Dean Wu

• Doctor of Philosophy
• Taipei Medical University

Our systematic review and meta-analysis estimated the prevalence of post-COVID sleep disturbances in adult population. We systematically searched relevant studies from four databases that reported post-COVID sleep disturbances prevalence with a mean or median follow-up duration of ≥28 days. We identified 153 eligible papers, with a total COVID-19 p...

Although associations among insomnia, cognitive impairment, and stroke have been demonstrated, whether insomnia increases the risk of cognitive impairment after stroke remains unclear. The aim of this study was to examine whether insomnia complaints moderated the association between stroke and cognitive impairment in older adults. This study was a...

Obstructive sleep apnea (OSA) has a heavy health-related burden on patients and the healthcare system. Continuous positive airway pressure (CPAP) is effective in treating OSA, but adherence to it is often inadequate. A promising solution is to detect sleep apnea events in advance, and to adjust the pressure accordingly, which could improve the long...

Gut microbiota (GM) are involved in the pathophysiology of Alzheimer's disease (AD) and might correlate to the machinery of the gut-brain axis. Alteration of the GM profiles becomes a potential therapy strategy in AD. Here, we found that plasmon-activated water (PAW) therapy altered GM profile and reduced AD symptoms in APPswe/PS1dE9 transgenic mic...

Objectives Obstructive sleep apnea (OSA) is typically diagnosed by polysomnography (PSG). However, PSG is time-consuming and has some clinical limitations. This study thus aimed to establish machine learning models to screen for the risk of having moderate-to-severe and severe OSA based on easily acquired features. Methods We collected PSG data on...

Background No study has examined the psychometric properties of the sleep condition indicator (SCI) for screening poststroke insomnia in the Indonesian population. We aimed to develop the Indonesian version of the sleep condition indicator (ISCI) and to examine its psychometric properties for screening adult patients in late sub-acute and chronic p...

Obstructive sleep apnea (OSA) is a risk factor for neurodegenerative diseases. This study determined whether continuous positive airway pressure (CPAP), which can alleviate OSA symptoms, can reduce neurochemical biomarker levels. Thirty patients with OSA and normal cognitive function were recruited and divided into the control (n = 10) and CPAP (n...

Objectives/background: Insomnia is a common sleep complaint among patients who had a stroke and has been recognized as an independent risk factor for cognitive impairment. However, the relationship between poststroke insomnia and cognitive impairment over time is under-researched. Therefore, we examined the association between poststroke insomnia...

Objectives Obstructive sleep apnea (OSA) may increase the risk of Alzheimer's disease (AD). However, potential associations among sleep-disordered breathing, hypoxia, and OSA-induced arousal responses should be investigated. This study determined differences in sleep parameters and investigated the relationship between such parameters and the risk...

Obstructive sleep apnea (OSA) is a global health concern and is typically diagnosed using in-laboratory polysomnography (PSG). However, PSG is highly time-consuming and labor-intensive. We, therefore, developed machine learning models based on easily accessed anthropometric features to screen for the risk of moderate to severe and severe OSA. We en...

Background The objective of this study was to examine associations of daily averages and daily variations in ambient relative humidity (RH), temperature, and PM2.5 on the obstructive sleep apnea (OSA) severity. Methods A case-control study was conducted to retrospectively recruit 8628 subjects in a sleep center between January 2015 and December 20...

BACKGROUND Obstructive sleep apnea (OSA) is sleep-disordered breathing and is typically diagnosed by polysomnography (PSG). However, PSG is time-consuming and has some clinical limitations. OBJECTIVE This study thus aimed to establish machine learning models to screen for the risk of having moderate-to-severe and severe OSA based on easily acquire...

Obstructive sleep apnea (OSA) is associated with seasonal variations. The objective of this study was to examine associations of ambient relative humidity (RH) and temperature on sleep parameters. We conducted a cross-sectional study by retrospectively recruiting 5204 adults from a sleep center in Taipei, Taiwan. Associations of 1-night polysomnogr...

