0332 Effect of Prior Sleep Duration on Distinct Measures of Daytime Cognitive Performance in Late Adolescence

Introduction

A recent longitudinal study of sleep need changes across adolescence reported how prior sleep duration affects daytime sleepiness and vigilant attention in children ages 10-16 years. In a follow-up study, we extend the age range in a new group of participants and add additional performance tests. Here we report year 1 data on the effect of systematically varied time in bed (TIB) on daytime vigilance, working memory, and decision making.

Methods

Data are for 52 participants aged 15.0-20.4 years (mean±SD: 17.7±1.8 years). Annually, participants keep each of three different TIB schedules: 7h, 8.5h or 10h TIB for 4 consecutive nights. The 4th night is followed by a laboratory day of performance testing. The day includes four 10-minute psychomotor vigilance tests (PVT); a serial position Sternberg working memory task; and an AX continuous performance test with switch (AX-CPTs) measuring cognitive flexibility in decision making.

Results

PVT performance evaluated by the log of the signal to noise ratio (LSNR) improved monotonically with increasing TIB (p<0.0001). TIB also affected serial position Sternberg task accuracy (p=0.008) but not the probe position effect (p=0.66), indicating that TIB did not affect working memory. TIB also affected AX-CPTs accuracy (p<0.0001), but TIB did not significantly affect decision making and cognitive flexibility measures extracted from this task (all p>0.09).

Conclusion

The initial data from this longitudinal study on older adolescents confirm what we observed for younger adolescents. Increasing TIB improves daytime vigilance but does not affect working memory. These initial results also do not indicate a TIB related improvement in decision making. Data from the entire three year longitudinal study will allow us to further investigate relations of performance to prior sleep duration and whether these relations change with age. Results from dose-response studies such as these can help guide sleep duration recommendations.

Support

PHS grant R01 HL116490 supported this work.

0324 Effect of Sleep Restriction on Sleep Electroencephalogram Waveforms in Adolescents

Introduction

Over the past 18 years, our laboratory has been carrying out longitudinal studies of sleep and sleep need across adolescence. Our current study uses a dose-response design to examine daytime performance and sleep EEG after varied sleep durations. Here we present results for 1-30 Hz EEG power in NREM and REM sleep.

Methods

Home EEG recording in children 10-16 years old (N=77, mean age = 13.2). Adhering to their habitual rise time participants kept an assigned TIB schedule of 7, 8.5, or 10 hours for four consecutive nights. Participants completed all three conditions each year of the 3 year study. EEG recordings from the fourth night of each condition were scored and analyzed with FFT.

Results

Reducing TIB from 10 to 7 hours effectively decreased total sleep time (TST) from an average of 531 min to an average of 407 min. Decreasing TIB (from 10 to 7 h) produced a small increase (4.6%, p=0.0004) in delta (1-4 Hz) power and a larger decrease (9.0%, p=0.0032) in alpha (8-11 Hz) power in the first 5 h of NREM sleep. In REM periods 2 and 3, the same TIB reduction also increased (12.1%, p<0.0001) delta power and decreased (14.2%, p<0.0001) alpha power. Decreasing TIB reduced (11%, p<0.0001) sigma (11-15 Hz) power in the first 5h of NREM sleep and reduced (28%, p<0.0001) all night NREM sigma energy.

Conclusion

Reducing TST changes EEG power in several frequency bands. The increase in NREM delta power, expected from homeostatic models, may be too small to be biologically significant. The larger loss of sigma power may be of greater consequence. Sigma frequency activity is an indicator of sleep spindles which have been affected in aging, learning, memory and psychopathology. The sigma response to sleep restriction could be used to study these relations.

Support

PHS grant R01 HL116490 supported this work.

0327 NREM Sleep EEG in Typically Developing and Drug-Naïve ADHD Adolescents: Data from a Longitudinal Study

Introduction

Structural MRI studies suggest delayed brain maturation in children with attention deficit hyperactivity disorder (ADHD). The steep adolescent decline in sleep slow wave EEG activity provides an opportunity to investigate brain electrophysiological evidence for this maturational delay. Most ADHD sleep EEG studies have been cross-sectional. Here we present data from an ongoing longitudinal study of the maturational trajectories of sleep EEG in drug-naïve ADHD and typically developing adolescents.

Methods

Nine children diagnosed with ADHD (combined subtype, DSM-V criteria, mean age 12.39±0.61 years), and nine typically developing controls (12.07±0.35 years) were recruited. Subjects underwent an adaptation night and all night polysomnography twice yearly at the Laboratory. Sleep EEG was analyzed using fast Fourier transform. NREM delta and theta EEG activity were compared across first two recordings.

Results

Group effects (ADHD vs. control) on all night delta and theta energy, and delta power were not significant (p>0.2 for all). All night theta power was lower (p=0.035) for the ADHD group, and all night NREM sleep duration trended (p=0.060) toward being lower for the ADHD group. Controlling for sleep duration differences by examining only the first 5 h of NREM sleep showed no group effect on delta power (p=0.77) and a trend toward lower theta power (p=0.057) for the ADHD group.

Conclusion

At age 12 to 13 years, NREM sleep delta EEG did not differ between ADHD and control subjects. Theta power, which declines at a younger age than delta, was lower in control subjects. The two recordings thus far differ only by 6 months. The entire study will provide 5 semiannual recordings and allow us to determine if the higher theta power in the ADHD group will hold and if delta power will be greater as well, and thus provide electrophysiological support for the delayed brain maturation suggested by MRI findings.

Support

Shota Rustaveli National Science Foundation Grant FR17_94; Subjects Recruitment Support - Mental Health Service in Tbilisi “Kamara”.

Abstract PD1-04: The contribution of rare variants, polygenic risk, and novel candidate genes to the hereditary risk of breast cancer in a large cohort of breast cancer families

Background: Identifying the missing hereditary factors underlying the familial risk of breast cancer could have a major and immediate impact on managing the breast cancer risk for these families.

Methods: We identified candidate breast cancer predisposition genes through whole exome sequencing of BRCAx families and subsequently sequenced up to 1325 genes, along with 76 common low penetrance variants associated with breast cancer, in index cases from 6,000 BRCAx families and 6,000 cancer free women (ethnically matched on principal component analysis).

Results: The role of recently described (PALB2) or suspected (MRE11A) moderately penetrant genes was confirmed. Conversely, the size of the cohort means that the absence of enrichment for loss of function (LoF mutations) provides strong evidence against other reported breast cancer genes (BRIP1, RINT1, RECQL). For further moderate risk variants (in CHEK2, ATM, BRCA2) we observed significant risk modification based on the polygenic risk score (PRS - calculated from the common variant data), with the risk restricted to the co-occurrence of the rare variant and high PRS. Novel candidate genes were identified based on LoF mutations, including NTHL1 (38 cases versus 15 controls, OR 2.5 p=0.002): a member of the base excision repair (BER) pathway. DNA sequencing of the breast carcinomas from 17 heterozygous NTHL1 mutation carriers revealed a strong bias towards a C:G>T:A (C>T) transitions, consistent with a BER defect, which confirmed the recent findings in colorectal carcinomas from bi-allelic NTHL1 mutation carriers. This data extends the cancer predisposition phenotype of NTHL1 to heterozygous carriers. In addition to NTHL1, there are a large number of candidate genes where the ratio of LoF mutations in cases versus controls indicates that they may convey an actionable level of risk; 46 genes (519 families) meet the basic criteria of multiple LoF variants and an OR >2 for cases versus controls – including previously proposed breast cancer genes MRE11A, BLM, MLH1, MYH, FANCD2 and functionally plausible candidates such as MLH3, PARP2 and ATR. Collectively the OR of breast cancer for LoF mutations in this group of genes is 3.3 (95% CI 2.7-3.9, P=3.5x10-41).

Conclusion: Our data shows that the effect of rare variation in established and novel breast cancer genes, along with consideration of the background polygenic risk, together explains a substantial component of the heritable risk of breast cancer in our cohort.

