A case of confusional arousal in an elderly man / 中华神经科杂志

Confusional arousal (CA) is a rare non-rapid eye movement sleep-related parasomnia and rarely reported in China, leading to misdiagnosis and mistreatment in clinic. A detailed collection of clinical symptoms and simultaneous video polysomnography is very important for diagnosis and differential diagnosis of CA. A elderly patient with CA was diagnosed according to the International classification of sleep disorders, third edition diagnostic criteria. The summary and analysis of the patient is conducted to improve the understanding of CA, meanwhile to avoid misdiagnosis and mistreatment.

Changed serum levels of neurotrophic factors and their correlations with sleep and cognition in patients with chronic insomnia disorder / 中华神经科杂志

Objective@#To explore serum levels of brain-derived neurotrophic factor (BDNF) and glial-derived neurotrophic factor (GDNF), and whether changes of BDNF and GDNF are correlated with sleep quality and cognitive function in patients with chronic insomnia disorder (CID).@*Methods@#Fifty-seven CID patients in the Department of Sleep Disorders, Chaohu Hospital of Anhui Medical University and 30 healthy controls were enrolled from May 2017 to July 2018. Pittsburgh Sleep Quality Index (PSQI) was used to assess the degree of insomnia severity (some CID patients were monitored by overnight polysomnography). Montreal Cognitive Assessment (MoCA) scale and Nine-Box Maze were used to assess general cognitive function and specific memory function, respectively. The serum levels of BDNF and GDNF were detected using ELISA.@*Results@#Compared to the controls, CID patients had significantly higher PSQI scores (CID patients: 14.0±2.2, healthy controls: 3.9±1.1; t=28.093, P<0.01), lower MoCA scores (CID patients: 24.5±3.6, healthy controls: 26.5±0.9; t=-2.985, P<0.01), more errors in object working memory (CID patients: 1.0 (0, 1.0), healthy controls: 0 (0, 0.3)), spatial working memory (CID patients: 3.0 (2.0, 4.0), healthy controls: 1.0 (1.0, 2.0)) and object recognition memory (CID patients: 0 (0, 0), healthy controls: 0 (0, 0); Z=-2.896、-5.007、-2.306, P<0.05), and lower serum BDNF (CID patients: (19.48±7.50) ng/ml, healthy controls: (46.49±13.33) ng/ml; t=-10.274, P<0.01) and GDNF (CID patients: (32.76±14.04) pg/ml, healthy controls: (59.63±20.30) pg/ml; t=-7.240, P<0.01). The partial correlation analysis showed that in the CID patients, the levels of BDNF and GDNF were correlated with PSQI scores negatively (r=-0.293, -0.320, P<0.05) and MoCA scores positively (r=0.331, 0.295, P<0.05). The BDNF level was also correlated with the duration of disease and the errors in the spatial working memory test negatively (r=-0.319, -0.393, P<0.05), and the GDNF level was correlated with the total sleep time detected with polysomnogram positively (r=0.520, P<0.05).@*Conclusion@#Serum BDNF and GDNF levels in CID patients were lower than those in healthy controls, and correlated with sleep quality and cognitive impairment.

Changed serum levels of neurotrophic factors and their correlations with sleep and cognition in patients with chronic insomnia disorder / 中华神经科杂志

Objective@#To explore serum levels of brain-derived neurotrophic factor (BDNF) and glial-derived neurotrophic factor (GDNF), and whether changes of BDNF and GDNF are correlated with sleep quality and cognitive function in patients with chronic insomnia disorder (CID).@*Methods@#Fifty-seven CID patients in the Department of Sleep Disorders, Chaohu Hospital of Anhui Medical University and 30 healthy controls were enrolled from May 2017 to July 2018. Pittsburgh Sleep Quality Index (PSQI) was used to assess the degree of insomnia severity (some CID patients were monitored by overnight polysomnography). Montreal Cognitive Assessment (MoCA) scale and Nine-Box Maze were used to assess general cognitive function and specific memory function, respectively. The serum levels of BDNF and GDNF were detected using ELISA.@*Results@#Compared to the controls, CID patients had significantly higher PSQI scores (CID patients: 14.0±2.2, healthy controls: 3.9±1.1; t=28.093, P<0.01), lower MoCA scores (CID patients: 24.5±3.6, healthy controls: 26.5±0.9; t=-2.985, P<0.01), more errors in object working memory (CID patients: 1.0 (0, 1.0), healthy controls: 0 (0, 0.3)), spatial working memory (CID patients: 3.0 (2.0, 4.0), healthy controls: 1.0 (1.0, 2.0)) and object recognition memory (CID patients: 0 (0, 0), healthy controls: 0 (0, 0); Z=-2.896、-5.007、-2.306, P<0.05), and lower serum BDNF (CID patients: (19.48±7.50) ng/ml, healthy controls: (46.49±13.33) ng/ml; t=-10.274, P<0.01) and GDNF (CID patients: (32.76±14.04) pg/ml, healthy controls: (59.63±20.30) pg/ml; t=-7.240, P<0.01). The partial correlation analysis showed that in the CID patients, the levels of BDNF and GDNF were correlated with PSQI scores negatively (r=-0.293, -0.320, P<0.05) and MoCA scores positively (r=0.331, 0.295, P<0.05). The BDNF level was also correlated with the duration of disease and the errors in the spatial working memory test negatively (r=-0.319, -0.393, P<0.05), and the GDNF level was correlated with the total sleep time detected with polysomnogram positively (r=0.520, P<0.05).@*Conclusion@#Serum BDNF and GDNF levels in CID patients were lower than those in healthy controls, and correlated with sleep quality and cognitive impairment.

