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L0045 Insomnia in stroke: clinical profile associated with insomnia in stroke patients after acute stage
Posters / Sleep Medicine 8 Suppl. 1 (2007) S69–S114 Although significant predictors for this specific group of patients can be found (age, gender and duration of the medical condition and treatment) in a regression analysis, many questions remain unanswered. We put forward the concept of ‘self identification’ as a possible explanation: many patients taking hypnotics often ‘see’ themselves as individuals with a sleep problem even when their sleep seems to be ‘normal’, just as a patient taking insulin ‘sees’ him or herself as a diabetic. This perception is a possible bias in epidemiological studies and may hide beneficial effects of – in this case – pharmacologic treatment. Contributed support: SLE-EP study sponsored by Sanofi-Aventis. L0045 Insomnia in stroke: clinical profile associated with insomnia in stroke patients after acute stage J.E. Shin, I.S. Kim, E.J. Kim, S.J. Jang. Department of Rehabilitation Medicine and Nuclear Medicine, Seoul National University College of Medicine, Republic of Korea Purpose: Although insomnia is commonly found in stroke patients, little is known about the insomnia after the acute stage of stroke. The purposes of the study were to document the clinical feature related to insomnia and to investigate the factors associated with insomnia in subacute and chronic stage after acute stroke. Methods: We evaluated the medical records of 416 consecutive stroke patients, who had a deficit lasting more than 4 weeks, admitted to the Korean National Rehabilitation Center from January 1, 2005 to December 31, 2005. Demographic and clinical data were collected by physicians, entered in our computer-based registry system, and analyzed in retrospect. Results: Of 416 patients, 78 suffered from insomnia; 60 patients had continuous and 18 episodic insomnia. Higher incidence in female patients was found than in male patients with marginal significance (P = 0.063), contrary to a significantly lower incidence in patients with associated hydrocephalus (P = 0.011). Overactive bladder presenting the symptom such as urinary frequency was related with insomnia (P = 0.05). Insomnia was not related with age, laterality and type of stroke, or constipation. Language and cognitive dysfunction, neglect, dysphagia, hemiplegic shoulder pain, and depression were not related to insomnia. Comorbidities including hypertension, DM, and hyperlipidemia were also unrelated to insomnia. Conclusion: Female sex and overactive bladder may be associated with insomnia in stroke patients after the acute phase while hydrocephalus is associated with a lower incidence of insomnia. L0046 Influence of long-term food restriction on sleep pattern in male rats T.A. Alvarenga, M.L. Andersen, L.A. Papale, I.B. Antunes, S. Tuf´ık. Department of Psychobiology, Universidade Federal de S˜ao Paulo, Rua Napoleao de Barros, 925, Vila Clementino, SP 04024−002, S˜ao Paulo, Brazil Objectives: The present purpose was to determine the effects of different schedules of long-term food restriction (FR) applied to rats from weaning to the 8th week. Methods: Rats were distributed into FR and ad libitum groups at weaning and fed at 7 am, at 7 pm, and finally, restricted rats fed ad libitum. The restricted rats started with 6 g/day and the food was increased by 1 g per week until reaching 15 g/day by adulthood. The rats were implanted with electrodes to record electrocorticogram/electromyogram signals. Their wake–sleep cycles were monitored over 3 consecutive days (72 h of recording). Results: The FR group fed at 7 am showed an increase in awake time, and decrease in slow wave sleep (SWS) and paradoxical sleep (PS) during the three light periods compared with the control recordings whereas in the dark periods, these sleep parameters were the opposite. The restricted group fed in the evening showed no statistical significances at diurnal periods; however, a significant decrease was observed in the dark recordings for awake time, but the SWS and PS were increased in relation to controls. The analysis of the 24-h period demonstrated that both FR groups presented increase in SWS time. After being FR, the rats were fed ad libitum and their sleep was monitored for 3 additional days. During the first dark recording,
