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      It’s About Time: The Circadian Network as Time-Keeper for Cognitive Functioning, Locomotor Activity and Mental Health

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          Abstract

          A variety of organisms including mammals have evolved a 24h, self-sustained timekeeping machinery known as the circadian clock (biological clock), which enables to anticipate, respond, and adapt to environmental influences such as the daily light and dark cycles. Proper functioning of the clock plays a pivotal role in the temporal regulation of a wide range of cellular, physiological, and behavioural processes. The disruption of circadian rhythms was found to be associated with the onset and progression of several pathologies including sleep and mental disorders, cancer, and neurodegeneration. Thus, the role of the circadian clock in health and disease, and its clinical applications, have gained increasing attention, but the exact mechanisms underlying temporal regulation require further work and the integration of evidence from different research fields. In this review, we address the current knowledge regarding the functioning of molecular circuits as generators of circadian rhythms and the essential role of circadian synchrony in a healthy organism. In particular, we discuss the role of circadian regulation in the context of behaviour and cognitive functioning, delineating how the loss of this tight interplay is linked to pathological development with a focus on mental disorders and neurodegeneration. We further describe emerging new aspects on the link between the circadian clock and physical exercise-induced cognitive functioning, and its current usage as circadian activator with a positive impact in delaying the progression of certain pathologies including neurodegeneration and brain-related disorders. Finally, we discuss recent epidemiological evidence pointing to an important role of the circadian clock in mental health.

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          Most cited references366

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          Executive Functions

          Executive functions (EFs) make possible mentally playing with ideas; taking the time to think before acting; meeting novel, unanticipated challenges; resisting temptations; and staying focused. Core EFs are inhibition [response inhibition (self-control—resisting temptations and resisting acting impulsively) and interference control (selective attention and cognitive inhibition)], working memory, and cognitive flexibility (including creatively thinking “outside the box,” seeing anything from different perspectives, and quickly and flexibly adapting to changed circumstances). The developmental progression and representative measures of each are discussed. Controversies are addressed (e.g., the relation between EFs and fluid intelligence, self-regulation, executive attention, and effortful control, and the relation between working memory and inhibition and attention). The importance of social, emotional, and physical health for cognitive health is discussed because stress, lack of sleep, loneliness, or lack of exercise each impair EFs. That EFs are trainable and can be improved with practice is addressed, including diverse methods tried thus far.
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            The Positive and Negative Syndrome Scale (PANSS) for Schizophrenia

            The variable results of positive-negative research with schizophrenics underscore the importance of well-characterized, standardized measurement techniques. We report on the development and initial standardization of the Positive and Negative Syndrome Scale (PANSS) for typological and dimensional assessment. Based on two established psychiatric rating systems, the 30-item PANSS was conceived as an operationalized, drug-sensitive instrument that provides balanced representation of positive and negative symptoms and gauges their relationship to one another and to global psychopathology. It thus constitutes four scales measuring positive and negative syndromes, their differential, and general severity of illness. Study of 101 schizophrenics found the four scales to be normally distributed and supported their reliability and stability. Positive and negative scores were inversely correlated once their common association with general psychopathology was extracted, suggesting that they represent mutually exclusive constructs. Review of five studies involving the PANSS provided evidence of its criterion-related validity with antecedent, genealogical, and concurrent measures, its predictive validity, its drug sensitivity, and its utility for both typological and dimensional assessment.
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              A new method for measuring daytime sleepiness: the Epworth sleepiness scale.

              The development and use of a new scale, the Epworth sleepiness scale (ESS), is described. This is a simple, self-administered questionnaire which is shown to provide a measurement of the subject's general level of daytime sleepiness. One hundred and eighty adults answered the ESS, including 30 normal men and women as controls and 150 patients with a range of sleep disorders. They rated the chances that they would doze off or fall asleep when in eight different situations commonly encountered in daily life. Total ESS scores significantly distinguished normal subjects from patients in various diagnostic groups including obstructive sleep apnea syndrome, narcolepsy and idiopathic hypersomnia. ESS scores were significantly correlated with sleep latency measured during the multiple sleep latency test and during overnight polysomnography. In patients with obstructive sleep apnea syndrome ESS scores were significantly correlated with the respiratory disturbance index and the minimum SaO2 recorded overnight. ESS scores of patients who simply snored did not differ from controls.
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                Author and article information

                Contributors
                Journal
                Front Physiol
                Front Physiol
                Front. Physiol.
                Frontiers in Physiology
                Frontiers Media S.A.
                1664-042X
                25 April 2022
                2022
                : 13
                : 873237
                Affiliations
                [1] 1 Institute for Theoretical Biology (ITB) , Charité—Universitätsmedizin Berlin , Corporate Member of Freie Universität Berlin , Humboldt-Universität zu Berlin and Berlin Institute of Health , Berlin, Germany
                [2] 2 Molecular Cancer Research Center (MKFZ) , Medical Department of Hematology, Oncology, and Tumour Immunology , Charité—Universitätsmedizin Berlin , Corporate Member of Freie Universität Berlin , Humboldt-Universität zu Berlin and Berlin Institute of Health , Berlin, Germany
                [3] 3 Institute for Systems Medicine and Faculty of Human Medicine , MSH Medical School Hamburg , Hamburg, Germany
                [4] 4 Institute and Policlinic of Occupational and Social Medicine , Faculty of Medicine , Technische Universität Dresden , Dresden, Germany
                [5] 5 Institute for Systems Medicine and Faculty of Human Sciences , MSH Medical School Hamburg , Hamburg, Germany
                [6] 6 Department of Psychology , Humboldt-Universität zu Berlin , Berlin, Germany
                [7] 7 Department of Clinical Neuroscience , Karolinska Institutet , Stockholm, Sweden
                [8] 8 Department of Child Health and Development , Norwegian Institute of Public Health , Oslo, Norway
                Author notes

                Edited by: Ezio Rosato, University of Leicester, United Kingdom

                Reviewed by: Sara Montagnese, University of Padua, Italy

                Martin Sládek, Academy of Sciences of the Czech Republic (ASCR), Czechia

                This article was submitted to Chronobiology, a section of the journal Frontiers in Physiology

                Article
                873237
                10.3389/fphys.2022.873237
                9081535
                35547585
                7794d91d-1338-4a69-8065-c59d315a761f
                Copyright © 2022 Yalçin, Mundorf, Thiel, Amatriain-Fernández, Kalthoff, Beucke, Budde, Garthus-Niegel, Peterburs and Relógio.

                This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

                History
                : 10 February 2022
                : 08 March 2022
                Funding
                Funded by: Dr. Rolf M. Schwiete Stiftung , doi 10.13039/501100020027;
                Funded by: Einstein Stiftung Berlin , doi 10.13039/501100006188;
                Categories
                Physiology
                Review

                Anatomy & Physiology
                circadian clock network,circadian medicine,circadian dysregulation,neurocognitive functioning,neurodegenerative disorders,mental health

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