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Mukherjee U, Sehar U, Brownell M, Reddy PH. Mechanisms, Consequences and Role of Interventions for Sleep Deprivation: Focus on Mild Cognitive Impairment and Alzheimer's Disease in Elderly. Ageing Res Rev 2024; 100:102457. [PMID: 39154978 DOI: 10.1016/j.arr.2024.102457] [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: 08/02/2024] [Revised: 08/12/2024] [Accepted: 08/13/2024] [Indexed: 08/20/2024]
Abstract
Sleep is established as an essential physiological need that impacts physical, emotional, and cognitive functions profoundly. Physiologically, inadequate sleep weakens immune function, heightening susceptibility to infections and chronic illnesses such as obesity, diabetes, and cardiovascular diseases. Hormonal disruptions due to sleep loss further exacerbate metabolic dysregulation, contributing to weight gain and other health complications. Emotionally, sleep deprivation leads to mood disturbances, including increased irritability, heightened stress responses, and a greater likelihood of mood disorders like depression and anxiety. These effects are compounded by cognitive impairments such as reduced alertness, impaired memory consolidation, and compromised decision-making abilities, akin to the impairments caused by alcohol consumption. Motor skills and coordination also suffer, elevating the risk of accidents, particularly in high-stress environments. For older adults, sleep quality is closely linked to cognitive function and overall longevity. Optimal sleep patterns are associated with slower brain aging and improved health outcomes. However, sleep disorders exacerbate existing conditions such as epilepsy and asthma, necessitating interventions like cognitive behavioral therapy (CBT) and medications such as melatonin to mitigate their impact. Education emerges as a crucial tool in promoting healthier sleep habits across all age groups. Addressing misconceptions about sleep and integrating sleep health into public health policies are essential steps toward improving overall well-being. Additionally, lifestyle factors such as diet and physical activity play significant roles in regulating sleep patterns, further emphasizing the interconnectedness of sleep with broader health outcomes. In summary, the articles underscore the intricate mechanisms through which sleep influences physiological functions and advocate for comprehensive approaches to enhance sleep hygiene and mitigate the adverse effects of sleep deprivation on human health.
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Affiliation(s)
- Upasana Mukherjee
- Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, TX, USA
| | - Ujala Sehar
- Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, TX, USA
| | - Malcolm Brownell
- Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, TX, USA
| | - P Hemachandra Reddy
- Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, TX, USA; Nutritional Sciences Department, College Human Sciences, Texas Tech University, Lubbock, TX, USA; Department of Pharmacology and Neuroscience, Texas Tech University Health Sciences Center, Lubbock, TX, USA; Department of Neurology, Texas Tech University Health Sciences Center, Lubbock, TX, USA; Department of Public Health, Graduate School of Biomedical Sciences, Texas Tech University Health Sciences Center, Lubbock, TX, USA; Department of Speech, Language, and Hearing Sciences, Texas Tech University Health Sciences Center, Lubbock, TX, USA.
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Ouyang A, Zhang C, Adra N, Tesh RA, Sun H, Lei D, Jing J, Fan P, Paixao L, Ganglberger W, Briggs L, Salinas J, Bevers MB, Wrann CD, Chemali Z, Fricchione G, Thomas RJ, Rosand J, Tanzi RE, Westover MB. Effects of Aerobic Exercise on Brain Age and Health in Middle-Aged and Older Adults: A Single-Arm Pilot Clinical Trial. Life (Basel) 2024; 14:855. [PMID: 39063609 PMCID: PMC11278044 DOI: 10.3390/life14070855] [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: 02/11/2024] [Revised: 05/26/2024] [Accepted: 06/27/2024] [Indexed: 07/28/2024] Open
Abstract
BACKGROUNDS Sleep disturbances are prevalent among elderly individuals. While polysomnography (PSG) serves as the gold standard for sleep monitoring, its extensive setup and data analysis procedures impose significant costs and time constraints, thereby restricting the long-term application within the general public. Our laboratory introduced an innovative biomarker, utilizing artificial intelligence algorithms applied to PSG data to estimate brain age (BA), a metric validated in cohorts with cognitive impairments. Nevertheless, the potential of exercise, which has been a recognized means of enhancing sleep quality in middle-aged and older adults to reduce BA, remains undetermined. METHODS We conducted an exploratory study to evaluate whether 12 weeks of moderate-intensity exercise can improve cognitive function, sleep quality, and the brain age index (BAI), a biomarker computed from overnight sleep electroencephalogram (EEG), in physically inactive middle-aged and older adults. Home wearable devices were used to monitor heart rate and overnight sleep EEG over this period. The NIH Toolbox Cognition Battery, in-lab overnight polysomnography, cardiopulmonary exercise testing, and a multiplex cytokines assay were employed to compare pre- and post-exercise brain health, exercise capacity, and plasma proteins. RESULTS In total, 26 participants completed the initial assessment and exercise program, and 24 completed all procedures. Data are presented as mean [lower 95% CI of mean, upper 95% CI of mean]. Participants significantly increased maximal oxygen consumption (Pre: 21.11 [18.98, 23.23], Post 22.39 [20.09, 24.68], mL/kg/min; effect size: -0.33) and decreased resting heart rate (Pre: 66.66 [63.62, 67.38], Post: 65.13 [64.25, 66.93], bpm; effect size: -0.02) and sleeping heart rate (Pre: 64.55 [61.87, 667.23], Post: 62.93 [60.78, 65.09], bpm; effect size: -0.15). Total cognitive performance (Pre: 111.1 [107.6, 114.6], Post: 115.2 [111.9, 118.5]; effect size: 0.49) was significantly improved. No significant differences were seen in BAI or measures of sleep macro- and micro-architecture. Plasma IL-4 (Pre: 0.24 [0.18, 0.3], Post: 0.33 [0.24, 0.42], pg/mL; effect size: 0.49) was elevated, while IL-8 (Pre: 5.5 [4.45, 6.55], Post: 4.3 [3.66, 5], pg/mL; effect size: -0.57) was reduced. CONCLUSIONS Cognitive function was improved by a 12-week moderate-intensity exercise program in physically inactive middle-aged and older adults, as were aerobic fitness (VO2max) and plasma cytokine profiles. However, we found no measurable effects on sleep architecture or BAI. It remains to be seen whether a study with a larger sample size and more intensive or more prolonged exercise exposure can demonstrate a beneficial effect on sleep quality and brain age.
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Affiliation(s)
- An Ouyang
- Henry and Allison McCance Center for Brain Health, Massachusetts General Hospital, Boston, MA 02114, USA (C.Z.); (R.A.T.); (H.S.); (C.D.W.)
- Department of Neurology, Massachusetts General Hospital, Boston, MA 02114, USA; (J.J.)
- Harvard Medical School, Boston, MA 02115, USA (M.B.B.); (R.J.T.)
- Marcus Institute for Aging Research, Hebrew SeniorLife, Boston, MA 02131, USA
| | - Can Zhang
- Henry and Allison McCance Center for Brain Health, Massachusetts General Hospital, Boston, MA 02114, USA (C.Z.); (R.A.T.); (H.S.); (C.D.W.)
- Department of Neurology, Massachusetts General Hospital, Boston, MA 02114, USA; (J.J.)
- Harvard Medical School, Boston, MA 02115, USA (M.B.B.); (R.J.T.)
| | - Noor Adra
- Henry and Allison McCance Center for Brain Health, Massachusetts General Hospital, Boston, MA 02114, USA (C.Z.); (R.A.T.); (H.S.); (C.D.W.)
- Department of Neurology, Massachusetts General Hospital, Boston, MA 02114, USA; (J.J.)
- Harvard Medical School, Boston, MA 02115, USA (M.B.B.); (R.J.T.)
| | - Ryan A. Tesh
- Henry and Allison McCance Center for Brain Health, Massachusetts General Hospital, Boston, MA 02114, USA (C.Z.); (R.A.T.); (H.S.); (C.D.W.)
- Department of Neurology, Massachusetts General Hospital, Boston, MA 02114, USA; (J.J.)
- Harvard Medical School, Boston, MA 02115, USA (M.B.B.); (R.J.T.)
| | - Haoqi Sun
- Henry and Allison McCance Center for Brain Health, Massachusetts General Hospital, Boston, MA 02114, USA (C.Z.); (R.A.T.); (H.S.); (C.D.W.)
- Department of Neurology, Massachusetts General Hospital, Boston, MA 02114, USA; (J.J.)
- Harvard Medical School, Boston, MA 02115, USA (M.B.B.); (R.J.T.)
| | - Dan Lei
- Henry and Allison McCance Center for Brain Health, Massachusetts General Hospital, Boston, MA 02114, USA (C.Z.); (R.A.T.); (H.S.); (C.D.W.)
- Department of Neurology, Massachusetts General Hospital, Boston, MA 02114, USA; (J.J.)
- Harvard Medical School, Boston, MA 02115, USA (M.B.B.); (R.J.T.)
| | - Jin Jing
- Department of Neurology, Massachusetts General Hospital, Boston, MA 02114, USA; (J.J.)
- Harvard Medical School, Boston, MA 02115, USA (M.B.B.); (R.J.T.)
| | - Peng Fan
- Department of Physical Therapy & Human Movement Science, Feinberg School of Medicine, Northwestern University, Chicago, IL 60611, USA
| | - Luis Paixao
- Department of Neurology, Massachusetts General Hospital, Boston, MA 02114, USA; (J.J.)
- Harvard Medical School, Boston, MA 02115, USA (M.B.B.); (R.J.T.)
- Department of Neurology, Washington University School of Medicine in St. Louis, St. Louis, MO 63110, USA
| | - Wolfgang Ganglberger
- Henry and Allison McCance Center for Brain Health, Massachusetts General Hospital, Boston, MA 02114, USA (C.Z.); (R.A.T.); (H.S.); (C.D.W.)
- Department of Neurology, Massachusetts General Hospital, Boston, MA 02114, USA; (J.J.)
- Harvard Medical School, Boston, MA 02115, USA (M.B.B.); (R.J.T.)
| | - Logan Briggs
- Harvard Medical School, Boston, MA 02115, USA (M.B.B.); (R.J.T.)
| | - Joel Salinas
- Department of Neurology, New York University Grossman School of Medicine, New York, NY 10016, USA
| | - Matthew B. Bevers
- Harvard Medical School, Boston, MA 02115, USA (M.B.B.); (R.J.T.)
- Department of Neurology, Brigham and Women’s Hospital, Boston, MA 02115, USA
| | - Christiane Dorothea Wrann
- Henry and Allison McCance Center for Brain Health, Massachusetts General Hospital, Boston, MA 02114, USA (C.Z.); (R.A.T.); (H.S.); (C.D.W.)
- Harvard Medical School, Boston, MA 02115, USA (M.B.B.); (R.J.T.)
- Cardiovascular Research Center, Massachusetts General Hospital, Boston, MA 02114, USA
| | - Zeina Chemali
- Henry and Allison McCance Center for Brain Health, Massachusetts General Hospital, Boston, MA 02114, USA (C.Z.); (R.A.T.); (H.S.); (C.D.W.)
- Department of Neurology, Massachusetts General Hospital, Boston, MA 02114, USA; (J.J.)
- Harvard Medical School, Boston, MA 02115, USA (M.B.B.); (R.J.T.)
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA 02114, USA
| | - Gregory Fricchione
- Henry and Allison McCance Center for Brain Health, Massachusetts General Hospital, Boston, MA 02114, USA (C.Z.); (R.A.T.); (H.S.); (C.D.W.)
- Department of Neurology, Massachusetts General Hospital, Boston, MA 02114, USA; (J.J.)
- Harvard Medical School, Boston, MA 02115, USA (M.B.B.); (R.J.T.)
| | - Robert J. Thomas
- Harvard Medical School, Boston, MA 02115, USA (M.B.B.); (R.J.T.)
- Department of Medicine, Division of Pulmonary, Critical Care & Sleep, Beth Israel Deaconess Medical Center, Boston, MA 02215, USA
| | - Jonathan Rosand
- Henry and Allison McCance Center for Brain Health, Massachusetts General Hospital, Boston, MA 02114, USA (C.Z.); (R.A.T.); (H.S.); (C.D.W.)
- Department of Neurology, Massachusetts General Hospital, Boston, MA 02114, USA; (J.J.)
- Harvard Medical School, Boston, MA 02115, USA (M.B.B.); (R.J.T.)
| | - Rudolph E. Tanzi
- Henry and Allison McCance Center for Brain Health, Massachusetts General Hospital, Boston, MA 02114, USA (C.Z.); (R.A.T.); (H.S.); (C.D.W.)
- Department of Neurology, Massachusetts General Hospital, Boston, MA 02114, USA; (J.J.)
- Harvard Medical School, Boston, MA 02115, USA (M.B.B.); (R.J.T.)
| | - Michael Brandon Westover
- Henry and Allison McCance Center for Brain Health, Massachusetts General Hospital, Boston, MA 02114, USA (C.Z.); (R.A.T.); (H.S.); (C.D.W.)
- Department of Neurology, Massachusetts General Hospital, Boston, MA 02114, USA; (J.J.)
- Harvard Medical School, Boston, MA 02115, USA (M.B.B.); (R.J.T.)
