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Cody KA, Langhough RE, Zammit MD, Clark L, Chin N, Christian BT, Betthauser TJ, Johnson SC. Characterizing brain tau and cognitive decline along the amyloid timeline in Alzheimer's disease. Brain 2024; 147:2144-2157. [PMID: 38667631 PMCID: PMC11146417 DOI: 10.1093/brain/awae116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Revised: 02/23/2024] [Accepted: 03/24/2024] [Indexed: 06/04/2024] Open
Abstract
Recent longitudinal PET imaging studies have established methods to estimate the age at which amyloid becomes abnormal at the level of the individual. Here we recontextualized amyloid levels into the temporal domain to better understand the downstream Alzheimer's disease processes of tau neurofibrillary tangle (NFT) accumulation and cognitive decline. This cohort study included a total of 601 individuals from the Wisconsin Registry for Alzheimer's Prevention and Wisconsin Alzheimer's Disease Research Center that underwent amyloid and tau PET, longitudinal neuropsychological assessments and met clinical criteria for three clinical diagnosis groups: cognitively unimpaired (n = 537); mild cognitive impairment (n = 48); or dementia (n = 16). Cortical 11C-Pittsburgh compound B (PiB) distribution volume ratio (DVR) and sampled iterative local approximation were used to estimate amyloid positive (A+; global PiB DVR > 1.16 equivalent to 17.1 centiloids) onset age and years of A+ duration at tau PET (i.e. amyloid chronicity). Tau PET burden was quantified using 18F-MK-6240 standardized uptake value ratios (70-90 min, inferior cerebellar grey matter reference region). Whole-brain and region-specific approaches were used to examine tau PET binding along the amyloid timeline and across the Alzheimer's disease clinical continuum. Voxel-wise 18F-MK-6240 analyses revealed that with each decade of A+, the spatial extent of measurable tau spread (i.e. progressed) from regions associated with early to late NFT tau stages. Regional analyses indicated that tau burden in the entorhinal cortex was detectable, on average, within 10 years of A+ onset. Additionally, the entorhinal cortex was the region most sensitive to early amyloid pathology and clinical impairment in this predominantly preclinical sample. Among initially cognitively unimpaired (n = 472) individuals with longitudinal cognitive follow-up, mixed effects models showed significant linear and non-linear interactions of A+ duration and entorhinal tau on cognitive decline, suggesting a synergistic effect whereby greater A+ duration, together with a higher entorhinal tau burden, increases the likelihood of cognitive decline beyond their separable effects. Overall, the amyloid time framework enabled a spatiotemporal characterization of tau deposition patterns across the Alzheimer's disease continuum. This approach, which examined cross-sectional tau PET data along the amyloid timeline to make longitudinal disease course inferences, demonstrated that A+ duration explains a considerable amount of variability in the magnitude and topography of tau spread, which largely recapitulated NFT staging observed in human neuropathological studies. By anchoring disease progression to the onset of amyloid, this study provides a temporal disease context, which may help inform disease prognosis and timing windows for anti-amyloid therapies.
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Affiliation(s)
- Karly A Cody
- Wisconsin Alzheimer’s Disease Research Center, University of Wisconsin School of Medicine and Public Health, Madison, WI 53792, USA
- Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI 53792, USA
| | - Rebecca E Langhough
- Wisconsin Alzheimer’s Disease Research Center, University of Wisconsin School of Medicine and Public Health, Madison, WI 53792, USA
- Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI 53792, USA
- Wisconsin Alzheimer’s Institute, University of Wisconsin School of Medicine and Public Health, Madison, WI 53792, USA
| | - Matthew D Zammit
- Wisconsin Alzheimer’s Disease Research Center, University of Wisconsin School of Medicine and Public Health, Madison, WI 53792, USA
- Waisman Laboratory for Brain Imaging and Behavior, University of Wisconsin-Madison, Madison, WI 53792, USA
- Department of Medical Physics, University of Wisconsin-Madison, Madison, WI 53792, USA
| | - Lindsay Clark
- Wisconsin Alzheimer’s Disease Research Center, University of Wisconsin School of Medicine and Public Health, Madison, WI 53792, USA
- Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI 53792, USA
- Wisconsin Alzheimer’s Institute, University of Wisconsin School of Medicine and Public Health, Madison, WI 53792, USA
| | - Nathaniel Chin
- Wisconsin Alzheimer’s Disease Research Center, University of Wisconsin School of Medicine and Public Health, Madison, WI 53792, USA
- Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI 53792, USA
- Wisconsin Alzheimer’s Institute, University of Wisconsin School of Medicine and Public Health, Madison, WI 53792, USA
| | - Bradley T Christian
- Wisconsin Alzheimer’s Disease Research Center, University of Wisconsin School of Medicine and Public Health, Madison, WI 53792, USA
- Waisman Laboratory for Brain Imaging and Behavior, University of Wisconsin-Madison, Madison, WI 53792, USA
- Department of Medical Physics, University of Wisconsin-Madison, Madison, WI 53792, USA
| | - Tobey J Betthauser
- Wisconsin Alzheimer’s Disease Research Center, University of Wisconsin School of Medicine and Public Health, Madison, WI 53792, USA
- Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI 53792, USA
- Department of Medical Physics, University of Wisconsin-Madison, Madison, WI 53792, USA
| | - Sterling C Johnson
- Wisconsin Alzheimer’s Disease Research Center, University of Wisconsin School of Medicine and Public Health, Madison, WI 53792, USA
- Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI 53792, USA
- Wisconsin Alzheimer’s Institute, University of Wisconsin School of Medicine and Public Health, Madison, WI 53792, USA
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Ourry V, Binette AP, St-Onge F, Strikwerda-Brown C, Chagnot A, Poirier J, Breitner J, Arenaza-Urquijo EM, Rabin JS, Buckley R, Gonneaud J, Marchant NL, Villeneuve S. How Do Modifiable Risk Factors Affect Alzheimer's Disease Pathology or Mitigate Its Effect on Clinical Symptom Expression? Biol Psychiatry 2024; 95:1006-1019. [PMID: 37689129 DOI: 10.1016/j.biopsych.2023.09.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Revised: 08/11/2023] [Accepted: 09/03/2023] [Indexed: 09/11/2023]
Abstract
Epidemiological studies show that modifiable risk factors account for approximately 40% of the population variability in risk of developing dementia, including sporadic Alzheimer's disease (AD). Recent findings suggest that these factors may also modify disease trajectories of people with autosomal-dominant AD. With positron emission tomography imaging, it is now possible to study the disease many years before its clinical onset. Such studies can provide key knowledge regarding pathways for either the prevention of pathology or the postponement of its clinical expression. The former "resistance pathway" suggests that modifiable risk factors could affect amyloid and tau burden decades before the appearance of cognitive impairment. Alternatively, the resilience pathway suggests that modifiable risk factors may mitigate the symptomatic expression of AD pathology on cognition. These pathways are not mutually exclusive and may appear at different disease stages. Here, in a narrative review, we present neuroimaging evidence that supports both pathways in sporadic AD and autosomal-dominant AD. We then propose mechanisms for their protective effect. Among possible mechanisms, we examine neural and vascular mechanisms for the resistance pathway. We also describe brain maintenance and functional compensation as bases for the resilience pathway. Improved mechanistic understanding of both pathways may suggest new interventions.
