Evidence map›Paper›PMID 34481662›Full record

ReviewBiological psychiatry2022

The Bidirectional Link Between Sleep Disturbances and Traumatic Brain Injury Symptoms: A Role for Glymphatic Dysfunction?

Juan A Piantino, Jeffrey J Iliff, Miranda M Lim

Open access · greenAbstract readReview
In one paragraph

Review in Biological psychiatry, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 33 papers.

0numbers the graph read from it
0cells of the map it votes in
33citing papers in PubMed
3.1field-weighted citation impact, top 7% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

33 citing papers in PubMed, 49 citations in OpenAlex.

  1. Review
  2. Article
  3. Article
  4. Article
  5. Observational
  6. Article
  7. RetrospectiveFrontiers in neuroscience · 2026
    Article
  8. Review
  9. Review
  10. Article
  11. Article
  12. Review
  13. Review
  14. Article
  15. Article
  16. The Glymphatic System and its Relationship to Migraine.Current neurology and neuroscience reports · 2024
    Review
  17. Article
  18. Article
  19. Review
  20. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

3 authors at 2 institutions in 1 country.

Juan A PiantinoDivision of Child Neurology, Department of Pediatrics, Doernbecher Children's Hospital, Oregon Health & Science University, Portland, Oregon.
Jeffrey J IliffVeterans Affairs Northwest Network (VISN 20) Mental Illness, Research, Education, and Clinical Center, Veterans Affairs Puget Sound Health Care System, Seattle, Washington; Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, Washington; Department of Neurology, University of Washington School of Medicine, Seattle, Washington.
Miranda M LimDepartment of Neurology, Department of Behavioral Neuroscience, and Department of Medicine - Division of Pulmonary and Critical Care Medicine, Oregon Health & Science University, Portland, Oregon; Oregon Institute of Occupational Health Sciences, Oregon Health & Science University, Portland, Oregon; Neurology Service and National Center for Rehabilitative Auditory Research, Veterans Affairs Portland Health Care System, Portland, Oregon. Electronic address: lmir@ohsu.edu.
Oregon Health & Science University · USUniversity of Washington · US

Funding

University of Washington Alzheimer's Disease Research CenterP30AG066509 · NIA · UNIVERSITY OF WASHINGTON · PI Lynn Bekris · 2020 to 2026
$29.0M
Defining the role of age-related glymphatic pathway impairment in amyloid beta plaque depositionR01AG054456 · NIA · SEATTLE INST FOR BIOMEDICAL/CLINICAL RES · PI ILIFF, JEFFREY J · 2017 to 2021
$1.8M
Role of perivascular aquaporin-4 polarization in post-traumatic neurodegenerationR01NS089709 · NINDS · SEATTLE INST FOR BIOMEDICAL/CLINICAL RES · PI ILIFF, JEFFREY J · 2015 to 2019
$1.7M
A link between sleep-wake disturbances and enlarged perivascular spaces in youth with traumatic brain injuryK23HL150217 · NHLBI · OREGON HEALTH & SCIENCE UNIVERSITY · PI PIANTINO, JUAN ANDRES · 2020 to 2024
$826k
Supplementation with Amino Acid Rehabilitative Therapy in TBI (SmART-TBI): A Randomized Placebo-Controlled Trial to Improve SleepI01CX002022 · VA · PORTLAND VA MEDICAL CENTER · PI Miranda M Lim · 2021 to 2026
–
Sleep-wake disturbances in traumatic brain injuryIK2BX002712 · VA · PORTLAND VA MEDICAL CENTER · PI LIM, MIRANDA M · 2016 to 2020
–
BLRD VA IK2 BX002712CSRD VA I01 CX002022NHLBI NIH HHS K23 HL150217NIA NIH HHS P30 AG066509NIA NIH HHS R01 AG054456NINDS NIH HHS R01 NS089709
6 · The paper itself

Abstract

Mild traumatic brain injury (mTBI), often referred to as concussion, is a major cause of morbidity and mortality worldwide. Sleep disturbances are common after mTBI. Moreover, subjects who develop subjective sleep complaints after mTBI also report more severe somatic, mental health, and cognitive impairment and take longer to recover from mTBI sequelae. Despite many previous studies addressing the role of sleep in post-mTBI morbidity, the mechanisms linking sleep to recovery after mTBI remain poorly understood. The glymphatic system is a brainwide network that supports fluid movement through the cerebral parenchyma and the clearance of interstitial solutes and wastes from the brain. Notably, the glymphatic system is active primarily during sleep. Clearance of cellular byproducts related to somatic, mental health, and neurodegenerative processes (e.g., amyloid-β and tau, among others) depends in part on intact glymphatic function, which becomes impaired after mTBI. In this viewpoint, we review the current knowledge regarding the association between sleep disturbances and post-mTBI symptoms. We also discuss the role of glymphatic dysfunction as a potential link between mTBI, sleep disruption, and posttraumatic morbidity. We outline a model where glymphatic dysfunction and sleep disruption caused by mTBI may have an additive effect on waste clearance, leading to cerebral dysfunction and impaired recovery. Finally, we review the novel techniques being developed to examine glymphatic function in humans and explore potential interventions to alter glymphatic exchange that may offer a novel therapeutic approach to those experiencing poor sleep and prolonged symptoms after mTBI.

Indexed as

Brain ConcussionBrain Injuries, TraumaticGlymphatic SystemSleep Wake DisordersHumansSleepGlymphatic systemPerivascular spacesSleepTraumatic brain injuryVirchow-Robin spaces

Identifiers

PMID34481662
PMCPMC8758801
OpenAlexW3178617810

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.