The effects of air pollution on sleep and dementia remain unclear. The objective of this study was to investigate the effects of air pollution on cognitive function as mediated by the sleep cycle. A cross-sectional study design was conducted to recruit 4866 subjects on which PSG had been performed. Fifty of them were further given a cognitive funct...

Purpose Obstructive sleep apnea syndrome (OSAS) has mostly been examined using in-laboratory polysomnography (Lab-PSG), which may overestimate severity. This study compared sleep parameters in different environments and investigated the association between the plasma levels of neurochemical biomarkers and sleep parameters. Methods Thirty Taiwanese...

Insomnia disorder (ID) and obstructive sleep apnea (OSA) with respiratory arousal threshold (ArTH) phenotypes often coexist in patients, presenting similar symptoms. However, the typical diagnosis examinations (in-laboratory polysomnography (lab-PSG) and other alternatives methods may therefore have limited differentiation capacities. Hence, this s...

(a) Objective: Obstructive sleep apnea syndrome (OSAS) is typically diagnosed through polysomnography (PSG). However, PSG incurs high medical costs. This study developed new models for screening the risk of moderate-to-severe OSAS (apnea-hypopnea index, AHI ≥15) and severe OSAS (AHI ≥30) in various age groups and sexes by using anthropometric featu...

Obstructive sleep apnoea (OSA) is a global health concern, and polysomnography (PSG) is the gold standard for assessing OSA severity. However, the sleep parameters of home-based and in-laboratory PSG vary because of environmental factors, and the magnitude of these discrepancies remains unclear. We enrolled 125 Taiwanese patients who underwent PSG...

Study objectives: Dementia is associated with sleep disorders. However, the relationship between dementia and sleep arousal remains unclear. This study explored the associations among sleep parameters, arousal responses, and risk of mild cognitive impairment (MCI). Methods: Participants with the chief complaints of memory problems and sleep diso...

The comparative efficacy of various approaches of digital cognitive behavioral therapy for insomnia (CBTi) is still unclear. This network meta-analysis explored the comparative efficacy of digital CBTi approaches in adults with insomnia. Four electronic databases were searched from inception to June 27, 2020. Primary outcomes were self-reported tot...

The effects of air pollution on sleep and dementia remain unclear. The objective of this study was to investigate the effects of air pollution on cognitive function as mediated by the sleep cycle. A cross-sectional study design was conducted to recruit 4866 subjects on which PSG had been performed. Fifty of them were further given a cognitive funct...

Purpose: Obstructive sleep apnoea (OSA) is a global health concern, and polysomnography (PSG) is the gold standard for assessing OSA severity. However, the sleep parameters of home-based and in-laboratory PSG vary because of environmental factors, and the magnitude of these discrepancies remains unclear. Methods: We enrolled 125 Taiwanese patients...

Introduction Previous studies indicated the accumulation of neurodegenerative protein may be caused by higher Obstructive sleep apnea syndrome (OSAS) severity. However, the association between arousal-related parameters induced by OSAS and the amyloid burden remains unclear. The aim of this study is to investigate the association between arousal th...

Air pollution is associated with sleep-related breathing disorders; however, the effects of air pollution on depression in patients with SRBDs remain unclear. A cross-sectional study was conducted to collect polysomnographic (PSG) data and Beck Depression Inventory-IA (BDI-IA) responses from 568 subjects with SRDBs in a sleep center in 2015 to 2017...

Background and Purpose The exact prevalence of sleep disorders following stroke or transient ischemic attack (TIA) remains unclear. We aimed to determine the prevalence of sleep-disordered breathing, insomnia, periodic leg movement during sleep, and restless leg syndrome following stroke or TIA in acute, subacute, and chronic phases and examine the...

