The role of sleep on cognition and functional connectivity in patients with multiple sclerosis

Geest, Quinten van; Westerik, B.; Werf, Ysbrand D. van der; Geurts, Jeroen J. G.; Hulst, Hanneke E.

doi:10.1007/s00415-016-8318-6

Cited by 39 publications

(32 citation statements)

References 37 publications

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“…[37] Chronic pain may also be exacerbated by insomnia in patients with MS, and a recent study suggests that poor sleep partially mediates the relationship between pain and depression in MS patients, making this an important component to consider in the treatment of depression [38]. A recent study using functional MRI also suggests an association between insomnia and subjective (though not objective) measures of cognitive function, as well as decreased thalamic functional connectivity [39]. …”

Section: Insomniamentioning

confidence: 99%

Overview: a Framework for the Discussion of Sleep in Multiple Sclerosis

Braley

2017

Curr Sleep Medicine Rep

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Purpose of review This review will focus on the causes, consequences, workup, and treatment of sleep disordered breathing, insomnia, and restless legs syndrome in patients with MS. An approach to the discussion of sleep problems and associated symptoms with MS patients, to facilitate timely and accurate diagnosis, is emphasized. Recent findings Recent research suggests that sleep disordered breathing, insomnia, and restless legs syndrome disproportionately affect patients with MS, and contribute to substantial morbidity in this population. Summary Sleep disordered breathing, insomnia, and restless legs syndrome are common but frequently under-recognized conditions in patients with MS. Additional efforts are needed to incorporate discussions about sleep into the clinical evaluation of MS patients. Neuroanatomical features, concomitant comorbidities, and medications associated with MS may partially explain the high prevalence of these disorders in MS. Prompt identification and treatment of sleep disorders may reduce fatigue, and a thorough discussion with the MS patient about their sleep will facilitate fatigue management. Research that further characterizes recently identified relationships between sleep disturbances and other chronic symptoms in MS such as pain, depression and cognitive dysfunction could identify new pathways to improve some of the most debilitating symptoms of MS.

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Section: Insomniamentioning

confidence: 99%

Overview: a Framework for the Discussion of Sleep in Multiple Sclerosis

Braley

2017

Curr Sleep Medicine Rep

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“…MS can result in a broad range of symptoms, of which cognitive disability is of particular interest because it occurs in 40–70% of patients at both the earlier and later stages (Chiaravalloti & DeLuca, ). Based on recent convergent research, the pathogenic effects of hippocampal abnormalities are implicated in MS‐related cognitive impairment (Preziosa et al, ; Sacco et al, ; Sumowski et al, ; van Geest, Westerik, van der Werf, Geurts, & Hulst, ). The hippocampus is a key region involved in memory (Eichenbaum, ) and is vulnerable in patients with relapsing–remitting MS (RRMS; Chiaravalloti & DeLuca, ; MacKenzie‐Graham et al, ).…”

Section: Introductionmentioning

confidence: 99%

“…the pathogenic effects of hippocampal abnormalities are implicated in MS-related cognitive impairment (Preziosa et al, 2016;Sacco et al, 2015;Sumowski et al, 2016;van Geest, Westerik, van der Werf, Geurts, & Hulst, 2016). The hippocampus is a key region involved in memory (Eichenbaum, 2000) and is vulnerable in patients with relapsing-remitting MS (RRMS; Chiaravalloti & DeLuca, 2008;MacKenzie-Graham et al, 2016).…”

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confidence: 99%

Altered hippocampal GABA and glutamate levels and uncoupling from functional connectivity in multiple sclerosis

et al. 2018

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There is growing evidence for dysfunctional glutamatergic excitation and/or gamma-aminobutyric acid (GABA)ergic inhibition in patients with multiple sclerosis (MS). Cognitive impairment may occur during the early stages of MS and hippocampal abnormalities have been suggested as biomarkers. However, researchers have not clearly determined whether changes in hippocampal GABA and glutamate (Glu) levels are associated with cognitive impairment and aberrant neural activity in patients with MS. We used magnetic resonance spectroscopy to measure GABA+ and Glu levels in the left hippocampal region of 29 patients with relapsing-remitting MS and 29 healthy controls (HCs). Resting-state functional connectivity (FC) with the hippocampus was also examined. Compared to HCs, patients exhibited significantly lower GABA+ and Glu levels, which were associated with verbal and visuospatial memory deficits, respectively. Patients also showed decreased FC strengths between the hippocampus and several cortical regions, which are located within the default mode network. Moreover, hippocampal GABA+ levels and Glu/GABA+ ratios correlated with the FC strengths in HCs but not in patients with MS. This study describes a novel method for investigating the complex relationships among excitatory/inhibitory neurotransmitters, brain connectivity and cognition in health and disease. Strategies that modulate Glu and GABA neurotransmission may represent new therapeutic treatments for patients with MS.

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“…Fatigue after cancer diagnosis and treatment is also increasingly recognized as an important quality of life issue and can persist long after treatment termination [18][19][20][21][22]. Certainly, fatigue may influence cognition and cognitive perception and vice versa, and this has been more clearly demonstrated in non-oncologic populations [23,24]. Our study shows a higher overall incidence of patient reported fatigue than perceived cognitive change in this population of older survivors, with over half describing overwhelming fatigue or tiredness when queried.…”

Section: Discussionmentioning

confidence: 67%