Self-reported sleep correlates with prefrontal-amygdala functional connectivity and emotional functioning

Pain-Insomnia-Depression Syndrome: Triangular Relationships, Pathobiological Correlations, Current Treatment Modalities, and Future Direction

Pain-insomnia-depression syndrome (PIDS) is a complex triad of chronic pain, insomnia, and depression that has profound effects on an individual's quality of life and mental health. The pathobiological context of PIDS involves complex neurobiological and physiological mechanisms, including alterations in neurotransmitter systems and impaired pain processing pathways. The first-line therapeutic approaches for the treatment of chronic pain, depression, and insomnia are a combination of pharmacological and non-pharmacological therapies. In cases where patients do not respond adequately to these treatments, additional interventions such as deep brain stimulation (DBS) may be required. Despite advances in understanding and treatment, there are still gaps in knowledge that need to be addressed. To improve our understanding, future research should focus on conducting longitudinal studies to uncover temporal associations, identify biomarkers and genetic markers associated with PIDS, examine the influence of psychosocial factors on treatment responses, and develop innovative interventions that address the complex nature of PIDS. The aim of this study is to provide a comprehensive overview of these components and to discuss their underlying pathobiological relationships.

Socioeconomic factors, sleep timing and duration, and amygdala resting-state functional connectivity in children

Introduction

Reduced sleep health has been consistently linked with increased negative emotion in children. While sleep characteristics have been associated with neural function in adults and adolescents, much less is known about these associations in children while considering socioeconomic context. In this study, we examined the associations among socioeconomic factors, sleep duration and timing, and resting-state functional connectivity (rsFC) of the amygdala in children.

Methods

Participants were typically-developing 5- to 9-year-olds from socioeconomically diverse families (61% female; N = 94). Parents reported on children's weekday and weekend bedtimes and wake-up times, which were used to compute sleep duration and midpoint. Analyses focused on amygdala-anterior cingulate cortex (ACC) connectivity followed by amygdala-whole brain connectivity.

Results

Lower family income-to-needs ratio and parental education were significantly associated with later weekday and weekend sleep timing and shorter weekday sleep duration. Shorter weekday sleep duration was associated with decreased amygdala-ACC and amygdala-insula connectivity. Later weekend sleep midpoint was associated with decreased amygdala-paracingulate cortex and amygdala-postcentral gyrus connectivity. Socioeconomic factors were indirectly associated with connectivity in these circuits via sleep duration and timing.

Discussion

These results suggest that socioeconomic disadvantage may interfere with both sleep duration and timing, in turn possibly altering amygdala connectivity in emotion processing and regulation circuits in children. Effective strategies supporting family economic conditions may have benefits for sleep health and brain development in children.

Reducing crash risk for young drivers: Protocol for a pragmatic randomised controlled trial to improve young driver sleep

Background

Road trauma is a leading cause of death and disability for young Australians (15-24 years). Young adults are overrepresented in crashes due to sleepiness, with two-thirds of their fatal crashes attributed to sleepy driving. This trial aims to examine the effectiveness of a sleep extension and education program for improved road safety in young adults.

Methods

Young adults aged 18-24 years (n = 210) will be recruited for a pragmatic randomised controlled trial employing a placebo-controlled, parallel-groups design. The intervention group will undergo sleep extension and receive education on sleep, whereas the placebo control group will be provided with information about diet and nutrition. The primary outcomes of habitual sleep and on-road driving performance will be assessed via actigraphy and in-vehicle accelerometery. A range of secondary outcomes including driving behaviours (driving simulator), sleep (diaries and questionnaire) and socio-emotional measures will be assessed.

Discussion

Sleep is a modifiable factor that may reduce the risk of sleepiness-related crashes. Modifying sleep behaviour could potentially help to reduce the risk of young driver sleepiness-related crashes. This randomised control trial will objectively assess the efficacy of implementing sleep behaviour manipulation and education on reducing crash risk in young adult drivers.

Validation of the Chinese version of the Sleep Regularity Questionnaire (SRQ) and analysis of influencing factors

BACKGROUND

Currently, there is no instrument to measure sleep regularity in China. In this study, the Sleep Regularity Questionnaire（SRQ） was translated into Chinese, tested for reliability and validity, and analyzed for factors affecting sleep regularity.

METHODS

The English version of the SRQ was translated into Chinese, and a total of 3642 individuals were included in this research. Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were used to examine the underlying factor structure of the Chinese version of the SRQ and to measure its reliability and validity. In addition, the correlations between sleep regularity and general information, personal habits, self-control, stress, anxiety, and depression were explored.

RESULTS

The Cronbach's α of the Chinese SRQ was 0.858, supporting the two-factor structure. Sleep regularity was statistically different between gender and ethnicity (p < 0.05), and personal habits (exercise, continued eating after dinner, smoking and drinking) had an effect on sleep regularity. Sleep regularity was positively associated with individual self-control and negatively associated with stress, anxiety, and depression.

CONCLUSIONS

The Chinese version of the SRQ has excellent reliability and validity. There are two dimensions, namely circadian regularity and sleep continuity regularity, which can be used to assess the sleep regularity of Chinese adults. The results of this study showed that males and Han Chinese having better sleep regularity. And people with good lifestyle habits and greater self-control sleep more regularly, while stress, anxiety and depression can affect individuals' sleep regularity.

Covariance patterns between sleep health domains and distributed intrinsic functional connectivity

Sleep health is both conceptually and operationally a composite concept containing multiple domains of sleep. In line with this, high dependence and interaction across different domains of sleep health encourage a transition in sleep health research from categorical to dimensional approaches that integrate neuroscience and sleep health. Here, we seek to identify the covariance patterns between multiple sleep health domains and distributed intrinsic functional connectivity by applying a multivariate approach (partial least squares). This multivariate analysis reveals a composite sleep health dimension co-varying with connectivity patterns involving the attentional and thalamic networks and which appear relevant at the neuromolecular level. These findings are further replicated and generalized to several unseen independent datasets. Critically, the identified sleep-health related connectome shows diagnostic potential for insomnia disorder. These results together delineate a potential brain connectome biomarker for sleep health with high potential for clinical translation.

Emotional intelligence mediates the protective role of the orbitofrontal cortex spontaneous activity measured by fALFF against depressive and anxious symptoms in late adolescence

As a stable personality construct, trait emotional intelligence (TEI) refers to a battery of perceived emotion-related skills that make individuals behave effectively to adapt to the environment and maintain well-being. Abundant evidence has consistently shown that TEI is important for the outcomes of many mental health issues, particularly depression and anxiety. However, the neural substrates involved in TEI and the underlying neurobehavioral mechanism of how TEI reduces depression and anxiety symptoms remain largely unknown. Herein, resting-state functional magnetic resonance imaging and a group of behavioral measures were applied to examine these questions among a large sample comprising 231 general adolescent students aged 16-20 years (52% female). Whole-brain correlation analysis and prediction analysis demonstrated that TEI was negatively linked with spontaneous activity (measured with the fractional amplitude of low-frequency fluctuations) in the bilateral medial orbitofrontal cortex (OFC), a critical site implicated in emotion-related processes. Furthermore, structural equation modeling analysis found that TEI mediated the link of OFC spontaneous activity to depressive and anxious symptoms. Collectively, the current findings present new evidence for the neurofunctional bases of TEI and suggest a potential "brain-personality-symptom" pathway for alleviating depressive and anxious symptoms among students in late adolescence.

