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associated with comorbid anxiety, mood, and personality disorders in both civilians and veterans. 3,4 PTSD is also associated with cardiovascular disease, arthritis, asthma, chronic pain, diabetes, bone and joint conditions, and gastrointestinal disorders, 3 leading to high utilization of health services. The prevalence of PTSD and its impact on health and healthcare utilization has prompted extensive research on effective ways to treat it. In 2017, the Department of Veterans Affairs (VA (...) Treatments for Posttraumatic Stress Disorder: Groundwork for a Publicly Available Repository of Randomized Controlled Trial Data Structured Abstract Background. Posttraumatic stress disorder (PTSD) reduces quality of life and functioning. People with PTSD have symptoms such as intrusive thoughts, nightmares, flashbacks, avoidance of trauma-related stimuli, negative beliefs about themselves and/or others, and hypervigilance. The symptoms may be due to direct or indirect exposure to trauma
Validity of the Mattis Dementia Rating Scale to Detect Mild Cognitive Impairment in Parkinson's Disease and REMSleepBehaviorDisorder. Mild cognitive impairment (MCI) is frequent in Parkinson's disease (PD) and idiopathic REMsleepbehaviordisorder (iRBD). However, only a few studies have evaluated the validity of brief cognitive measures to detect MCI in PD or iRBD using standard diagnostic criteria for MCI. Our aim was to evaluate the validity of the Mini-Mental State Examination (MMSE
Associated factors for REMsleepbehaviordisorder in Parkinson disease. To investigate the frequency, phenomenology, and associated risk factors of REMsleepbehaviordisorder (RBD) in Parkinson disease (PD).An unselected cohort of sleep-disturbed patients with PD (n=457) was investigated with video-supported polysomnography. We determined the frequency of RBD and analyzed the influence of age, clinical disease features, disease duration, cognitive and physical impairment, medication (...) of levodopa (p=0.002). The presence of RBD was related to slightly increased sleep efficiency (p=0.007), a higher amount of REMsleep (p=0.000), and more periodic leg movements during sleep (p=0.019).RBD is a frequent and clinically relevant nocturnal disturbance for all stages of PD. It increases with age and disease duration and may contribute to the nocturnal problems of patients with PD and their bed partners.
Stage III and REMsleep and increased sleep latency and wake after sleep onset time. Following levodopa, improved sleep efficiency with reduced sleep latency and wake after sleep onset time was noted, coupled with improved PDSS scores. However, NREM Stage III and REMsleep duration did not increase.PD patients take longer to fall asleep and have difficulty in sleep maintenance. Sleep maintenance is affected by nocturia, REMbehavioraldisorder, nocturnal cramps, akinesia, and tremors, as observed (...) Sleep disturbances in drug naÃ¯ve Parkinson's disease (PD) patients and effect of levodopa on sleep Parkinson's disease (PD) is associated with sleep disturbances, attributed to the neurodegenerative process and therapeutic drugs. Studies have found levodopa to increase wakefulness in some patients while increasing sleepiness in others.To confirm sleep disturbances in drug naïve PD patients and understand the impact of levodopa on their sleep.Twenty-three drug naïve PD patients and 31 age
table for MeSH terms Depression Depressive Disorder Depressive Disorder, Major Respiratory Aspiration Sleep Apnea SyndromesBehavioral Symptoms Mood Disorders Mental Disorders Respiration Disorders Respiratory Tract Diseases Pathologic Processes Apnea SleepDisorders, Intrinsic Dyssomnias Sleep Wake Disorders Nervous System Diseases (...) with depression and sleep-disordered breathing. Participants will be randomly assigned to receive either PAP therapy (PAP group) or treatment as usual within obstetrics (TAU group). Mood and sleep assessments will be completed at baseline, after 1 week of enrollment, and monthly thereafter through 12 weeks postpartum. Cortisol will be measured using saliva collection at baseline and again 8 weeks later. Condition or disease Intervention/treatment Phase Sleep-disordered Breathing Major Depressive Disorder
