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  1. Article: Activation of nucleus accumbens projections to the ventral tegmental area alters molecular signaling and neurotransmission in the reward system.

    Khayat, Alaa / Yaka, Rami

    Frontiers in molecular neuroscience

    2024  Volume 17, Page(s) 1271654

    Abstract: The nucleus accumbens (NAc) and the ventral tegmental area (VTA) are integral brain regions involved in reward processing and motivation, including responses to drugs of abuse. Previously, we have demonstrated that activation of NAc-VTA afferents during ... ...

    Abstract The nucleus accumbens (NAc) and the ventral tegmental area (VTA) are integral brain regions involved in reward processing and motivation, including responses to drugs of abuse. Previously, we have demonstrated that activation of NAc-VTA afferents during the acquisition of cocaine conditioned place preference (CPP) reduces the rewarding properties of cocaine and diminished the activity of VTA dopamine neurons. In the current study, we examined the impact of enhancing these inhibitory inputs on molecular changes and neurotransmission associated with cocaine exposure. Our results unveiled significant reductions in extracellular signal-regulated kinase (ERK) levels in the VTA and medial prefrontal cortex (mPFC) of both cocaine-treated groups compared with the saline control group. Furthermore, optic stimulation of NAc-VTA inputs during cocaine exposure decreased the expression of GluA1 subunit of AMPA receptor in the VTA and mPFC. Notably, in the NAc, cocaine exposure paired with optic stimulation increased ERK levels and reduced GluA1 phosphorylation at Ser845 as compared with all other groups. Additionally, both cocaine-treated groups exhibited decreased levels of GluA1 phosphorylation at Ser831 in the NAc compared with the saline control group. Moreover, cocaine exposure led to reduced ERK, GluA1, and GluA1 phosphorylation at Ser845 and Ser831 in the mPFC. Augmentation of GABAergic tone from the NAc during cocaine conditioning mitigated changes in GluA1 phosphorylation at Ser845 in the mPFC but reduced ERK, GluA1, and GluA1 phosphorylation at Ser831 compared with the saline control group. Interestingly, enhancing GABAergic tone during saline conditioning decreased GluA1 phosphorylation at Ser831 compared with the saline control group in the mPFC. Our findings highlight the influence of modulating inhibitory inputs from the NAc to the VTA on molecular signaling and glutamatergic neurotransmission in cocaine-exposed animals. Activation of these inhibitory inputs during cocaine conditioning induced alterations in key signaling molecules and AMPA receptor, providing valuable insights into the neurobiological mechanisms underlying cocaine reward and cocaine use disorder. Further exploration of these pathways may offer potential therapeutic targets for the treatment of substance use disorder.
    Language English
    Publishing date 2024-03-11
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 2452967-9
    ISSN 1662-5099
    ISSN 1662-5099
    DOI 10.3389/fnmol.2024.1271654
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Insomnia: Advancements and Limitations of Current Management Strategies.

    Healy, William J / Khayat, Rami N / Kwon, Younghoon

    American family physician

    2024  Volume 109, Issue 2, Page(s) 107–108

    MeSH term(s) Humans ; Sleep Initiation and Maintenance Disorders/diagnosis ; Sleep Initiation and Maintenance Disorders/therapy
    Language English
    Publishing date 2024-02-23
    Publishing country United States
    Document type Editorial
    ZDB-ID 412694-4
    ISSN 1532-0650 ; 0002-838X ; 0572-3612
    ISSN (online) 1532-0650
    ISSN 0002-838X ; 0572-3612
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Breathe Better and Preserve Heart.

    Healy, William J / Khayat, Rami / Kwon, Younghoon

    Journal of the American Heart Association

    2023  Volume 12, Issue 14, Page(s) e030806

    MeSH term(s) Humans ; Heart ; Sleep Apnea, Obstructive ; Heart Failure ; Stroke Volume
    Language English
    Publishing date 2023-07-08
    Publishing country England
    Document type Editorial ; Comment
    ZDB-ID 2653953-6
    ISSN 2047-9980 ; 2047-9980
    ISSN (online) 2047-9980
    ISSN 2047-9980
    DOI 10.1161/JAHA.123.030806
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: Sleep and the Heart: What's Next?

