Background: Sleep is associated with glymphatic circulation activity; however, there is no direct imaging modality to validate glymphatic circulation disorders in patients with insomnia. Therefore, this study aimed to explore the relationship between insomnia disorder (ID) and the glymphatic system. Dynamic synthetic magnetic resonance imaging (syMRI) was performed.
Methods: Thirty-two patients with insomnia and ten healthy volunteers were prospectively recruited from the Second Affiliated Medical Hospital of Nanchang University, China. All subjects underwent syMRI at baseline (0 h), 0.5 h, 1 h, 1.5 h, 12 h, and 3 d after enhancement. The MAGiC post-processing workstation was used to measure T1 signal changes in different brain regions, peak ΔT1, and slopes at different time periods. All patients with insomnia underwent polysomnography (PSG) and were evaluated using the Pittsburgh Sleep Quality Index (PSQI). Repeated measures analysis of variance, Bonferroni multiple comparison, Shapiro-Wilk test, t-test, and Pearson or Spearman correlation analysis were used.
Results: The main effect of T1 values for the cerebral white matter, cerebral gray matter, putamen, thalamus, and cerebellar white matter at different measurement times were significant in all subjects (all p < 0.05). The T1 values of the insula gray matter at 0.5 h were statistically different between the insomnia group and the control group (1231.76 ± 9.42 vs. 1272.95 ± 16.86 ms; p = 0.005), and the T1 values of the hippocampal gray matter at 3 d were different between the two groups (1198.24 ± 9.01 vs. 1234.55 ± 16.12 ms; p = 0.025). The time-varying curves of the T1 values in the cerebral gray matter and putamen were statistically different between the two groups (p = 0.009, 0.026). The cerebellar gray matter slope (1-1.5 h) and thalamic slope (1-1.5 h) were statistically different between the two groups [-113 (-188.5, -28) vs. 4.739 (-2.07, 7.98); 52 (-10, 119.75) vs. -19.25 (-120, 31.50]; p = 0.048, 0.017).
Conclusion: Reduced clearance of the gadolinium-based contrast agent by the gray matter and deep nuclei indicates the presence of glymphatic system impairment in insomnia.
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http://dx.doi.org/10.1016/j.sleep.2024.12.038 | DOI Listing |
EClinicalMedicine
August 2024
Department of Psychiatry, University of Oxford, Warneford Hospital, Warneford Lane, Oxford, OX3 7JX, United Kingdom.
Background: While semaglutide, approved for type-2 diabetes mellitus (T2DM), is being investigated as a treatment for brain disorders, concerns over adverse neuropsychiatric events have emerged. More data are therefore needed to assess the effects of semaglutide on brain health. This study provides robust estimates of the risk of neurological and psychiatric outcomes following semaglutide use compared to three other antidiabetic medications.
View Article and Find Full Text PDFClin Med Insights Case Rep
January 2025
Department of Rehabilitation, Nara Prefectural General Medical Center, Nara, Japan.
Background: Spasticity is an upper motor neuron syndrome that exacerbates motor paralysis and is rarely associated with pain. This report elucidates the management of drug-resistant pain attributed to an adolescent brain tumor using botulinum therapy.
Case Presentation: A 15-year-old female patient experienced dizziness, developed muscle weakness in her upper extremities, and was diagnosed with diffuse glioblastoma of the pons.
Psychogeriatrics
January 2025
Kastamonu Training and Research Hospital, Division of Rheumatology, University of Health Sciences, Kastamonu, Turkey.
Purpose: This study aims to compare the prevalence of depression and related geriatric syndromes in earlier-onset rheumatoid arthritis (EORA) patients, who have experienced prolonged inflammation and medication use, with those with late-onset rheumatoid arthritis (LORA) patients, who often present with an acute and severe course.
Methods: In this multidisciplinary study, patients with EORA and LORA aged 60 and over who were referred to a tertiary rheumatology clinic underwent a geronto-rheumatologic evaluation. Muscle mass and handgrip strength, cognitive function, nutritional status, Fried frailty index, fall history, gait speed, depression according to Geriatric Depression Scale and Insomnia Severity Index were recorded.
BMJ Open
January 2025
Regional Center of Ehlers-Danlos Syndrome, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
Objective: This study investigates the prevalence and underlying factors of fatigue in individuals with Marfan syndrome (MFS) and hypermobile Ehlers-Danlos syndromes (hEDS), highlighting the necessity for focused research on this symptom within these patient populations.
Design: Cross-sectional, multicentre study.
Setting: Data were collected from participants diagnosed with MFS or hEDS across multiple healthcare centres.
Cureus
December 2024
Psychiatry, Krishna Institute of Medical Sciences, Krishna Vishwa Vidyapeeth (Deemed to be University), Karad, IND.
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