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Affiliation(s)
- Valentin Ourry
- Department of Psychiatry, Faculty of Medicine, McGill University, Montreal, Quebec, Canada; Douglas Mental Health University Institute, Montreal, Quebec, Canada.
| | - Alexa Pichet Binette
- Department of Psychiatry, Faculty of Medicine, McGill University, Montreal, Quebec, Canada; Douglas Mental Health University Institute, Montreal, Quebec, Canada; Clinical Memory Research Unit, Department of Clinical Sciences, Lunds Universitet, Malmö, Sweden
| | - Frédéric St-Onge
- Department of Psychiatry, Faculty of Medicine, McGill University, Montreal, Quebec, Canada; Douglas Mental Health University Institute, Montreal, Quebec, Canada; Integrated Program in Neuroscience, Faculty of Medicine, McGill University, Montreal, Quebec, Canada
| | - Cherie Strikwerda-Brown
- Department of Psychiatry, Faculty of Medicine, McGill University, Montreal, Quebec, Canada; Douglas Mental Health University Institute, Montreal, Quebec, Canada; School of Psychological Science, The University of Western Australia, Perth, Western Australia, Australia
| | - Audrey Chagnot
- UK Dementia Research Institute, Edinburgh Medical School, University of Edinburgh, Edinburgh, United Kingdom; Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, United Kingdom
| | - Judes Poirier
- Department of Psychiatry, Faculty of Medicine, McGill University, Montreal, Quebec, Canada; Douglas Mental Health University Institute, Montreal, Quebec, Canada
| | - John Breitner
- Department of Psychiatry, Faculty of Medicine, McGill University, Montreal, Quebec, Canada; Douglas Mental Health University Institute, Montreal, Quebec, Canada
| | - Eider M Arenaza-Urquijo
- Environment and Health over the Lifecourse Programme, Barcelona Institute for Global Health (ISGlobal), Barcelona, Spain; Department of Radiology, Mayo Clinic, Rochester, Minnesota
| | - Jennifer S Rabin
- Division of Neurology, Department of Medicine, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada; Harquail Centre for Neuromodulation, Hurvitz Brain Sciences Program, Sunnybrook Research Institute, University of Toronto, Toronto, Ontario, Canada; Rehabilitation Sciences Institute, University of Toronto, Toronto, Ontario, Canada
| | - Rachel Buckley
- Melbourne School of Psychological Sciences University of Melbourne, Parkville, Victoria, Australia; Department of Neurology, Massachusetts General Hospital, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts; Center for Alzheimer Research and Treatment, Department of Neurology, Brigham and Women's Hospital, Boston, Massachusetts
| | - Julie Gonneaud
- Normandie University, UNICAEN, INSERM, U1237, PhIND "Physiopathology and Imaging of Neurological Disorders," Institut Blood and Brain @ Caen-Normandie, GIP Cyceron, Caen, France
| | - Natalie L Marchant
- Division of Psychiatry, University College London, London, United Kingdom
| | - Sylvia Villeneuve
- Department of Psychiatry, Faculty of Medicine, McGill University, Montreal, Quebec, Canada; Douglas Mental Health University Institute, Montreal, Quebec, Canada; McConnell Brain Imaging Center, Montreal Neurological Institute, McGill University, Montreal, Quebec, Canada.
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Bransby L, Yassi N, Rosenich E, Buckley R, Li QX, Maruff P, Pase M, Lim YY. Associations between multidomain modifiable dementia risk factors with AD biomarkers and cognition in middle-aged and older adults. Neurobiol Aging 2024; 138:63-71. [PMID: 38537555 DOI: 10.1016/j.neurobiolaging.2024.02.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Revised: 02/26/2024] [Accepted: 02/28/2024] [Indexed: 04/09/2024]
Abstract
This study aimed to determine associations between modifiable dementia risk factors (MDRF), across domains mood symptomatology, lifestyle behaviors, cardiovascular conditions, cognitive/social engagement, sleep disorders/symptomatology, with cognition, beta-amyloid (Aβ) and tau, and brain volume. Middle-aged/older adults (n=82) enrolled in a sub-study of the Healthy Brain Project completed self-report questionnaires and a neuropsychological battery. Cerebrospinal fluid levels of Aβ 1-42, total tau (t-tau), and phosphorylated tau (p-tau181) (Roche Elecsys), and MRI markers of hippocampal volume and total brain volume were obtained. Participants were classified as no/single domain risk (≤1 domains) or multidomain risk (≥2 domains). Compared to the no/single domain risk group, the multidomain risk group performed worse on the Preclinical Alzheimer's Cognitive Composite (d=0.63, p=.005), and Executive Function (d=0.50, p=.016), and had increased p-tau181 (d=0.47, p=.042) and t-tau (d=0.54, p=.021). In middle-aged/older adults, multidomain MDRFs were related to increases in tau and worse cognition, but not Aβ or brain volume. Findings suggest that increases in AD biomarkers are apparent in midlife, particularly for individuals with greater burden, or variety of MDRFs.