Citation Format: Campbell IG, Li N, Rowley S, Goode D, Devereux L, McInerny S, Grewal N, Lee A, Trainer A, Wong-Brown M, Scott R, Gorringe K, James P. The contribution of rare variants, polygenic risk, and novel candidate genes to the hereditary risk of breast cancer in a large cohort of breast cancer families [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr PD1-04.

Abstract P3-04-08: Genomic analysis of breast papillomas

Background: Papillomas are often found co-existing with breast carcinoma yet they are not considered to be a true precursor of the disease. Previous studies have shown that some cases may carry copy number alterations (CNA) or mutations in AKT1/PIK3CA (Troxell et al., 2010, Modern Pathology 23: 27-37) suggesting this lesion may have malignant potential. To date, a detailed study of both pure papillomas (not associated with cancer) and those seen in the same breast as a carcinoma has not been undertaken. Therefore, we set out to investigate the molecular changes associated with this lesion and whether papillomas can be clonally related to synchronous breast carcinoma.

Method: Papilloma cases were identified from a hospital database and independently reviewed by consultant pathologists followed by micro-dissection of formalin-fixed paraffin-embedded tumour tissue and DNA extraction. For CNA detection either Affymetrix Molecular inversion Probe (MIP) 330K arrays were used or low-coverage whole genome sequencing using 5-10 ng of DNA (Kader et al., 2016, Genome Medicine 8: 121) where there was insufficient DNA for MIP arrays. We applied either of these 2 methods to 24 cases of pure papilloma as well as 20 papilloma with synchronous ductal carcinoma in situ (DCIS) and/or invasive ductal carcinoma (IDC). Additionally, targeted exon sequencing of breast cancer driver genes was performed for a subset of cases.

Results: Among the pure papillomas 31% (5/16) showed CN change with, the most frequent change being 16q loss (2/16). Of the papillomas synchronous with DCIS/IDC analysed to date, 2/5 were shown to be clonal with the co-existing carcinoma. Final CNA analysis will be presented for 24 pure papilloma cases and 20 synchronous cases.

Targeted sequencing revealed that all for pure papillomas analysed to date harboured somatic mutations in PIK3CA (3/4 cases) and PIK3R1 (1/4,) suggesting that most papillomas are driven by alterations in the PI3-kinase/AKT pathway. The final sequencing data to be presented will include an additional 5 pure papillomas and 10 synchronous cases.

Conclusion: Our observation that 40% of papillomas are clonal to breast carcinoma suggests that DCIS or IDC can arise from a common ancestor as co-existing papillomas, however, most papillomas co-existing with carcinoma are likely to be independent in our cohort.

Citation Format: Elder KJ, Kader T, Hill P, Opeskin K, Goode DL, Pang J-M, Fox SB, Mann GB, Campbell IG, Gorringe KL. Genomic analysis of breast papillomas [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr P3-04-08.

Abstract PD1-07: Population genetic testing for breast cancer susceptibility

Background. Germline mutations in certain genes account for a large proportion of inherited risk for breast and ovarian cancer. The identification of asymptomatic mutation carriers could significantly reduce the incidence of these diseases as active risk management can dramatically reduce the risk of developing cancer.

In most countries, identifying high-risk individuals is based on their family history. In general, a family is first identified because one family member develops cancer and, because of high-risk indicators is referred to a familial cancer centre (FCC). However, current data suggests that many BRCA1 or BRCA2 mutation carriers do not have a remarkable history of cancer in a close relative. Population-based genetic testing would be a far more effective strategy for identification of at-risk individuals. To test the feasibility of such a strategy we are conducting a population genetic testing trial for actionable mutations in 11 breast/ovarian cancer predisposition genes (BRCA1, BRCA2, PALB2, ATM, CDH1, PTEN, STK11, TP53, BRIP1, RAD51C, RAD51D) among 15,000 healthy women from the Australian population.

Methods. All subjects are female participants in the LifePool cohort (www.lifepool.org) who had no personal history of breast or ovarian cancer at the time of DNA collection. Participants found to carry an actionable germline mutation were notified by letter with an invitation to contact the PeterMac telephone genetic counselling service for further information and/or also invited for counselling at an FCC. Only participants with an actionable mutation were notified of their genetic testing result.

Results. Of the 5,557 women tested to date, 40 (0.72%) were carriers of mutations that are currently actionable in the Australian context (BRCA1 n=7, BRCA2 n=15, PALB2 n=15, ATM n=3). All 40 women accepted the invitation to attend a familial cancer centre for formal predictive testing. Less than 20% of the women would have met the minimum threshold for clinical genetic testing under current guidelines. A further 16 participants (0.29%) carried mutations in BRIP1, RAD51C and RAD51D but were not notified of the result as these genes are not currently actionable in Australia. No mutations were identified in CDH1, PTEN, STK11 or TP53.

Conclusions. A relatively large proportion of cancer free-women from Australia carry high-risk mutations in BRCA genes and subsequent uptake of clinical genetic testing was very high. Population-based genetic testing is well accepted and can identify a much larger proportion of the at risk-population than contemporary family history based approaches.

Citation Format: Campbell IG, Rowley S, Devereux L, McInerny S, Grewal N, Young M-A, Lee A, Trainer A, James P. Population genetic testing for breast cancer susceptibility [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr PD1-07.

Abstract P2-02-01: Identifying the remaining causes of hereditary breast cancer

Identifying the missing hereditary factors of familial breast cancer could have a major and immediate impact on reducing breast cancer risk in these family members.

Up to 1,325 candidate breast cancer predisposition genes, identified through exome sequencing of BRCAx families, were sequenced in index cases of up to 4,000 BRCAx families and 4,000 cancer free women from the LifePool study in Australia.

Interrogation of the data to refine the highest priority candidates is ongoing, but it is noteworthy that known (PALB2) or suspected (MRE11A) moderately penetrant breast cancer genes showed enrichment of loss of function (LoF) mutations in this dataset. Conversely, some other recently proposed breast cancer genes (BRIP1 and RINT1) did not show a significantly higher LoF mutation frequency in the cases compared to controls. Based on the number of LoF mutations leading candidates include NTHL1 (12 cases versus 4 controls) and ALKBH1 (7 cases versus 2 controls) which are each important members of the base excision repair and direct nucleotide repair pathways. We examined other genes in the base excision and direct repair pathways that were on our sequencing capture design and observed a significant enrichment of potentially deleterious mutations in 12 genes (NTHL1, OGG1, APEX1, APEX2, NEIL1, NEIL2, NEIL3, MUTYH, MPG, ALKBH1, ALKBH2, ALKBH3): Among the 1,638 cases and 1,654 controls analysed to date, 76 LoF variants were detected in these genes among the cases versus 47 LoF variants among the controls (p=0.007). Based on the overall distribution of variants between cases and controls the probability of selecting 12 genes with such enrichment from the 1,325 genes screened was less than 1 in 200.

Our data implicates rare mutations in base excision and direct DNA repair pathways genes as moderate-penetrance breast cancer susceptibility alleles.

Citation Format: Campbell IG, Trainer AH, Devereux L, James PA, Rowley S, Li N. Identifying the remaining causes of hereditary breast cancer [abstract]. In: Proceedings of the 2016 San Antonio Breast Cancer Symposium; 2016 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2017;77(4 Suppl):Abstract nr P2-02-01.

Abstract P2-09-02: Panel testing for familial breast cancer: Tension at the boundary of research and clinical care

Gene panel sequencing is revolutionizing germline risk assessment for hereditary breast cancer. Despite scant evidence supporting the role of many of these genes in breast cancer predisposition, results are often reported to families as the definitive explanation for their family history. We assessed the frequency of mutations in 18 genes commonly included in hereditary breast cancer panels among 2,000 index cases from breast cancer families and 1,997 population controls. Cases were predominantly breast cancer-affected women referred to specialized familial cancer centers (BRCA1 and BRCA2 wild-type). Controls were cancer-free women from the LifePool study (www.lifepool.org). Sequencing data were filtered for known pathogenic or novel loss of function mutations.