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Wang Z, Li X, Wang J, Yang W, Dove A, Lu W, Qi X, Sindi S, Xu W. Association of past and current sleep duration with structural brain differences: A large population-based study from the UK Biobank. Sleep Med 2024; 119:179-186. [PMID: 38692219 DOI: 10.1016/j.sleep.2024.04.033] [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: 12/24/2023] [Revised: 04/19/2024] [Accepted: 04/24/2024] [Indexed: 05/03/2024]
Abstract
OBJECTIVE This study aimed to examine the association between past/current sleep duration and macro-/micro-structural brain outcomes and explore whether hypertension or social activity plays a role in such association. METHODS Within the UK Biobank, 40 436 dementia-free participants (age 40-70 years) underwent a baseline assessment followed by a brain magnetic resonance imaging (MRI) scan 9 years later. Past (baseline) and current (MRI scans) sleep duration (hours/day) were recorded and classified as short (≤5), intermediate (6-8), and long (≥9). Brain structural volumes and diffusion markers were assessed by MRI scans. RESULTS Compared with past intermediate sleep, past short sleep was related to smaller cortex volumes (standardized β [95 % CI]: -0.04 [-0.07, -0.02]) and lower regional fractional anisotropy (FA) (-0.08 [-0.13, -0.03]), while past long sleep was related to smaller regional subcortical volumes (standardized β: -0.04 to -0.07 for thalamus, accumbens, and hippocampus). Compared to current intermediate sleep, current short sleep was associated with smaller cortex volumes (-0.03 [-0.05, -0.01]), greater white matter hyperintensities (WMH) volumes (0.04 [0.01, 0.08]), and lower regional FA (-0.07 [-0.11, -0.02]). However, current long sleep was related to smaller total brain (-0.03 [-0.05, -0.02]), grey matter (-0.05 [-0.07, -0.03]), cortex (-0.05 [-0.07, -0.03]), regional subcortical volumes [standardized β: -0.05 to -0.09 for putamen, thalamus, hippocampus, and accumbens]), greater WMH volumes (0.06 [0.03, 0.09]), as well as lower regional FA (-0.05 [-0.09, -0.02]). The association between current long sleep duration and poor brain health was stronger among people with hypertension or low frequency of social activity (all Pinteraction <0.05). CONCLUSIONS Both past and current short/long sleep are associated with smaller brain volume and poorer white matter health in the brain, especially in individuals with hypertension and low frequency of social activity. Our findings highlight the need to maintain 6-8 h' sleep duration for healthy brain aging.
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Affiliation(s)
- Zhiyu Wang
- Department of Occupational and Environmental Health, School of Public Health, Tianjin Medical University, Tianjin, China; Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin, China; Center for International Collaborative Research on Environment, Nutrition and Public Health, Tianjin, China
| | - Xuerui Li
- Department of Geriatrics, Tianjin Medical University General Hospital, Tianjin Geriatrics Institute, Tianjin, China
| | - Jiao Wang
- Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin, China; Center for International Collaborative Research on Environment, Nutrition and Public Health, Tianjin, China; Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Wenzhe Yang
- Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin, China; Center for International Collaborative Research on Environment, Nutrition and Public Health, Tianjin, China; Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Abigail Dove
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | - Wenli Lu
- Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin, China; Center for International Collaborative Research on Environment, Nutrition and Public Health, Tianjin, China; Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Xiuying Qi
- Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin, China; Center for International Collaborative Research on Environment, Nutrition and Public Health, Tianjin, China; Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University, Tianjin, China.
| | - Shireen Sindi
- Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden; Ageing Epidemiology Research Unit (AGE), School of Public Health, Faculty of Medicine, Imperial College London, UK
| | - Weili Xu
- Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin, China; Center for International Collaborative Research on Environment, Nutrition and Public Health, Tianjin, China; Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University, Tianjin, China; Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.
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Nance RM, Fohner AE, McClelland RL, Redline S, Nick Bryan R, Desiderio L, Habes M, Longstreth WT, Schwab RJ, Wiemken AS, Heckbert SR. The Association of Upper Airway Anatomy with Brain Structure: The Multi-Ethnic Study of Atherosclerosis. Brain Imaging Behav 2024; 18:510-518. [PMID: 38194040 PMCID: PMC11222025 DOI: 10.1007/s11682-023-00843-w] [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] [Accepted: 12/21/2023] [Indexed: 01/10/2024]
Abstract
Sleep apnea, affecting an estimated 1 in 4 American adults, has been reported to be associated with both brain structural abnormality and impaired cognitive function. Obstructive sleep apnea is known to be affected by upper airway anatomy. To better understand the contribution of upper airway anatomy to pathways linking sleep apnea with impaired cognitive function, we investigated the association of upper airway anatomy with structural brain abnormalities. Based in the Multi-Ethnic Study of Atherosclerosis, a longitudinal cohort study of community-dwelling adults, a comprehensive sleep study and an MRI of the upper airway and brain were performed on 578 participants. Machine learning models were used to select from 74 upper airway measures those measures most associated with selected regional brain volumes and white matter hyperintensity volume. Linear regression assessed associations between the selected upper airway measures, sleep measures, and brain structure. Maxillary divergence was positively associated with hippocampus volume, and mandible length was negatively associated with total white and gray matter volume. Both coefficients were small (coefficients per standard deviation 0.063 mL, p = 0.04, and - 7.0 mL, p < 0.001 respectively), and not affected by adjustment for sleep study measures. Self-reported snoring >2 times per week was associated with larger hippocampus volume (coefficient 0.164 mL, p = 0.007), and higher percentage of time in the N3 sleep stage was associated with larger total white and gray matter volume (4.8 mL, p = 0.004). Despite associations of two upper airway anatomy measures with brain volume, the evidence did not suggest that these upper airway and brain structure associations were acting primarily through the pathway of sleep disturbance.
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Affiliation(s)
- Robin M Nance
- University of Washington, Seattle, WA, USA.
- , 325 9th Ave, Box 359931, Seattle, WA, 98104, USA.
| | - Alison E Fohner
- Department of Epidemiology & Cardiovascular Health Research Unit, University of Washington, Seattle, WA, USA
| | | | - Susan Redline
- Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - R Nick Bryan
- Department of Radiology, University of Pennsylvania, Philadelphia, PA, USA
| | | | - Mohamad Habes
- Neuroimage Analytics Laboratory and Biggs Institute Neuroimaging Core, Glenn Biggs Institute for Neurodegenerative Disorders, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
| | - W T Longstreth
- Departments of Neurology and Epidemiology, University of Washington, Seattle, WA, USA
| | - Richard J Schwab
- Department of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Andrew S Wiemken
- Department of Medicine, University of Pennsylvania, Philadelphia, PA, USA
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Moon C, Schneider A, Cho YE, Zhang M, Dang H, Vu K. Sleep duration, sleep efficiency, and amyloid β among cognitively healthy later-life adults: a systematic review and meta-analysis. BMC Geriatr 2024; 24:408. [PMID: 38714912 PMCID: PMC11076214 DOI: 10.1186/s12877-024-05010-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Accepted: 04/24/2024] [Indexed: 05/12/2024] Open
Abstract
BACKGROUND Abnormal amyloid β (Aβ) deposits in the brain are a hallmark of Alzheimer's disease (AD). Insufficient sleep duration and poor sleep quality are risk factors for developing AD. Sleep may play a role in Aβ regulation, but the magnitude of the relationship between sleep and Aβ deposition remains unclear. This systematic review examines the relationship between sleep (i.e., duration and efficiency) with Aβ deposition in later-life adults. METHODS A search of PubMed, CINAHL, Embase, and PsycINFO generated 5,005 published articles. Fifteen studies met the inclusion criteria for qualitative syntheses; thirteen studies for quantitative syntheses related to sleep duration and Aβ; and nine studies for quantitative syntheses related to sleep efficiency and Aβ. RESULTS Mean ages of the samples ranged from 63 to 76 years. Studies measured Aβ using cerebrospinal fluid, serum, and positron emission tomography scans with two tracers: Carbone 11-labeled Pittsburgh compound B or fluorine 18-labeled. Sleep duration was measured subjectively using interviews or questionnaires, or objectively using polysomnography or actigraphy. Study analyses accounted for demographic and lifestyle factors. Based on 13 eligible articles, our synthesis demonstrated that the average association between sleep duration and Aβ was not statistically significant (Fisher's Z = -0.055, 95% CI = -0.117 ~ 0.008). We found that longer self-report sleep duration is associated with lower Aβ (Fisher's Z = -0.062, 95% CI = -0.119 ~ -0.005), whereas the objectively measured sleep duration was not associated with Aβ (Fisher's Z = 0.002, 95% CI = -0.108 ~ 0.113). Based on 9 eligible articles for sleep efficiency, our synthesis also demonstrated that the average association between sleep efficiency and Aβ was not statistically significant (Fisher's Z = 0.048, 95% CI = -0.066 ~ 0.161). CONCLUSION The findings from this review suggest that shorter self-reported sleep duration is associated with higher Aβ levels. Given the heterogeneous nature of the sleep measures and outcomes, it is still difficult to determine the exact relationship between sleep and Aβ. Future studies with larger sample sizes should focus on comprehensive sleep characteristics and use longitudinal designs to better understand the relationship between sleep and AD.
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Affiliation(s)
- Chooza Moon
- University of Iowa College of Nursing, 50 Newton Rd, Iowa City, IA, 52242, USA.
| | - Aaron Schneider
- University of Iowa College of Liberal Arts and Sciences Department of Health and Human Physiology, 225 S. Grand Ave., Iowa City, IA, 52240, USA
| | - Young-Eun Cho
- University of Iowa College of Nursing, 50 Newton Rd, Iowa City, IA, 52242, USA
| | - Meina Zhang
- University of Iowa College of Nursing, 50 Newton Rd, Iowa City, IA, 52242, USA
| | - Hellen Dang
- University of Iowa College of Liberal Arts and Sciences Department of Health and Human Physiology, 225 S. Grand Ave., Iowa City, IA, 52240, USA
| | - Kelly Vu
- University of Iowa College of Pharmacy, 180 S. Grand Avenue, Iowa City, IA, 52242, USA
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Fu X, Wan XJ, Liu JY, Sun Q, Shen Y, Li J, Mao CJ, Ma QH, Wang F, Liu CF. Effects of sleep fragmentation on white matter pathology in a rat model of cerebral small vessel disease. Sleep 2024; 47:zsad225. [PMID: 37638817 DOI: 10.1093/sleep/zsad225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Revised: 08/10/2023] [Indexed: 08/29/2023] Open
Abstract
STUDY OBJECTIVES Mounting evidence indicated the correlation between sleep and cerebral small vessel disease (CSVD). However, little is known about the exact causality between poor sleep and white matter injury, a typical signature of CSVD, as well as the underlying mechanisms. METHODS Spontaneously hypertensive rats (SHR) and control Wistar Kyoto rats were subjected to sleep fragmentation (SF) for 16 weeks. The effects of chronic sleep disruption on the deep white matter and cognitive performance were observed. RESULTS SHR were validated as a rat model for CSVD. Fragmented sleep induced strain-dependent white matter abnormalities, characterized by reduced myelin integrity, impaired oligodendrocytes precursor cells (OPC) maturation and pro-inflammatory microglial polarization. Partially reversible phenotypes of OPC and microglia were observed in parallel following sleep recovery. CONCLUSIONS Long-term SF-induced pathological effects on the deep white matter in a rat model of CSVD. The pro-inflammatory microglial activation and the block of OPC maturation may be involved in the mechanisms linking sleep to white matter injury.
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Affiliation(s)
- Xiang Fu
- Department of Neurology and Clinical Research Center of Neurological Disease, The Second Affiliated Hospital of Soochow University, Suzhou, China
- Jiangsu Key Laboratory of Neuropsychiatric Diseases and Institute of Neuroscience, Soochow University, Suzhou, China
| | - Xiao-Jie Wan
- Department of Neurology and Clinical Research Center of Neurological Disease, The Second Affiliated Hospital of Soochow University, Suzhou, China
- Jiangsu Key Laboratory of Neuropsychiatric Diseases and Institute of Neuroscience, Soochow University, Suzhou, China
| | - Jun-Yi Liu
- Jiangsu Key Laboratory of Neuropsychiatric Diseases and Institute of Neuroscience, Soochow University, Suzhou, China
| | - Qian Sun
- Department of Neurology and Clinical Research Center of Neurological Disease, The Second Affiliated Hospital of Soochow University, Suzhou, China
| | - Yun Shen
- Department of Neurology and Clinical Research Center of Neurological Disease, The Second Affiliated Hospital of Soochow University, Suzhou, China
| | - Jie Li
- Department of Neurology and Clinical Research Center of Neurological Disease, The Second Affiliated Hospital of Soochow University, Suzhou, China
| | - Cheng-Jie Mao
- Department of Neurology and Clinical Research Center of Neurological Disease, The Second Affiliated Hospital of Soochow University, Suzhou, China
- Jiangsu Key Laboratory of Neuropsychiatric Diseases and Institute of Neuroscience, Soochow University, Suzhou, China
| | - Quan-Hong Ma
- Department of Neurology and Clinical Research Center of Neurological Disease, The Second Affiliated Hospital of Soochow University, Suzhou, China
- Jiangsu Key Laboratory of Neuropsychiatric Diseases and Institute of Neuroscience, Soochow University, Suzhou, China
| | - Fen Wang
- Department of Neurology and Clinical Research Center of Neurological Disease, The Second Affiliated Hospital of Soochow University, Suzhou, China
- Jiangsu Key Laboratory of Neuropsychiatric Diseases and Institute of Neuroscience, Soochow University, Suzhou, China
| | - Chun-Feng Liu
- Department of Neurology and Clinical Research Center of Neurological Disease, The Second Affiliated Hospital of Soochow University, Suzhou, China
- Jiangsu Key Laboratory of Neuropsychiatric Diseases and Institute of Neuroscience, Soochow University, Suzhou, China
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Gottesman RF, Lutsey PL, Benveniste H, Brown DL, Full KM, Lee JM, Osorio RS, Pase MP, Redeker NS, Redline S, Spira AP. Impact of Sleep Disorders and Disturbed Sleep on Brain Health: A Scientific Statement From the American Heart Association. Stroke 2024; 55:e61-e76. [PMID: 38235581 DOI: 10.1161/str.0000000000000453] [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: 01/19/2024]
Abstract
Accumulating evidence supports a link between sleep disorders, disturbed sleep, and adverse brain health, ranging from stroke to subclinical cerebrovascular disease to cognitive outcomes, including the development of Alzheimer disease and Alzheimer disease-related dementias. Sleep disorders such as sleep-disordered breathing (eg, obstructive sleep apnea), and other sleep disturbances, as well, some of which are also considered sleep disorders (eg, insomnia, sleep fragmentation, circadian rhythm disorders, and extreme sleep duration), have been associated with adverse brain health. Understanding the causal role of sleep disorders and disturbances in the development of adverse brain health is complicated by the common development of sleep disorders among individuals with neurodegenerative disease. In addition to the role of sleep disorders in stroke and cerebrovascular injury, mechanistic hypotheses linking sleep with brain health and biomarker data (blood-based, cerebrospinal fluid-based, and imaging) suggest direct links to Alzheimer disease-specific pathology. These potential mechanisms and the increasing understanding of the "glymphatic system," and the recognition of the importance of sleep in poststroke recovery, as well, support a biological basis for the indirect (through the worsening of vascular disease) and direct (through specific effects on neuropathology) connections between sleep disorders and brain health. Given promising evidence for the benefits of treatment and prevention, sleep disorders and disturbances represent potential targets for early treatment that may improve brain health more broadly. In this scientific statement, we discuss the evidence supporting an association between sleep disorders and disturbances and poor brain health ranging from stroke to dementia and opportunities for prevention and early treatment.
