Centre Limburg, Maastricht University, Maastricht, The Netherlands
- Gordon Center for Medical Imaging, Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA
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Kim RT, Zhou L, Li Y, Krieger AC, Nordvig AS, Butler T, de Leon MJ, Chiang GC. Impaired sleep is associated with tau deposition on 18F-flortaucipir PET and accelerated cognitive decline, accounting for medications that affect sleep. J Neurol Sci 2024; 458:122927. [PMID: 38341949 PMCID: PMC10947806 DOI: 10.1016/j.jns.2024.122927] [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: 10/23/2023] [Revised: 01/06/2024] [Accepted: 02/06/2024] [Indexed: 02/13/2024]
Abstract
BACKGROUND Impaired sleep is commonly associated with Alzheimer's disease (AD), although the underlying mechanisms remain unclear. Furthermore, the moderating effects of sleep-affecting medications, which have been linked to AD pathology, are incompletely characterized. Using data from the Alzheimer's Disease Neuroimaging Initiative, we investigated whether a medical history of impaired sleep, informant-reported nighttime behaviors, and sleep-affecting medications are associated with beta-amyloid and tau deposition on PET and cognitive change, cross-sectionally and longitudinally. METHODS We included 964 subjects with 18F-florbetapir PET scans. Measures of sleep impairment and medication use were obtained from medical histories and the Neuropsychiatric Inventory Questionnaire. Multivariate models, adjusted for covariates, were used to assess associations among sleep-related features, beta-amyloid and tau, and cognition. Cortical tau deposition, categorized by Braak stage, was assessed using the standardized uptake value peak alignment (SUVP) method on 18F-flortaucipir PET. RESULTS Medical history of sleep impairment was associated with greater baseline tau in the meta-temporal, Braak 1, and Braak 4 regions (p = 0.04, p < 0.001, p = 0.025, respectively). Abnormal nighttime behaviors were also associated with greater baseline tau in the meta-temporal region (p = 0.024), and greater cognitive impairment, cross-sectionally (p = 0.007) and longitudinally (p < 0.001). Impaired sleep was not associated with baseline beta-amyloid (p > 0.05). Short-term use of selective serotonin reuptake inhibitors and benzodiazepines slightly weakened the sleep-tau relationship. CONCLUSIONS Sleep impairment was associated with tauopathy and cognitive decline, which could be linked to increased tau secretion from neuronal hyperactivity. Clinically, our results help identify high-risk individuals who could benefit from sleep-related interventions aimed to delay cognitive decline and AD.
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Affiliation(s)
- Ryan T Kim
- From the Department of Stem Cell and Regenerative Biology, Harvard University, Bauer-Sherman Fairchild Complex 7 Divinity Avenue, Cambridge, MA 02138, United States of America.
| | - Liangdong Zhou
- From the Department of Radiology, Brain Health Imaging Institute, Weill Cornell Medicine, NewYork-Presbyterian Hospital, 407 E 61(st) Street, New York, NY 10065, United States of America.
| | - Yi Li
- From the Department of Radiology, Brain Health Imaging Institute, Weill Cornell Medicine, NewYork-Presbyterian Hospital, 407 E 61(st) Street, New York, NY 10065, United States of America.
| | - Ana C Krieger
- From the Departments of Medicine and Neurology, Division of Sleep Neurology, Weill Cornell Medicine, NewYork-Presbyterian Hospital, 425 E 61st St., 5th Floor, New York, NY 10065, United States of America.
| | - Anna S Nordvig
- From the Department of Neurology, Alzheimer's Disease and Memory Disorders Program, Weill Cornell Medicine, NewYork-Presbyterian Hospital, 428 East 72(nd) Street Suite 500, New York, NY 10021, United States of America.
| | - Tracy Butler
- From the Department of Radiology, Brain Health Imaging Institute, Weill Cornell Medicine, NewYork-Presbyterian Hospital, 407 E 61(st) Street, New York, NY 10065, United States of America.
| | - Mony J de Leon
- From the Department of Radiology, Brain Health Imaging Institute, Weill Cornell Medicine, NewYork-Presbyterian Hospital, 407 E 61(st) Street, New York, NY 10065, United States of America.
| | - Gloria C Chiang
- From the Department of Radiology, Brain Health Imaging Institute, Weill Cornell Medicine, NewYork-Presbyterian Hospital, 407 E 61(st) Street, New York, NY 10065, United States of America; From the Department of Radiology, Division of Neuroradiology, Weill Cornell Medicine, NewYork-Presbyterian Hospital, 525 East 68th Street, Starr Pavilion, Box 141, New York, NY 10065, United States of America.
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Jia Y, Woltering S, Deutz NEP, Engelen MPKJ, Coyle KS, Maio MR, Husain M, Liu ZX. Working Memory Precision and Associative Binding in Mild Cognitive Impairment. Exp Aging Res 2024; 50:206-224. [PMID: 36755482 DOI: 10.1080/0361073x.2023.2172949] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Accepted: 01/23/2023] [Indexed: 02/10/2023]
Abstract
To better understand working memory (WM) deficits in Mild Cognitive Impairment (MCI), we examined information precision and associative binding in WM in 21 participants with MCI, compared to 16 healthy controls, using an item-location delayed reproduction task. WM, along with other executive functions (i.e. Trail Making Task (TMT) and Stroop task), were measured before and after a 2-h nap. The napping manipulation was intended as an exploratory element to this study exploring potential impacts of napping on executive functions.Compared to healthy participants, participants with MCI exhibited inferior performance not only in identifying encoded WM items but also on item-location associative binding and location precision even when only one item was involved. We also found changes on TMT and Stroop tasks in MCI, reflecting inferior attention and inhibitory control. Post-napping performance improved in most of these WM and other executive measures, both in MCI and their healthy peers.Our study shows that associative binding and WM precision can reliably differentiate MCIs from their healthy peers. Additionally, most measures showed no differential effect of group pre- and post-napping. These findings may contribute to better understanding cognitive deficits in MCI therefore improving the diagnosis of MCI.
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Affiliation(s)
- Yajun Jia
- Department of Educational Psychology, Texas A&M University, College Station, Texas, USA
- School of Social Work, Columbia University, New York City, New York, USA
| | - Steven Woltering
- Department of Educational Psychology, Texas A&M University, College Station, Texas, USA
| | - Nicolaas E P Deutz
- Center for Translational Research in Aging and Longevity, Department of Health and Kinesiology, Texas A&M University, College Station, Texas, USA
| | - Mariëlle P K J Engelen
- Center for Translational Research in Aging and Longevity, Department of Health and Kinesiology, Texas A&M University, College Station, Texas, USA
| | - Kimberly S Coyle
- Center for Translational Research in Aging and Longevity, Department of Health and Kinesiology, Texas A&M University, College Station, Texas, USA
| | - Maria R Maio
- Nuffield Dept of Clinical Neurosciences, Department of Experimental Psychology and Wellcome Trust Centre for Integrative Neuroimaging, University of Oxford, Oxford, UK
| | - Masud Husain
- Nuffield Dept of Clinical Neurosciences, Department of Experimental Psychology and Wellcome Trust Centre for Integrative Neuroimaging, University of Oxford, Oxford, UK
| | - Zhong-Xu Liu
- Department of Behavioral Sciences, University of Michigan-Dearborn, Dearborn, Michigan, USA
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26
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Xiao X, Rui Y, Jin Y, Chen M. Relationship of Sleep Disorder with Neurodegenerative and Psychiatric Diseases: An Updated Review. Neurochem Res 2024; 49:568-582. [PMID: 38108952 DOI: 10.1007/s11064-023-04086-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Revised: 12/08/2023] [Accepted: 12/09/2023] [Indexed: 12/19/2023]
Abstract
Sleep disorders affect many people worldwide and can accompany neurodegenerative and psychiatric diseases. Sleep may be altered before the clinical manifestations of some of these diseases appear. Moreover, some sleep disorders affect the physiological organization and function of the brain by influencing gene expression, accelerating the accumulation of abnormal proteins, interfering with the clearance of abnormal proteins, or altering the levels of related hormones and neurotransmitters, which can cause or may be associated with the development of neurodegenerative and psychiatric diseases. However, the detailed mechanisms of these effects are unclear. This review mainly focuses on the relationship between and mechanisms of action of sleep in Alzheimer's disease, depression, and anxiety, as well as the relationships between sleep and Parkinson's disease, Huntington's disease, and amyotrophic lateral sclerosis. This summary of current research hotspots may provide researchers with better clues and ideas to develop treatment solutions for neurodegenerative and psychiatric diseases associated with sleep disorders.
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Affiliation(s)
- Xiao Xiao
- School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, Anhui, China
- Department of Pharmacology, School of Basic Medical Sciences, Anhui Medical University, Hefei, Anhui, China
| | - Yimin Rui
- School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, Anhui, China
- Department of Pharmacology, School of Basic Medical Sciences, Anhui Medical University, Hefei, Anhui, China
| | - Yu Jin
- Department of Pharmacology, School of Basic Medical Sciences, Anhui Medical University, Hefei, Anhui, China
| | - Ming Chen
- Department of Pharmacology, School of Basic Medical Sciences, Anhui Medical University, Hefei, Anhui, China.
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27
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Xiong Y, Tvedt J, Åkerstedt T, Cadar D, Wang HX. Impact of sleep duration and sleep disturbances on the incidence of dementia and Alzheimer's disease: A 10-year follow-up study. Psychiatry Res 2024; 333:115760. [PMID: 38301285 DOI: 10.1016/j.psychres.2024.115760] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 01/23/2024] [Accepted: 01/26/2024] [Indexed: 02/03/2024]
Abstract
The nature of the relationship between sleep problems and dementia remains unclear. This study investigated the relationship between sleep measures and dementia in older adults (≥ 65) using data from the English Longitudinal Study of Ageing (ELSA) and further investigated the causal association in Mendelian randomization (MR) analysis. In total of 7,223 individuals, 5.7 % developed dementia (1.7 % Alzheimer's disease (AD)) within an average of 8 (± 2.9) years. Cox regression models and MR were employed. Long sleep duration (>8 h) was associated with 64 % increased risk of incident dementia and 2-fold high risk of AD compared to ideal sleep duration (7-8 h). This association was particularly evident in older-older adults (≥70 years) and those who consumed alcohol. Short sleep duration (<7 h) was associated with lower risk of incident dementia among older-older but higher risk among younger-older adults. Sleep disturbances and perceived sleep quality were not associated with dementia or AD. The MR study did not reveal causal associations between sleep duration and dementia. These findings suggest that self-reported short sleep in younger-older and long sleep in older-older adults and those with frequent alcohol consumption are associated with dementia. Early detection of these sleep patterns may help identify individuals at higher dementia risk.