The frequency of pathogenic mutations in BRCA1 and BRCA2 in the control group was 0.2% (4 mutations) and 0.4% (8 mutations), respectively, which is consistent with previous indirect estimates for Caucasian populations but to our knowledge this the largest direct assessment of their prevalence.

Excluding 18 mutations identified in BRCA1 and BRCA2 among the cases and controls, a total of 69 cases (3.5%) and 26 controls (1.3%) were found to carry an "actionable mutation". PALB2 was most frequently mutated (22 cases, 3 controls), while no mutations were identified in PTEN or STK11. Among the remaining genes, loss of function mutations were rare with similar frequency between cases and controls.

The frequency of mutations in most breast cancer panel genes among individuals selected for possible hereditary breast cancer is low and in many cases similar or even lower than that observed among cancer-free population controls. While multi-gene panels can significantly aid in cancer risk management, they equally have the potential to provide clinical misinformation and harm at the individual level if the data is not interpreted cautiously.

Citation Format: Campbell IG, Thompson ER, Rowely SM, Li N, McInerny S, Devereux L, Wong-Brown MW, Trainer AH, Mitchell G, Scott RJ, James PA. Panel testing for familial breast cancer: Tension at the boundary of research and clinical care. [abstract]. In: Proceedings of the Thirty-Eighth Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2015 Dec 8-12; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2016;76(4 Suppl):Abstract nr P2-09-02.

Predicting breast cancer risk in BRCA1 and BRCA2 carriers: Methylation studies using intraductal fluid

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Background: Genomic alterations are likely to precede the phenotypic changes of breast cancer (BC) and include hyper- methylation of tumour suppressor genes. An intraductal approach, such as ductal lavage (DL), is an attractive means of accessing ductal epithelial and other cells in a prospective fashion. Methods: Women with at least one breast unaffected by BC, with a germline BRCA1 or BRCA2 mutation, attended for 6-monthly DL collection for up to 3 years. Standard methods were used for DNA extraction and bisulfite conversion. Hyper-methylation of p16, RASSF1A, twist and RARβ genes was investigated using a qualitative, real-time, nested PCR assay. Associations between methylation status and categorical variables were tested using Fisher's exact test including cytological findings and BC incidence. Logistic regression was used to examine the relationship between methylation status and patient age, and to examine the effects of multiple variables. Analyses were performed at three levels; samples from a single breast over time and from a single duct over time and each sample in isolation. Results: A total of 173 DL samples from 98 ducts in 56 breasts were analysed in 34 women (16 BRCA1 and 18 BRCA2 mutation carriers) with a median age of 43 years (range 27- 60). DL fluid was collected from all women on at least one occasion (median 2.5 visits, range 1–5). Five women developed BC on study. Methylation of p16 was strongly associated with a known BRCA1 mutation (p=0.0003, p<0.0001 and p<0.0001 at the breast, duct and sample levels respectively) and was also more likely in women with a previous history of contralateral BC (p=0.0008 and p<0.0001 at the duct and sample level respectively). Independent associations were seen for women who developed BC on study and methylation of p16 and RASSF1A (p16: p=0.0023 at the sample level only) and (RASSF1A: p=0.0760, p=0.0178 and p<0.0001- at the breast, duct and sample level respectively). Conclusions: The methylation pattern in a panel of genes could be used as a biomarker for risk of future breast cancer. In addition p16 methylation may be a predictor of BRCA1 mutation status. Further research is required to corroborate these findings as the numbers recruited for this study are small with a short duration of clinical follow up.

No significant financial relationships to disclose.

ST7-mediated suppression of tumorigenicity of prostate cancer cells is characterized by remodeling of the extracellular matrix

Multiple lines of evidence have provided compelling evidence for the existence of a tumor suppressor gene (TSG) on chromosome 7q31.1. ST7 may be the target of this genetic instability but its designation as a TSG is controversial. In this study, we show that, functionally, ST7 behaves as a tumor suppressor in human cancer. ST7 suppressed growth of PC-3 prostate cancer cells inoculated subcutaneously into severe combined immunodeficient mice, and increased the latency of tumor detection from 13 days in control tumors to 23 days. Re-expression of ST7 was also associated with suppression of colony formation under anchorage-independent conditions in MDA-MB-231 breast cancer cells and ST7 mRNA expression was downregulated in 44% of primary breast cancers. Expression profiling of PC-3 cells revealed that ST7 predominantly induces changes in genes involved in re-modeling the extracellular matrix such as SPARC, IGFBP5 and several matrix metalloproteinases. These data indicate that ST7 may mediate tumor suppression through modification of the tumor microenvironment.

Homeostatic behavior of fast fourier transform power in very low frequency non-rapid eye movement human electroencephalogram

Basic research shows that the physiological and molecular mechanisms of very low frequency (<1 Hz) electroencephalogram (EEG) waves of non-rapid eye movement (NREM) sleep differ from those of the higher (1-4 Hz) delta frequencies. Human studies show that the across-NREM period dynamics of very low frequency and 1-4 Hz EEG also differ. These differences and the reported failure of very low frequency EEG power to increase after a night of total sleep deprivation raise the question of whether very low frequency EEG shows the other homeostatic properties established for higher delta frequencies. Here we tested the relation of very low frequency EEG power density to prior waking duration across a normal day and whether these low frequencies meet another criterion for homeostatic sleep EEG: conservation of power across a late nap and post-nap sleep. Data from 19 young adults recorded in four separate sessions of baseline, daytime nap and post-nap sleep were analyzed. Power density in very low frequency NREM EEG increased linearly when naps were taken later in the day (i.e. were preceded by longer waking durations). In the night following an 18:00 h nap, very low frequency power was reduced by roughly the amount of power in the nap. Thus, very low frequency EEG meets two major homeostatic criteria. We hypothesize that these low frequencies reflect the executive rather than the functional processes by which NREM sleep reverses the effects of waking brain activity.

Changes in gene expressions elicited by physiological concentrations of genistein on human endometrial cancer cells

The incidence of hormone-related diseases such as prostatic, breast, ovarian, and endometrial cancer is lower in Asian populations compared to Western countries. High consumption of soybean products that are rich in phytoestrogens, predominantly genistein, is postulated to be responsible for the lower incidence of hormone-related disease, although the mechanism through which this effect might be mediated is unclear. In this study, microarray analysis was used to identify the changes in gene expression elicited by treatment of the human endometrial cancer cell line, Ishikawa, with genistein at both physiologically achievable and supraphysiological concentrations. Genistein treatment at 5 microM concentration induced multiple changes in gene expression including some implicated in oncogenesis. In contrast, treatment with a supraphysiological concentration of genistein predominantly activated stress response genes and showed very limited overlap with the genes regulated at lower concentrations. Of the genes regulated by genistein, 9.3% were also regulated by 17beta-estradiol suggesting that genistein exerts its response via the estrogen pathway. These results indicate that at physiological concentrations, genistein is able to elicit pleiotropic effects on a variety of pathways believed to be involved in tumorigenesis. Supraphysiological concentrations of genistein, such as those used in many previous studies, elicit changes in gene expression that are unlikely to occur in vivo.

