Slaapstoornis Wetenschap

Cognitive impairment in obstructive sleep apnea syndrome: a descriptive review.

Sleep Breath. 2020 May 23;:

Authors: Caporale M, Palmeri R, Corallo F, Muscarà N, Romeo L, Bramanti A, Marino S, Lo Buono V

Abstract
PURPOSE: Obstructive sleep apnea syndrome is a clinical sleep disorder defined by total or partial airflow restraint during sleep that results in fragmented sleep and hypoxemia, impacting negatively with cognitive functioning. This review was conducted on studies investigating structural brain alteration and cognitive impairment in obstructive sleep apnea syndrome.
METHOD: We searched on PubMed databases and screening references of included studies and review articles for additional citations. From initial 190 publications, only 17 met search criteria and described the cognitive impairment in obstructive sleep apnea syndrome.
RESULTS: Findings showed that patients with this syndrome had worse performance than healthy controls in attention, memory, and executive functions, showing specific neuroanathomical features. Cognitive impairment is also related to the severity of pathology. Treatment could improve certain cognitive aspects.
CONCLUSIONS: Cognitive deficits seem to be mainly attributable to decreased daytime vigilance and nocturnal hypoxemia.

PMID: 32447633 [PubMed - as supplied by publisher]

Visual hallucinations and illusions in Parkinson's disease: the role of ocular pathology.

J Neurol. 2020 May 23;:

Authors: Marques A, Beze S, Pereira B, Chassain C, Monneyron N, Delaby L, Lambert C, Fontaine M, Derost P, Debilly B, Rieu I, Lewis SJG, Chiambaretta F, Durif F

Abstract
INTRODUCTION: Whether different mechanisms, particularly ocular pathology, could lead to the emergence of visual hallucinations (VH) (defined as false perceptions with no external stimulus) versus visual illusions (VI) (defined as a misperception of a real stimulus) in Parkinson's disease (PD) remains debated. We assessed retinal, clinical and structural brain characteristics depending on the presence of VH or VI in PD.
METHODS: In this case-control study, we compared retinal thickness using optical coherence tomography (OCT), between PD patients with: VI (PD-I; n = 26), VH (PD-H; n = 28), and without VI or VH (PD-C; n = 28), and assessed demographic data, disease severity, treatment, anatomical and functional visual complaints, cognitive and visuo-perceptive functions and MRI brain volumetry for each group of PD patients.
RESULTS: Parafoveal retina was thinner in PD-H compared to PD-C (p = 0.005) and PD-I (p = 0.009) but did not differ between PD-I and PD-C (p = 0.85). Multivariate analysis showed that 1/retinal parafoveal thinning and total brain gray matter atrophy were independently associated with the presence of VH compared to PD-I; 2/retinal parafoveal thickness, PD duration, sleep quality impairment and total brain gray matter volume were independent factors associated with the presence of VH compared to PD-C; 3/anterior ocular abnormalities were the only factor independently associated with the presence of illusions compared to PD-C.
CONCLUSION: These findings reinforce the hypothesis that there may be different mechanisms contributing to VH and VI in PD, suggesting that these two entities may also have a different prognosis rather than simply lying along a continuous spectrum.
REGISTRATION NUMBER: Clinicaltrials.gov number NCT01114321.

PMID: 32447550 [PubMed - as supplied by publisher]

The role of eugeroics in the treatment of affective disorders.

Psychiatr Pol. 2020 Feb 29;54(1):21-33

Authors: Urban AE, Cubała WJ

Abstract
Eugeroics are a relatively new class of wakefulness-promoting agents. Thegroup includes adrafinil, modafinil and armodafinil. Modafinil is the most widely used and the best studied agent. Indications for the use of modafinil include the treatment of narcolepsy, shift-work sleep disorders and excessive daytime sleepiness associated with obstructive sleep apnea. Many studies show the utility of modafinil and armodafinil in the treatment of depression - both in monotherapy andas potentiation therapy if needed. Modafinil has proven to be effective in the treatment of residual symptoms of unipolar and bipolar depression such as fatigue, excessive sleepiness and some cognitive impairment. Research on armodafinil points to its effectiveness mainly in augmentation therapy of depression in the course of bipolar disorder. There are also reports on the effectiveness of eugeroics in special cases - seasonal depression, atypical depression with hyperphagia, apathy in the course of depression or as an isolated symptom, cancer-related fatigue in patients receiving chemotherapy, fatigue and excessive sleepiness in neurological diseases. Eugeroics due to their high selectivity of action in the CNS have a low addictive potential compared with other stimulants. The risk of manic switch is comparable to placebo. In general, they are well-tolerated and safe. The purpose of this paper is to review the literature on the use of eugeroics in the treatment of affective disorders.

PMID: 32447354 [PubMed - as supplied by publisher]

Association of sleep with cognition and beta amyloid accumulation in adults with Down syndrome.

Neurobiol Aging. 2020 Apr 29;93:44-51

Authors: Cody KA, Piro-Gambetti B, Zammit MD, Christian BT, Handen BL, Klunk WE, Zaman S, Johnson SC, Plante DT, Hartley SL

Abstract
Adults with Down syndrome have an increased risk for both disordered sleep and Alzheimer's disease (AD). In the general population, disrupted sleep has been linked to beta amyloid accumulation, an early pathophysiologic feature of AD. In this study, the association among sleep, beta amyloid, and measures of AD-related cognitive decline was examined in 47 non-demented adults with Down syndrome (aged 26-56 years). Sleep was measured using actigraphy over 7 nights. Pittsburgh Compound B positron emission tomography was used to assess global and striatal beta amyloid burden. Participants had the following clinical AD status: 7 (15%) mild cognitive impairment and 40 (85%) cognitively unaffected. Average length of night-time awakenings was significantly positively associated with striatal beta amyloid and decreased cognitive performance in executive functioning and motor planning and coordination. Findings suggest that disrupted sleep is associated with beta amyloid accumulation and cognitive features of preclinical AD in Down syndrome. Early identification and treatment of sleep problems could be a lifestyle intervention that may delay beta amyloid accumulation and cognitive decline in this AD vulnerable group.

PMID: 32447011 [PubMed - as supplied by publisher]

Gaps in opioid prescription for severe breathlessness in hospitalised patients with chronic obstructive pulmonary disease or interstitial lung disease.

J Pain Symptom Manage. 2020 May 21;:

Authors: Chen X, Treanor D, Le B, Smallwood N

PMID: 32446973 [PubMed - as supplied by publisher]