Ellemarije Altena

University of Bordeaux · INCIA- Sleep/Wake Aging and Cognition

Sleep is known to be affected in space travel and in residents of the international space station. But little is known about the direct effects of gravity changes on sleep, if other factors, such as sleep conditions, are kept constant. Here, as a first exploration , we investigated sleep before and after exposure to short bouts of microgravity and...

Progress in the field of insomnia since 2017 necessitated this update of the European Insomnia Guideline. Recommendations for the diagnostic procedure for insomnia and its comorbidities are: clinical interview (encompassing sleep and medical history); the use of sleep questionnaires and diaries (and physical examination and additional measures wher...

Despite cognitive behaviour therapy for insomnia (CBT-I) being the first-line intervention for the disorder, it is often not readily available to patients in need. The stepped care model (SCM) represents an approach to facilitating efficient and wide-ranging provision of evidence-based care to those with insomnia. The SCM reflects a pyramid of ther...

Objective/background: Though sleep problems (apnea, insomnia) and related daytime symptoms (fatigue, anxiety, depression) have been associated with vestibular problems (falls, dizziness), it is not well known which particular sleep features relate to vestibular problems. We thus assessed symptoms of vestibular problems in patients visiting a sleep...

Although much is known now about behavioural, cognitive and physiological consequences of insomnia, little is known about changes after cognitive behavioural therapy for insomnia on these particular factors. We here report baseline findings on each of these factors in insomnia, after which we address findings on their changes after cognitive behavi...

Stress and sleep are very closely linked, and stressful life events can trigger acute insomnia. The ongoing COVID-19 pandemic is highly likely to represent one such stressful life event. Indeed, a wide range of cross-sectional studies demonstrate that the pandemic is associated with poor sleep and sleep disturbances. Given the high economic and hea...

Heatwaves are occurring more frequently and are known to affect particularly night-time temperatures. We review here literature on how night-time ambient temperature changes affect body temperature and sleep quality. We then discuss how these temperature effects impact particularly vulnerable populations such as older adults, children, pregnant wom...

Models describing insomnia symptoms have focused on behaviour (time in bed, bedroom activities), cognition (worry, rumination, dysfunctional beliefs) and hyperarousal (elevated cortisol, heartrate, EEG frequency). When investigating those psychophysiological mechanisms explaining effectiveness of CBT‐I through mediator research, behavioural and cog...

Insomnia symptoms are frequent during peripartum and are considered risk factors for peripartum psychopathology. Assessing and treating insomnia and related conditions of sleep loss during peripartum should be a priority in the clinical practice. The aim of this paper was to conduct a systematic review on insomnia evaluation and treatment during pe...

Background Though insomnia is associated with affected emotion regulation and dysfunctional ideas about sleep, little is known about the relation of these problems with objective sleep disruption. We aimed to explore this relationship in young adults with and without insomnia. Methods Twenty young adults with diagnosed insomnia disorder (aged 27.7...

While there is an extensive literature on predisposing, precipitating, coping and perpetuating factors in those with chronic insomnia, very little work has been undertaken to evaluate these factors over the early developmental course of insomnia. The present aim was to determine whether several hypothesized factors in each domain (predisposing, pre...

Study objectives Emotional reactivity to negative stimuli has been investigated in insomnia, but little is known about emotional reactivity to positive stimuli and its neural representation. Methods We used 3T fMRI to determine neural reactivity during the presentation of standardized short, 10-40-s, humorous films in insomnia patients (n=20, 18 f...

Sleep problems can have a major impact on daytime functioning across all domains (i.e.., cognitive, affective and physical). It can affect attention, concentration and higher cognitive functions, such as working memory [1], as well as the levels of stress, anxiety and depression [2]. The prevalence of sleep problems has increased exponentially sinc...

Background Improving maternal’s health is a worldwide priority. Sleep is a fundamental operating state of the central nervous system and it may be one of the most important psychophysiological processes for brain function and mental health. The study of maternal sleep problem including insomnia, however, implies deepening our understanding of famil...

The dynamic of the temporal correlations between brain areas, called functional connectivity (FC), undergoes complex transformations through the life span. In this review, we aim to provide an overview of these changes in the nonpathological brain from fetal life to advanced age. After a brief description of the main methods, we propose that FC dev...

In the current global home confinement situation due to the COVID-19 outbreak, most individuals are exposed to an unprecedented stressful situation of unknown duration. This may not only increase daytime stress, anxiety and depression levels, but also disrupt sleep. Importantly, because of the fundamental role that sleep plays in emotion regulation...

Study Objectives The study objectives were to examined accidental risks associated with insomnia or hypnotic medications, and how these risk factors interact with sex and age. Methods A population-based sample of 3413 adults (Mage = 49.0 years old; 61.5% female), with or without insomnia, were surveyed annually for five consecutive years about the...

Emotional reactivity in insomnia is affected both subjectively and on a physiological level for negative emotional material, but little is known about reactions to positive stimuli. We here investigated whether in younger adult insomnia patients, presentation of short humorous films would lead to heart rate decreases during and after film viewing,...