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Affiliation(s)
- Ying Xiong
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Jonas Tvedt
- Division of Psychobiology and Epidemiology, Department of Psychology, Stockholm University, Stockholm, Sweden
| | - Torbjörn Åkerstedt
- Division of Psychobiology and Epidemiology, Department of Psychology, Stockholm University, Stockholm, Sweden; Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Dorina Cadar
- Centre for Dementia Studies, Department of Neuroscience, Brighton and Sussex Medical School, Brighton, United Kingdom; Department of Behavioural Science and Health, University College London, London, United Kingdom
| | - Hui-Xin Wang
- Division of Psychobiology and Epidemiology, Department of Psychology, Stockholm University, Stockholm, Sweden.
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Gorgoni M, Cenani J, Scarpelli S, D'Atri A, Alfonsi V, Annarumma L, Pietrogiacomi F, Ferrara M, Marra C, Rossini PM, De Gennaro L. The role of the sleep K-complex on the conversion from mild cognitive impairment to Alzheimer's disease. J Sleep Res 2024; 33:e14046. [PMID: 37718942 DOI: 10.1111/jsr.14046] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Revised: 07/24/2023] [Accepted: 08/29/2023] [Indexed: 09/19/2023]
Abstract
The present literature points to an alteration of the human K-complex during non-rapid eye movement sleep in Alzheimer's disease. Nevertheless, the few findings on the K-complex changes in mild cognitive impairment and their possible predictive role on the Alzheimer's disease conversion show mixed findings, lack of replication, and a main interest for the frontal region. The aim of the present study was to assess K-complex measures in amnesic mild cognitive impairment subsequently converted in Alzheimer's disease over different cortical regions, comparing them with healthy controls and stable amnesic mild cognitive impairment. We assessed baseline K-complex density, amplitude, area under the curve and overnight changes in frontal, central and parietal midline derivations of 12 amnesic mild cognitive impairment subsequently converted in Alzheimer's disease, 12 stable amnesic mild cognitive impairment and 12 healthy controls. We also assessed delta electroencephalogram power, to determine if K-complex alterations in amnesic mild cognitive impairment occur with modification of the electroencephalogram power in the frequency range of the slow-wave activity. We found a reduced parietal K-complex density in amnesic mild cognitive impairment subsequently converted in Alzheimer's disease compared with stable amnesic mild cognitive impairment and healthy controls, without changes in K-complex morphology and overnight modulation. Both amnesic mild cognitive impairment groups showed decreased slow-wave sleep percentage compared with healthy controls. No differences between groups were observed in slow-wave activity power. Our findings suggest that K-complex alterations in mild cognitive impairment may be observed earlier in parietal regions, likely mirroring the topographical progression of Alzheimer's disease-related brain pathology, and express a frontal predominance only in a full-blown phase of Alzheimer's disease. Consistently with previous results, such K-complex modification occurs in the absence of significant electroencephalogram power changes in the slow oscillations range.
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Affiliation(s)
- Maurizio Gorgoni
- Department of Psychology, Sapienza University of Rome, Rome, Italy
- Body and Action Lab, IRCCS Fondazione Santa Lucia, Rome, Italy
| | - Jessica Cenani
- Department of Psychology, Sapienza University of Rome, Rome, Italy
| | - Serena Scarpelli
- Department of Psychology, Sapienza University of Rome, Rome, Italy
| | - Aurora D'Atri
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
| | | | | | | | - Michele Ferrara
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
| | - Camillo Marra
- Institute of Neurology, Catholic University, Rome, Italy
| | - Paolo Maria Rossini
- Brain Connectivity Laboratory, Department of Neuroscience and Neurorehabilitation, IRCCS San Raffaele Roma, Rome, Italy
| | - Luigi De Gennaro
- Department of Psychology, Sapienza University of Rome, Rome, Italy
- Body and Action Lab, IRCCS Fondazione Santa Lucia, Rome, Italy
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29
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Astara K, Tsimpolis A, Kalafatakis K, Vavougios GD, Xiromerisiou G, Dardiotis E, Christodoulou NG, Samara MT, Lappas AS. Sleep disorders and Alzheimer's disease pathophysiology: The role of the Glymphatic System. A scoping review. Mech Ageing Dev 2024; 217:111899. [PMID: 38163471 DOI: 10.1016/j.mad.2023.111899] [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: 08/25/2023] [Revised: 12/14/2023] [Accepted: 12/26/2023] [Indexed: 01/03/2024]
Abstract
BACKGROUND Alzheimer's disease (AD) is highly intertwined with sleep disturbances throughout its whole natural history. Sleep consists of a major compound of the functionality of the glymphatic system, as the synchronized slow-wave activity during NREM facilitates cerebrospinal and interstitial long-distance mixing. OBJECTIVE The present study undertakes a scoping review of research on the involvement of the glymphatic system in AD-related sleep disturbances. DESIGN we searched Medline, Embase, PsychInfo and HEAL-link databases, without limitations on date and language, along with reference lists of relevant reviews and all included studies. We included in vivo, in vitro and post-mortem studies examining glymphatic implications of sleep disturbances in human populations with AD spectrum pathology. A thematic synthesis of evidence based on the extracted content was applied and presented in a narrative way. RESULTS In total, 70 original research articles were included and were grouped as following: a) Protein aggregation and toxicity, after sleep deprivation, along with its effects on sleep architecture, b) Glymphatic Sequalae in SDB, yielding potential glymphatic markers c) Circadian Dysregulation, d) Possible Interventions. CONCLUSIONS this review sought to provide insight into the role of sleep disturbances in AD pathogenesis, in the context of the glymphatic disruption.
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Affiliation(s)
- Kyriaki Astara
- Department of Psychiatry, Faculty of Medicine, University of Thessaly, Larissa, Greece; Department of Neurology, 417 Army Equity Fund Hospital (NIMTS), Athens, Greece
| | - Alexandros Tsimpolis
- Department of Pharmacology, Medical School, University of Crete & Institute of Molecular Biology and Biotechnology, Foundation of Research and Technology Hellas, Heraklion, Crete, Greece
| | - Konstantinos Kalafatakis
- Faculty of Medicine & Dentistry (Malta campus), Queen Mary University of London, VCT 2520, Victoria, Gozo, Malta.
| | - George D Vavougios
- Department of Neurology, Faculty of Medicine, University of Cyprus, Lefkosia, Cyprus; Department of Respiratory Medicine, Faculty of Medicine, University of Thessaly, Larissa, Greece; Department of Neurology, Athens Naval Hospital, Athens, Greece
| | - Georgia Xiromerisiou
- Department of Neurology, University Hospital of Larissa, Faculty of Medicine, School of Health Sciences, University of Thessaly, 41110 Larissa, Greece
| | - Efthimios Dardiotis
- Department of Neurology, University Hospital of Larissa, Faculty of Medicine, School of Health Sciences, University of Thessaly, 41110 Larissa, Greece
| | - Nikos G Christodoulou
- Department of Psychiatry, Faculty of Medicine, University of Thessaly, Larissa, Greece; Medical School, University of Nottingham, Lenton, Nottingham, UK
| | - Myrto T Samara
- Department of Psychiatry, Faculty of Medicine, University of Thessaly, Larissa, Greece
| | - Andreas S Lappas
- Department of Psychiatry, Faculty of Medicine, University of Thessaly, Larissa, Greece; Aneurin Bevan University Health Board, Wales, UK
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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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Kron JOZJ, Keenan RJ, Hoyer D, Jacobson LH. Orexin Receptor Antagonism: Normalizing Sleep Architecture in Old Age and Disease. Annu Rev Pharmacol Toxicol 2024; 64:359-386. [PMID: 37708433 DOI: 10.1146/annurev-pharmtox-040323-031929] [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] [Indexed: 09/16/2023]
Abstract
Sleep is essential for human well-being, yet the quality and quantity of sleep reduce as age advances. Older persons (>65 years old) are more at risk of disorders accompanied and/or exacerbated by poor sleep. Furthermore, evidence supports a bidirectional relationship between disrupted sleep and Alzheimer's disease (AD) or related dementias. Orexin/hypocretin neuropeptides stabilize wakefulness, and several orexin receptor antagonists (ORAs) are approved for the treatment of insomnia in adults. Dysregulation of the orexin system occurs in aging and AD, positioning ORAs as advantageous for these populations. Indeed, several clinical studies indicate that ORAs are efficacious hypnotics in older persons and dementia patients and, as in adults, are generally well tolerated. ORAs are likely to be more effective when administered early in sleep/wake dysregulation to reestablish good sleep/wake-related behaviors and reduce the accumulation of dementia-associated proteinopathic substrates. Improving sleep in aging and dementia represents a tremendous opportunity to benefit patients, caregivers, and health systems.
