Association Between Sleep Quality and Cognitive Symptoms in Patients with Major Depressive Disorder

Cognitive symptoms and sleep disturbance (SD) are common non-mood-related symptoms of major depressive disorder (MDD). In clinical practice, both ...

NO 984 Hospital of PLA

Early life adversity (ELA) is not uncommon in Major Depressive Disorder (MDD) patients. Childhood trauma has been reported more frequently in adult MDD patients relative to healthy control. Recent researches have demonstrated that ELA could result in changes in brain morphology which might be an etiological factor of MDD development.

Early life adversity induced third ventricular enlargement in young adult male patients suffered from major depressive disorder: A study of brain morphology.

Cerebral small vessel disease (SVD) refers to a heterogeneous group of pathological processes that result from damage to the small penetrating vessels in the brain. Spatial navigation, one of the most fundamental behaviors, has lately attracted considerable clinical interest. This study aimed to determine whether spatial navigation performance is impaired in elderly SVD patients. In total, 18 elderly patients with severe SVD, 40 elderly patients with non-severe SVD, and 41 age-matched healthy volunteers were classified according to the Fazekas scale. Spatial navigation was evaluated by Amunet (a computer-based analogy of Morris water maze software), and a mini-mental scale evaluation (MMSE), animal category verbal fluency test (VFT), clock drawing test (CDT), and trail making test (TMT) -B were also applied. Compared to healthy controls, severe SVD, rather than non-severe SVD patients, exhibited significantly worse performance on "allocentric + egocentric" (41.74 ± 29.10 vs. 31.50 ± 16.47 vs. 29.21 ± 19.03;  = 0.031). Furthermore, the different abilities of spatial navigation among groups reached a statistical level on allocentric subtests (46.93 ± 31.27 vs. 43.69 ± 23.95 vs. 28.56 ± 16.38;  = 0.003), but not on egocentric subtest (56.16 ± 39.85 vs. 56.00 ± 28.81 vs. 43.06 ± 25.07;  = 0.105). The linear regression analysis revealed that allocentric navigation deficit was significantly correlated with TMT-B ( = 0.000, standardized β = 0.342) and VFT ( = 0.016, standardized β = -0.873) performance in elderly SVD patients. These results elucidated that spatial navigation ability could be a manifestation of cognitive deficits in elderly patients with SVD.

Spatial Navigation Is Impaired in Elderly Patients With Cerebral Small Vessel Disease.

Dual-task walking (DTW) is common in daily life and represents an ideal paradigm for elucidating gait irregularity. Under single-task walking (STW) and DTW conditions, the symmetric and bilaterally coordinated human gait pattern found in healthy individuals is absent in individuals with neurological ailments such as Parkinson's disease, Alzheimer's disease and post-stroke issues. Cerebral small vessel disease (CSVD) is a neuropathological and radiological issue that has been reported to be associated with cognitive and motor disorders. However, few gait analyses have focused on elderly individuals with CSVD under DTW conditions.

Gait characteristics under single-/dual-task walking conditions in elderly patients with cerebral small vessel disease: Analysis of gait variability, gait asymmetry and bilateral coordination of gait.

Rest-activity rhythms (RAR) is one of the most fundamental biological patterns that influence basic physical and mental health, as well as working performance. Nowadays, with the utilization of actigraphy device in detecting and analyzing RAR objectively, evidence has confirmed that RAR could be interrupted by shift work. Nurses need to participate shift work in their daily routine. The aim of the present study is to identify the RAR of nurses working rotating shifts and find out the relationship between RAR and executive function.

Executive Performance Is Associated With Rest-Activity Rhythm in Nurses Working Rotating Shifts.

Apathy is attracting more and more attention in clinical practice. As one of the most common features of cerebral small vessel disease (CSVD), the assessment of apathy still mainly relies on observers. With the development of Information and Communication Technologies (ICTs), new objective tools take part in the early detection of apathy.

Detecting apathy in patients with cerebral small vessel disease.

Preventive strategies implemented during the COVID-19 pandemic may negatively influence the management of patients with acute ischemic stroke (AIS). Nowadays, studies have demonstrated that the pandemic has led to a delay in treatment among patients with AIS. Whether this delay contributes to meaningful short-term outcome differences warranted further exploration.

The impact of COVID-19 pandemic on treatment delay and short-term neurological functional prognosis for acute ischemic stroke during the lockdown period.

