Search

Your search keyword '"Alakuijala, Anniina"' showing total 40 results
Start Over Author "Alakuijala, Anniina"
40 results on '"Alakuijala, Anniina"'

11. Accuracy of Actigraphy Compared to Concomitant Ambulatory Polysomnography in Narcolepsy and Other Sleep Disorders

Author

Alakuijala, Anniina, Sarkanen, Tomi, Jokela, Tomi, Partinen, Markku, Tampere University, Department of Neurosciences and Rehabilitation, Clinical Medicine, HUS Neurocenter, HUS Medical Imaging Center, Kliinisen neurofysiologian yksikkö, Helsinki University Hospital Area, University of Helsinki, Faculty of Medicine, Department of Neurosciences, and Clinicum

Subjects
insufficient sleep, Neurology, central disorders of hypersomnolence, actimetry, 3112 Neurosciences, diagnostics, 3124 Neurology and psychiatry, Original Research, sleep quantity
Abstract

Actigraphy provides longitudinal sleep data over multiple nights. It is a less expensive and less cumbersome method for measuring sleep than polysomnography. Studies assessing accuracy of actigraphy compared to ambulatory polysomnography in different sleep-disordered patients are rare. We aimed to compare the concordance between these methods in clinical setting. We included 290 clinical measurements of 281 sleep laboratory patients (mean age 37.9 years, 182 female). Concomitant ambulatory polysomnography and actigraphy were analyzed to determine the agreement in patients with obstructive sleep apnea, narcolepsy, periodic leg movement disorder, hypersomnia, other rarer sleep disorders, or no organic sleep disorder. Bland-Altman plots showed excellent accuracy, but poor precision in single night results between the two methods in the measurement of sleep time, sleep efficiency, and sleep latency. On average, actigraphy tended to overestimate sleep time by a negligible amount, −0.13 min, 95% confidence interval [−5.9, 5.6] min in the whole sample. Overestimation was largest, −12.8 [−25.1, −0.9] min, in patients with obstructive sleep apnea. By contrast, in patients with narcolepsy, actigraphy tended to underestimate sleep time by 24.3 [12.4, 36.1] min. As for sleep efficiency, actigraphy underestimated it by 0.18 [−0.99, 1.35] % and sleep latency by 11.0 [8.5, 13.6] min compared to polysomnography. We conclude that, in measuring sleep time, actigraphy is reasonably reliable and helpful to be used for a week or two to exclude insufficient sleep in patients with the suspicion of narcolepsy. However, the effectiveness of actigraphy in determining sleep seems to decrease in subjects with low sleep efficiencies. publishedVersion

Published
2021

20. Predicting Technical Success in Home Sleep Apnea Test

Author

Alakuijala, Anniina, Tervamäki, Julia, Maasilta, Paula, Bachour, Adel, HUS Neurocenter, HUS Medical Imaging Center, and Clinicum

Subjects
education, 3112 Neurosciences, 3124 Neurology and psychiatry
Published
2019

24. Narkolepsian moninainen oirekuva ja käypä diagnostiikka

Author

Partinen, Markku, Alakuijala, Anniina, Sarkanen, Tomi, Sved, Gabriele, HUS Kuvantaminen, Clinicum, and Kliinisen neurofysiologian yksikkö

Subjects
Sleep Wake Disorders, Orexins, Hallucinations, GeneralLiterature_INTRODUCTORYANDSURVEY, +diagnosis, Polysomnography, Disorders of Excessive Somnolence, Sleep Paralysis, Sleep Latency, Weight Gain, Actigraphy, +epidemiology, Cataplexy, HLA Antigens, ComputingMethodologies_DOCUMENTANDTEXTPROCESSING, Obesity, Cognition Disorders, GeneralLiterature_REFERENCE(e.g.,dictionaries,encyclopedias,glossaries), +classification, 3112 Neurotieteet, +cerebrospinal fluid, Fatigue, Narcolepsy, 3124 Neurologia ja psykiatria
Abstract

English summary

Published
2018

31. Expression of functional GABAc receptors in the brain

Author

Helsingin yliopisto, lääketieteellinen tiedekunta, biolääketieteen laitos, Helsingfors universitet, medicinska fakulteten, biomedicinska institutionen, University of Helsinki, Faculty of Medicine, Institute of Biomedicine, Department of Pharmacology, Institute of Biotechnology, Alakuijala, Anniina, Helsingin yliopisto, lääketieteellinen tiedekunta, biolääketieteen laitos, Helsingfors universitet, medicinska fakulteten, biomedicinska institutionen, University of Helsinki, Faculty of Medicine, Institute of Biomedicine, Department of Pharmacology, Institute of Biotechnology, and Alakuijala, Anniina