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Wang S, Wu M, Wu S, Lin F, Ji X, Yan J. A polysomnographic study of slow-wave sleep loss in elderly patients with epilepsy. Heliyon 2024; 10:e25904. [PMID: 38379992 PMCID: PMC10877289 DOI: 10.1016/j.heliyon.2024.e25904] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Revised: 01/02/2024] [Accepted: 02/05/2024] [Indexed: 02/22/2024] Open
Abstract
Objective The primary objective is to explore what causes slow-wave sleep loss in elderly patients with epilepsy. The secondary objective is to identify the PSG characteristics in elderly patients with epilepsy. The clinical demographics, sleep architecture, sleep-related events, and interictal epileptiform discharges are to be evaluated in the objectives. Methods The video electroencephalography (VEEG) and polysomnogram (PSG) data from 44 elderly patients with epilepsy and 52 elderly patients with sleep disorders but without definite central nervous system diseases were analysed. This was a case-control study. The differences in the PSG sleep architecture parameters (total sleep time (TST), sleep efficiency, wake after sleep onset, etc.) and sleep-related events (apnea hypopnea index, oxygen desaturation index (ODI), periodic limb movement index, etc.) between the epilepsy and control groups. As Additionally, these parameters were assessed within the elderly patients with epilepsy, comparing the slow-wave sleep existence and slow-wave sleep loss groups, using VEEG and PSG. Results The epileptic group exhibited significantly lower TST (343.477 ± 96.3046min vs 389.115 ± 61.5727min, p < 0.05), rapid eye movement (%) (13.011 ± 7.5384 vs 16.992 ± 6.7025, p < 0.05), non-rapid eye movement stage 3 (%) (1.35[0,7.225] vs 3.65[0.425,13.75], p < 0.05), and sleep efficiency (%) (69.482 ± 14.1771% vs 77.242 ± 10.6171%, p < 0.05). Conversely, the ODI (25.6[9.825,51.775] events/hour vs 16.85[5.3,30.425] events/hour, p < 0.05) and spontaneous arousal index (4.0455[2.1805,6.9609] events/hour vs 2.9709[1.4747,5.0554] events/hour, p < 0.05) were significantly higher in elderly patients with epilepsy. The prevalence of obstructive sleep apnea-hypopnea syndrome (OSAHS) was significantly higher in the slow-wave sleep loss group than in the slow-wave sleep existence group (100% vs 77.8%, p < 0.05). The incidence of slow-wave sleep loss was lower in patients with epilepsy aged between 75 and 85 years compared to those aged between 65 and 75 years. Conclusion Elderly patients with epilepsy exhibit higher levels of ODI and spontaneous arousal index. Our findings indicate that OSAHS could be a contributing factor to slow-wave sleep loss in this population. The incidence of slow-wave sleep loss was lower in patients aged above 75 years among elderly patients with epilepsy.
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Affiliation(s)
| | | | - Sangru Wu
- Department of Neurology and Sleep Medical Center, Fujian Provincial Governmental Hospital, Fuzhou, China
| | - Fang Lin
- Department of Neurology and Sleep Medical Center, Fujian Provincial Governmental Hospital, Fuzhou, China
| | - Xiaolin Ji
- Department of Neurology and Sleep Medical Center, Fujian Provincial Governmental Hospital, Fuzhou, China
| | - Jinzhu Yan
- Department of Neurology and Sleep Medical Center, Fujian Provincial Governmental Hospital, Fuzhou, China
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Mazzotti DR. Multimodal integration of sleep electroencephalogram, brain imaging, and cognitive assessments: approaches using noisy clinical data. Sleep 2024; 47:zsad305. [PMID: 38019853 PMCID: PMC10851849 DOI: 10.1093/sleep/zsad305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Indexed: 12/01/2023] Open
Affiliation(s)
- Diego R Mazzotti
- Division of Medical Informatics, Department of Internal Medicine, University of Kansas Medical Center, Kansas City, KS, USA
- Division of Pulmonary Critical Care and Sleep Medicine, Department of Internal Medicine, University of Kansas Medical Center, Kansas City, KS, USA
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Wei R, Ganglberger W, Sun H, Hadar P, Gollub R, Pieper S, Billot B, Au R, Eugenio Iglesias J, Cash SS, Kim S, Shin C, Westover MB, Joseph Thomas R. Linking brain structure, cognition, and sleep: insights from clinical data. Sleep 2024; 47:zsad294. [PMID: 37950486 PMCID: PMC10851868 DOI: 10.1093/sleep/zsad294] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Revised: 10/13/2023] [Indexed: 11/12/2023] Open
Abstract
STUDY OBJECTIVES To use relatively noisy routinely collected clinical data (brain magnetic resonance imaging (MRI) data, clinical polysomnography (PSG) recordings, and neuropsychological testing), to investigate hypothesis-driven and data-driven relationships between brain physiology, structure, and cognition. METHODS We analyzed data from patients with clinical PSG, brain MRI, and neuropsychological evaluations. SynthSeg, a neural network-based tool, provided high-quality segmentations despite noise. A priori hypotheses explored associations between brain function (measured by PSG) and brain structure (measured by MRI). Associations with cognitive scores and dementia status were studied. An exploratory data-driven approach investigated age-structure-physiology-cognition links. RESULTS Six hundred and twenty-three patients with sleep PSG and brain MRI data were included in this study; 160 with cognitive evaluations. Three hundred and forty-two participants (55%) were female, and age interquartile range was 52 to 69 years. Thirty-six individuals were diagnosed with dementia, 71 with mild cognitive impairment, and 326 with major depression. One hundred and fifteen individuals were evaluated for insomnia and 138 participants had an apnea-hypopnea index equal to or greater than 15. Total PSG delta power correlated positively with frontal lobe/thalamic volumes, and sleep spindle density with thalamic volume. rapid eye movement (REM) duration and amygdala volume were positively associated with cognition. Patients with dementia showed significant differences in five brain structure volumes. REM duration, spindle, and slow-oscillation features had strong associations with cognition and brain structure volumes. PSG and MRI features in combination predicted chronological age (R2 = 0.67) and cognition (R2 = 0.40). CONCLUSIONS Routine clinical data holds extended value in understanding and even clinically using brain-sleep-cognition relationships.
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Affiliation(s)
- Ruoqi Wei
- Division of Pulmonary Critical Care & Sleep Medicine, Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA
- McCance Center for Brain Health, Massachusetts General Hospital, Boston, MA, USA
- Division of Sleep Medicine, Harvard Medical School, Boston, Massachusetts, USA
- Department of Health Outcomes and Biomedical Informatics, College of Medicine, University of Florida, Gainesville, FL, USA
| | - Wolfgang Ganglberger
- McCance Center for Brain Health, Massachusetts General Hospital, Boston, MA, USA
- Division of Sleep Medicine, Harvard Medical School, Boston, Massachusetts, USA
- Department of Neurology, Beth Israel Deaconess Medical Center, Boston, MA, USA
- Sleep and Health Zurich, University of Zurich, Zurich, Switzerland
| | - Haoqi Sun
- McCance Center for Brain Health, Massachusetts General Hospital, Boston, MA, USA
- Division of Sleep Medicine, Harvard Medical School, Boston, Massachusetts, USA
- Department of Neurology, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Peter N Hadar
- Department of Neurology, Massachusetts General Hospital, Boston, MA, USA
| | - Randy L Gollub
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
- Department of Radiology, Massachusetts General Hospital, Boston, MA, USA
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Boston, MA, USA
| | | | - Benjamin Billot
- Computer Science and Artificial Intelligence Lab, MIT, Boston, MA, USA
| | - Rhoda Au
- Anatomy& Neurobiology, Neurology, Medicine and Epidemiology, Boston University Chobanian & Avedisian School of Medicine and School of Public Health, Boston University, Boston, MA, USA
| | - Juan Eugenio Iglesias
- Department of Radiology, Massachusetts General Hospital, Boston, MA, USA
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Boston, MA, USA
- Isomics, Inc. Cambridge, MA, USA
- Center for Medical Image Computing, University College London, London, UK
| | - Sydney S Cash
- Department of Neurology, Massachusetts General Hospital, Boston, MA, USA
| | - Soriul Kim
- Institute of Human Genomic Study, College of Medicine, Kore University, Seoul, Republic of Korea
| | - Chol Shin
- Institute of Human Genomic Study, College of Medicine, Kore University, Seoul, Republic of Korea
- Biomedical Research Center, Korea University Ansan Hospital, Ansan, Republic of Korea
| | - M Brandon Westover
- McCance Center for Brain Health, Massachusetts General Hospital, Boston, MA, USA
- Division of Sleep Medicine, Harvard Medical School, Boston, Massachusetts, USA
- Department of Neurology, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Robert Joseph Thomas
- Division of Pulmonary Critical Care & Sleep Medicine, Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA
- Division of Sleep Medicine, Harvard Medical School, Boston, Massachusetts, USA
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Boston, MA, USA
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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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González KA, Tarraf W, Stickel AM, Kaur S, Agudelo C, Redline S, Gallo LC, Isasi CR, Cai J, Daviglus ML, Testai FD, DeCarli C, González HM, Ramos AR. Sleep duration and brain MRI measures: Results from the SOL-INCA MRI study. Alzheimers Dement 2024; 20:641-651. [PMID: 37772658 PMCID: PMC10840814 DOI: 10.1002/alz.13451] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Revised: 08/08/2023] [Accepted: 08/09/2023] [Indexed: 09/30/2023]
Abstract
INTRODUCTION Sleep duration has been associated with dementia and stroke. Few studies have evaluated sleep pattern-related outcomes of brain disease in diverse Hispanics/Latinos. METHODS The SOL-INCA (Study of Latinos-Investigation of Neurocognitive Aging) magnetic resonance imaging (MRI) study recruited diverse Hispanics/Latinos (35-85 years) who underwent neuroimaging. The main exposure was self-reported sleep duration. Our main outcomes were total and regional brain volumes. RESULTS The final analytic sample included n = 2334 participants. Increased sleep was associated with smaller brain volume (βtotal_brain = -0.05, p < 0.01) and consistently so in the 50+ subpopulation even after adjusting for mild cognitive impairment status. Sleeping >9 hours was associated with smaller gray (βcombined_gray = -0.17, p < 0.05) and occipital matter volumes (βoccipital_gray = -0.18, p < 0.05). DISCUSSION We found that longer sleep duration was associated with lower total brain and gray matter volume among diverse Hispanics/Latinos across sex and background. These results reinforce the importance of sleep on brain aging in this understudied population. HIGHLIGHTS Longer sleep was linked to smaller total brain and gray matter volumes. Longer sleep duration was linked to larger white matter hyperintensities (WMHs) and smaller hippocampal volume in an obstructive sleep apnea (OSA) risk group. These associations were consistent across sex and Hispanic/Latino heritage groups.
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Affiliation(s)
- Kevin A. González
- Department of Neurosciences and Shiley‐Marcos Alzheimer's Disease Research CenterUniversity of California San Diego School of MedicineSan DiegoCaliforniaUSA
| | - Wassim Tarraf
- Department of Healthcare Sciences and Institute of GerontologyWayne State UniversityDetroitMichiganUSA
| | - Ariana M. Stickel
- Department of PsychologySan Diego State UniversitySan DiegoCaliforniaUSA
| | - Sonya Kaur
- Department of NeurologyUniversity of Miami Miller School of MedicineMiamiFloridaUSA
| | - Christian Agudelo
- Department of NeurologyUniversity of Miami Miller School of MedicineMiamiFloridaUSA
| | - Susan Redline
- Department of MedicineBrigham and Women's HospitalHarvard Medical SchoolBostonMassachusettsUSA
| | - Linda C. Gallo
- Department of Psychology and South Bay Latino Research CenterSan Diego State UniversitySan DiegoCaliforniaUSA
| | - Carmen R. Isasi
- Department of Epidemiology & Population HealthAlbert Einstein College of MedicineBronxNew YorkUSA
| | - Jianwen Cai
- Department of BiostatisticsUniversity of North CarolinaChapel HillNorth CarolinaUSA
| | - Martha L. Daviglus
- Institute for Minority Health ResearchCollege of MedicineUniversity of Illinois at ChicagoChicagoIllinoisUSA
| | - Fernando D. Testai
- Department of Neurology and RehabilitationUniversity of Illinois College of MedicineChicagoIllinoisUSA
| | - Charles DeCarli
- Department of NeurologyUniversity of California DavisSacramentoCaliforniaUSA
| | - Hector M. González
- Department of Neurosciences and Shiley‐Marcos Alzheimer's Disease Research CenterUniversity of California San Diego School of MedicineSan DiegoCaliforniaUSA
| | - Alberto R. Ramos
- Department of NeurologyUniversity of Miami Miller School of MedicineMiamiFloridaUSA
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Jaromirska J, Kaczmarski P, Strzelecki D, Sochal M, Białasiewicz P, Gabryelska A. Shedding light on neurofilament involvement in cognitive decline in obstructive sleep apnea and its possible role as a biomarker. Front Psychiatry 2023; 14:1289367. [PMID: 38098628 PMCID: PMC10720906 DOI: 10.3389/fpsyt.2023.1289367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Accepted: 10/30/2023] [Indexed: 12/17/2023] Open
Abstract
Obstructive sleep apnea is one of the most common sleep disorders with a high estimated global prevalence and a large number of associated comorbidities in general as well as specific neuropsychiatric complications such as cognitive impairment. The complex pathogenesis and effects of the disorder including chronic intermittent hypoxia and sleep fragmentation may lead to enhanced neuronal damage, thereby contributing to neuropsychiatric pathologies. Obstructive sleep apnea has been described as an independent risk factor for several neurodegenerative diseases, including Alzheimer's disease and all-cause dementia. The influence of obstructive sleep apnea on cognitive deficits is still a topic of recent debate, and several mechanisms, including neurodegeneration and depression-related cognitive dysfunction, underlying this correlation are taken into consideration. The differentiation between both pathomechanisms of cognitive impairment in obstructive sleep apnea is a complex clinical issue, requiring the use of multiple and costly diagnostic methods. The studies conducted on neuroprotection biomarkers, such as brain-derived neurotrophic factors and neurofilaments, are recently gaining ground in the topic of cognition assessment in obstructive sleep apnea patients. Neurofilaments as neuron-specific cytoskeletal proteins could be useful non-invasive indicators of brain conditions and neurodegeneration, which already are observed in many neurological diseases leading to cognitive deficits. Additionally, neurofilaments play an important role as a biomarker in other sleep disorders such as insomnia. Thus, this review summarizes the current knowledge on the involvement of neurofilaments in cognitive decline and neurodegeneration in obstructive sleep apnea patients as well as discusses its possible role as a biomarker of these changes.