The present study explores whether SVD affects bimanual coordination, which is easier to detect than by conventional, MRI-based methods. We tested nine severe SVD patients, eight non-severe (i.e., moderate or mild) SVD patients, eleven healthy age-matched controls, and eight young adults. They were grouped according to Fazekas scale and by age. Participants performed horizontal line drawings with both hands simultaneously on two pen tablets. The movements consisted of rhythmic patterns where participants used both hands to draw horizontal lines in anti-phase on two pen tablets. Each participant underwent a series of neuropsychiatric assessments. Results showed that SVD patients exhibited in each hand smaller horizontal movement amplitudes with variability larger compared to the healthy age-matched controls. Only movement amplitudes appeared to decrease significantly with severity of SVD. Interestingly, we found no relevant differences between the age-matched, elderly controls and the young controls. Therefore, this effect appeared indicative of SVD. The variability of the lines orthogonal to the horizontal lines of the left, non-dominant hand differed only between the severe SVD group and the other groups. Furthermore, partial correlations demonstrated that the mean horizontal movement amplitude of the left hand was positively associated with the clock drawing test score, and the inter-manual asynchrony of the horizontal movements was positively associated with the Trail Making Test-B time. These results indicated that SVD patients show poor bimanual coordination, as reflected by spatial features such as movement amplitudes and variabilities, and abnormal bimanual coordination was associated with executive dysfunction.

Aged Patients With Severe Small Vessel Disease Exhibit Poor Bimanual Coordination During the Anti-Phase Horizontal Line Drawing Task.

Insufficient sleep affects cognitive function, but the underlying mechanism and potential protective ways are yet to be fully understood. This study aimed to explore the influence of chronic sleep restriction (CSR) on the insulin-like growth factor-1 (IGF-1) signaling pathway, and whether down-regulating IGF-1 signaling pathway would modulate amyloid-β (Aβ) peptides metabolism and its cortical deposition after CSR. Methods 8-week IGF-1R mice and wild-type (WT) C57BL/6 (C57) mice were divided into four groups: IGF-1R CSR (MUSR), IGF-1R control (MUCO), C57 CSR (C57SR) and C57 control (C57CO). CSR model was established by application of slowly rotating drum for 2 months. Body weight and Lee's index were measured. The level of IGF-1 in plasma was measured by enzyme linked immunosorbent assay (ELISA). Aβ accumulation was detected by immunofluorescence. The expressions of amyloid precursor protein (APP), β-site amyloid precursor protein-cleaving enzyme-1 (BACE-1) and C99 were detected using western-blot (WB). Results Two-way ANOVA showed genotypic effect was significant on body weight and Lee's index. Neither treatment effect nor interaction reached significant difference on body weight and Lee's index. The level of IGF-1 in plasma was significantly decreased in C57SR compared with C57CO. Besides, compared with C57CO, Aβ was markedly accumulated in frontal cortex, in parallel with increased expressions of BACE-1 and C99, and with no difference of APP in C57SR group. Further, no significant changes of Aβ, BACE-1, C99 and APP were detected in MUSR compared with MUCO. Conclusions This study showed that CSR could induce the decrease of circulating IGF-1 in mice. By using the IGF-1R mice, we found that down-regulating IGF-1R could reduce Aβ deposition in mice frontal cortex after CSR via inhibiting BACE-1 protein expression and activity, which were independent of the changes of body weight and Lee's index. These findings indicate that the blockage of IGF-1 signaling pathway might be a protection mechanism for alleviating the impact of CSR.

Down-regulating insulin-like growth factor-1 receptor reduces amyloid-β deposition in mice cortex induced by chronic sleep restriction.

The goal of the current study was to demonstrate if the rest-activity rhythm (RAR) was altered in apathetic older adults with cerebral small vessel disease (CSVD) and find out the relationship between apathy/depression severity and RAR features in CSVD patients. This is a cross-sectional observational investigation including 53 CSVD cases (54.74% men), aged 70.70 ± 6.18 years old. The participants were assessed by neuropsychiatric inventory (NPI) subscale of apathy (NPI-apathy) and depression (NPI-depression) in succession, according to updated diagnostic criteria for apathy (DCA). Each subject wore an actigraph device (ActiGraph GT3X) in their nondominant hand for 7 days to collect raw data. Using a non-parametric methodological analysis, this study determined RAR variables such as interdaily stability (IS), intraday variability (IV) and relative amplitude (RA). Patients in the apathy-positive group had a higher Fazekas score than those in the apathy-negative group. IS, but not IV, RA, or objective sleep variables, differed between elderly patients with varying degrees of CSVD burden. Furthermore, apathy severity was statistically correlated with RA after adjusting for age, gender and education level, whereas depression severity was not associated with RAR variables. Finally, we discovered that the severity of apathy had no significant relationship with the severity of depression. All these findings indicated that the RAR altered in apathetic older adults with CSVD, and apathy was associated with decreased RAR amplitude.

The relationship between apathy and nonparametric variables of rest activity rhythm in older adults with cerebral small vessel disease.

Several studies have reported that the walking trail making test (WTMT) completion time is significantly higher in patients with developmental coordination disorders and mild cognitive impairments. We hypothesized that WTMT performance would be altered in older adults with white matter hyperintensities (WMH).

Hongyi Zhao

Department of Neurology

NO 984 Hospital of PLA

Association Between Sleep Quality and Cognitive Symptoms in Patients with Major Depressive Disorder

Hongyi Zhao

.css-o250i3{font-size:18px;font-family:Open Sans,sans-serif;line-height:21.6px;}Department of Neurology

NO 984 Hospital of PLA

Association Between Sleep Quality and Cognitive Symptoms in Patients with Major Depressive Disorder

Department of Neurology