Understanding Anxiety in Cervical Dystonia: An Imaging Study.

Background: Anxiety may precede motor symptoms in cervical dystonia (CD) and is associated with an earlier onset of dystonia. Our understanding of anxiety in CD is inadequate.

Objective: To investigate brain networks associated with anxiety in CD.

Altered Impulsivity Across Drug-Naïve Parkinsonism, Isolated Rapid Eye Movement Sleep Behavior Disorder, and Their High-Risk Relatives.

Objective: To determine multidimensional impulsivity levels across different early stages of α-synucleinopathy.

Methods: This cross-sectional study investigated motor and decisional impulsivity levels using a panel of computerized tasks among drug-naïve parkinsonism patients, isolated/idiopathic rapid eye movement sleep behavior disorder (iRBD) patients and their first-degree relatives (iRBD-FDRs), and control participants. Trait impulsivity and impulse control behaviors were assessed by self-reported questionnaires.

School-Based Sleep Education Program for Children: A Cluster Randomized Controlled Trial.

Insufficient sleep contributes negatively to child developmental processes and neurocognitive abilities, which argues the need for implementing interventions to promote sleep health in children. In this study, we evaluated the effectiveness of a multimodal and multilevel school-based sleep education program in primary school children using a cluster randomized controlled design. Twelve schools were randomly assigned to either the sleep education or nonactive control groups.

Familial α-synucleinopathy spectrum features in patients with psychiatric REM sleep behaviour disorder.

Background: Rapid eye movement (REM) sleep behaviour disorder (RBD) is one of the earliest and most specific prodromes of the α-synucleinopathies including Parkinson's disease (PD). It remains uncertain whether RBD occurring in the context of psychiatric disorders (psy-RBD), although very common, is merely a benign epiphenomenon of antidepressant treatment, or whether it harbours an underlying α-synucleinopathy. We hypothesised that patients with psy-RBD demonstrate a familial predisposition to an α-synucleinopathy.

Early- and late-onset of isolated rapid eye movement sleep behavior disorder: A retrospective cohort study.

Objective: Age at onset of neurodegenerative disease has significant implications in differentiating disease profiles. We aimed to determine whether age at onset could identify clinical and neurodegenerative profiles in patients with isolated/idiopathic rapid eye movement sleep behavior disorder (iRBD) - a prodromal stage of α-synucleinopathies.

Methods: In this retrospective cohort study, the time of the first episode of dream-enactment behaviors that the patient/bed-partners recalled at the time of the patient's first visit to sleep clinic was collected.

Isolated dream-enactment behaviours as a prodromal hallmark of rapid eye movement sleep behaviour disorder.

Recurrent dream-enactment behaviours (DEB) and rapid eye movement (REM) sleep without atonia (RSWA) are two diagnostic hallmarks of REM sleep behaviour disorder (RBD), a specific prodrome of α-synucleinopathy. Whilst isolated RSWA (without DEB) was suggested as a prodrome of RBD, the implication of 'isolated' recurrent DEB remains under-investigated. In this cross-sectional study, we sought to investigate neurodegenerative markers amongst the first-degree relatives (FDRs, aged >40 years) of patients with RBD who underwent clinical assessment for DEB, neurodegenerative markers, and video-polysomnography assessment.

The impact of sleep-corrected social jetlag on mental health, behavioral problems, and daytime sleepiness in adolescents.

Study Objectives: This study aimed to examine the effect of sleep-corrected social jetlag (SJLsc) on mental health, behavioral problems, and daytime sleepiness in adolescents.

Methods: This was a cross-sectional study which included 4787 adolescents (Mean age: 14.83±1.

Efficacy of Email-delivered Versus Face-to-face Group Cognitive Behavioral Therapy for Insomnia in Youths: A Randomized Controlled Trial.

Purpose: The purpose of the study was to compare the efficacy of group-based therapy (GT) and email-delivered self-help (ESH) cognitive behavioral therapy for insomnia (CBT-I) with the wait-list (WL) control group in youths.

