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Petrovic D, Haba-Rubio J, de Mestral Vargas C, Kelly-Irving M, Vineis P, Kivimäki M, Nyberg S, Gandini M, Bochud M, Vollenweider P, d’Errico A, Barros H, Fraga S, Goldberg M, Zins M, Steptoe A, Delpierre C, Heinzer R, Carmeli C, Chadeau-Hyam M, Stringhini S. The contribution of sleep to social inequalities in cardiovascular disorders: a multi-cohort study. Cardiovasc Res 2020; 116:1514-1524. [PMID: 31754700 PMCID: PMC7425783 DOI: 10.1093/cvr/cvz267] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2019] [Revised: 08/28/2019] [Accepted: 10/30/2019] [Indexed: 12/12/2022] Open
Abstract
AIMS Sleep disturbances exhibit a strong social patterning, and inadequate sleep has been associated with adverse health outcomes, including cardiovascular disorders (CVD). However, the contribution of sleep to socioeconomic inequalities in CVD is unclear. This study pools data from eight European cohorts to investigate the role of sleep duration in the association between life-course socioeconomic status (SES) and CVD. METHODS AND RESULTS We used cross-sectional data from eight European cohorts, totalling 111 205 participants. Life-course SES was assessed using father's and adult occupational position. Self-reported sleep duration was categorized into recommended (6-8.5 h/night), long (>8.5 h/night), and short (<6 h/night). We examined two cardiovascular outcomes: coronary heart disease (CHD) and stroke. Main analyses were conducted using pooled data and examined the association between life-course SES and CVD, and the contribution of sleep duration to this gradient using counterfactual mediation. Low father's occupational position was associated with an increased risk of CHD (men: OR = 1.19, 95% CI [1.04; 1.37]; women: OR = 1.25, 95% CI [1.02; 1.54]), with marginal decrease of the gradient after accounting for adult occupational position (men: OR = 1.17, 95% CI [1.02; 1.35]; women: OR = 1.22, 95% CI [0.99; 1.52]), and no mediating effect by short sleep duration. Low adult occupational position was associated with an increased risk of CHD in both men and women (men: OR = 1.48, 95% CI [1.14; 1.92]; women: OR = 1.53, 95% CI [1.04; 2.21]). Short sleep duration meaningfully contributed to the association between adult occupational position and CHD in men, with 13.4% mediation. Stroke did not exhibit a social patterning with any of the variables examined. CONCLUSION This study suggests that inadequate sleep accounts to a meaningful proportion of the association between adult occupational position and CHD, at least in men. With sleep increasingly being considered an important cardiovascular risk factor in its own terms, our study additionally points to its potential role in social inequalities in cardiovascular disease.
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Affiliation(s)
- Dusan Petrovic
- Centre universitaire de médecine Générale et santé publique (UNISANTÉ), Institute of Social and Preventive Medicine (IUMSP), Route de la Corniche 10, 1010 Lausanne, Switzerland
| | - José Haba-Rubio
- Center for Investigation and Research in Sleep, Lausanne University Hospital, Lausanne, Switzerland
| | - Carlos de Mestral Vargas
- Centre universitaire de médecine Générale et santé publique (UNISANTÉ), Institute of Social and Preventive Medicine (IUMSP), Route de la Corniche 10, 1010 Lausanne, Switzerland
| | - Michelle Kelly-Irving
- INSERM, UMR 1027, Toulouse, France
- Université Toulouse III Paul-Sabatier, UMR1027, Toulouse, France
| | - Paolo Vineis
- Department of Epidemiology and Biostatistics, Centre for Environment and Health, School of Public Health, Imperial College London, London, UK
| | - Mika Kivimäki
- Department of Epidemiology and Public Health, University College London, London, UK
| | - Solja Nyberg
- Clinicum, Department of Public Health, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Martina Gandini
- Epidemiology Unit, ASL TO3 Piedmont Region, Grugliasco, Italy
| | - Murielle Bochud