Correlations of serum sympathetic activity markers with sleep and cognition in patients with chronic insomnia / 中华神经科杂志

Objective:To explore the changes of serum levels of copeptin and α-amylase and their correlations with sleep and cognition in patients with chronic insomnia (CI).Methods:From September 1, 2018 to May 31, 2019, fifty CI outpatients or inpatients from the Department of Sleep Disorder, Affiliated Chaohu Hospital of Anhui Medical University, were enrolled continuously, and thirty good sleepers from the Physical Examination Center of the hospital, were also enrolled to serve as controls. Pittsburgh Sleep Quality Index (PSQI), polysomnography (PSG) and Pre-Sleep Arousal Scale (PSAS) were used to assess the insomnia severity and sleep disorder susceptibility. Montreal Cognitive Assessment scale (MoCA) and Nine-Box Maze were used to respectively assess general cognition and memories. The serum levels of copeptin and α-amylase were detected using enzyme linked immunosorbent assay.Results:Compared to the controls, the CI patients had increased PSQI score (16.0 (15.0, 17.0) vs 4.0 (2.8, 6.0); Z=-7.678, P<0.001) and PSAS score (33.0 (30.0, 37.5) vs 17.0 (16.0, 18.5); Z=-7.350, P<0.001), decreased MoCA score (24.1±2.5 vs 26.7±1.9, t=-4.625, P<0.001), increased numbers of errors in the object working (1.0 (0, 1.0) vs 0 (0, 1.0), Z=-2.099, P=0.036), spatial working (2.0 (1.0, 4.0) vs 1.0 (0, 2.0), Z=-3.935, P<0.001) and object recognition (1.0 (0, 2.0) vs 0 (0, 0), Z=-2.266, P=0.023) memories, and elevated serum levels of copeptin ((35.1±19.9) pg/ml vs (14.8±6.9) pg/ml, t=5.414, P<0.001) and α-amylase ((990.1±193.7) U/L vs (728.9±230.5) U/L, t=5.597, P<0.001). In the CI patients, the level of copeptin was positively correlated with PSQI score ( r=0.338, P=0.013), PSAS score ( r=0.316, P=0.021), sleep latency ( r=0.324, P=0.018), number of awake ( r=0.325, P=0.017) and stage 1 percent of non-rapid eye movement sleep ( r=0.278, P=0.044), and negatively correlated with stage 2 percent of non-rapid eye movement sleep ( r=-0.279, P=0.043); α-amylase was positively correlated with numbers of awake in PSG ( r=0.293, P=0.033). Multiple linear regression analysis showed that copeptin level affected PSQI score (β=0.255, P=0.043) and sleep latency (β=0.254, P=0.043). Conclusion:The levels of copeptin and α-amylase in CI patients elevate, and copeptin may be associated with initial sleep difficulties, but not with cognitive ability, in patients with CI.

Changed serum levels of neurotrophic factors and their correlations with sleep and cognition in patients with chronic insomnia disorder / 中华神经科杂志