Background: Parkinson disease (PD), the second most common neurodegenerative disease, has no cure or applicable disease-modifying approach, only symptomatic therapy. Oxidative stress and mitochondrial dysfunction play key roles in PD pathophysiology. Animal studies have demonstrated that photobiomodulation (PBM) may enhance mitochondrial function...

In the hospital, a sleep postures monitoring system is usually adopted to transform sensing signals into sleep behaviors. However, a home-care sleep posture monitoring system needs to be user friendly. In this paper, we present iSleePost—a user-friendly home-care intelligent sleep posture monitoring system. We address the labor-intensive labeling i...

Study objectives: Polysomnography is the gold standard in identifying sleep stages; however, there are discrepancies in how technicians use the standards. Because organizing meetings to evaluate this discrepancy and/or reach a consensus among multiple sleep centers is time consuming, we developed an artificial intelligence (AI) system to efficient...

The authors wish to make the following changes to this paper [...].

Two types of intraocular lenses (IOLs), namely ultraviolet-filtering IOL (UVF-IOL) and blue-light-filtering IOL (BF-IOL), are used to replace the aging lens in cataract patients. This provides a clinical scenario to investigate the BF and UVF effects on circadian rhythm. We revisited this topic and conducted an updated meta-analysis investigating t...

Epidemiological and toxicological evidence indicates that fine particulate matter (PM2.5, particulate matter < 2.5 µm in aerodynamic diameter) causes cardiopulmonary toxicity; however, its neurotoxic effects remain unclear. The objective of this study was to investigate the role of the neurofilament light (NEFL) serum polypeptide in neurotoxicity....

Objective Amyotrophic lateral sclerosis (ALS) is a fatal motor neuron degenerative disease with characteristic of progressive general muscle weakness and atrophy. ALS is still lack of efficient treatment and laboratory biomarkers. In this study, we longitudinally examined ALS patients' peripheral blood to search potential biomarkers. 18 ALS patient...

In older individuals, hand fine motor skill disability is associated with cognitive levels. Similarly, patients with moderate-to-advanced Parkinson’s disease (PD) often have cognitive dysfunction. Here, we investigated the association between hand fine motor skill and cognitive dysfunction in patients with moderate-to-advanced PD. Moderate and adva...

Cognitive decline is an important issue of global public health. Cognitive aging might begin at middle adulthood, the period particularly vulnerable to stress in lifespan. Essence of chicken (EOC) has consistently demonstrated its beneficial effects on various cognitive domains as nutritional supplementation. This study primarily aimed to examine t...

Objectives Cholinesterase inhibitors (ChEIs) are the most effective treatment for Alzheimer disease (AD), but the response to treatment varies. Vascular lesions are associated with the pathogenesis of AD, and cerebral microbleeds (CMBs) are an indicator of hemorrhagic vascular pathology, which can be detected through susceptibility-weighted magneti...

[This corrects the article DOI: 10.1371/journal.pone.0221750.].

Background Obstructive Sleep Apnea Syndrome (OSAS) is a major global health concern and is typically diagnosed by in-lab polysomnography (PSG). This examination though has high medical manpower costs and alternative portable methods have further limitations. This paper develops a new model for screening the risk of OSAS in different age groups and...

Study objectives: People with obstructive sleep apnea (OSA) remain undiagnosed owing to lack of easy and comfortable screening tools. Through this study, we aimed to compare the diagnostic accuracy of chest wall motion and cyclic variation of heart rate (CVHR) in detecting OSA by using a single-lead electrocardiogram (ECG) patch with a 3-axis acce...

Background: Insulin resistance (IR), considered a hallmark of diabetes at the cellular level, is implicated in pre-diabetes, results in type 2 diabetes, and negatively affects mitochondrial function. Diabetes is increasingly associated with enhanced risk of developing Parkinson’s disease (PD); however, the underlying mechanism remains unclear. This...

Ischemic stroke is a rare complication of varicella-zoster virus (VZV) infection. We present the case of a patient with a medical history of type 2 diabetes mellitus (DM) who experienced disseminated cutaneous VZV infection followed by multiple cerebral infarcts associated with VZV vasculopathy. Brain magnetic resonance imaging revealed multiple hy...

