Circadian rest-activity rhythm alterations in idiopathic REM sleep behavior disorder and neurodegenerative diseases: a novel prodromal marker?
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摘要Background and purpose: Circadian rhythm disturbances are commonly observed at different stages of neurodegenerative diseases, such as Parkinson’s disease and Alzheimer’s disease. However, whether circadian rhythm is altered in idiopathic REM sleep behavior disorder (iRBD), a widely accepted prodromal stage of neurodegenerative diseases, remains unclear. Hence, this case-control study aims to investigate circadian rest-activity rhythm situations in iRBD, thereby exploring whether a trajectory of circadian restactivity rhythm changes exists from iRBD to neurodegenerative diseases.
Methods: Eighteen patients with neurodegenerative diseases [mean age: 69.5 ± 9.3 years; 15 males (83.3%)], sex- and age- matched eighteen patients with iRBD [mean age: 71.0 ± 10.5 years; 15 males (83.3%)], and eighteen healthy controls [mean age: 71.6 ± 10.9 years; 15 males (83.3%)] were assessed by using wrist-worn actigraphy for seven days. The parameters of circadian rest-activity rhythm, including intradaily variability, interdaily stability, percentage of rhythm, mesor, 24-hour amplitude and 24-hour acrophase, and neurocognitive assessments were performed.
Results: Compared with healthy controls, both iRBD and neurodegenerative groups expressed altered circadian rest-activity rhythm characterized by significantly lower mesor (193.2 ± 56.7 vs. 145.3 ± 59.1 vs. 94.2 ± 55.6, P < 0.01) and 24-hour amplitude (142.4 ± 45.3 vs. 110.0 ± 51.2 vs. 74.7 ± 48.5, P < 0.01), both with significant decline trends (all P for trend < 0.05). However, there were no significant differences in intradaily variability, interdaily stability, percentage of rhythm and 24-hour acrophase among healthy controls, iRBD and neurodegenerative groups (all P > 0.05).
Conclusion: Alterations in circadian rest-activity rhythm exist not only in patients with neurodegenerative diseases but also in patients with iRBD. These alterations with significant tendencies suggest that they may serve as prodromal expressions of neurodegenerative diseases. Longitudinal studies with larger sample size are warranted to further clarify the role of circadian rest-activity rhythm changes in neurodegeneration progression.
著者Lauren CHEN, Hongliang FENG, Siu Ping LAM, Shirley Xin LI, Yaping LIU, Yun Kwok WING, Jihui ZHANG
會議名稱2nd Congress of Asian Society of Sleep Medicine

上次更新時間 2018-05-10 於 17:09