    Khayat, Rami N

    Sleep medicine clinics

    2017  Volume 12, Issue 2, Page(s) xiii–xiv

    Language English
    Publishing date 2017-06
    Publishing country United States
    Document type Editorial
    ISSN 1556-4088
    ISSN (online) 1556-4088
    DOI 10.1016/j.jsmc.2017.03.002
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article ; Online: Central sleep apnea treatment in patients with heart failure with reduced ejection fraction: a network meta-analysis.

    Iftikhar, Imran H / Khayat, Rami N

    Sleep & breathing = Schlaf & Atmung

    2021  Volume 26, Issue 3, Page(s) 1227–1235

    Abstract: Purpose: Adaptive servo-ventilation (ASV) is contraindicated for the treatment of central sleep apnea (CSA) in patients with heart failure with reduced ejection fraction (HFrEF), limiting treatment options. Though continuous positive airway pressure ( ... ...

    Abstract Purpose: Adaptive servo-ventilation (ASV) is contraindicated for the treatment of central sleep apnea (CSA) in patients with heart failure with reduced ejection fraction (HFrEF), limiting treatment options. Though continuous positive airway pressure (CPAP), bi-level PAP with back-up rate (BPAP-BUR), and transvenous phrenic nerve stimulation (TPNS) are alternatives, not much is known about their comparative efficacies, which formed the basis of conducting this network meta-analysis. We sought to analyze their comparative effectiveness in reducing apnea hypopnea index (AHI). Additionally, we also studied their comparative effectiveness on subjective daytime sleepiness as assessed by Epworth sleepiness score (ESS).
    Methods: Randomized controlled trials (RCTs) from PubMed were analyzed in a network meta-analysis and relative superiority was computed based on P-score ranking and Hasse diagrams.
    Results: Network meta-analysis based on 8 RCTs showed that when compared to guideline-directed medical therapy (GDMT-used as a common comparator across trials), reduction in AHI by ASV (- 26.05 [- 38.80; - 13.31]), TPNS (- 24.90 [- 42.88; - 6.92]), BPAP-BUR (- 20.36 [- 36.47; - 4.25]), and CPAP (- 16.01 [- 25.42; - 6.60]) were statistically significant but not between the interventions. Based on 6 RCTs of all the interventions, only TPNS showed a statistically significant decrease in ESS (- 3.70 (- 5.58; - 1.82)) when compared to GDMT, while also showing significant differences when compared with ASV (- 3.20 (- 5.86; - 0.54)), BPAP-BUR (- 4.00 (- 7.33; - 0.68)), and CPAP (- 4.45 (- 7.75; - 1.14)). Ranking of treatments based on Hasse diagram, accounting for both AHI and ESS as outcomes for relative hierarchy showed relative superiority of both ASV and TPNS over BPAP-BUR and CPAP.
    Conclusions: Results indicated relative superiority of TPNS and ASV to BPAP-BUR and CPAP in their effects on AHI and ESS.
    MeSH term(s) Continuous Positive Airway Pressure ; Disorders of Excessive Somnolence ; Heart Failure ; Humans ; Network Meta-Analysis ; Sleep Apnea, Central
    Language English
    Publishing date 2021-10-26
    Publishing country Germany
    Document type Journal Article ; Meta-Analysis
    ZDB-ID 1500381-4
    ISSN 1522-1709 ; 1520-9512
    ISSN (online) 1522-1709
    ISSN 1520-9512
    DOI 10.1007/s11325-021-02512-y
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article ; Online: Adaptive servo-ventilation and mortality in patients with systolic heart failure and central sleep apnea: a single-center experience.

    Sun, Paulina / Porter, Kyle / Randerath, Winfried / Jarjoura, David / Khayat, Rami

    Sleep & breathing = Schlaf & Atmung

    2023  Volume 27, Issue 5, Page(s) 1909–1915

    Abstract: Background: Central sleep apnea (CSA) is associated with increased mortality and morbidity in patients with heart failure with reduced ejection fraction (HFrEF). Treatment of CSA with a certain type of adaptive servo-ventilation (ASV) device that ... ...

