Sleep and sleep deprivation differentially alter white matter microstructure: A mixed model design utilising advanced diffusion modelling

Voldsbekk, Irene; Groote, Inge Rasmus; Zak, Nathalia; Roelfs, Daniël; Geier, Oliver; Due‐Tønnessen, Paulina; Løkken, Lise Linn; Strømstad, Marie; Blakstvedt, Taran Y; Kuiper, Yvonne S; Elvsåshagen, Torbjørn; Westlye, Lars T.; Bjørnerud, Atle; Maximov, Ivan I.

doi:10.1016/j.neuroimage.2020.117540

Cited by 31 publications

(33 citation statements)

References 60 publications

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“…A group of Norwegian investigators [ 5 ] recently reported on a cohort of healthy volunteers in whom they studied sleep deprivation, a condition during which the top half of the brain has been sitting on the bottom half for too long—possibly resulting in excessive gravitational ischemia. They used novel brain MRI techniques to examine the white matter microstructure of subjects compared to a control group.…”

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confidence: 99%

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Gravity-induced ischemia in the brain-and prone positioning for COVID-19 patients breathing spontaneously

Jaster

Ottaviani

2022

Acute Crit Care

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A group of Tunisian investigators recently explored whether the early application of prone positioning can improve severe hypoxemia and respiratory failure in coronavirus disease 2019 patients with spontaneous breathing-through a prospective observational study of patients admitted to the intensive care unit (ICU). After studying 21 subject-patients and 17 control-patients, who underwent prone positioning within 6 hours following ICU admission, they reported affirmatively in Acute and Critical Care [1] that yes, early prone positioning can improve severe hypoxemia-and significantly so.But there was still a problem. The resolution of hypoxemia resulted in no change in the rate of mortality, or in the need for mechanical ventilation. How can that be possible? If ventilation/perfusion ratios are improving significantly throughout the lungs, and measured respiratory parameters are improving, why are patients still dying at the same rate? The answer may lie not in the lungs, but elsewhere. The Tunisian Investigators, in designing this study, made use of gravitational considerations within the lungs. In prone positioning, the beneficial changes in ventilation/perfusion ratios are based largely on gravity. But no one made use of gravitational considerations within the brain-even as concurrent reports [2,3] from 2021 have suggested their importance.In the article, "Impact of prone position on outcomes of COVID-19 patients with spontaneous breathing" [1] all of 21 subject-patients were placed in prone position for 2 to 4 hours (as tolerated by the patient) followed by 2 hours of supine positioning during the day, and placed in prone position at night, when possible. "Gravitational ischemia in the brain" results from the mass effect of one part of the brain upon another in a gravitational field [2,3]. In any given head position, the top half of the brain (farthest from the center of the earth) is sitting on the bottom half as a weight-burden. In healthy individuals, head and body positions are roughly vertical for 16 hours a day, and then roughly horizontal for 8 hours at night during sleep. Ischemia, which may form on the bottom layers, is reversible in its early stages [2,3].Gravitational ischemia in the brain may potentially be largely preventable by frequently changing the head tilt-just as ischemic skin breakdown, bed sores, and decubitus ulcers are currently prevented by frequent changes in general body positioning, focused on the effects of gravity. It might have been reasonably hoped that alternating between supine and prone positioning "rotisserie-style" would significantly relieve gravitational ischemia in the brain; but research results, like those of the Tunisian Investigators, suggest that this may not always

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confidence: 99%

“…The Norwegian investigators found significant white matter changes during sleep deprivation compared to during a normal sleep/wake cycle—which they considered to represent changes in axonal diffusivity [ 2 , 5 ].…”

mentioning

confidence: 99%

Gravity-induced ischemia in the brain-and prone positioning for COVID-19 patients breathing spontaneously

Jaster

Ottaviani

2022

Acute Crit Care

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“…Recent sleep deprivation studies looking at more global diffusivity have observed similar changes in fractional anisotropy (Elvsåshagen et al, 2015;Voldsbekk et al, 2021;Voldsbekk et al, 2020). Specifically, fractional anisotropy increased throughout the waking day, but decreased during sleep deprivation in relation to increased radial diffusivity and decreased axial diffusivity (Elvsåshagen et al, 2015;Voldsbekk et al, 2020).…”

Section: Discussionmentioning

confidence: 79%

Age Differences in Diffusivity in the Locus Coeruleus and its Ascending Noradrenergic Tract

Porat

Sibilia

Yoon

et al. 2021

Preprint

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The noradrenergic locus coeruleus (LC) is a small brainstem nucleus that promotes arousal and attention. Recent studies have examined the microstructural properties of the LC using diffusion-weighted magnetic resonance imaging and found unexpected age-related differences in fractional anisotropy - a measure of white matter integrity. Here, we used three datasets (Berlin Aging Study-II, N = 301, the Leipzig Study for Mind-Body-Emotion Interactions, N = 220, and Stockholm Sleepy Brain, N = 49), to replicate published findings and expand them by investigating diffusivity in the LC’s ascending noradrenergic bundle. In younger adults, LC fractional anisotropy was significantly lower, compared to older adults. However, in the LC’s ascending noradrenergic bundle, we observed significantly higher fractional anisotropy in younger adults, relative to older adults. These findings indicate that diffusivity in the LC versus the ascending noradrenergic bundle are both susceptible to microstructural changes in aging that have opposing effects on fractional anisotropy.HighlightsFractional anisotropy in the locus coeruleus was lower in younger adultsFractional anisotropy in the noradrenergic bundle was higher in younger adultsSleep deprivation may affect diffusivity in younger adults more than older adults

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“…A small collection of concurrent reports may potentially contribute to the "mechanistic insight' sought by the metabolism physiology investigators-as to why sleep deprivation is associated with changes in muscle metabolism. A group of Norwegian sleep investigators (Voldsbekk et al, 2021) recently reported on a cohort of healthy volunteers in whom they studied sleep deprivation using novel brain magnetic resonance imaging (MRI) techniques to examine the white matter microstructure compared to a control group. They found significant white matter changes during sleep deprivation compared to during a normal sleep/wake cycle-which they considered to represent changes in axonal diffusivity.…”

Section: Gravity In the Brain-how It May Regulate Skeletal Muscle Metabolism By Balancing Compressive Ischemic Changes In The Weight-bearmentioning

confidence: 99%

Gravity in the brain—how it may regulate skeletal muscle metabolism by balancing compressive ischemic changes in the weight‐bearing pituitary and hypothalamus

Jaster

2021

Physiol Rep

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Sleep and sleep deprivation differentially alter white matter microstructure: A mixed model design utilising advanced diffusion modelling

Cited by 31 publications

References 60 publications

Gravity-induced ischemia in the brain-and prone positioning for COVID-19 patients breathing spontaneously

Gravity-induced ischemia in the brain-and prone positioning for COVID-19 patients breathing spontaneously

Age Differences in Diffusivity in the Locus Coeruleus and its Ascending Noradrenergic Tract

Gravity in the brain—how it may regulate skeletal muscle metabolism by balancing compressive ischemic changes in the weight‐bearing pituitary and hypothalamus

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