The metabotropic glutamate (mGLU)2/3 receptor antagonist LY341495 [2S-2-amino-2-(1S,2S-2-carboxycyclopropyl-1-yl)-3-(xanth-9-yl)propanoic acid] stimulates waking and fast electroencephalogram power and blocks the effects of the mGLU2/3 receptor agonist ly379268 [(-)-2-oxa-4-aminobicyclo[3.1.0]hexane-4,6-dicarboxylate] in rats

The highly selective metabotropic glutamate (mGlu)2/3 receptor agonist LY379268 [(-)-2-oxa-4-aminobicyclo[3.1.0]hexane-4,6-dicarboxylate] completely suppresses rapid eye movement (REM) sleep and strongly depresses theta (6-10 Hz) and high-frequency (10-60 Hz) power in the waking and nonrapid eye movement (NREM) EEG, effects consistent with depressed brain excitation (arousal). We hypothesized the selective mGlu2/3 receptor antagonist LY341495 [2S-2-amino-2-(1S,2S-2-carboxycyclopropyl-1-yl)-3-(xanth-9-yl)propanoic acid] given alone would 1) increase arousal, producing sleep-wake EEG effects opposite those of LY379268, and 2) block/reverse the effects of LY379268 when the drugs are coadministered. Rats with implanted electrodes were injected with 1, 5, or 10 mg/kg LY341495 at hour 5.5 of the dark period. In the coadministration study the rats received the same dose of LY341495 followed 30 min later by 1 mg/kg LY379268. LY341495 alone increased waking by reducing NREM and REM sleep. LY341495 also depressed low-frequency and stimulated high-frequency EEG power. It produced a sharp spike in theta power in waking but not NREM sleep, a striking state-dependent difference in pharmacological response. These changes indicate that blocking mGlu2/3 receptors increases brain arousal. Moreover, they show that mGlu2/3 receptors actively support arousal even in the absence of heightened glutamate excitation. The coadministration experiment demonstrates that LY341495 is selective in vivo since it dose-dependently attenuates or reverses the sleep-wake EEG effects of the highly selective mGlu2/3 receptor agonist LY379268. The capacity of mGlu2/3 receptor agonists and antagonists to alter the sleep wake balance suggests they could be developed to enhance sleep or sustain arousal. Their opposing actions on theta EEG could test the putative role of these oscillations in memory consolidation.

The selective group mGlu2/3 receptor agonist LY379268 suppresses REM sleep and fast EEG in the rat

Studies of ionotropic receptors indicate that glutamate (Glu) neurotransmission plays a role in sleep. Here, we show for the first time that metabotropic 2/3 Glu (mGlu2/3) receptors play an active or permissive role in the control of REM sleep. The potent, selective, and systemically active mGlu2/3 receptor agonist LY379268 was administered systemically in doses of 1.0 and 0.25 mg/kg sc. The drug produced a dose-dependent suppression of rapid eye movement (REM) sleep and fast (10-50 Hz) EEG in non-rapid eye movement (NREM) sleep. The 1.0-mg/kg effect on REM sleep was remarkably powerful: REM sleep was totally suppressed in the 6-h postinjection and reduced by 80% in the next 6 h. NREM duration was unchanged during the REM suppression in spite of the strong and unusual depression of EEG power in fast NREM frequencies. These sleep and EEG effects were unaccompanied by motor or behavioral abnormalities. We hypothesize that the REM and the fast EEG suppression were both caused by a depression of brain arousal levels by LY379268. If correct, depressing arousal by reducing excitatory neurotransmission with an mGlu2/3 receptor agonist produces electrophysiological effects that differ drastically from those produced by depressing arousal by enhancing neural inhibition with GABAergic drugs. This different approach to modifying the excitation/inhibition balance in the brain might yield novel therapeutic actions.

Sleep deprivation impairs long-term potentiation in rat hippocampal slices

To determine if 12-h sleep deprivation disrupts neural plasticity, we compared long-term potentiation (LTP) in five sleep-deprived and five control rats. Thirty minutes after tetanus population spike amplitude increased 101 +/- 15% in 16 slices from sleep deprived rats and 139 +/- 14% in 14 slices from control rats. This significant (P < 0.05) reduction of LTP, the first demonstration that the sleep deprivation protocol impairs plasticity in adult rats, may be due to several factors. Reduced LTP may indicate that sleep provides a period of recuperation for cellular processes underlying neural plasticity. Alternatively, the stress of sleep deprivation, as indicated by elevated blood corticosterone levels, or other non-sleep-specific factors of deprivation may contribute to the LTP reduction.

Thermoregulatory responses during prolonged upper-body exercise in cool and warm conditions

The thermoregulatory responses of upper-body trained athletes were examined at rest, during prolonged arm crank exercise and recovery in cool (21.5 +/- 0.9 degrees C, 43.9 +/- 10.1% relative humidity; mean +/- s) and warm (31.5 +/- 0.6 degrees C, 48.9 +/- 8.4% relative humidity) conditions. Aural temperature increased from rest by 0.7 +/- 0.7 degrees C (P< 0.05) during exercise in cool conditions and by 1.6 +/- 0.7 degrees C during exercise in warm conditions (P< 0.05). During exercise in cool conditions, calf skin temperature decreased (1.5 +/- 1.3 degrees C), whereas an increase was observed during exercise in warm conditions (3.0 +/- 1.7 degrees C). Lower-body skin temperatures tended to increase by greater amounts than upper-body skin temperatures during exercise in warm conditions. No differences were observed in blood lactate, heart rate or respiratory exchange ratio responses between conditions. Perceived exertion at 45 min of exercise was greater than that reported at 5 min of exercise during the cool trial (P< 0.05), whereas during exercise in the warm trial the rating of perceived exertion increased from initial values by 30 min (P < 0.05). Heat storage, body mass losses and fluid consumption were greater during exercise in warm conditions (7.06 +/- 2.25 J x g(-1) x degrees C(-1), 1.3 +/- 0.5 kg and 1,038 +/- 356 ml, respectively) than in cool conditions (1.35 +/- 0.23 J x g(-1) x degrees C(-1), 0.8 +/- 0.2 kg and 530 +/- 284 ml, respectively; P < 0.05). The results of this study indicate that the increasing thermal strain with constant thermal stress in warm conditions is due to heat storage within the lower body. These results may aid in understanding thermoregulatory control mechanisms of populations with a thermoregulatory dysfunction, such as those with spinal cord injuries.

Microsomal epoxide hydrolase polymorphism and susceptibility to ovarian cancer

Polymorphic variants of microsomal epoxide hydrolase (mEPHX) with altered enzyme activity have been associated with an increased risk for ovarian cancer. We assessed the frequency of exon 3 and exon 4 variants of mEPHX among 291 ovarian cancers and 257 controls from a UK-based population. The distribution of the exon 3 alleles among both the cancer and control groups was significantly different from that expected under Hardy-Weinberg equilibrium suggesting that the PCR restriction fragment length polymorphism (PCR-RFLP) genotyping assay might be flawed. The codon 113 polymorphism was reassessed using a two-color allele-specific PCR-based assay. We found that a codon 119 G>A polymorphism, present in 20% of the British population and linked to the wild-type exon 3 allele, resulted in some Tyr113/His113 heterozygotes being falsely classified as His113/His113 homozygotes when using the PCR-RFLP assay. Consequently, we reassessed all our codon 113 data using the new allele-specific assay. We found no evidence of an association of ovarian cancer risk with the exon 3 Tyr113>His113 variant. Similarly the frequencies of the exon 4 His139>Arg139 genotypes were not significantly different between cases and controls. Stratifying the genotyping data according to the predicted mEPHX activity revealed a highly significant decrease in high mEPHX activity among the serous ovarian cancers (P=0.01) suggesting that high mEPHX activity may be protective for this histological sub-type. Furthermore previous disease association studies of exon 3 alleles which utilized the PCR-RFLP assay may be compromised by the existence of a codon 119 G>A polymorphism which may be common in Caucasian populations.

The effect of glucose ingestion on endurance upper-body exercise and performance

The physiological responses to glucose supplementation during arm crank exercise were investigated. Ten subjects of mean age 28 +/- 8 years; stature 180.8 +/- 6.5 cm; mass 82.7 +/- 11.5 kg, .VO(2) peak 3.10 +/- 0.50 l x min(-1) were tested on two occasions separated by a week. A 7.6% glucose drink or placebo was administered in a blind crossover design 20 min prior to exercise. Subject's arm cranked for 60 min at an exercise intensity of 65% .VO(2)peak followed by a 20 min performance test. Rate of ventilation, oxygen uptake, RER, heart rate and blood lactate demonstrated similar responses between trials throughout the course of the hour. The blood glucose concentrations at rest were similar between trials increasing after glucose ingestion to show a significant difference (p < 0.05) to the placebo trial at the onset of exercise, then returning to resting values after 20 min. The 20 min performance tests revealed that after glucose ingestion athletes achieved a greater mean distance of 12.55 +/- 1.29 km than in the placebo trial of 11.50 +/- 1.68 km (p < 0.05). In conclusion, the results showed that after one-hour of arm crank exercise, performance over a further twenty minutes was improved when glucose was ingested twenty minutes prior to exercise.

