Faculty Bibliography

OBJECTIVE:Cognitive impairment is associated with insomnia. However, there is a lack of evidence suggesting a link between insomnia and cognitive dysfunction in objective testing. The objectives of our current study were to assess the differences in components of attentional performance between primary insomnia patients and normal-sleeping controls and to examine potential predictors of attention impairment in patients with insomnia. METHODS:We studied 36 patients (age 40.39 ± 12.36 years; 57.1% male) with insomnia and 25 normal-sleeping controls (age 39.88 ± 12.50 years; 52.9% male) who underwent one-night polysomnography followed by Multiple Sleep Latency Test (MSLT) and Attention Network Task (ANT). ANT reflected three attentional networks termed the alerting, orienting, and executive control networks. RESULTS:After controlling for age, gender, body mass index, depression, anxiety, and education levels, patients with insomnia scored higher on the executive control variable of the ANT compared with normal-sleeping controls (96.75 ± 7.60 vs. 57.00 ± 10.49, p = 0.01). This higher score was independently associated with insufficiency of slow-wave sleep during nighttime sleep (β = -0.38, p = 0.04). CONCLUSION:Our findings suggest that insomnia is associated with deficits in executive control of attention and that the underlying mechanism may be insufficiency of slow-wave sleep in chronic insomnia.

High-throughput sequencing of T cell receptors to define and quantify T cell populations emerges as a diagnostic tool with the remarkable ability to discriminate between CTCL and benign inflammatory conditions (Kirsch et al., this issue).

A 2-day method using flow cytometry and FISH for interphase cells was developed to detect monosomy 7 cells in myelodysplastic syndrome patients. The method, Interphase Chromosome Flow-FISH (IC Flow-FISH), involves fixation of leukocytes from blood, membrane permeabilization, hybridization of cellular DNA with peptide nucleic acid probes with cells intact, and analysis by flow cytometry. Hundreds to thousands of monosomy 7 cells were consistently detected from 10-20 mL of blood in patients with monosomy 7. Proportions of monosomy 7 cells detected in IC Flow-FISH were compared with results from conventional cytogenetics; identification of monosomy 7 populations was verified with FACS; and patient and donor cells were mixed to test for sensitivity. IC Flow-FISH allows for detecting monosomy 7 without requiring bone marrow procurement or the necessity of metaphase spreads, and wider applications to other chromosomal abnormalities are in development.