Generation R Study Group, Erasmus University Medical Center, Rotterdam, The Netherlands.
Department of Child and Adolescent Psychiatry, Erasmus Medical Center, Rotterdam, The Netherlands.
J Child Psychol Psychiatry. 2019 Nov;60(11):1242-1250. doi: 10.1111/jcpp.13085. Epub 2019 Jun 25.
Sleep problems occur in up to 30% of children and have been associated with adverse developmental outcomes. However, due to a lack of longitudinal neuroimaging studies, the neurobiological changes that may underlie some of these associations have remained unclear. This study explored the association between sleep problems during childhood and white matter (WM) microstructure in preadolescence.
Children from the population-based birth cohort, the Generation R Study, who had repeatedly assessed sleep problems between 1.5 and 10 years of age and a MRI scan at age 10 (N = 2,449), were included. Mothers reported on their child's sleep problems using the Child Behavior Checklist (CBCL 1.5-5) when children were 1.5, 3, and 6 years of age. At age 2, mothers completed very similar questions. At age 10, both children and their mothers reported on sleep problems. We used whole-brain and tract-specific fractional anisotropy (FA) and mean diffusivity (MD) values obtained through diffusion tensor imaging as measures of WM microstructure.
Childhood sleep problems at 1.5, 2, and 6 years of age were associated with less WM microstructural integrity (approximately 0.05 SD lower global FA score per 1-SD sleep problems). In repeated-measures analyses, children with more sleep problems (per 1-SD) at baseline had lower FA values at age 10 in particular in the corticospinal tract (-0.12 SD, 95% CI:-0.20;-0.05), the uncinate fasciculus (-0.12 SD, 95% CI:-0.19;-0.05), and the forceps major (-0.11 SD, 95% CI:-0.18;-0.03), although effect estimates across the tracts did not differ substantially.
Childhood sleep disturbances are associated with less WM microstructural integrity in preadolescence. Our results show that early neurodevelopment may be a period of particular vulnerability to sleep problems. This study cannot demonstrate causality but suggests that preventive interventions addressing sleep problems should be further explored to test whether they impact adverse neurodevelopment.
睡眠问题在多达 30%的儿童中出现，并与不良发育结果相关。然而，由于缺乏纵向神经影像学研究，一些潜在关联的神经生物学变化仍不清楚。本研究探讨了儿童期睡眠问题与青春期前白质（WM）微观结构之间的关系。
该研究纳入了来自基于人群的出生队列——“世代研究”的儿童，这些儿童在 1.5 至 10 岁期间反复接受睡眠问题评估，并且在 10 岁时接受 MRI 扫描（N=2449）。当孩子 1.5、3 和 6 岁时，母亲使用儿童行为检查表（CBCL 1.5-5）报告孩子的睡眠问题。在 2 岁时，母亲完成了非常相似的问题。在 10 岁时，孩子和他们的母亲都报告了睡眠问题。我们使用弥散张量成像获得的全脑和束特异性分数各向异性（FA）和平均弥散度（MD）值作为 WM 微观结构的测量指标。
1.5、2 和 6 岁时的儿童期睡眠问题与 WM 微观结构完整性降低有关（每 1 个标准差的睡眠问题约降低 0.05 个标准差的整体 FA 评分）。在重复测量分析中，基线时睡眠问题更多（每 1 个标准差）的儿童在 10 岁时 FA 值较低，特别是在皮质脊髓束（-0.12 个标准差，95%置信区间：-0.20；-0.05）、钩束（-0.12 个标准差，95%置信区间：-0.19；-0.05）和内囊前肢（-0.11 个标准差，95%置信区间：-0.18；-0.03），尽管各束之间的效应估计值差异不大。
儿童期睡眠障碍与青春期前 WM 微观结构完整性降低有关。我们的研究结果表明，早期神经发育可能是易受睡眠问题影响的特定时期。本研究不能证明因果关系，但表明应进一步探索针对睡眠问题的预防干预措施，以检验它们是否会对不良神经发育产生影响。