Background: As the disease progresses to moderate to advanced stages, people with Parkinson's disease (PwP) are likely to have various degrees of disability due to the motor and non-motor symptoms, such as ambulatory difficulty and cognitive impairment. The objective of this study was to investigate the impact of cognition and ambulation status on...

With the great extension of the human lifespan in recent times, many aging diseases have inevitably followed. Dementia is one of the most-commom neurodegenerative aging diseases, in which inflammation-related Alzheimer’s disease (AD) is the most prevalent cause of dementia. Amyloid accumulation in the brain, which occurs before any clinical present...

Background Several clinical trials reported that clopidogrel was superior to aspirin in secondary stroke prevention by reducing the risk of major adverse cardiovascular events (MACE). We aimed to compare the efficacy of clopidogrel with aspirin in reducing one-year risk of MACE based on real-world evidence from Taiwan Health Insurance Database. Me...

Sleep postures monitoring systems in the hospital aim at transforming sensing signals into quantitative data to characterize the sleep behaviors of the patient. However, a home-care sleep posture monitoring system needs to be user friendly. In this paper, we present iSleePost - a user-friendly home-care intelligent sleep posture monitoring system....

Objective: To identify empirical evidence on the effectiveness of Tai Chi in treating fibromyalgia (FM). Method: We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) to compare the effectiveness of Tai Chi and standard care or conventional therapeutic exercise in patients with FM. PubMed, Medline, and Physiot...

Dementia is a common nonmotor condition among people with moderate or advanced Parkinson’s disease (PD). Undoubtedly, profound motor symptoms cause remarkable impairment in daily activities; however, dementia-related disabilities have not been thoroughly investigated, especially not with consideration of differences according to sex. The present st...

Dementia is highly comorbid with gait disturbance, and both conditions negatively impact the ability of elderly people to conduct daily living activities. The ambulatory status of older adults with dementia may cause variable functional disability, which is crucial for the progression of dementia. The present study investigated the association betw...

The kidney harbors one of the strongest circadian clocks in the body. Kidney failure has long been known to cause circadian sleep disturbances. Using an adenine-induced model of chronic kidney disease (CKD) in mice, we probe the possibility that such sleep disturbances originate from aberrant circadian rhythms in kidney. Under the CKD condition, mi...

Introduction: Treatment with antiparkinsonism anticholinergics (AAs) has been well-established for patients with Parkinson's disease (PD), especially for tremor. However, concerns regarding the association between anticholinergics and dementia risk are increasing. This retrospective cohort study investigated whether AAs increase the risk of dement...

Introduction: Dizziness and balance impairment are common symptoms of mild traumatic brain injury (mTBI). Acid-sensing ion channel 3 (ASIC3) is expressed in the vestibular and proprioceptive systems and associated with balance functions. However, whether the genetic variants of ASIC3 are associated with people who suffer dizziness and balance impai...

Introduction: Autonomic nervous system (ANS) dysfunction contributes to several non-motor symptoms of Parkinson's disease (PD). In addition, ANS plays a role in the genesis and maintenance of atrial fibrillation (AF). This study investigated the temporal association between PD and AF. Methods: Data were obtained from the National Health Insurance R...

Objectives: Association between net vertebral artery flow volume (NVAFV) and stroke types remains unclear. We hypothesize NVAFV is low in patients with posterior circulation infarction (PCI) and an ideal cut-off value for discriminating PCI from anterior circulation infarction (ACI) and controls may be present. Materials and Methods: As study candi...

Cerebrospinal fluid (CSF) is a fluidic part of the brain’s microenvironment that isolates the brain from the rest of the body. CSF dilutes metabolites from neuronal activities and removes them from the brain. Its production and resorption are regulated dynamically and are central to maintaining brain homeostasis. We discovered that the major CSF so...

