Functional Resting State Networks In Sickle Cell Disease: Relationship With Sleep

There are few data on the impact of sleep deprivation or disturbance in children and young adults living with sickle cell disease (CYA). This study investigated the relationship between sleep disturbance and functional network connection in CYA and controls using resting state fMRI (rsfMRI). Twenty CYA (13 female, Mean age=20.69±4.90 years) and twelve ethnicity-age matched healthy controls (10 female, Mean age=19.26±2.91 years) wore an Actiwatch for 5-7 nights and underwent rsfMRI during this period. Functional connectivity measures (i.e., regions of interests (ROI-to-ROI) were computed using CONN for nineteen nodes in the following networks: (1) default mode (DMN); (2) dorsal attention (DAN); (3) fronto-parietal (FPN) and (4) salience (SN). CYA experienced lower sleep quality (i.e., more fragmented sleep), more night wakings and movement at night compared to controls. Although non-significant (Global Connectivity, GC: p=0.31; Local Connectivity, LC: p=0.55), greater global and local functional connectivity was observed for CYA. Group difference was observed for the right lateral prefrontal cortex (CYA: 0.40±0.09, Controls: 0.25±0.16; p=0.009). Correlational analysis in CYA showed that GC (average distance between nodes) increased with total sleep time, while the inverse relationship was true for LC (efficiency of neighbouring sub-graphs). Sleep fragmentation, night awakening and mobile minutes at night had a negative relationship with GC, particularly in the FPN. From these rsfMRI data, global and local connectivity appear to differ in CYA compared with controls. In CYA, poor quality sleep may affect connectivity, particularly in the FPN, with a potential effect on executive function.