Sleep Disturbance and Cognitive Decline in Multiple Sclerosis Patients with Isolated Optic Neuritis As the First Demyelinating Event

Overview

Journal Int Ophthalmol

Specialty Ophthalmology

Date 2019 Aug 22

PMID 31432354

Citations 3

Authors

Recai Turkoglu

Gulcin Benbir

Selen Ozyurt

Erdil Arsoy

Ece Akbayir

Selin Turan

Derya Karadeniz

Vuslat Yilmaz

Mehmet Gencer

Erdem Tuzun

Affiliations

Soon will be listed here.

Abstract

Purpose: Multiple sclerosis (MS) patients whose first demyelinating event is optic neuritis have been claimed to display a milder disease course and reduced physical disability. Our aim was to investigate the impact of the clinical features of the first clinical episode on cognitive disability and sleep dysfunction in MS.

Methods: A total of 26 (10 with optic neuritis as the first clinical event) MS patients were recruited. A comprehensive sleep study was performed, and a panel of tests were administered to examine cognitive and motor performance. Serum levels of sleep-related mediators orexin-A and melatonin were measured by enzyme-linked immunosorbent assay. Subjective sleep quality was evaluated by Pittsburgh sleep quality test, and daytime excessive sleepiness was tested by Epworth sleepiness scale.

Results: MS patients with the first clinical episode of optic neuritis and patients with at least one optic neuritis attack exhibited increased daytime sleepiness, higher sleep efficiency and NREM duration and lower total wake time. Patients with a history of optic neuritis obtained more favorable scores in neuropsychological tests measuring executive functions and complex attention as compared to those who had never experienced optic neuritis. Melatonin and orexin-A levels were lower in patients with optic neuritis onset. The higher no. of optic neuritis attacks was associated with reduced wake time and higher symbol digit modalities test scores.

Conclusions: Having a history of optic neuritis is associated with improved sleep quality and executive functions but increased daytime sleepiness. Reduction of orexin-A and melatonin levels might be one of the underlying mechanisms.

Citing Articles

Sleep and cognitive outcomes in multiple sclerosis; a systematic review.

Golabi B, Razmaray H, Seyedi-Sahebari S, Bandehagh H, Hakimzadeh Z, Khosroshahi A BMC Psychiatry. 2024; 24(1):638.

PMID: 39342299 PMC: 11438219. DOI: 10.1186/s12888-024-06103-5.

Orexinergic System in Neurodegenerative Diseases.

Wang Q, Cao F, Wu Y Front Aging Neurosci. 2021; 13:713201.

PMID: 34483883 PMC: 8416170. DOI: 10.3389/fnagi.2021.713201.

Multiple Sclerosis: Melatonin, Orexin, and Ceramide Interact with Platelet Activation Coagulation Factors and Gut-Microbiome-Derived Butyrate in the Circadian Dysregulation of Mitochondria in Glia and Immune Cells.

Anderson G, Rodriguez M, Reiter R Int J Mol Sci. 2019; 20(21).

PMID: 31694154 PMC: 6862663. DOI: 10.3390/ijms20215500.

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