Abstract
Chronic headache (persistent or recurrent headache for 3-months or longer) is highly prevalent among youth. While sleep disturbances have been associated with headache, their inter-relationship with brain connectivity remains unknown. This observational study examined whether self-report and actigraphy measures of sleep were associated with alterations to white matter tracts (i.e., uncinate fasciculus and cingulum) in youth with chronic headache versus healthy controls. Thirty youth aged 10–18 years with chronic headache and thirty controls underwent an MRI. Diffusion tensor images were obtained and mean fractional anisotropy values of the cingulum and uncinate were extracted. One-week prior to their MRI, youth wore an actigraph to obtain sleep duration, wake after sleep onset and sleep efficiency measures. Moreover, they completed questionnaires regarding their sleep quality and pain symptomatology. Linear regression was applied to examine the relationships between sleep (self-report and actigraphy), fractional anisotropy, and number of headache days per month. Self-report and actigraphy measures of sleep did not differ between patients and controls. However, poorer self-reported sleep quality was associated with lower fractional anisotropy values in the left uncinate (P = 0.05). Lower left uncinate fractional anisotropy was related to increased headache frequency (P = 0.002) in youth with chronic headache. Therefore, alterations to connectivity may be associated with the relationship between altered perceptions of sleep and headache chronicity.
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Data availability
De-identified participant data, and the study protocol, statistical analysis plan, and analytic code will be made available upon reasonable request. Proposals should be directed to jillian.miller1@ucalgary.ca to gain access, and data requestors will need to sign a data access agreement.
Abbreviations
- Alberta Children’s Hospital:
-
ACH
- Anxiety Subscale:
-
AXT
- Cognitive behavioral therapy:
-
CBT
- Depression Subscale:
-
MDD
- Diffusion tensor imaging:
-
DTI
- Fractional anisotropy:
-
FA
- Regions of interest:
-
ROI
- Revised child anxiety and depression scale:
-
RCADS
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Acknowledgements
We are grateful to the families who participated, and Allison McPeak for her assistance with describing the actigraphy data.
Funding
This work was supported by the Canadian Institutes of Health Research Strategy for Patient Oriented Research (1041605), the Shaikh Family Research Award (1042861) and the Alberta Children’s Hospital Research Institute awarded to Dr. Noel. Dr. Miller is supported by the Alberta Children’s Hospital Foundation.
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Isabella Derij Vandergaag conducted investigations of the data, formal analysis, wrote the original draft and reviewed and revised the manuscript. Cara Nania was involved in data curation, formal analysis, reviewed and revised the manuscript. Dr. Inge Timmers assisted with the methodology, data curation, investigation, validation, and reviewed and revised the manuscript. Dr. Laura Simons and Dr. Catherine Lebel assisted with methodology, resources, and reviewed and revised the manuscript. Dr. Rasic was involved in supervision and reviewed and revised the manuscript. Dr. Andrew Walker was consulted regarding the analyses, and reviewed and revised the manuscript. Dr. Melanie Noel acquired the funding for this study. She was also involved in the conceptualization, and supervision, assisted with the methodology and resources, and reviewed and revised the manuscript. Dr. Jillian Vinall Miller was involved in the conceptualization, supervision, investigation, curation of the data, formal analysis, assisted with writing the original draft, and reviewed and revised the manuscript. All authors approved the final manuscript as submitted and agree to be accountable for all aspects of the work.
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Vandergaag, I.D., Nania, C., Timmers, I. et al. Sleep disturbances, altered brain microstructure and chronic headache in youth. Brain Imaging and Behavior (2024). https://doi.org/10.1007/s11682-024-00876-9
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DOI: https://doi.org/10.1007/s11682-024-00876-9