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Affiliation(s)
- Lisa Bransby
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, Victoria, Australia
| | - Nawaf Yassi
- Department of Medicine and Neurology, Melbourne Brain Centre at the Royal Melbourne Hospital, University of Melbourne, Parkville, Victoria, Australia; Population Health and Immunity Division, The Walter and Eliza Hall Institute of Medical Research, Parkville, Victoria, Australia
| | - Emily Rosenich
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, Victoria, Australia
| | - Rachel Buckley
- Melbourne School of Psychological Sciences, University of Melbourne, Parkville, Victoria, Australia; Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA; Center for Alzheimer Research and Treatment, Department of Neurology, Brigham and Women's Hospital, Boston, MA, USA
| | - Qiao-Xin Li
- Florey Institute of Neuroscience and Mental Health, Parkville, Victoria, Australia
| | - Paul Maruff
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, Victoria, Australia; Florey Institute of Neuroscience and Mental Health, Parkville, Victoria, Australia; Cogstate Ltd., Melbourne, Victoria, Australia
| | - Matthew Pase
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, Victoria, Australia; Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Yen Ying Lim
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, Victoria, Australia.
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Deantoni M, Reyt M, Baillet M, Dourte M, De Haan S, Lesoinne A, Vandewalle G, Maquet P, Berthomier C, Muto V, Hammad G, Schmidt C. Napping and circadian sleep-wake regulation during healthy aging. Sleep 2024; 47:zsad287. [PMID: 37943833 DOI: 10.1093/sleep/zsad287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Revised: 09/27/2023] [Indexed: 11/12/2023] Open
Abstract
STUDY OBJECTIVES Daytime napping is frequently reported among the older population and has attracted increasing attention due to its association with multiple health conditions. Here, we tested whether napping in the aged is associated with altered circadian regulation of sleep, sleepiness, and vigilance performance. METHODS Sixty healthy older individuals (mean age: 69 years, 39 women) were recruited with respect to their napping habits (30 nappers, 30 non-nappers). All participants underwent an in-lab 40-hour multiple nap protocol (10 cycles of 80 minutes of sleep opportunity alternating with 160 minutes of wakefulness), preceded and followed by a baseline and recovery sleep period. Saliva samples for melatonin assessment, sleepiness, and vigilance performance were collected during wakefulness and electrophysiological data were recorded to derive sleep parameters during scheduled sleep opportunities. RESULTS The circadian amplitude of melatonin secretion was reduced in nappers, compared to non-nappers. Furthermore, nappers were characterized by higher sleep efficiencies and REM sleep proportion during day- compared to nighttime naps. The nap group also presented altered modulation in sleepiness and vigilance performance at specific circadian phases. DISCUSSION Our data indicate that napping is associated with an altered circadian sleep-wake propensity rhythm. They thereby contribute to the understanding of the biological correlates underlying napping and/or sleep-wake cycle fragmentation during healthy aging. Altered circadian sleep-wake promotion can lead to a less distinct allocation of sleep into nighttime and/or a reduced wakefulness drive during the day, thereby potentially triggering the need to sleep at adverse circadian phase.
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Affiliation(s)
- Michele Deantoni
- Sleep and Chronobiology Group, GIGA-CRC-In Vivo Imaging Research Unit, University of Liège, Liège, Belgium
| | - Mathilde Reyt
- Sleep and Chronobiology Group, GIGA-CRC-In Vivo Imaging Research Unit, University of Liège, Liège, Belgium
- Psychology and Neuroscience of Cognition Research Unit (PsyNCog), Faculty of Psychology and Educational Sciences, University of Liège, Liège, Belgium
| | - Marion Baillet
- Sleep and Chronobiology Group, GIGA-CRC-In Vivo Imaging Research Unit, University of Liège, Liège, Belgium
| | - Marine Dourte
- Sleep and Chronobiology Group, GIGA-CRC-In Vivo Imaging Research Unit, University of Liège, Liège, Belgium
- Psychology and Neuroscience of Cognition Research Unit (PsyNCog), Faculty of Psychology and Educational Sciences, University of Liège, Liège, Belgium
| | - Stella De Haan
- Sleep and Chronobiology Group, GIGA-CRC-In Vivo Imaging Research Unit, University of Liège, Liège, Belgium
| | - Alexia Lesoinne
- Sleep and Chronobiology Group, GIGA-CRC-In Vivo Imaging Research Unit, University of Liège, Liège, Belgium
| | - Gilles Vandewalle
- Sleep and Chronobiology Group, GIGA-CRC-In Vivo Imaging Research Unit, University of Liège, Liège, Belgium
| | - Pierre Maquet
- Sleep and Chronobiology Group, GIGA-CRC-In Vivo Imaging Research Unit, University of Liège, Liège, Belgium
- Department of Neurology, University Hospital of Liège, University of Liège, Liège, Belgium
| | | | - Vincenzo Muto
- Sleep and Chronobiology Group, GIGA-CRC-In Vivo Imaging Research Unit, University of Liège, Liège, Belgium
| | - Gregory Hammad
- Sleep and Chronobiology Group, GIGA-CRC-In Vivo Imaging Research Unit, University of Liège, Liège, Belgium
| | - Christina Schmidt
- Sleep and Chronobiology Group, GIGA-CRC-In Vivo Imaging Research Unit, University of Liège, Liège, Belgium
- Psychology and Neuroscience of Cognition Research Unit (PsyNCog), Faculty of Psychology and Educational Sciences, University of Liège, Liège, Belgium
