Sleep-related eating disorder versus sleepwalking: a controlled study.

BACKGROUND/OBJECTIVE: Sleep-related eating disorder (SRED) may have some common clinical features with sleepwalking and with eating behavior disorders. The objective of this study was to compare clinical, sleep, and eating behavior measures in patients with SRED vs. sleepwalkers and controls. METHODS: Overall, 15 patients with SRED, 21 sleepwalkers, and 20 age- and sex-matched healthy volunteers underwent interviews, completed sleep, anxiety, depression, and eating behavior scales, and had a night-time videopolysomnography. RESULTS: Patients with SRED were mainly women, had disease onset in adulthood, suffered nightly episodes and insomnia, and had more frequent eating problems in childhood and higher current anorexia scores than sleepwalkers and controls. Unlike controls, they shared several commonalities with sleepwalkers, including a high frequency (66%) of past or current sleepwalking, a similar timing of parasomnia episodes during the first half of the night, numerous arousals from stage N3, and a similarly altered level of daytime sleepiness and anxiety, but higher awareness during parasomnia episodes. Conversely, only 10% of sleepwalkers ate during their sleepwalking episodes. On videopolysomnography, the eating episodes occurred mostly within 1min after awakening from stage N2 (n=9) or stage N3 (n=6). The frequencies of restless legs syndrome, periodic leg movements, and sleep apnea were similar across the three groups. CONCLUSIONS: Patients with SRED share several clinical commonalities with sleepwalkers (although their level of awareness is higher) plus former or current eating behavior problems. It suggests that they have specialized a former sleepwalking behavior toward sleep-related eating because they are more vulnerable to eating behavior problems during the daytime.

Chemobrain: is systemic chemotherapy neurotoxic?

PURPOSE OF REVIEW: The existence of chemobrain has become almost universally accepted, although many details of the concept are controversial. Data about the different types of cognitive impairment and their duration are not always consistent in the literature. We still do not know which cytotoxic agents are responsible, which characteristics make patients vulnerable, and which biologic mechanisms are involved. RECENT FINDINGS: Through this review of the recent literature, we provide an actualized definition of chemobrain including recent functional imaging data and we debate its controversial aspects. Potential causes such as oxidative stress and their potential clinical application in the prevention and treatment of chemobrain are also discussed. Eventually, the methodological aspects of published studies are questioned and propositions are provided in order to improve the design of future trials. SUMMARY: This issue is of clinical importance given the prevalence of breast carcinoma, the increased use of chemotherapy as adjuvant therapy, the increasing use of more aggressive dosing schedules, and the increasing survival rates. Better designed future trials should lead to a better definition and understanding of chemobrain and to future therapies.

Effects of periodic interruptions on the intelligibility of speech based on temporal fine-structure or envelope cues.

The intelligibility of speech signals processed to retain either temporal envelope (E) or fine structure (TFS) cues within 16 0.4-oct-wide frequency bands was evaluated when processed stimuli were periodically interrupted at different rates. The interrupted E- and TFS-coded stimuli were highly intelligible in all conditions. However, the different patterns of results obtained for E- and TFS-coded speech suggest that the two types of stimuli do not convey identical speech cues. When an effect of interruption rate was observed, the effect occurred at low interruption rates (<8 Hz) and was stronger for E- than TFS-coded speech, suggesting larger involvement of modulation masking with E-coded speech.