Association between angiotensin-converting enzyme insertion/deletion polymorphism and migraine: a meta-analysis

Background: Many studies investigated the association between angiotensin-converting enzyme (ACE) insertion/deletion (I/D) polymorphism and migraine, with controversial results. Thus, we performed a meta-analysis to better evaluate the correlation of this polymorphism and migraine. Methods: We retrieved studies published up to September 2014 about the ACE gene polymorphism and migraine from electronic database. Pooled odds ratios (ORs) with 95% confidence interval (CI) were calculated to examine the strength of association between the ACE I/D polymorphism and migraine, using random-effects models. Results: We identified 14 separate studies, in which 7334 migraineurs and 22 990 healthy controls were eligible for the meta-analysis. The results showed no relationship between the ACE I/D polymorphism and any migraine. Stratification revealed a protective effect in the Turkish population against migraine with aura for the II genotype model (II vs. DD: pooled OR = 0.366, 95% CI = 0.137–0.980; II vs. DI + DD: pooled OR = 0.370, 95% CI = 0.145–0.945). Similar results were obtained for Turkish people with migraine without aura (II vs. DD: pooled OR = 0.386; 95% CI = 0.166–0.900; II vs. DI + DD: pooled OR = 0.347; 95% CI = 0.156–0.773). Conclusions: The data suggest that the ACE II genotype could exert a protective effect against migraine with aura and without aura at least in the Turkish population.     

Dopaminergic system and dream recall: An MRI study in Parkinson's disease patients

We investigated the role of the dopamine system [i.e., subcortical‐medial prefrontal cortex (mPFC) network] in dreaming, by studying patients with Parkinson's Disease (PD) as a model of altered dopaminergic transmission. Subcortical volumes and cortical thickness were extracted by 3T‐MR images of 27 PD patients and 27 age‐matched controls, who were asked to fill out a dream diary upon morning awakening for one week. PD patients do not substantially differ from healthy controls with respect to the sleep, dream, and neuroanatomical measures. Multivariate correlational analyses in PD patients show that dopamine agonist dosage is associated to qualitatively impoverished dreams, as expressed by lower bizarreness and lower emotional load values. Visual vividness (VV) of their dream reports positively correlates with volumes of both the amygdalae and with thickness of the left mPFC. Emotional load also positively correlates with hippocampal volume. Beside the replication of our previous finding on the role of subcortical nuclei in dreaming experience of healthy subjects, this represents the first evidence of a specific role of the amygdala‐mPFC dopaminergic network system in dream recall. The association in PD patients between higher dopamine agonist dosages and impoverished dream reports, however, and the significant correlations between VV and mesolimbic regions, however, provide an empirical support to the hypothesis that a dopamine network plays a key role in dream generation. The causal relation is however precluded by the intrinsic limitation of assuming the dopamine agonist dosage as a measure of the hypodopaminergic state in PD. Hum Brain Mapp 37:1136–1147, 2016. © 2015 Wiley Periodicals, Inc .     

Optogenetic activation of melanin‐concentrating hormone neurons increases non‐rapid eye movement and rapid eye movement sleep during the night in rats

Neurons containing melanin‐concentrating hormone (MCH) are located in the hypothalamus. In mice, optogenetic activation of the MCH neurons induces both non‐rapid eye movement (NREM) and rapid eye movement (REM) sleep at night, the normal wake‐active period for nocturnal rodents [R. R. Konadhode et al. (2013) J. Neurosci., 33, 10257–10263]. Here we selectively activate these neurons in rats to test the validity of the sleep network hypothesis in another species. Channelrhodopsin‐2 (ChR2) driven by the MCH promoter was selectively expressed by MCH neurons after injection of rAAV‐MCHp‐ChR2‐EYFP into the hypothalamus of Long–Evans rats. An in vitro study confirmed that the optogenetic activation of MCH neurons faithfully triggered action potentials. In the second study, in Long–Evans rats, rAAV‐MCH‐ChR2, or the control vector, rAAV‐MCH‐EYFP, were delivered into the hypothalamus. Three weeks later, baseline sleep was recorded for 48 h without optogenetic stimulation (0 Hz). Subsequently, at the start of the lights‐off cycle, the MCH neurons were stimulated at 5, 10, or 30 Hz (1 mW at tip; 1 min on – 4 min off) for 24 h. Sleep was recorded during the 24‐h stimulation period. Optogenetic activation of MCH neurons increased both REM and NREM sleep at night, whereas during the day cycle, only REM sleep was increased. Delta power, an indicator of sleep intensity, was also increased. In control rats without ChR2, optogenetic stimulation did not increase sleep or delta power. These results lend further support to the view that sleep‐active MCH neurons contribute to drive sleep in mammals.     