Rapid eye movement sleep behavior disorder (RBD) is a parasomnia, with abnormal dream-enacting behavior during the rapid eye movement (REM) sleep. RBD is either idiopathic or secondary to other neurologic disorders and medications. Dementia with Lewy bodies (DLB) is the third most common cause of dementia, and the typical clinical presentation is r...

Neurodegenerative diseases, such as dementia, Parkinson's disease, and parkinsonism, are due to the gradual and progressive loss of neural cells, leading to nervous system dysfunction. Increasing epidemiological and toxicological evidence has demonstrated the possible association between neurological diseases and particulate air pollution. Chronic...

Objectives: The motor symptoms of Parkinson's disease (PD) vary among patients and have been categorized into 3 subtypes: tremor dominant, akinetic rigidity, and postural instability and gait disturbance (PIGD). Cerebral microbleed (CMB) is prevalent in people with PD and is associated with some nonmotor symptoms. The present study investigated th...

To develop an applicable prediction for obstructive sleep apnea (OSA) is still a challenge in clinical practice. We apply a modern machine learning method, the support vector machine to establish a predicting model for the severity of OSA. The support vector machine was applied to build up a prediction model based on three anthropometric features (...

Purpose: Mild traumatic brain injury (mTBI) is a major public health concern. The apolipoprotein E (APOE) gene contains three polymorphisms, and the APOE4 polymorphism may affect several physiological states, such as the recovery from mTBI as well as sleep. This study aims to investigate the association between APOE4 with the recovery of sleep dis...

Purpose: Obstructive sleep apnea (OSA) is associated with nocturnal hypoxemia, excessive daytime sleepiness (EDS), and sympathetic hyperactivation. Continuous positive airway pressure is the first-line treatment for OSA. However, some patients may have residual EDS. Modafinil and its R-enantiomer, armodafinil, are wakefulness-promoting agents know...

Val66Met polymorphism on the brain-derived neurotrophic factor (BDNF) gene is associated with hippocampal pathology and impaired episodic memory. However, the influence of this polymorphism on working memory (WM) performance and patterns of brain activation is controversial. This study investigated the effects of BDNF Val66Met polymorphism on funct...

Background and aim: Mild traumatic brain injury (mTBI) causes transient sleep disorders and circadian dysrhythmia. One of the clock genes, PERIOD3 (PER3), regulates the circadian rhythm and contains a genetic polymorphism, namely a variable-number tandem repeat in the coding area with either four or five repeats. PER3(5) carriers are inclined to h...

Background: Transforming growth factor-β (TGF-β)-activated kinase 1 (TAK1) is a key regulator of signal cascades of TNF-α receptor and TLR4, and can induce NF-κB activation for preventing cell apoptosis and eliciting inflammation response. Results: TAK1 inhibitor (TAKI) can decrease the cell viability of murine bone marrow-derived macrophages (B...

meningitis or encephalitis with or without neurological deficits. JEV typically attacks the thalamus, corpus striatum, brainstem and spinal cord. The laboratory diagnosis of JEV infection involves the detection of anti-JEV antibody IgMs using an enzyme-linked immunosorbent assay (ELISA), which has high sensitivity and specificity. Because of the la...

The detailed course of mental disorders at the acute and subacute stages of mild traumatic brain injury (mTBI), especially with regard to recovery from sleep disturbances, has not been well characterised. The aim of this study was to determine the course of depression, anxiety and sleep disturbance, following an mTBI. We recruited patients with mTB...

Parthanatos is a programmed necrotic demise characteristic of ATP consumption due to NAD(+) depletion by PARP1-dependent poly(ADP-ribosyl)ation on target proteins. However, how the bioenergetics is adaptively regulated during parthanatos, especially under the condition of macroautophagy deficiency, remains poorly characterized. Here, we demonstrate...