Abstract

γ-aminobutyric acid (GABA) is the main inhibitory transmitter in the nervous system and acts via three distinct receptor classes: A, B, and C. GABAC receptors are ionotropic receptors comprising ρ subunits. In this work, we aimed to elucidate the expression of ρ subunits in the postnatal brain, the characteristics of ρ2 homo-oligomeric receptors, and the function of GABAC receptors in the hippocampus. In situ hybridization on rat brain slices showed ρ2 mRNA expression from the newborn in the superficial grey layer of the superior colliculus, from the first postnatal week in the hippocampal CA1 region and the pretectal nucleus of the optic tract, and in the adult dorsal lateral geniculate nucleus. Quantitative RT-PCR revealed expression of all three ρ subunits in the hippocampus and superior colliculus from the first postnatal day. In the hippocampus, ρ2 mRNA expression clearly dominated over ρ1 and ρ3. GABAC receptor protein expression was confirmed in the adult hippocampus, superior colliculus, and dorsal lateral geniculate nucleus by immunohistochemistry. From the selective distribution of ρ subunits, GABAC receptors may be hypothesized to be specifically involved in aspects of visual image motion processing in the rat brain. Although previous data had indicated a much higher expression level for ρ2 subunit transcripts than for ρ1 or ρ3 in the brain, previous work done on Xenopus oocytes had suggested that rat ρ2 subunits do not form functional homo-oligomeric GABAC receptors but need ρ1 or ρ3 subunits to form hetero-oligomers. Our results demonstrated, for the first time, that HEK 293 cells transfected with ρ2 cDNA displayed currents in whole-cell patch-clamp recordings. Homomeric rat ρ2 receptors had a decreased sensitivity to, but a high affinity for picrotoxin and a marked sensitivity to the GABAC receptor agonist CACA. Our results suggest that ρ2 subunits may contribute to brain function, also in areas not expressing other ρ subunits. Using extracellular elec, Gamma-aminovoihappo (GABA) on keskushermoston tärkein ehkäisevä välittäjäaine. GABA-reseptorit jaetaan rakenteen ja farmakologisten ominaisuuksien perusteella kolmeen ryhmään. GABAA- ja GABAC-reseptorit ovat ionotrooppisia kloridikanavareseptoreita, kun taas GABAB-reseptorit ovat metabotrooppisia. Ionotrooppiset GABA-reseptorit koostuvat viidestä alayksiköstä, joita tunnetaan GABAC-reseptoreille kolme erilaista: ρ1, ρ2 ja ρ3. Väitöskirjatyön tarkoituksena oli selvittää GABAC-reseptoreiden ilmentymistä ja toimintaa keskushermostossa, erityisesti hippokampuksessa. Ensimmäisessä osatyössä GABAC-reseptoreiden ρ-alayksikköjä löytyi varhaisemmassa yksilönkehityksen vaiheessa ja useammalta keskushermoston alueelta kuin aiemmin oli havaittu. In situ -hybridisaatiomenetelmällä havaittiin ρ2-alayksikön lähetti-RNA:ta verkkokalvon, hippokampuksen, ylemmän nelikukkulalevyn ja muiden näköjärjestelmän tumakkeiden lisäksi myös näköaivokuorelta kolmesta eri kerroksesta. Kvantitatiivisella RT-PCR-menetelmällä todettiin kaikkien kolmen alayksikön lähetti-RNA:ta hippokampuksesta jo vastasyntyneeltä. Immunosytokemiallisilla vasta-ainevärjäyksillä voitiin vahvistaa, että ρ-proteiinia löytyi kaikilta niiltä aivoalueilta, joilla oli todettu ρ2-alayksikön mRNA:ta. Toisessa osatyössä pystyttiin ensimmäistä kertaa ekspressoimaan toimivia rotan ρ2-alayksikön muodostamia homomeerisiä reseptoreita HEK-293-soluissa. Ne olivat herkempiä sekä GABAlle että pelkästään GABAC-reseptoreihin vaikuttavalle CACAlle kuin ρ1ρ2-heteromeerit, mutta huomattavan epäherkkiä pikrotoksiinille, joka pystyi suurillakin pitoisuuksilla aiheuttamaan vain osittaisen antagonismin. Toisaalta kuitenkin tällä homomeerillä oli hyvin korkea-affiininen pikrotoksiinin sitoutumiskohta. Kolmannessa osatyössä voitiin osoittaa, että hippokampuksen CA1-alueen pyramidaalisoluissa on toimivia GABAC-reseptoreita. Niiden aktivaatio hyvin pienellä, toisen osatyön perusteella ρ2-alayksikköspesifisellä CACA-pitoisuudella pienensi hermosolu