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Moon C, Schneider A, Cho YE, Zhang M, Dang H, Vu K. Sleep duration, sleep efficiency, and amyloid β among cognitively healthy later-life adults: a systematic review and meta-analysis. BMC Geriatr 2024; 24:408. [PMID: 38714912 PMCID: PMC11076214 DOI: 10.1186/s12877-024-05010-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Accepted: 04/24/2024] [Indexed: 05/12/2024] Open
Abstract
BACKGROUND Abnormal amyloid β (Aβ) deposits in the brain are a hallmark of Alzheimer's disease (AD). Insufficient sleep duration and poor sleep quality are risk factors for developing AD. Sleep may play a role in Aβ regulation, but the magnitude of the relationship between sleep and Aβ deposition remains unclear. This systematic review examines the relationship between sleep (i.e., duration and efficiency) with Aβ deposition in later-life adults. METHODS A search of PubMed, CINAHL, Embase, and PsycINFO generated 5,005 published articles. Fifteen studies met the inclusion criteria for qualitative syntheses; thirteen studies for quantitative syntheses related to sleep duration and Aβ; and nine studies for quantitative syntheses related to sleep efficiency and Aβ. RESULTS Mean ages of the samples ranged from 63 to 76 years. Studies measured Aβ using cerebrospinal fluid, serum, and positron emission tomography scans with two tracers: Carbone 11-labeled Pittsburgh compound B or fluorine 18-labeled. Sleep duration was measured subjectively using interviews or questionnaires, or objectively using polysomnography or actigraphy. Study analyses accounted for demographic and lifestyle factors. Based on 13 eligible articles, our synthesis demonstrated that the average association between sleep duration and Aβ was not statistically significant (Fisher's Z = -0.055, 95% CI = -0.117 ~ 0.008). We found that longer self-report sleep duration is associated with lower Aβ (Fisher's Z = -0.062, 95% CI = -0.119 ~ -0.005), whereas the objectively measured sleep duration was not associated with Aβ (Fisher's Z = 0.002, 95% CI = -0.108 ~ 0.113). Based on 9 eligible articles for sleep efficiency, our synthesis also demonstrated that the average association between sleep efficiency and Aβ was not statistically significant (Fisher's Z = 0.048, 95% CI = -0.066 ~ 0.161). CONCLUSION The findings from this review suggest that shorter self-reported sleep duration is associated with higher Aβ levels. Given the heterogeneous nature of the sleep measures and outcomes, it is still difficult to determine the exact relationship between sleep and Aβ. Future studies with larger sample sizes should focus on comprehensive sleep characteristics and use longitudinal designs to better understand the relationship between sleep and AD.
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Affiliation(s)
- Chooza Moon
- University of Iowa College of Nursing, 50 Newton Rd, Iowa City, IA, 52242, USA.
| | - Aaron Schneider
- University of Iowa College of Liberal Arts and Sciences Department of Health and Human Physiology, 225 S. Grand Ave., Iowa City, IA, 52240, USA
| | - Young-Eun Cho
- University of Iowa College of Nursing, 50 Newton Rd, Iowa City, IA, 52242, USA
| | - Meina Zhang
- University of Iowa College of Nursing, 50 Newton Rd, Iowa City, IA, 52242, USA
| | - Hellen Dang
- University of Iowa College of Liberal Arts and Sciences Department of Health and Human Physiology, 225 S. Grand Ave., Iowa City, IA, 52240, USA
| | - Kelly Vu
- University of Iowa College of Pharmacy, 180 S. Grand Avenue, Iowa City, IA, 52242, USA
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Jonaitis EM, Hermann BP, Mueller KD, Clark LR, Du L, Betthauser TJ, Cody K, Gleason CE, Christian BT, Asthana S, Chappell RJ, Chin NA, Johnson SC, Langhough RE. Longitudinal normative standards for cognitive tests and composites using harmonized data from two Wisconsin AD-risk-enriched cohorts. Alzheimers Dement 2024; 20:3305-3321. [PMID: 38539269 PMCID: PMC11095443 DOI: 10.1002/alz.13774] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Revised: 02/02/2024] [Accepted: 02/06/2024] [Indexed: 04/06/2024]
Abstract
INTRODUCTION Published norms are typically cross-sectional and often are not sensitive to preclinical cognitive changes due to dementia. We developed and validated demographically adjusted cross-sectional and longitudinal normative standards using harmonized outcomes from two Alzheimer's disease (AD) risk-enriched cohorts. METHODS Data from the Wisconsin Registry for Alzheimer's Prevention and the Wisconsin Alzheimer's Disease Research Center were combined. Quantile regression was used to develop unconditional (cross-sectional) and conditional (longitudinal) normative standards for 18 outcomes using data from cognitively unimpaired participants (N = 1390; mean follow-up = 9.25 years). Validity analyses (N = 2456) examined relationships between percentile scores (centiles), consensus-based cognitive statuses, and AD biomarker levels. RESULTS Unconditional and conditional centiles were lower in those with consensus-based impairment or biomarker positivity. Similarly, quantitative biomarker levels were higher in those whose centiles suggested decline. DISCUSSION This study presents normative standards for cognitive measures sensitive to pre-clinical changes. Future directions will investigate potential clinical applications of longitudinal normative standards. HIGHLIGHTS Quantile regression was used to construct longitudinal norms for cognitive tests. Poorer percentile scores were related to concurrent diagnosis and Alzheimer's disease biomarkers. A ShinyApp was built to display test scores and norms and flag low performance.
