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Biomedical subjects

M Mirmiran

Publications and source records attributed to M Mirmiran.

At least 37 records · Page 2Linked to original sources
PubMed1997

Indirect bright light improves circadian rest-activity rhythm disturbances in demented patients.

Light is known to be an important modulator of circadian rhythms. We tested the hypothesis than an enduring increase in the daytime environmental illumination level improves rest-activity rhythm disturbances in demented patients. Actigraphy was performed before, during, and after 4 weeks of increased illumination in the living rooms of 22 patients with dementia clinically diagnosed as probable Alzheimer's disease, multi-infarct dementia, dementia associated with alcoholism, or normal pressure hydrocephalus. The results indicated that during increased illumination, the stability of the rest-activity rhythm increased in patients with intact vision, but not in visually impaired patients.

Aged↗
PubMed1997

The diurnal rhythm in fetal heart rate in a twin pregnancy with discordant anencephaly: comparison with three normal twin pregnancies.

In a discordant anencephalic twin the hypothesis was tested that the fetal brain is necessary for the expression of a diurnal rhythm in fetal heart rate. Fetal heart rate recordings were made over a 24 h period in a discordant anencephalic twin pregnancy and in three normal twin pregnancies. Cosinor analysis was used to assess rhythmicity in fetal heart rate and maternal heart rate or activity. Correlations between maternal and fetal rhythms were calculated. A significant diurnal rhythm was found for the fetuses of the control twins, but in neither of the fetuses of the discordant anencephalic twin pregnancy. The maternal rhythm was 1-2 h in advance of the heart rate rhythms in all fetuses except the anencephalic one, whose heart rate did not show any correlation with the maternal diurnal rhythm. We conclude that the fetal brain contributes to the generation of the diurnal rhythm in fetal heart rate and synchronization of maternal-fetal rhythms.

Adult↗
PubMed1997

Long-term fitness training improves the circadian rest-activity rhythm in healthy elderly males.

In old age, the circadian timing system loses optimal functioning. This process is even accelerated in Alzheimer's disease. Because pharmacological treatment of day-night rhythm disturbances usually is not very effective and may have considerable side effects, nonpharmacological treatments deserve attention. Bright light therapy has been shown to be effective. It is known from animal studies that increased activity, or an associated process, also strongly affects the circadian timing system, and the present study addresses the question of whether an increased level of physical activity may improve circadian rhythms in elderly. In the study, 10 healthy elderly males were admitted to a fitness training program for 3 months. The circadian rest-activity rhythm was assessed by means of actigraphy before and after the training period and again 1 year after discontinuation. As a control for possible seasonal effects, repeated actigraphic recordings were performed during the same times of the year as were the pre and post measurements in a control group of 8 healthy elderly males. Fitness training induced a significant reduction in the fragmentation of the rest-activity rhythm. Moreover, the fragmentation of the rhythm was negatively correlated with the level of fitness achieved after the training. No seasonal effect was found. Previous findings in human and animal studies are reviewed, and several possible mechanisms involved in the effect of fitness training on circadian rhythms are discussed. The results suggest that fitness training may be helpful in elderly people suffering from sleep problems related to circadian rhythm disturbances.

Activity Cycles↗
PubMed1997

Developmental care does not alter sleep and development of premature infants.

