Risk Factors and Brain Metabolic Mechanism of Sleep Disorders in Autoimmune Encephalitis

BackgroundSleep disorders (SDs) in autoimmune encephalitis (AE) have received little attention and are poorly understood. We investigated the clinical characteristics, risk factors, and cerebral metabolic mechanism of SD in AE.MethodsClinical, laboratory, and imaging data were retrospectively review...

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Autores principales:	Xiao Liu, Tingting Yu, Xiaobin Zhao, Ping Yu, Ruijuan Lv, Chunxue Wang, Lin Ai, Qun Wang
Formato:	article
Lenguaje:	EN
Publicado:	Frontiers Media S.A. 2021
Materias:	autoimmune encephalitis sleep disorders risk factors positron emission tomography brain metabolism pathological mechanism Immunologic diseases. Allergy RC581-607
Acceso en línea:	https://doaj.org/article/beb30e13842f4eda8fd1c87b3f28cbb2
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spelling	oai:doaj.org-article:beb30e13842f4eda8fd1c87b3f28cbb22021-11-30T18:48:25ZRisk Factors and Brain Metabolic Mechanism of Sleep Disorders in Autoimmune Encephalitis1664-322410.3389/fimmu.2021.738097https://doaj.org/article/beb30e13842f4eda8fd1c87b3f28cbb22021-11-01T00:00:00Zhttps://www.frontiersin.org/articles/10.3389/fimmu.2021.738097/fullhttps://doaj.org/toc/1664-3224BackgroundSleep disorders (SDs) in autoimmune encephalitis (AE) have received little attention and are poorly understood. We investigated the clinical characteristics, risk factors, and cerebral metabolic mechanism of SD in AE.MethodsClinical, laboratory, and imaging data were retrospectively reviewed in 121 consecutively patients with definite AE. The risk factors for SD in AE were estimated by logistic regression analysis. Group comparisons based on 18F-fluorodeoxy-glucose positron emission tomography (18F-FDG-PET) data were made between patients with and without SD, to further analyze potential brain metabolic mechanism of SD in AE.ResultsA total of 52.9% patients (64/121) with SD were identified. The multivariate logistic model analysis showed that smoking [odds ratio (OR), 6.774 (95% CI, 1.238–37.082); p = 0.027], increased Hamilton Depression scale (HAMD) score [OR, 1.074 (95% CI, 1.002–1.152); p = 0.045], hyperhomocysteinemia [OR, 2.815 (95% CI, 1.057–7.496); p = 0.038], elevated neuron-specific enolase (NSE) level [OR, 1.069 (95% CI, 1.007–1.135); p = 0.03] were independently correlated with higher risk of SD in AE patients. Contrastingly, high MoCA score [OR, 0.821 (95% CI, 0.752–0.896); p < 0.001] was associated with lower risk of SD in AE subjects. Compared to controls, AE patients had less total sleep time, less sleep efficiency, longer sleep latency, more wake, higher percent of stage N1, lower percent of stage N3 and rapid eye movement, and more arousal index in non-rapid eye movement sleep (p < 0.05 for all). Voxel-based group comparison analysis showed that, compared to patients without SD, patients with SD had increased metabolism in the basal ganglia, cerebellum, brainstem, median temporal lobe, thalamus, and hypothalamus [p < 0.05, false discovery rate (FDR) corrected]; decreased metabolism in superior frontal gyrus, medial frontal gyrus, and posterior cingulate cortex (p < 0.001, uncorrected). These results were confirmed by region of interest-based analysis between PET and sleep quality.ConclusionSmoking, increased HAMD score, hyperhomocysteinemia, and elevated NSE level were correlated with higher risk of SD. High MoCA score was associated with lower risk of SD in AE subjects. Moreover, a widespread metabolic network dysfunction may be involved in the pathological mechanism of SD in AE.Xiao LiuXiao LiuTingting YuTingting YuXiaobin ZhaoPing YuRuijuan LvRuijuan LvChunxue WangChunxue WangChunxue WangLin AiLin AiQun WangQun WangQun WangFrontiers Media S.A.articleautoimmune encephalitissleep disordersrisk factorspositron emission tomographybrain metabolismpathological mechanismImmunologic diseases. AllergyRC581-607ENFrontiers in Immunology, Vol 12 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	autoimmune encephalitis sleep disorders risk factors positron emission tomography brain metabolism pathological mechanism Immunologic diseases. Allergy RC581-607
