White matter microstructure and sleep-wake disturbances in individuals at ultra-high risk of psychosis
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White matter microstructure and sleep-wake disturbances in individuals at ultra-high risk of psychosis. / Rasmussen, Jesper O.; Nordholm, Dorte; Glenthoj, Louise B.; Jensen, Marie A.; Garde, Anne H.; Ragahava, Jayachandra M.; Jennum, Poul J.; Glenthoj, Birte Y.; Nordentoft, Merete; Baandrup, Lone; Ebdrup, Bjørn H.; Kristensen, Tina D.
In: Frontiers in Human Neuroscience, Vol. 16, 1029149, 2022.Research output: Contribution to journal › Journal article › Research › peer-review
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TY - JOUR
T1 - White matter microstructure and sleep-wake disturbances in individuals at ultra-high risk of psychosis
AU - Rasmussen, Jesper O.
AU - Nordholm, Dorte
AU - Glenthoj, Louise B.
AU - Jensen, Marie A.
AU - Garde, Anne H.
AU - Ragahava, Jayachandra M.
AU - Jennum, Poul J.
AU - Glenthoj, Birte Y.
AU - Nordentoft, Merete
AU - Baandrup, Lone
AU - Ebdrup, Bjørn H.
AU - Kristensen, Tina D.
PY - 2022
Y1 - 2022
N2 - AimWhite matter changes in individuals at ultra-high risk for psychosis (UHR) may be involved in the transition to psychosis. Sleep-wake disturbances commonly precede the first psychotic episode and predict development of psychosis. We examined associations between white matter microstructure and sleep-wake disturbances in UHR individuals compared to healthy controls (HC), as well as explored the confounding effect of medication, substance use, and level of psychopathology. MethodsSixty-four UHR individuals and 35 HC underwent clinical interviews and diffusion weighted imaging. Group differences on global and callosal mean fractional anisotropy (FA) was tested using general linear modeling. Sleep-wake disturbances were evaluated using the subjective measures disturbed sleep index (DSI) and disturbed awakening index (AWI) from the Karolinska Sleep Questionnaire, supported by objective sleep measures from one-night actigraphy. The primary analyses comprised partial correlation analyses between global FA/callosal FA and sleep-wake measures. Secondary analyses investigated multivariate patterns of covariance between measures of sleep-wake disturbances and FA in 48 white matter regions of interest using partial least square correlations. ResultsUltra-high risk for psychosis individuals displayed lower global FA (F = 14.56, p < 0.001) and lower callosal FA (F = 11.34, p = 0.001) compared to HC. Subjective sleep-wake disturbances were significantly higher among the UHR individuals (DSI: F = 27.59, p < 0.001, AWI: F = 36.42, p < 0.001). Lower callosal FA was correlated with increased wake after sleep onset (r = -0.34, p = 0.011) and increased sleep fragmentation index (r = -0.31, p = 0.019) in UHR individuals. Multivariate analyses identified a pattern of covariance in regional FA which were associated with DSI and AWI in UHR individuals (p = 0.028), but not in HC. Substance use, sleep medication and antipsychotic medication did not significantly confound these associations. The association with objective sleep-wake measures was sustained when controlling for level of depressive and UHR symptoms, but symptom level confounded the covariation between FA and subjective sleep-wake measures in the multivariate analyses. ConclusionCompromised callosal microstructure in UHR individuals was related to objectively observed disruptions in sleep-wake functioning. Lower FA in ventrally located regions was associated with subjectively measured sleep-wake disturbances and was partly explained by psychopathology. These findings call for further investigation of sleep disturbances as a potential treatment target.
AB - AimWhite matter changes in individuals at ultra-high risk for psychosis (UHR) may be involved in the transition to psychosis. Sleep-wake disturbances commonly precede the first psychotic episode and predict development of psychosis. We examined associations between white matter microstructure and sleep-wake disturbances in UHR individuals compared to healthy controls (HC), as well as explored the confounding effect of medication, substance use, and level of psychopathology. MethodsSixty-four UHR individuals and 35 HC underwent clinical interviews and diffusion weighted imaging. Group differences on global and callosal mean fractional anisotropy (FA) was tested using general linear modeling. Sleep-wake disturbances were evaluated using the subjective measures disturbed sleep index (DSI) and disturbed awakening index (AWI) from the Karolinska Sleep Questionnaire, supported by objective sleep measures from one-night actigraphy. The primary analyses comprised partial correlation analyses between global FA/callosal FA and sleep-wake measures. Secondary analyses investigated multivariate patterns of covariance between measures of sleep-wake disturbances and FA in 48 white matter regions of interest using partial least square correlations. ResultsUltra-high risk for psychosis individuals displayed lower global FA (F = 14.56, p < 0.001) and lower callosal FA (F = 11.34, p = 0.001) compared to HC. Subjective sleep-wake disturbances were significantly higher among the UHR individuals (DSI: F = 27.59, p < 0.001, AWI: F = 36.42, p < 0.001). Lower callosal FA was correlated with increased wake after sleep onset (r = -0.34, p = 0.011) and increased sleep fragmentation index (r = -0.31, p = 0.019) in UHR individuals. Multivariate analyses identified a pattern of covariance in regional FA which were associated with DSI and AWI in UHR individuals (p = 0.028), but not in HC. Substance use, sleep medication and antipsychotic medication did not significantly confound these associations. The association with objective sleep-wake measures was sustained when controlling for level of depressive and UHR symptoms, but symptom level confounded the covariation between FA and subjective sleep-wake measures in the multivariate analyses. ConclusionCompromised callosal microstructure in UHR individuals was related to objectively observed disruptions in sleep-wake functioning. Lower FA in ventrally located regions was associated with subjectively measured sleep-wake disturbances and was partly explained by psychopathology. These findings call for further investigation of sleep disturbances as a potential treatment target.
KW - ultra-high risk of psychosis
KW - white matter
KW - diffusion weighted imaging
KW - sleep
KW - substance use
KW - psychopathology
KW - MENTAL STATE
KW - YOUNG-PEOPLE
KW - DIFFUSION
KW - SCHIZOPHRENIA
KW - RELIABILITY
KW - SYMPTOMS
KW - QUALITY
KW - ONSET
KW - ASSOCIATIONS
KW - METAANALYSIS
U2 - 10.3389/fnhum.2022.1029149
DO - 10.3389/fnhum.2022.1029149
M3 - Journal article
C2 - 36393990
VL - 16
JO - Frontiers in Human Neuroscience
JF - Frontiers in Human Neuroscience
SN - 1662-5161
M1 - 1029149
ER -
ID: 327481971