Oxygen uptake-heart rate relationship in élite wheelchair racers

The American College of Sports Medicine (ACSM) recommends that, as a general rule for health purposes, individuals should exercise at 40%-85% of their maximal oxygen uptakes. Moreover, it has been suggested that 55%-90% of the maximal heart rate may be used as an alternative estimate of these percentage maximal oxygen uptake values. The present study examined the relationship between percentage peak heart rate (% HRpeak) and percentage peak oxygen uptake (% VO2peak) during steady-state incremental intensity wheelchair propulsion of 16 élite, male wheelchair racers (WR). Oxygen uptake was determined during each submaximal exercise stage and heart rate (HR) was continuously monitored. The VO2peak was subsequently determined using a separate protocol. Linear regression equations of % HRpeak versus % VO2peak for each participant included % HRpeak values corresponding to 40%, 60%, 80% and 85% VO2peak. The linear regression equation, derived as the group mean of the slope and intercept terms determined for each individual, was: % peak HR = 0.681 x % peak VO2 + 33.2. The group mean of the individual correlation coefficients for the VO2-HR relationship was 0.99. The values of % HRpeak for each of the % VO2peak values below 85% were significantly greater (P<0.01) than those suggested by the ACSM. This suggests that the ACSM guidelines below 85% VO2peak, based on % HRpeak, may underestimate the relative exercise intensity (i.e. % VO2peak) in the WR population. However, in élite level WR, % HRpeak can be recommended as an alternative estimate of % VO2peak at wheelchair propulsion intensities of 85% VO2peak or more.

Mutation of the ST7 tumor suppressor gene on 7q31.1 is rare in breast, ovarian and colorectal cancers

The gene ST7 has recently been implicated as the broad-range tumor suppressor on human chromosome 7q31.1. We did not detect somatic mutations in ST7 in any of 149 primary ovarian, breast or colon carcinomas. These data suggest that epigenetic downregulation or haploinsufficiency, rather than somatic genetic alterations, may be the primary mechanism of abrogation of ST7 function in these tumor types.

The phosphatidylinositol 3'-kinase p85alpha gene is an oncogene in human ovarian and colon tumors

Phosphatidylinositol 3'-kinases (PI3ks) are a family of lipid kinases that play a crucial role in a wide range of important cellular processes associated with malignant behavior including cell growth, migration, and survival. We have used single-strand conformational polymorphism/heteroduplex analysis to demonstrate the presence of somatic mutations in the gene for the p85alpha regulatory subunit of PI3k (PIK3R1) in primary human colon and ovarian tumors and cancer cell lines. All of the mutations lead to deletions in the inter-SH2 region of the molecule proximal to the serine608 autoregulatory site. Expression of a mutant protein with a 23 amino acid deletion leads to constitutive activation of PI3k providing the first direct evidence that p85alpha is a new oncogene involved in human tumorigenesis.

Internight reliability and benchmark values for computer analyses of non-rapid eye movement (NREM) and REM EEG in normal young adult and elderly subjects

OBJECTIVE

To determine the reliability of computer measured non-rapid eye movement (NREM) and REM frequency bands in the 0.3-45 Hz range and to provide benchmark data for these measures in young normal (YN) and elderly normal (EN) subjects (Ss).

METHODS

Sleep EEG was recorded in 19 YN and 19 EN Ss on 4 non-consecutive baseline nights and simultaneously quantified as fast Fourier transform (FFT) power and 3 zero-cross period-amplitude (PA) measures: integrated amplitude, time in band and average wave amplitude.

RESULTS

The shapes of both the FFT and PA spectra differed among Ss but were highly consistent within individuals. Inter-night reliability of the separate frequency bands was correspondingly high. Despite substantial age effects, the reliability of computer-measured sleep EEG in the elderly equaled that of the YN Ss. Within both the YN and EN groups, the shapes of the NREM and REM spectral curves differed significantly. The NREM and REM also differed significantly in the two age groups.

CONCLUSIONS

Computer-measured sleep EEG is highly reliable across non-consecutive nights in both young and elderly normal Ss. The trait-like stability of these measures suggests they are genetically determined. This possibility is supported by twin study data that show strong heritability for FFT-measured waking EEG. The different shapes of NREM and REM spectra add further evidence that these are fundamentally different states of brain organization. The age differences in spectral shape, along with PA data for wave incidence, demonstrate that age effects on sleep EEG are not caused by changes in skull impedance or other non-cerebral factors.

A kinetic analysis of trained wheelchair racers during two speeds of propulsion

The purpose of the study was to investigate the propulsion kinetics of wheelchair racers at racing speeds and to assess how these change with an increase in speed. It was hypothesised that propulsive force would increase in proportion to speed, to accommodate the additional work required. Six wheelchair racers volunteered to participate in this study which required each athlete to push a racing wheelchair at 4.70 and 5.64 m s(-1) on a wheelchair ergometer (WERG). Eight pairs (16 in total) of strain gauges, mounted on four bars attached to the hand-rim of a racing wheelchair wheel, measured the medio-lateral and tangential forces applied to the hand-rim. Kinetic data were sampled at 200 Hz while a single on-line (ELITE) infrared camera operating at 100 Hz was positioned perpendicular to the WERG to record the location of the hand with respect to the hand-rim. In general, peak tangential force occurred when the hand was positioned on the hand-rim between 140 and 180 degrees. With the increase in speed, the peak hand-rim forces applied tangentially increased from 132 to 158 N and those applied medio-laterally increased from 90 to 104 N. The ratio of tangential to total measured force was similar at both speeds (80 and 82%, respectively). In conclusion, these data indicate that wheelchair racers adopt a different propulsion strategy than that employed in everyday chairs and that the forces increase in proportion to propulsion speed.

A simple method for computer quantification of stage REM eye movement potentials

We describe a simple method for computer quantification of eye movement (EM) potentials during REM sleep. This method can be applied by investigators using either period-amplitude (PA) or Fast Fourier Transform (FFT) spectral EEG analysis without special hardware or computer programming. It provides good correlations with visual ratings of EM in baseline sleep and after administration of GABAergic hypnotics. We present baseline data for both PA and FFT measures for 16 normal subjects, studied for 5 consecutive nights. Both visually rated and computer-measured EM density (EMD) showed high night-to-night correlations across baseline and drug nights and the computer measures detected the EMD suppression that is produced by GABAergic drugs. Measurement of EM in addition to stage REM provides biologically significant information and application of this simple computer method, which does not require pattern recognition algorithms or special hardware, could provide reliable data that can be compared across laboratories.

The influence of recovery posture on post-exercise hypotension in normotensive men

PURPOSE

Postexercise hypotension may be the result of an impaired vasoconstrictor response. This hypothesis was investigated by examining the central and peripheral hemodynamic responses during supine and seated recovery after maximal upright exercise.

METHODS

After supine or seated baseline measurements, seven normotensive male volunteers completed a graded upright cycling protocol to volitional exhaustion. This was immediately followed by either supine or seated recovery. Measurements of pulsatile arterial blood pressure and central and peripheral hemodynamic variables recorded 30 min before exercise were compared with those taken throughout 60 min of recovery.

RESULTS

Compared with baseline, mean arterial pressure (MAP) was reduced after exercise (P < 0.05) although the degree of change was not different between the supine (-9 +/- 4 mm Hg) and seated positions (-6 +/- 2 mm Hg). This change in MAP was associated with a reduction in diastolic blood pressure (DBP) (P < 0.05) and arterial pulse pressure (APP) (P < 0.01) for the supine and seated positions, respectively. The reduction in APP during seated recovery was accompanied by a decline in stroke volume (SV) (P < 0.05), not seen in the supine position, that limited the contribution of cardiac output (CO) to the maintenance of MAP. This effect of seated recovery was compensated by greater systemic (SVR) and regional vascular resistances in the forearm (FVR) and the forearm skin (SkVRA). There was also evidence of an augmented return of FVR and SkVRA to resting levels in the seated position after exercise.