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Affiliation(s)
- Erin M. Jonaitis
- Wisconsin Alzheimer's InstituteSchool of Medicine and Public HealthUniversity of Wisconsin – MadisonMadisonWisconsinUSA
- Wisconsin Alzheimer's Disease Research CenterSchool of Medicine and Public HealthUniversity of Wisconsin – MadisonMadisonWisconsinUSA
| | - Bruce P. Hermann
- Department of NeurologySchool of Medicine and Public HealthUniversity of Wisconsin – MadisonMadisonWisconsinUSA
| | - Kimberly D. Mueller
- Department of Communication Sciences and DisordersUniversity of Wisconsin – MadisonMadisonWisconsinUSA
- Division of GeriatricsUniversity of Wisconsin – MadisonMadisonWisconsinUSA
| | - Lindsay R. Clark
- Division of GeriatricsUniversity of Wisconsin – MadisonMadisonWisconsinUSA
- Geriatric Research Education and Clinical CenterWilliam S. Middleton Memorial Veterans Hospital, MadisonMadisonWisconsinUSA
| | - Lianlian Du
- Wisconsin Alzheimer's InstituteSchool of Medicine and Public HealthUniversity of Wisconsin – MadisonMadisonWisconsinUSA
| | - Tobey J. Betthauser
- Wisconsin Alzheimer's Disease Research CenterSchool of Medicine and Public HealthUniversity of Wisconsin – MadisonMadisonWisconsinUSA
- Department of MedicineSchool of Medicine and Public HealthUniversity of Wisconsin – MadisonMadisonWisconsinUSA
| | - Karly Cody
- Wisconsin Alzheimer's Disease Research CenterSchool of Medicine and Public HealthUniversity of Wisconsin – MadisonMadisonWisconsinUSA
| | - Carey E. Gleason
- Wisconsin Alzheimer's Disease Research CenterSchool of Medicine and Public HealthUniversity of Wisconsin – MadisonMadisonWisconsinUSA
- Division of GeriatricsUniversity of Wisconsin – MadisonMadisonWisconsinUSA
- Geriatric Research Education and Clinical CenterWilliam S. Middleton Memorial Veterans Hospital, MadisonMadisonWisconsinUSA
- Department of MedicineSchool of Medicine and Public HealthUniversity of Wisconsin – MadisonMadisonWisconsinUSA
| | - Bradley T. Christian
- Wisconsin Alzheimer's Disease Research CenterSchool of Medicine and Public HealthUniversity of Wisconsin – MadisonMadisonWisconsinUSA
- Waisman CenterUniversity of Wisconsin – MadisonMadisonWisconsinUSA
- Department of Medical PhysicsSchool of Medicine and Public HealthUniversity of Wisconsin – MadisonMadisonWisconsinUSA
| | - Sanjay Asthana
- Wisconsin Alzheimer's Disease Research CenterSchool of Medicine and Public HealthUniversity of Wisconsin – MadisonMadisonWisconsinUSA
- Department of MedicineSchool of Medicine and Public HealthUniversity of Wisconsin – MadisonMadisonWisconsinUSA
| | - Richard J. Chappell
- Department of StatisticsSchool of ComputerData and Information SciencesUniversity of Wisconsin – MadisonMadisonWisconsinUSA
- Department of Biostatistics and Medical InformaticsSchool of Medicine and Public HealthUniversity of Wisconsin – MadisonMadisonWisconsinUSA
| | - Nathaniel A. Chin
- Wisconsin Alzheimer's Disease Research CenterSchool of Medicine and Public HealthUniversity of Wisconsin – MadisonMadisonWisconsinUSA
- Division of GeriatricsUniversity of Wisconsin – MadisonMadisonWisconsinUSA
| | - Sterling C. Johnson
- Wisconsin Alzheimer's InstituteSchool of Medicine and Public HealthUniversity of Wisconsin – MadisonMadisonWisconsinUSA
- Wisconsin Alzheimer's Disease Research CenterSchool of Medicine and Public HealthUniversity of Wisconsin – MadisonMadisonWisconsinUSA
- Geriatric Research Education and Clinical CenterWilliam S. Middleton Memorial Veterans Hospital, MadisonMadisonWisconsinUSA
- Department of MedicineSchool of Medicine and Public HealthUniversity of Wisconsin – MadisonMadisonWisconsinUSA
| | - Rebecca E. Langhough
- Wisconsin Alzheimer's InstituteSchool of Medicine and Public HealthUniversity of Wisconsin – MadisonMadisonWisconsinUSA
- Wisconsin Alzheimer's Disease Research CenterSchool of Medicine and Public HealthUniversity of Wisconsin – MadisonMadisonWisconsinUSA
- Department of MedicineSchool of Medicine and Public HealthUniversity of Wisconsin – MadisonMadisonWisconsinUSA
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Pivac LN, Brown BM, Sewell KR, Doecke JD, Villemagne VL, Doré V, Weinborn M, Sohrabi HR, Gardener SL, Bucks RS, Laws SM, Taddei K, Maruff P, Masters CL, Rowe C, Martins RN, Rainey‐Smith SR. Suboptimal self-reported sleep efficiency and duration are associated with faster accumulation of brain amyloid beta in cognitively unimpaired older adults. ALZHEIMER'S & DEMENTIA (AMSTERDAM, NETHERLANDS) 2024; 16:e12579. [PMID: 38651160 PMCID: PMC11033837 DOI: 10.1002/dad2.12579] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Revised: 02/28/2024] [Accepted: 03/10/2024] [Indexed: 04/25/2024]
Abstract
INTRODUCTION This study investigated whether self-reported sleep quality is associated with brain amyloid beta (Aβ) accumulation. METHODS Linear mixed effect model analyses were conducted for 189 cognitively unimpaired (CU) older adults (mean ± standard deviation 74.0 ± 6.2; 53.2% female), with baseline self-reported sleep data, and positron emission tomography-determined brain Aβ measured over a minimum of three time points (range 33.3-72.7 months). Analyses included random slopes and intercepts, interaction for apolipoprotein E (APOE) ε4 allele status, and time, adjusting for sex and baseline age. RESULTS Sleep duration <6 hours, in APOE ε4 carriers, and sleep efficiency <65%, in the whole sample and APOE ε4 non-carriers, is associated with faster accumulation of brain Aβ. DISCUSSION These findings suggest a role for self-reported suboptimal sleep efficiency and duration in the accumulation of Alzheimer's disease (AD) neuropathology in CU individuals. Additionally, poor sleep efficiency represents a potential route via which individuals at lower genetic risk may progress to preclinical AD. Highlights In cognitively unimpaired older adults self-report sleep is associated with brain amyloid beta (Aβ) accumulation.Across sleep characteristics, this relationship differs by apolipoprotein E (APOE) genotype.Sleep duration <6 hours is associated with faster brain Aβ accumulation in APOE ε4 carriers.Sleep efficiency < 65% is associated with faster brain Aβ accumulation in APOE ε4 non-carriers.Personalized sleep interventions should be studied for potential to slow Aβ accumulation.