-PD, excessive daytime sleepiness (EDS) was a complaint in 33% patients and short sleep latencies on the MSLT, which are indicative of objective EDS, were found in 71%. Sleep attacks occurred in three LRRK2-PD patients and a narcoleptic phenotype was not observed. REMsleepbehaviordisorder (RBD) was diagnosed in three LRRK2-PD. EDS and RBD were always reported to start after the onset of parkinsonism in LRRK2-PD. In NMC, EDS was rarely reported and RBD was absent. When compared to IPD, sleep (...) SleepDisorders in Parkinsonian and Nonparkinsonian LRRK2 Mutation Carriers In idiopathic Parkinson disease (IPD) sleepdisorders are common and may antedate the onset of parkinsonism. Based on the clinical similarities between IPD and Parkinson disease associated with LRRK2 gene mutations (LRRK2-PD), we aimed to characterize sleep in parkinsonian and nonmanifesting LRRK2 mutation carriers (NMC).A comprehensive interview conducted by sleep specialists, validated sleep scales and questionnaires
Effects of Sleep on Memory for Conditioned Fear and Fear Extinction. Learning and memory for extinction of conditioned fear is a basic mammalian mechanism for regulating negative emotion. Sleep promotes both the consolidation of memory and the regulation of emotion. Sleep can influence consolidation and modification of memories associated with both fear and its extinction. After brief overviews of the behavior and neural circuitry associated with fear conditioning, extinction learning (...) deprivation experiments. REMsleep is accompanied by selective activation of the same limbic structures implicated in the learning and memory of fear and extinction. Preliminary evidence also suggests extinction learning can take place during slow wave sleep. Study of low-level processes such as conditioning, extinction, and habituation may allow sleep effects on emotional memory to be identified and inform study of sleep's effects on more complex, emotionally salient declarative memories. Anxiety
. Alterations of the sleep/wakefulness behavior experienced as insomnia, excessive daytime sleepiness, sleep/wake cycle fragmentation and REMsleepbehaviordisorder are among the non-motor symptoms that predate motor alterations and inevitably worsen over disease progression. The absence of adequate humanized animal models with the perfect phenocopy of these sleep alterations contribute undoubtedly to the lack of efficient therapies for these non-motor complications. In the context of developing efficient (...) translational therapies, we provide an overview of the strengths and limitations of the various currently available models to replicate sleep alterations of Parkinson's disease. Our investigation reveals that although these models replicate dopaminergic deficiency and related parkinsonism, they rarely display a combination of sleep fragmentation and excessive daytime sleepiness and never REMsleepbehaviordisorder. In this light, we critically discuss the construct, face and predictive validities of both
oophorectomy, all with surgery at least 1 month before dosing). A current diagnosis of sleep-related breathing disorder, periodic limb movement disorder, restless legs syndrome, circadian rhythm sleepdisorder, or narcolepsy, or an exclusionary score on screening instruments to rule out individuals with symptoms of certain sleepdisorders other than insomnia. Reports experiencing within the past year confusional arousals, symptoms of REMBehaviorDisorder, or sleep-related violent behavior on Munich (...) : Completed First Posted : January 29, 2015 Last Update Posted : November 3, 2015 Sponsor: Eisai Inc. Information provided by (Responsible Party): Eisai Inc. Study Details Study Description Go to Brief Summary: This is a single-dose, randomized, placebo-controlled, 3-way crossover study of 2 dosage strengths of E2006 (5 mg and 10 mg) in subjects with insomnia disorder. Condition or disease Intervention/treatment Phase Insomnia Disorder Drug: E2006 5 mg Drug: E2006 10 mg Drug: E2006-matched placebo Drug