CONCLUSION

The lower peripheral resistance in the supine compared with seated recovery position suggests there is potential for greater vasoconstriction, although this is not evoked to increase blood pressure. This further suggests that the arterial baroreceptor reflex is reset to a lower operating pressure after exercise.

Evidence that endometriosis behaves in a malignant manner

It is well known that certain aspects of endometriosis are similar to those of malignant disease. For example, like cancer, endometriosis can be both locally and distantly metastatic; it attaches to other tissues, invades, and damages them. Endometriosis is a common disease that does not create a cachectic or catabolic state, and is rarely fatal. There are, however, numerous reported cases of malignancy arising from endometriotic deposits and substantial histologic evidence that endometriosis is associated with endometrioid carcinoma and clear cell carcinoma of the ovary. A large review article by Mostoufizadeh and Scully investigated the association between endometriosis and endometrioid carcinoma, noting that women who had both diseases tended to be younger [1]. They found no association between endometriosis and serous or mucinous carcinoma of the ovary, and reported that malignant transformation of endometriosis was rare and associated with the use of exogenous estrogens. An epidemiological study of Swedish women reported a higher incidence of breast and ovarian cancer and non-Hodgkin's lymphoma in women with endometriosis compared with controls [2]. Vercellini and colleagues also reported a higher incidence of endometrioid and clear cell carcinoma in women with endometriosis compared with controls [3]. Mutations in genes associated with galactose metabolism have been identified as one possible mechanism for this association. These mutations are more common in ovarian cancer and have been reported to be more common in women with endometriosis. We compared 78 women with endometriosis with 248 controls and were unable to demonstrate an increased frequency of these mutations in any of these groups.

Molecular genetic defects in endometriosis

In a series of studies, we have hypothesised that endometriotic proliferation is, in part, precipitated by mutations in oncogenes or deletions in tumor suppressor genes that have been shown to be important steps in the transformation from a benign to a malignant epithelium. We reported previously that we could find no mutations in the TP53 and RASK genes in cases of endometriosis. However, having shown that endometriotic deposits were monoclonal, we showed loss of heterozygosity on chromosomes 9p (18%), 11q (18%), and 22q (15%) - in total 28% of endometriotic lesions showed loss of heterozygosity at one or more sites [1]. We could not demonstrate any loss of heterozygosity in normal endometrium. We examined adjacent endometriosis, atypical endometriosis, and endometrioid carcinoma of the ovary and showed common genetic alterations that are consistent with a common lineage. These common alterations were not seen in lesions that were distant from each other [2]. In endometrioid tumors, we reported an increased frequency of mutations in the PTEN/MMAC tumor suppressor genes that was not seen in clear cell or serous carcinoma, suggesting distinct developmental pathways for these tumors [3].

Loss of heterozygosity at 7q22 and mutation analysis of the CDP gene in human epithelial ovarian tumors

Many tumor types including that of the ovary show loss of heterozygosity (LOH) on chromosome arm 7q, which suggests the existence of at least one tumor suppressor gene (TSG) on this chromosome arm. We have studied the region surrounding the putative tumor suppressor gene CUTL1 at 7q22 in 127 epithelial ovarian tumors. LOH was found across 7q22 in 31% of malignant and 14% of benign ovarian tumors. In 16% of the tumors the LOH appeared to be centered on the CUTL1 gene. This gene has been implicated previously as a TSG in both uterine leiomyomas and breast carcinoma. However, mutation analysis of the CUTL1 gene in 47 tumors with 7q22 LOH failed to identify any somatic alterations in the coding regions. This finding suggests that CUTL1 may not be the target of the 7q22 LOH in ovarian cancers.

Polymorphic variation in CYP19 and the risk of breast cancer

The production of estrogen from androgen via the estrogen biosynthesis pathway is catalyzed by aromatase P450 (cyp19). We have assessed the frequency of allelic variants of the CYP19 intron 4 [TTTA]n repeat in 327 breast cancer cases and 253 controls from southern England. Previous studies have suggested that the [TTTA](10) repeat and [TTTA](12) repeat variants represent low penetrance breast cancer susceptibility alleles. Compared with controls our breast cancer cases had a statistically significant positive association with the [TTTA](10) allele (1.5 versus 0.2%, P = 0.028) and the [TTTA](8) allele (13.5 versus 8.7%, P = 0.012). The frequency of the [TTTA](12) allele was not significantly elevated in our study group compared with controls (2.3 versus 2.2%, P = 1.00). The CYP19 intron 4 [TTTA]n repeat is unlikely to have a functional effect on aromatase activity and it is more likely that the [TTTA](8) and [TTTA](10) variants are in linkage disequilibrium with other functional CYP19 variants.

Endometriosis: candidate genes

Endometriosis is generally regarded as a benign disease but it does exhibit some characteristics reminiscent of malignancy. This raises the possibility that, like malignant diseases, the development of endometriosis may involve the acquisition of somatic genetic alterations in genes that regulate cell growth and differentiation. Studies over the past few years have substantiated this view with the identification of a variety of genetic abnormalities usually only associated with malignancies. Our own studies have shown that genetic alterations, as shown by loss of heterozygosity, are relatively common in endometriosis implying that tumour suppressor gene inactivation is likely to be involved in the proliferation and maintenance of all endometriotic implants. We have also shown by DNA fingerprinting that endometriotic lesions found adjacent to ovarian cancers have a common lineage, reinforcing the compelling histological and epidemiological data that endometriosis is a precursor of endometrioid and clear cell ovarian cancers. It is now well accepted that susceptibility to endometriosis may also involve an inherited genetic component. Studies aimed at identifying the predisposing genes are still in their infancy but should eventually provide invaluable insights into the pathology and aetiology of endometriosis.

GSTM1 null polymorphism and susceptibility to endometriosis and ovarian cancer

It is likely that heritable genetic factors contribute to the development of endometriosis, which is a putative precursor of the endometrioid and clear cell histological subtypes of ovarian cancer. The phase II glutathione S-transferases (GSTs) are a family of enzymes responsible for metabolism of a broad range of xenobiotics and carcinogens. Allelic variants of GSTs that have impaired detoxification function may increase the rate of genetic damage and thereby increase the susceptibility to cancer. The null genetic polymorphism in the gene encoding the GST class mu (GSTM1) enzyme has been reported to be significantly elevated in endometriosis patients and may represent an endometriosis susceptibility allele. In this study the frequency of the GSTM1 null genotype was investigated in 84 cases of endometriosis, 293 cases of ovarian cancer and 219 controls. All cases and controls were derived from women resident in the south east of England. The frequency of the GSTM1 null allele was not over-represented in the endometriosis patients (47.6%) compared with the controls (48.9%) (P = 0.898). In the ovarian cancer group the GSTM1 null genotype was significantly elevated compared with controls (59.0 versus 48.9%, P = 0.025). When stratified according to histological subtype a significantly increased GSTM1 null genotype was only observed for the endometrioid (65.4%, P = 0.013) and the combined endometrioid/clear cell ovarian cancers (67.0%, P = 0.004). We conclude that the GSTM1 null allele is not an endometriosis susceptibility allele, however, it may predispose endometriotic lesions to malignant transformation to endometrioid and clear cell ovarian cancer.

Mapping of tumor suppressor genes in ovarian cancers

Although cancer is fundamentally a genetic disease, in the majority of cancers the mutations occur somatically (i.e., only in the tissue from which the cancer is derived). However, for many types of cancer, for example, breast, ovarian, and colorectal cancer there are a small number of cases that arise because of an inherited germline mutation. Genetic linkage analysis of such families enables the likely location of the TSG to be determined and has proven very successful in cloning some important TSGs. However, the genes responsible for inherited predisposition to cancer represent only a fraction of the total number of genetic defects that underlie the disease process.