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Affiliation(s)
- Julia Jaromirska
- Department of Sleep Medicine and Metabolic Disorders, Medical University of Lodz, Lodz, Poland
| | - Piotr Kaczmarski
- Department of Sleep Medicine and Metabolic Disorders, Medical University of Lodz, Lodz, Poland
| | - Dominik Strzelecki
- Department of Affective and Psychotic Disorders, Medical University of Lodz, Lodz, Poland
| | - Marcin Sochal
- Department of Sleep Medicine and Metabolic Disorders, Medical University of Lodz, Lodz, Poland
| | - Piotr Białasiewicz
- Department of Sleep Medicine and Metabolic Disorders, Medical University of Lodz, Lodz, Poland
| | - Agata Gabryelska
- Department of Sleep Medicine and Metabolic Disorders, Medical University of Lodz, Lodz, Poland
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Carvalho DZ, McCarter SJ, St Louis EK, Przybelski SA, Johnson Sparrman KL, Somers VK, Boeve BF, Petersen RC, Jack CR, Graff-Radford J, Vemuri P. Association of Polysomnographic Sleep Parameters With Neuroimaging Biomarkers of Cerebrovascular Disease in Older Adults With Sleep Apnea. Neurology 2023; 101:e125-e136. [PMID: 37164654 PMCID: PMC10351545 DOI: 10.1212/wnl.0000000000207392] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2022] [Accepted: 03/23/2023] [Indexed: 05/12/2023] Open
Abstract
BACKGROUND AND OBJECTIVES Our objective was to determine whether polysomnographic (PSG) sleep parameters are associated with neuroimaging biomarkers of cerebrovascular disease (CVD) related to white matter (WM) integrity in older adults with obstructive sleep apnea (OSA). METHODS From the population-based Mayo Clinic Study of Aging, we identified participants without dementia who underwent at least 1 brain MRI and PSG. We quantified 2 CVD biomarkers: WM hyperintensities (WMHs) from fluid-attenuated inversion recovery (FLAIR)-MRI, and fractional anisotropy of the genu of the corpus callosum (genu FA) from diffusion MRI. For this cross-sectional analysis, we fit linear models to assess associations between PSG parameters (NREM stage 1 percentage, NREM stage 3 percentage [slow-wave sleep], mean oxyhemoglobin saturation, and log of apnea-hypopnea index [AHI]) and CVD biomarkers (log of WMH and log of genu FA), respectively, while adjusting for age (at MRI), sex, APOE ε4 status, composite cardiovascular and metabolic conditions (CMC) score, REM stage percentage, sleep duration, and interval between MRI and PSG. RESULTS We included 140 participants with FLAIR-MRI (of which 103 had additional diffusion MRI). The mean ± SD age was 72.7 ± 9.6 years at MRI with nearly 60% being men. The absolute median (interquartile range [IQR]) interval between MRI and PSG was 1.74 (0.9-3.2) years. 90.7% were cognitively unimpaired (CU) during both assessments. For every 10-point decrease in N3%, there was a 0.058 (95% CI 0.006-0.111, p = 0.030) increase in the log of WMH and 0.006 decrease (95% CI -0.012 to -0.0002, p = 0.042) in the log of genu FA. After matching for age, sex, and N3%, participants with severe OSA had higher WMH (median [IQR] 0.007 [0.005-0.015] vs 0.006 [0.003-0.009], p = 0.042) and lower genu FA (median [IQR] 0.57 [0.55-0.63] vs 0.63 [0.58-0.65], p = 0.007), when compared with those with mild/moderate OSA. DISCUSSION We found that reduced slow-wave sleep and severe OSA were associated with higher burden of WM abnormalities in predominantly CU older adults, which may contribute to greater risk of cognitive impairment, dementia, and stroke. Our study supports the association between sleep depth/fragmentation and intermittent hypoxia and CVD biomarkers. Longitudinal studies are required to assess causation.
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Affiliation(s)
- Diego Z Carvalho
- From the Department of Neurology (D.Z.C., S.J.M., E.K.S.L., B.F.B., R.C.P., J.G.-R.), Center for Sleep Medicine (D.Z.C., S.J.M., E.K.S.L., B.F.B.), Division of Pulmonary and Critical Care, Department of Internal Medicine, Department of Quantitative Health Sciences (S.A.P., R.C.P.), Department of Radiology (K.L.J.S., C.R.J., P.V.), and Department of Cardiovascular Medicine (V.K.S.), Mayo Clinic, Rochester, MN.
| | - Stuart J McCarter
- From the Department of Neurology (D.Z.C., S.J.M., E.K.S.L., B.F.B., R.C.P., J.G.-R.), Center for Sleep Medicine (D.Z.C., S.J.M., E.K.S.L., B.F.B.), Division of Pulmonary and Critical Care, Department of Internal Medicine, Department of Quantitative Health Sciences (S.A.P., R.C.P.), Department of Radiology (K.L.J.S., C.R.J., P.V.), and Department of Cardiovascular Medicine (V.K.S.), Mayo Clinic, Rochester, MN
| | - Erik K St Louis
- From the Department of Neurology (D.Z.C., S.J.M., E.K.S.L., B.F.B., R.C.P., J.G.-R.), Center for Sleep Medicine (D.Z.C., S.J.M., E.K.S.L., B.F.B.), Division of Pulmonary and Critical Care, Department of Internal Medicine, Department of Quantitative Health Sciences (S.A.P., R.C.P.), Department of Radiology (K.L.J.S., C.R.J., P.V.), and Department of Cardiovascular Medicine (V.K.S.), Mayo Clinic, Rochester, MN
| | - Scott A Przybelski
- From the Department of Neurology (D.Z.C., S.J.M., E.K.S.L., B.F.B., R.C.P., J.G.-R.), Center for Sleep Medicine (D.Z.C., S.J.M., E.K.S.L., B.F.B.), Division of Pulmonary and Critical Care, Department of Internal Medicine, Department of Quantitative Health Sciences (S.A.P., R.C.P.), Department of Radiology (K.L.J.S., C.R.J., P.V.), and Department of Cardiovascular Medicine (V.K.S.), Mayo Clinic, Rochester, MN
| | - Kohl L Johnson Sparrman
- From the Department of Neurology (D.Z.C., S.J.M., E.K.S.L., B.F.B., R.C.P., J.G.-R.), Center for Sleep Medicine (D.Z.C., S.J.M., E.K.S.L., B.F.B.), Division of Pulmonary and Critical Care, Department of Internal Medicine, Department of Quantitative Health Sciences (S.A.P., R.C.P.), Department of Radiology (K.L.J.S., C.R.J., P.V.), and Department of Cardiovascular Medicine (V.K.S.), Mayo Clinic, Rochester, MN
| | - Virend K Somers
- From the Department of Neurology (D.Z.C., S.J.M., E.K.S.L., B.F.B., R.C.P., J.G.-R.), Center for Sleep Medicine (D.Z.C., S.J.M., E.K.S.L., B.F.B.), Division of Pulmonary and Critical Care, Department of Internal Medicine, Department of Quantitative Health Sciences (S.A.P., R.C.P.), Department of Radiology (K.L.J.S., C.R.J., P.V.), and Department of Cardiovascular Medicine (V.K.S.), Mayo Clinic, Rochester, MN
| | - Bradley F Boeve
- From the Department of Neurology (D.Z.C., S.J.M., E.K.S.L., B.F.B., R.C.P., J.G.-R.), Center for Sleep Medicine (D.Z.C., S.J.M., E.K.S.L., B.F.B.), Division of Pulmonary and Critical Care, Department of Internal Medicine, Department of Quantitative Health Sciences (S.A.P., R.C.P.), Department of Radiology (K.L.J.S., C.R.J., P.V.), and Department of Cardiovascular Medicine (V.K.S.), Mayo Clinic, Rochester, MN
| | - Ronald C Petersen
- From the Department of Neurology (D.Z.C., S.J.M., E.K.S.L., B.F.B., R.C.P., J.G.-R.), Center for Sleep Medicine (D.Z.C., S.J.M., E.K.S.L., B.F.B.), Division of Pulmonary and Critical Care, Department of Internal Medicine, Department of Quantitative Health Sciences (S.A.P., R.C.P.), Department of Radiology (K.L.J.S., C.R.J., P.V.), and Department of Cardiovascular Medicine (V.K.S.), Mayo Clinic, Rochester, MN
| | - Clifford R Jack
- From the Department of Neurology (D.Z.C., S.J.M., E.K.S.L., B.F.B., R.C.P., J.G.-R.), Center for Sleep Medicine (D.Z.C., S.J.M., E.K.S.L., B.F.B.), Division of Pulmonary and Critical Care, Department of Internal Medicine, Department of Quantitative Health Sciences (S.A.P., R.C.P.), Department of Radiology (K.L.J.S., C.R.J., P.V.), and Department of Cardiovascular Medicine (V.K.S.), Mayo Clinic, Rochester, MN
| | - Jonathan Graff-Radford
- From the Department of Neurology (D.Z.C., S.J.M., E.K.S.L., B.F.B., R.C.P., J.G.-R.), Center for Sleep Medicine (D.Z.C., S.J.M., E.K.S.L., B.F.B.), Division of Pulmonary and Critical Care, Department of Internal Medicine, Department of Quantitative Health Sciences (S.A.P., R.C.P.), Department of Radiology (K.L.J.S., C.R.J., P.V.), and Department of Cardiovascular Medicine (V.K.S.), Mayo Clinic, Rochester, MN
| | - Prashanthi Vemuri
- From the Department of Neurology (D.Z.C., S.J.M., E.K.S.L., B.F.B., R.C.P., J.G.-R.), Center for Sleep Medicine (D.Z.C., S.J.M., E.K.S.L., B.F.B.), Division of Pulmonary and Critical Care, Department of Internal Medicine, Department of Quantitative Health Sciences (S.A.P., R.C.P.), Department of Radiology (K.L.J.S., C.R.J., P.V.), and Department of Cardiovascular Medicine (V.K.S.), Mayo Clinic, Rochester, MN
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Lafrenière A, Lina JM, Hernandez J, Bouchard M, Gosselin N, Carrier J. Sleep slow waves' negative-to-positive-phase transition: a marker of cognitive and apneic status in aging. Sleep 2023; 46:zsac246. [PMID: 36219687 PMCID: PMC9832517 DOI: 10.1093/sleep/zsac246] [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: 04/08/2022] [Revised: 08/12/2022] [Indexed: 11/07/2022] Open
Abstract
The sleep slow-wave (SW) transition between negative and positive phases is thought to mirror synaptic strength and likely depends on brain health. This transition shows significant age-related changes but has not been investigated in pathological aging. The present study aimed at comparing the transition speed and other characteristics of SW between older adults with amnestic mild cognitive impairment (aMCI) and cognitively normal (CN) controls with and without obstructive sleep apnea (OSA). We also examined the association of SW characteristics with the longitudinal changes of episodic memory and executive functions and the degree of subjective cognitive complaints. aMCI (no/mild OSA = 17; OSA = 15) and CN (no/mild OSA = 20; OSA = 17) participants underwent a night of polysomnography and a neuropsychological evaluation at baseline and 18 months later. Participants with aMCI had a significantly slower SW negative-to-positive-phase transition speed and a higher proportion of SW that are "slow-switchers" than CN participants. These SW measures in the frontal region were significantly correlated with memory decline and cognitive complaints in aMCI and cognitive improvements in CN participants. The transition speed of the SW that are "fast-switchers" was significantly slower in OSA compared to no or mild obstructive sleep apnea participants. The SW transition-related metrics showed opposite correlations with the longitudinal episodic memory changes depending on the participants' cognitive status. These relationships were particularly strong in participants with aMCI. As the changes of the SW transition-related metrics in pathological aging might reflect synaptic alterations, future studies should investigate whether these new metrics covary with biomarker levels of synaptic integrity in this population.
