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Biomedical subjects

M V Vitiello

Publications and source records attributed to M V Vitiello.

At least 37 records · Page 2Linked to original sources
PubMed1995

Higher plasma IGF-1 levels are associated with increased delta sleep in healthy older men.

BACKGROUND: Sleep quality declines with age, with less time in deep or slow wave sleep (SWS) and reduced amplitude of the delta waves that characterize it. Age-related declines also occur in lean body mass, growth hormone (GH), and insulin-like growth factor 1 (IGF-1). These changes in sleep quality and anabolic status may be related, as administration of GH or growth hormone releasing hormone (GHRH) can enhance SWS and decrease awakenings in young men. Here we examine the relationship between plasma IGF levels and delta sleep quality in older men. METHODS: The sleep EEG of 30 healthy elderly men (64 +/- 6 yrs; range 50-75) was recorded on the second of 2 consecutive nights. Plasma samples were drawn within 3 weeks of EEG recording, and IGF levels were assayed by RIA after acid extraction. RESULTS: IGF explained 28% (semi-partial correlation coefficient r = .53; p = .003) of the variance in average delta energy per epoch of SWS, after age-related variance was removed. Higher IGF was associated with higher average delta energy. Similar results were obtained for total delta energy during SWS (r = .37, p = .04) 4nd time spent in SWS (r = .42, p = .02). Other measures of sleep quality (e.g., wakefulness, REM sleep) were not correlated with IGF. The IGF delta relationship was minimally influenced by moderator variables such as thyroxine (T3, T4), and/or body mass index (BMI). CONCLUSION: We conclude that age-adjusted IGF levels in healthy senior men co-vary significantly with SWS and the delta energy that characterizes it.

Aged↗
PubMed1995

A note on the night-to-night stability of stages 3 + 4 sleep in healthy older adults: a comparison of visual and spectral evaluations of stages 3 + 4 sleep.

Night-to-night variability in the minutes of slow-wave sleep (SWS: combined minutes of stages 3 and 4 sleep) was examined for 50 healthy adults: 23 women (56-82 years old) and 27 men (54-74 years old). Visually rated SWS was more variable night to night than computer-evaluated SWS using power spectral techniques. The night-to-night correlation of the visually rated SWS was 0.61. The night-to-night correlation of the spectrally evaluated SWS was 0.91.

Aged↗
PubMed1994

Predicting long-term outcome in individuals at risk for Alzheimer's disease with the Dementia Rating Scale.

The Dementia Rating Scale, previously shown to be sensitive to dementia progression, was used to differentiate among normal control subjects, patients with Alzheimer's disease (AD), and those judged to be at risk for AD on the basis of subclinical memory impairment. The memory scale of the Dementia Rating Scale predicted with 93% accuracy which at-risk individuals would develop AD at 4- to 6-year follow-up.

Aged↗
PubMed1994

C STAGE, automated sleep scoring: development and comparison with human sleep scoring for healthy older men and women.

Using the sleep records of 200 men and women (age 55-85 years), we have developed a human-assisted computer scoring system, C STAGE. The system can have many applications, including quantitative electroencephalographic (EEG) analysis during specific stages of sleep. C STAGE classifies sleep/wake stages using power spectral analysis and other techniques applied to one channel of EEG data. Here we report comparability data between C STAGE- and human-rated sleep-stage scoring using Rechtschaffen and Kales criteria for 70 normal subjects (a subset of the 200). Because the method was developed using these subjects, we also report comparability data for an independent validation sample of 45 normal older men and women. For waking measures, sleep stages 3 and 4, and total sleep time, C STAGE yielded ratings comparable with the human rater (r = 0.73-0.91; p < 0.001). For sleep stages 1 and 2 and REM sleep, C STAGE correlated less well with human ratings (r = 0.59-0.81; p < 0.001). Overall, these correlations compare well with other currently available computer stage-scoring methods. Epoch-by-epoch comparisons in the validation sample revealed a mean proportion of agreement of 0.74 and a mean Kappa coefficient of 0.57, indicating the two methods provide reasonable agreement on an epoch-by-epoch basis. We conclude that C STAGE is a valid sleep/waking scoring system for healthy older adults.