Factors associated with perceived sleep quality of nurses working on rotating shifts

Aims. To explore nurses’ perceived sleep quality and examine factors that contribute to insufficient sleep quality. Background. Shift work is an important source of disturbances in the health and well‐being of nurses. However, nursing services must be available on a 24‐hour basis, making shift work a necessity. Sleep disorders tend to occur among nurses typically working on a rotating schedule. Although many studies related to nurses’ sleep quality have been carried out in the West, few have investigated factors linked to nurses’ sleep quality in Hong Kong. Design. A cross‐sectional study. Method. The study was conducted during the period November 2005–June 2006 in two local hospitals in Hong Kong. Nurses (n = 163) completed a self‐reported questionnaire. Demographic data and information on health status, strain and symptom levels and perceived sleep quality were collected. Results. More than 70% of the nurses reported having insufficient sleep and strain and symptom levels were higher in this group. Older age, perceived poor sleep status, gastrointestinal symptoms and higher strain and symptom levels were risk factors that contributed to insufficient sleep. Conclusions. Evaluation of internal stressors and modification of shift work schedules are important areas of future research; these should aim at finding the best compromise between productivity and employees’ sleep quality, health and performance. Relevance to clinical practice. Healthcare workers’ job task analysis, the evaluation of internal stressors and the modification of shift work schedules are important areas of future research and should result in the best compromise between productivity and employees’ sleep quality, health and performance.     

阻塞性睡眠呼吸暂停低通气综合征合并高血压患者血浆内皮素1、血管性假血友病因子及血栓调节蛋白的水平研究

目的 研究阻塞性睡眠呼吸暂停低通气综合征(obstructive sleep apnea-hypopnea syndrome,OSAHS)及OSAHS合并高血压血浆内皮素1(endothelin-1,ET-1)、血栓调节蛋白(thrombomodulin,TM)、血管性假血友病因子(yon Willebrand factor,vWF)的变化.方法 检测OSAHS、OSAHS合并高血压患者血浆ET-1、TM、vWF含量并与睡眠呼吸监测指标进行相关性分析.结果 单纯OSAHS、OSAHS合并高血压患者与对照组比较,ET-1、TM及vWF水平升高,并与两者病情严重程度有相关性;ET-1、TM、vWF水平的升高在OSAHS合并高血压患者组更明显.结论 OSAHS及OSAHS合并高血压患者均存在血管内皮损伤,内皮功能损伤在OSAHS合并高血压患者中更为明显.血管内皮损伤在OSAHS合并高血压的发病中有重要的作用.     

冠心病患者中睡眠呼吸暂停综合征的监测及其临床意义

目的:观察冠心病(CHD)患者中阻塞性睡眠呼吸暂停综合征(OSAS)的患病率,探讨OSAS与CHD的关系.方法:83例可疑CHD的患者行冠状动脉造影,依据造影结果分为CHD组(48例),冠状动脉造影阴性组(35例), 83例患者均行多导睡眠仪(PSG)监测,依据PSG监测得出的睡眠呼吸暂停低通气指数(AHI)分为轻度OSAS组(10≤AHI<20, 23例)、中重度OSAS组(AHI≥20,21例)和非OSAS组(对照组,AHI<10, 39例).3组均计算Gensini评分,用于评估冠状动脉粥样硬化病变的程度.用Logistic回归评估OSAS以及其他危险对CHD的影响.结果:CHD组中OSAS的患病率高于冠状动脉造影阴性组.轻度和中重度OSAS组,最低血氧饱和度低于对照组;CHD患病率高于对照组;冠状动脉病变单支受累百分率显著高于对照组,多支受累百分率高于对照组;中重度OSAS组的Gensini评分显著高于对照组.多因素Logistic回归得出OSAS、高血压以及脂蛋白(a)与CHD独立相关.结论:在冠状动脉造影证实的CHD患者中OSAS患病率较高,多因素回归发现OSAS与CHD独立相关,OSAS可能是导致冠心病的一个重要的独立危险因素.     

老年代谢综合征合并阻塞性睡眠呼吸暂停综合征的临床分析

目的探讨老年人群代谢综合征（MS）合并阻塞性睡眠呼吸暂停综合征（OSAHS）的患病情况,分析各组别之间的相关性。方法对我院老年科诊断为MS的患者进行日间嗜睡情况调查和多导睡眠监测,调查OSAHS的患病率;将MS患者分为四组：非OSAHS组、轻度OSAHS组、中度OSAHS组和重度OSAHS组,比较不同程度OSAHS组的体重、腰围和BMI情况;对患者的夜间睡眠呼吸紊乱和体重、腰围、BMI做相关性分析;比较不同程度OSAHS患者的MS的组构成差异;分析OSAHS的严重程度与MS组的相关性。结果（1）64例符合MS诊断标准,55例完成多导睡眠图（PSG）,其中49例（89．1％）诊断为OSAHS;（2）非OSAHS组的腰围、BMI和体重显著低于重度OSAHS组ESS评分显著低于中度OSAHS和重度OSAHS组;（3）Z综合征患者呼吸暂停低通气指数（AHI）及氧减饱和指数（ODI）均与腰围和BMI呈正相关,最低氧饱和度（LSaO2）与BMI呈负相关;（4）四组患者MS各组构成比无明显差异,但OSAHS随MS组增多存在加重趋势。结论老年MS人群中OSAHS患病率极高,OSAHS随腰围和BMI的升高而加重。符合MS诊断较多组的患者,OSAHS的严重程度也较高。