Relationships Among Short Self-Reported Sleep Duration, Cognitive Impairment, and Insular Functional Connectivity in Late-Life Depression

Article type: Research Article

Authors: Yang, Mingfeng^{a; b; c; 1} | Chen, Ben^{a; c; 1} | Zhou, Huarong^a | Mai, Naikeng^d | Zhang, Min^a | Wu, Zhangying^a | Peng, Qi^a | Wang, Qiang^a | Liu, Meiling^a | Zhang, Si^a | Lin, Gaohong^a | Lao, Jingyi^a | Zeng, Yijie^a | Zhong, Xiaomei^{a; c; *} | Ning, Yuping^{a; b; c; e; *}

Affiliations: [a] Geriatric Neuroscience Center, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, Guangdong Province, China | [b] The first School of Clinical Medicine, Southern Medical University, Guangzhou, Guangdong Province, China | [c] Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education of China, Guangzhou Medical University, Guangzhou, Guangdong Province, China | [d] Department of Neurology, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, Guangdong Province, China | [e] Guangdong Engineering Technology Research Center for Translational Medicine of Mental Disorders, Guangzhou, Guangdong Province, China

Correspondence: [*] Correspondence to: Yuping Ning and Xiaomei Zhong, Department of Geriatric Psychiatry, The Affiliated Brain Hospital of Guangzhou Medical University, No.36, Mingxin Road, Liwan District, Guangzhou, Guangdong 0086 510370, China. Tel.:+86 020 81268181; Fax: +86 020 81891351; E-mails: ningjeny@126.com and lovlaugh@163.com.

Note: [1] These authors contributed equally to this work.

Abstract: Background:Both late-life depression (LLD) and short sleep duration increase the risk of cognitive impairment. Increased insular resting-state functional connectivity (FC) has been reported in individuals with short sleep duration and dementia. Objective:This study aimed to investigate whether short sleep duration is associated with impaired cognition and higher insular FC in patients with LLD. Methods:This case– control study recruited 186 patients with LLD and 83 normal controls (NC), and comprehensive psychometric assessments, sleep duration reports and resting-state functional MRI scans (81 LLD patients and 54 NC) were conducted. Results:Patients with LLD and short sleep duration (LLD-SS patients) exhibited more severe depressive symptoms and worse cognitive function than those with normal sleep duration (LLD-NS patients) and NC. LLD-SS patients exhibited higher FC between the bilateral insula and inferior frontal gyrus (IFG) pars triangularis than LLD-NS patients and NC, while LLD-NS patients exhibited lower FC than NC. Increased insular FC was correlated with short sleep duration, severe depressive symptoms, and slower information processing speeds. Furthermore, an additive effect was found between sleep duration and LLD on global cognition and insular FC. Conclusion:LLD-SS patients exhibited impaired cognition and increased insular FC. Abnormal FC in LLD-SS patients may be a therapeutic target for neuromodulation to improve sleep and cognitive performance and thus decrease the risk of dementia.

Keywords: Alzheimer’s disease, cognitive impairment, functional connectivity, late-life depression, MRI, sleep duration

DOI: 10.3233/JAD-220968

Journal: Journal of Alzheimer's Disease, vol. 93, no. 4, pp. 1317-1327, 2023