High internight reliability of computer-measured NREM delta, sigma, and beta: biological implications

BACKGROUND

Computer analysis of the sleep electroencephalogram (EEG) waveforms is widely employed, but there have been no systematic studies of its reliability.

METHODS

The most commonly used computer methods are power spectral analysis with the fast-Fourier transform (FFT) and period amplitude analysis (PAA) with zero cross or zero first derivative half-wave measurement. We applied all three computer methods to the digitized EEG of 16 normal subjects who underwent 5 consecutive nights of baseline (placebo) recording. We evaluated the internight reliability of three non-rapid eye movement (NREM) frequency bands of special importance to sleep research: delta (0.3-3 Hz), sigma (12-15 Hz), and beta (15-23 Hz).

RESULTS

Both FFT and the two methods of PAA gave excellent internight reliability for delta and sigma. Even a single night of recording correlated highly (r >.9) with the 5-night mean. Beta reliability was lower but still highly significant for both the PAA and the FFT measures.

CONCLUSIONS

Computer-analyzed sleep EEG data are highly reliable. Period amplitude methods demonstrate that wave incidence and period as well as amplitude are reliable, indicating that the reliability of composite measures (FFT power, PAA integrated amplitude) is not solely based on individual differences in EEG amplitude. The high internight stability of NREM delta indicates that it possesses traitlike characteristics and is relatively independent of day-to-day variations in state.

Effects of hypnotics on the sleep EEG of healthy young adults: new data and psychopharmacologic implications

Benzodiazepine hypnotics increase NREM sleep and alter its EEG by reducing delta (0.3-3 Hz) and increasing sigma (12-15 Hz) and beta (15-23 Hz) activity. We tested whether the nonbenzodiazepine hypnotic, zolpidem (10 mg), produced the same pattern of sleep and EEG changes as two "classical" benzodiazepines, triazolam (0.25 mg) and temazepam (30 mg). Sleep EEG of 16 subjects was analyzed with period amplitude analysis for 3 nights during drug administration or placebo. The effects of zolpidem were in the same direction but generally of smaller magnitude than those of the classical benzodiazepines. These differences are more likely the result of non-equivalent dosages than different pharmacologic actions. Period amplitude analysis showed that the decreased delta activity resulted mainly from a decrease in wave amplitude. In contrast, the increased sigma and beta activity were produced by increased wave incidence. Delta suppression increased with repeated drug administration but sigma and beta stimulation did not. While these findings have little relevance for the clinical choice of hypnotics they may hold important implications for the brain mechanisms involved in hypnotic tolerance and withdrawal delirium.

Refinement of an ovarian cancer tumour suppressor gene locus on chromosome arm 22q and mutation analysis of CYP2D6, SREBP2 and NAGA

Loss of heterozygosity on chromosome 22q was detected in 53% of 123 ovarian carcinomas, suggesting the presence of at least one tumour suppressor gene. We have refined the location of one possible tumour suppressor gene to the region between the microsatellite markers D22S299 and CYP2D. Located within this region are the genes SREBP2 (sterol regulatory element binding protein 2) and NAGA (N-acetyl-alpha-D-galactosaminidase). Investigation of the coding exons of these genes by single stranded conformational polymorphism/heteroduplex analysis failed to identify any somatic genetic alterations in 57 ovarian tumours which exhibited LOH on 22q13. The CYP2D gene locus straddles the distal boundary of the candidate region. Germline variants of the active CYP2D6 gene with differing abilities to metabolise specific substrates have been implicated in the development of various cancers. Comparison of the frequency of the two common germline mutations among 258 ovarian tumours and 231 non-cancer controls did not reveal any significant differences between the two groups. This suggests that the known polymorphic variants of CYP2D6 are not involved in ovarian cancer predisposition. We also conclude that neither NAGA nor SREBP2 are likely to be mutated in ovarian carcinomas.

Refinement of an ovarian cancer tumour suppressor gene locus on chromosome arm 22q and mutation analysis of CYP2D6, SREBP2 and NAGA

Loss of heterozygosity on chromosome 22q was detected in 53% of 123 ovarian carcinomas, suggesting the presence of at least one tumour suppressor gene. We have refined the location of one possible tumour suppressor gene to the region between the microsatellite markers D22S299 and CYP2D. Located within this region are the genes SREBP2 (sterol regulatory element binding protein 2) and NAGA (N-acetyl-alpha-D-galactosaminidase). Investigation of the coding exons of these genes by single stranded conformational polymorphism/heteroduplex analysis failed to identify any somatic genetic alterations in 57 ovarian tumours which exhibited LOH on 22q13. The CYP2D gene locus straddles the distal boundary of the candidate region. Germline variants of the active CYP2D6 gene with differing abilities to metabolise specific substrates have been implicated in the development of various cancers. Comparison of the frequency of the two common germline mutations among 258 ovarian tumours and 231 non-cancer controls did not reveal any significant differences between the two groups. This suggests that the known polymorphic variants of CYP2D6 are not involved in ovarian cancer predisposition. We also conclude that neither NAGA nor SREBP2 are likely to be mutated in ovarian carcinomas.

Independence of sleep EEG responses to GABAergic hypnotics: biological implications

GABAergic hypnotics are known to depress non-rapid eye movement delta and rapid eye movements and to stimulate non-rapid eye movement sigma (spindles) and beta EEG. This study addressed the question of whether the magnitudes of these effects are significantly correlated. Data were from a study in 16 normal subjects whose sleep was recorded for five nights under placebo and for three nights each under zolpidem (10 mg), triazolam (0.25 mg) and temazepam (30 mg). EEG was analyzed with both period-amplitude and power spectral (FFT) analysis. The magnitudes of the EEG and eye movement density responses were not significantly correlated for any of the three drugs. It is therefore unlikely that sleep responses to GABAergic drugs can be explained by the common cellular action (increased chloride conductance) of these drugs. We suggest that the sleep EEG responses are manifestations of complex (but consistent) interactions of excitation and inhibition in large brain systems although certain aspects of these responses (e.g. the different time courses of delta vs sigma and eye movement responses) may reflect molecular adaptations. A separate observation in this study was the strong traitlike characteristics of the sleep variables studied. These variables were highly correlated across nights of baseline sleep; in addition, individual differences in baseline sleep were significantly retained on the third night of temazepam administration.

The effect of aerobic exercise training on the lipid-lipoprotein profile of children and adolescents

Longitudinal paediatric population studies have provided evidence that the risk factor theory may be extended to children and adolescents. These studies could assist in identifying individuals at increased coronary risk. Numerous studies have focused on the effects of regular exercise on the paediatric lipoprotein profile, a recognised primary risk factor, with equivocal results. Cross-sectional comparisons of dichotomised groups provide the strongest evidence of an exercise effect. 'Trained' or 'active' children and adolescents demonstrate 'favourable' levels of high density lipoprotein-cholesterol (HDL-C), triacylglycerol, total cholesterol (TC)/HDL-C and low density lipoprotein-cholesterol (LDL-C)/HDL-C, whilst TC is generally unaffected. The evidence regarding LDL-C in these studies is equivocal. A possible self-selection bias means that a cause-effect relationship between exercise and the lipoprotein profile cannot be readily established from this design. Correlational studies are difficult to interpret because of differences in participant characteristics, methods employed to assess peak oxygen uptake and habitual physical activity (HPA), and the statistical techniques used to analyse multivariate data. Directly measured cardiorespiratory fitness does not appear to be related to lipoprotein profiles in the children and adolescents studied to date, although there are data to the contrary. The relationship with HPA is more difficult to decipher. The evidence suggests that a 'favourable' lipoprotein profile may be related to higher levels of HPA, although differences in assessment methods preclude a definitive answer. While few prospective studies exist, the majority of these longitudinal investigations suggest that imposed regular exercise has little, if any, influence on the lipoprotein levels of children and adolescents. However, most prospective studies have several serious methodological design weaknesses, including low sample size, inadequate exercise training volume and a lack of control individuals. Recent studies have suggested that increases in HDL-C and reductions in LDL-C may be possible with regular exercise. The identification of a dose-response relationship between exercise training and the lipoprotein profile during the paediatric years remains elusive.

