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Astroglial Mechanisms Underlying Chronic Insomnia Disorder: A Clinical Study

Authors Zhang P, Li YX, Zhang ZZ, Yang Y, Rao JX, Xia L, Li XY, Chen GH, Wang F

Received 28 May 2020

Accepted for publication 27 August 2020

Published 8 October 2020 Volume 2020:12 Pages 693—704

DOI https://doi.org/10.2147/NSS.S263528

Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 3

Editor who approved publication: Dr Sutapa Mukherjee


Ping Zhang,1,* Ying-Xue Li,1,* Zhe-Zhe Zhang,2 Ye Yang,1 Ji-Xian Rao,1 Lan Xia,3 Xue-Yan Li,1 Gui-Hai Chen,1 Fang Wang2

1Department of Sleep Disorders, The Affiliated Chaohu Hospital of Anhui Medical University, Hefei 238000, People’s Republic of China; 2Department of Neurology, The First Affiliated Hospital of Anhui Medical University, Hefei 230022, People’s Republic of China; 3Department of Neurology, The Second Affiliated Hospital of Anhui Medical University, Hefei 230601, People’s Republic of China

*These authors contributed equally to this work

Correspondence: Fang Wang
Department of Neurology, The First Affiliated Hospital of Anhui Medical University, Hefei 230022, People’s Republic of China
Tel/Fax +86-551-62922426
Email doctorwangfang2006@163.com
Gui-Hai Chen
Department of Sleep Disorders, The Affiliated Chaohu Hospital of Anhui Medical University, Hefei, (Chaohu) 238000, People’s Republic of China
Tel/Fax +86-551-82324252
Email doctorcgh@163.com

Purpose: The objective of this study was to investigate whether the serum biomarkers S100 calcium binding protein B (S100B), glial fibrillary acidic protein (GFAP), brain-derived neurotrophic factor (BDNF), and glial cell line-derived neurotrophic factor (GDNF) change in patients with chronic insomnia disorder (CID), and if this is the case, whether the altered levels of these serum biomarkers are associated with poor sleep quality and cognitive decline in CID.
Patients and Methods: Fifty-seven CID outpatients constituted the CID group; thirty healthy controls (HC) were also enrolled. Questionnaires, polysomnography, Chinese-Beijing Version of Montreal Cognitive Assessment (MoCA-C) and Nine Box Maze Test (NBMT) were used to assess their sleep and neuropsychological function. Serum S100B, GFAP, BDNF, and GDNF were evaluated using enzyme-linked immunosorbent assay.
Results: The CID group had higher levels of S100B and GFAP and lower levels of BDNF and GDNF than the HC group. Spearman correlation analysis revealed that poor sleep quality, assessed by subjective and objective measures, was positively correlated with S100B level and negatively correlated with BDNF level. GFAP level correlated positively with poor subjective sleep quality. Moreover, S100B and GFAP levels correlated negatively with general cognitive function assessed using MoCA-C. GFAP level correlated positively with poor spatial working memory (SWM) in the NBMT; BDNF level was linked to poor SWM and object recognition memory (ORcM) in the NBMT. However, principal component analysis revealed that serum S100B level was positively linked to the errors in object working memories, BDNF and GDNF concentrations were negatively linked with errors in ORcM, and GFAP concentration was positively correlated with the errors in the SWM and spatial reference memories.
Conclusion: Serum S100B, GFAP, BDNF, and GDNF levels were altered in patients with CID, indicating astrocyte damage, and were associated with insomnia severity or/and cognitive dysfunction.

Keywords: cognition, S100 calcium binding protein B, glial fibrillary acidic protein, brain-derived neurotrophic factor, glial cell line-derived neurotrophic factor

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