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This study aims to establish a research cohort on sleep and sleep disorders in patients with neurological diseases to systematically evaluate the relationship between various neurological conditions and sleep characteristics or disturbances.
The cohort will include patients with confirmed diagnoses such as stroke, Parkinson's disease, epilepsy, cognitive disorders, neuroinfections, and immune-mediated neurological diseases, with collection of demographic data, medical history, and lifestyle factors. All participants will undergo standardized polysomnography (PSG), sleep questionnaires, assessments of cognition, mood, daytime function, as well as relevant imaging and laboratory tests. Designed as a prospective observational study, the cohort will focus on sleep architecture alterations, periodic limb movements, sleep-disordered breathing, REM sleep behavior disorder, nocturnal awakenings, heart rate, and oxygen saturation, and their associations with disease severity and progression. The data will provide a basis for exploring the mechanisms, early indicators, and potential interventions for sleep disturbances in neurological patients.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| patients with neurological diseases | patients with confirmed diagnoses such as stroke, Parkinson's disease, epilepsy, cognitive disorders, neuroinfections, and immune-mediated neurological diseases |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Symptomatic and Etiological Treatment | Other | sleep-related |
|
| Measure | Description | Time Frame |
|---|---|---|
| Total sleep time measured by polysomnography | Total sleep time is defined as the total amount of time spent asleep during the overnight polysomnography recording, expressed in minutes. | baseline, 3 months and one year |
| Wake after sleep onset measured by polysomnography | Wake after sleep onset is defined as the total duration of wakefulness after sleep onset and before final awakening during the overnight polysomnography recording, expressed in minutes. | baseline, 3 months and one year |
| Sleep onset latency measured by polysomnography | Sleep onset latency is defined as the time from lights off to the first epoch of sleep during overnight polysomnography. | baseline, 3 months and one year |
| Number of arousal events measured by polysomnography | The number of arousal events is defined as the total number of arousals occurring during the overnight polysomnography recording. | baseline, 3 months and one year |
| Rapid eye movement sleep onset latency measured by polysomnography | Rapid eye movement sleep onset latency is defined as the interval between sleep onset and the first occurrence of rapid eye movement sleep during the overnight polysomnography recording, expressed in minutes. | baseline, 3 months and one year |
| Non rapid eye movement sleep stage 1, 2, 3, and rapid eye movement sleep time measured by polysomnography | Non-rapid eye movement (NREM) sleep stages 1, 2, and 3, and rapid eye movement (REM) sleep time are defined as the total duration spent in each sleep stage during overnight polysomnography, expressed in minutes. |
| Measure | Description | Time Frame |
|---|---|---|
| The score of Insomnia Severity Index scale | The total score ranges from 0 to 28, and a higher score indicates higher levels of insomnia severity. A score of 8 or greater is the cut point for clinically possible insomnia. | baseline, 3 months and one year |
| The score of 14-item Hamilton anxiety rating scale |
| Measure | Description | Time Frame |
|---|---|---|
| Plasma corticotropin-releasing factor level | Plasma corticotropin-releasing factor concentration was measured as a biomarker of hypothalamic-pituitary adrenal axis activity. Higher levels indicate increased neuroendocrine stress response. Unit of Measure: pg/mL. | baseline, 3 months and one year |
| Plasma cortisol level |
Inclusion Criteria:
Exclusion Criteria:
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Neurology patients able to undergo polysomnography examination
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| The first hospital of Jilin University | Changchun | Jilin | 130000 | China |
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| baseline, 3 months and one year |
| Number of awakenings related to the event measured by polysomnography | The number of awakenings related to respiratory events is defined as the total count of awakenings temporally associated with respiratory events during overnight polysomnography. | baseline, 3 months and one year |
| Number of respiratory events measured by polysomnography | The number of respiratory events is defined as the total count of apnea and hypopnea events identified during overnight polysomnography. | baseline, 3 months and one year |
| Number of decreases in oxygen saturation measured by polysomnography | The number of respiratory events is defined as the total count of respiratory events identified during overnight polysomnography. | baseline, 3 months and one year |
| Sleep period heart rate measured by polysomnography | Sleep period heart rate is defined as the average heart rate measured during the sleep period as recorded by overnight polysomnography. | baseline, 3 months and one year |