The impact of mindfulness training on posttraumatic stress disorder symptoms, subjective sleep quality, and objective sleep outcomes in police officers

OBJECTIVE

Sleep disturbances cooccur with posttraumatic stress disorder (PTSD) and are often correlated with PTSD severity. Previous research has shown that sleep problems mediate the relationship between PTSD and negative physical and mental health outcomes but has relied on self-reported sleep quality. We tested the effects of mindfulness training-previously shown to improve sleep quality and reduce PTSD symptoms-on subjective and objective sleep metrics and relationships with reduced PTSD symptoms.

METHOD

Following baseline data collection in 114 law enforcement officers, we randomly assigned participants to either an 8-week mindfulness training group or a waitlist control group. We repeated assessments immediately posttraining and at 3-month follow-up. Self-reported PTSD symptoms and subjective sleep quality were measured at each visit with the PTSD checklist and Pittsburgh Sleep Quality Index (PSQI), respectively. Participants also wore a Fitbit Charge 2 continuously over the course of a 4- to 6-day work week following each visit, from which we extracted two distinct objective sleep metrics: total minutes of sleep and sleep efficiency.

RESULTS

At baseline, PTSD symptoms were correlated with PSQI scores but not objective Fitbit metrics. Relative to waitlist, mindfulness training led to improved subjective sleep quality and reduced PTSD symptoms. Reduced PTSD symptoms mediated the improvement in subjective sleep quality following mindfulness training. Neither objective sleep metric demonstrated improvements following mindfulness training, nor did these metrics mediate reduced PTSD symptoms.

CONCLUSIONS

This study provides evidence linking improved subjective sleep quality, but not objective sleep markers, to reductions in PTSD symptoms following mindfulness training. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Sleep deprivation altered encoding of basolateral amygdala on fear acquisition

Sleep deprivation (SD) may lead to the development of fear- and anxiety-related emotional disorders. However, the neural mechanisms underlying the effects of SD on fear acquisition are unclear. Here, we tested whether and how SD influences the behavioral and neural manifestations of fear acquisition. We found that subjective fear ratings and objective fear indices (skin conductance response [SCR]) in the SD group were greater than those in the control group during fear acquisition, suggesting that SD facilitated fear acquisition (nSD = 18 and ncontrol = 23 for self-reported rating analysis; nSD = 10 and ncontrol = 10 for SCR analysis). Neuroimaging data showed that the SD group exhibited stronger activity in the left basolateral amygdala (BLA) and left superficial amygdala (SFA). Moreover, the left BLA activity, which positively correlated with the objective fear indices, significantly mediated the effect of SD on fear acquisition. Together, the present findings indicate that SD facilitates fear acquisition by augmenting threat-specific encoding in the BLA, which may be a potential biomarker of the risk of developing fear-related disorders under traumatic and distressing situations.

Impaired emotional intelligence is related to symptoms severity and suicidal attempts in depression

OBJECTIVE

Few studies demonstrated the impairment of perceived emotional intelligence 'EI' among depressed patients. This study aimed to assess the perceived EI in a group of depressed patients, and its association with different clinical characteristics.

METHODS

Forty-five patients diagnosed with depression were assessed by the Hamilton Depression Rating Scale and compared to 45 controls that were assessed by the Arabic version of General Health Questionnaire to exclude Psychiatric disorders. The Arabic version of Trait Meta-Mood Scale (TMMS) is used to evaluate EI in both groups.

RESULTS

Patients with depression showed significantly lower EI scores in the three parts of TMMS (repair, clarity and attention) compared to the controls (p < .001). Patients showed significant difference in clarity subscale (p = .005) and attention regarding severity of depression (p < .001). Clarity of feelings was significantly higher in patients who suffered more than two episodes (p = .012). Depressive patients with suicidal attempts showed significantly lower scores of repair (p = .044) and attention (p = .016) subscales. There were no significant differences of TMMS subscales between patients with and without suicidal ideation, sleep disturbance and somatic symptoms.

CONCLUSIONS

The current study demonstrates impaired perceived EI among patients with depression that is correlated with symptom severity and suicidal attempts.

Metabotropic glutamate receptor function and regulation of sleep-wake cycles

Metabotropic glutamate (mGlu) receptors are the most abundant family of G-protein coupled receptors and are widely expressed throughout the central nervous system (CNS). Alterations in glutamate homeostasis, including dysregulations in mGlu receptor function, have been indicated as key contributors to multiple CNS disorders. Fluctuations in mGlu receptor expression and function also occur across diurnal sleep-wake cycles. Sleep disturbances including insomnia are frequently comorbid with neuropsychiatric, neurodevelopmental, and neurodegenerative conditions. These often precede behavioral symptoms and/or correlate with symptom severity and relapse. Chronic sleep disturbances may also be a consequence of primary symptom progression and can exacerbate neurodegeneration in disorders including Alzheimer's disease (AD). Thus, there is a bidirectional relationship between sleep disturbances and CNS disorders; disrupted sleep may serve as both a cause and a consequence of the disorder. Importantly, comorbid sleep disturbances are rarely a direct target of primary pharmacological treatments for neuropsychiatric disorders even though improving sleep can positively impact other symptom clusters. This chapter details known roles of mGlu receptor subtypes in both sleep-wake regulation and CNS disorders focusing on schizophrenia, major depressive disorder, post-traumatic stress disorder, AD, and substance use disorder (cocaine and opioid). In this chapter, preclinical electrophysiological, genetic, and pharmacological studies are described, and, when possible, human genetic, imaging, and post-mortem studies are also discussed. In addition to reviewing the important relationships between sleep, mGlu receptors, and CNS disorders, this chapter highlights the development of selective mGlu receptor ligands that hold promise for improving both primary symptoms and sleep disturbances.

A short-term follow-up study on the relationship between early adolescent proactive/reactive aggression and sleep quality

OBJECTIVE/BACKGROUND

Sleep quality is closely related to aggressive behavior. Previous studies rarely focused on the relationship between proactive/reactive aggression and sleep quality through a person-centered approach.

METHODS

The Pittsburgh Sleep Quality Index Scale and the Reactive-Proactive Aggression Questionnaire were used to assess 553 elementary and middle school students twice at 6-month intervals to better understand the relationship between proactive/reactive aggression and sleep quality in early adolescence.

RESULTS

Findings revealed that (1) Sleep quality was positive longitudinally related to both proactive aggression and reactive aggression; Proactive aggression negatively influenced sleep quality, and reactive aggression did not influence sleep quality longitudinally. (2) The sleep quality of persistent non-aggressors and stopped aggressors was significantly better than that of persistent aggressors and new aggressors.

CONCLUSION

In early adolescence, proactive aggression was mutually related to sleep quality. Therefore, future research should focus on the bidirectional association between aggression and sleep quality. In addition, we should improve the sleep quality for different types of aggressors and transformers, especially for new aggressors.

Sleep and Daily Positive Emotions – Is Heart Rate Variability a Mediator?