Methods: The study involved an assessor-blind, parallel group randomized controlled trial in youths meeting the diagnostic criteria for insomnia disorder. Participants were randomized to one of the three groups (8-week GT, 8-week ESH, or WL).

Prevalence and correlates of REM sleep behaviour disorder in patients with major depressive disorder: a two-phase study.

Objective: To investigate the prevalence and clinical correlates of video polysomnography (vPSG)-confirmed rapid eye movement sleep behaviour disorder (RBD) in patients with major depressive disorder (MDD).

Methods: This is a clinic-based two-phase epidemiological study. In phase 1, patients with MDD were screened by a validated questionnaire, RBD Questionnaire-Hong Kong (RBDQ-HK).

A Prevention Program for Insomnia in At-risk Adolescents: A Randomized Controlled Study.

Objectives: To prevent the future development of insomnia in at-risk adolescents.

Methods: A randomized controlled trial comparing 4 weekly insomnia prevention program with a nonactive control group. Subjects were assessed at baseline, postintervention, and 6 and 12 months after intervention.

Residual Injurious Symptoms and Its Association With Neurodegenerative Outcomes in Idiopathic Rapid Eye Movement Sleep Behavior Disorder: A Retrospective, Longitudinal Follow-up Study.

Background: The risk of neurodegenerative disorders in idiopathic rapid eye movement sleep behavior disorder (iRBD) patients with residual injurious symptoms (RIS) after symptomatic treatment with clonazepam and/or melatonin is unclear.

Objective: The objective of this study was to determine the rate and correlates of RIS and its association with the risk of neurodegenerative diseases in patients with iRBD.

Methods: This was a retrospective cohort study.

Rest-Activity Pattern Alterations in Idiopathic REM Sleep Behavior Disorder.

Objective: The purpose of this study was to investigate the differences in actigraphy-measured rest-activity patterns (eg, sleep-wake cycle, circadian rest-activity rhythm, and physical activity) across different stages of α-synucleinopathy.

Methods: We compared alterations in 7-day actigraphy-measured rest-activity patterns among patients with clinically diagnosed α-synucleinopathies (n = 44), and their age-, sex-, and body mass index (BMI)-matched patients with idiopathic rapid eye movement (REM) sleep behavior disorder (iRBD, n = 88), and non-rapid eye movement (REM) sleep behavior disorder (RBD) controls (n = 44) in a case-control study (study 1) and between convertors (n = 22) and their age-, sex-, BMI-, iRBD-duration, and follow-up duration-matched non-convertors (n = 66) in a prospective nested case-control study (study 2).

Results: In study 1, there were significant increases (all p values were adjusted by false discovery rate < 0.

Electromyography activity level in rapid eye movement sleep predicts neurodegenerative diseases in idiopathic rapid eye movement sleep behavior disorder: a 5-year longitudinal study.

Objectives: To investigate whether baseline electromyography (EMG) activity during rapid eye movement (REM) sleep predicts the development of neurodegenerative diseases over time in patients with idiopathic REM sleep behavior disorder (iRBD).

Methods: A total of 216 patients with polysomnography-confirmed iRBD were recruited from September 1997 to December 2016 with a mean follow-up duration of 5.0 ± 3.

A case-control-family study of idiopathic rapid eye movement sleep behavior disorder.

Objective: To determine the familial aggregation of idiopathic rapid eye movement sleep behavior disorder (iRBD), neurodegenerative diseases, and related biomarkers.

Methods: A total of 404 and 387 first-degree relatives of 102 patients with iRBD and of 89 controls were recruited, respectively. Among them, 204 and 208 relatives of patients and controls underwent face-to-face clinical assessment, whereas 97 and 75 relatives underwent further video-polysomnographic assessment, respectively.

Excessive daytime sleepiness among children and adolescents: prevalence, correlates, and pubertal effects.

Objectives: To examine the prevalence and correlates of excessive daytime sleepiness (EDS) among Hong Kong children and adolescents. We investigated the potential roles of sex and puberty in modulating the occurrence of EDS.

Methods: A total of 10,086 students (male, 48.