Insomnia, the most prevalent sleep disorder worldwide, confers marked risks for both physical and mental health. Furthermore, insomnia is associated with considerable direct and indirect healthcare costs. Recent guidelines in the US and Europe unequivocally conclude that cognitive behavioural therapy for insomnia (CBT-I) should be the first-line tr...

Objective: The study goal was to test whether induced stress during driving could be measured at the event level through electrodermal activity responses. Background: Stress measured in simulation scenarios could thus far show an overall change in the stress state, but not be well attributed to acute stressful events. Driving simulator scenarios...

Objectif Les outils de simulation nous permettent d’évaluer le fonctionnement diurne dans des environnements écologiques, simulant des situations de la vie quotidienne. Le mal du simulateur pose toutefois un problème dans l’application de ces outils et a été associée à des problèmes de santé préexistants. Le lien entre mal du simulateur et troubles...

Introduction Amyloid plaque deposition in the brain is an early pathological change in Alzheimer's disease (AD), causing disrupted synaptic connections. Brain network disruptions in AD have been demonstrated with eigenvector centrality (EC), a measure that identifies central regions within networks. Carrying an apolipoprotein (APOE)‐ε4 allele is a...

Objectives: To quantify the effect of hypoglossal nerve stimulation (HNS), a novel therapy for patients with obstructive sleep apnea, on objective level of alertness (measured with Maintenance of Wakefulness Test [MWT] values) and nocturnal sleep architecture. Methods: Ten male patients (mean age 52.0 ± 9.4 years; mean body mass index 28.8 ± 3.3...

Introduction Hypoglossal nerve stimulation (HNS) is a novel therapy for patients suffering from obstructive sleep apnea (OSA) that has proven its efficacy in reducing the apnea-hypopnea index (AHI). This study evaluated the impact of HNS on sleep architecture and objective level of alertness. Methods Ten patients who received HNS were included. Tr...

This study explores the association between specific insomnia symptoms (sleep onset, sleep maintenance and early morning awakenings symptoms) and self-efficacy (perceived self-confidence in the ability to use CPAP) with CPAP compliance in French patients with obstructive sleep apnea syndrome (OSAS). We performed a retrospective, cross-sectional ana...

Virtual reality and simulation tools enable us to assess daytime functioning in environments that simulate real life as close as possible. Simulator sickness, however, poses a problem in the application of these tools, and has been related to pre‐existing health problems. How sleep problems contribute to simulator sickness has not yet been investig...

Hyperarousal is a 24-h state of elevated cognitive and physiological activation, and is a core feature of insomnia. The extent to which sleep quality is affected by stressful events-so-called sleep reactivity-is a vulnerability factor for developing insomnia. Given the increasing prevalence of insomnia with age, we aimed to investigate how hyperaro...

large cohort study on insomnia vulnerability factors in different age groups

Daytime stress can disturb nighttime sleep, and sleep deprivation can affect daytime stress (Altena et al. 2016). How pre-existing poor sleep affects induced stress is however not well known. HYPOTHESIS : Pre-existing naturally disturbed sleep enhances the physiological response illicited by the sympathetic nervous system (measured through electrod...

Objective: It remains unclear whether daytime impairments in ADHD patients are better explained by an altered level of alertness and/or by cognitive deficits. The aim of this study was to determine the respective contribution of these factors on driving performance in ADHD adults. Method: ADHD adults (n= 39) and healthy controls (n= 18) underwen...

Sleep disturbances are highly prevalent and greatly affect consecutive emotional reactivity, while sleep quality itself can be strongly affected by reactions to previous emotional events. In this review, we shed light on this bidirectional relation through examples of pathology: insomnia and bipolar disorder. We show that both experimental sleep de...

Recent studies indicate that selective noradrenergic (atomoxetine) and serotonergic (citalopram) reuptake inhibitors may improve response inhibition in selected patients with Parkinson's disease, restoring behavioral performance and brain activity. We reassessed the behavioral efficacy of these drugs in a larger cohort and developed predictive mode...

We aimed to examine brain activation patterns during verbal fluency performance in patients with progressive muscular atrophy (PMA) and amyotrophic lateral sclerosis (ALS). We used functional MRI (fMRI) to examine the blood oxygenation level dependent (BOLD) response during letter and category fluency performance in 18 PMA patients, 21 ALS patients...

Objective: To examine brain activation patterns during verbal fluency performance in patients with progressive muscular atrophy (PMA) and amyotrophic lateral sclerosis (ALS). Methods: fMRI was used to examine the blood oxygen level-dependent response during letter and category fluency performance in 18 patients with PMA, 21 patients with ALS, an...

Background / Purpose: Motor inhibition deficits occur in Parkinson’s disease (PD) even in the absence of impulse control disorders. Their aetiology is multifactorial, including the loss of noradrenergic and seroton-ergic projects to the forebrain and structural change in fronto-striatal circuits. Main conclusion: Our study showed that increasi...