Abstract. Sleep quality is considered a basic dimension of emotional health. The psychophysiological mechanisms underlying the associations between sleep quality and positive emotions are still largely unknown, yet autonomic regulation may play a role. This study employed a two-day ecological momentary assessment methodology in a sample of young adults to investigate whether subjective sleep quality reported in the morning was associated with daily positive emotional experience and whether this association was mediated by heart rate variability (HRV), a measure of cardiac vagal tone. Sleep quality was assessed using an electronic sleep diary upon awakening, while resting HRV and positive emotions were inspected at random times throughout the day using photoplethysmography and an electronic diary, respectively. Relevant confounding variables such as smoking, alcohol intake, and physical exercise between each measurement were also assessed. The sample included 121 participants (64.8% females, Mage = 25.97 ± 5.32 years). After controlling for relevant confounders including health behaviors and psychiatric comorbidities, mediation analysis revealed that greater sleep quality positively predicted daily HRV (β = .289, p < .001) which, in turn, had a direct influence on positive emotions (β = .244, p = .006). Also, sleep quality directly predicted positive emotional experience (β = .272, p = .001). Lastly, the model showed an indirect effect between sleep quality and positive emotions via HRV (β = .071, 95% BCI [.011, .146]). Results support the view of HRV as a process variable linking sleep to positive emotions. Experimental data is needed to consolidate the present findings.

Perceived stress modulates the activity between the amygdala and the cortex

The significant link between stress and psychiatric disorders has prompted research on stress's impact on the brain. Interestingly, previous studies on healthy subjects have demonstrated an association between perceived stress and amygdala volume, although the mechanisms by which perceived stress can affect brain function remain unknown. To better understand what this association entails at a functional level, herein, we explore the association of perceived stress, measured by the PSS10 questionnaire, with disseminated functional connectivity between brain areas. Using resting-state fMRI from 252 healthy subjects spanning a broad age range, we performed both a seed-based amygdala connectivity analysis (static connectivity, with spatial resolution but no temporal definition) and a whole-brain data-driven approach to detect altered patterns of phase interactions between brain areas (dynamic connectivity with spatiotemporal information). Results show that increased perceived stress is directly associated with increased amygdala connectivity with frontal cortical regions, which is driven by a reduced occurrence of an activity pattern where the signals in the amygdala and the hippocampus evolve in opposite directions with respect to the rest of the brain. Overall, these results not only reinforce the pathological effect of in-phase synchronicity between subcortical and cortical brain areas but also demonstrate the protective effect of counterbalanced (i.e., phase-shifted) activity between brain subsystems, which are otherwise missed with correlation-based functional connectivity analysis.

Adolescent sleep and the foundations of prefrontal cortical development and dysfunction

Modern life poses many threats to good-quality sleep, challenging brain health across the lifespan. Curtailed or fragmented sleep may be particularly damaging during adolescence, when sleep disruption by delayed chronotypes and societal pressures coincides with our brains preparing for adult life via intense refinement of neural connectivity. These vulnerabilities converge on the prefrontal cortex, one of the last brain regions to mature and a central hub of the limbic-cortical circuits underpinning decision-making, reward processing, social interactions and emotion. Even subtle disruption of prefrontal cortical development during adolescence may therefore have enduring impact. In this review, we integrate synaptic and circuit mechanisms, glial biology, sleep neurophysiology and epidemiology, to frame a hypothesis highlighting the implications of adolescent sleep disruption for the neural circuitry of the prefrontal cortex. Convergent evidence underscores the importance of acknowledging, quantifying and optimizing adolescent sleep's contributions to normative brain development and to lifelong mental health.

Non-rapid eye movement sleep determines resilience to social stress

Resilience, the ability to overcome stressful conditions, is found in most mammals and varies significantly among individuals. A lack of resilience can lead to the development of neuropsychiatric and sleep disorders, often within the same individual. Despite extensive research into the brain mechanisms causing maladaptive behavioral-responses to stress, it is not clear why some individuals exhibit resilience. To examine if sleep has a determinative role in maladaptive behavioral-response to social stress, we investigated individual variations in resilience using a social-defeat model for male mice. Our results reveal a direct, causal relationship between sleep amount and resilience-demonstrating that sleep increases after social-defeat stress only occur in resilient mice. Further, we found that within the prefrontal cortex, a regulator of maladaptive responses to stress, pre-existing differences in sleep regulation predict resilience. Overall, these results demonstrate that increased NREM sleep, mediated cortically, is an active response to social-defeat stress that plays a determinative role in promoting resilience. They also show that differences in resilience are strongly correlated with inter-individual variability in sleep regulation.

Investigating the effects of sleep and sleep loss on the different stages of episodic emotional memory: A narrative review and guide to the future

For two decades, sleep has been touted as one of the primary drivers for the encoding, consolidation, retention, and retrieval of episodic emotional memory. Recently, however, sleep’s role in emotional memory processing has received renewed scrutiny as meta-analyses and reviews have indicated that sleep may only contribute a small effect that hinges on the content or context of the learning and retrieval episodes. On the one hand, the strong perception of sleep’s importance in maintaining memory for emotional events may have been exacerbated by publication bias phenomena, such as the “winner’s curse” and “file drawer problem.” On the other hand, it is plausible that there are sets of circumstances that lead to consistent and reliable effects of sleep on emotional memory; these circumstances may depend on factors such as the placement and quality of sleep relative to the emotional experience, the content and context of the emotional experience, and the probes and strategies used to assess memory at retrieval. Here, we review the literature on how sleep (and sleep loss) influences each stage of emotional episodic memory. Specifically, we have separated previous work based on the placement of sleep and sleep loss in relation to the different stages of emotional memory processing: (1) prior to encoding, (2) immediately following encoding during early consolidation, (3) during extended consolidation, separated from initial learning, (4) just prior to retrieval, and (5) post-retrieval as memories may be restructured and reconsolidated. The goals of this review are three-fold: (1) examine phases of emotional memory that sleep may influence to a greater or lesser degree, (2) explicitly identify problematic overlaps in traditional sleep–wake study designs that are preventing the ability to better disentangle the potential role of sleep in the different stages of emotional memory processing, and (3) highlight areas for future research by identifying the stages of emotional memory processing in which the effect of sleep and sleep loss remains under-investigated. Here, we begin the task of better understanding the contexts and factors that influence the relationship between sleep and emotional memory processing and aim to be a valuable resource to facilitate hypothesis generation and promote important future research.

The Mind After Midnight: Nocturnal Wakefulness, Behavioral Dysregulation, and Psychopathology

Sufficient sleep with minimal interruption during the circadian/biological night supports daytime cognition and emotional regulation. Conversely, disrupted sleep involving significant nocturnal wakefulness leads to cognitive and behavioral dysregulation. Most studies to-date have examined how fragmented or insufficient sleep affects next-day functioning, but recent work highlights changes in cognition and behavior that occur when someone is awake during the night. This review summarizes the evidence for day-night alterations in maladaptive behaviors, including suicide, violent crime, and substance use, and examines how mood, reward processing, and executive function differ during nocturnal wakefulness. Based on this evidence, we propose the Mind after Midnight hypothesis in which attentional biases, negative affect, altered reward processing, and prefrontal disinhibition interact to promote behavioral dysregulation and psychiatric disorders.

Correlates of Canadian mothers' anger during the postpartum period: a cross-sectional survey

BACKGROUND

Although some women experience anger as a mood problem after childbirth, postpartum anger has been neglected by researchers. Mothers' and infants' poor sleep quality during the postpartum period has been associated with mothers' depressive symptoms; however, links between mothers' sleep quality and postpartum anger are unclear. This study aimed to determine proportions of women with intense anger, depressive symptoms, and comorbid intense anger and depressive symptoms, and to examine mothers' and infants' sleep quality as correlates of postpartum anger.