| Number of rapid eye movement sleep without atonia measured by polysomnography | The number of rapid eye movement sleep without atonia events is defined as the total count of rapid eye movement sleep epochs exhibiting increased muscle activity during overnight polysomnography. | baseline, 3 months and one year |
| Hypoxic burden measured by polysomnography | Hypoxic burden is a quantitative measure of the cumulative severity of nocturnal hypoxemia, calculated from overnight polysomnography. It represents the total area under the curve of oxygen desaturation events, integrating both the depth and duration of oxygen desaturation across the entire sleep period. | baseline, 3 months and one year |
The total score ranges from 0 to 56, and a higher score indicates higher levels of anxiety symptoms. A score of 7 or greater is the cut point for clinically possible anxiety. |
| baseline, 3 months and one year |
| The score of 17-item Hamilton depression rating scale | The total score ranges from 0 to 52, and a higher score indicates higher levels of depression symptoms. A score of 7 or greater is the cut point for clinically possible depression symptom | baseline, 3 months and one year |
| The score of montreal cognitive assessment scale | The total score ranges from 0 to 30, with higher scores indicating better global cognitive function. A score below 26 is commonly used as the cut-off for cognitive impairment. | baseline, 3 months and one year |
Plasma cortisol concentration was assessed as an indicator of hypothalamic-pituitary-adrenal axis function. Higher levels reflect increased physiological stress response. Unit of Measure: μg/dL. |
| baseline, 3 months and one year |
| Serum interleukin-6 level | Serum interleukin-6 concentration was measured as a marker of systemic inflammation. Higher levels indicate greater inflammatory activity. Unit of Measure: pg/mL. | baseline, 3 months and one year |
| Serum brain-derived neurotrophic factor level | Serum brain-derived neurotrophic factor concentration was measured as a biomarker associated with neuroplasticity and neuronal function. Higher levels indicate enhanced neurotrophic activity. Unit of Measure: pg/mL. | baseline, 3 months and one year |
| Gray matter volume measured by structural magnetic resonance Imaging | Gray matter volume was derived from T1-weighted structural MRI using voxel-based morphometry, reflecting regional brain tissue volume. | baseline, 3 months and one year |
| Cortical thickness measured by structural magnetic resonance Imaging | Cortical thickness was quantified from T1-weighted MRI as the distance between the white matter and pial surfaces, reflecting cortical integrity. | baseline, 3 months and one year |
| Hippocampal volume measured by structural magnetic resonance Imaging | Hippocampal volume was extracted from T1-weighted MRI using automated segmentation and normalized for intracranial volume. | baseline, 3 months and one year |
| Resting-state functional connectivity measured by resting-state functional magnetic resonance imaging | Functional connectivity was assessed by calculating temporal correlations of blood-oxygen-level-dependent signals between predefined brain regions during rest. | baseline, 3 months and one year |
| Amplitude of low-frequency fluctuation measured by resting-state functional magnetic resonance | Amplitude of low-frequency fluctuation reflects the amplitude of spontaneous low-frequency BOLD signal oscillations, indicating regional intrinsic neural activity. | baseline, 3 months and one year |
| Regional homogeneity measured by resting-state functional magnetic resonance | Regional homogeneity was calculated to assess the similarity of the time series of a given voxel with its neighboring voxels, reflecting local synchronization of brain activity. | baseline, 3 months and one year |
| Global blood-oxygen-level-dependent signal measured by resting-state functional magnetic resonance | The global blood-oxygen-level-dependent signal represents the average blood-oxygen-level-dependent signal across the whole brain, reflecting the overall amplitude and synchronization of brain activity. | baseline, 3 months and one year |
| Fractional anisotropy measured by diffusion tensor imaging | Fractional anisotropy reflects the degree of directional water diffusion and was used to assess white matter microstructural integrity. | baseline, 3 months and one year |
| Mean diffusivity measured by diffusion tensor imaging | Mean diffusivity quantifies the overall magnitude of water diffusion and reflects microstructural tissue changes. | baseline, 3 months and one year |
| Cerebrospinal fluid flow dynamics measured by resting-state functional magnetic resonance | Cerebrospinal fluid flow dynamics were assessed using MRI-based methods to characterize CSF motion and pulsatility. | baseline, 3 months and one year |
| Phase difference of dynamic cerebral autoregulation | Dynamic cerebral autoregulation was assessed using the phase difference between cerebral blood flow velocity and arterial blood pressure fluctuations. Larger phase differences indicate better autoregulatory function. | baseline, 3 months and one year |
| Gain of dynamic cerebral autoregulation | Gain represents the magnitude of cerebral blood flow velocity changes in response to blood pressure fluctuations, with lower gain values indicating more effective autoregulation. | baseline, 3 months and one year |