Impact of a modest delay in school start time in Hong Kong school adolescents.

Objective: To examine the effects of a modest delay (15 min) in school start time (SST) on adolescent sleep patterns, mood, and behaviors.

Methods: Two secondary schools in Hong Kong with a total of 1173 students (intervention: n = 617; comparison school n = 556) completed both baseline and follow-up questionnaires. School start time was delayed by 15 min, from 7:45 a.

Magnetoencephalography and New Imaging Modalities in Epilepsy.

The success of epilepsy surgery is highly dependent on correctly identifying the entire epileptogenic region. Current state-of-the-art for localizing the extent of surgically amenable areas involves combining high resolution three-dimensional magnetic resonance imaging (MRI) with electroencephalography (EEG) and magnetoencephalography (MEG) source modeling of interictal epileptiform activity. Coupling these techniques with newer quantitative structural MRI techniques, such as cortical thickness measurements, however, may improve the extent to which the abnormal epileptogenic region can be visualized.

A prospective, naturalistic follow-up study of treatment outcomes with clonazepam in rapid eye movement sleep behavior disorder.

Background: Rapid eye movement sleep behavior disorder (RBD) is characterized by prominent dream-enacting behaviors, often resulting in sleep-related injuries.

Objectives: This study aimed to prospectively examine the treatment response of people with RBD treated with clonazepam, by quantitatively delineating the characteristic changes in the clinical and polysomnographic features, and to explore the factors associated with this response.

Methods: Patients diagnosed with idiopathic RBD (iRBD) were consecutively recruited and invited to complete clinical and polysomnographic (PSG) assessments and self-administered questionnaires (including the modified REM Sleep Behavior Questionnaire, RBDQ-3M) before and after the initiation of treatment with clonazepam.

Help-seeking behaviors for insomnia in Hong Kong Chinese: a community-based study.

Objectives: To determine the prevalence and correlates of help-seeking behaviors for insomnia in Hong Kong Chinese middle-aged adults and their offspring.

Methods: A total of 2231 middle-aged adults (54.2% females, mean age 45.

Family conflict and lower morning cortisol in adolescents and adults: modulation of puberty.

We aimed to explore the association between family conflict and HPA axis activity, especially with respect to the potential modulating effect of puberty. A total of 205 adolescents and 244 adult parents were recruited. Family conflict was assessed by the family conflict subscale of the Family Environmental Scale and serial salivary cortisol was measured in all participants.

Altered Sleep Stage Transitions of REM Sleep: A Novel and Stable Biomarker of Narcolepsy.

Objectives: To determine the diagnostic values, longitudinal stability, and HLA association of the sleep stage transitions in narcolepsy.

Methods: To compare the baseline differences in the sleep stage transition to REM sleep among 35 patients with type 1 narcolepsy, 39 patients with type 2 narcolepsy, 26 unaffected relatives, and 159 non-narcoleptic sleep patient controls, followed by a reassessment at a mean duration of 37.4 months.

Eveningness and insomnia: independent risk factors of nonremission in major depressive disorder.

Background: It is unclear whether there is an association between chronotype and nonremission of depression, and whether the association is related to the confounding effect of insomnia.

Method: A cohort of patients with major depressive disorder were assessed for chronotype (by Morningness-Eveningness Questinnaire [MEQ]), depressive symptoms, insomnia severity and clinical outcomes in a naturalistic follow-up study.

Results: Of the 253 recruited subjects (age 50.

Residual sleep disturbances in patients remitted from major depressive disorder: a 4-year naturalistic follow-up study.

Study Objectives: To investigate the prevalence and clinical, psychosocial, and functional correlates of residual sleep disturbances in remitted depressed outpatients.

Design: A 4-yr prospective observational study in a cohort of psychiatric outpatients with major depressive disorder was conducted with a standardized diagnostic psychiatric interview and a packet of questionnaires, including a sleep questionnaire, Hospital Anxiety and Depression Scale, NEO personality inventory, and Short Form-12 Health Survey.

Settings: A university-affiliated psychiatric outpatient clinic.