Published
2007

35. Evidence for a functional role of GABAC receptors in the rat mature hippocampus.

Author

Alakuijala, Anniina, Alakuijala, Jyrki, and Pasternack, Michael

Subjects
*AMINOBUTYRIC acid, *AMINO acids, *BUTYRIC acid, *HIPPOCAMPUS (Brain), *CEREBRAL cortex, *LIMBIC system, *NEUROSCIENCES
Abstract

Both γ-aminobutyric acid (GABA)C receptor subunit mRNA and protein are expressed in the stratum pyramidale in the CA1 area of the adult rat hippocampus, but so far no conclusive evidence about functional hippocampal GABAC receptors has been presented. Here, the contribution of GABAC receptors to stimulus-evoked postsynaptic potentials was studied in the hippocampal CA1 area with extracellular and intracellular recordings at the age range of 21–47 postnatal days. Activation of GABAC receptors with the specific agonist cis-4-aminocrotonic acid (CACA) suppressed postsynaptic excitability and increased the membrane conductance. The GABAC receptor antagonist 1,2,5,6-tetrahydropyridine-4-ylmethylphosphinic acid (TPMPA), but not the GABAA receptor antagonist bicuculline, inhibited the effects of CACA. GABA-mediated long-lasting depolarizing responses evoked by high-frequency stimulation of local inhibitory interneurons in the CA1 area in the presence of ionotropic glutamate receptor and GABAB receptor blockers were prolonged by TPMPA, indicating that GABAC receptors are activated under these conditions. For weaker stimulation, the effect of TPMPA was enhanced after GABA uptake was inhibited. Our data demonstrate that GABAC receptors can be activated by endogenous synaptic transmitter release following strong stimulation or under conditions of reduced GABA uptake. The lack of GABAC receptor activation by less intensive stimulation under control conditions suggests that these receptors are extrasynaptic and activated via spillover of synaptically released GABA. [ABSTRACT FROM AUTHOR]

Published
2006
Full Text
View/download PDF

36. Functional characterization of ratρ2 subunits expressed in HEK 293 cells.

Author

Alakuijala, Anniina, TalviOja, Katri, Pasternack, Arja, and Pasternack, Michael

Subjects
*GABA, *AMINO acid neurotransmitters, *AMINOBUTYRIC acid, *CELLS, *POLYMERS, *PICROTOXIN
Abstract

GABAC receptors are thought to be homo- or heteropentamers composed ofρ1,ρ2 andρ3 subunits. Previous work on ratρ2 subunits expressed inXenopusoocytes has suggested that they do not form functional homo-oligomeric GABAC receptors, but do combine withρ1 orρ3 subunits to form hetero-oligomers. These findings are difficult to interpret because both human and mouseρ2 subunits do form functional homo-oligomeric receptors. Also, many regions of the rat brain express solelyρ2 subunit transcripts which, according to presently available evidence, would not result in expression of functional GABAC receptors. We show here that homomeric ratρ2 receptors can be expressed in HEK 293 cells. Homo-oligomeric ratρ2 receptors expressed in mammalian cells maturedslowly and displayed small but detectable GABA-induced currents with slow kinetics. Ratρ2 receptors also had a decreased sensitivity to picrotoxin and a marked sensitivity to the GABAC receptor agonistcis-aminocrotonic acid. Our results demonstrate for the first time the expression of functional homomeric ratρ2 receptors, and suggest thatρ2 subunits may contribute to brain function, including in areas not expressing otherρ subunits. [ABSTRACT FROM AUTHOR]

Published
2005
Full Text
View/download PDF

39. Narcolepsy : clinical picture, diagnostics, and association with H1N1 vaccination

Author

Sarkanen, Tomi, University of Helsinki, Faculty of Medicine, Clinical Neurosciences, Neurology, Doctoral Program in Clinical Research, Vitalmed Research Center, Helsinki, Finland, Central Finland Central Hospital, Jyväskylä, Finland, Department of Neurology, Tampere University Hospital, Tampere, Finland, Helsingin yliopisto, lääketieteellinen tiedekunta, Kliininen tohtoriohjelma, Helsingfors universitet, medicinska fakulteten, Doktorandprogrammet i klinisk forskning, Jennum, Poul, Partinen, Markku, and Alakuijala, Anniina