    Abstract Background: Central sleep apnea (CSA) is associated with increased mortality and morbidity in patients with heart failure with reduced ejection fraction (HFrEF). Treatment of CSA with a certain type of adaptive servo-ventilation (ASV) device that targets minute ventilation (ASVmv) was found to be harmful in these patients. A newer generation of ASV devices that target peak flow (ASVpf) is presumed to have different effects on ventilation and airway patency. We analyzed our registry of patients with HFrEF-CSA to examine the effect of exposure to ASV and role of each type of ASV device on mortality.
    Methods: This is a retrospective cohort study in patients with HFrEF and CSA who were treated with ASV devices between 2008 and 2015 at a single institution. Mortality data were collected through the institutional data honest broker. Usage data were obtained from vendors' and manufacturers' servers. Median follow-up was 64 months.
    Results: The registry included 90 patients with HFrEF-CSA who were prescribed ASV devices. Applying a 3-h-per-night usage cutoff, we found a survival advantage at 64 months for those who used the ASV device above the cutoff (n = 59; survival 76%) compared to those who did not (n = 31; survival 49%; hazard ratio 0.44; CI 95%, 0.20 to 0.97; P = 0.04). The majority (n = 77) of patients received ASVpf devices with automatically adjusting end-expiratory pressure (EPAP) and the remainder (n = 13) received ASVmv devices mostly with fixed EPAP (n = 12). There was a trend towards a negative correlation between ASVmv with fixed EPAP and survival.
    Conclusion: In this population of patients with HFrEF and CSA, there was no evidence that usage of ASV devices was associated with increased mortality. However, there was evidence of differential effects of type of ASV technology on mortality.
    MeSH term(s) Humans ; Sleep Apnea, Central/therapy ; Sleep Apnea, Central/complications ; Heart Failure, Systolic/therapy ; Heart Failure, Systolic/complications ; Heart Failure/therapy ; Heart Failure/complications ; Retrospective Studies ; Stroke Volume ; Respiration ; Ventricular Dysfunction, Left ; Treatment Outcome
    Language English
    Publishing date 2023-03-15
    Publishing country Germany
    Document type Journal Article
    ZDB-ID 1500381-4
    ISSN 1522-1709 ; 1520-9512
    ISSN (online) 1522-1709
    ISSN 1520-9512
    DOI 10.1007/s11325-023-02807-2
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  7. Article: A mathematical model to serve as a clinical tool for assessing obstructive sleep apnea severity.

    Qayyum, Nida T / Wallace, C Hunter / Khayat, Rami N / Grosberg, Anna

    Frontiers in physiology

    2023  Volume 14, Page(s) 1198132

    Abstract: Obstructive sleep apnea (OSA) is a sleep disorder caused by periodic airway obstructions and has been associated with numerous health consequences, which are thought to result from tissue hypoxia. However, challenges in the direct measurement of tissue- ... ...

    Abstract Obstructive sleep apnea (OSA) is a sleep disorder caused by periodic airway obstructions and has been associated with numerous health consequences, which are thought to result from tissue hypoxia. However, challenges in the direct measurement of tissue-level oxygenation make it difficult to analyze the hypoxia exposure pattern in patients. Furthermore, current clinical practice relies on the apnea-hypopnea index (AHI) and pulse oximetry to assess OSA severity, both of which have limitations. To overcome this, we developed a clinically deployable mathematical model, which outputs tissue-level oxygenation. The model incorporates spatial pulmonary oxygen uptake, considers dissolved oxygen, and can use time-dependent patient inputs. It was applied to explore a series of breathing patterns that are clinically differentiated. Supporting previous studies, the result of this analysis indicated that the AHI is an unreliable indicator of hypoxia burden. As a proof of principle, polysomnography data from two patients was analyzed with this model. The model showed greater sensitivity to breathing in comparison with pulse oximetry and provided systemic venous oxygenation, which is absent from clinical measurements. In addition, the dissolved oxygen output was used to calculate hypoxia burden scores for each patient and compared to the clinical assessment, highlighting the importance of event length and cumulative impact of obstructions. Furthermore, an intra-patient statistical analysis was used to underscore the significance of closely occurring obstructive events and to highlight the utility of the model for quantitative data processing. Looking ahead, our model can be used with polysomnography data to predict hypoxic burden on the tissues and help guide patient treatment decisions.
    Language English
    Publishing date 2023-08-03
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 2564217-0
    ISSN 1664-042X
    ISSN 1664-042X
    DOI 10.3389/fphys.2023.1198132
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  8. Article ; Online: GABAergic projections to the ventral tegmental area govern cocaine-conditioned reward.