- Centre universitaire de médecine Générale et santé publique (UNISANTÉ), Institute of Social and Preventive Medicine (IUMSP), Route de la Corniche 10, 1010 Lausanne, Switzerland
| | - Peter Vollenweider
- Centre universitaire de médecine Générale et santé publique (UNISANTÉ), Institute of Social and Preventive Medicine (IUMSP), Route de la Corniche 10, 1010 Lausanne, Switzerland
| | - Angelo d’Errico
- Epidemiology Unit, ASL TO3 Piedmont Region, Grugliasco, Italy
| | - Henrique Barros
- EPIUnit-Institute of Public Health, University of Porto, Porto, Portugal
| | - Silvia Fraga
- EPIUnit-Institute of Public Health, University of Porto, Porto, Portugal
| | - Marcel Goldberg
- Population-Based Epidemiological Cohorts Unit, INSERM UMS 11, Villejuif, France
- Paris Descartes University, Paris, France
| | - Marie Zins
- Population-Based Epidemiological Cohorts Unit, INSERM UMS 11, Villejuif, France
- Paris Descartes University, Paris, France
| | - Andrew Steptoe
- Department of Epidemiology and Public Health, University College London, London, UK
| | - Cyrille Delpierre
- INSERM, UMR 1027, Toulouse, France
- Université Toulouse III Paul-Sabatier, UMR1027, Toulouse, France
| | - Raphael Heinzer
- Center for Investigation and Research in Sleep, Lausanne University Hospital, Lausanne, Switzerland
| | - Cristian Carmeli
- Centre universitaire de médecine Générale et santé publique (UNISANTÉ), Institute of Social and Preventive Medicine (IUMSP), Route de la Corniche 10, 1010 Lausanne, Switzerland
| | - Marc Chadeau-Hyam
- Department of Epidemiology and Biostatistics, Centre for Environment and Health, School of Public Health, Imperial College London, London, UK
| | - Silvia Stringhini
- Centre universitaire de médecine Générale et santé publique (UNISANTÉ), Institute of Social and Preventive Medicine (IUMSP), Route de la Corniche 10, 1010 Lausanne, Switzerland
- Unit of Population Epidemiology, Primary Care Division, Geneva University Hospital, Geneva, Switzerland
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Murray AL, Ribeaud D, Eisner M, Murray G, McKenzie K. Should We Subtype ADHD According to the Context in Which Symptoms Occur? Criterion Validity of Recognising Context-Based ADHD Presentations. Child Psychiatry Hum Dev 2019; 50:308-320. [PMID: 30168001 PMCID: PMC6428792 DOI: 10.1007/s10578-018-0842-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
ADHD symptoms show considerable individual variation in the contexts in which they are expressed. It has previously been proposed that subtyping individuals according to the contexts in which symptoms are expressed may be clinically useful. We examined context-based patterns of ADHD symptoms in a longitudinal cohort study of n = 1388 children, as well as context-specific and context-general predictors of symptoms. Participants were community-ascertained and provided ADHD symptom data at ages 7, 9, and 11. Using growth mixture modelling we identified five inattention and five hyperactivity/impulsivity categories that differed in the developmental patterns of symptoms reported by parent and teacher informants. We found some evidence that context-specific predictors were related to context-specific expressions. Specifically, after controlling for other risk factors for ADHD symptoms, relationships with teachers predicted school-specific (teacher-reported) but not home-specific (parent-reported) symptom levels. However, no subtypes defined by exclusively home-based symptoms emerged, suggesting that while symptoms may sometimes be specific to the school context, they are only rarely confined to the home context. Subtyping by context could be informative; however, further work will required to uncover the nature of any etiological, functional, or outcome differences between those who show symptom expression in different contexts.
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Affiliation(s)
- Aja Louise Murray
- Institute of Criminology, University of Cambridge, CB3 9DA, Cambridge, UK.
