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Rodríguez-Labrada R, Canales-Ochoa N, Galicia-Polo MDL, Cruz-Rivas E, Romanzetti S, Peña-Acosta A, Estupiñán-Rodríguez A, Vázquez-Mojena Y, Dogan I, Auburger G, Reetz K, Velázquez-Pérez L. Structural Brain Correlates of Sleep Microstructure in Spinocerebellar Ataxia Type 2 and its Role on Clinical Phenotype. CEREBELLUM (LONDON, ENGLAND) 2024; 23:1839-1847. [PMID: 38438827 DOI: 10.1007/s12311-024-01674-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 02/20/2024] [Indexed: 03/06/2024]
Abstract
The influence of brain atrophy on sleep microstructure in Spinocerebellar Ataxias (SCAs) has not been extensively explored limiting the use of these sleep traits as surrogate biomarkers of neurodegeneration and clinical phenotype. The objective of the study is to explore the relationship between sleep microstructure and brain atrophy in SCA2 and its role in the clinical phenotype. Fourteen SCA2 mutation carriers (7 pre-manifest and 7 manifest subjects) underwent polysomnographic, structural MRI, and clinical assessments. Particularly, markers of REM and non-REM sleep microstructure, measures of cerebellar and brainstem atrophy, and clinical scores were analyzed through correlation and mediation analyses. The sleep spindle activity exhibited a negative correlation with the number of trials required to complete the verbal memory test (VMT), and a positive correlation with the cerebellar volume, but the significance of the latter correlation did not survive multiple testing corrections. However, the causal mediation analyses unveiled that sleep spindle activity significantly mediates the association between cerebellar atrophy and VMT performance. Regarding REM sleep, both phasic EMG activity and REM sleep without atonia exhibited significant associations with pontine atrophy and disease severity measures. However, they did not demonstrate a causal mediation effect between the atrophy measures and disease severity. Our study provides evidence about the association of the pontocerebellar atrophy with sleep microstructure in SCA2 offering insights into the cerebellar involvement in cognition via the control of the sleep spindle activity. Therefore, our findings may help to understand the disease pathogenesis and to better characterize sleep microstructure parameters as disease biomarkers.Clinical trial registration number (TRN): No applicable.
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Affiliation(s)
- Roberto Rodríguez-Labrada
- Centre for the Research and Rehabilitation of Hereditary Ataxias, Libertad St 16 between 12 St & 16 St. 80100, Holguin, Cuba.
- Cuban Centre for Neurosciences, 190 St, between 25 St & 27 St, 11300, Playa, Havana, Cuba.
| | - Nalia Canales-Ochoa
- Centre for the Research and Rehabilitation of Hereditary Ataxias, Libertad St 16 between 12 St & 16 St. 80100, Holguin, Cuba
| | | | | | - Sandro Romanzetti
- Department of Neurology, RWTH Aachen University, Pauwelsstr. 3052074, Aachen, Germany
- JARA-BRAIN Institute Molecular Neuroscience and Neuroimaging, Forschungszentrum Jülich GmbH, RWTH Aachen University, 52074, Aachen, Germany
| | - Arnoy Peña-Acosta
- Centre for the Research and Rehabilitation of Hereditary Ataxias, Libertad St 16 between 12 St & 16 St. 80100, Holguin, Cuba
| | - Annelié Estupiñán-Rodríguez
- Centre for the Research and Rehabilitation of Hereditary Ataxias, Libertad St 16 between 12 St & 16 St. 80100, Holguin, Cuba
| | - Yaimeé Vázquez-Mojena
- Cuban Centre for Neurosciences, 190 St, between 25 St & 27 St, 11300, Playa, Havana, Cuba
| | - Imis Dogan
- Department of Neurology, RWTH Aachen University, Pauwelsstr. 3052074, Aachen, Germany
- JARA-BRAIN Institute Molecular Neuroscience and Neuroimaging, Forschungszentrum Jülich GmbH, RWTH Aachen University, 52074, Aachen, Germany
| | - Georg Auburger
- Clinic of Neurology, Experimental Neurology, Goethe University Frankfurt, University Hospital, 60590, Frankfurt, Germany
| | - Kathrin Reetz
- Department of Neurology, RWTH Aachen University, Pauwelsstr. 3052074, Aachen, Germany
- JARA-BRAIN Institute Molecular Neuroscience and Neuroimaging, Forschungszentrum Jülich GmbH, RWTH Aachen University, 52074, Aachen, Germany
| | - Luis Velázquez-Pérez
- Centre for the Research and Rehabilitation of Hereditary Ataxias, Libertad St 16 between 12 St & 16 St. 80100, Holguin, Cuba.
- Cuban Academy of Sciences, Cuba St 460, Between Teniente Rey & Amargura , 10100, Habana Vieja, Havana, Cuba.
- Department of Human Physiology, Medical University of Havana, 146 St, 3102, 11300, Playa, Havana, Cuba.
- Faculty of Chemistry, University of Havana, Zapata St Between G St & Carlitos Aguirre St., 10400, Plaza de La Revolución, Havana, Cuba.
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Abstract
The cerebellum has a well-established role in controlling motor functions, including coordination, posture, and the learning of skilled movements. The mechanisms for how it carries out motor behavior remain under intense investigation. Interestingly though, in recent years the mechanisms of cerebellar function have faced additional scrutiny since nonmotor behaviors may also be controlled by the cerebellum. With such complexity arising, there is now a pressing need to better understand how cerebellar structure, function, and behavior intersect to influence behaviors that are dynamically called upon as an animal experiences its environment. Here, we discuss recent experimental work that frames possible neural mechanisms for how the cerebellum shapes disparate behaviors and why its dysfunction is catastrophic in hereditary and acquired conditions-both motor and nonmotor. For these reasons, the cerebellum might be the ideal therapeutic target.
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Affiliation(s)
- Linda H Kim
- Jan and Dan Duncan Neurological Research Institute, Texas Children's Hospital, Houston, Texas, USA
- Department of Pathology & Immunology, Baylor College of Medicine, Houston, Texas, USA;
| | - Detlef H Heck
- Center for Cerebellar Network Structure and Function in Health and Disease, University of Minnesota, Duluth, Minnesota, USA
- Department of Biomedical Sciences, University of Minnesota Medical School, Duluth, Minnesota, USA
| | - Roy V Sillitoe
- Departments of Neuroscience and Pediatrics, Program in Developmental Biology, and Development, Disease Models & Therapeutics Graduate Program, Baylor College of Medicine, Houston, Texas, USA
- Jan and Dan Duncan Neurological Research Institute, Texas Children's Hospital, Houston, Texas, USA
- Department of Pathology & Immunology, Baylor College of Medicine, Houston, Texas, USA;
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