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Randomized Controlled Trial
. 2025 Apr 27;40(3):437-444.
doi: 10.1093/arclin/acae096.

The Impact of Cognitive Behavioral Therapy for Insomnia on Neurofilament Light and Phosphorylated Tau in Individuals with a Concussion

Rebecca Ludwig  1 , Michael Rippee  2 , Linda D'Silva  1 , Jeff Radel  3 , Aaron M Eakman  4 , Jill Morris  2 , Alvin Beltramo  5 , Michelle Drerup  6 , Catherine Siengsukon  1
Affiliations
Randomized Controlled Trial

The Impact of Cognitive Behavioral Therapy for Insomnia on Neurofilament Light and Phosphorylated Tau in Individuals with a Concussion

Rebecca Ludwig et al. Arch Clin Neuropsychol. .

Abstract

Background: Concussions damage neurologic tissue, increasing release of intercellular proteins including phosphorylated Tau (pTau) and neurofilament light (NfL). Disrupted sleep from a concussion negatively impacts the ability of the glymphatic system to remove cellular waste from the brain.

Objective: The purpose of this study was to determine if enhancing sleep using Cognitive Behavioral Therapy for Insomnia (CBT-I) impacts pTau and NFL levels following a concussion.

Methods: This is pre/post intervention analysis of a larger wait-list control study. Participants had their blood sampled pre/post the CBT-I intervention which was analyzed using SIMOA analytics. Paired sampling statistics and linear regression models were used to examine how insomnia severity impacts pTau181 and NfL.

Results: Twenty-eight participants were enrolled in this study. Age and baseline protein level were significantly associated with post-intervention protein levels, but post-intervention insomnia severity was not associated with post-intervention protein levels. About 50% of participants that had clinically meaningful change in insomnia and had a reduction in their NfL and pTau181 values.

Conclusions: Post-intervention insomnia was not associated with post-intervention NfL or pTau. Yet, on an individual level, ~50% of participants had a clinically meaningful change in insomnia and reduced level of NfL and pTau 18.1.

Clinical trial registration: NCT04885205 https://clinicaltrials.gov.

Keywords: Cognitive Behavioral therapy for insomnia; Concussion; Insomnia; NfL; pTau181.

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Conflict of interest statement

Catherine Siengsukon is owner of Sleep Health and Wellness LLC. All other authors have no competing interest to declare.

Figures

Fig. 1
Fig. 1
CONSOT diagram.
Fig. 2
Fig. 2
Change in NfL before and after CBT-I. Solid line is mean; dotted lines are individual values.
Fig. 3
Fig. 3
Change in pTau before and after CBT-I. Solid line is mean; dotted lines are individual values.
See this image and copyright information in PMC

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