    Weitz, Moriya / Khayat, Alaa / Yaka, Rami

    Addiction biology

    2021  Volume 26, Issue 4, Page(s) e13026

    Abstract: Elevated dopamine (DA) levels in the reward system underlie various drug-related behaviors, including addiction. As a major DA source in the reward system, the ventral tegmental area (VTA) is highly regulated by GABAergic inputs projected from different ... ...

    Abstract Elevated dopamine (DA) levels in the reward system underlie various drug-related behaviors, including addiction. As a major DA source in the reward system, the ventral tegmental area (VTA) is highly regulated by GABAergic inputs projected from different brain regions. It was previously shown that cocaine exposure reduces GABA
    MeSH term(s) Animals ; Cocaine/pharmacology ; Conditioning, Psychological/drug effects ; Dopamine/metabolism ; Dopaminergic Neurons ; GABAergic Neurons/metabolism ; Nucleus Accumbens/metabolism ; Optogenetics ; Rats ; Reward ; Ventral Tegmental Area/metabolism ; gamma-Aminobutyric Acid/metabolism
    Chemical Substances gamma-Aminobutyric Acid (56-12-2) ; Cocaine (I5Y540LHVR) ; Dopamine (VTD58H1Z2X)
    Language English
    Publishing date 2021-02-26
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 1324314-7
    ISSN 1369-1600 ; 1355-6215
    ISSN (online) 1369-1600
    ISSN 1355-6215
    DOI 10.1111/adb.13026
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  9. Article ; Online: A Practical Approach to the Identification and Management of Sleep-Disordered Breathing in Heart Failure Patients.

    Kahwash, Rami / Khayat, Rami N

    Sleep medicine clinics

    2017  Volume 12, Issue 2, Page(s) 205–219

    Abstract: Sleep-disordered breathing (SDB) is a major health problem affecting much of the general population. Although SDB is responsible for rapid progression of heart failure (HF) and the worsening morbidity and mortality, advanced HF state is associated with ... ...

    Abstract Sleep-disordered breathing (SDB) is a major health problem affecting much of the general population. Although SDB is responsible for rapid progression of heart failure (HF) and the worsening morbidity and mortality, advanced HF state is associated with accelerated development of SDB. In the face of recent developments in SDB treatment and availability of effective therapeutic options known to improve quality of life, exercise tolerance, and heart function, most HF patients with SDB are left unrecognized and untreated. This article provides an overview of SDB in HF with focus on practical approaches intended to facilitate screening and treatment.
    MeSH term(s) Comorbidity ; Continuous Positive Airway Pressure ; Heart Failure/complications ; Humans ; Risk Factors ; Sleep Apnea Syndromes/complications ; Sleep Apnea Syndromes/diagnosis ; Sleep Apnea Syndromes/therapy
    Language English
    Publishing date 2017-06
    Publishing country United States
    Document type Journal Article ; Review
    ISSN 1556-4088
    ISSN (online) 1556-4088
    DOI 10.1016/j.jsmc.2017.01.002
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  10. Article ; Online: Reducing disparities in cardiovascular health in African Americans through integrated cardiovascular sleep care in outpatient setting.

    Healy, William J / Jean-Louis, Girardin / Yancy, Clyde W / Billings, Martha E / Khayat, Rami / Kwon, Younghoon

    Sleep advances : a journal of the Sleep Research Society

    2022  Volume 3, Issue 1, Page(s) zpac016

    Language English
    Publishing date 2022-05-12
    Publishing country United States
    Document type Editorial
    ISSN 2632-5012
    ISSN (online) 2632-5012
    DOI 10.1093/sleepadvances/zpac016
    Database MEDical Literature Analysis and Retrieval System OnLINE

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