The association between sleep spindles and cognitive performance in euthymic bipolar disorder
Translational Psychiatry, vol. 16
Abstract
Many people with bipolar disorder (BD) experience persistent cognitive deficits. Sleep spindles have been linked to cognitive ability in healthy populations and psychotic disorders. While there is preliminary evidence for altered spindle activity in BD, research directly examining the association between sleep spindle parameters and cognitive performance in this population is lacking. Therefore, our primary objective was to examine the association between fast spindle density and episodic memory performance in euthymic individuals with BD. As exploratory analyses, we looked at associations between fast and slow spindle density and subjective sleep quality with other cognitive domains. We also conducted a sensitivity analysis, separating all analyses by lithium intake. Thirty-four euthymic participants with BD underwent comprehensive cognitive assessments and were assessed for three consecutive nights using mobile sleep-EEG headbands. Sleep spindles were detected using validated, adapted algorithms and characterised by fast and slow spindle density. Fast spindle density was not associated with episodic memory performance (r = -0.004, p = 0.491, 95% CI [-0.353, 0.499]) but did show a significant positive association with working memory (r = 0.423, p = 0.014, 95% CI (bootstrapped) [-0.167, 0.722]). When removing participants taking lithium, several positive associations emerged between fast spindle density and cognitive performance. These findings suggest domain-specific relationships between sleep spindle activity and cognition in BD, with fast spindles potentially being associated with working memory. Preliminary evidence for lithium-related modulation highlights the importance of considering pharmacological factors. However, the analyses were underpowered, and large-scale studies are needed to deepen our understanding of sleep spindle-cognition relationships in BD.
Authors 12
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Anna Tröger corresponding
King's College London · University Hospital Carl Gustav Carus · Technische Universität Dresden
Affiliation as printed
Department of Psychiatry and Psychotherapy, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany. anna.troeger@kcl.ac.uk
Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK. anna.troeger@kcl.ac.uk
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University Hospital Carl Gustav Carus · Technische Universität Dresden
Affiliation as printed
Department of Psychiatry and Psychotherapy, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
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Affiliation as printed
Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
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Stephan Bialonski Aachen Department of Medical Engineering and Technomathematics Institute for Data-Driven Technologies
Affiliation as printed
Department of Medical Engineering and Technomathematics, Institute for Data-Driven Technologies, FH Aachen University of Applied Sciences, Jülich, Germany
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Niklas Grieger Aachen Department of Medical Engineering and Technomathematics Institute for Data-Driven Technologies
Utrecht University · FH Aachen
Affiliation as printed
Department of Information and Computing Sciences, Utrecht University, Utrecht, The Netherlands
Department of Medical Engineering and Technomathematics, Institute for Data-Driven Technologies, FH Aachen University of Applied Sciences, Jülich, Germany
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King's College London · Imperial College London
Affiliation as printed
Department of Brain Sciences, Faculty of Medicine, Imperial College London, London, UK
Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
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Affiliation as printed
Department of Psychiatry, University of Oxford, Oxford, UK
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Affiliation as printed
Department of Psychiatry, University of Oxford, Oxford, UK
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Affiliation as printed
Department of Psychiatry, University of Oxford, Oxford, UK
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King's College London · Imperial College London
Affiliation as printed
Department of Brain Sciences, Faculty of Medicine, Imperial College London, London, UK
Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
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King's College London · University Hospital Carl Gustav Carus · Technische Universität Dresden
Affiliation as printed
Department of Psychiatry and Psychotherapy, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
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Affiliation as printed
Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
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