失眠的认知行为疗法对脑震荡患者神经丝轻链和磷酸化tau蛋白的影响
The Impact of Cognitive Behavioral Therapy for Insomnia on Neurofilament Light and Phosphorylated Tau in Individuals with a Concussion.
作者信息
Ludwig Rebecca, Rippee Michael, D'Silva Linda, Radel Jeff, Eakman Aaron M, Morris Jill, Beltramo Alvin, Drerup Michelle, Siengsukon Catherine
机构信息
Department of Physical Therapy, Rehabilitation Science, and Athletic Training, University of Kansas Medical Center, 3901 Rainbow Blvd. Mail Stop 2002, Kansas City, KS 66160, USA.
Department of Neurology, University of Kansas Medical Center, 3901 Rainbow Blvd, Mailstop 2012, Kansas City, KS 66160, USA.
出版信息
Arch Clin Neuropsychol. 2025 Apr 27;40(3):437-444. doi: 10.1093/arclin/acae096.
BACKGROUND
Concussions damage neurologic tissue, increasing release of intercellular proteins including phosphorylated Tau (pTau) and neurofilament light (NfL). Disrupted sleep from a concussion negatively impacts the ability of the glymphatic system to remove cellular waste from the brain.
OBJECTIVE
The purpose of this study was to determine if enhancing sleep using Cognitive Behavioral Therapy for Insomnia (CBT-I) impacts pTau and NFL levels following a concussion.
METHODS
This is pre/post intervention analysis of a larger wait-list control study. Participants had their blood sampled pre/post the CBT-I intervention which was analyzed using SIMOA analytics. Paired sampling statistics and linear regression models were used to examine how insomnia severity impacts pTau181 and NfL.
RESULTS
Twenty-eight participants were enrolled in this study. Age and baseline protein level were significantly associated with post-intervention protein levels, but post-intervention insomnia severity was not associated with post-intervention protein levels. About 50% of participants that had clinically meaningful change in insomnia and had a reduction in their NfL and pTau181 values.
CONCLUSIONS
Post-intervention insomnia was not associated with post-intervention NfL or pTau. Yet, on an individual level, ~50% of participants had a clinically meaningful change in insomnia and reduced level of NfL and pTau 18.1.
CLINICAL TRIAL REGISTRATION
NCT04885205 https://clinicaltrials.gov.
背景
脑震荡会损伤神经组织，增加包括磷酸化 Tau（pTau）和神经丝轻链（NfL）在内的细胞内蛋白质的释放。脑震荡导致的睡眠中断会对类淋巴系统从大脑清除细胞废物的能力产生负面影响。
目的
本研究的目的是确定使用失眠认知行为疗法（CBT-I）改善睡眠是否会影响脑震荡后的 pTau 和 NFL 水平。
方法
这是一项对一项更大的等待列表对照研究的干预前后分析。参与者在 CBT-I 干预前后进行血液采样，并使用单分子阵列（SIMOA）分析进行分析。采用配对抽样统计和线性回归模型来研究失眠严重程度如何影响 pTau181 和 NfL。
结果
本研究共纳入 28 名参与者。年龄和基线蛋白质水平与干预后蛋白质水平显著相关，但干预后失眠严重程度与干预后蛋白质水平无关。约 50% 的参与者在失眠方面有临床意义的变化，且其 NfL 和 pTau181 值降低。
结论
干预后失眠与干预后 NfL 或 pTau 无关。然而，在个体层面上，约 50% 的参与者在失眠方面有临床意义的变化，且 NfL 和 pTau 18.1 水平降低。
临床试验注册
NCT04885205 https://clinicaltrials.gov
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