METHODS

This cross-sectional survey study was advertised as an examination of mothers' and babies' sleep. Women, with healthy infants between 6 and 12 months of age, were recruited using community venues. The survey contained validated measures of sleep quality for mothers and infants, and fatigue, social support, anger, depressive symptoms, and cognitions about infant sleep.

RESULTS

278 women participated in the study. Thirty-one percent of women (n = 85) reported intense anger (≥ 90th percentile on State Anger Scale) while 26% (n = 73) of mothers indicated probable depression (>12 on Edinburgh Postnatal Depression Scale). Over half of the participants rated their sleep as poor (n = 144, 51.8%). Using robust regression analysis, income (β = -0.11, p < 0.05), parity (β = 0.2, p < 0.01), depressive symptoms (β = 0.22, p < 0.01), and mothers' sleep quality (β = 0.10, p < 0.05), and anger about infant sleep (β = 0.25, p < 0.01) were significant predictors of mothers' anger.

CONCLUSIONS

Mothers' sleep quality and anger about infant sleep are associated with their state anger. Clinicians can educate families about sleep pattern changes during the perinatal time frame and assess women's mood and perceptions of their and their infants' sleep quality in the first postpartum year. They can also offer evidence-based strategies for improving parent-infant sleep. Such health promotion initiatives could reduce mothers' anger and support healthy sleep.

Sleep and violence perpetration: A review of biological and environmental substrates

Violence is a worldwide societal burden that negatively impacts individual health, wellbeing and economic development. Evidence suggests a bidirectional relationship between sleep changes and violence. This review details, evaluates and discusses the biological and demographic substrates linking sleep and violence perpetration, and summarizes the overlap of brain areas, functional neuronal systems and genetic features involved, not including violent behaviours during sleep. Knowledge on the biological variables that affect the individual's susceptibility to violent behaviour may have implications for criminology, management of detentions and rehabilitation strategies.

Sleep quality and duration are associated with greater trait emotional intelligence

OBJECTIVES

Prior work suggests that short sleep and total sleep deprivation are associated with reduced trait Emotional Intelligence (trait EI) but not reduced ability Emotional Intelligence (ability EI). To expand this knowledge base, we investigated the role of habitual sleep quality on trait and ability EI above and beyond the known effects of recent sleep duration.

METHODS

A large sample, comprising 477 healthy adults completed the Pittsburgh Sleep Quality Index (PSQI), Trait Emotional Intelligence Questionnaire (TEIQue; trait EI), and Mayer-Salovey-Caruso Emotional Intelligence Scale (MSCEIT; ability EI).

RESULTS

Bivariate correlation and multiple linear regression showed that recent sleep duration and PSQI sleep quality each independently predicted higher trait EI scores, including Emotionality, Self-Control, Sociability, and Well-being, but were unrelated to ability EI scores.

CONCLUSIONS

In this large community sample, recent sleep duration and habitual sleep quality both independently associated with self-perceived dispositional aspects of EI (ie, trait EI). In contrast, recent sleep duration and PSQI score were unrelated to more crystalized aspects of EI performance, which encompass the general fund of emotional information and the ability to understand and reason about emotional concepts (ie, ability EI). In sum, greater self-perceived sleep duration and quality was associated with subjective perceptions of better emotional functioning, but was unrelated to performance-based metrics of emotional reasoning.

Sleep, Distressed Appearance, and Quality of Life Relate to Satisfaction with Orthognathic Surgery

BACKGROUND

In this study, we aimed to identify factors correlating with satisfaction with orthognathic surgery in order to improve its outcome.

METHODS

We recruited 77 participants who had received orthognathic surgery and 32 age- and gender-matched normal-controls. Questionnaires that included devised questions for family support, Big Five Inventory, Derriford Appearance Score, Pittsburgh Sleep Quality Index, Hospital Anxiety and Depression Scale, 36-Item Short-Form Health Survey, and a visual analogy scale for satisfaction, were completed before and one month and nine months after the surgery. The statistical analysis methods included descriptive statistics, t-test, and Pearson correlation.

RESULTS

All participants received the preoperative and one-month follow-up, while 28 also completed the nine-month follow-up. Satisfaction was not significantly related to demographic data, but long-term satisfaction was related to an extraverted personality. The preoperative and postoperative results of the Derriford Appearance Scale were related to short-term and long-term satisfaction. Furthermore, both the preoperative and one-month postoperative Pittsburgh Sleep Quality Index findings were significantly related to short-term satisfaction. The postoperative 36-Item Short-Form Health Survey was significantly related to short-term and long-term satisfaction.

CONCLUSIONS

Not only subjective distress and dysfunction of appearance but also sleep problems and quality of life were correlated to satisfaction with orthognathic surgery. In the future, relevant interventions can be developed to further improve patient's satisfaction and their physical and mental health.

Emotion Regulation Failures Are Preceded by Local Increases in Sleep-like Activity

Emotion self-regulation relies both on cognitive and behavioral strategies implemented to modulate the subjective experience and/or the behavioral expression of a given emotion. Although it is known that a network encompassing fronto-cingulate and parietal brain areas is engaged during successful emotion regulation, the functional mechanisms underlying failures in emotion suppression (ES) are still unclear. In order to investigate this issue, we analyzed video and high-density EEG recordings of 20 healthy adult participants during an ES and a free expression task performed on two consecutive days. Changes in facial expression during ES, but not free expression, were preceded by local increases in sleep-like activity (1-4 Hz) in brain areas responsible for emotional suppression, including bilateral anterior insula and anterior cingulate cortex, and in right middle/inferior frontal gyrus (p < .05, corrected). Moreover, shorter sleep duration the night before the ES experiment correlated with the number of behavioral errors (p = .03) and tended to be associated with higher frontal sleep-like activity during ES failures (p = .09). These results indicate that local sleep-like activity may represent the cause of ES failures in humans and may offer a functional explanation for previous observations linking lack of sleep, changes in frontal activity, and emotional dysregulation.

A neurobiological link between transportation noise exposure and metabolic disease in humans

BACKGROUND

Chronic transportation noise exposure associates with cardiovascular events through a link involving heightened stress-associated neurobiological activity (as amygdalar metabolic activity, AmygA) on ¹⁸F-fluorodeoxyglucose positron emission tomography/computed tomography (¹⁸F-FDG-PET/CT). Increased AmygA also associates with greater visceral adipose tissue (VAT) and type 2 diabetes mellitus (DM). While relationships between noise exposure and VAT and DM have been reported, the underlying mechanisms remain incompletely understood. We tested whether: (1) transportation noise exposure associates with greater (a) baseline and gains in VAT and (b) DM risk, and (2) heightened AmygA partially mediates the link between noise exposure and these metabolic diseases.

METHODS

VAT was measured in a retrospective cohort (N = 403) who underwent clinical ¹⁸F-FDG-PET/CT. AmygA was measured in those with brain imaging (N = 238). Follow-up VAT was remeasured on available imaging (N = 67). Among individuals (N = 224) without baseline DM, incident DM was adjudicated over 2 years from clinical records. Noise (24-h average) was modeled at each individual's home address. Linear regression, survival, and mediation analyses were employed.