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Affiliation(s)
- Jarrah O-Z J Kron
- The Florey Institute of Neuroscience and Mental Health, Parkville, Victoria, Australia;
| | - Ryan J Keenan
- The Florey Institute of Neuroscience and Mental Health, Parkville, Victoria, Australia;
- Department of Physiology, Monash Biomedicine Discovery Institute, Monash University, Clayton, Victoria, Australia
| | - Daniel Hoyer
- The Florey Institute of Neuroscience and Mental Health, Parkville, Victoria, Australia;
- Department of Biochemistry and Pharmacology, School of Biomedical Sciences, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Parkville, Victoria, Australia;
- Department of Molecular Medicine, The Scripps Research Institute, La Jolla, California, USA
| | - Laura H Jacobson
- The Florey Institute of Neuroscience and Mental Health, Parkville, Victoria, Australia;
- Department of Biochemistry and Pharmacology, School of Biomedical Sciences, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Parkville, Victoria, Australia;
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Hu YH, Su T, Wu L, Wu JF, Liu D, Zhu LQ, Yuan M. Deregulation of the Glymphatic System in Alzheimer's Disease: Genetic and Non-Genetic Factors. Aging Dis 2024:AD.2023.1229. [PMID: 38270115 DOI: 10.14336/ad.2023.1229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Accepted: 12/29/2023] [Indexed: 01/26/2024] Open
Abstract
Alzheimer's disease (AD) is the most prevalent form of dementia and is characterized by progressive degeneration of brain function. AD gradually affects the parts of the brain that control thoughts, language, behavior and mental function, severely impacting a person's ability to carry out daily activities and ultimately leading to death. The accumulation of extracellular amyloid-β peptide (Aβ) and the aggregation of intracellular hyperphosphorylated tau are the two key pathological hallmarks of AD. AD is a complex condition that involves both non-genetic risk factors (35%) and genetic risk factors (58-79%). The glymphatic system plays an essential role in clearing metabolic waste, transporting tissue fluid, and participating in the immune response. Both non-genetic and genetic risk factors affect the glymphatic system to varying degrees. The main purpose of this review is to summarize the underlying mechanisms involved in the deregulation of the glymphatic system during the progression of AD, especially concerning the diverse contributions of non-genetic and genetic risk factors. In the future, new targets and interventions that modulate these interrelated mechanisms will be beneficial for the prevention and treatment of AD.
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Affiliation(s)
- Yan-Hong Hu
- Department of Neurology, The Second Affiliated Hospital, Hengyang Medical School, University of South China, Hengyang, Hunan 421001, China
| | - Ting Su
- Department of Neurology, The Second Affiliated Hospital, Hengyang Medical School, University of South China, Hengyang, Hunan 421001, China
| | - Lin Wu
- Department of Neurology, The Second Affiliated Hospital, Hengyang Medical School, University of South China, Hengyang, Hunan 421001, China
| | - Jun-Fang Wu
- Department of Neurology, The Second Affiliated Hospital, Hengyang Medical School, University of South China, Hengyang, Hunan 421001, China
| | - Dan Liu
- Department of Pathophysiology, School of Basic Medicine, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030, China
| | - Ling-Qiang Zhu
- Department of Pathophysiology, School of Basic Medicine, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030, China
| | - Mei Yuan
- Department of Neurology, The Second Affiliated Hospital, Hengyang Medical School, University of South China, Hengyang, Hunan 421001, China
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Johnson CE, Duncan MJ, Murphy MP. Sex and Sleep Disruption as Contributing Factors in Alzheimer's Disease. J Alzheimers Dis 2024; 97:31-74. [PMID: 38007653 PMCID: PMC10842753 DOI: 10.3233/jad-230527] [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] [Indexed: 11/27/2023]
Abstract
Alzheimer's disease (AD) affects more women than men, with women throughout the menopausal transition potentially being the most under researched and at-risk group. Sleep disruptions, which are an established risk factor for AD, increase in prevalence with normal aging and are exacerbated in women during menopause. Sex differences showing more disrupted sleep patterns and increased AD pathology in women and female animal models have been established in literature, with much emphasis placed on loss of circulating gonadal hormones with age. Interestingly, increases in gonadotropins such as follicle stimulating hormone are emerging to be a major contributor to AD pathogenesis and may also play a role in sleep disruption, perhaps in combination with other lesser studied hormones. Several sleep influencing regions of the brain appear to be affected early in AD progression and some may exhibit sexual dimorphisms that may contribute to increased sleep disruptions in women with age. Additionally, some of the most common sleep disorders, as well as multiple health conditions that impair sleep quality, are more prevalent and more severe in women. These conditions are often comorbid with AD and have bi-directional relationships that contribute synergistically to cognitive decline and neuropathology. The association during aging of increased sleep disruption and sleep disorders, dramatic hormonal changes during and after menopause, and increased AD pathology may be interacting and contributing factors that lead to the increased number of women living with AD.
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Affiliation(s)
- Carrie E. Johnson
- University of Kentucky, College of Medicine, Department of Molecular and Cellular Biochemistry, Lexington, KY, USA
| | - Marilyn J. Duncan
- University of Kentucky, College of Medicine, Department of Neuroscience, Lexington, KY, USA
| | - M. Paul Murphy
- University of Kentucky, College of Medicine, Department of Molecular and Cellular Biochemistry, Lexington, KY, USA
- University of Kentucky, Sanders-Brown Center on Aging, Lexington, KY, USA
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Pulver RL, Kronberg E, Medenblik LM, Kheyfets VO, Ramos AR, Holtzman DM, Morris JC, Toedebusch CD, Sillau SH, Bettcher BM, Lucey BP, McConnell BV. Mapping sleep's oscillatory events as a biomarker of Alzheimer's disease. Alzheimers Dement 2024; 20:301-315. [PMID: 37610059 PMCID: PMC10840635 DOI: 10.1002/alz.13420] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Revised: 07/05/2023] [Accepted: 07/10/2023] [Indexed: 08/24/2023]
Abstract
INTRODUCTION Memory-associated neural circuits produce oscillatory events including theta bursts (TBs), sleep spindles (SPs), and slow waves (SWs) in sleep electroencephalography (EEG). Changes in the "coupling" of these events may indicate early Alzheimer's disease (AD) pathogenesis. METHODS We analyzed 205 aging adults using single-channel sleep EEG, cerebrospinal fluid (CSF) AD biomarkers, and Clinical Dementia Rating® (CDR®) scale. We mapped SW-TB and SW-SP neural circuit coupling precision to amyloid positivity, cognitive impairment, and CSF AD biomarkers. RESULTS Cognitive impairment correlated with lower TB spectral power in SW-TB coupling. Cognitively unimpaired, amyloid positive individuals demonstrated lower precision in SW-TB and SW-SP coupling compared to amyloid negative individuals. Significant biomarker correlations were found in oscillatory event coupling with CSF Aβ42 /Aβ40 , phosphorylated- tau181 , and total-tau. DISCUSSION Sleep-dependent memory processing integrity in neural circuits can be measured for both SW-TB and SW-SP coupling. This breakdown associates with amyloid positivity, increased AD pathology, and cognitive impairment. HIGHLIGHTS At-home sleep EEG is a potential biomarker of neural circuits linked to memory. Circuit precision is associated with amyloid positivity in asymptomatic aging adults. Levels of CSF amyloid and tau also correlate with circuit precision in sleep EEG. Theta burst EEG power is decreased in very early mild cognitive impairment. This technique may enable inexpensive wearable EEGs for monitoring brain health.
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Affiliation(s)
- Rachelle L. Pulver
- Department of NeurologyUniversity of Colorado School of MedicineAuroraColoradoUSA
- University of Colorado Alzheimer's and Cognition CenterUniversity of Colorado School of MedicineAuroraColoradoUSA
| | - Eugene Kronberg
- Department of NeurologyUniversity of Colorado School of MedicineAuroraColoradoUSA
| | - Lindsey M. Medenblik
- Department of NeurologyUniversity of Colorado School of MedicineAuroraColoradoUSA
- University of Colorado Alzheimer's and Cognition CenterUniversity of Colorado School of MedicineAuroraColoradoUSA
| | - Vitaly O. Kheyfets
- Department of Pediatric Critical Care MedicineUniversity of Colorado School of MedicineAuroraColoradoUSA
| | - Alberto R. Ramos
- Department of NeurologyUniversity of Miami Miller School of MedicineMiamiFloridaUSA
| | - David M. Holtzman
- Department of NeurologyWashington University School of MedicineSt LouisMissouriUSA
- Knight Alzheimer Disease Research CenterWashington University School of MedicineSt LouisMissouriUSA
- Hope Center for Neurological DisordersWashington University School of MedicineSt LouisMissouriUSA
| | - John C. Morris
- Department of NeurologyWashington University School of MedicineSt LouisMissouriUSA
- Knight Alzheimer Disease Research CenterWashington University School of MedicineSt LouisMissouriUSA
- Hope Center for Neurological DisordersWashington University School of MedicineSt LouisMissouriUSA
| | | | - Stefan H Sillau
- Department of NeurologyUniversity of Colorado School of MedicineAuroraColoradoUSA
- University of Colorado Alzheimer's and Cognition CenterUniversity of Colorado School of MedicineAuroraColoradoUSA
| | - Brianne M. Bettcher
- Department of NeurologyUniversity of Colorado School of MedicineAuroraColoradoUSA
- University of Colorado Alzheimer's and Cognition CenterUniversity of Colorado School of MedicineAuroraColoradoUSA
| | - Brendan P. Lucey
- Department of NeurologyWashington University School of MedicineSt LouisMissouriUSA
- Knight Alzheimer Disease Research CenterWashington University School of MedicineSt LouisMissouriUSA
- Hope Center for Neurological DisordersWashington University School of MedicineSt LouisMissouriUSA
| | - Brice V. McConnell
- Department of NeurologyUniversity of Colorado School of MedicineAuroraColoradoUSA
- University of Colorado Alzheimer's and Cognition CenterUniversity of Colorado School of MedicineAuroraColoradoUSA
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Giri S, Mehta R, Mallick BN. REM Sleep Loss-Induced Elevated Noradrenaline Plays a Significant Role in Neurodegeneration: Synthesis of Findings to Propose a Possible Mechanism of Action from Molecule to Patho-Physiological Changes. Brain Sci 2023; 14:8. [PMID: 38275513 PMCID: PMC10813190 DOI: 10.3390/brainsci14010008] [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: 12/01/2023] [Accepted: 12/17/2023] [Indexed: 01/27/2024] Open
Abstract
Wear and tear are natural processes for all living and non-living bodies. All living cells and organisms are metabolically active to generate energy for their routine needs, including for survival. In the process, the cells are exposed to oxidative load, metabolic waste, and bye-products. In an organ, the living non-neuronal cells divide and replenish the lost or damaged cells; however, as neuronal cells normally do not divide, they need special feature(s) for their protection, survival, and sustenance for normal functioning of the brain. The neurons grow and branch as axons and dendrites, which contribute to the formation of synapses with near and far neurons, the basic scaffold for complex brain functions. It is necessary that one or more basic and instinct physiological process(es) (functions) is likely to contribute to the protection of the neurons and maintenance of the synapses. It is known that rapid eye movement sleep (REMS), an autonomic instinct behavior, maintains brain functioning including learning and memory and its loss causes dysfunctions. In this review we correlate the role of REMS and its loss in synaptogenesis, memory consolidation, and neuronal degeneration. Further, as a mechanism of action, we will show that REMS maintains noradrenaline (NA) at a low level, which protects neurons from oxidative damage and maintains neuronal growth and synaptogenesis. However, upon REMS loss, the level of NA increases, which withdraws protection and causes apoptosis and loss of synapses and neurons. We propose that the latter possibly causes REMS loss associated neurodegenerative diseases and associated symptoms.