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Affiliation(s)
- Alexandre Lafrenière
- Center for Advanced Research in Sleep Medicine, Hôpital du Sacré-Coeur de Montréal, CIUSSS du Nord-de-l’Île-de-Montréal, Montreal, Canada
- Department of Psychology, Université de Montréal, Montreal, Canada
| | - Jean-Marc Lina
- Center for Advanced Research in Sleep Medicine, Hôpital du Sacré-Coeur de Montréal, CIUSSS du Nord-de-l’Île-de-Montréal, Montreal, Canada
- Department of Electrical Engineering, École de Technologie Supérieure, Montreal, Canada
- Centre de Recherches Mathématiques, Université de Montréal, Montreal, Canada
| | - Jimmy Hernandez
- Center for Advanced Research in Sleep Medicine, Hôpital du Sacré-Coeur de Montréal, CIUSSS du Nord-de-l’Île-de-Montréal, Montreal, Canada
- Department of Neurosciences, Université de Montréal, Montreal, Canada
| | - Maude Bouchard
- Center for Advanced Research in Sleep Medicine, Hôpital du Sacré-Coeur de Montréal, CIUSSS du Nord-de-l’Île-de-Montréal, Montreal, Canada
| | - Nadia Gosselin
- Center for Advanced Research in Sleep Medicine, Hôpital du Sacré-Coeur de Montréal, CIUSSS du Nord-de-l’Île-de-Montréal, Montreal, Canada
- Department of Psychology, Université de Montréal, Montreal, Canada
| | - Julie Carrier
- Center for Advanced Research in Sleep Medicine, Hôpital du Sacré-Coeur de Montréal, CIUSSS du Nord-de-l’Île-de-Montréal, Montreal, Canada
- Department of Psychology, Université de Montréal, Montreal, Canada
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Stowe TA, McClung CA. How Does Chronobiology Contribute to the Development of Diseases in Later Life. Clin Interv Aging 2023; 18:655-666. [PMID: 37101656 PMCID: PMC10124625 DOI: 10.2147/cia.s380436] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Accepted: 04/13/2023] [Indexed: 04/28/2023] Open
Abstract
An increasingly older population is one of the major social and medical challenges we currently face. Between 2010 and 2050, it is estimated that the proportion of adults over 65 years of age will double from 8% to 16% of the global population. A major concern associated with aging is the changes in health that can lead to various diseases such as cancer and neurogenerative diseases, which are major burdens on individuals and societies. Thus, it is imperative to better understand changes in sleep and circadian rhythms that accompany aging to improve the health of an older population and target diseases associated with aging. Circadian rhythms play a role in most physiological processes and can contribute to age-related diseases. Interestingly, there is a relationship between circadian rhythms and aging. For example, many older adults have a shift in chronotype, which is an individual's natural inclination to sleep certain times of the day. As adults age, most people tend to go to sleep earlier while also waking up earlier. Numerous studies also suggest that disrupted circadian rhythms may be indicative of developing age-related diseases, like neurodegenerative disorders and cancer. Better understanding the relationship between circadian rhythms and aging may allow us to improve current treatments or develop novel ones that target diseases commonly associated with aging.
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Affiliation(s)
- Taylor A Stowe
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Colleen A McClung
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
- Translational Neuroscience Program, Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
- Center for Neuroscience, University of Pittsburgh, Pittsburgh, PA, USA
- Correspondence: Colleen A McClung, Email
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17
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Li Y, Li Q, Zou X, Zhong Z, Ouyang Q, Zeng Q, Hu Y, Wang M, Luo Y, Yao D. Effects of CPAP treatment on electroencephalographic activity in patients with obstructive sleep apnea syndrome during deep sleep: Preliminary findings of a cross-sectional study. Chron Respir Dis 2023; 20:14799731231215094. [PMID: 37967573 PMCID: PMC10655652 DOI: 10.1177/14799731231215094] [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: 12/04/2022] [Accepted: 10/30/2023] [Indexed: 11/17/2023] Open
Abstract
Study objectives: To investigate whether electroencephalographic (EEG) activities during non-rapid eye movement sleep stage 3 (N3) in obstructive sleep apnea syndrome (OSAS) patients were changed with continuous positive airway pressure (CPAP) treatment.Methods: A cross-sectional study of EEG activity during N3 sleep was conducted in 15 patients with moderate to severe OSAS without and with CPAP treatment compared to 15 normal controls. The amplitude, and absolute and relative power of delta, theta, alpha and beta waves as well as the absolute power ratio of slow to fast EEG waves (i.e., absolute power of delta and theta waves/absolute power of alpha and beta waves) and the spectral power density of 0-30 Hz EEG activities were analyzed.Results: CPAP significantly increased N3 sleep, the absolute and relative powers, amplitudes of delta and theta waves, and absolute power ratio of slow to fast EEG waves, but decreased relative alpha and beta powers during N3 sleep. However, there were no significant differences in those parameters between the OSAS patients with CPAP treatment and normal controls.Conclusions: CPAP prolongs N3 sleep and increases the power and amplitude of slow EEG waves during N3 sleep, which indicates an improvement in sleep quality and further provides evidence for recommendation of CPAP treatment for OSAS patients.
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Affiliation(s)
- Yiran Li
- Neurological Institute of Jiangxi Province and Department of Neurology, Jiangxi Provincial People’s Hospital and The First Affiliated Hospital of Nanchang Medical College, Nanchang, China
- Neurological Institute of Jiangxi Province and Department of Neurology, Xiangya Hospital of Central South University at Jiangxi, Nanchang, China
| | - Qi Li
- Neurological Institute of Jiangxi Province and Department of Neurology, Jiangxi Provincial People’s Hospital and The First Affiliated Hospital of Nanchang Medical College, Nanchang, China
- Neurological Institute of Jiangxi Province and Department of Neurology, Xiangya Hospital of Central South University at Jiangxi, Nanchang, China
| | - Xueliang Zou
- Jiangxi Mental Hospital, Nanchang University, Nanchang, China
| | - Zhijun Zhong
- Neurological Institute of Jiangxi Province and Department of Neurology, Jiangxi Provincial People’s Hospital and The First Affiliated Hospital of Nanchang Medical College, Nanchang, China
- Neurological Institute of Jiangxi Province and Department of Neurology, Xiangya Hospital of Central South University at Jiangxi, Nanchang, China
| | - Qian Ouyang
- Neurological Institute of Jiangxi Province and Department of Neurology, Jiangxi Provincial People’s Hospital and The First Affiliated Hospital of Nanchang Medical College, Nanchang, China
- Neurological Institute of Jiangxi Province and Department of Neurology, Xiangya Hospital of Central South University at Jiangxi, Nanchang, China
| | - Qinghong Zeng
- Neurological Institute of Jiangxi Province and Department of Neurology, Jiangxi Provincial People’s Hospital and The First Affiliated Hospital of Nanchang Medical College, Nanchang, China
- Neurological Institute of Jiangxi Province and Department of Neurology, Xiangya Hospital of Central South University at Jiangxi, Nanchang, China
| | - Yinyin Hu
- Neurological Institute of Jiangxi Province and Department of Neurology, Jiangxi Provincial People’s Hospital and The First Affiliated Hospital of Nanchang Medical College, Nanchang, China
- Neurological Institute of Jiangxi Province and Department of Neurology, Xiangya Hospital of Central South University at Jiangxi, Nanchang, China
| | - Mengmeng Wang
- Neurological Institute of Jiangxi Province and Department of Neurology, Jiangxi Provincial People’s Hospital and The First Affiliated Hospital of Nanchang Medical College, Nanchang, China
- Neurological Institute of Jiangxi Province and Department of Neurology, Xiangya Hospital of Central South University at Jiangxi, Nanchang, China
| | - Yaxing Luo
- Neurological Institute of Jiangxi Province and Department of Neurology, Jiangxi Provincial People’s Hospital and The First Affiliated Hospital of Nanchang Medical College, Nanchang, China
- Neurological Institute of Jiangxi Province and Department of Neurology, Xiangya Hospital of Central South University at Jiangxi, Nanchang, China
| | - Dongyuan Yao
- Neurological Institute of Jiangxi Province and Department of Neurology, Jiangxi Provincial People’s Hospital and The First Affiliated Hospital of Nanchang Medical College, Nanchang, China
- Neurological Institute of Jiangxi Province and Department of Neurology, Xiangya Hospital of Central South University at Jiangxi, Nanchang, China
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18
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Li Y, Wang J, Ji L, Cheng C, Su T, Wu S, Han F, Cox DJ, Wang E, Chen R. Cortical thinning in male obstructive sleep apnoea patients with excessive daytime sleepiness. Front Neurol 2023; 14:1019457. [PMID: 37034093 PMCID: PMC10076663 DOI: 10.3389/fneur.2023.1019457] [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: 08/15/2022] [Accepted: 02/28/2023] [Indexed: 04/11/2023] Open
Abstract
Background and purpose Obstructive sleep apnoea is associated with excessive daytime sleepiness due to sleep fragmentation and hypoxemia, both of which can lead to abnormal brain morphology. However, the pattern of brain structural changes associated with excessive daytime sleepiness is still unclear. This study aims to investigate the effects of excessive daytime sleepiness on cortical thickness in patients with obstructive sleep apnoea. Materials and methods 61 male patients with newly diagnosed obstructive sleep apnoea were included in the present study. Polysomnography and structural MRI were performed for each participant. Subjective daytime sleepiness was assessed using the Epworth Sleepiness Scale score. Surface-based morphometric analysis was performed using Statistical Parametric Mapping 12 and Computational Anatomy 12 toolboxes to extract cortical thickness. Results Using the median Epworth Sleepiness Scale score, patients were divided into the non-sleepiness group and the sleepiness group. The cortical thickness was markedly thinner in the sleepiness group in the left temporal, frontal, and parietal lobe and bilateral pre- and postcentral gyri (pFWE < 0.05). There was a significant negative correlation between the cortical thickness and the Epworth Sleepiness Scale score. After adjusting for age, body mass index, and obstructive sleep apnoea severity, the Epworth Sleepiness Scale score remained an independent factor affecting the cortical thickness of the left middle temporal lobe, transverse temporal and temporal pole. Conclusion Subjective daytime sleepiness is associated with decreased cortical thickness, and the Epworth Sleepiness Scale score may be of utility as a clinical marker of brain injury in patients with obstructive sleep apnoea.
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Affiliation(s)
- Yezhou Li
- School of Biological Sciences, University of Manchester, Manchester, United Kingdom
| | - Jing Wang
- Department of Respiratory and Critical Care, The Second Affiliated Hospital of Soochow University, Suzhou, China
- Department of Sleep Centre, The Second Affiliated Hospital of Soochow University, Suzhou, China
| | - Lirong Ji
- Department of Radiology, The Second Affiliated Hospital of Soochow University, Suzhou, China
| | - Chaohong Cheng
- Department of Respiratory and Critical Care, The Second Affiliated Hospital of Soochow University, Suzhou, China
- Department of Sleep Centre, The Second Affiliated Hospital of Soochow University, Suzhou, China
| | - Tong Su
- Department of Respiratory and Critical Care, The Second Affiliated Hospital of Soochow University, Suzhou, China
- Department of Sleep Centre, The Second Affiliated Hospital of Soochow University, Suzhou, China
| | - Shuqing Wu
- Department of Sleep Centre, The Second Affiliated Hospital of Soochow University, Suzhou, China
| | - Fei Han
- Department of Sleep Centre, The Second Affiliated Hospital of Soochow University, Suzhou, China
| | - Daniel J. Cox
- Division of Psychology, Communication, and Human Neuroscience, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, United Kingdom
| | - Erlei Wang
- Department of Radiology, The Second Affiliated Hospital of Soochow University, Suzhou, China
- Erlei Wang,
| | - Rui Chen
- Department of Respiratory and Critical Care, The Second Affiliated Hospital of Soochow University, Suzhou, China
- Department of Sleep Centre, The Second Affiliated Hospital of Soochow University, Suzhou, China
- *Correspondence: Rui Chen,
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19
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Wing D, Eyler LT, Lenze EJ, Wetherell JL, Nichols JF, Meeusen R, Godino JG, Shimony JS, Snyder AZ, Nishino T, Nicol GE, Nagels G, Roelands B. Fatness, fitness and the aging brain: A cross sectional study of the associations between a physiological estimate of brain age and physical fitness, activity, sleep, and body composition. NEUROIMAGE. REPORTS 2022; 2:100146. [PMID: 36743444 PMCID: PMC9894084 DOI: 10.1016/j.ynirp.2022.100146] [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] [Indexed: 11/19/2022]
Abstract
Introduction Changes in brain structure and function occur with aging. However, there is substantial heterogeneity both in terms of when these changes begin, and the rate at which they progress. Understanding the mechanisms and/or behaviors underlying this heterogeneity may allow us to act to target and slow negative changes associated with aging. Methods Using T1 weighted MRI images, we applied a novel algorithm to determine the physiological age of the brain (brain-predicted age) and the predicted age difference between this physiologically based estimate and chronological age (BrainPAD) to 551 sedentary adults aged 65 to 84 with self-reported cognitive complaint measured at baseline as part of a larger study. We also assessed maximal aerobic capacity with a graded exercise test, physical activity and sleep with accelerometers, and body composition with dual energy x-ray absorptiometry. Associations were explored both linearly and logistically using categorical groupings. Results Visceral Adipose Tissue (VAT), Total Sleep Time (TST) and maximal aerobic capacity all showed significant associations with BrainPAD. Greater VAT was associated with higher (i.e,. older than chronological) BrainPAD (r = 0.149 p = 0.001)Greater TST was associated with higher BrainPAD (r = 0.087 p = 0.042) and greater aerobic capacity was associated with lower BrainPAD (r = - 0.088 p = 0.040). With linear regression, both VAT and TST remained significant (p = 0.036 and 0.008 respectively). Each kg of VAT predicted a 0.741 year increase in BrainPAD, and each hour of increased TST predicted a 0.735 year increase in BrainPAD. Maximal aerobic capacity did not retain statistical significance in fully adjusted linear models. Discussion Accumulation of visceral adipose tissue and greater total sleep time, but not aerobic capacity, total daily physical activity, or sleep quantity and/or quality are associated with brains that are physiologically older than would be expected based upon chronological age alone (BrainPAD).
