Inflammation, circadian rest-activity rhythms, and behavioral sequelae of chronic graft-versus-host disease

• Published in: Brain, behavior, and immunity behavior, and immunity, 2017-11, Vol.66, p.e1-e1
• Main Authors: Costanzo, E.S., Juckett, M.B., Coe, C.L., Dickson, D.A., Morris, K., Hematti, P., Rumble, M.E.
• Format: Article
• Language: English
• ISSN: 0889-1591; 1090-2139
• DOI: 10.1016/j.bbi.2017.07.020

Chronic graft-versus-host-disease (cGVHD) is a common complication of hematopoietic stem cell transplantation that involves alloegeneic and autoimmune dysregulation affecting multiple organ systems. We hypothesized that disrupted circadian rest-activity rhythms and inflammation contribute to co-occurring behavioral symptoms in this population. Adults with cGVHD (N=55) wore a wrist actigraph for 7days, provided a blood sample, completed self-report measures of depression (IDAS), fatigue (FSI), and cognition (PROMIS), and underwent clinical evaluation. Rest-activity indices (mesor, amplitude, acrophase) were derived from actigraphy. Cytokines and chemokines relevant to cGVHD (IL-6, IL-8, TNFα, MIF, MCP-1, MIP-1 alpha) were measured with multiplex detection. After covarying for disease severity and age, participants with less optimal rest-activity patterns, including less overall activity (mesor) and less distinction between daytime and nighttime activity (amplitude), reported more severe depression (β=−.372, −.296), fatigue (β=-.237, −.314), and cognitive dysfunction (β=.331, .440) and had poorer physician-rated performance status (β=.340, .383); all p