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Affiliation(s)
- Louise N. Pivac
- Centre for Healthy Ageing, Health Futures InstituteMurdoch UniversityMurdochWestern AustraliaAustralia
- Alzheimer's Research Australia, Sarich Neuroscience Research InstituteNedlandsWestern AustraliaAustralia
| | - Belinda M. Brown
- Centre for Healthy Ageing, Health Futures InstituteMurdoch UniversityMurdochWestern AustraliaAustralia
| | - Kelsey R. Sewell
- Centre for Healthy Ageing, Health Futures InstituteMurdoch UniversityMurdochWestern AustraliaAustralia
| | - James D. Doecke
- Australian E‐Health Research Centre, CSIROHerstonQueenslandAustralia
| | | | - Vincent Doré
- Australian E‐Health Research Centre, CSIROHerstonQueenslandAustralia
- Department of Molecular ImagingAustin HealthHeidelbergVictoriaAustralia
| | - Michael Weinborn
- School of Psychological ScienceUniversity of Western AustraliaPerthWestern AustraliaAustralia
| | - Hamid R. Sohrabi
- Centre for Healthy Ageing, Health Futures InstituteMurdoch UniversityMurdochWestern AustraliaAustralia
| | - Samantha L. Gardener
- School of Medical and Health SciencesEdith Cowan UniversityJoondalupWestern AustraliaAustralia
| | - Romola S. Bucks
- School of Psychological ScienceUniversity of Western AustraliaPerthWestern AustraliaAustralia
- School of Population and Global HealthUniversity of Western AustraliaPerthWestern AustraliaAustralia
| | - Simon M. Laws
- School of Medical and Health SciencesEdith Cowan UniversityJoondalupWestern AustraliaAustralia
- Centre for Precision HealthEdith Cowan UniversityJoondalupWestern AustraliaAustralia
- Collaborative Genomics and Translation GroupEdith Cowan UniversityJoondalupWestern AustraliaAustralia
- Curtin Medical SchoolCurtin UniversityBentleyWestern AustraliaAustralia
| | - Kevin Taddei
- School of Medical and Health SciencesEdith Cowan UniversityJoondalupWestern AustraliaAustralia
| | - Paul Maruff
- Cogstate Ltd., MelbourneMelbourneVictoriaAustralia
- The Florey Institute of Neuroscience and Mental HealthUniversity of MelbourneMelbourneVictoriaAustralia
| | - Colin L. Masters
- The Florey Institute of Neuroscience and Mental HealthUniversity of MelbourneMelbourneVictoriaAustralia
| | - Christopher Rowe
- Department of Molecular ImagingAustin HealthHeidelbergVictoriaAustralia
- The Florey Institute of Neuroscience and Mental HealthUniversity of MelbourneMelbourneVictoriaAustralia
| | - Ralph N. Martins
- School of Medical and Health SciencesEdith Cowan UniversityJoondalupWestern AustraliaAustralia
- Department of Biomedical SciencesMacquarie UniversityMacquarie UniversitySydneyNew South WalesAustralia
| | - Stephanie R. Rainey‐Smith
- Centre for Healthy Ageing, Health Futures InstituteMurdoch UniversityMurdochWestern AustraliaAustralia
- Alzheimer's Research Australia, Sarich Neuroscience Research InstituteNedlandsWestern AustraliaAustralia
- School of Psychological ScienceUniversity of Western AustraliaPerthWestern AustraliaAustralia
- School of Medical and Health SciencesEdith Cowan UniversityJoondalupWestern AustraliaAustralia
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8
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Mayer G, Frohnhofen H, Jokisch M, Hermann DM, Gronewold J. Associations of sleep disorders with all-cause MCI/dementia and different types of dementia - clinical evidence, potential pathomechanisms and treatment options: A narrative review. Front Neurosci 2024; 18:1372326. [PMID: 38586191 PMCID: PMC10995403 DOI: 10.3389/fnins.2024.1372326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2024] [Accepted: 03/11/2024] [Indexed: 04/09/2024] Open
Abstract
Due to worldwide demographic change, the number of older persons in the population is increasing. Aging is accompanied by changes of sleep structure, deposition of beta-amyloid (Aß) and tau proteins and vascular changes and can turn into mild cognitive impairment (MCI) as well as dementia. Sleep disorders are discussed both as a risk factor for and as a consequence of MCI/dementia. Cross-sectional and longitudinal population-based as well as case-control studies revealed sleep disorders, especially sleep-disorderded breathing (SDB) and excessive or insufficient sleep durations, as risk factors for all-cause MCI/dementia. Regarding different dementia types, SDB was especially associated with vascular dementia while insomnia/insufficient sleep was related to an increased risk of Alzheimer's disease (AD). Scarce and still inconsistent evidence suggests that therapy of sleep disorders, especially continuous positive airway pressure (CPAP) in SDB, can improve cognition in patients with sleep disorders with