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Affiliation(s)
- David Wing
- Herbert Wertheim School of Public Health and Human Longevity, University of California, San Diego, United States
- Exercise and Physical Activity Resource Center (EPARC), University of California, San Diego, United States
| | - Lisa T. Eyler
- Department of Psychiatry, University of California, San Diego, United States
- San Diego Veterans Administration Health Care System, San Diego, United States
| | - Eric J. Lenze
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, United States
| | - Julie Loebach Wetherell
- Mental Health Service, VA San Diego Healthcare System, United States
- Department of Psychiatry, University of California, San Diego, United States
| | - Jeanne F. Nichols
- Herbert Wertheim School of Public Health and Human Longevity, University of California, San Diego, United States
- Exercise and Physical Activity Resource Center (EPARC), University of California, San Diego, United States
| | - Romain Meeusen
- Human Physiology & Sports Physiotherapy Research Group, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium
| | - Job G. Godino
- Herbert Wertheim School of Public Health and Human Longevity, University of California, San Diego, United States
- Exercise and Physical Activity Resource Center (EPARC), University of California, San Diego, United States
| | - Joshua S. Shimony
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO, United States
| | - Abraham Z. Snyder
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO, United States
| | - Tomoyuki Nishino
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, United States
| | - Ginger E. Nicol
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, United States
| | - Guy Nagels
- Department of Neurology, UZ Brussel, Brussels, Belgium
- Center for Neurosciences (C4N), Vrije Universiteit Brussel (VUB), Brussels, Belgium
| | - Bart Roelands
- Human Physiology & Sports Physiotherapy Research Group, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium
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20
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Baril AA, Pinheiro AA, Himali JJ, Beiser A, Sanchez E, Pase MP, Seshadri S, Demissie S, Romero JR. Lighter sleep is associated with higher enlarged perivascular spaces burden in middle-aged and elderly individuals. Sleep Med 2022; 100:558-564. [PMID: 36308914 PMCID: PMC9815141 DOI: 10.1016/j.sleep.2022.10.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Revised: 08/31/2022] [Accepted: 10/10/2022] [Indexed: 11/09/2022]
Abstract
BACKGROUND While healthy sleep is suggested to promote glymphatic clearance in the brain, poorer sleep may be associated with higher enlarged perivascular spaces (ePVS) burden, potentially representing impaired perivascular drainage. This study aims to evaluate the association between ePVS burden and polysomnographic sleep characteristics in a large community-based sample. METHODS 552 dementia and stroke-free Framingham Heart Study participants (age: 58.6 ± 8.9 years; 50.4% men) underwent a full-night in-home polysomnography. Three years later on average, participants underwent a brain MRI. ePVS were rated in the basal ganglia and centrum semiovale, and dichotomized as low burden (<20 counts, grades 1 and 2) or high burden (>20 counts, grades 3 and 4). Logistic regression analyses relating sleep variables to subsequent ePVS burden were used, adjusted for age, sex, time interval between polysomnography and MRI, ApoE ε4 allele carrier status, hypertension, and smoking. RESULTS Longer N1 sleep and shorter N3 sleep duration were associated with higher ePVS burden in the centrum semiovale. When stratifying these associations by subpopulations, longer N1 sleep duration with ePVS burden was observed especially in older individuals and hypertensive participants. Associations between ePVS burden and other sleep characteristics such as total sleep time and REM sleep duration varied according to ApoE ε4 allele carrier status. CONCLUSIONS Lighter sleep, as characterized by longer N1 sleep and shorter slow-wave sleep, is associated with higher ePVS burden. These findings suggest that sleep architecture may be involved in glymphatic clearance and cerebral small vessel disease, which could be an important biological link between sleep and dementia risk.
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Affiliation(s)
- Andrée-Ann Baril
- The Framingham Heart Study, Framingham, USA; Douglas Mental Health University Institute, Montreal, Canada; Department of Psychiatry, McGill University, Montreal, Canada
| | - Adlin A Pinheiro
- The Framingham Heart Study, Framingham, USA; Department of Biostatistics, Boston University School of Public Health, Boston, USA
| | - Jayandra J Himali
- The Framingham Heart Study, Framingham, USA; Department of Biostatistics, Boston University School of Public Health, Boston, USA; Department of Neurology, Boston University School of Medicine, Boston, USA; Glenn Biggs Institute for Alzheimer's & Neurodegenerative Diseases, UT Health San Antonio, San Antonio, USA; Department of Population Health Sciences, University of Texas Health Science Center, San Antonio, TX, USA
| | - Alexa Beiser
- The Framingham Heart Study, Framingham, USA; Department of Biostatistics, Boston University School of Public Health, Boston, USA
| | - Erlan Sanchez
- Sunnybrook Research Institute, University of Toronto, Toronto, Canada
| | - Matthew P Pase
- The Framingham Heart Study, Framingham, USA; Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, VIC, Australia; Harvard T.H. Chan School of Public Health, Boston, USA
| | - Sudha Seshadri
- The Framingham Heart Study, Framingham, USA; Department of Neurology, Boston University School of Medicine, Boston, USA; Glenn Biggs Institute for Alzheimer's & Neurodegenerative Diseases, UT Health San Antonio, San Antonio, USA
| | - Serkalem Demissie
- The Framingham Heart Study, Framingham, USA; Department of Biostatistics, Boston University School of Public Health, Boston, USA
| | - Jose R Romero
- The Framingham Heart Study, Framingham, USA; Department of Neurology, Boston University School of Medicine, Boston, USA.
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21
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Chylinski D, Narbutas J, Balteau E, Collette F, Bastin C, Berthomier C, Salmon E, Maquet P, Carrier J, Phillips C, Lina JM, Vandewalle G, Van Egroo M. Frontal grey matter microstructure is associated with sleep slow waves characteristics in late midlife. Sleep 2022; 45:zsac178. [PMID: 35869626 PMCID: PMC9644125 DOI: 10.1093/sleep/zsac178] [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: 03/24/2022] [Revised: 07/13/2022] [Indexed: 07/25/2023] Open
Abstract
STUDY OBJECTIVES The ability to generate slow waves (SW) during non-rapid eye movement (NREM) sleep decreases as early as the 5th decade of life, predominantly over frontal regions. This decrease may concern prominently SW characterized by a fast switch from hyperpolarized to depolarized, or down-to-up, state. Yet, the relationship between these fast and slow switcher SW and cerebral microstructure in ageing is not established. METHODS We recorded habitual sleep under EEG in 99 healthy late midlife individuals (mean age = 59.3 ± 5.3 years; 68 women) and extracted SW parameters (density, amplitude, frequency) for all SW as well as according to their switcher type (slow vs. fast). We further used neurite orientation dispersion and density imaging (NODDI) to assess microstructural integrity over a frontal grey matter region of interest (ROI). RESULTS In statistical models adjusted for age, sex, and sleep duration, we found that a lower SW density, particularly for fast switcher SW, was associated with a reduced orientation dispersion of neurites in the frontal ROI (p = 0.018, R2β* = 0.06). In addition, overall SW frequency was positively associated with neurite density (p = 0.03, R2β* = 0.05). By contrast, we found no significant relationships between SW amplitude and NODDI metrics. CONCLUSIONS Our findings suggest that the complexity of neurite organization contributes specifically to the rate of fast switcher SW occurrence in healthy middle-aged individuals, corroborating slow and fast switcher SW as distinct types of SW. They further suggest that the density of frontal neurites plays a key role for neural synchronization during sleep. TRIAL REGISTRATION NUMBER EudraCT 2016-001436-35.
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Affiliation(s)
- Daphne Chylinski
- GIGA-Cyclotron Research Centre-In Vivo Imaging, University of Liège, Liège, Belgium
| | - Justinas Narbutas
- GIGA-Cyclotron Research Centre-In Vivo Imaging, University of Liège, Liège, Belgium
- Psychology and Cognitive Neuroscience Research Unit, University of Liège, Liège, Belgium
| | - Evelyne Balteau
- GIGA-Cyclotron Research Centre-In Vivo Imaging, University of Liège, Liège, Belgium
| | - Fabienne Collette
- GIGA-Cyclotron Research Centre-In Vivo Imaging, University of Liège, Liège, Belgium
- Psychology and Cognitive Neuroscience Research Unit, University of Liège, Liège, Belgium
| | - Christine Bastin
- GIGA-Cyclotron Research Centre-In Vivo Imaging, University of Liège, Liège, Belgium
- Psychology and Cognitive Neuroscience Research Unit, University of Liège, Liège, Belgium
| | | | - Eric Salmon
- GIGA-Cyclotron Research Centre-In Vivo Imaging, University of Liège, Liège, Belgium
- Psychology and Cognitive Neuroscience Research Unit, University of Liège, Liège, Belgium
- Department of Neurology, University Hospital of Liège, Liège, Belgium
| | - Pierre Maquet
- GIGA-Cyclotron Research Centre-In Vivo Imaging, University of Liège, Liège, Belgium
- Department of Neurology, University Hospital of Liège, Liège, Belgium
| | - Julie Carrier
- CARSM, CIUSSS of Nord-de l’Île-de-Montréal, Montreal, Canada
- Department of Psychology, University of Montreal, Canada
| | - Christophe Phillips
- GIGA-Cyclotron Research Centre-In Vivo Imaging, University of Liège, Liège, Belgium
- GIGA-In Silico Medicine, University of Liège, Liège, Belgium
| | - Jean-Marc Lina
- CARSM, CIUSSS of Nord-de l’Île-de-Montréal, Montreal, Canada
- Department of Psychology, University of Montreal, Canada
| | - Gilles Vandewalle
- Corresponding authors. Gilles Vandewalle, GIGA-Cyclotron Research Centre-In Vivo Imaging, Bâtiment B30, Université de Liège, Allée du Six Août, 8, 4000 Liège, Belgium.
| | - Maxime Van Egroo
- Maxime Van Egroo, Faculty of Health, Medicine and Life Sciences, School for Mental Health and Neuroscience, Alzheimer Centre Limburg, Maastricht University, Universiteitssingel 40, 6229 ER Maastricht, Maastricht, The Netherlands.
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22
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Baril AA, Beiser AS, Sanchez E, Mysliwiec V, Redline S, Gottlieb DJ, O’Connor GT, Gonzales MM, Himali D, Seshadri S, Himali JJ, Pase MP. Insomnia symptom severity and cognitive performance: Moderating role of APOE genotype. Alzheimers Dement 2022; 18:408-421. [PMID: 34310026 PMCID: PMC8802306 DOI: 10.1002/alz.12405] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Revised: 04/13/2021] [Accepted: 05/12/2021] [Indexed: 11/11/2022]
Abstract
INTRODUCTION We evaluated whether insomnia symptom severity was associated with cognitive function, and whether this relationship was modified by biomarkers associated with Alzheimer's disease risk. METHODS We examined insomnia symptoms and neuropsychological performance 3.4 years later in 511 dementia-free Framingham Heart Study participants (62.65 ± 8.7 years, 50.9% male). Additionally, we explored insomnia symptoms combined with self-reported short habitual sleep duration and effect modification by apolipoprotein E (APOE) ε4 allele status. RESULTS More severe insomnia symptoms were associated with lower performance on global cognition, and immediate and delayed Logical Memory recall, especially when insomnia symptoms were combined with short sleep duration. The association between insomnia symptoms and poorer memory recall was more pronounced in APOE ε4 allele carriers. DISCUSSION Insomnia symptom severity was associated with worse subsequent global cognitive and memory performance, which was especially apparent in APOE ε4 allele carriers, suggesting that poor sleep might be particularly detrimental when the brain is already vulnerable to neurodegeneration.