RESULTS

Higher noise exposure (upper tertile vs. others) associated with greater: baseline VAT (standardized β [95% confidence interval (CI)]= 0.230 [0.021, 0.438], p = 0.031), gains in VAT (0.686 [0.185, 1.187], p = 0.008 adjusted for baseline VAT), and DM (hazard ratio [95% CI]=2.429 [1.031, 5.719], p = 0.042). The paths of: ↑noise exposure→↑AmygA→↑baseline VAT and ↑noise exposure→↑AmygA→↑subsequent DM were significant (p < 0.05).

CONCLUSIONS

Increased transportation noise exposure associates with greater VAT and DM. This relationship is partially mediated by stress-associated neurobiological activity. These findings suggest altered neurobiology contributes to noise exposure's link to metabolic diseases.

Good Sleep Quality Improves the Relationship Between Pain and Depression Among Individuals With Chronic Pain

Individuals with chronic pain often experience co-existing sleep problems and depression-related states. Chronic pain, sleep problems, and depression interrelate, and have been shown to exacerbate one another, which negatively impacts quality of life. This study explored the relationships between pain severity, pain interference, sleep quality, and depression among individuals with chronic pain. Secondly, we tested whether sleep quality may moderate the relationship between pain and depression. A cross-sectional survey was completed by 1,059 adults with non-malignant chronic pain conditions (M age 43 years, 88% identified as women) and collected measures related to pain severity, pain interference, sleep quality, and depression. Multiple regression analyses found that pain severity, pain interference, and sleep quality are all significantly associated with depression. Secondly, moderated regression analyses revealed that sleep quality moderates the relationship between pain interference and depression among individuals with chronic pain such that good sleep quality attenuates the effect of pain interference on depression, and poor sleep quality amplifies the effect of pain interference on depression. These findings suggest that sleep quality may be a relevant therapeutic target for individuals with chronic pain and co-existing depression.

Assessment of Physician Sleep and Wellness, Burnout, and Clinically Significant Medical Errors

IMPORTANCE

Sleep-related impairment in physicians is an occupational hazard associated with long and sometimes unpredictable work hours and may contribute to burnout and self-reported clinically significant medical error.

OBJECTIVE

To assess the associations between sleep-related impairment and occupational wellness indicators in physicians practicing at academic-affiliated medical centers and the association of sleep-related impairment with self-reported clinically significant medical errors, before and after adjusting for burnout.

DESIGN, SETTING, AND PARTICIPANTS

This cross-sectional study used physician wellness survey data collected from 11 academic-affiliated medical centers between November 2016 and October 2018. Analysis was completed in January 2020. A total of 19 384 attending physicians and 7257 house staff physicians at participating institutions were invited to complete a wellness survey. The sample of responders was used for this study.

EXPOSURES

Sleep-related impairment.

MAIN OUTCOMES AND MEASURES

Association between sleep-related impairment and occupational wellness indicators (ie, work exhaustion, interpersonal disengagement, overall burnout, and professional fulfillment) was hypothesized before data collection. Assessment of the associations of sleep-related impairment and burnout with self-reported clinically significant medical errors (ie, error within the last year resulting in patient harm) was planned after data collection.

RESULTS

Of all physicians invited to participate in the survey, 7700 of 19 384 attending physicians (40%) and 3695 of 7257 house staff physicians (51%) completed sleep-related impairment items, including 5279 women (46%), 5187 men (46%), and 929 (8%) who self-identified as other gender or elected not to answer. Because of institutional variation in survey domain inclusion, self-reported medical error responses from 7538 physicians were available for analyses. Spearman correlations of sleep-related impairment with interpersonal disengagement (r = 0.51; P < .001), work exhaustion (r = 0.58; P < .001), and overall burnout (r = 0.59; P < .001) were large. Sleep-related impairment correlation with professional fulfillment (r = -0.40; P < .001) was moderate. In a multivariate model adjusted for gender, training status, medical specialty, and burnout level, compared with low sleep-related impairment levels, moderate, high, and very high levels were associated with increased odds of self-reported clinically significant medical error, by 53% (odds ratio, 1.53; 95% CI, 1.12-2.09), 96% (odds ratio, 1.96; 95% CI, 1.46-2.63), and 97% (odds ratio, 1.97; 95% CI, 1.45-2.69), respectively.

CONCLUSIONS AND RELEVANCE

In this study, sleep-related impairment was associated with increased burnout, decreased professional fulfillment, and increased self-reported clinically significant medical error. Interventions to mitigate sleep-related impairment in physicians are warranted.

A combined fMRI and EMG study of emotional contagion following partial sleep deprivation in young and older humans

Sleep deprivation is proposed to inhibit top-down-control in emotion processing, but it is unclear whether sleep deprivation affects emotional mimicry and contagion. Here, we aimed to investigate effects of partial sleep deprivation on emotional contagion and mimicry in young and older humans. Participants underwent partial sleep deprivation (3 h sleep opportunity at the end of night), crossed-over with a full sleep condition in a balanced order, followed by a functional magnetic resonance imaging and electromyography (EMG) experiment with viewing of emotional and neutral faces and ratings of emotional responses. The final sample for main analyses was n = 69 (n = 36 aged 20–30 years, n = 33 aged 65–75 years). Partial sleep deprivation caused decreased activation in fusiform gyri for angry faces and decreased ratings of happiness for all stimuli, but no significant effect on the amygdala. Older participants reported more anger compared to younger participants, but no age differences were seen in brain responses to emotional faces or sensitivity to partial sleep deprivation. No effect of the sleep manipulation was seen on EMG. In conclusion, emotional contagion, but not mimicry, was affected by sleep deprivation. Our results are consistent with the previously reported increased negativity bias after insufficient sleep.

The Stockholm sleepy brain study: effects of sleep deprivation on cognitive and emotional processing in young and old. https://clinicaltrials.gov/ct2/show/NCT02000076.

Sleep and the aging brain. A multifaceted approach

In the current review we provide a theoretical background on studies examining the association between sleep and brain function. We focus on the association between sleep and cognitive performance, cognitive changes over time and incident dementia as well. We then present some data on the link between sleep and subjective cognitive complaints, in participants without any objective clinical cognitive decline. We conclude with investigating the association between sleep and brain biomarkers, by highlighting the importance of specific genes and specific brain regions' morphometry. The role of sleep is vital in maintaining a healthy aging brain, and multiple factors should be taken under account when investigating this association.

Association of naturally occurring sleep loss with reduced amygdala resting-state functional connectivity following psychosocial stress

Enduring sleep loss is a risk factor for a variety of both somatic and mental health issues. When subjected to sleep loss, the brain becomes vulnerable to critical alterations in cognitive and emotional processing. In our study, we examined the effect of psychosocial stress on amygdala resting-state functional connectivity in participants with cumulative sleep loss calculated across the seven days preceding scanning. For this purpose, forty-five healthy male participants completed a one-week sleep diary and underwent resting-state scans before and after taking part in the ScanSTRESS paradigm, which allows social stress induction during functional magnetic resonance imaging. Sleep loss was negatively associated with seed-based functional connectivity of the left amygdala with the medial prefrontal cortex, dorsal anterior cingulate cortex, anterior insula, posterior cingulate cortex, and dorsolateral prefrontal cortex. That is, participants with higher amounts of sleep loss showed reduced left amygdala connectivity after social stress induction to cortical regions encompassing main nodes of the brain's default mode network and salience network. Our results shed more light on how brain functional connectivity may shape the brain's stress response in the context of naturally occurring sleep loss, revealing a potential neural mechanism for increased vulnerability to stress-related psychopathology.

