ABSTRACT
Objective: Cyclic alternanting pattern (CAP) has been considered a marker of sleep instability in children. The aim of this study was to evaluate the CAP in infants with laryngomalacia. Material and Methods: CAP were quantified in 15 infants with laryngomalacia (mean age 167.2±97.21 days) and 10 controls (mean age of 158.5±116.2 days) using polysomnography. Results: The distribution of the A2 subtypes across NREM stages in infants with laryngomalacia showed a decrease, as well as in the mean duration of CAP sequences. The A3 CAP and arousals increased in infants with laryngomalacia. Our data showed a stronger correlation between the mean duration of A1 CAP and the age in healthy controls than in infants with laryngomalacia. In accordance to previous reports infants with laryngomalacia exhibited an increase in total awake time, apnea-hypopnea index, and a decrease in N3 stage compared to controls. Discussion: Our findings add to a growing body of literature of CAP as an indicator of brain maturation.
ABSTRACT
INTRODUCTION: Lisdexamfetamine (LDX) is a drug used to treat ADHD/impulsive patients. Impulsivity is known to affect inhibitory, emotional and cognitive function. On the other hand, smell and odor processing are known to be affected by neurological disorders, as they are modulators of addictive and impulsive behaviors specifically. We hypothesize that, after LDX ingestion, inhibitory pathways of the brain would change, and complementary behavioral regulation mechanisms would appear to regulate decision-making and impulsivity. METHODS: 20 children were studied in an aleatory crossover study. Imaging of BOLD-fMRI activity, elicited by olfactory stimulation in impulsive children, was performed after either LDX or placebo ingestion. RESULTS: Findings showed that all subjects who underwent odor stimulation presented activations of similar intensities in the olfactory centers of the brain. This contrasted with inhibitory regions of the brain such as the cingulate cortex and frontal lobe regions, which demonstrated changed activity patterns and intensities. While some differences between the placebo and medicated states were found in motor areas, precuneus, cuneus, calcarine, supramarginal, cerebellum and posterior cingulate cortex, the main changes were found in frontal, temporal and parietal cortices. When comparing olfactory cues separately, pleasant food smells like chocolate seemed not to present large differences between the medicated and placebo scenarios, when compared to non-food-related smells. CONCLUSION: It was demonstrated that LDX, first, altered the inhibitory pathways of the brain, secondly it increased activity in several brain regions which were not activated by smell in drug-naïve patients, and thirdly, it facilitated a complementary behavioral regulation mechanism, run by the cerebellum, which regulated decision-making and impulsivity in motor and frontal structures.
Subject(s)
Brain/drug effects , Central Nervous System Stimulants/pharmacology , Impulsive Behavior/drug effects , Lisdexamfetamine Dimesylate/pharmacology , Brain/diagnostic imaging , Brain/physiopathology , Child , Cross-Over Studies , Cues , Frontal Lobe/diagnostic imaging , Frontal Lobe/drug effects , Functional Neuroimaging , Gyrus Cinguli/diagnostic imaging , Gyrus Cinguli/drug effects , Humans , Magnetic Resonance Imaging , Male , Neural Inhibition/drug effects , Odorants , Olfactory Cortex/diagnostic imaging , Olfactory Cortex/drug effects , Parietal Lobe/diagnostic imaging , Parietal Lobe/drug effects , Temporal Lobe/diagnostic imaging , Temporal Lobe/drug effectsABSTRACT
[This corrects the article DOI: 10.1371/journal.pone.0099119.].