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Affiliation(s)
- Shatrunjai Giri
- Department of Biosciences, Manipal University Jaipur, Jaipur 303007, India;
| | - Rachna Mehta
- Amity Institute of Neuropsychology & Neurosciences, Amity University, Noida 201301, India;
| | - Birendra Nath Mallick
- Amity Institute of Neuropsychology & Neurosciences, Amity University, Noida 201301, India;
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Yoon SH, Kim HK, Lee JH, Chun JH, Sohn YH, Lee PH, Ryu YH, Cho H, Yoo HS, Lyoo CH. Association of Sleep Disturbances With Brain Amyloid and Tau Burden, Cortical Atrophy, and Cognitive Dysfunction Across the AD Continuum. Neurology 2023; 101:e2162-e2171. [PMID: 37813585 PMCID: PMC10663023 DOI: 10.1212/wnl.0000000000207917] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Accepted: 08/24/2023] [Indexed: 10/14/2023] Open
Abstract
BACKGROUND AND OBJECTIVES Patients with Alzheimer disease (AD) frequently suffer from various sleep disturbances. However, how sleep disturbance is associated with AD and its progression remains poorly investigated. We investigated the association of total sleep time with brain amyloid and tau burden, cortical atrophy, cognitive dysfunction, and their longitudinal changes in the AD spectrum. METHODS In this retrospective cohort study, we enrolled participants on the AD spectrum who were positive on 18F-florbetaben (FBB) PET. All participants underwent the Pittsburgh Sleep Quality Index, brain MRI, FBB PET, 18F-flortaucipir (FTP) PET, and detailed neuropsychological testing. In addition, a subset of participants completed follow-up assessments. We analyzed the association of total sleep time with the baseline and longitudinal FBB-standardized uptake value ratio (SUVR), FTP-SUVR, cortical thickness, and cognitive domain composite scores. RESULTS We examined 138 participants on the AD spectrum (15 with preclinical AD, 62 with prodromal AD, and 61 with AD dementia; mean age 73.4 ± 8.0 years; female 58.7%). Total sleep time was longer in the AD dementia group (7.4 ± 1.6 hours) compared with the preclinical (6.5 ± 1.4 hours; p = 0.026) and prodromal groups (6.6 ± 1.4 hours; p = 0.001), whereas other sleep parameters did not differ between groups. Longer total sleep time was not associated with amyloid accumulation but rather with tau accumulation, especially in the amygdala, hippocampus, basal forebrain, insular, cingulate, occipital, inferior temporal cortices, and precuneus. Longer total sleep time predicted faster tau accumulation in Braak regions V-VI (β = 0.016, p = 0.007) and disease progression to mild cognitive impairment or dementia (hazard ratio = 1.554, p = 0.024). Longer total sleep time was also associated with memory deficit (β = -0.19, p = 0.008). DISCUSSION Prolonged total sleep time was associated with tau accumulation in sleep-related cortical and subcortical areas as well as memory dysfunction. It also predicted faster disease progression with tau accumulation. Our study highlights the clinical importance of assessing total sleep time as a marker for disease severity and prognosis in the AD spectrum.
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Affiliation(s)
- So Hoon Yoon
- From the Department of Neurology (S.H.Y.), International St. Mary's Hospital, Catholic Kwandong University College of Medicine, Incheon; Departments of Neurology (H.-K.K., H.C., H.S.Y., C.H.L.) and Nuclear Medicine (J.-H.L., Y.H.R.), Gangnam Severance Hospital; Departments of Nuclear Medicine (J.-H.C.) and Neurology (Y.H.S., P.H.L.), Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Han-Kyeol Kim
- From the Department of Neurology (S.H.Y.), International St. Mary's Hospital, Catholic Kwandong University College of Medicine, Incheon; Departments of Neurology (H.-K.K., H.C., H.S.Y., C.H.L.) and Nuclear Medicine (J.-H.L., Y.H.R.), Gangnam Severance Hospital; Departments of Nuclear Medicine (J.-H.C.) and Neurology (Y.H.S., P.H.L.), Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Jae-Hoon Lee
- From the Department of Neurology (S.H.Y.), International St. Mary's Hospital, Catholic Kwandong University College of Medicine, Incheon; Departments of Neurology (H.-K.K., H.C., H.S.Y., C.H.L.) and Nuclear Medicine (J.-H.L., Y.H.R.), Gangnam Severance Hospital; Departments of Nuclear Medicine (J.-H.C.) and Neurology (Y.H.S., P.H.L.), Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Joong-Hyun Chun
- From the Department of Neurology (S.H.Y.), International St. Mary's Hospital, Catholic Kwandong University College of Medicine, Incheon; Departments of Neurology (H.-K.K., H.C., H.S.Y., C.H.L.) and Nuclear Medicine (J.-H.L., Y.H.R.), Gangnam Severance Hospital; Departments of Nuclear Medicine (J.-H.C.) and Neurology (Y.H.S., P.H.L.), Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Young H Sohn
- From the Department of Neurology (S.H.Y.), International St. Mary's Hospital, Catholic Kwandong University College of Medicine, Incheon; Departments of Neurology (H.-K.K., H.C., H.S.Y., C.H.L.) and Nuclear Medicine (J.-H.L., Y.H.R.), Gangnam Severance Hospital; Departments of Nuclear Medicine (J.-H.C.) and Neurology (Y.H.S., P.H.L.), Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Phil Hyu Lee
- From the Department of Neurology (S.H.Y.), International St. Mary's Hospital, Catholic Kwandong University College of Medicine, Incheon; Departments of Neurology (H.-K.K., H.C., H.S.Y., C.H.L.) and Nuclear Medicine (J.-H.L., Y.H.R.), Gangnam Severance Hospital; Departments of Nuclear Medicine (J.-H.C.) and Neurology (Y.H.S., P.H.L.), Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Young Hoon Ryu
- From the Department of Neurology (S.H.Y.), International St. Mary's Hospital, Catholic Kwandong University College of Medicine, Incheon; Departments of Neurology (H.-K.K., H.C., H.S.Y., C.H.L.) and Nuclear Medicine (J.-H.L., Y.H.R.), Gangnam Severance Hospital; Departments of Nuclear Medicine (J.-H.C.) and Neurology (Y.H.S., P.H.L.), Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Hanna Cho
- From the Department of Neurology (S.H.Y.), International St. Mary's Hospital, Catholic Kwandong University College of Medicine, Incheon; Departments of Neurology (H.-K.K., H.C., H.S.Y., C.H.L.) and Nuclear Medicine (J.-H.L., Y.H.R.), Gangnam Severance Hospital; Departments of Nuclear Medicine (J.-H.C.) and Neurology (Y.H.S., P.H.L.), Yonsei University College of Medicine, Seoul, Republic of Korea.
| | - Han Soo Yoo
- From the Department of Neurology (S.H.Y.), International St. Mary's Hospital, Catholic Kwandong University College of Medicine, Incheon; Departments of Neurology (H.-K.K., H.C., H.S.Y., C.H.L.) and Nuclear Medicine (J.-H.L., Y.H.R.), Gangnam Severance Hospital; Departments of Nuclear Medicine (J.-H.C.) and Neurology (Y.H.S., P.H.L.), Yonsei University College of Medicine, Seoul, Republic of Korea.
| | - Chul Hyoung Lyoo
- From the Department of Neurology (S.H.Y.), International St. Mary's Hospital, Catholic Kwandong University College of Medicine, Incheon; Departments of Neurology (H.-K.K., H.C., H.S.Y., C.H.L.) and Nuclear Medicine (J.-H.L., Y.H.R.), Gangnam Severance Hospital; Departments of Nuclear Medicine (J.-H.C.) and Neurology (Y.H.S., P.H.L.), Yonsei University College of Medicine, Seoul, Republic of Korea
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Postnov D, Semyachkina-Glushkovskaya O, Litvinenko E, Kurths J, Penzel T. Mechanisms of Activation of Brain's Drainage during Sleep: The Nightlife of Astrocytes. Cells 2023; 12:2667. [PMID: 37998402 PMCID: PMC10670149 DOI: 10.3390/cells12222667] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2023] [Revised: 11/09/2023] [Accepted: 11/15/2023] [Indexed: 11/25/2023] Open
Abstract
The study of functions, mechanisms of generation, and pathways of movement of cerebral fluids has a long history, but the last decade has been especially productive. The proposed glymphatic hypothesis, which suggests a mechanism of the brain waste removal system (BWRS), caused an active discussion on both the criticism of some of the perspectives and our intensive study of new experimental facts. It was especially found that the intensity of the metabolite clearance changes significantly during the transition between sleep and wakefulness. Interestingly, at the cellular level, a number of aspects of this problem have been focused on, such as astrocytes-glial cells, which, over the past two decades, have been recognized as equal partners of neurons and perform many important functions. In particular, an important role was assigned to astrocytes within the framework of the glymphatic hypothesis. In this review, we return to the "astrocytocentric" view of the BWRS function and the explanation of its activation during sleep from the viewpoint of new findings over the last decade. Our main conclusion is that the BWRS's action may be analyzed both at the systemic (whole-brain) and at the local (cellular) level. The local level means here that the neuro-glial-vascular unit can also be regarded as the smallest functional unit of sleep, and therefore, the smallest functional unit of the BWRS.