Effect of push frequency on the economy of wheelchair racers

PURPOSE

The aim of the study was to examine the effect of varying push frequency on pushing economy (oxygen uptake at a given speed).

METHODS

Eight male wheelchair racers completed a series of exercise bouts on a wheelchair ergometer (Bromking Turbo Trainer, Bromakin, UK) at 6.58 m x s(-1). Initially, subjects self-selected their freely chosen push frequency (FCF); this was followed by 4 random trials pushing at 60, 80, 120, and 140% of this FCF. Steady state VO2 was determined using Douglas bags, and heart rate was recorded by telemetry. After each condition, a small capillary blood sample was obtained and analyzed for blood lactate concentration (BLa) and a rating of perceived exertion (RPE) was recorded.

RESULTS

At 6.58 m x s(-1) oxygen uptake, RPE, and gross mechanical efficiency were nonlinearly related to push frequency. Analysis of variance showed a significant effect (P < 0.05) of cycle frequency on VO2. VO2 was 11% higher at the 140% FCF compared with the 100% FCF condition. Changes in push frequency had little effect on HR although BLa increased linearly and was higher at the 140% FCF condition compared with 60% FCF (P < 0.05). A two-dimensional sagittal plane video analysis showed large interindividual differences in propulsion style. Both cycle time and the propulsion phase (%) decreased as the push frequency increased. The start angle and end angle of hand contact were similar for conditions, whereas the range of trunk motion decreased with push frequency (P < 0.05).

CONCLUSION

The results of this study showed that the push frequency had an effect on pushing economy, and that the athletes' FCF was the most economical.

Absence of PPP2R1B gene alterations in primary ovarian cancers

The PPP2R1B gene has recently been implicated as a tumor suppressor based on the finding of somatic alterations in lung and colon cancers. PPP2R1B is located on chromosome 11q22-24 which coincides with the site of frequent loss of heterozygosity (LOH) in ovarian cancer. We investigated if the PPP2R1B gene was inactivated in ovarian cancer by single strand conformational polymorphism (SSCP) and heteroduplex (HD) analysis of 99% of the coding region. LOH at the PPP2R1B locus was detected in 32% of the malignant tumors but no somatic alterations were detected in any of 65 malignant, five borderline or six benign tumors. A germline G > A transition (GGC > GAC) in codon 90 was detected in 4/76 tumors. This alteration has previously been described as a mutation but on further investigation we found that the frequency of this variant among 167 ovarian cancers (4.2%) was not statistically significantly different from that observed in 247 non-cancer random controls (2.4%). We conclude that the PPP2R1B gene is not involved in the pathogenesis of ovarian cancer. The codon 90 Gly > Asp alteration may represent a non-pathological polymorphism and consequently the mutation frequency reported in lung cancers may have been overstated and the designation of PPP2R1B as a tumor suppressor gene should be regarded with caution.

Selected predictor variables and the lipid-lipoprotein profile of prepubertal girls and boys

PURPOSE

It is still unclear how habitual physical activity (HPA), peak VO2, percent body fat (%BF), and dietary composition are related to the lipid-lipoprotein profile in children. The purpose of this study was to identify independent contributions from these selected predictor variables to prepubertal children's lipid-lipoprotein profile.

METHODS

Peak VO2, HPA from continuous heart rate monitoring, %BF, 7-d dietary analysis, total cholesterol (TC), total triacylglycerol (TG), high density lipoprotein (HDL) cholesterol (HDL-C), low density lipoprotein (LDL) cholesterol (LDL-C), TC/HDL-C, and LDL-C/HDL-C were determined in 33 prepubertal girls and 38 prepubertal boys (mean +/- SD age, 10.6 +/- 0.7 yr).

RESULTS

Bivariate correlation analyses revealed that peak VO2, %BF, and HPA were related to the lipid-lipoprotein profile in girls (P < 0.05). For the boys, HPA was only related to TC/HDL-C (P < 0.05) and LDL-C/HDL-C (P < 0.05), whereas daily energy intake (kJ x d(-1)) was associated with TC and LDL-C (P < 0.05). Multiple linear regression analyses indicated that peak VO2, %BF and HPA were the main predictor variables for the girls. Peak VO2 accounted for 22.7%, 24.8%, 22.5%, and 24.2% of the unique variance (sr(i)2) in TG, HDL-C, LDL-C/HDL-C, and TC/HDL-C, respectively. For TC and LDL-C in girls, sr(i)2 were 18.0% and 22.6%, respectively, from HPA. In contrast, only daily energy intake had a significant unique contribution to the variance of TC (15.4%) and LDL-C (22.0%) for the boys.

SUMMARY

The main findings from this study were that the predictor variables are lipid-lipoprotein specific and depend on gender. These results would support the growing evidence that it is important to nurture an active lifestyle in children from an early age and that an awareness of fitness and body fatness is required.

Thermoregulatory responses of spinal cord injured and able-bodied athletes to prolonged upper body exercise and recovery

STUDY DESIGN

Single trial, two factor repeated measures design.

SETTING

England, Cheshire.

OBJECTIVES

To examine the thermoregulatory responses of able-bodied (AB) athletes, paraplegic (PA) athletes and a tetraplegic (TP) athlete at rest, during prolonged upper body exercise and recovery.

METHODS

Exercise was performed on a Monark cycle ergometer (Ergomedic 814E) adapted for arm exercise at 60% VO2 peak for 60 min in cool conditions ('normal' laboratory temperature; 21.5+/-1.7 degrees C and 47+/-7.8% relative humidity). Aural and skin temperatures were continually monitored.

RESULTS

Mean (+/-S.D.) peak oxygen uptake values were greater (P<0. 05) for the AB when compared to the PA (3.45+/-0.45 l min-1 and 2. 00+/-0.46 l min-1, respectively). Peak oxygen uptake for the TP was 0.91 l min-1. At rest, aural temperature was similar between groups (36.2+/-0.3 degrees C, 36.3+/-0.3 degrees C and 36.3 degrees C for AB, PA and TP athletes, respectively). During exercise, aural temperature demonstrated relatively steady state values increasing by 0.6+/-0.4 degrees C and 0.6+/-0.3 degrees C for the AB and PA athletes, respectively. The TP athlete demonstrated a gradual rise in aural temperature throughout the exercise period of 0.9 degrees C. Thigh skin temperature increased by 1.3+/-2.5 degrees C for the AB athletes (P<0.05) whereas the PA athletes demonstrated little change in temperature (0.1+/-3.4 degrees C and -0.7 degrees C respectively). Calf temperature increased for the PA athletes by 1.0+/-3.6 degrees C (P<0.05), whereas a decrease was observed for the AB athletes of -1.0+/-2.0 degrees C (P<0.05) during the exercise period. During 30 min of passive recovery, the AB athletes demonstrated greater decreases in aural temperatures than those for the PA athletes (P<0. 05). Aural temperature for the TP increased peaking at 5 min of recovery remaining elevated until the end of the recovery period. Fluid consumption and weight losses were similar for the AB and PA athletes (598+/-433 ml and 403+/-368 ml; 0.38+/-0.39 kg and 0.38+/-0. 31 kg, respectively), whereas changes in plasma volume were greater for the AB athletes (-9.8+/-5.8% and 4.36+/-4.9%, respectively; P<0. 05).

CONCLUSION

The results of this study suggest that under the experimental conditions PA athletes are at no greater thermal risk than AB athletes. A relationship between the available muscle mass for heat production and sweating capacity appears evident for the maintenance of thermal balance. During recovery from exercise, decreases in aural temperature, skin temperature and heat storage were greatest for the AB athletes with the greatest capacity for heat loss and lowest for the TP athlete with the smallest capacity for heat loss. Initial observations on one TP athlete suggest substantial thermoregulatory differences when compared to AB and PA athletes.