Parkinson disease (PD) is a neurodegenerative disease characterized by motor and nonmotor dysfunctions, which include sleep disturbances. Rapid eye movement (REM) sleep is associated with numerous physiologic changes such as memory consolidation. Compelling evidence suggests that nitric oxide (NO) is crucial to both sleep regulation and memory cons...

Objective: Toll-like receptors (TLRs) are important molecules for detecting both pathogen invasion and tissue damage. The expression of TLR4 is upregulated in ischemic stroke, at least in the subacute stage. However, the TLR downstream pathways in the context of stroke have not been well studied in previous research. The purpose of this study is t...

Controversies and interest are present in the associations between specific brain locations and depression or anxiety. This study investigated the association between stroke location and emotional changes in stroke patients. This prospective observational study analyzed the neuroimages and neuropsychiatric conditions of 26 patients with acute middl...

Sleep disorders are frequently seen in patients with Parkinson disease (PD), including rapid eye movement (REM) behavior disorder and periodic limb movement disorder. However, knowledge about changes in non-REM sleep in patients with PD is limited. This study explored the characteristics of electroencephalography (EEG) during sleep in patients with...

BACKGROUND AND PURPOSE:APOE4 is the best-documented genetic risk factor for sporadic AD. Previous research showed that APOE4 is associated with increased risk of occurrence and earlier onset of AD in a gene dose-dependent manner. However, the specific role of APOE4 in processing of brain functions requires further investigation. Investigators have...

Objectives: Toll-like receptors (TLRs) are molecules conserved in evolution for detecting pathogen invasions and tissue damage and are involved in atherogenesis. This study explores the mRNA expression of TLRs and their probable role in further disease occurrence among ischemic stroke patients. Design and methods: A total of 89 ischemic stroke p...

Clinical research of cervicocranial fibromuscular dysplasia (FMD) is rare in Asian populations. Our study reviewed Taiwanese ischemic stroke patients with cervicocranial FMD and compared them with previous reports. Between 2000 and 2011, we collected 19 consecutive cervicocranial FMD patients who received demographic registration, a blood test for...

Acetylcholine (ACh) plays an important role in cognitive function and muscle atonia in rapid eye movement (REM) sleep. This quantitative study used surface electromyography (sEMG) to investigate changes in muscular activity, which may indicate a deficiency of ACh among patients with cognitive impairment. We recruited 9 controls without dementia, 6...

Background: Atherosclerosis potentially represents a chronic inflammatory disease in which both endothelial cells and monocytes are involved. Monocyte-endothelium adhesion, which is heavily dependent on the expression of adhesion molecules, such as vascular cell adhesion molecule 1 (VCAM-1), is one of the key stages of atherogenesis. Toll-like rece...

Alien hand syndrome (AHS) is actually two distinct syndromes with distinct clinical and anatomic features, that is, a frontal type and a callosal type. Frontal AHS occurs in the dominant hand; is associated with reflexive grasping, groping, and compulsive manipulation of tools. Callosal AHS is characterized primarily by intermanual conflict. We rep...

A 38-year-old man had postictal global aphasia after generalized tonic-clonic seizure, but recovered within 1 day. There was a focal increase in the signal intensity of the left frontoparietal sulci on fluid-attenuated inversion recovery magnetic resonance (MR) sequence 6 hours after the seizure, which disappeared 1 month later. The transient seizu...

We report the case of a 44-year-old man with superior sagittal and transverse sinus thrombi, who initially presented with venous subarachnoid hemorrhage over the right parietal sulci. After 7 days of intravenous anticoagulation therapy, his condition stabilized. Cerebral venous thrombosis can be difficult to diagnose and is further complicated when...

A 36-year-old male was a victim of alcoholic liver cirrhosis. He was admitted for esophageal varices (EV) bleeding. During hospitalization, conscious disturbance with quadriplegia developed after hyponatremia had been rapidly corrected. Under a tentative diagnosis of central pontine myelinolysis (CPM), MR images was done and hyperintense lesions in...