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Affiliation(s)
- Dmitry Postnov
- Department of Optics and Biophotonics, Saratov State University, Astrakhanskaya Str. 83, 410012 Saratov, Russia;
| | - Oxana Semyachkina-Glushkovskaya
- Department of Biology, Saratov State University, Astrakhanskaya Str. 83, 410012 Saratov, Russia; (O.S.-G.); (J.K.)
- Physics Department, Humboldt University, Newtonstrasse 15, 12489 Berlin, Germany
| | - Elena Litvinenko
- Department of Optics and Biophotonics, Saratov State University, Astrakhanskaya Str. 83, 410012 Saratov, Russia;
| | - Jürgen Kurths
- Department of Biology, Saratov State University, Astrakhanskaya Str. 83, 410012 Saratov, Russia; (O.S.-G.); (J.K.)
- Physics Department, Humboldt University, Newtonstrasse 15, 12489 Berlin, Germany
- Potsdam Institute for Climate Impact Research, Telegrafenberg A31, 14473 Potsdam, Germany
| | - Thomas Penzel
- Department of Biology, Saratov State University, Astrakhanskaya Str. 83, 410012 Saratov, Russia; (O.S.-G.); (J.K.)
- Charité — Universitätsmedizin Berlin, Charitéplatz 1, 10117 Berlin, Germany
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Shoob S, Buchbinder N, Shinikamin O, Gold O, Baeloha H, Langberg T, Zarhin D, Shapira I, Braun G, Habib N, Slutsky I. Deep brain stimulation of thalamic nucleus reuniens promotes neuronal and cognitive resilience in an Alzheimer's disease mouse model. Nat Commun 2023; 14:7002. [PMID: 37919286 PMCID: PMC10622498 DOI: 10.1038/s41467-023-42721-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2022] [Accepted: 10/19/2023] [Indexed: 11/04/2023] Open
Abstract
The mechanisms that confer cognitive resilience to Alzheimer's Disease (AD) are not fully understood. Here, we describe a neural circuit mechanism underlying this resilience in a familial AD mouse model. In the prodromal disease stage, interictal epileptiform spikes (IESs) emerge during anesthesia in the CA1 and mPFC regions, leading to working memory disruptions. These IESs are driven by inputs from the thalamic nucleus reuniens (nRE). Indeed, tonic deep brain stimulation of the nRE (tDBS-nRE) effectively suppresses IESs and restores firing rate homeostasis under anesthesia, preventing further impairments in nRE-CA1 synaptic facilitation and working memory. Notably, applying tDBS-nRE during the prodromal phase in young APP/PS1 mice mitigates age-dependent memory decline. The IES rate during anesthesia in young APP/PS1 mice correlates with later working memory impairments. These findings highlight the nRE as a central hub of functional resilience and underscore the clinical promise of DBS in conferring resilience to AD pathology by restoring circuit-level homeostasis.
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Affiliation(s)
- Shiri Shoob
- Department of Physiology and Pharmacology, Faculty of Medicine, Tel Aviv University, 69978, Tel Aviv, Israel
| | - Nadav Buchbinder
- Department of Physiology and Pharmacology, Faculty of Medicine, Tel Aviv University, 69978, Tel Aviv, Israel
- Sagol School of Neuroscience, Tel Aviv University, 69978, Tel Aviv, Israel
| | - Ortal Shinikamin
- Department of Physiology and Pharmacology, Faculty of Medicine, Tel Aviv University, 69978, Tel Aviv, Israel
| | - Or Gold
- Edmond & Lily Safra Center for Brain Sciences, The Hebrew University of Jerusalem, Jerusalem, Israel
| | - Halit Baeloha
- Department of Physiology and Pharmacology, Faculty of Medicine, Tel Aviv University, 69978, Tel Aviv, Israel
| | - Tomer Langberg
- Department of Physiology and Pharmacology, Faculty of Medicine, Tel Aviv University, 69978, Tel Aviv, Israel
- Sagol School of Neuroscience, Tel Aviv University, 69978, Tel Aviv, Israel
| | - Daniel Zarhin
- Department of Physiology and Pharmacology, Faculty of Medicine, Tel Aviv University, 69978, Tel Aviv, Israel
| | - Ilana Shapira
- Department of Physiology and Pharmacology, Faculty of Medicine, Tel Aviv University, 69978, Tel Aviv, Israel
| | - Gabriella Braun
- Department of Physiology and Pharmacology, Faculty of Medicine, Tel Aviv University, 69978, Tel Aviv, Israel
- Sagol School of Neuroscience, Tel Aviv University, 69978, Tel Aviv, Israel
| | - Naomi Habib
- Edmond & Lily Safra Center for Brain Sciences, The Hebrew University of Jerusalem, Jerusalem, Israel
| | - Inna Slutsky
- Department of Physiology and Pharmacology, Faculty of Medicine, Tel Aviv University, 69978, Tel Aviv, Israel.
- Sagol School of Neuroscience, Tel Aviv University, 69978, Tel Aviv, Israel.
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Kinugawa K. Obstructive sleep apnea and dementia: A role to play? Rev Neurol (Paris) 2023; 179:793-803. [PMID: 37633736 DOI: 10.1016/j.neurol.2023.08.006] [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: 06/30/2023] [Accepted: 08/04/2023] [Indexed: 08/28/2023]
Abstract
A growing number of studies, in animal models and humans, have highlighted the link between sleep and Alzheimer's disease (AD) pathophysiology. Among sleep disorders, obstructive sleep apnea (OSA) appears to be a potentially interesting comorbidity, as it is highly prevalent in the middle-aged and elderly population, often associated with some cognitive impairment, associated with an increased risk of developing cognitive decline and dementia including AD, and indeed treatable. The association between OSA and cognition varies according to the studies, but OSA is more frequent in older people with AD than those who are cognitively normal. People with OSA suffer from daytime sleepiness, impaired cognitive function and an increased risk of developing mild cognitive impairment, dementia and AD than those without OSA. Finally, the literature suggests a link between OSA and AD biomarkers. Whether screening and treating OSA could have positive impact on the levels of AD biomarkers and slow or even prevent incident dementia remain to be investigated. It therefore seems essential to understand the role of OSA in the pathophysiology of AD, as there is still no effective treatment to slow or halt its progression. At present, treating the risk factors that can promote the development and/or worsening of AD represents a promising strategy for delaying or even thwarting the onset of symptoms.
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Affiliation(s)
- K Kinugawa
- Sorbonne University, CNRS, UMR Biological Adaptation and Aging, AP-HP, Paris, France; Charles-Foix Hospital, Functional Exploration Unit for Older Patients, 94200 Ivry-sur-Seine, France.
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40
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Blackman J, Morrison HD, Gabb V, Biswas B, Li H, Turner N, Jolly A, Trender W, Hampshire A, Whone A, Coulthard E. Remote evaluation of sleep to enhance understanding of early dementia due to Alzheimer's Disease (RESTED-AD): an observational cohort study protocol. BMC Geriatr 2023; 23:590. [PMID: 37742001 PMCID: PMC10518099 DOI: 10.1186/s12877-023-04288-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Accepted: 09/06/2023] [Indexed: 09/25/2023] Open
Abstract
BACKGROUND Sleep and circadian rhythm disorders are well recognised in both AD (Alzheimer's Disease) dementia and MCI-AD (Mild Cognitive Impairment due to Alzheimer's Disease). Such abnormalities include insomnia, excessive daytime sleepiness, decreased sleep efficiency, increased sleep fragmentation and sundowning. Enhancing understanding of sleep abnormalities may unveil targets for intervention in sleep, a promising approach given hypotheses that sleep disorders may exacerbate AD pathological progression and represent a contributory factor toward impaired cognitive performance and worse quality of life. This may also permit early diagnosis of AD pathology, widely acknowledged as a pre-requisite for future disease-modifying therapies. This study aims to bridge the divide between in-laboratory polysomnographic studies which allow for rich characterisation of sleep but in an unnatural setting, and naturalistic studies typically approximating sleep through use of non-EEG wearable devices. It is also designed to record sleep patterns over a 2 month duration sufficient to capture both infradian rhythm and compensatory responses following suboptimal sleep. Finally, it harnesses an extensively phenotyped population including with AD blood biomarkers. Its principal aims are to improve characterisation of sleep and biological rhythms in individuals with AD, particularly focusing on micro-architectural measures of sleep, compensatory responses to suboptimal sleep and the relationship between sleep parameters, biological rhythms and cognitive performance. METHODS/DESIGN This observational cohort study has two arms (AD-MCI / mild AD dementia and aged-matched healthy adults). Each participant undergoes a baseline visit for collection of demographic, physiological and neuropsychological information utilising validated questionnaires. The main study period involves 7 nights of home-based multi-channel EEG sleep recording nested within an 8-week study period involving continuous wrist-worn actigraphy, sleep diaries and regular brief cognitive tests. Measurement of sleep parameters will be at home thereby obtaining a real-world, naturalistic dataset. Cognitive testing will be repeated at 6 months to stratify participants by longitudinal disease progression. DISCUSSION This study will generate new insights particularly in micro-architectural measures of sleep, circadian patterns and compensatory sleep responses in a population with and without AD neurodegenerative change. It aims to enhance standards of remotely based sleep research through use of a well-phenotyped population and advanced sleep measurement technology.