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the decrease in awake time and increase in SWS were still present; however, as ad libitum food continued, these sleep parameters returned to control values, reestablishing the normal sleep pattern. Conclusions: These results suggest that dietary restriction, regardless to the feeding schedule, caused increase in total sleep time, during the active period. Contributed support: AFIP and FAPESP. L0047 Effects of long-term food restriction on genital reflexes in male paradoxically sleep deprived rats T.A.F. Alvarenga, M.L. Andersen, L.A. Papale, S. Tuf´ık. Department of Psychobiology – Universidade Federal de S˜ao Paulo, Escola Paulista de Medicina (UNIFESP/EPM), S˜ao Paulo, SP, Brazil Objective: The purpose was to ascertain whether the different schedules of long-term food restriction (FR) exert influence on genital reflexes (penile erection [PE] and ejaculation [EJ]) induced by paradoxical sleep deprivation (PSD) in male rats. Methods: Diet restriction began at weaning with 6 g/day and food was increased by 1 g per week until reaching 15 g/day by adulthood. Rats submitted to FR and those fed ad libitum were distributed into PSD (96 hours) or maintained as control groups and challenged with saline or cocaine, and placed in observation cages. Results: PSD+saline induced PE and EJ in both ad libitum and FR groups, but cocaine only potentiated reflexes in ad libitum group. In an attempt to revert the effects of FR on genital reflexes, we provided food ad libitum to the restricted group during the PSD period (4 days). When compared to FR rats, an increase in the frequency of PE was observed in the FR group fed ad libitum during PSD (both groups were challenged with cocaine). Further, we sought to investigate motivational behavior by placing food within the behavioral cage during the evaluation of genital reflexes. The FR PSD+saline group challenged with food did not display genital reflexes but when injected with cocaine the responses were similar to those observed in FR PSD+cocaine rats not challenged with food. Conclusions: Our data suggest that the facilitatory effect of PSD on genital reflexes did not override the inhibitory effect of FR on erectile function, but different schedules of FR produce distinct effects on genital reflexes. Contributed support: AFIP and FAPESP. L0048 Suppression of activity of central orexinergic system by lack of OCTN2, a carnitine transporter N. Eguchi1 , M. Sakata1 , M. Horiuchi2 , T. Saheki2 . 1 Waseda-Olympus Bioscience Research Institute, Waseda University, 11 Biopolis Way, Singapore 138667, Singapore, 2 Department of Molecular Metabolism and Biochemical Genetics, Kagoshima University Graduate School of Medicine and Dental Sciences, 8-35−1 Sakuragaoka, Kagoshima 890–8544, Kagoshima, Japan Fatty acids are the major energy source, and fatty acid oxidation (FAO) is disturbed by a carnitine deficiency in the diet. L-carnitine treatment is used clinically for recovery from depressed mood and lethargy in the secondary carnitine deficiency of the patients with cancer or diabetes. However, the effect of carnitine deficiency on the central nervous system of patients with FAO disorders is still unclear. In this study, we found that the nocturnal locomotor activity of OCTN2 mutant mice, an animal model of systemic carnitine deficiency, was reduced under the fasting condition, as compared with that of the control wild-type mice. This reduced activity was recovered to control level by the administration of sucrose or L-carnitine, but not medium-chain triglycerides. Moreover, modafinil, which is an activator of locomotor activity through the dopamine pathway in the brain, enhanced the reduced locomotor activity in fasted OCTN2 mutant mice. As judged from EEG/EMG profiles, the fasted wild-type mice showed prolonged wakefulness during the dark active period, whereas the OCTN2 mutant mice exhibited a disruption of the prolonged wakefulness with a higher frequency of brief episodes of non-REM sleep. Since the orexinergic arousal system plays important roles in the locomotor activity and in the maintenance of wakefulness, we determined orexin neuronal activity in the mouse brain under the fasting condition. Fasted OCTN2 mutant mice showed a reduced