Sleep and behavior during vesicular stomatitis virus induced encephalitis in BALB/cJ and C57BL/6J mice. Intranasal application of vesicular stomatitis virus (VSV) produces a well-characterized model of viral encephalitis in mice. Within one day post-infection (PI), VSV travels to the olfactory bulb and, over the course of 7 days, it infects regions and tracts extending into the brainstem followed by clearance and recovery in most mice by PI day 14 (PI 14). Infectious diseases are commonly (...) consecutive days and analyzed on PI 0, 1, 3, 5, 7, 10, and 14. Compared to baseline, amounts of non-rapid eye movement sleep (NREM) were increased in B6 mice during the dark period of PI 1-5, whereas rapid eye movement sleep (REM) was significantly reduced during the light periods of PI 0-14. In contrast, BALB/c mice showed significantly fewer changes in NREM and REM. These data demonstrate sleep architecture is differentially altered in these mouse strains and suggests that, in B6 mice, VSV can alter
Pharmacological Targeting of the Mammalian Clock Regulates Sleep Architecture and Emotional Behavior Synthetic drug-like molecules that directly modulate the activity of key clock proteins offer the potential to directly modulate the endogenous circadian rhythm and treat diseases associated with clock dysfunction. Here we demonstrate that synthetic ligands targeting a key component of the mammalian clock, the nuclear receptors REV-ERBα and β, regulate sleep architecture and emotional behaviour (...) in mice. REV-ERB agonists induce wakefulness and reduce REM and slow-wave sleep. Interestingly, REV-ERB agonists also reduce anxiety-like behaviour. These data are consistent with increased anxiety-like behaviour of REV-ERBβ-null mice, in which REV-ERB agonists have no effect. These results indicate that pharmacological targeting of REV-ERB may lead to the development of novel therapeutics to treat sleepdisorders and anxiety.
or early neurodegenerative dis- orders. Here, our data shows that greater nocturnal wakefulness as measured by actigraphic monitoring Figure 3 The normal synchronous relationships between sleep and daytime activity and cortisol, melatonin and body temperature. Hickie et al. BMC Medicine 2013, 11:79 Page 11 of 27 http://www.biomedcentral.com/1741-7015/11/79relates to neuropsychological dysfunction in late-life de- pression , mild cognitive impairment , and REMsleepbehaviordisorder (...) depression, but expressed to a lesser degree [177-184] ? Biological rhythms Higher levels of ‘eveningness’ preference  Lower circadian amplitude  Delayed sleep phase and melatonin onset, especially in those with bipolar disorder [123,212] Elevated evening/nighttime cortisol levels [186,187] Late-life depression ? Macro and microarchitecture of sleep Lower increase in REMsleep duration  Otherwise similar features to that seen in adult depression, but more pronounced  ? Biological
on a speakers bureau for Allergan Inc.; and receives research support from the NIH Office of Rare Diseases Research via the Dystonia Coalition, unrelated to the content of this guideline. His spouse has received an NIH grant unrelated to the content of this guideline. 5 F. Hammond is a member of the ACRM Disorders of Consciousness Task Force; served on the US Department of Defence INTrust Scientific Advisory Council and Avanir Prism II Study Steering Committee; has received royalties from Demos Publishing (...) diagnostic assessment procedures that incorporate the Aspen Neurobehavioral Workgroup criteria accurately detect behavioral signs of consciousness or differentiate specific DoCs (VS/UWS, MCS, and posttraumatic confusional state [PTCS]) compared with consensus-based diagnostic opinion or standardized behavioral assessment. Readers are referred to a previously published systematic review completed by the ACRM Disorders of Consciousness Task Force that provides evidence-based recommendations for clinical
functioning (eg, nighttime disruption). Behavioral problems (eg, bedtime avoidance, fear of the dark). Daytime sleepiness. Fatigue or low energy. Impaired occupational or educational function. Impaired interpersonal/social function. Nightmare disorder is common, affecting 4% of the adult population in the United States. Nightmare disorder negatively impacts quality of life, resulting in sleep avoidance and deprivation. – It can also cause or exacerbate underlying psychiatric distress and illness (...) significantly impair quality of life. This paper provides the American Academy of Sleep Medicine (AASM) position regarding various treatments of nightmare disorder in adults. Methods: A literature search was performed based upon the keywords and MeSH terms from the Best Practice Guide for the Treatment of Nightmare Disorder in Adults that was published in 2010 by the AASM. The search used the date range March 2009 to August of 2017, and sought to find available evidence pertaining to the use of behavioral