OBJECTIVE: The Neonatal Individualized Developmental Care Program (NIDCAP) for very low birth weight (VLBW) preterm infants has been suggested by Als et al to improve several medical outcome variables such as time on ventilator, time to nipple feed, the duration of hospital stay, better behavioral performance on Assessment of Preterm Infants' Behavior (APIB), and improved neurodevelopmental outcomes. We have tested the hypothesis of whether the infants who had received NIDCAP would show advanced sleep-wake pattern, behavioral, and neurodevelopmental outcome. METHODS: Thirty-five VLBW infants were randomly assigned to receive NIDCAP or routine infant care. The goals for NIDCAP intervention were to enhance comfort and stability and to reduce stress and agitation for the preterm infants by: a) altering the environment by decreasing excess light and noise in the neonatal intensive care unit (NICU) and by using covers over the incubators and cribs; b) use of positioning aids such as boundary supports, nests, and buntings to promote a balance of flexion and extension postures; c) modification of direct hands-on caregiving to maximize preparation of infants for, tolerance of, and facilitation of recovery from interventions; d) promotion of self-regulatory behaviors such as holding on, grasping, and sucking; e) attention to the readiness for and the ability to take oral feedings; and f) involving parents in the care of their infants as much as possible. The infants' sleep was recorded at 36 weeks postconceptional age (PCA) and at 3 months corrected age (CA) using the Motility Monitoring System (MMS), an automated, nonintrusive procedure for determining sleep state from movement and respiration patterns. Behavioral and developmental outcome was assessed by the Neurobehavioral Assessment of the Preterm Infant (NAPI) at 36 weeks PCA, the APIB at 42 weeks PCA, and by the Bayley Scales of Infant Development (BSID) at 4, 12, and 24 months CA. RESULTS: Sleep developmental measures at 3 months CA showed a clear developmental change compared with 36 weeks PCA. These include: increased amount of quiet sleep, reduced active sleep and indeterminate sleep, decreased arousal, and transitions during sleep. Longest sleep period at night showed a clear developmental effect (increased) when comparing nighttime sleep pattern of infants at 3 months with those at 36 weeks of age. Day-night rhythm of sleep-wake increased significantly from 36 weeks PCA to 3 months CA. However, neither of these sleep developmental changes showed any significant effects of NIDCAP intervention. Although all APIB measures showed better organized behavior in NIDCAP patients, neither NAPI nor Bayley showed any developmental advantages for the intervention group. The neurodevelopmental outcome measured by the Bayley at 4, 12, and 24 months CA showed 64% of the NIDCAP intervention group at the lowest possible score compared with 33% of the control group. These findings could not be explained by the occurrence of intraventricular hemorrhage or the socioeconomic status of the parents, which showed no significant group effect. CONCLUSION: The results of this study, including measures of sleep maturation and neurodevelopmental outcome up to 2 years of age did not demonstrate that the NIDCAP intervention results in increased maturity or development. Buehler et al (Pediatrics. 1995;96:923-932) have reported that premature infants (N = 12; mean gestational age 32 weeks, mean birth weight 1700 g) who received developmental care compared with a similar group of infants who received routine care showed better organized behavioral performance on an APIB assessment at 42 weeks PCA. None of the medical outcome measures were significantly different in this study. Although our APIB results are in agreement, the results of the NAPI, the Bayley and sleep measures do not show an increase in neurodevelopmental maturation. In the earlier report by Als et al (Journal of the American Medical Associatio

Adult↗
PubMed1996

Circadian rest-activity rhythm disturbances in Alzheimer's disease.

Previous studies showed circadian rhythm disturbances in patients with Alzheimer's disease. Rest-activity rhythm disturbances manifest themselves through a fragmentation of the rhythm, a weak coupling with Zeitgebers, and high levels of activity during the night. The aim of the present study was to investigate which factors contribute to the presence of these disturbances. Therefore, several rest-activity rhythm, constitutional, and environmental variables were assessed in a heterogeneous group of 34 patients with Alzheimer's disease, including presenile and senile patients living at home or in a nursing home, as well as in 11 healthy controls. Circadian rest-activity rhythm disturbances were most prominent in institutionalized patients. Regression analyses showed the involvement of the following variables. First stability of the rest-activity rhythm is associated with high levels of daytime activity and high levels of environmental light resulting from seasonal effects as well as from indoor illumination. Presenile onset contributed to instability of the rhythm. Second, fragmentation of periods of activity and rest is associated with low levels of daytime activity, and is most prominent in moderately severe dementia. Third, night-time activity level is higher during the times of the year when the days are getting shorter and lower when the days are growing longer. These findings indicate that rest-activity rhythm disturbances may improve by increasing environmental light and daytime activity, an assumption for which empirical evidence has recently been published.

Aged↗
PubMed1996

Gravitational artefact in frequency spectra of movement acceleration: implications for actigraphy in young and elderly subjects.

Actigraphy, the long-term assessment of wrist movements by means of a small solid-state recorder, is widely used in a variety of human research fields, among which sheep, circadian rhythms and aging. Actigraphs assess movement with the use of accelerometers, which sense accelerations resulting from muscle force as well as accelerations due to changes in the position of the sensor in the gravitational field. In the present paper a method is described to minimise gravitational artefact in movement assessment by calculating the instantaneous acceleration vector from 3 perpendicular acceleration signals. It is shown that the power spectra of single axis acceleration signals are dominated by low-frequency components (+/- 0.25 Hz) due to gravitational artefact. Spectra of the instantaneous acceleration vector indicate that 'true' movement accelerations resulting from muscle force are present in a much wider range: from 0.25 to 11 Hz. Wrist accelerations in elderly subjects were found to be of lower amplitude and frequency as compared to young subjects. It is furthermore shown that a bandpass filter of 0.25 to 2 or 3 Hz, as has been used in commercially available actigraphs, is far from optional, and may even result in a positive bias for movement detection in the elderly. This bias may underly contradictory findings in actigraphic studies on human aging. When a bandpass filter of 0.5-11 Hz is applied to a single-axis acceleration signal, the influence of gravitational artefact and bias are minimized, and the age-related decline in activity is properly detected.