Aged↗
PubMed1993

Major unipolar depression and mild Alzheimer's disease: differentiation by quantitative tonic REM EEG.

In a previous report, tonic REM sleep epochs from the all-night sleep EEG were processed and analyzed to produce a diagnostic that discriminated mild Alzheimer's disease (AD) from cognitively unimpaired control subjects. Here, we examine the specificity of this diagnostic in distinguishing depression from AD. Twenty-four cognitively unimpaired seniors (aged 63 +/- 1.3) with major depressive disorder (unipolar) were monitored for all-night EEG in a manner identical to that used in our previous report. Tonic REM EEG epochs were preconditioned, spectrally analyzed and compared with known populations of control and AD EEG spectra. Instances when a given depressed subject's spectra fell within spectral zones unique to control or AD populations formed a diagnostic score (control, AD, neither of these). Diagnostic scores correctly identified 88% (21/24) of cognitively unimpaired seniors with major depressive disorder (unipolar). This can be compared with 89% (31/35) of mild AD subjects and 100% (43/43) of control subjects correctly identified in our previous report. This diagnostic also correctly classified as to eventual clinical AD/not AD outcome 8 subjects with both major depressive disorder and validated memory complaints. The diagnostic discrimination of AD is based on the fact that AD subjects have significantly less tonic REM EEG energy in the 13-30 Hz frequency range and more in the 1-10 Hz range than control or depressed subjects, as shown in conventional spectral analysis.

Aged↗
PubMed1993

Dim light melatonin onset and circadian temperature during a constant routine in hypersomnic winter depression.

The onset of melatonin secretion under dim light conditions (DLMO) and the circadian temperature rhythm during a constant routine were assessed in 6 female controls and 6 female patients with winter depression (seasonal affective disorder, SAD) before and after bright light treatment. After sleep was standardized for 6 days, the subjects were sleep-deprived and at bedrest for 27 h while core temperature and evening melatonin levels were determined. The DLMO of the SAD patients was phase-delayed compared with controls (2310 vs 2138); with bright light treatment, the DLMO advanced (2310 to 2135). The minimum of the fitted rectal temperature rhythm was phase-delayed in the SAD group compared with the controls (0542 vs 0316); with bright light treatment, the minimum advanced (0542 vs 0336).

Adult↗
PubMed1992

EEG markers of early Alzheimer's disease in computer selected tonic REM sleep.

All night sleep/wake EEGs were examined for diagnostic features sensitive to early Alzheimer's disease (AD) using computer automated techniques. Thirty-nine mild AD patients and 43 normal controls underwent 9 h of EEG recording in the sleep laboratory. All-night EEGs were screened for ideal, low artifact tonic REM sleep using autoregressive and power spectral techniques. The frequency spectra during tonic REM sleep revealed a significant shift towards slower wave forms in AD vs. control subjects. Beta (greater than 12 Hz) was reduced and theta and delta (2-8 Hz) increased in AD compared to control groups. This frequency shift was demonstrated by several analytic techniques, including binned spectral energies and unique zones in the frequency spectra. Discriminant analyses using optimal binned EEG variables correctly classified 74% of AD and 98% of control subjects, and unique zone scores correctly classified 92% of AD and 95% of control subjects, indicating that these sleep EEG changes are apparently predictive of AD status.

Aged↗
PubMed1992

Letter matching: effects of age, Alzheimer's disease, and major depression.

We compared Alzheimer's disease (AD) patients and Major Depressive Disorder (MDD), Aged normal, and Young normal controls on a letter-matching task designed to measure the time needed to access overlearned linguistic information in long-term memory. Name identity (NI) and physical identity (PI) reaction time and the NI-PI difference were compared for ADs, MDDs, and Aged normals and separately for Aged and Young normal groups. AD subjects had slower NI and PI reaction times and a bigger NI-PI difference than Aged normal and MDD subjects, suggesting that speed of access to overlearned letter-name information in long-term memory is slowed for ADs. There were no reliable differences between Aged normal and MDD subjects. Aged normals had slower NI and PI reaction times and a bigger NI-PI difference than Young normals, suggesting that the highly practiced operations needed to access letter-name information slow with age. A discriminant analysis was used to evaluate the usefulness of the "easy to perform" letter-matching task for diagnostic purposes. Ninety percent of normal and MDD subjects but only 68% of AD subjects were classified correctly.