Sleep in the anxiety-related disorders: A meta-analysis of subjective and objective research

Although sleep disturbance is implicated in psychopathology, its role in anxiety-related disorders remains unclear. The present meta-analysis characterizes sleep disturbance in anxiety-related disorders collectively and individually. Subjective measures of total sleep time and sleep continuity were included with objective measures. Results indicate a large effect for increased subjective sleep disturbance (g = 2.16), medium effects for decreased total sleep time (g = -.40) and sleep continuity (g = -.49), and a small effect for decreased sleep depth (g = -.20) in anxiety-related disorders compared to healthy controls. Each anxiety-related disorder exhibited a distinct sleep disturbance pattern, suggesting that sleep may facilitate identification of unique biopsychological underpinnings. Effects were not moderated by comorbid depression and were similar in magnitude to those found for depression. Sleep disturbances, particularly decreased sleep continuity, may be a key pathology in the anxiety-related disorders that could highlight novel etiological mechanisms and intervention targets.

Integrating sleep, neuroimaging, and computational approaches for precision psychiatry

In advancing precision psychiatry, we focus on what imaging technology and computational approaches offer for the future of diagnostic subtyping and personalized tailoring of interventions for sleep impairment in mood and anxiety disorders. Current diagnostic criteria for mood and anxiety tend to lump different forms of sleep disturbance together. Parsing the biological features of sleep impairment and brain circuit dysfunction is one approach to identifying subtypes within these disorders that are mechanistically coherent and offer targets for intervention. We focus on two large-scale neural circuits implicated in sleep impairment and in mood and anxiety disorders: the default mode network and negative affective network. Through a synthesis of existing knowledge about these networks, we pose a testable framework for understanding how hyper- versus hypo-engagement of these networks may underlie distinct features of mood and sleep impairment. Within this framework we consider whether poor sleep quality may have an explanatory role in previously observed associations between network dysfunction and mood symptoms. We expand this framework to future directions including the potential for connecting circuit-defined subtypes to more distal features derived from digital phenotyping and wearable technologies, and how new discovery may be advanced through machine learning approaches.

Emotional Effects of the Duration, Efficiency, and Subjective Quality of Sleep in Healthcare Personnel

Considering that both sleep quality and duration are linked to psychological variables, this study analyzed the relationships between sleep components and emotional intelligence and the effects that sleep duration has on stress management and mood in a sample of nurses. The sample was made up of 1073 professionals. Data were collected by the Pittsburgh Sleep Quality Index and the Brief Emotional Intelligence Inventory for Senior Citizens. The results showed that the components of sleep quality were negatively related to stress management and mood. Furthermore, nurses who had short sleep patterns also had low moods and high stress levels. This study emphasizes the importance of subjective sleep quality as a necessary resource for professionals to manage stressful situations and mood and improve their relations with their patients and with each other.

Vulnerability to mood degradation during sleep deprivation is influenced by white-matter compactness of the triple-network model

Sleep deprivation (SD) is often associated with significant shifts in mood state relative to baseline functioning. Prior work suggests that there are consistent trait-like differences among individuals in the degree to which their mood and performances are affected by sleep loss. The goal of this study was to determine the extent to which trait-like individual differences in vulnerability/resistance to mood degradation during a night of SD are dependent upon region-specific white and grey matter (WM/GM) characteristics of a triple-network model, including the default-mode network (DMN), control-execution network (CEN) and salience network (SN). Diffusion-weighted and anatomical brain data were collected from 45 healthy individuals several days prior to a 28-h overnight SD protocol. During SD, a visual analog mood scale was administered every hour from 19:15 (time point1; TP1) to 11:15 (TP17) the following morning to measure two positive and six negative mood states. Four core regions within the DMN, five within the CEN, and seven within the SN were used as regions of interest (ROIs). An index of mood resistance (IMR) was defined as the averaged differences between positive and negative mood states over 12 TPs (TP5 to TP16) relative to baseline (TP1 to TP4). For each ROI, characteristics of WM - quantitative anisotropy (QA) and mean curvature index (WM-MCI), and GM - cortical volume (CV) and GM-MCI were estimated, and used to predict IMR. WM characteristics, particularly QA, of all of regions within the DMN, and most of the regions within the CEN and SN predicted IMR during SD. In contrast, most ROIs did not show significant association between IMR and any of the GM characteristics (CV and MCI) or WM MCI. Our findings suggest that greater resilience to mood degradation induced by total SD appears to be associated with more compact axonal pathways within the DMN, CEN and SN.

Self-regulation and social behavior during sleep deprivation

An emerging literature is specifically focusing on the effects of sleep deprivation on aspects of social functioning and underlying neural changes. Two critical facets of social behavior emerge that are negatively impacted by sleep deprivation-self-regulation, which includes behavioral and emotional regulation, and social monitoring, which includes perceiving and interpreting cues relating to self and others. Sleep deprived individuals performing tasks with social components show altered brain activity in areas of the prefrontal cortex implicated in self-control, inhibition, evaluation, and decision-making, in proximity to mesocorticolimbic pathways to reward and emotional processing areas. These cognitive changes lead to increased reward seeking and behaviors that promote negative health outcomes (such as increased consumption of indulgence foods). These changes also lead to emotional disinhibition and increased responses to negative stimuli, leading to reductions in trust, empathy, and humor. Concomitant attentional instability leads to impaired social information processing, impairing individual and team performance and increasing likelihood of error, incident, and injury. Together, changes to reward seeking, the foundational components of social interaction, and interpretation of social cues, can result in unpleasant or deviant behavior. These behaviors are perceived and negatively responded to by others, leading to a cycle of conflict and withdrawal. Further studies are necessary and timely. Educational and behavioral interventions are required to reduce health-damaging behaviors, and to reduce emotionally-laden negative interpretation of sleep-deprived exchanges. This may assist with health, and with team cohesion (and improved performance and safety) in the workplace and the home.

Sleep restriction caused impaired emotional regulation without detectable brain activation changes-a functional magnetic resonance imaging study

Sleep restriction has been proposed to cause impaired emotional processing and emotional regulation by inhibiting top-down control from prefrontal cortex to amygdala. Intentional emotional regulation after sleep restriction has, however, never been studied using brain imaging. We aimed here to investigate the effect of partial sleep restriction on emotional regulation through cognitive reappraisal. Forty-seven young (age 20-30) and 33 older (age 65-75) participants (38/23 with complete data and successful sleep intervention) performed a cognitive reappraisal task during fMRI after a night of normal sleep and after restricted sleep (3 h). Emotional downregulation was associated with significantly increased activity in the dorsolateral prefrontal cortex (p _FWE < 0.05) and lateral orbital cortex (p _FWE < 0.05) in young, but not in older subjects. Sleep restriction was associated with a decrease in self-reported regulation success to negative stimuli (p < 0.01) and a trend towards perceiving all stimuli as less negative (p = 0.07) in young participants. No effects of sleep restriction on brain activity nor connectivity were found in either age group. In conclusion, our data do not support the idea of a prefrontal-amygdala disconnect after sleep restriction, and neural mechanisms underlying behavioural effects on emotional regulation after insufficient sleep require further investigation.

Dynamic functional abnormalities in generalized anxiety disorders and their increased network segregation of a hyperarousal brain state modulated by insomnia

BACKGROUND

Insomnia is frequently accompanied by the generalized anxiety disorder (GAD) but mostly fMRI studies investigated their aberrant functional connectivity (FC) without this issue. Recently, dynamic FC approach is prevailing to capture the time-varying fluctuations of spontaneous brain activities. Nevertheless, it is unclear how the dynamic FC characteristics are altered by insomnia in GAD.