Acceleration↗
PubMed1996

An on-line automated sleep-wake classification system for laboratory animals.

A computerized sleep-wake classification program is presented that is capable of classifying sleep-wake states on-line in four animals simultaneously. Every 10 s the classification algorithm assigns sleep-wake states on the basis of the power spectrum of an EEG signal and the standard deviation of an EMG signal. The system was developed specifically for long-term circadian rhythm experiments and can run uninterrupted for an unlimited period of time. To validate the system a total of 5760 sleep-wake epochs from 4 rats was classified both visually and by computer. The results show a good agreement between visual and computer automated (kappa = 0.770) sleep-wake scoring. Therefore, the presented sleep-wake classification system can be regarded as a reliable time saving alternative for visual scoring in sleep research.

Animals↗
PubMed1996

Is brain plasticity preserved during aging and in Alzheimer's disease?

Alzheimer's disease is a progressive neurodegenerative disorder believed to involve selective neuronal cell atrophy/loss in certain brain regions. The progress of the disease is accompanied by selective cognitive impairments and behavioral disturbances. The hypothesis has been put forward that by activation of selective brain areas throughout life one might protect or delay the degenerative process. This hypothesis, paraphrased as "a differential level of brain cell activity may account for cell selective loss" or "use it or lose it", further suggests that a certain level of neuronal plasticity persists during aging and even in Alzheimer's disease.

Aging↗
PubMed1996

Perinatal development of human circadian rhythms.

The early development of circadian rhythms in primates, including man, was reviewed. Continuous 24-h recordings were carried out for maternal and fetal circadian rhythms during gestation as well as in preterm infants. Several propositions were made based on these new findings: 1. The fetal biological clock is an endogenous clock capable of generating circadian rhythms and responding to maternal entraining signals long before the moment of birth. 2. Through the fetal biological clock, maternal circadian rhythms influence the fetal overt rhythms. 3. Maternal rhythms influence the fetus, and fetal rhythms feed back to the mother (via the placenta). Disruption of this fetal-maternal interaction during gestation leads to: a. disturbances of maternal and fetal circadian rhythms; b. disappearance of circadian rhythms at the time of birth; c. a gestational period which is either too short or too long (see also Honnebier and Swaab, 1973); d. delayed or impaired maturation of the circadian rhythms of the infant.

Body Temperature↗
PubMed1996

Decreased hypothalamic serotonin levels in adult rats treated neonatally with clomipramine.

Early postnatal treatment with the antidepressant drug clomipramine has repeatedly been shown to lead to behavioural and physiological changes in adult rats. To provide some neurochemical correlates to these studies we have measured a number of monoaminergic parameters in the brains of adult (one year old) rats that were treated twice daily with 15 mg/kg clomipramine from postnatal day 2-14. The most consistent finding was that the hypothalamic levels of serotonin (5-HT) were decreased and those of the dopamine metabolite dihydroxyphenylacetic acid (DOPAC) were increased in rats irrespectively whether they went through a range of behavioural and physiological tests or not. The numbers of beta-adrenoceptors in the frontal cortex and of alpha 2-adrenoceptors in the amygdala/piriform cortex were not changed. The decrease in hypothalamic 5-HT concentrations appears to be up to now the most consistent neurochemical alteration in adult rats that were neonatally treated with antidepressant drugs. It is, however, not clear what the relation is with the functional changes in these rats, that are proposed by some authors as an animal model for depression.

Animals↗
PubMed1995

Circadian rhythm generation in the cultured suprachiasmatic nucleus.

The suprachiasmatic nucleus (SCN) of the hypothalamus is involved in the generation and entrainment of circadian rhythms. The results of a series of experiments in long-term cultured organotypic SCN slices suggest that (1) some but not all SCN neurons display circadian rhythmicity in their extracellular discharges. To the extent they could be studied, these neurons did not usually show synchronized high/low levels of activity; (2) simultaneous daily depolarization of these neurons (K+ pulses) to some extent influenced the distribution of the firing rate of SCN neurons around the time of expected daily pulses; (3) extracellular Ca++ and synaptic input is required for the pacemaker activity of the SCN. We conclude that the mammalian biological clock is a heterogeneous neuronal system in which the circadian pacemaker rhythm is generated and entrained via complex interactions among SCN neurons.

Animals↗
PubMed1994

The effect of old age on the free-running period of circadian rhythms in rat.

