The relationship between sleep-wake cycle and cognitive functioning in young people with affective disorders.
The relationship between sleep-wake cycle and cognitive functioning in young people with affective disorders.
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DOI：
10.1371/journal.pone.0124710
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发表时间：
2015
期刊：
影响因子：
3.7
通讯作者：
Hickie IB
中科院分区：
文献类型：
--
作者：
Carpenter JS;Robillard R;Lee RS;Hermens DF;Naismith SL;White D;Whitwell B;Scott EM;Hickie IB
虽然早期情感障碍与认知功能障碍和睡眠-觉醒中断有关，但这些因素之间的关系尚未在年轻人中进行专门研究。情感性精神障碍患者的睡眠和昼夜节律紊乱具有相当大的异质性，并且可能与认知功能障碍没有简单的线性关系。本研究的目的是探讨情感性精神障碍患者的睡眠和昼夜节律紊乱的特征，并研究这些特征与认知能力之间的关系。在152名初步诊断为情感性精神障碍的年轻人（16-30岁; 66%为女性）和69名健康对照（18-30岁; 57%为女性）中完成了腕动计监测。患者还接受了详细的神经心理学评估。对活动记录数据进行处理，以估计睡眠和昼夜参数。患者在心理灵活性和视觉记忆相关任务上的整体神经心理学表现较差。两项分层聚类分析根据睡眠变量确定了三个不同的患者群体，根据昼夜节律变量确定了三个不同的患者群体。睡眠集群包括“长时间睡眠”集群，“中断睡眠”集群和“延迟和中断睡眠”集群。昼夜节律聚类包括“强昼夜节律”聚类、“弱昼夜节律”聚类和“延迟昼夜节律”聚类。各组之间的药物使用情况不同。与“睡眠中断”组相比，“长时间睡眠”组的视觉记忆表现明显较差。集群之间没有其他认知功能的差异。这些结果突出了情感障碍的年轻人的睡眠和昼夜节律的异质性，并提供了初步证据，支持睡眠和视觉记忆之间的关系，这可能是通过使用抗精神病药物介导的。这些发现对情感性疾病早期治疗的个性化和改善年轻人的功能具有意义。
Although early-stage affective disorders are associated with both cognitive dysfunction and sleep-wake disruptions, relationships between these factors have not been specifically examined in young adults. Sleep and circadian rhythm disturbances in those with affective disorders are considerably heterogeneous, and may not relate to cognitive dysfunction in a simple linear fashion. This study aimed to characterise profiles of sleep and circadian disturbance in young people with affective disorders and examine associations between these profiles and cognitive performance. Actigraphy monitoring was completed in 152 young people (16–30 years; 66% female) with primary diagnoses of affective disorders, and 69 healthy controls (18–30 years; 57% female). Patients also underwent detailed neuropsychological assessment. Actigraphy data were processed to estimate both sleep and circadian parameters. Overall neuropsychological performance in patients was poor on tasks relating to mental flexibility and visual memory. Two hierarchical cluster analyses identified three distinct patient groups based on sleep variables and three based on circadian variables. Sleep clusters included a ‘long sleep’ cluster, a ‘disrupted sleep’ cluster, and a ‘delayed and disrupted sleep’ cluster. Circadian clusters included a ‘strong circadian’ cluster, a ‘weak circadian’ cluster, and a ‘delayed circadian’ cluster. Medication use differed between clusters. The ‘long sleep’ cluster displayed significantly worse visual memory performance compared to the ‘disrupted sleep’ cluster. No other cognitive functions differed between clusters. These results highlight the heterogeneity of sleep and circadian profiles in young people with affective disorders, and provide preliminary evidence in support of a relationship between sleep and visual memory, which may be mediated by use of antipsychotic medication. These findings have implications for the personalisation of treatments and improvement of functioning in young adults early in the course of affective illness.
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