Objective To explore serum levels of brain-derived neurotrophic factor (BDNF) and glial-derived neurotrophic factor (GDNF),and whether changes of BDNF and GDNF are correlated with sleep quality and cognitive function in patients with chronic insomnia disorder (CID).Methods Fifty-seven CID patients in the Department of Sleep Disorders,Chaohu Hospital of Anhui Medical University and 30 healthy controls were enrolled from May 2017 to July 2018.Pittsburgh Sleep Quality Index (PSQI) was used to assess the degree of insomnia severity (some CID patients were monitored by overnight polysomnography).Montreal Cognitive Assessment (MoCA) scale and Nine-Box Maze were used to assess general cognitive function and specific memory function,respectively.The serum levels of BDNF and GDNF were detected using ELISA.Results Compared to the controls,CID patients had significantly higher PSQI scores (CID patients:14.0±2.2,healthy controls:3.9± 1.1;t=28.093,P＜0.01),lower MoCA scores (CID patients:24.5±3.6,healthy controls:26.5±0.9;t=-2.985,P＜0.01),more errors in object working memory(CID patients:1.0 (0,1.0),healthy controls:0 (0,0.3)),spatial working memory (CID patients:3.0 (2.0,4.0),healthy controls:1.0 (1.0,2.0)) and object recognition memory (CID patients:0 (0,0),healthy controls:0 (0,0);Z=-2.896、-5.007、-2.306,P＜0.05),and lower serum BDNF (CID patients:(19.48 ± 7.50) ng/ml,healthy controls:(46.49± 13.33) ng/ml;t=-10.274,P＜0.01) and GDNF (CID patients:(32.76± 14.04) pg/ml,healthy controls:(59.63±20.30) pg/ml;t=-7.240,P＜0.01).The partial correlation analysis showed that in the CID patients,the levels of BDNF and GDNF were correlated with PSQI scores negatively (r=-0.293,-0.320,P＜0.05) and MoCA scores positively (r=0.331,0.295,P＜0.05).The BDNF level was also correlated with the duration of disease and the errors in the spatial working memory test negatively (r=-0.319,-0.393,P＜0.05),and the GDNF level was correlated with the total sleep time detected with polysomnogram positively (r=0.520,P＜0.05).Conclusion Serum BDNF and GDNF levels in CID patients were lower than those in healthy controls,and correlated with sleep quality and cognitive impairment.

Observation of curative effect of Wenxinkeli combined with buspironeon patients with cardiac neurosis associated with ST-T changes / 安徽医科大学学报

Objective To observe the effects of Wenxinkeli combination use with buspirone on the treatment of cardiac neurosis with ST-T changes.Methods Ninety patients with cardiac neuropathy were randomly divided into placebo group, Wenxin Granule group and combination use group (Wenxinkeli combination use with buspirone),30 cases in each group.The scores of HAMA-14 and HAMD-24 of the three groups were observed at the end of 4 and 8 weeks after treatment when the score of SF-36 and the improvement of ST-T of combination use group were evaluated followed 12 weeks treatment.Results After 4 weeks of treatment, the two scale scores of combination use group and the Wenxinkeli group, including HAMD-24 and HAMA-14, were significantly lower than the placebo group (P<0.05).In comparison with placebo group, the scores of HAMD-24 and the HAMA-14 were significantly lower after 8 weeks treatment.After 12 months of follow-up treatment, the SF-36 scores of combination use group were significantly higher than the other two groups'(P<0.05).Meanwhile, our results showed that the ST-T changes of the combination use group was significantly improved than the other two groups'(P<0.05).Conclusion The treatment of Wenxinkeli combination use with buspirone can significantly decrease anxiety and improve depression in patients with cardiac neurosis, moreover, long-term combination use treatment can distinctly improve patients' quality of life and relieve their physical symptoms of ST-T changes.

Changes of procedural memory in patients with primary insomnia / 中华神经科杂志

Objective To explore changes of procedural memory in patients with primary insomnia(PI) and its characteristics.Methods Thirty-six PI patients and 36 controls were enrolled.The procedural memory was respectively detected with category exemplar generation and motor sequence tasks,and the declarative memory was assessed by free recall task.Results Compared with the controls,PI patients showed few correct numbers in the category exemplar generation (7.0 (6.0,8.8) vs 9.0 (9.0,11.0),Z=5.537,P＜0.01) and motor sequence task (8.0±3.3 vs 11.5 (8.6,13.8),Z=4.152,P＜ 0.01)and the phases of immediate recall (3.0 (2.3,4.0) vs 6.0 (5.0,7.0),Z =6.479,P ＜ 0.01),delayed recall (9.0 ± 2.2 vs 11.0 (10.0,12.0),Z =4.747,P ＜ 0.01) and delayed recognition (15.0 (13.0,15.0) vs 15.0 (15.0,15.0),Z=4.637,P＜0.01) of the free recall task.Furthermore,the early morning awakening group had significantly lower correct numbers in the motor sequence task,the delayed recall and recognition phases of the free recall task than the difficulty initiating and maintaining sleep groups.Conclusion The procedural and declarative memories are impaired in the PI patients,especially the early morning awakening insomniacs.