METHODS

We acquired resting state fMRI and neuropsychological tests for the 17 comorbid GAD with insomnia (GAD/IS), 15 GAD and 24 healthy controls (HC). Then, based on the sliding window correlations, we estimated distinct brain states and statistically compared their dynamic properties. Further combining with graph theory, their network properties of each state among groups were accessed. Lastly, we examined associations between abnormal parameters and neuropsychological tests.

RESULTS

We identified four brain states but did not observe significance on the state transitions. The mean dwell time and fraction of one globally hypoactive state accounted for high proportion of brain activities were significantly different (GAD > HC > GAD/IS). Meanwhile, we found gradual decreases in a brain state representing slight sleep/drowsiness (HC > GAD/IS > GAD). Additionally, we observed the GAD/IS patients had significantly increased network segregation and posterior cingulate cortex in a hyperarousal state, as well as significant associations with anxiety and insomnia severity.

LIMITATIONS

The influences of depression on dynamic FC properties in GAD are unclear yet and more subjects should be recruited.

CONCLUSIONS

These results provide new insights about the temporal features in GAD and offer potential biomarkers to evaluate the impacts of insomnia.

Developmental Trajectories of Early Life Stress and Trauma: A Narrative Review on Neurobiological Aspects Beyond Stress System Dysregulation

Early life stressors display a high universal prevalence and constitute a major public health problem. Prolonged psychoneurobiological alterations as sequelae of early life stress (ELS) could represent a developmental risk factor and mediate risk for disease, leading to higher physical and mental morbidity rates in later life. ELS could exert a programming effect on sensitive neuronal brain networks related to the stress response during critical periods of development and thus lead to enduring hyper- or hypo-activation of the stress system and altered glucocorticoid signaling. In addition, alterations in emotional and autonomic reactivity, circadian rhythm disruption, functional and structural changes in the brain, as well as immune and metabolic dysregulation have been lately identified as important risk factors for a chronically impaired homeostatic balance after ELS. Furthermore, human genetic background and epigenetic modifications through stress-related gene expression could interact with these alterations and explain inter-individual variation in vulnerability or resilience to stress. This narrative review presents relevant evidence from mainly human research on the ten most acknowledged neurobiological allostatic pathways exerting enduring adverse effects of ELS even decades later (hypothalamic-pituitary-adrenal axis, autonomic nervous system, immune system and inflammation, oxidative stress, cardiovascular system, gut microbiome, sleep and circadian system, genetics, epigenetics, structural, and functional brain correlates). Although most findings back a causal relation between ELS and psychobiological maladjustment in later life, the precise developmental trajectories and their temporal coincidence has not been elucidated as yet. Future studies should prospectively investigate putative mediators and their temporal sequence, while considering the potentially delayed time-frame for their phenotypical expression. Better screening strategies for ELS are needed for a better individual prevention and treatment.

Effects of Duration and Midpoint of Sleep on Corticolimbic Circuitry in Youth

INTRODUCTION

Adequate sleep is essential for cognitive and emotion-related functioning, and 9 to 12 hr of sleep is recommended for children ages 6 to 12 years and 8 to 10 hr for children ages 13 to 18 years. However, national survey data indicate that older youth sleep for fewer hours and fall asleep later than younger youth. This shift in sleep duration and timing corresponds with a sharp increase in onset of emotion-related problems (e.g., anxiety, depression) during adolescence. Given that both sleep duration and timing have been linked to emotion-related outcomes, the present study tests the effects of sleep duration and timing, and their interaction, on resting-state functional connectivity (RS-FC) of corticolimbic emotion-related neural circuitry in children and adolescents.

METHODS

A total of 63 children and adolescents (6-17 years, 34 females) completed a weekend overnight sleep journal and a 10-min resting-state functional magnetic resonance imaging scan the next day (Sunday). Whole-brain RS-FC of the amygdala was computed, and the effects of sleep duration, timing (i.e., midpoint of sleep), and their interaction were explored using regression analyses.

RESULTS

Overall, we found that older youth tended to sleep later and for fewer hours than younger youth. Controlling for age, shorter sleep duration was associated with lower RS-FC between the amygdala and regions implicated in emotion regulation, including ventral anterior cingulate cortex, precentral gyrus, and superior temporal gyrus. Interestingly, midpoint of sleep was associated with altered connectivity in a distinct set of brain regions involved in interoception and sensory processing, including insula, supramarginal gyrus, and postcentral gyrus. Our data also indicate widespread interactive effects of sleep duration and midpoint on brain regions implicated in emotion regulation, sensory processing, and motor control.

CONCLUSION

These results suggest that both sleep duration and midpoint of sleep are associated with next-day RS-FC within corticolimbic emotion-related neural circuitry in children and adolescents. The observed interactive effects of sleep duration and timing on RS-FC may reflect how homeostatic and circadian process interact in the brain and explain the complex patterns observed with respect to emotional health when considering sleep duration and timing. Sleep-related changes in corticolimbic circuitry may contribute to the onset of emotion-related problems during adolescence.

Sleep deprivation affects fear memory consolidation: bi-stable amygdala connectivity with insula and ventromedial prefrontal cortex

Sleep plays an important role for successful fear memory consolidation. Growing evidence suggests that sleep disturbances might contribute to the development and the maintenance of posttraumatic stress disorder (PTSD), a disorders characterized by dysregulations in fear learning mechanisms, as well as exaggerated arousal and salience processing. Against this background, the present study examined the effects of sleep deprivation (SD) on the acquisition of fear and the subsequent neural consolidation. To this end, the present study assessed fear acquisition and associated changes in fMRI-based amygdala-functional connectivity following 24 h of SD. Relative to non-sleep deprived controls, SD subjects demonstrated increased fear ratings and skin conductance responses (SCR) during fear acquisition. During fear consolidation SD inhibited increased amygdala-ventromendial prefrontal cortex (vmPFC) connectivity and concomitantly increased changes in amygdala-insula connectivity. Importantly, whereas in controls fear indices during acquisition were negatively associated with amygdala-vmPFC connectivity during consolidation, fear indices were positively associated with amygdala-insula coupling following SD. Together the findings suggest that SD may interfere with vmPFC control of the amygdala and increase bottom-up arousal signaling in the amygdala-insula pathway during fear consolidation, which might mediate the negative impact of sleep disturbances on PSTD symptomatology.

Review of Neurobiological Influences on Externalizing and Internalizing Pathways to Alcohol Use Disorder

Purpose of review

Two developmental courses through which alcohol use disorder (AUD) may emerge include externalizing and internalizing pathways. We review recent neuroimaging studies of potential neural risk factors for AUD and link findings to potential behavioral risk factors for AUD.

Recent findings

There is evidence that early-emerging weakness in prefrontal functioning and later-emerging differences in reward-system functioning contribute to an externalizing risk pathway. Stress may be an important contributor in the internalizing pathway through a blunting of reward-related activation, which may act alone or in combination with heightened emotion-related reactivity.

Summary

This review highlights areas for future work, including investigation of the relative balance between prefrontal and subcortical circuitry, attention to stages of AUD, and consideration of environmental factors such as stress and sleep. Particularly important is longitudinal work to understand the temporal ordering of associations among brain maturation, behavioral risk, and alcohol use.