Academy of Neurology AEs: adverse effects ALT: alanine aminotransferase ARRs: annualized relapse rates AST: aspartate aminotransferase CIS: clinically isolated syndrome CMSC: Consortium of Multiple Sclerosis Centers” COI: conflict of interest CV: curriculum vitae DMTs: disease-modifying therapies EDSS: Expanded Disability Status Scale FDA: US Food and Drug Administration GDDI: Guideline Development, Dissemination, and Implementation Subcommittee IOM: Institute of Medicine mIUs: milli-international (...) , and stopping disease-modifying therapies (DMTs) for multiple sclerosis (MS) in people with clinically isolated syndrome (CIS), relapsing ?remitting MS (RRMS), and progressive forms of MS; and to develop recommendations for starting, switching, and stopping DMTs. Methods: The guideline panel followed the American Academy of Neurology (AAN) 2011 guideline development process, as amended. Relevant, peer-reviewed research articles, systematic reviews, and abstracts were identified using a literature search
Behavioural and Cognitive-Behavioural Treatments of Parasomnias Parasomnias are unpleasant or undesirable behaviours or experiences that occur predominantly during or within close proximity to sleep. Pharmacological treatments of parasomnias are available, but their efficacy is established only for few disorders. Furthermore, most of these disorders tend spontaneously to remit with development. Nonpharmacological treatments therefore represent valid therapeutic choices. This paper reviews (...) behavioural and cognitive-behavioural managements employed for parasomnias. Referring to the ICSD-3 nosology we consider, respectively, NREM parasomnias, REM parasomnias, and other parasomnias. Although the efficacy of some of these treatments is proved, in other cases their clinical evidence cannot be provided because of the small size of the samples. Due to the rarity of some parasomnias, further multicentric researches are needed in order to offer a more complete account of behavioural and cognitive
-Rolandic cortices in CBS, we used digital pathology to count Lewy bodies and to quantify intracytoplasmic and neuritic α-synuclein and phospho-tau burden in the motor cortex.DLBD patients with antemortem features of CBS were significantly younger at disease onset and less likely to have REMsleepbehaviordisorder than DLBD cases who met clinical criteria for DLB during life. Patients with DLBD manifesting as CBS had more Lewy bodies in the motor cortex than DLBD manifesting as clinically probable DLB (...) Diffuse Lewy body disease manifesting as corticobasal syndrome: A rare form of Lewy body disease. To describe clinical and pathologic characteristics of diffuse Lewy body disease (DLBD) manifesting as corticobasal syndrome (CBS).In 523 autopsy-confirmed cases of DLBD, we identified 11 patients diagnosed with CBS. For comparison, we studied 22 DLBD brains with antemortem presentation of dementia with Lewy bodies (DLB). Given previous studies suggesting the importance of pathology in peri
A motor signature of REMsleepbehaviordisorder. The purpose of this study was to determine if there was a common pattern in movements during REMsleepbehaviordisorder (RBD).We blindly compared video-monitored movements during RBD (n = 136 clips) and wakefulness/arousal (n = 53 clips) in patients with Parkinson's disease (n = 29) and without parkinsonism (idiopathic RBD, n = 31; narcolepsy, n = 5).The scorers accurately guessed the sleep/wake stage of 94% of video clips. Compared with wake (...) movements, RBD movements were faster and more often repeated, jerky, and pseudohallucinatory, not self-centered, never associated with tremor, and rarely involved the environment in an appropriate manner. A specific posture of the hand (limp wrist with flexed digits) during grasping movements was evidenced during RBD in 48% of patients, reminiscent of hand-babbling in babies.These characteristics of movements were found in the 3 conditions (Parkinson's disease, idiopathic RBD, and primary narcolepsy