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Affiliation(s)
- Jonathan Blackman
- Bristol Medical School, University of Bristol, Bristol, BS2 8DZ UK
- Bristol Brain Centre, North Bristol NHS Trust, Bristol, BS10 5NB UK
| | - Hamish Duncan Morrison
- Bristol Medical School, University of Bristol, Bristol, BS2 8DZ UK
- Bristol Brain Centre, North Bristol NHS Trust, Bristol, BS10 5NB UK
| | - Victoria Gabb
- Bristol Medical School, University of Bristol, Bristol, BS2 8DZ UK
- Bristol Brain Centre, North Bristol NHS Trust, Bristol, BS10 5NB UK
| | - Bijetri Biswas
- Bristol Medical School, University of Bristol, Bristol, BS2 8DZ UK
| | - Haoxuan Li
- Bristol Medical School, University of Bristol, Bristol, BS2 8DZ UK
- Bristol Brain Centre, North Bristol NHS Trust, Bristol, BS10 5NB UK
| | - Nicholas Turner
- Bristol Medical School, University of Bristol, Bristol, BS2 8DZ UK
| | - Amy Jolly
- Faculty of Medicine, Imperial College London, London, SW7 2AZ UK
| | - William Trender
- Faculty of Medicine, Imperial College London, London, SW7 2AZ UK
| | - Adam Hampshire
- Faculty of Medicine, Imperial College London, London, SW7 2AZ UK
| | - Alan Whone
- Bristol Brain Centre, North Bristol NHS Trust, Bristol, BS10 5NB UK
| | - Elizabeth Coulthard
- Bristol Medical School, University of Bristol, Bristol, BS2 8DZ UK
- Bristol Brain Centre, North Bristol NHS Trust, Bristol, BS10 5NB UK
- Bristol Medical School, Learning & Research Building, Southmead Hospital, University of Bristol, Bristol, BS10 5NB UK
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Tang M, Wu L, Shen Z, Chen J, Yang Y, Zhang M, Zhao P, Jiang G. Association between Sleep and Alzheimer's Disease: A Bibliometric Analysis from 2003 to 2022. Neuroepidemiology 2023; 57:377-390. [PMID: 37699365 DOI: 10.1159/000533700] [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: 05/17/2023] [Accepted: 07/26/2023] [Indexed: 09/14/2023] Open
Abstract
INTRODUCTION Alzheimer's disease (AD) often presents with sleep disorders, which are also an important risk factor for AD, affecting cognitive function to a certain extent. This study aimed to reveal the current global status, present hotspots, and discuss emerging trends of sleep and AD using a bibliometric approach. METHODS Research and review articles related to sleep and AD from 2003 to 2022 were extracted from the Web of Science Core Collection. VOSviewer 1.6.18.0, Scimago Graphica, and CiteSpace 6.2.R2 were used to map the productive and highly cited countries, institutions, journals, authors, references, and keywords in the field. RESULTS Overall, 4,008 publications were included in this bibliometric analysis. The number of publications and citations showed an increasing trend over the past two decades. The USA and China had the largest and second largest, respectively, number of publications and citations and cooperated with other countries more closely. Ancoli-Israel Sonia published the most papers, and Holtzman David M was co-cited most frequently. The most productive journal was Journal of Alzheimer's Disease, and Neurology was the most frequently cited journal. The risk factors, β-amyloid (Aβ), tau, neuroinflammation, astrocytes, glymphatic system, orexin, functional connectivity, and management have been the main research directions of researchers over the past few years and may be the future trend of valuable research. CONCLUSION We identified hotspots and emerging trends including risk factors, Aβ, tau, neuroinflammation, the glymphatic system, orexin, and management, which may help identify new therapeutic targets and improve clinical efficacy of sleep and AD.
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Affiliation(s)
- Ming Tang
- Department of Neurology, Affiliated Hospital of North Sichuan Medical College; Institute of Neurological Diseases, North Sichuan Medical College, Nanchong, China
| | - Li Wu
- Department of Neurology, Affiliated Hospital of North Sichuan Medical College; Institute of Neurological Diseases, North Sichuan Medical College, Nanchong, China
| | - Ziyi Shen
- Department of Neurology, Affiliated Hospital of North Sichuan Medical College; Institute of Neurological Diseases, North Sichuan Medical College, Nanchong, China
| | - Junwen Chen
- Department of Neurology, Affiliated Hospital of North Sichuan Medical College; Institute of Neurological Diseases, North Sichuan Medical College, Nanchong, China
| | - Yang Yang
- Department of Neurology, Affiliated Hospital of North Sichuan Medical College; Institute of Neurological Diseases, North Sichuan Medical College, Nanchong, China
| | - Ming Zhang
- Department of Neurology, Affiliated Hospital of North Sichuan Medical College; Institute of Neurological Diseases, North Sichuan Medical College, Nanchong, China
| | - Peilin Zhao
- Department of Neurology, Affiliated Hospital of North Sichuan Medical College; Institute of Neurological Diseases, North Sichuan Medical College, Nanchong, China
| | - Guohui Jiang
- Department of Neurology, Affiliated Hospital of North Sichuan Medical College; Institute of Neurological Diseases, North Sichuan Medical College, Nanchong, China
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Sauers SC, Toedebusch CD, Richardson R, Spira AP, Morris JC, Holtzman DM, Lucey BP. Chronotype is Associated with Sleep Quality in Older Adults. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2023:2023.09.04.23294997. [PMID: 37732218 PMCID: PMC10508806 DOI: 10.1101/2023.09.04.23294997] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/22/2023]
Abstract
Introduction Disrupted sleep is common in individuals with Alzheimer's disease (AD) and may be a marker for AD risk. The timing of sleep or chronotype affects sleep-wake activity and is also associated with AD, but little is known about links between sleep and chronotype in older adults. In this study, we tested if different measures of sleep and chronotype are associated among older adults even after adjusting for multiple potentially confounding variables. Methods Participants (N=243) with a mean age of 74 underwent standardized cognitive assessments, measurement of CSF AD biomarkers, and sleep monitoring via single-channel EEG, actigraphy, and self-reported sleep logs. Chronotype was defined as the midpoint of sleep measured by actigraphy. Results Later mid-point of sleep (i.e., late chronotype) was associated with African American race and greater night-to-night variability in the sleep mid-point. After controlling for age, race, sex, cognitive status, AD biomarkers, and sleep disorders, a later mid-point of sleep was associated with longer rapid eye movement (REM) onset latency, decreased REM sleep time, lower sleep efficiency, increased sleep onset latency, and more awakenings at night. Late chronotype was also associated with increased <2 Hz non-REM slow-wave activity. Conclusions To identify individuals at risk for cognitive impairment before symptoms onset, non-invasive in vivo markers of brain function, such as sleep, are needed to track both future risk of cognitive impairment and response to interventions. Chronotype is a potential modifiable AD risk factor and should also be taken into account when using sleep as a marker for AD risk.
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Affiliation(s)
- Scott C. Sauers
- Department of Neurology, Washington University School of Medicine, St Louis, MO 63110
| | | | - Rachel Richardson
- Department of Neurology, Washington University School of Medicine, St Louis, MO 63110
| | - Adam P. Spira
- Department of Mental Health, The Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
- Department of Psychiatry and Behavioral Sciences, The Johns Hopkins School of Medicine, Baltimore, MD 21205
- The Johns Hopkins Center on Aging and Health, Baltimore, MD 21205
| | - John C. Morris
- Department of Neurology, Washington University School of Medicine, St Louis, MO 63110
- Knight Alzheimer Disease Research Center, Washington University School of Medicine, St Louis, MO 63110
| | - David M. Holtzman
- Department of Neurology, Washington University School of Medicine, St Louis, MO 63110
- Knight Alzheimer Disease Research Center, Washington University School of Medicine, St Louis, MO 63110
- Center on Biological Rhythms and Sleep, Washington University School of Medicine, St Louis, MO 63110
| | - Brendan P. Lucey
- Department of Neurology, Washington University School of Medicine, St Louis, MO 63110
- Center on Biological Rhythms and Sleep, Washington University School of Medicine, St Louis, MO 63110
- Hope Center for Neurological Disorders, Washington University School of Medicine, St Louis, MO 63110
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Lee YF, Russ AN, Zhao Q, Perle SJ, Maci M, Miller MR, Hou SS, Algamal M, Zhao Z, Li H, Gelwan N, Liu Z, Gomperts SN, Araque A, Galea E, Bacskai BJ, Kastanenka KV. Optogenetic targeting of astrocytes restores slow brain rhythm function and slows Alzheimer's disease pathology. Sci Rep 2023; 13:13075. [PMID: 37567942 PMCID: PMC10421876 DOI: 10.1038/s41598-023-40402-3] [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: 04/13/2023] [Accepted: 08/09/2023] [Indexed: 08/13/2023] Open
Abstract
Patients with Alzheimer's disease (AD) exhibit non-rapid eye movement (NREM) sleep disturbances in addition to memory deficits. Disruption of NREM slow waves occurs early in the disease progression and is recapitulated in transgenic mouse models of beta-amyloidosis. However, the mechanisms underlying slow-wave disruptions remain unknown. Because astrocytes contribute to slow-wave activity, we used multiphoton microscopy and optogenetics to investigate whether they contribute to slow-wave disruptions in APP/PS1 mice. The power but not the frequency of astrocytic calcium transients was reduced in APP/PS1 mice compared to nontransgenic controls. Optogenetic activation of astrocytes at the endogenous frequency of slow waves restored slow-wave power, reduced amyloid deposition, prevented neuronal calcium elevations, and improved memory performance. Our findings revealed malfunction of the astrocytic network driving slow-wave disruptions. Thus, targeting astrocytes to restore circuit activity underlying sleep and memory disruptions in AD could ameliorate disease progression.