Sleep-amount differentially affects fear-processing neural circuitry in pediatric anxiety: A preliminary fMRI investigation

Insufficient sleep, as well as the incidence of anxiety disorders, both peak during adolescence. While both conditions present perturbations in fear-processing-related neurocircuitry, it is unknown whether these neurofunctional alterations directly link anxiety and compromised sleep in adolescents. Fourteen anxious adolescents (AAs) and 19 healthy adolescents (HAs) were compared on a measure of sleep amount and neural responses to negatively valenced faces during fMRI. Group differences in neural response to negative faces emerged in the dorsal anterior cingulate cortex (dACC) and the hippocampus. In both regions, correlation of sleep amount with BOLD activation was positive in AAs, but negative in HAs. Follow-up psychophysiological interaction (PPI) analyses indicated positive connectivity between dACC and dorsomedial prefrontal cortex, and between hippocampus and insula. This connectivity was correlated negatively with sleep amount in AAs, but positively in HAs. In conclusion, the presence of clinical anxiety modulated the effects of sleep-amount on neural reactivity to negative faces differently among this group of adolescents, which may contribute to different clinical significance and outcomes of sleep disturbances in healthy adolescents and patients with anxiety disorders.

Dissociated resting-state functional networks between the dream recall frequency and REM sleep percentage

Rapid eye movement (REM) sleep has been frequently associated with dreaming. However, mounting evidence obtained from behavioral, pharmacological, and brain imaging studies suggests that REM sleep is not indicative of the dream report and may originate from diverse neural substrates in brain functionality. The aim of the current study was to investigate the functional systems associated with inter-individual differences in dream recall and REM sleep through assessments of the resting-state functional connectivity. We collected resting-state functional magnetic resonance imaging (fMRI) data for functional connectivity evaluations from 43 healthy adult volunteers (23 men) before and after sleep. For assessment of the dream recall frequency, a 2-week sleep diary was maintained by all volunteers. In addition, whole-night polysomnography was performed for measuring the REM sleep percentage. Voxel-wise correlation analyses of 12 functional connectivity networks of interest with the dream recall frequency and REM sleep percentage were conducted using general linear model analysis. Both the dream recall frequency and REM sleep percentage showed negative associations with multiple brain functional networks. However, the dream recall frequency was mainly related to functional connectivity within the lateral visual network and thalamus, whereas the REM sleep percentage was mainly associated with connectivity within the frontoparietal networks and cerebellum. In addition, the dream recall frequency showed stronger coupling with the lateral visual network connectivity at night, whereas the coupling between the REM sleep percentage and cerebellum was higher in the morning. This indicated a significant time of day effect. Our results provide neuroimaging evidence that the functional system associated with the dream recall frequency is different from that associated with the REM sleep percentage.

Emotional intelligence is associated with connectivity within and between resting state networks

Emotional intelligence (EI) is defined as an individual’s capacity to accurately perceive, understand, reason about, and regulate emotions, and to apply that information to facilitate thought and achieve goals. Although EI plays an important role in mental health and success in academic, professional and social realms, the neurocircuitry underlying this capacity remains poorly characterized, and no study to date has yet examined the relationship between EI and intrinsic neural network function. Here, in a sample of 54 healthy individuals (28 women, 26 men), we apply independent components analysis (ICA) with dual regression to functional magnetic resonance imaging (fMRI) data acquired while subjects were resting in the scanner to investigate brain circuits (intrinsic resting state networks) whose activity is associated with greater self-reported (i.e. Trait) and objectively measured (i.e. Ability) EI. We show that higher Ability EI, but not Trait EI, is associated with stronger negatively correlated spontaneous fMRI signals between the basal ganglia/limbic network (BGN) and posterior default mode network (DMN), and regions involved in emotional processing and regulation. Importantly, these findings suggest that the functional connectivity within and between intrinsic networks associated with mentation, affective regulation, emotion processing, and reward are strongly related to ability EI.

Neurophysiological differences in the adolescent brain following a single night of restricted sleep - A 7T fMRI study

Sleep deprivation in youth has garnered international attention in recent years, as correlational studies have demonstrated significant relationships between lack of sleep and detrimental behavioral and academic outcomes. However, no study to date has systematically examined the neurophysiological consequences of a single night of sleep restriction (i.e., 4 h) in adolescents using ultra-high field functional neuroimaging. Much of what we know regarding the neural consequences of sleep deprivation has come from the adult literature, and among those studies, the majority use region of interest (ROI) approaches, thus disregarding the dynamic mechanisms that may subserve the behavioral effects of sleep restriction. Leveraging a crossover within-subjects design, we demonstrate that pivotal brain regions involved in the default mode and limbic regulatory centers have disrupted functioning following a night of restricted sleep compared to a night of "normal sleep". Specifically, a normal night (i.e., 8 h) of sleep led to increased global and local efficiency of bilateral amygdala, and less efficiency in the posterior cingulate, as measured by graph theory, compared to a night of sleep restriction. Furthermore, aberrant functional connectivity patterns were identified in key fronto-limbic circuitry, suggesting a potential pathophysiological mechanism underlying the widespread effects of sleep deprivation in youth.

Increased Posterior Insula-Sensorimotor Connectivity Is Associated with Cognitive Function in Healthy Participants with Sleep Complaints

Insomnia is characterized by sensory hypersensitivity and cognitive impairments. Recent work has identified the insula as a central brain region involved in both bottom-up gating of sensory information and top-down cognitive control. However, the specific relationships between insular subregion connectivity and emotional and cognitive functions remain unclear. In this study, resting-state functional magnetic resonance imaging data were obtained from 25 healthy participants with sleep complaints (HPS) and 25 age-, gender- and educational level-matched healthy participants without insomnia complaints (HP). We performed insular subregion (ventral anterior, dorsal anterior and posterior) functional connectivity (FC) analyses, and cognitive function was measured with several validated test procedures (e.g., the Wisconsin Card Sorting Test [WCST], Continuous Performance Test [CPT] and Trail making Test [TMT]). There were no significant differences between the two groups for WCST, CPT and TMT scores. The HPS group showed enhanced connectivity from the right posterior insula (R-PI) to the left postcentral gyrus (L-postCG) compared to HP group. WCST random errors (RE), sleep disturbance scores and HAMA scores correlated with this connectivity measurement in both HP and HPS groups. Our results provide direct evidence that the posterior insula (PI) synchronizes with sensorimotor areas to detect homeostatic changes and suggest that alteration of the latter is related to executive dysfunction in subjects with insomnia.

The Association between Sleep and Theory of Mind in School Aged Children with ADHD

Theory of Mind (ToM) is defined as the ability to infer a range of internal mental states of others, including beliefs, intentions, desires, and emotions. These abilities are associated with children’s ability to socialize effectively with peers. ToM impairments are associated with peer rejection and psychiatric disorders such as Attention-Deficit/Hyperactivity Disorder (ADHD). Previous studies have found poor sleep negatively impacts executive functioning (EF) and emotional information processing, which are essential for the effective use of ToM. Youth with ADHD have EF deficits and sleep problems. However, the relationship between sleep, executive functioning, and ToM in children with ADHD has not been studied. In this review, we propose that the poor social and interpersonal skills characterizing individuals with ADHD could be explained by the impact of poor sleep on the emotional and cognitive mechanisms underlying ToM.