The free-running period is regarded to be an exclusive feature of the endogenous circadian clock. Changes during aging in the free-running period may therefore reflect age-related changes in the internal organization of this clock. However, the literature on alterations in the free-running period in aging is not unequivocal. In the present study, with various confounding factors kept to a minimum, it was found that the free-running periods for active wakefulness, body temperature, and drinking behavior were significantly shorter (by 12-17 min) in old than in young rats. In addition, it was found that the day-to-day stability of the different sleep states was reduced in old rats, whereas that of the drinking rhythm was enhanced. Transient cycles were not observed, nor were there any age-related differences in daily totals of the various sleep-wake states. The amplitudes of the circadian rhythms of active wakefulness, quiet sleep, and temperature were reduced, whereas those of paradoxical sleep and quiet wakefulness remained unchanged.

Aging↗
PubMed1993

Non-pharmacological treatment of sleep and wake disturbances in aging and Alzheimer's disease: chronobiological perspectives.

Numerous studies indicate a deterioration of nighttime sleep and daytime cognitive performance in elderly people and Alzheimer patients. As a result of the increasing number of elderly people and Alzheimer patients in the western society, attention for these problems has grown. However, so far, the major research effort has been concentrating on the development of pharmacological therapies for an isolated age-related problem. In the present review it is argued that several age-related problems with sleep and wakefulness may reflect a dampening of circadian rhythm amplitudes. Non-pharmacological manipulation of circadian rhythms by means of various external stimuli appears to be effective in improving sleep and cognitive functioning in elderly people and Alzheimer patients.

Aged↗
PubMed1993

Ambulatory monitoring of tremor and other movements before and after thalamotomy: a new quantitative technique.

Tremor, e.g. in Parkinson patients, often shows large spontaneous fluctuations in severity over the day, to such an extent that a short observation is usually not sufficient to assess the overall severity or the effect of a treatment. Since momentary impressions of the tremor can thus be misleading, long-term ambulatory recordings would be helpful in the evaluation of severity and treatment effectiveness. As existing methods for long-term tremor registration have several shortcomings, a new method is proposed: an algorithm was designed to discriminate tremor from other movements and to describe the amount (i.e. the proportion of tremor or movements per time unit) as well as the intensity (i.e. average acceleration amplitude) of the two types of movement. In the evaluation of the severity of tremor both the amount and intensity of tremor episodes are of importance. The algorithm was tested on 24-h analog tape recordings of wrist-movement in 10 young and 10 aged controls, as well as in 8 patients with tremor--both before and after a tremor relieving thalamotomy. The algorithm scored movements as 'tremor' exclusively in patients prior to the operation. Fluctuations in tremor severity over the day were detected, and tremor could be discriminated from non-pathological movements. Moreover, following thalamotomy, motor slowing (bradykinesia) was detectable using this algorithm. Based on these test results, a miniaturized device in wrist-watch format is now being developed for long-term registrations.

Adult↗
PubMed1993

Effects of excitatory and inhibitory amino acids on neuronal discharges in the cultured suprachiasmatic nucleus.

The influence of amino acids on neuronal activity was studied microiontophoretically in the cultured suprachiasmatic nucleus (SCN). Three types of SCN neurons could be characterized: silent (glutamate responsive), irregular, and regular neurons. Glutamate excited about 70% of the regular and 60% of the irregular cells. GABA inhibited both the spontaneous and the glutamate-evoked activity of more than 90% of all three types of SCN neurons. MK-801 partially blocked glutamate responses. N-acetyl-aspartyl-glutamate (NAAG), a new neurotransmitter found in the retinohypothalamic fibers, directly increased firing rate and potentiated glutamate responses in the SCN neurons that were studied. These results indicate the potential significance of the amino acids in neuronal transmission within the biological clock.

Amino Acids↗
PubMed1993

Effect of light intensity on diurnal sleep-wake distribution in young and old rats.

During the aging process, the amplitude of the circadian rhythms of many physiological variables is reduced. It has been hypothesized that increasing light intensity during the light phase of the light-dark cycle might result in a reduction of age-related changes in the circadian rhythms. Indeed, in the present sleep-wake study in young and old rats it was found that (a) various parameters, such as the light-dark differences and total amounts of each behavioral state responded positively to changes in environmental light intensity (i.e., age-related trends were reversed), (b) in both age groups, the logarithm of light intensity appeared to have a linear dose-response relationship with light-dark differences of the sleep-wake states, (c) the light-dark difference of active wakefulness and quiet sleep of old rats under high light intensity were comparable to those of young rats under low light intensity. The results of the present study suggest that, under appropriate conditions, light could be of clinical use in reducing age-related circadian sleep disturbances in humans. This may, in turn, reduce the use of sedatives in elderly people.

Aging↗