| | - Denis Ribeaud
- Jacobs Center for Productive Youth Development, University of Zurich, Zurich, Switzerland
| | - Manuel Eisner
- Institute of Criminology, University of Cambridge, CB3 9DA, Cambridge, UK
| | - George Murray
- Department of Psychology, Northumbria University, Newcastle, UK
| | - Karen McKenzie
- Department of Psychology, Northumbria University, Newcastle, UK
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Sahib AK, Erb M, Marquetand J, Martin P, Elshahabi A, Klamer S, Vulliemoz S, Scheffler K, Ethofer T, Focke NK. Evaluating the impact of fast-fMRI on dynamic functional connectivity in an event-based paradigm. PLoS One 2018; 13:e0190480. [PMID: 29357371 PMCID: PMC5777653 DOI: 10.1371/journal.pone.0190480] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2017] [Accepted: 12/15/2017] [Indexed: 01/08/2023] Open
Abstract
The human brain is known to contain several functional networks that interact dynamically. Therefore, it is desirable to analyze the temporal features of these networks by dynamic functional connectivity (dFC). A sliding window approach was used in an event-related fMRI (visual stimulation using checkerboards) to assess the impact of repetition time (TR) and window size on the temporal features of BOLD dFC. In addition, we also examined the spatial distribution of dFC and tested the feasibility of this approach for the analysis of interictal epileptiforme discharges. 15 healthy controls (visual stimulation paradigm) and three patients with epilepsy (EEG-fMRI) were measured with EPI-fMRI. We calculated the functional connectivity degree (FCD) by determining the total number of connections of a given voxel above a predefined threshold based on Pearson correlation. FCD could capture hemodynamic changes relative to stimulus onset in controls. A significant effect of TR and window size was observed on FCD estimates. At a conventional TR of 2.6 s, FCD values were marginal compared to FCD values using sub-seconds TRs achievable with multiband (MB) fMRI. Concerning window sizes, a specific maximum of FCD values (inverted u-shape behavior) was found for each TR, indicating a limit to the possible gain in FCD for increasing window size. In patients, a dynamic FCD change was found relative to the onset of epileptiform EEG patterns, which was compatible with their clinical semiology. Our findings indicate that dynamic FCD transients are better detectable with sub-second TR than conventional TR. This approach was capable of capturing neuronal connectivity across various regions of the brain, indicating a potential to study the temporal characteristics of interictal epileptiform discharges and seizures in epilepsy patients or other brain diseases with brief events.
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Affiliation(s)
- Ashish Kaul Sahib
- Werner Reichardt Centre for Integrative Neuroscience, Tuebingen, Germany
- Department of Biomedical Magnetic Resonance, University Hospital Tuebingen, Tuebingen, Germany
- Department of Neurology/Epileptology, University Hospital Tuebingen and Hertie Institute of Clinical Brain Research, Tuebingen, Germany
- Graduate School of Neural and Behavioural Sciences/International Max Planck Research School, University of Tuebingen, Tuebingen, Germany
| | - Michael Erb
- Department of Biomedical Magnetic Resonance, University Hospital Tuebingen, Tuebingen, Germany
| | - Justus Marquetand
- Department of Neurology/Epileptology, University Hospital Tuebingen and Hertie Institute of Clinical Brain Research, Tuebingen, Germany
| | - Pascal Martin
- Department of Neurology/Epileptology, University Hospital Tuebingen and Hertie Institute of Clinical Brain Research, Tuebingen, Germany
| | - Adham Elshahabi
- Department of Neurology/Epileptology, University Hospital Tuebingen and Hertie Institute of Clinical Brain Research, Tuebingen, Germany
- MEG-Center, University of Tuebingen, Tuebingen, Germany
| | - Silke Klamer
- Department of Neurology/Epileptology, University Hospital Tuebingen and Hertie Institute of Clinical Brain Research, Tuebingen, Germany
| | - Serge Vulliemoz
- Department of Neurology, University Hospital of Geneva, Geneva, Switzerland
| | - Klaus Scheffler
- Department of Biomedical Magnetic Resonance, University Hospital Tuebingen, Tuebingen, Germany
- Max-Planck-Institute for Biological Cybernetics, Tuebingen, Germany
| | - Thomas Ethofer
- Werner Reichardt Centre for Integrative Neuroscience, Tuebingen, Germany
- Department of Biomedical Magnetic Resonance, University Hospital Tuebingen, Tuebingen, Germany
| | - Niels K. Focke
- Werner Reichardt Centre for Integrative Neuroscience, Tuebingen, Germany
- Department of Neurology/Epileptology, University Hospital Tuebingen and Hertie Institute of Clinical Brain Research, Tuebingen, Germany
- Clinical Neurophysiology, University Medicine, Goettingen, Germany
- * E-mail:
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