Subjects
Lääketiede
Abstract

After the 2009-2010 pandemic H1N1 vaccination campaign the incidence of narcolepsy increased sharply in countries where the Pandemrix vaccination was used. An increased incidence was observed also in China, where vaccine coverage was very low. Moreover, epidemiological studies are prone to biases, and animal studies suggest that H1N1 virus infection per se might be able to manifest a narcolepsy-like phenotype. Therefore, some controversy exists in the association between vaccination and narcolepsy. pNC cases had severe onset and common psychiatric comorbidity, which warranted thorough analysis of the pNC phenotype. Tools to measure narcolepsy symptoms or to help in diagnostics remain scarce. Our first aim was to systematically analyze the magnitude of the risk of H1N-vaccine-associated narcolepsy (pNC) and to examine whether an increased association emerged with any other vaccine or H1N1 virus infection. In Studies II and III, we aimed to determine whether differences were present in clinical, polysomnographic (PSG), or actigraphic (ACT) characteristics between pNC and sporadic narcolepsy (sNC). In study IV we aimed to validate the Ullanlinna Narcolepsy Scale (UNS), a population screening tool for narcolepsy published in 1994, in clinical population. Based on the meta-analysis in Study I, the relative risk of narcolepsy was increased 5- to 14-fold in children and adolescents and 2- to 7-fold in adults in the countries where Pandemrix vaccine was used widely (Finland, Sweden, Norway, France, England, Ireland). The vaccine-attributable risk in children and adolescents was 1 per 18,400 vaccines. The risk seems to have increased for two years and was not associated with any other vaccine. In study II we analyzed PSG and ACT characteristics of 69 pNC and 57 sNC subjects and in study III sleep questionnaires of 26 pNC and 25 sNC subjects. We found that pNC patients had shorter diagnostic delays, were diagnosed younger, had less periodic limb movements in sleep, and had earlier sleep-wake rhythm than sNC patients. The clinical course was highly variable in a two-year follow-up. There were no significant differences between pNC and sNC questionnaire scores. In study IV we analyzed questionnaire scores of patients with narcolepsy type 1 (n = 89), narcolepsy type 2 (n = 10), sleep apnea (n = 37), restless legs syndrome or periodic limb movement disorder (n = 56), other sleep-related disorders (n = 56), or other hypersomnias (n = 24). Sensitivity and specificity of the UNS in separating NT1 from other disorders were 83.5-85.4% and 84.1-87.6%, respectively. The UNS had a strong negative correlation with hypocretin-1 levels and mean sleep latency in MSLT. Tyypin 1 narkolepsia on aivoperäinen liikaunisuussairaus, joka aiheutuu oreksiinia tuottavien hermosolujen tuhoutumisesta. Narkolepsian ilmaantuvuuden huomattiin lisääntyneen huomattavasti H1N1-pandemiarokotekampanjan jälkeen niissä maissa, joissa käytettiin Pandemrix-rokotetta. Toisaalta samaan aikaan Pekingin seudulla Kiinassa, jossa rokotekattavuus oli hyvin matala, todettiin myös noin kolminkertainen määrä narkolepsiatapauksia tavanomaiseen nähden. Eläinkokeissa on myös todettu tietyissä olosuhteissa H1N1-viruksen itsessään kykenevän aiheuttamaan narkolepsian kaltaista oirekuvaa. H1N1-rokotteeseen liittyvän narkolepsian alku oli monilla sairastuneilla hyvin äkillinen ja voimakas. Tutkimuksiin hakeuduttiin nopeasti, jo ennen kuin tietoisuus sairaudesta oli lisääntynyt. Aiemmin viive narkolepsiadiagnoosin on ollut hyvin pitkä. Niinpä heräsi kysymys siitä, eroaako rokotenarkolepsia jollain tavoin tavanomaisesta narkolepsiasta. Tämä väitöskirja koostuu neljästä osatyöstä. Ensimmäisessä toteutimme systemaattisen katsauksen ja meta-analyysin tutkien narkolepsian ilmaantuvuutta H1N1-rokotekampanjan jälkeen ja selvitimme, liittyykö lisääntynyttä riskiä mihinkään muuhun kuin Pandemrix-rokotteeseen. Toisessa ja kolmannessa osatyössä analysoimme rokotenarkolepsian oirekuvaa ja neurofysiologisten tutkimustulosten löydöksiä ja vertasimme niitä tavanomaiseen narkolepsiaan. Neljännessä osatyössä tutkimme Ullanlinnan narkolepsia-asteikon (UNS) soveltuvuutta kliinisessä työssä narkolepsian tunnistamiseen. Totesimme narkolepsian riskin lisääntyneen lapsilla ja nuorilla 5-14-kertaiseksi ja aikuisilla 2-7-kertaiseksi H1N1-rokotekampanjan jälkeen. Yhtä rokoteannosta kohden riski oli 1 per 18 000 ja riski vaikuttaa olleen koholla kahden vuoden ajan rokottamisesta. Mihinkään muuhun kuin Pandemrix-rokotteeseen ei liity lisääntynyttä riskiä eikä H1N1-virukseen liittyvää riskiä todettu missään muualla kuin Kiinassa. Pääosin neurofysiologisten tutkimusten tulokset olivat samansuuntaisia tavanomaisessa ja rokotenarkolepsiassa. Diagnostinen viive oli lyhyempi ja diagnoosi-ikä varhaisempi rokotenarkolepsiassa. Rokotenarkolepsiassa unenaikaisia jaksottaisia raajaliikkeitä oli vähemmän ja vuorokausirytmi oli aikaisempi. Kliinisessä oirekuvassa ei ollut suurta eroa sairauksien välillä. Toisaalta rokotenarkolepsiaa sairastavien oirekuva on hyvin vaihteleva. UNS vaikuttaa tunnistavan narkolepsian hyvin ja erottavan sen muista unihäiriöistä katkaisupistemäärällä 14. Jos pistemäärä on alle 9, narkolepsia on hyvin epätodennäköinen. Asteikolla on myös kohtalainen negatiivinen korrelaatio aivoselkäydinnesteen oreksiinipitoisuuden kanssa.