and without comorbid dementia and delay onset of MCI/dementia in patients with sleep disorders without previous cognitive impairment. Regarding potential pathomechanisms via which sleep disorders lead to MCI/dementia, disturbed sleep, chronic sleep deficit and SDB can impair glymphatic clearance of beta-amyloid (Aß) and tau which lead to amyloid deposition and tau aggregation resulting in changes of brain structures responsible for cognition. Orexins are discussed to modulate sleep and Aß pathology. Their diurnal fluctuation is suppressed by sleep fragmentation and the expression suppressed at the point of hippocampal atrophy, contributing to the progression of dementia. Additionally, sleep disorders can lead to an increased vascular risk profile and vascular changes such as inflammation, endothelial dysfunction and atherosclerosis which can foster neurodegenerative pathology. There is ample evidence indicating that changes of sleep structure in aging persons can lead to dementia and also evidence that therapy of sleep disorder can improve cognition. Therefore, sleep disorders should be identified and treated early.
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Affiliation(s)
- Geert Mayer
- Department of Neurology, Philipps-Universität Marburg, Marburg, Germany
| | - Helmut Frohnhofen
- Department of Orthopedics and Trauma Surgery, University Hospital Düsseldorf, Heinrich Heine University, Düsseldorf, Germany
- Department of Medicine, Geriatrics, Faculty of Health, University Witten-Herdecke, Witten, Germany
| | - Martha Jokisch
- Department of Neurology and Center for Translational Neuro-and Behavioral Sciences (C-TNBS), University Hospital Essen, University Duisburg-Essen, Essen, Germany
| | - Dirk M. Hermann
- Department of Neurology and Center for Translational Neuro-and Behavioral Sciences (C-TNBS), University Hospital Essen, University Duisburg-Essen, Essen, Germany
| | - Janine Gronewold
- Department of Neurology and Center for Translational Neuro-and Behavioral Sciences (C-TNBS), University Hospital Essen, University Duisburg-Essen, Essen, Germany
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9
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Kim RT, Zhou L, Li Y, Krieger AC, Nordvig AS, Butler T, de Leon MJ, Chiang GC. Impaired sleep is associated with tau deposition on 18F-flortaucipir PET and accelerated cognitive decline, accounting for medications that affect sleep. J Neurol Sci 2024; 458:122927. [PMID: 38341949 PMCID: PMC10947806 DOI: 10.1016/j.jns.2024.122927] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Revised: 01/06/2024] [Accepted: 02/06/2024] [Indexed: 02/13/2024]
Abstract
BACKGROUND Impaired sleep is commonly associated with Alzheimer's disease (AD), although the underlying mechanisms remain unclear. Furthermore, the moderating effects of sleep-affecting medications, which have been linked to AD pathology, are incompletely characterized. Using data from the Alzheimer's Disease Neuroimaging Initiative, we investigated whether a medical history of impaired sleep, informant-reported nighttime behaviors, and sleep-affecting medications are associated with beta-amyloid and tau deposition on PET and cognitive change, cross-sectionally and longitudinally. METHODS We included 964 subjects with 18F-florbetapir PET scans. Measures of sleep impairment and medication use were obtained from medical histories and the Neuropsychiatric Inventory Questionnaire. Multivariate models, adjusted for covariates, were used to assess associations among sleep-related features, beta-amyloid and tau, and cognition. Cortical tau deposition, categorized by Braak stage, was assessed using the standardized uptake value peak alignment (SUVP) method on 18F-flortaucipir PET. RESULTS Medical history of sleep impairment was associated with greater baseline tau in the meta-temporal, Braak 1, and Braak 4 regions (p = 0.04, p < 0.001, p = 0.025, respectively). Abnormal nighttime behaviors were also associated with greater baseline tau in the meta-temporal region (p = 0.024), and greater cognitive impairment, cross-sectionally (p = 0.007) and longitudinally (p < 0.001). Impaired sleep was not associated with baseline beta-amyloid (p > 0.05). Short-term use of selective serotonin reuptake inhibitors and benzodiazepines slightly weakened the sleep-tau relationship. CONCLUSIONS Sleep impairment was associated with tauopathy and cognitive decline, which could be linked to increased tau secretion from neuronal hyperactivity. Clinically, our results help identify high-risk individuals who could benefit from sleep-related interventions aimed to delay cognitive decline and AD.