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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, 02129, USA
- Department of Anatomy and Neurobiology, Boston University School of Medicine, Boston, MA, 02118, USA
| | - Alyssa N Russ
- Department of Neurology, MassGeneral Institute of Neurodegenerative Diseases, Massachusetts General Hospital and Harvard Medical School, Charlestown, MA, 02129, USA
| | - Qiuchen Zhao
- Department of Neurology, MassGeneral Institute of Neurodegenerative Diseases, Massachusetts General Hospital and Harvard Medical School, Charlestown, MA, 02129, USA
| | - Stephen J Perle
- Department of Neurology, MassGeneral Institute of Neurodegenerative Diseases, Massachusetts General Hospital and Harvard Medical School, Charlestown, MA, 02129, USA
| | - Megi Maci
- Department of Neurology, MassGeneral Institute of Neurodegenerative Diseases, Massachusetts General Hospital and Harvard Medical School, Charlestown, MA, 02129, USA
| | - Morgan R Miller
- Department of Neurology, MassGeneral Institute of Neurodegenerative Diseases, Massachusetts General Hospital and Harvard Medical School, Charlestown, MA, 02129, USA
| | - Steven S Hou
- Department of Neurology, MassGeneral Institute of Neurodegenerative Diseases, Massachusetts General Hospital and Harvard Medical School, Charlestown, MA, 02129, USA
| | - Moustafa Algamal
- Department of Neurology, MassGeneral Institute of Neurodegenerative Diseases, Massachusetts General Hospital and Harvard Medical School, Charlestown, MA, 02129, USA
| | - Zhuoyang Zhao
- Department of Neurology, MassGeneral Institute of Neurodegenerative Diseases, Massachusetts General Hospital and Harvard Medical School, Charlestown, MA, 02129, USA
| | - Hanyan Li
- Department of Neurology, MassGeneral Institute of Neurodegenerative Diseases, Massachusetts General Hospital and Harvard Medical School, Charlestown, MA, 02129, USA
| | - Noah Gelwan
- Department of Neurology, MassGeneral Institute of Neurodegenerative Diseases, Massachusetts General Hospital and Harvard Medical School, Charlestown, MA, 02129, USA
| | - Zhe Liu
- Department of Neurology, MassGeneral Institute of Neurodegenerative Diseases, Massachusetts General Hospital and Harvard Medical School, Charlestown, MA, 02129, USA
| | - Stephen N Gomperts
- Department of Neurology, MassGeneral Institute of Neurodegenerative Diseases, Massachusetts General Hospital and Harvard Medical School, Charlestown, MA, 02129, USA
| | - Alfonso Araque
- Department of Neuroscience, University of Minnesota, Minneapolis, MN, 55455, USA
| | - Elena Galea
- Department of Neurology, MassGeneral Institute of Neurodegenerative Diseases, Massachusetts General Hospital and Harvard Medical School, Charlestown, MA, 02129, USA
| | - Brian J Bacskai
- Department of Neurology, MassGeneral Institute of Neurodegenerative Diseases, Massachusetts General Hospital and Harvard Medical School, Charlestown, MA, 02129, USA.
| | - Ksenia V Kastanenka
- Department of Neurology, MassGeneral Institute of Neurodegenerative Diseases, Massachusetts General Hospital and Harvard Medical School, Charlestown, MA, 02129, USA.
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Rios RL, Kafashan M, Hyche O, Lenard E, Lucey BP, Lenze EJ, Palanca BJA. Targeting Slow Wave Sleep Deficiency in Late-Life Depression: A Case Series With Propofol. Am J Geriatr Psychiatry 2023; 31:643-652. [PMID: 37105885 PMCID: PMC10544727 DOI: 10.1016/j.jagp.2023.03.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Revised: 03/14/2023] [Accepted: 03/16/2023] [Indexed: 04/29/2023]
Abstract
Slow wave sleep (SWS), characterized by large electroencephalographic oscillations, facilitates crucial physiologic processes that maintain synaptic plasticity and overall brain health. Deficiency in older adults is associated with depression and cognitive dysfunction, such that enhancing sleep slow waves has emerged as a promising target for novel therapies. Enhancement of SWS has been noted after infusions of propofol, a commonly used anesthetic that induces electroencephalographic patterns resembling non-rapid eye movement sleep. This paper 1) reviews the scientific premise underlying the hypothesis that sleep slow waves are a novel therapeutic target for improving cognitive and psychiatric outcomes in older adults, and 2) presents a case series of two patients with late-life depression who each received two propofol infusions. One participant, a 71-year-old woman, had a mean of 2.8 minutes of evening SWS prior to infusions (0.7% of total sleep time). SWS increased on the night after each infusion, to 12.5 minutes (5.3% of total sleep time) and 24 minutes (10.6% of total sleep time), respectively. Her depression symptoms improved, reflected by a reduction in her Montgomery-Asberg Depression Rating Scale (MADRS) score from 26 to 7. In contrast, the other participant, a 77-year-old man, exhibited no SWS at baseline and only modest enhancement after the second infusion (3 minutes, 1.3% of total sleep time). His MADRS score increased from 13 to 19, indicating a lack of improvement in his depression. These cases provide proof-of-concept that propofol can enhance SWS and improve depression for some individuals, motivating an ongoing clinical trial (ClinicalTrials.gov NCT04680910).
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Affiliation(s)
- Rachel L Rios
- Department of Anesthesiology (RLR, MK, OH, EJL, BJAP), Washington University School of Medicine in St. Louis, St. Louis, MO
| | - MohammadMehdi Kafashan
- Department of Anesthesiology (RLR, MK, OH, EJL, BJAP), Washington University School of Medicine in St. Louis, St. Louis, MO
| | - Orlandrea Hyche
- Department of Anesthesiology (RLR, MK, OH, EJL, BJAP), Washington University School of Medicine in St. Louis, St. Louis, MO
| | - Emily Lenard
- Department of Psychiatry (EL, EJL, BJAP), Washington University School of Medicine in St. Louis, St. Louis, MO
| | - Brendan P Lucey
- Center on Biological Rhythms and Sleep (BPL, BJAP), Washington University School of Medicine in St. Louis, St. Louis, MO; Department of Neurology (BPL), Washington University in St. Louis, MO
| | - Eric J Lenze
- Department of Anesthesiology (RLR, MK, OH, EJL, BJAP), Washington University School of Medicine in St. Louis, St. Louis, MO; Department of Psychiatry (EL, EJL, BJAP), Washington University School of Medicine in St. Louis, St. Louis, MO
| | - Ben Julian A Palanca
- Department of Anesthesiology (RLR, MK, OH, EJL, BJAP), Washington University School of Medicine in St. Louis, St. Louis, MO; Department of Psychiatry (EL, EJL, BJAP), Washington University School of Medicine in St. Louis, St. Louis, MO; Center on Biological Rhythms and Sleep (BPL, BJAP), Washington University School of Medicine in St. Louis, St. Louis, MO; Department of Biomedical Engineering (BJAP), Washington University in St. Louis, St. Louis, MO; Division of Biology and Biomedical Sciences (BJAP), Washington University School of Medicine in St. Louis, St. Louis, MO.
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Berry AS, Harrison TM. New perspectives on the basal forebrain cholinergic system in Alzheimer's disease. Neurosci Biobehav Rev 2023; 150:105192. [PMID: 37086935 PMCID: PMC10249144 DOI: 10.1016/j.neubiorev.2023.105192] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Revised: 02/27/2023] [Accepted: 03/28/2023] [Indexed: 04/24/2023]
Abstract
The basal forebrain cholinergic system (BFCS) has long been implicated in age-related cognitive changes and the pathophysiology of Alzheimer's disease (AD). Limitations of cholinergic interventions helped to inspire a shift away from BFCS in AD research. A resurgence in interest in the BFCS following methodological and analytical advances has resulted in a call for the BFCS to be examined in novel frameworks. We outline the basic structure and function of the BFCS, its role in supporting cognitive and affective function, and its vulnerability to aging and AD. We consider the BFCS in the context of the amyloid hypothesis and evolving concepts in AD research: resilience and resistance to pathology, selective neuronal vulnerability, trans-synaptic pathology spread and sleep health. We highlight 1) the potential role of the BFCS in cognitive resilience, 2) recent work refining understanding about the selective vulnerability of BFCS to AD, 3) BFCS connectivity that suggests it is related to tau spreading and neurodegeneration and 4) the gap between BFCS involvement in AD and sleep-wake cycles.
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Affiliation(s)
| | - Theresa M Harrison
- Helen Wills Neuroscience Institute, University of California Berkeley, Berkeley, CA 94720, USA
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Jouvencel A, Baillet M, Meyer M, Dilharreguy B, Lamare F, Pérès K, Helmer C, Dartigues J, Amieva H, Mayo W, Catheline G. Night-to-night variability in sleep and amyloid beta burden in normal aging. ALZHEIMER'S & DEMENTIA (AMSTERDAM, NETHERLANDS) 2023; 15:e12460. [PMID: 37745892 PMCID: PMC10512442 DOI: 10.1002/dad2.12460] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Revised: 05/25/2023] [Accepted: 06/27/2023] [Indexed: 09/26/2023]
Abstract
INTRODUCTION Alzheimer's disease is associated with sleep disturbances and accumulation of cerebral amyloid beta. The objective was to examine whether actigraphy-detected sleep parameters might be biomarkers for early amyloid burden. METHODS Participants underwent a week of actigraphy and an amyloid positron emission tomography (PET) scan. Sleep duration and continuity disruption (sleep fragmentation and nocturnal awakenings) were extracted and compared between amyloid-positive and amyloid-negative participants. Then multiple linear regressions were used between mean or night-to-night intra-individual variability (standard deviation) of sleep parameters and brain amyloid burden in a voxel-wise analysis. RESULTS Eighty-six subjects were included (80.3 ± 5.4 years; 48.8% of women). Amyloid-positive participants had a higher variability of sleep fragmentation compared to amyloid-negative participants. This parameter was associated with a higher amyloid burden in the frontal and parietal regions, and in the precuneus, in the whole sample. DISCUSSION This study highlights the relevance of using variability in sleep continuity as a potential biomarker of early amyloid pathogenesis.
