Sleep spindles across youth affected by schizophrenia or anti-N-methyl-D-aspartate-receptor encephalitis

Frontiers in Psychiatry

Psychiatry

Maria E. Dimitriades¹  Reto Huber²  Bigna K. Bölsterli³  Judith L. Rapoport⁴  David I. Driver⁴  Miriam Gerstenberg⁵  Maurizia Franscini⁶  Susanne Walitza⁷  Agnese Suppiej⁸  Kevin Rostasy⁹  Salome Kurth^1,10  Andjela Markovic^1,11  Stefano Sartori^1,12  Margherita Nosadini^1,12  Ashura Buckley^1,13  Silvano R. Gefferie^1,14  Leila Tarokh^1,15 

[1] Child Development Center, University Children's Hospital Zurich, Zurich, Switzerland;Children's Research Center, University Children's Hospital Zurich, Zurich, Switzerland;Child Development Center, University Children's Hospital Zurich, Zurich, Switzerland;Children's Research Center, University Children's Hospital Zurich, Zurich, Switzerland;Department of Child and Adolescent Psychiatry and Psychotherapy, Psychiatric University Hospital Zurich, University of Zurich, Zurich, Switzerland;Neuroscience Center Zurich, University of Zurich and Swiss Federal Institute of Technology Zurich, Zurich, Switzerland;Child Development Center, University Children's Hospital Zurich, Zurich, Switzerland;Children's Research Center, University Children's Hospital Zurich, Zurich, Switzerland;Department of Pediatric Neurology, University Children's Hospital Zurich, Zurich, Switzerland;Department of Pediatric Neurology, Children's Hospital of Eastern Switzerland, St. Gallen, Switzerland;Child Psychiatry Branch, National Institute of Mental Health, Bethesda, MD, United States;Children's Research Center, University Children's Hospital Zurich, Zurich, Switzerland;Department of Child and Adolescent Psychiatry and Psychotherapy, Psychiatric University Hospital Zurich, University of Zurich, Zurich, Switzerland;Department of Child and Adolescent Psychiatry and Psychotherapy, Psychiatric University Hospital Zurich, University of Zurich, Zurich, Switzerland;Department of Child and Adolescent Psychiatry and Psychotherapy, Psychiatric University Hospital Zurich, University of Zurich, Zurich, Switzerland;Neuroscience Center Zurich, University of Zurich and Swiss Federal Institute of Technology Zurich, Zurich, Switzerland;Zurich Center for Integrative Human Physiology, University of Zurich, Zurich, Switzerland;Department of Medical Sciences, Pediatric Section, University of Ferrara, Ferrara, Italy;Department of Pediatric Neurology, Children's Hospital Datteln, Witten/Herdecke University, Datteln, Germany;Department of Psychology, University of Fribourg, Fribourg, Switzerland;Department of Pulmonology, University Hospital Zurich, Zurich, Switzerland;University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland;Department of Psychology, University of Fribourg, Fribourg, Switzerland;Paediatric Neurology and Neurophysiology Unit, Department of Women's and Children's Health, University Hospital of Padova, Padova, Italy;Neuroimmunology Group, Paediatric Research Institute Città della Speranza, Padova, Italy;Pediatrics and Neurodevelopmental Neuroscience, National Institute of Mental Health, Bethesda, MD, United States;Stichting Epilepsie Instellingen Nederland, Heemstede, Netherlands;Department of Neurology, Leiden University Medical Center, Leiden, Netherlands;University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland;Translational Research Center, University Hospital of Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland;

关键词: psychosis;    schizophrenia;    anti-NMDAR encephalitis;    sleep EEG;    sleep spindles;    thalamocortical network;   

DOI  :  10.3389/fpsyt.2023.1055459

 received in 2022-09-27, accepted in 2023-05-19,  发布年份 2023

来源: Frontiers

【 摘 要 】

BackgroundSleep disturbances are intertwined with the progression and pathophysiology of psychotic symptoms in schizophrenia. Reductions in sleep spindles, a major electrophysiological oscillation during non-rapid eye movement sleep, have been identified in patients with schizophrenia as a potential biomarker representing the impaired integrity of the thalamocortical network. Altered glutamatergic neurotransmission within this network via a hypofunction of the N-methyl-D-aspartate receptor (NMDAR) is one of the hypotheses at the heart of schizophrenia. This pathomechanism and the symptomatology are shared by anti-NMDAR encephalitis (NMDARE), where antibodies specific to the NMDAR induce a reduction of functional NMDAR. However, sleep spindle parameters have yet to be investigated in NMDARE and a comparison of these rare patients with young individuals with schizophrenia and healthy controls (HC) is lacking. This study aims to assess and compare sleep spindles across young patients affected by Childhood-Onset Schizophrenia (COS), Early-Onset Schizophrenia, (EOS), or NMDARE and HC. Further, the potential relationship between sleep spindle parameters in COS and EOS and the duration of the disease is examined.MethodsSleep EEG data of patients with COS (N = 17), EOS (N = 11), NMDARE (N = 8) aged 7–21 years old, and age- and sex-matched HC (N = 36) were assessed in 17 (COS, EOS) or 5 (NMDARE) electrodes. Sleep spindle parameters (sleep spindle density, maximum amplitude, and sigma power) were analyzed.ResultsCentral sleep spindle density, maximum amplitude, and sigma power were reduced when comparing all patients with psychosis to all HC. Between patient group comparisons showed no differences in central spindle density but lower central maximum amplitude and sigma power in patients with COS compared to patients with EOS or NMDARE. Assessing the topography of spindle density, it was significantly reduced over 15/17 electrodes in COS, 3/17 in EOS, and 0/5 in NMDARE compared to HC. In the pooled sample of COS and EOS, a longer duration of illness was associated with lower central sigma power.ConclusionsPatients with COS demonstrated more pronounced impairments of sleep spindles compared to patients with EOS and NMDARE. In this sample, there is no strong evidence that changes in NMDAR activity are related to spindle deficits.

【 授权许可】

Unknown   
Copyright © 2023 Dimitriades, Markovic, Gefferie, Buckley, Driver, Rapoport, Nosadini, Rostasy, Sartori, Suppiej, Kurth, Franscini, Walitza, Huber, Tarokh, Bölsterli and Gerstenberg.