Impulsivity is common in Parkinson's disease even in the absence of impulse control disorders. It is likely to be multifactorial, including a dopaminergic 'overdose' and structural changes in the frontostriatal circuits for motor control. In addition, we proposed that changes in serotonergic projections to the forebrain also contribute to response...

Background Dopaminergic drugs remain the mainstay of Parkinson’s disease therapy but often fail to improve cognitive problems such as impulsivity. This may be due to the loss of other neurotransmitters, including noradrenaline which is linked to impulsivity and response inhibition. We therefore examined the effect of the selective noradrenaline reu...

The volitional impairments of alien limb and apraxia are a defining feature of the corticobasal syndrome, but a limited understanding of their neurocognitive aetiology has hampered progress towards effective treatments. Here we combined several key methods to investigate the mechanism of impairments in voluntary action in corticobasal syndrome. We...

Insomnia is prevalent, severe and partially heritable. Unfortunately, its neuronal correlates remain enigmatic, hampering the development of mechanistic models and rational treatments. Consistently reported impairments concern fragmented sleep, hyper-arousal and executive dysfunction. Because fronto-striatal networks could well play a role in sleep...

Background / Purpose: Impulsivity in Parkinson’s disease (PD) is common even in the absence of impulse control disorders and is likely to be multifactorial. In addition to dopaminergic “overdose” and structural changes in the frontostriatal circuits for motor control, changes in serotonergic projections to the forebrain may also exacerbate the im...

We have previously shown that patients with Parkinson's disease (PD) perseverate in their choice of action relative to healthy controls, and that this is affected by dopaminergic medication (Hughes LE, Barker RA, Owen AM, Rowe JB. 2010. Parkinson's disease and healthy aging: Independent and interacting effects on action selection. Hum Brain Mapp. 3...

Diffusion magnetic resonance imaging is increasingly used as a non-invasive method to investigate white matter structure in neurological and neuropsychiatric disease. However, many options are available for the acquisition sequence and analysis method. Here we used Parkinson's disease as a model neurodegenerative disorder to compare imaging protoco...

We have previously shown that patients with Parkinson's disease (PD) perseverate in their choice of action relative to healthy controls, and that this is affected by dopaminergic medication (Hughes LE, Barker RA, Owen AM, Rowe JB. 2010. Parkinson's disease and healthy aging: Independent and interacting effects on action selection. Hum Brain Mapp. 3...

Total sleep deprivation in healthy subjects has a profound effect on the performance on tasks measuring sustained attention or vigilance. We here report how a selective disruption of deep sleep only, that is, selective slow-wave activity (SWA) reduction, affects the performance of healthy well-sleeping subjects on several tasks: a "simple" and a "c...

The cognitive changes that occur with ageing are usually referred to as 'age-related cognitive decline'. The most pronounced changes may be found in the executive functions that require integrity of the prefrontal cortical circuitry. With age, sleep also changes profoundly, with more sleep fragmentation, earlier awakenings and less slow wave sleep...

Chronic insomnia is a poorly understood disorder. Risk factors for developing chronic insomnia are largely unknown, yet disturbances in brain indexes of arousal seem to accompany the disorder. We here investigate whether insomnia patients and control participants differ with respect to brain responses to direct stimulation, i.e., cortical excitabil...

Brain mechanisms of chronic insomnia, a highly prevalent condition, have barely been investigated. We demonstrate here a decrease in orbitofrontal gray matter (GM) volume that strongly correlates with the severity of complaints. In a case-control study, optimized voxel-based morphometry was used to compare the regional brain volumes of 24 medicatio...

Sleep before learning benefits memory encoding through unknown mechanisms. We found that even a mild sleep disruption that suppressed slow-wave activity and induced shallow sleep, but did not reduce total sleep time, was sufficient to affect subsequent successful encoding-related hippocampal activation and memory performance in healthy human subjec...

Although subjective complaints about daytime cognitive functioning are an essential symptom of chronic insomnia, abnormalities in functional brain activation have not previously been investigated. This study was designed to investigate functional brain activation differences as a possible result of chronic insomnia, and the reversibility of these d...

Although complaints of impaired daytime functioning are essential to the diagnosis of primary insomnia, objective evidence for cognitive dysfunction has been hard to establish. A prerequisite for understanding the neurocognitive consequences of primary insomnia is to establish task paradigms that robustly differentiate insomniacs from well-sleeping...

In dit artikel beschrijven we de cognitieve training die wij hebben uitgevoerd bij twee patiënten met een associatieve visuele objectagnosie. Deze training was bedoeld om visuele herkenning van voorwerpen te verbeteren door het aanleren van een bewuste visuele analysestrategie naar de kenmerken van een object. De training bestond uit diverse soorte...

Hoewel wij gemiddeld een derde van ons leven slapend doorbrengen en er al ongeveer veertig jaar onderzoek naar slaap wordt gedaan, hebben we nog steeds niet de functie van slaap kunnen doorgronden (De Koninck 1997 ). Toch kan een gebrek aan slaap ons leven overdag aanzienlijk verstoren. Concentratiestoornissen, prikkelbaarheid en gemoedsverstoringe...