spellingShingle	autoimmune encephalitis sleep disorders risk factors positron emission tomography brain metabolism pathological mechanism Immunologic diseases. Allergy RC581-607 Xiao Liu Xiao Liu Tingting Yu Tingting Yu Xiaobin Zhao Ping Yu Ruijuan Lv Ruijuan Lv Chunxue Wang Chunxue Wang Chunxue Wang Lin Ai Lin Ai Qun Wang Qun Wang Qun Wang Risk Factors and Brain Metabolic Mechanism of Sleep Disorders in Autoimmune Encephalitis
description	BackgroundSleep disorders (SDs) in autoimmune encephalitis (AE) have received little attention and are poorly understood. We investigated the clinical characteristics, risk factors, and cerebral metabolic mechanism of SD in AE.MethodsClinical, laboratory, and imaging data were retrospectively reviewed in 121 consecutively patients with definite AE. The risk factors for SD in AE were estimated by logistic regression analysis. Group comparisons based on 18F-fluorodeoxy-glucose positron emission tomography (18F-FDG-PET) data were made between patients with and without SD, to further analyze potential brain metabolic mechanism of SD in AE.ResultsA total of 52.9% patients (64/121) with SD were identified. The multivariate logistic model analysis showed that smoking [odds ratio (OR), 6.774 (95% CI, 1.238–37.082); p = 0.027], increased Hamilton Depression scale (HAMD) score [OR, 1.074 (95% CI, 1.002–1.152); p = 0.045], hyperhomocysteinemia [OR, 2.815 (95% CI, 1.057–7.496); p = 0.038], elevated neuron-specific enolase (NSE) level [OR, 1.069 (95% CI, 1.007–1.135); p = 0.03] were independently correlated with higher risk of SD in AE patients. Contrastingly, high MoCA score [OR, 0.821 (95% CI, 0.752–0.896); p < 0.001] was associated with lower risk of SD in AE subjects. Compared to controls, AE patients had less total sleep time, less sleep efficiency, longer sleep latency, more wake, higher percent of stage N1, lower percent of stage N3 and rapid eye movement, and more arousal index in non-rapid eye movement sleep (p < 0.05 for all). Voxel-based group comparison analysis showed that, compared to patients without SD, patients with SD had increased metabolism in the basal ganglia, cerebellum, brainstem, median temporal lobe, thalamus, and hypothalamus [p < 0.05, false discovery rate (FDR) corrected]; decreased metabolism in superior frontal gyrus, medial frontal gyrus, and posterior cingulate cortex (p < 0.001, uncorrected). These results were confirmed by region of interest-based analysis between PET and sleep quality.ConclusionSmoking, increased HAMD score, hyperhomocysteinemia, and elevated NSE level were correlated with higher risk of SD. High MoCA score was associated with lower risk of SD in AE subjects. Moreover, a widespread metabolic network dysfunction may be involved in the pathological mechanism of SD in AE.
format	article
author	Xiao Liu Xiao Liu Tingting Yu Tingting Yu Xiaobin Zhao Ping Yu Ruijuan Lv Ruijuan Lv Chunxue Wang Chunxue Wang Chunxue Wang Lin Ai Lin Ai Qun Wang Qun Wang Qun Wang
author_facet	Xiao Liu Xiao Liu Tingting Yu Tingting Yu Xiaobin Zhao Ping Yu Ruijuan Lv Ruijuan Lv Chunxue Wang Chunxue Wang Chunxue Wang Lin Ai Lin Ai Qun Wang Qun Wang Qun Wang
author_sort	Xiao Liu
title	Risk Factors and Brain Metabolic Mechanism of Sleep Disorders in Autoimmune Encephalitis
title_short	Risk Factors and Brain Metabolic Mechanism of Sleep Disorders in Autoimmune Encephalitis
title_full	Risk Factors and Brain Metabolic Mechanism of Sleep Disorders in Autoimmune Encephalitis
title_fullStr	Risk Factors and Brain Metabolic Mechanism of Sleep Disorders in Autoimmune Encephalitis
title_full_unstemmed	Risk Factors and Brain Metabolic Mechanism of Sleep Disorders in Autoimmune Encephalitis
title_sort	risk factors and brain metabolic mechanism of sleep disorders in autoimmune encephalitis
publisher	Frontiers Media S.A.
publishDate	2021
url	https://doaj.org/article/beb30e13842f4eda8fd1c87b3f28cbb2
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Risk Factors and Brain Metabolic Mechanism of Sleep Disorders in Autoimmune Encephalitis

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