Objective sleep duration is associated with cognitive deficits in primary insomnia: BDNF may play a role
Objective sleep duration is associated with cognitive deficits in primary insomnia: BDNF may play a role
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客观睡眠持续时间与原发性失眠的认知缺陷相关：BDNF 可能发挥作用
DOI：
10.1093/sleep/zsy192
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发表时间：
2019-01-01
期刊：
影响因子：
5.6
通讯作者：
Liu, Jia Jia
中科院分区：
文献类型：
--
作者：
Fan, Teng-Teng;Chen, Wen-Hao;Liu, Jia Jia
研究目标：客观睡眠时间与失眠的严重程度有关。但是，很少有人解决失眠患者的认知功能。脑衍生的神经营养因子（BDNF）在认知功能中具有重要作用，并且最近与临床失眠有关。本研究旨在评估原发性睡眠持续时间不同的原发性失眠患者的全面认知功能，并进一步研究外围BDNF的参与。方法：57人失眠患者被细分为短时间的睡眠时间（SSD，睡眠时间= SSD，睡眠时间=基于多渗透学数据的6小时）组。 29个健康对照（HC）与年龄，性别和教育相匹配。使用全面和敏感的神经心理测试电池评估认知功能。估计客观和主观失眠状态。血清BDNF水平是使用酶联免疫吸附测定法测量的：与HC相比，SSD组在空间跨度，短暂的视觉空间记忆测试，流利程度，管理情绪，情绪和持续的绩效测试中显示出神经心理学的障碍。相比之下，NSD仅在简短的视觉空间记忆测试和连续性能测试中的性能不佳，并且在后一个测试中相对较好。与HC相比，SSD失眠但没有NSD的人的BDNF水平降低，而神经心理学表现仅与SSD组的BDNF水平正相关。结论：主要失眠症与神经心理学的受损相关，并且障碍可能与目标睡眠降低有关期间。此外，降低的外周BDNF可能会介导失眠患者的认知功能受损。我们发现，睡眠持续时间短的失眠症患者的认知表现要比失眠持续时间正常。我们目前的研究为先前发现的证据增加了证据，表明睡眠时间短的失眠症是一种生物学上的失眠类型，可以预测更严重的医疗状况。我们还建议外围BDNF水平可以被视为客观失眠的生物标志物，并有助于认知表现受损。因此，我们推测失眠为慢性应激源会导致BDNF水平降低，进而导致认知功能障碍。需要进一步的前瞻性研究，具有较大的样本量。
Study Objectives: Objective sleep duration has been linked to insomnia severity. However, cognitive functions of people with insomnia with different sleep durations have been seldom addressed. Brain-derived neurotrophic factor (BDNF) has an important role in cognitive function and has been linked to clinical insomnia recently. The present study aimed to evaluate the comprehensive cognitive functions in people with primary insomnia with different objective sleep durations, and further examine the involvement of peripheral BDNF.Methods: Fifty-seven people with insomnia were subdivided into short sleep duration (SSD, sleep time = 6 hr) group based on polysomnography data. Twenty-nine healthy controls (HC) were matched on age, gender, and education. Cognitive function was assessed using a comprehensive and sensitive neuropsychological test battery. Both objective and subjective insomnia statuses were estimated. Serum BDNF level was measured using enzyme-linked immune sorbent assay.Results: Compared with HC, the SSD group showed impaired neuropsychological performances in spatial span, brief visuospatial memory test, fluency, managing emotions, and continuous performance tests. In contrast, NSD had bad performance only in brief visuospatial memory test and continuous performance tests, and relatively better than SSD group in the latter test. People with SSD insomnia but not NSD had decreased BDNF levels compared with HC, and neuropsychological performance was positively correlated with BDNF levels only in SSD group.Conclusions: Primary insomnia was associated with impaired neuropsychological performance, and the impairment might be related to decreased objective sleep duration. In addition, decreased peripheral BDNF might mediate the impaired cognitive functions of people with insomnia with SSD.Statement of SignificanceThis is the first study addressing the role of brain-derived neurotrophic factor (BDNF) in cognitive functions of people with primary insomnia. We found that people with insomnia with short sleep duration had worse cognitive performance than people with insomnia with normal sleep duration. Our present study added evidence to previous findings that insomnia with short sleep duration is a biologically severer type of insomnia and could predict worse medical conditions. We also suggested that peripheral BDNF levels could be considered as a biomarker of objective insomnia and contribute to the impaired cognitive performance. We therefore speculate that insomnia as a chronic stressor leads to decreased BDNF levels, which in turn result in cognitive dysfunction. Further prospective studies with larger sample size are needed.