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Affiliation(s)
| | - Marion Baillet
- GIGA‐CRC‐In Vivo Imaging Research UnitUniversity of LiègeLiègeBelgium
| | - Marie Meyer
- INCIA, EPHE, Université PSLUniv BordeauxCNRSBordeauxFrance
- Nuclear Medicine DepartmentUniversity Hospital of BordeauxBordeauxFrance
| | | | - Frederic Lamare
- INCIA, EPHE, Université PSLUniv BordeauxCNRSBordeauxFrance
- Nuclear Medicine DepartmentUniversity Hospital of BordeauxBordeauxFrance
| | - Karine Pérès
- INSERMBordeaux Population Health Research CenterUniversity of BordeauxUMR U1219BordeauxFrance
| | - Catherine Helmer
- INSERMBordeaux Population Health Research CenterUniversity of BordeauxUMR U1219BordeauxFrance
| | - Jean‐François Dartigues
- INSERMBordeaux Population Health Research CenterUniversity of BordeauxUMR U1219BordeauxFrance
| | - Hélène Amieva
- INSERMBordeaux Population Health Research CenterUniversity of BordeauxUMR U1219BordeauxFrance
| | - Willy Mayo
- INCIA, EPHE, Université PSLUniv BordeauxCNRSBordeauxFrance
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Semyachkina-Glushkovskaya O, Penzel T, Poluektov M, Fedosov I, Tzoy M, Terskov A, Blokhina I, Sidorov V, Kurths J. Phototherapy of Alzheimer's Disease: Photostimulation of Brain Lymphatics during Sleep: A Systematic Review. Int J Mol Sci 2023; 24:10946. [PMID: 37446135 DOI: 10.3390/ijms241310946] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Revised: 06/18/2023] [Accepted: 06/26/2023] [Indexed: 07/15/2023] Open
Abstract
The global number of people with Alzheimer's disease (AD) doubles every 5 years. It has been established that unless an effective treatment for AD is found, the incidence of AD will triple by 2060. However, pharmacological therapies for AD have failed to show effectiveness and safety. Therefore, the search for alternative methods for treating AD is an urgent problem in medicine. The lymphatic drainage and removal system of the brain (LDRSB) plays an important role in resistance to the progression of AD. The development of methods for augmentation of the LDRSB functions may contribute to progress in AD therapy. Photobiomodulation (PBM) is considered to be a non-pharmacological and safe approach for AD therapy. Here, we highlight the most recent and relevant studies of PBM for AD. We focus on emerging evidence that indicates the potential benefits of PBM during sleep for modulation of natural activation of the LDRSB at nighttime, providing effective removal of metabolites, including amyloid-β, from the brain, leading to reduced progression of AD. Our review creates a new niche in the therapy of brain diseases during sleep and sheds light on the development of smart sleep technologies for neurodegenerative diseases.
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Affiliation(s)
- Oxana Semyachkina-Glushkovskaya
- Department of Physics, Humboldt University, Newtonstrasse 15, 12489 Berlin, Germany
- Department of Biology, Saratov State University, Astrakhanskaya 82, 410012 Saratov, Russia
| | - Thomas Penzel
- Department of Biology, Saratov State University, Astrakhanskaya 82, 410012 Saratov, Russia
- Interdisziplinäres Schlafmedizinisches Zentrum, Charité-Universitätsmedizin Berlin, Charitéplatz 1, 10117 Berlin, Germany
| | - Mikhail Poluektov
- Department of Nervous Diseases, Sechenov First Moscow State Medical University, Bolshaya Pirogovskaya 2, Building 4, 119435 Moscow, Russia
| | - Ivan Fedosov
- Department of Biology, Saratov State University, Astrakhanskaya 82, 410012 Saratov, Russia
| | - Maria Tzoy
- Department of Biology, Saratov State University, Astrakhanskaya 82, 410012 Saratov, Russia
| | - Andrey Terskov
- Department of Biology, Saratov State University, Astrakhanskaya 82, 410012 Saratov, Russia
| | - Inna Blokhina
- Department of Biology, Saratov State University, Astrakhanskaya 82, 410012 Saratov, Russia
| | - Viktor Sidorov
- Company "Lazma" for Research and Production Enterprise of Laser Medical Equipment, Kuusinena Str. 11, 123308 Moscow, Russia
| | - Jürgen Kurths
- Department of Physics, Humboldt University, Newtonstrasse 15, 12489 Berlin, Germany
- Department of Biology, Saratov State University, Astrakhanskaya 82, 410012 Saratov, Russia
- Department of Complexity Science, Potsdam Institute for Climate Impact Research, Telegrafenberg A31, 14473 Potsdam, Germany
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Kam K, Vetter K, Tejiram RA, Pettibone WD, Shim K, Audrain M, Yu L, Daehn IS, Ehrlich ME, Varga AW. Effect of Aging and a Dual Orexin Receptor Antagonist on Sleep Architecture and Non-REM Oscillations Including an REM Behavior Disorder Phenotype in the PS19 Mouse Model of Tauopathy. J Neurosci 2023; 43:4738-4749. [PMID: 37230765 PMCID: PMC10286944 DOI: 10.1523/jneurosci.1828-22.2023] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Revised: 04/21/2023] [Accepted: 04/28/2023] [Indexed: 05/27/2023] Open
Abstract
The impact of tau pathology on sleep microarchitecture features, including slow oscillations, spindles, and their coupling, has been understudied, despite the proposed importance of these electrophysiological features toward learning and memory. Dual orexin receptor antagonists (DORAs) are known to promote sleep, but whether and how they affect sleep microarchitecture in the setting of tauopathy is unknown. In the PS19 mouse model of tauopathy MAPT (microtubule-associated protein tau) P301S (both male and female), young PS19 mice 2-3 months old show a sleep electrophysiology signature with markedly reduced spindle duration and power and elevated slow oscillation (SO) density compared with littermate controls, although there is no significant tau hyperphosphorylation, tangle formation, or neurodegeneration at this age. With aging, there is evidence for sleep disruption in PS19 mice, characterized by reduced REM duration, increased non-REM and REM fragmentation, and more frequent brief arousals at the macrolevel and reduced spindle density, SO density, and spindle-SO coupling at the microlevel. In ∼33% of aged PS19 mice, we unexpectedly observed abnormal goal-directed behaviors in REM, including mastication, paw grasp, and forelimb/hindlimb extension, seemingly consistent with REM behavior disorder (RBD). Oral administration of DORA-12 in aged PS19 mice increased non-REM and REM duration, albeit with shorter bout lengths, and increased spindle density, spindle duration, and SO density without change to spindle-SO coupling, power in either the SO or spindle bands, or the arousal index. We observed a significant effect of DORA-12 on objective measures of RBD, thereby encouraging future exploration of DORA effects on sleep-mediated cognition and RBD treatment.SIGNIFICANCE STATEMENT The specific effect of tauopathy on sleep macroarchitecture and microarchitecture throughout aging remains unknown. Our key findings include the following: (1) the identification of a sleep EEG signature constituting an early biomarker of impending tauopathy; (2) sleep physiology deteriorates with aging that are also markers of off-line cognitive processing; (3) the novel observation that dream enactment behaviors reminiscent of RBD occur, likely the first such observation in a tauopathy model; and (4) a dual orexin receptor antagonist is capable of restoring several of the sleep macroarchitecture and microarchitecture abnormalities.
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Affiliation(s)
- Korey Kam
- Catherine and Henry J. Gaisman Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, New York 10029
| | - Kenny Vetter
- Catherine and Henry J. Gaisman Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, New York 10029
| | - Rachel A Tejiram
- Catherine and Henry J. Gaisman Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, New York 10029
| | - Ward D Pettibone
- Catherine and Henry J. Gaisman Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, New York 10029
| | - Kaitlyn Shim
- Catherine and Henry J. Gaisman Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, New York 10029
| | - Mickael Audrain
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, New York 10029
| | - Liping Yu
- Division of Nephrology, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, New York 10029
| | - Ilse S Daehn
- Division of Nephrology, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, New York 10029
| | - Michelle E Ehrlich
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, New York 10029
| | - Andrew W Varga
- Catherine and Henry J. Gaisman Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, New York 10029
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Xiong J, Bhimani R, Carney-Anderson L. Review of Risk Factors Associated With Biomarkers for Alzheimer Disease. J Neurosci Nurs 2023; 55:103-109. [PMID: 37094378 DOI: 10.1097/jnn.0000000000000705] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/26/2023]
Abstract
ABSTRACT BACKGROUND: Alzheimer disease (AD) is a neurodegenerative disease with no cure. The number of individuals living with AD doubles every 5 years. The current clinical practice relies on clinical history, mental status tests, cerebrum imaging, and physical and neurological examinations; however, recent advances in the field of biomarkers have provided clues for the early detection of AD. High levels of tau and low levels of amyloid-β (Aβ) in cerebrospinal fluid are well-known biomarkers for AD. METHODS: A database search of PubMed, Ovid MEDLINE, and CINAHL was conducted to identify relevant articles published within the last 5 years. The search was limited to articles concerning adults 65 years or older and published in the English language. Twelve articles were included in the review. RESULTS: Risk factors of sleep disruption, depression, and motor function are implicated. Cerebrospinal fluid parameters for biomarkers of tau and Aβ were universally lower among Blacks compared with Whites, raising concern that norm reference may not be accurate for all populations. Older adults are more at risk for AD. Results are inconclusive regarding whether depression is related to Aβ and tau pathology. CONCLUSION: Nurses should screen for sleep architecture, depression, and motor function in their patients and educate them on good sleep hygiene. Sleep studies should be advocated for people with suspected sleep apnea to mitigate the risk factor related to abnormal Aβ and tau pathology. Falls and decreased motor function require screening because they may be early indicators of abnormal biomarkers leading to AD.
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Faerman A, Clark JB, Sutton JP. Neuropsychological considerations for long-duration deep spaceflight. Front Physiol 2023; 14:1146096. [PMID: 37275233 PMCID: PMC10235498 DOI: 10.3389/fphys.2023.1146096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Accepted: 05/09/2023] [Indexed: 06/07/2023] Open
Abstract
The deep space environment far beyond low-Earth orbit (LEO) introduces multiple and simultaneous risks for the functioning and health of the central nervous system (CNS), which may impair astronauts' performance and wellbeing. As future deep space missions to Mars, moons, or asteroids will also exceed current LEO stay durations and are estimated to require up to 3 years, we review recent evidence with contemporary and historic spaceflight case studies addressing implications for long-duration missions. To highlight the need for specific further investigations, we provide neuropsychological considerations integrating cognitive and motor functions, neuroimaging, neurological biomarkers, behavior changes, and mood and affect to construct a multifactorial profile to explain performance variability, subjective experience, and potential risks. We discuss the importance of adopting a neuropsychological approach to long-duration deep spaceflight (LDDS) missions and draw specific recommendations for future research in space neuropsychology.
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Affiliation(s)
- Afik Faerman
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, United States
| | - Jonathan B. Clark
- Center for Space Medicine, Baylor College of Medicine, Houston, TX, United States
- Department of Neurology, Baylor College of Medicine, Houston, TX, United States
| | - Jeffrey P. Sutton
- Center for Space Medicine, Baylor College of Medicine, Houston, TX, United States
- Translational Research Institute for Space Health, Baylor College of Medicine, Houston, TX, United States
- Department of Medicine, Baylor College of Medicine, Houston, TX, United States
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