Adult↗
PubMed1992

Sleep in Alzheimer's disease and the sundown syndrome.

Approximately 10% of the elderly population have a dementing illness that manifests itself clinically by significant cognitive deficits. Half of these individuals have Alzheimer's disease (AD), a progressive degeneration of cortical and subcortical neurons. Disturbances of sleep and the sleep-wake rhythm are a common clinical observation in AD, as is "sundowning," the onset or exacerbation of delirium during the evening or night. Here we describe the neurologic basis for the disturbed sleep of patients with AD, the phenomenology of that disturbance, and its implications. Further, we describe the prevalence, possible causes, and treatment of sundowning.

Aged↗
PubMed1991

Sleep in Alzheimer's disease and other dementing disorders.

It is estimated that up to 10% of the elderly population have clinically significant cognitive deficits. The neuronal pathologies that underlie the dementing disorders cause both cognitive dysfunction and disturbances in normal sleep/wake patterns. Here we report the changes in sleep/wake patterns seen with increasing severity of Alzheimer's disease, probably the most common dementing disorder. In addition, studies examining sleep/wake patterns in a number of other dementing disorders are reviewed.

Alzheimer Disease↗
PubMed1991

Healthy elderly women and men have different entrained circadian temperature rhythms.

Body core temperature was measured in healthy elderly men and women under entrained conditions. Female subjects showed a larger amplitude and a higher peak temperature than male subjects. In addition, acrophase was advanced for females by an average of 49 minutes. Variability in acrophase was greater for males than females. This pattern of gender differences varies considerably from the pattern others have observed in young subjects, suggesting that aging may affect the circadian timing system of males and females differently.

Aged↗
PubMed1990

Sleep is undisturbed in elderly, depressed individuals who have not sought health care.

Sleep deficits are commonly found in geriatric depressed patients, particularly shortened rapid eye movements (REM) latency, disturbed sleep continuity, and decreased slow wave sleep (SWS). Here we report the sleep patterns of community volunteers responding to ads about memory loss and depression. The two groups, 24 geriatric-onset major depressive disorder (MDD) subjects with a minimal history of seeking treatment for depression and 24 gender- and age-matched control subjects, significantly differed from each other on only one measure of sleep--sleep latency; the MDD group showed a modest but significant shortening of latency to fall asleep. All other sleep/wake measures, including REM latency, temporal distribution of REM sleep across the night, SWS, and measures of nighttime wakefulness did not differ between groups. This lack of significant sleep disturbance suggests that the sleep deficits reported in many studies of major depression may be related to factors underlying treatment-seeking behaviors, physical health status, severity of the depression, or heterogeneity within the MDD population with some types seeking treatment and others not seeking it, rather than depressive state per se. The data indicate that community-dwelling healthy elderly individuals who have a diagnosed major depression but who have not actively sought health care do not necessarily manifest the sleep disturbances thought to be characteristic of major depressive illness.

Clinical Trials as Topic↗
PubMed1990

Sleep disturbances in patients with mild-stage Alzheimer's disease.

We examined the ability of sleep/wake measures to discriminate 45 control subjects from 44 mild Alzheimer's disease (AD) patients. Sleep fragmentation was observed as indicated by significant increases in time awake (37-52%) and number of awakenings (31-36%) during the night as compared to controls. Further, slow wave sleep (SWS) was significantly reduced (22%) in AD patients relative to controls. These findings are consistent with our earlier observations of increased wakefulness and decreased SWS in mild-moderate, moderate-severe, and severe stage AD patients. However, when we used these sleep/wake stage measures in discriminant analyses to classify the current AD subjects vs control subjects, the analyses failed to confirm our earlier high classification rate (90%). The present groups were discriminated at overall classification rates of only 63-67%. We conclude that while sleep/wake patterns are significantly disturbed in AD, this phenomenon is not diagnostically useful for discrimination of mild stage AD.