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the decrease in awake time and increase in SWS were still present; however, as ad libitum food continued, these sleep parameters returned to control values, reestablishing the normal sleep pattern. Conclusions: These results suggest that dietary restriction, regardless to the feeding schedule, caused increase in total sleep time, during the active period. Contributed support: AFIP and FAPESP. L0047 Effects of long-term food restriction on genital reflexes in male paradoxically sleep deprived rats T.A.F. Alvarenga, M.L. Andersen, L.A. Papale, S. Tuf´ık. Department of Psychobiology – Universidade Federal de S˜ao Paulo, Escola Paulista de Medicina (UNIFESP/EPM), S˜ao Paulo, SP, Brazil Objective: The purpose was to ascertain whether the different schedules of long-term food restriction (FR) exert influence on genital reflexes (penile erection [PE] and ejaculation [EJ]) induced by paradoxical sleep deprivation (PSD) in male rats. Methods: Diet restriction began at weaning with 6 g/day and food was increased by 1 g per week until reaching 15 g/day by adulthood. Rats submitted to FR and those fed ad libitum were distributed into PSD (96 hours) or maintained as control groups and challenged with saline or cocaine, and placed in observation cages. Results: PSD+saline induced PE and EJ in both ad libitum and FR groups, but cocaine only potentiated reflexes in ad libitum group. In an attempt to revert the effects of FR on genital reflexes, we provided food ad libitum to the restricted group during the PSD period (4 days). When compared to FR rats, an increase in the frequency of PE was observed in the FR group fed ad libitum during PSD (both groups were challenged with cocaine). Further, we sought to investigate motivational behavior by placing food within the behavioral cage during the evaluation of genital reflexes. The FR PSD+saline group challenged with food did not display genital reflexes but when injected with cocaine the responses were similar to those observed in FR PSD+cocaine rats not challenged with food. Conclusions: Our data suggest that the facilitatory effect of PSD on genital reflexes did not override the inhibitory effect of FR on erectile function, but different schedules of FR produce distinct effects on genital reflexes. Contributed support: AFIP and FAPESP. L0048 Suppression of activity of central orexinergic system by lack of OCTN2, a carnitine transporter N. Eguchi1 , M. Sakata1 , M. Horiuchi2 , T. Saheki2 . 1 Waseda-Olympus Bioscience Research Institute, Waseda University, 11 Biopolis Way, Singapore 138667, Singapore, 2 Department of Molecular Metabolism and Biochemical Genetics, Kagoshima University Graduate School of Medicine and Dental Sciences, 8-35−1 Sakuragaoka, Kagoshima 890–8544, Kagoshima, Japan Fatty acids are the major energy source, and fatty acid oxidation (FAO) is disturbed by a carnitine deficiency in the diet. L-carnitine treatment is used clinically for recovery from depressed mood and lethargy in the secondary carnitine deficiency of the patients with cancer or diabetes. However, the effect of carnitine deficiency on the central nervous system of patients with FAO disorders is still unclear. In this study, we found that the nocturnal locomotor activity of OCTN2 mutant mice, an animal model of systemic carnitine deficiency, was reduced under the fasting condition, as compared with that of the control wild-type mice. This reduced activity was recovered to control level by the administration of sucrose or L-carnitine, but not medium-chain triglycerides. Moreover, modafinil, which is an activator of locomotor activity through the dopamine pathway in the brain, enhanced the reduced locomotor activity in fasted OCTN2 mutant mice. As judged from EEG/EMG profiles, the fasted wild-type mice showed prolonged wakefulness during the dark active period, whereas the OCTN2 mutant mice exhibited a disruption of the prolonged wakefulness with a higher frequency of brief episodes of non-REM sleep. Since the orexinergic arousal system plays important roles in the locomotor activity and in the maintenance of wakefulness, we determined orexin neuronal activity in the mouse brain under the fasting condition. Fasted OCTN2 mutant mice showed a reduced