Published
2019

40. Cognitive behavioural therapy for insomnia (CBT-I) in schizophrenia and schizoaffective disorder: protocol for a randomised controlled trial.

Author

Tanskanen TE, Wegelius A, Härkönen T, Gummerus EM, Stenberg JH, Selinheimo SIK, Alakuijala A, Tenhunen M, Paajanen T, Järnefelt H, Kajaste S, Blom K, Kieseppä T, Tuisku K, and Paunio T

Subjects
Humans, Randomized Controlled Trials as Topic, Adult, Female, Male, Finland, Sleep Initiation and Maintenance Disorders therapy, Sleep Initiation and Maintenance Disorders etiology, Cognitive Behavioral Therapy methods, Schizophrenia therapy, Schizophrenia complications, Psychotic Disorders therapy, Psychotic Disorders complications, Quality of Life
Abstract

Introduction: Insomnia is a common symptom among patients with schizophrenia and schizoaffective disorder, negatively impacting symptom severity, functioning and well-being; however, it is rarely the direct focus of treatment. The main recommended treatment for insomnia is cognitive behavioural therapy (CBT-I). There is some evidence that CBT-I can also be used to treat insomnia in patients with schizophrenia, but only a few randomised controlled trials (RCTs) have been published. The aim of this ongoing RCT is to determine whether we can alleviate symptoms of insomnia and improve the quality of life in patients with schizophrenia and schizoaffective disorder through CBT-I delivered via the internet or in a group mode., Methods and Analyses: The aim of this study is to recruit 84-120 outpatients from the Psychosis Clinics of Helsinki University Hospital and the City of Helsinki Health Services. The main inclusion criteria are a diagnosis of schizophrenia or schizoaffective disorder and self-reported sleep problems. The study will be performed on a cyclic basis, with a target of 12-24 patients per cycle. Participants are randomly assigned into three groups: (1) a group receiving only treatment as usual (TAU), (2) internet-based individual therapy for insomnia (iCBT-I)+TAU or (3) group therapy for insomnia (GCBT-I) conducted via a virtual platform+TAU. The primary outcome measures are quantitative changes in the Insomnia Severity Index score and/or changes in health-related quality of life using the 15D quality of life measure. Secondary outcomes include self-reported variables for sleep, health, stress and the severity of psychotic and depressive symptoms; objective outcomes include actigraphy and bed sensor data to evaluate circadian rhythms and motor activity. Outcome measures are assessed at baseline and after the treatment period at weeks 12, 24 and 36., Ethics and Dissemination: The Coordinating Ethics Committee of the Hospital District of Helsinki and Uusimaa, Finland, approved the study protocol. The results will be published in peer-reviewed journals., Trial Registration Number: NCT04144231., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Published
2024
Full Text
View/download PDF

Catalog

Books, media, physical & digital resources
See catalog results