Aged↗
PubMed1990

Nighttime hypoxemia is increased in abstaining chronic alcoholic men.

Previously we reported that abstaining chronic alcoholic men demonstrated significantly more nighttime hypoxemia than a control group. Here, we report a replication employing a larger sample of abstaining chronic alcoholics and a more appropriate control group than that used in the previous study. Forty-seven males, 48.4 +/- 1.7 years of age (mean +/- SEM), reporting 24.8 +/- 1.5 years of heavy alcohol use, comprised the abstaining alcohol group. Thirty-five age- and weight-matched males, 50.3 +/- 1.7 years were the control group. The alcohol group had significantly more nighttime oxygen desaturations below 90% than did the control group (16.9 +/- 3.3 vs. 6.2 +/- 1.4, F = 7.8, p less than 0.01), with significantly higher percentages of individuals in the alcohol group manifesting more than 10 or 20 oxygen desaturations below 90%. Regression analyses within the alcohol group revealed that severity of alcohol abuse, but not age, body mass index, days abstinent, or smoking significantly predicted levels of nighttime hypoxemia. These results confirm our original observation of increased nighttime hypoxemia in abstaining chronic alcoholic men and suggest that long-term alcohol abuse may be a risk factor for development of sleep apnea.

Aging↗
PubMed1990

Relationship of alcohol abuse history to nighttime hypoxemia in abstaining chronic alcoholic men.

The nighttime blood oxygen saturation of 35 abstaining chronic alcoholic men was studied. Regression analyses indicated that various measures of alcohol abuse history (r = -.61, p less than .001) account for significant variance in nighttime hypoxemia. Age (r = -.39, p less than .05) and smoking history (r = .45, p less than .01) were less powerful predictors and both obesity and days abstinent from alcohol failed to correlate with hypoxemia. Possible mechanisms to explain the relationship between alcohol abuse history and hypoxemia are discussed. This and previously reported findings indicate that chronic alcohol abuse may predispose an individual to nighttime hypoxemia and be a risk factor for sleep apnea.

Alcoholism↗
PubMed1989

Dominant occipital (alpha) rhythm frequency in early stage Alzheimer's disease and depression.

The sinusoidal 8-13 Hz wave form that dominates in the occipital EEG record during relaxed wakefulness is known as alpha rhythm or dominant occipital rhythm. The frequency of this rhythm is known to decrease with normal aging with organic brain diseases. Here we report dominant occipital frequency (DOF) data for 41 early stage AD patients, 50 age-, sex- and health-matched control subjects and 22 subjects with major depressive disorder. DOF was assessed blindly for each subject from 10 or more samples during relaxed wakefulness in an all-night polysomnogram. Mean DOF was significantly lower in the AD (mean +/- S.D. was 8.24 +/- 1.04) than control group (9.48 +/- 0.57; F = 56, P less than 0.001). Mean DOF was also significantly lower in the depressed than control group (9.20 +/- 0.50 vs. 9.48, F = 5.0, P less than 0.05). In discriminant analyses, DOF achieved an overall correct classification rate of 77% for AD vs. control subjects, and 72% for AD vs. depressed subjects. These results indicate that DOF may be useful in identifying early stages of AD in healthy, drug-free populations.

Aged↗
PubMed1989

The effect of subliminal oedipal and competitive stimulation on dart throwing: another miss.

Silverman and his associates have reported that subliminal presentation of oedipally relevant competitive stimuli can modify dart-throwing performance in male subjects. This study replicated their paradigm, but also examined the effects on performance of nonoedipal competitive stimuli. Our results failed to support Silverman's. Both types of subliminally presented competitive stimuli failed to have any systematic effect on dart-throwing performance.

Adolescent↗