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Affiliation(s)
- Andrée-Ann Baril
- The Framingham Heart Study, Framingham, Massachusetts, USA
- Department of Neurology, Boston University School of Medicine, Boston, Massachusetts, USA
| | - Alexa S. Beiser
- The Framingham Heart Study, Framingham, Massachusetts, USA
- Department of Neurology, Boston University School of Medicine, Boston, Massachusetts, USA
- Department of Biostatistics, Boston University School of Public Health, Boston, Massachusetts, USA
| | - Erlan Sanchez
- Centre for Advanced Research in Sleep Medicine, Hôpital du Sacré-Coeur de MontréalCIUSSS-NIM, Montreal, Québec, Canada
- Department of Neuroscience, Université de Montréal, Montreal, Québec, Canada
| | - Vincent Mysliwiec
- Glenn Biggs Institute for Alzheimer’s & Neurodegenerative DiseasesUniversity of Texas Health Sciences Center, San Antonio, Texas, USA
| | - Susan Redline
- Division of Sleep and Circadian Disorders, Brigham & Women’s Hospital, Boston, Massachusetts, USA
- Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA
- Division of Sleep Medicine, Harvard Medical School, Boston, Massachusetts, USA
| | - Daniel J. Gottlieb
- Division of Sleep and Circadian Disorders, Brigham & Women’s Hospital, Boston, Massachusetts, USA
- Division of Sleep Medicine, Harvard Medical School, Boston, Massachusetts, USA
- VA Boston Healthcare System, Boston, Massachusetts, USA
| | - George T. O’Connor
- The Framingham Heart Study, Framingham, Massachusetts, USA
- Department of Medicine, Boston University School of Medicine, Boston, Massachusetts, USA
| | - Mitzi M. Gonzales
- Glenn Biggs Institute for Alzheimer’s & Neurodegenerative DiseasesUniversity of Texas Health Sciences Center, San Antonio, Texas, USA
| | - Dibya Himali
- The Framingham Heart Study, Framingham, Massachusetts, USA
| | - Sudha Seshadri
- The Framingham Heart Study, Framingham, Massachusetts, USA
- Department of Neurology, Boston University School of Medicine, Boston, Massachusetts, USA
- Glenn Biggs Institute for Alzheimer’s & Neurodegenerative DiseasesUniversity of Texas Health Sciences Center, San Antonio, Texas, USA
| | - Jayandra J. Himali
- The Framingham Heart Study, Framingham, Massachusetts, USA
- Department of Neurology, Boston University School of Medicine, Boston, Massachusetts, USA
- Department of Biostatistics, Boston University School of Public Health, Boston, Massachusetts, USA
- Glenn Biggs Institute for Alzheimer’s & Neurodegenerative DiseasesUniversity of Texas Health Sciences Center, San Antonio, Texas, USA
- Department of Population Health Sciences, University of Texas Health Science Center, San Antonio, Texas, USA
| | - Matthew P. Pase
- The Framingham Heart Study, Framingham, Massachusetts, USA
- School of Psychological Sciences, Turner Institute for Brain and Mental Health Monash University, Clayton, VIC, Australia
- Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
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23
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Siow TY, Toh CH, Hsu JL, Liu GH, Lee SH, Chen NH, Fu CJ, Castillo M, Fang JT. Association of Sleep, Neuropsychological Performance, and Gray Matter Volume With Glymphatic Function in Community-Dwelling Older Adults. Neurology 2022; 98:e829-e838. [PMID: 34906982 DOI: 10.1212/wnl.0000000000013215] [Citation(s) in RCA: 45] [Impact Index Per Article: 22.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2021] [Accepted: 12/02/2021] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND AND OBJECTIVES The glymphatic system, which is robustly enabled during some stages of sleep, is a fluid-transport pathway that clears cerebral waste products. Most contemporary knowledge regarding the glymphatic system is inferred from rodent experiments and human research is limited. Our objective is to explore the associations between human glymphatic function, sleep, neuropsychological performance, and cerebral gray matter volumes. METHODS This cross-sectional study included individuals 60 years or older who had participated in the Integrating Systemic Data of Geriatric Medicine to Explore the Solution for Health Aging study between September 2019 and October 2020. Community-dwelling older adults were enrolled at 2 different sites. Participants with dementia, major depressive disorders, and other major organ system abnormalities were excluded. Sleep profile was accessed using questionnaires and polysomnography. Administered neuropsychological test batteries included Everyday Cognition (ECog) and the Consortium to Establish a Registry for Alzheimer's Disease Neuropsychological Battery (CERAD-NB). Gray matter volumes were estimated based on MRI. Diffusion tensor imaging analysis along the perivascular space (DTI-ALPS) index was used as the MRI marker of glymphatic function. RESULTS A total of 84 participants (mean [SD] age 73.3 [7.1] years, 47 [56.0%] women) were analyzed. Multivariate linear regression model determined that age (unstandardized β, -0.0025 [SE 0.0001]; p = 0.02), N2 sleep duration (unstandardized β, 0.0002 [SE 0.0001]; p = 0.04), and the apnea-hypopnea index (unstandardized β, -0.0011 [SE 0.0005]; p = 0.03) were independently associated with DTI-ALPS. Higher DTI-ALPS was associated with better ECog language scores (unstandardized β, -0.59 [SE 0.28]; p = 0.04) and better CERAD-NB word list learning delayed recall subtest scores (unstandardized β, 6.17 [SE 2.31]; p = 0.009) after covarying for age and education. Higher DTI-ALPS was also associated with higher gray matter volume (unstandardized β, 107.00 [SE 43.65]; p = 0.02) after controlling for age, sex, and total intracranial volume. DISCUSSION Significant associations were identified between glymphatic function and sleep, stressing the importance of sleep for brain health. This study also revealed associations between DTI-ALPS, neuropsychological performance, and cerebral gray matter volumes, suggesting the potential of DTI-ALPS as a biomarker for cognitive disorders.
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Affiliation(s)
- Tiing Yee Siow
- From the Department of Medical Imaging and Intervention (T.Y.S., C.H.T.) and Neuroscience Research Center, Department of Neurology, Medical Center and College of Medicine (J.-L.H.), Chang Gung University College of Medicine, and Division of Acupuncture and Moxibustion, Department of Traditional Chinese Medicine (G.-H.L.), Department of Psychiatry (S.-H.L.), Department of Pulmonary and Critical Care Medicine (N.-H.C.), Biomedical Informatics Unit, Clinical Trial Center (C.J.F.), and Department of Nephrology (J.-T.F.), Chang Gung Memorial Hospital at Linkou, Taoyuan; Graduate Institute of Mind, Brain, & Consciousness (J.-L.H.), Taipei Medical University; Brain & Consciousness Research Center (J.-L.H.), Shuang Ho Hospital, New Taipei City; School of Traditional Chinese Medicine (G.-H.L., N.-H.C.) and School of Medicine (J.-T.F.), College of Medicine (S.-H.L.), Chang Gung University; Sleep Center (G.-H.L., N.-H.C.), Chang Gung Memorial Hospital, Taoyuan, Taiwan; and Department of Radiology (M.C.), University of North Carolina School of Medicine, Chapel Hill
| | - Cheng Hong Toh
- From the Department of Medical Imaging and Intervention (T.Y.S., C.H.T.) and Neuroscience Research Center, Department of Neurology, Medical Center and College of Medicine (J.-L.H.), Chang Gung University College of Medicine, and Division of Acupuncture and Moxibustion, Department of Traditional Chinese Medicine (G.-H.L.), Department of Psychiatry (S.-H.L.), Department of Pulmonary and Critical Care Medicine (N.-H.C.), Biomedical Informatics Unit, Clinical Trial Center (C.J.F.), and Department of Nephrology (J.-T.F.), Chang Gung Memorial Hospital at Linkou, Taoyuan; Graduate Institute of Mind, Brain, & Consciousness (J.-L.H.), Taipei Medical University; Brain & Consciousness Research Center (J.-L.H.), Shuang Ho Hospital, New Taipei City; School of Traditional Chinese Medicine (G.-H.L., N.-H.C.) and School of Medicine (J.-T.F.), College of Medicine (S.-H.L.), Chang Gung University; Sleep Center (G.-H.L., N.-H.C.), Chang Gung Memorial Hospital, Taoyuan, Taiwan; and Department of Radiology (M.C.), University of North Carolina School of Medicine, Chapel Hill.
| | - Jung-Lung Hsu
- From the Department of Medical Imaging and Intervention (T.Y.S., C.H.T.) and Neuroscience Research Center, Department of Neurology, Medical Center and College of Medicine (J.-L.H.), Chang Gung University College of Medicine, and Division of Acupuncture and Moxibustion, Department of Traditional Chinese Medicine (G.-H.L.), Department of Psychiatry (S.-H.L.), Department of Pulmonary and Critical Care Medicine (N.-H.C.), Biomedical Informatics Unit, Clinical Trial Center (C.J.F.), and Department of Nephrology (J.-T.F.), Chang Gung Memorial Hospital at Linkou, Taoyuan; Graduate Institute of Mind, Brain, & Consciousness (J.-L.H.), Taipei Medical University; Brain & Consciousness Research Center (J.-L.H.), Shuang Ho Hospital, New Taipei City; School of Traditional Chinese Medicine (G.-H.L., N.-H.C.) and School of Medicine (J.-T.F.), College of Medicine (S.-H.L.), Chang Gung University; Sleep Center (G.-H.L., N.-H.C.), Chang Gung Memorial Hospital, Taoyuan, Taiwan; and Department of Radiology (M.C.), University of North Carolina School of Medicine, Chapel Hill
| | - Geng-Hao Liu
- From the Department of Medical Imaging and Intervention (T.Y.S., C.H.T.) and Neuroscience Research Center, Department of Neurology, Medical Center and College of Medicine (J.-L.H.), Chang Gung University College of Medicine, and Division of Acupuncture and Moxibustion, Department of Traditional Chinese Medicine (G.-H.L.), Department of Psychiatry (S.-H.L.), Department of Pulmonary and Critical Care Medicine (N.-H.C.), Biomedical Informatics Unit, Clinical Trial Center (C.J.F.), and Department of Nephrology (J.-T.F.), Chang Gung Memorial Hospital at Linkou, Taoyuan; Graduate Institute of Mind, Brain, & Consciousness (J.-L.H.), Taipei Medical University; Brain & Consciousness Research Center (J.-L.H.), Shuang Ho Hospital, New Taipei City; School of Traditional Chinese Medicine (G.-H.L., N.-H.C.) and School of Medicine (J.-T.F.), College of Medicine (S.-H.L.), Chang Gung University; Sleep Center (G.-H.L., N.-H.C.), Chang Gung Memorial Hospital, Taoyuan, Taiwan; and Department of Radiology (M.C.), University of North Carolina School of Medicine, Chapel Hill
| | - Shwu-Hua Lee
- From the Department of Medical Imaging and Intervention (T.Y.S., C.H.T.) and Neuroscience Research Center, Department of Neurology, Medical Center and College of Medicine (J.-L.H.), Chang Gung University College of Medicine, and Division of Acupuncture and Moxibustion, Department of Traditional Chinese Medicine (G.-H.L.), Department of Psychiatry (S.-H.L.), Department of Pulmonary and Critical Care Medicine (N.-H.C.), Biomedical Informatics Unit, Clinical Trial Center (C.J.F.), and Department of Nephrology (J.-T.F.), Chang Gung Memorial Hospital at Linkou, Taoyuan; Graduate Institute of Mind, Brain, & Consciousness (J.-L.H.), Taipei Medical University; Brain & Consciousness Research Center (J.-L.H.), Shuang Ho Hospital, New Taipei City; School of Traditional Chinese Medicine (G.-H.L., N.-H.C.) and School of Medicine (J.-T.F.), College of Medicine (S.-H.L.), Chang Gung University; Sleep Center (G.-H.L., N.-H.C.), Chang Gung Memorial Hospital, Taoyuan, Taiwan; and Department of Radiology (M.C.), University of North Carolina School of Medicine, Chapel Hill
| | - Ning-Hung Chen
- From the Department of Medical Imaging and Intervention (T.Y.S., C.H.T.) and Neuroscience Research Center, Department of Neurology, Medical Center and College of Medicine (J.-L.H.), Chang Gung University College of Medicine, and Division of Acupuncture and Moxibustion, Department of Traditional Chinese Medicine (G.-H.L.), Department of Psychiatry (S.-H.L.), Department of Pulmonary and Critical Care Medicine (N.-H.C.), Biomedical Informatics Unit, Clinical Trial Center (C.J.F.), and Department of Nephrology (J.-T.F.), Chang Gung Memorial Hospital at Linkou, Taoyuan; Graduate Institute of Mind, Brain, & Consciousness (J.-L.H.), Taipei Medical University; Brain & Consciousness Research Center (J.-L.H.), Shuang Ho Hospital, New Taipei City; School of Traditional Chinese Medicine (G.-H.L., N.-H.C.) and School of Medicine (J.-T.F.), College of Medicine (S.-H.L.), Chang Gung University; Sleep Center (G.-H.L., N.-H.C.), Chang Gung Memorial Hospital, Taoyuan, Taiwan; and Department of Radiology (M.C.), University of North Carolina School of Medicine, Chapel Hill
| | - Changjui James Fu
- From the Department of Medical Imaging and Intervention (T.Y.S., C.H.T.) and Neuroscience Research Center, Department of Neurology, Medical Center and College of Medicine (J.-L.H.), Chang Gung University College of Medicine, and Division of Acupuncture and Moxibustion, Department of Traditional Chinese Medicine (G.-H.L.), Department of Psychiatry (S.-H.L.), Department of Pulmonary and Critical Care Medicine (N.-H.C.), Biomedical Informatics Unit, Clinical Trial Center (C.J.F.), and Department of Nephrology (J.-T.F.), Chang Gung Memorial Hospital at Linkou, Taoyuan; Graduate Institute of Mind, Brain, & Consciousness (J.-L.H.), Taipei Medical University; Brain & Consciousness Research Center (J.-L.H.), Shuang Ho Hospital, New Taipei City; School of Traditional Chinese Medicine (G.-H.L., N.-H.C.) and School of Medicine (J.-T.F.), College of Medicine (S.-H.L.), Chang Gung University; Sleep Center (G.-H.L., N.-H.C.), Chang Gung Memorial Hospital, Taoyuan, Taiwan; and Department of Radiology (M.C.), University of North Carolina School of Medicine, Chapel Hill
| | - Mauricio Castillo
- From the Department of Medical Imaging and Intervention (T.Y.S., C.H.T.) and Neuroscience Research Center, Department of Neurology, Medical Center and College of Medicine (J.-L.H.), Chang Gung University College of Medicine, and Division of Acupuncture and Moxibustion, Department of Traditional Chinese Medicine (G.-H.L.), Department of Psychiatry (S.-H.L.), Department of Pulmonary and Critical Care Medicine (N.-H.C.), Biomedical Informatics Unit, Clinical Trial Center (C.J.F.), and Department of Nephrology (J.-T.F.), Chang Gung Memorial Hospital at Linkou, Taoyuan; Graduate Institute of Mind, Brain, & Consciousness (J.-L.H.), Taipei Medical University; Brain & Consciousness Research Center (J.-L.H.), Shuang Ho Hospital, New Taipei City; School of Traditional Chinese Medicine (G.-H.L., N.-H.C.) and School of Medicine (J.-T.F.), College of Medicine (S.-H.L.), Chang Gung University; Sleep Center (G.-H.L., N.-H.C.), Chang Gung Memorial Hospital, Taoyuan, Taiwan; and Department of Radiology (M.C.), University of North Carolina School of Medicine, Chapel Hill
| | - Ji-Tseng Fang
- From the Department of Medical Imaging and Intervention (T.Y.S., C.H.T.) and Neuroscience Research Center, Department of Neurology, Medical Center and College of Medicine (J.-L.H.), Chang Gung University College of Medicine, and Division of Acupuncture and Moxibustion, Department of Traditional Chinese Medicine (G.-H.L.), Department of Psychiatry (S.-H.L.), Department of Pulmonary and Critical Care Medicine (N.-H.C.), Biomedical Informatics Unit, Clinical Trial Center (C.J.F.), and Department of Nephrology (J.-T.F.), Chang Gung Memorial Hospital at Linkou, Taoyuan; Graduate Institute of Mind, Brain, & Consciousness (J.-L.H.), Taipei Medical University; Brain & Consciousness Research Center (J.-L.H.), Shuang Ho Hospital, New Taipei City; School of Traditional Chinese Medicine (G.-H.L., N.-H.C.) and School of Medicine (J.-T.F.), College of Medicine (S.-H.L.), Chang Gung University; Sleep Center (G.-H.L., N.-H.C.), Chang Gung Memorial Hospital, Taoyuan, Taiwan; and Department of Radiology (M.C.), University of North Carolina School of Medicine, Chapel Hill
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24
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Yang S, Yin J, Qin W, Yang L, Hu W. Poor Sleep Quality Associated With Enlarged Perivascular Spaces in Patients With Lacunar Stroke. Front Neurol 2022; 12:809217. [PMID: 35153985 PMCID: PMC8831757 DOI: 10.3389/fneur.2021.809217] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Accepted: 12/28/2021] [Indexed: 11/13/2022] Open
Abstract
Background and Objective Enlarged perivascular spaces (EPVSs) are considered as an MRI marker of cerebral small vessel diseases and were reported to be associated with brain waste clearance dysfunction. A previous study found that interstitial fluid clearance in the mouse brain occurred mainly during sleep. However, the relationship between sleep quality and EPVS in humans has not been well-understood. Thus, we aimed to investigate the relationship between sleep and EPVS in humans. Methods This retrospective study was conducted in patients with lacunar stroke in the Neurology Department of Beijing Chaoyang Hospital. Patients with EPVS >10 on one side of the basal ganglia (BG) and white matter slice containing the maximum amount were defined as the BG-EPVS group and the white matter (WM)-EPVS group, respectively. Patients with EPVS <10 in the slice containing the maximum amount were defined as the control group. Sleep quality was evaluated by the Pittsburgh Sleep Quality Index (PSQI) including seven components, where a score of 6 or higher indicated poor sleep quality. Spearman's correlation analysis and the binary logistic regression analysis were performed to analyze the relationship between poor sleep quality and BG-EPVS and WM-EPVS, respectively. Results A total of 398 patients were enrolled in this study, including 114 patients in the BG-EPVS group and 85 patients in the WM-EPVS group. The proportion of poor sleep quality in the BG-EPVS group was higher than that in the control group (58.8 vs. 32.5%, p < 0.001). The score of PSQI, subjective sleep quality, sleep latency, sleep duration, and sleep efficiency were higher in the BG-EPVS group than that in the control group (p < 0.05). The proportion of poor sleep quality was also higher in the WM-EPVS group than that in the control group (50.6 vs. 35.3%, p = 0.031). The score of sleep duration and sleep disturbances was higher in the WM-EPVS group than that in the control group. Spearman's correlation analysis showed that poor sleep quality was positively associated with BG-EPVS (ρ = 0.264, p < 0.001) and WM-EPVS (ρ = 0.154, p = 0.044). The binary logistic regression analysis showed that poor sleep quality, longer sleep latency, and less sleep duration were independently related to BG-EPVS and poor sleep quality, less sleep duration, and more serious sleep disturbances were independently related to WM-EPVS after adjusting for confounders (P < 0.05). Conclusion Poor sleep quality was independently associated with EPVS in BG and WM.
