Hein Matthieu, Lanquart Jean-Pol, Mungo Anaïs, Hubain Philippe, Loas Gwenolé
Erasme Hospital, Department of Psychiatry and Sleep Laboratory, Université libre de Bruxelles, ULB, Brussels, Belgium.
Erasme Hospital, Department of Psychiatry and Sleep Laboratory, Université libre de Bruxelles, ULB, Brussels, Belgium.
Psychiatry Res. 2020 Jan 26;285:112818. doi: 10.1016/j.psychres.2020.112818.
Given the contradictory data on REMS alterations in major depression, the aim of this study was to empirically demonstrate that based on the number of sleep ultradian cycles, it was possible to highlight different subtypes of major depression characterized by specific patterns of REMS alterations. Demographic and polysomnographic data from 211 individuals (30 healthy controls and 181 untreated major depressed individuals) recruited from the sleep laboratory database were analyzed. Major depressed individuals with sleep ultradian cycles <4 showed alterations consistent with REMS deficiency (non-shortened REM latency as well as decrease in REMS percentage, REMS duration and REMS/NREMS ratio) whereas major depressed individuals with sleep ultradian cycles >4 showed alterations consistent with REMS disinhibition (shortened REM latency as well as increase in REMS percentage, REMS duration and REMS/NREMS ratio). Regarding major depressed individuals with 4 sleep ultradian cycles, their REMS alterations were intermediate to those present in major depressed individuals with sleep ultradian cycles <4 and >4. Thus, in major depressed individuals, the highlighting of this heterogeneity of REMS alterations based on the number of sleep ultradian cycles seems to suggest the involvement of distinct pathophysiological mechanisms and could open new perspectives for future sleep research in psychiatry.
鉴于关于重度抑郁症中快速眼动睡眠（REMS）改变的矛盾数据，本研究的目的是通过实证证明，基于睡眠超日周期的数量，可以突出以特定REMS改变模式为特征的不同重度抑郁症亚型。对从睡眠实验室数据库招募的211名个体（30名健康对照者和181名未经治疗的重度抑郁个体）的人口统计学和多导睡眠图数据进行了分析。睡眠超日周期<4的重度抑郁个体表现出与REMS缺乏一致的改变（REM潜伏期未缩短以及REMS百分比、REMS持续时间和REMS/非快速眼动睡眠（NREMS）比率降低），而睡眠超日周期>4的重度抑郁个体表现出与REMS去抑制一致的改变（REM潜伏期缩短以及REMS百分比、REMS持续时间和REMS/NREMS比率增加）。对于有4个睡眠超日周期的重度抑郁个体，其REMS改变介于睡眠超日周期<4和>4的重度抑郁个体之间。因此，在重度抑郁个体中，基于睡眠超日周期数量突出这种REMS改变的异质性似乎表明涉及不同的病理生理机制，并可能为未来精神病学睡眠研究开辟新的前景。