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Affiliation(s)
- Shuna Yang
- Department of Neurology, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China
| | - Jiangmei Yin
- Department of Neurology, Beijing Pinggu District Hospital, Beijing, China
| | - Wei Qin
- Department of Neurology, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China
| | - Lei Yang
- Department of Neurology, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China
| | - Wenli Hu
- Department of Neurology, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China
- *Correspondence: Wenli Hu
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25
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Abstract
Although a relationship between traditional cardiovascular risk factors and stroke has long been recognized, these risk factors likely play a role in other aspects of brain health. Clinical stroke is only the tip of the iceberg of vascular brain injury that includes covert infarcts, white matter hyperintensities, and microbleeds. Furthermore, an individual's risk for not only stroke but poor brain health includes not only these traditional vascular risk factors but also lifestyle and genetic factors. The purpose of this narrative review is to summarize the state of the evidence on traditional and nontraditional vascular risk factors and their contributions to brain health. Additionally, we will review important modifiers that interact with these risk factors to increase, or, in some cases, reduce risk of adverse brain health outcomes, with an emphasis on genes and biomarkers associated with Alzheimer disease. Finally, we will consider the importance of social determinants of health in brain health outcomes.
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Affiliation(s)
- Rebecca F Gottesman
- Stroke Branch, National Institute of Neurological Disorders and Stroke Intramural Research Program, Bethesda, MD (R.F.G.)
| | - Sudha Seshadri
- Glenn Biggs Institute for Alzheimer's and Neurodegenerative Diseases, UTHSA, San Antonio, TX (S.S.).,Department of Neurology, Boston University School of Medicine, Boston, MA (S.S.)
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26
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Weihs A, Frenzel S, Garvert L, Kühn L, Wittfeld K, Ewert R, Fietze I, Penzel T, Stubbe B, Szentkirályi A, Wulms N, Völzke H, Grabe HJ. The relationship between Alzheimer's‐related brain atrophy patterns and sleep macro‐architecture. ALZHEIMER'S & DEMENTIA: DIAGNOSIS, ASSESSMENT & DISEASE MONITORING 2022; 14:e12371. [PMID: 36381559 PMCID: PMC9652484 DOI: 10.1002/dad2.12371] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 10/05/2022] [Accepted: 10/06/2022] [Indexed: 11/15/2022]
Abstract
Introduction Sleep is increasingly recognized as a major risk factor for neurodegenerative disorders such as Alzheimer's disease (AD). Methods Using an magnetic resonance imaging (MRI)-based AD score based on clinical data from the Alzheimer's Disease Neuroimaging Initiative 1 (ADNI1) case-control cohort, we investigated the associations between polysomnography-based sleep macro-architecture and AD-related brain atrophy patterns in 712 pre-symptomatic, healthy subjects from the population-based Study of Health in Pomerania. Results We identified a robust inverse association between slow-wave sleep and the AD marker (estimate: -0.019; 95% confidence interval: -0.03 to -0.0076; false discovery rate [FDR] = 0.0041), as well as with gray matter (GM) thicknesses in typical individual cortical AD-signature regions. No effects were identified regarding rapid eye movement or non-rapid eye movement (NREM) stage 2 sleep, and NREM stage 1 was positively associated with GM thickness, mainly in the prefrontal cortical regions. Discussion There is a cross-sectional relationship between AD-related neurodegenerative patterns and the proportion of sleep spent in slow-wave sleep.
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Affiliation(s)
- Antoine Weihs
- Department of Psychiatry and Psychotherapy University Medicine Greifswald Greifswald Mecklenburg‐Vorpommern Germany
| | - Stefan Frenzel
- Department of Psychiatry and Psychotherapy University Medicine Greifswald Greifswald Mecklenburg‐Vorpommern Germany
| | - Linda Garvert
- Department of Psychiatry and Psychotherapy University Medicine Greifswald Greifswald Mecklenburg‐Vorpommern Germany
| | - Luise Kühn
- Department of Psychiatry and Psychotherapy University Medicine Greifswald Greifswald Mecklenburg‐Vorpommern Germany
| | - Katharina Wittfeld
- Department of Psychiatry and Psychotherapy University Medicine Greifswald Greifswald Mecklenburg‐Vorpommern Germany
- German Centre for Neurodegenerative Diseases (DZNE) Site Rostock/Greifswald Greifswald Mecklenburg‐Vorpommern Germany
| | - Ralf Ewert
- Department of Internal Medicine B–Cardiology Pneumology, Infectious Diseases Intensive Care Medicine University Medicine Greifswald Greifswald Mecklenburg‐Vorpommern Germany
| | - Ingo Fietze
- Interdisciplinary Centre of Sleep Medicine CC 12 University Hospital Charité Berlin Berlin Germany
- The Fourth People's hospital of Guangyuan Guangyuan City Sichuan China
| | - Thomas Penzel
- Interdisciplinary Centre of Sleep Medicine CC 12 University Hospital Charité Berlin Berlin Germany
| | - Beate Stubbe
- Department of Internal Medicine B–Cardiology Pneumology, Infectious Diseases Intensive Care Medicine University Medicine Greifswald Greifswald Mecklenburg‐Vorpommern Germany
| | - András Szentkirályi
- Institute of Epidemiology and Social Medicine University of Muenster Muenster Nordrhein‐Westfalen Germany
| | - Niklas Wulms
- Institute of Epidemiology and Social Medicine University of Muenster Muenster Nordrhein‐Westfalen Germany
| | - Henry Völzke
- Institute for Community Medicine Department SHIP/Clinical Epidemiological Research University Medicine Greifswald Greifswald Mecklenburg‐Vorpommern Germany
- German Centre for Cardiovascular Research (DZHK) Partner Site Greifswald Greifswald Mecklenburg‐Vorpommern Germany
| | - Hans J. Grabe
- Department of Psychiatry and Psychotherapy University Medicine Greifswald Greifswald Mecklenburg‐Vorpommern Germany
- German Centre for Neurodegenerative Diseases (DZNE) Site Rostock/Greifswald Greifswald Mecklenburg‐Vorpommern Germany
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27
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Jang DJ, Lim DK, Kim JK. Polysomnography Analysis of Electroencephalography in Patients Expending Benzodiazepine Drugs. KOREAN JOURNAL OF CLINICAL LABORATORY SCIENCE 2021. [DOI: 10.15324/kjcls.2021.53.4.333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Affiliation(s)
- Da Jun Jang
- Department of Biomedical Laboratory Science, General Graduate School, Dankook University, Cheonan, Korea
| | - Dong Kyu Lim
- Department of Medical Laser, Dankook University Graduate School of Medicine, Cheonan, Korea
| | - Jae Kyung Kim
- Department of Biomedical Laboratory Science, Dankook University College of Health Sciences, Cheonan, Korea
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28
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Salinas J, O’Donnell A, Kojis DJ, Pase MP, DeCarli C, Rentz DM, Berkman LF, Beiser A, Seshadri S. Association of Social Support With Brain Volume and Cognition. JAMA Netw Open 2021; 4:e2121122. [PMID: 34398201 PMCID: PMC8369356 DOI: 10.1001/jamanetworkopen.2021.21122] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
IMPORTANCE Cognitive resilience refers to the general capacity of cognitive processes to be less susceptible to differences in brain structure from age- and disease-related changes. Studies suggest that supportive social networks reduce Alzheimer disease and related disorder (ADRD) risk by enhancing cognitive resilience, but data on specific social support mechanisms are sparse. OBJECTIVE To examine the association of individual forms of social support with a global neuroanatomical measure of early ADRD vulnerability and cognition. DESIGN, SETTING, AND PARTICIPANTS This retrospective cross-sectional analysis used prospectively collected data from Framingham Study participants without dementia, stroke, or other neurological conditions who underwent brain magnetic resonance imaging and neuropsychological testing at the same visit. Data from this large, population-based, longitudinal cohort were collected from June 6, 1997, to December 13, 1999 (original cohort), and from September 11, 1998, to October 26, 2001 (offspring cohort). Data were analyzed from May 22, 2017, to June 1, 2021. EXPOSURES Total cerebral volume and, as a modifying exposure variable, self-reported availability of 5 types of social support measured by the Berkman-Syme Social Network Index. MAIN OUTCOMES AND MEASURES The primary outcome was a global measure of cognitive function. Cognitive resilience was defined as the modification of total cerebral volume's association with cognition, such that smaller β estimates (presented in SD units) indicate greater cognitive resilience (ie, better cognitive performance than estimated by lower total cerebral volume). RESULTS The study included 2171 adults (164 in the original cohort and 2007 in the offspring cohort; mean [SD] age, 63 [10] years; 1183 [54%] female). High listener availability was associated with greater cognitive resilience (β = 0.08, P < .001) compared with low listener availability (β = 0.20, P = .002). Overall findings persisted after adjustment for potential confounders. Other forms of social support were not significant modifiers (advice: β = -0.04; P = .40 for interaction; love-affection: β = -0.07, P = .28 for interaction; emotional support: β = -0.02, P = .73 for interaction; and sufficient contact: β = -0.08; P = .11 for interaction). CONCLUSIONS AND RELEVANCE The results of this cross-sectional cohort study suggest that social support in the form of supportive listening is associated with greater cognitive resilience, independently modifying the association between lower total cerebral volume and poorer cognitive function that would otherwise indicate increased ADRD vulnerability at the preclinical stage. A refined understanding of social support mechanisms has the potential to inform strategies to reduce ADRD risk and enhance cognitive resilience.
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Affiliation(s)
- Joel Salinas
- Center for Cognitive Neurology, Department of Neurology, New York University Grossman School of Medicine, New York
- The Framingham Study, Boston, Massachusetts
- Harvard Center for Population and Development Studies, Harvard University, Cambridge, Massachusetts
| | - Adrienne O’Donnell
- The Framingham Study, Boston, Massachusetts
- Department of Biostatistics, Boston University School of Public Health, Boston, Massachusetts
| | - Daniel J. Kojis
- The Framingham Study, Boston, Massachusetts
- Department of Biostatistics, Boston University School of Public Health, Boston, Massachusetts
| | - Matthew P. Pase
- The Framingham Study, Boston, Massachusetts
- Harvard T. H. Chan School of Public Health, Boston, Massachusetts
- Turner Institute for Brain and Mental Health, Monash University, Clayton, Victoria, Australia
| | | | - Dorene M. Rentz
- Center for Alzheimer Research and Treatment, Department of Neurology, Brigham and Women’s Hospital, Boston, Massachusetts
| | - Lisa F. Berkman
- Harvard Center for Population and Development Studies, Harvard University, Cambridge, Massachusetts
- Harvard T. H. Chan School of Public Health, Boston, Massachusetts
| | - Alexa Beiser
- The Framingham Study, Boston, Massachusetts
- Department of Biostatistics, Boston University School of Public Health, Boston, Massachusetts
- Department of Neurology, Boston University School of Medicine, Boston, Massachusetts
| | - Sudha Seshadri
- The Framingham Study, Boston, Massachusetts
- Department of Neurology, Boston University School of Medicine, Boston, Massachusetts
- Glenn Biggs Institute for Alzheimer’s and Neurodegenerative Diseases, University of Texas Health Sciences Center, San Antonio
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