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Affiliation(s)
- Ryan T Kim
- From the Department of Stem Cell and Regenerative Biology, Harvard University, Bauer-Sherman Fairchild Complex 7 Divinity Avenue, Cambridge, MA 02138, United States of America.
| | - Liangdong Zhou
- From the Department of Radiology, Brain Health Imaging Institute, Weill Cornell Medicine, NewYork-Presbyterian Hospital, 407 E 61(st) Street, New York, NY 10065, United States of America.
| | - Yi Li
- From the Department of Radiology, Brain Health Imaging Institute, Weill Cornell Medicine, NewYork-Presbyterian Hospital, 407 E 61(st) Street, New York, NY 10065, United States of America.
| | - Ana C Krieger
- From the Departments of Medicine and Neurology, Division of Sleep Neurology, Weill Cornell Medicine, NewYork-Presbyterian Hospital, 425 E 61st St., 5th Floor, New York, NY 10065, United States of America.
| | - Anna S Nordvig
- From the Department of Neurology, Alzheimer's Disease and Memory Disorders Program, Weill Cornell Medicine, NewYork-Presbyterian Hospital, 428 East 72(nd) Street Suite 500, New York, NY 10021, United States of America.
| | - Tracy Butler
- From the Department of Radiology, Brain Health Imaging Institute, Weill Cornell Medicine, NewYork-Presbyterian Hospital, 407 E 61(st) Street, New York, NY 10065, United States of America.
| | - Mony J de Leon
- From the Department of Radiology, Brain Health Imaging Institute, Weill Cornell Medicine, NewYork-Presbyterian Hospital, 407 E 61(st) Street, New York, NY 10065, United States of America.
| | - Gloria C Chiang
- From the Department of Radiology, Brain Health Imaging Institute, Weill Cornell Medicine, NewYork-Presbyterian Hospital, 407 E 61(st) Street, New York, NY 10065, United States of America; From the Department of Radiology, Division of Neuroradiology, Weill Cornell Medicine, NewYork-Presbyterian Hospital, 525 East 68th Street, Starr Pavilion, Box 141, New York, NY 10065, United States of America.
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10
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Kim JS, Han JW, Oh DJ, Suh SW, Kwon MJ, Park J, Jo S, Kim JH, Kim KW. Effects of sleep quality on diurnal variation of brain volume in older adults: A retrospective cross-sectional study. Neuroimage 2024; 288:120533. [PMID: 38340880 DOI: 10.1016/j.neuroimage.2024.120533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Revised: 02/02/2024] [Accepted: 02/07/2024] [Indexed: 02/12/2024] Open
Abstract
AIM Brain volume is influenced by several factors that can change throughout the day. In addition, most of these factors are influenced by sleep quality. This study investigated diurnal variation in brain volume and its relation to overnight sleep quality. METHODS We enrolled 1,003 healthy Koreans without any psychiatric disorders aged 60 years or older. We assessed sleep quality and average wake time using the Pittsburgh Sleep Quality Index, and divided sleep quality into good, moderate, and poor groups. We estimated the whole and regional brain volumes from three-dimensional T1-weighted brain MRI scans. We divided the interval between average wake-up time and MRI acquisition time (INT) into tertile groups: short (INT1), medium (INT2), and long (INT3). RESULTS Whole and regional brain volumes showed no significance with respect to INT. However, the `interaction between INT and sleep quality showed significance for whole brain, cerebral gray matter, and cerebrospinal fluid volumes (p < .05). The INT2 group showed significantly lower volumes of whole brain, whole gray matter, cerebral gray matter, cortical gray matter, subcortical gray matter, and cerebrospinal fluid than the INT1 and INT3 groups only in the individuals with good sleep quality. CONCLUSION Human brain volume changes significantly within a day associated with overnight sleep in the individuals with good sleep quality.
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Affiliation(s)
- Jun Sung Kim
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, South Korea
| | - Ji Won Han
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, South Korea; Department of Psychiatry, Seoul National University, College of Medicine, Seoul, South Korea
| | - Dae Jong Oh
- Department of Psychiatry, Seoul National University, College of Medicine, Seoul, South Korea; Department of Psychiatry, SMG-SNU Boramae Medical Center, Seoul Korea
| | - Seung Wan Suh
- Department of Psychiatry, Kangdong Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea
| | - Min Jeong Kwon
- Department of Brain and Cognitive Science, Seoul National University College of Natural Sciences, Seoul, South Korea
| | - Jieun Park
- Department of Brain and Cognitive Science, Seoul National University College of Natural Sciences, Seoul, South Korea
| | - Sungman Jo
- Department of Health Science and Technology, Graduate school of convergence science and technology, Seoul National University, Seoul, South Korea
| | - Jae Hyoung Kim
- Department of Radiology, Seoul National University Bundang Hospital, Seongnam, South Korea
| | - Ki Woong Kim
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, South Korea; Department of Psychiatry, Seoul National University, College of Medicine, Seoul, South Korea; Department of Brain and Cognitive Science, Seoul National University College of Natural Sciences, Seoul, South Korea; Department of Health Science and Technology, Graduate school of convergence science and technology, Seoul National University, Seoul, South Korea.
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11
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Astara K, Tsimpolis A, Kalafatakis K, Vavougios GD, Xiromerisiou G, Dardiotis E, Christodoulou NG, Samara MT, Lappas AS. Sleep disorders and Alzheimer's disease pathophysiology: The role of the Glymphatic System. A scoping review. Mech Ageing Dev 2024; 217:111899. [PMID: 38163471 DOI: 10.1016/j.mad.2023.111899] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Revised: 12/14/2023] [Accepted: 12/26/2023] [Indexed: 01/03/2024]
Abstract
BACKGROUND Alzheimer's disease (AD) is highly intertwined with sleep disturbances throughout its whole natural history. Sleep consists of a major compound of the functionality of the glymphatic system, as the synchronized slow-wave activity during NREM facilitates cerebrospinal and interstitial long-distance mixing. OBJECTIVE The present study undertakes a scoping review of research on the involvement of the glymphatic system in AD-related sleep disturbances. DESIGN we searched Medline, Embase, PsychInfo and HEAL-link databases, without limitations on date and language, along with reference lists of relevant reviews and all included studies. We included in vivo, in vitro and post-mortem studies examining glymphatic implications of sleep disturbances in human populations with AD spectrum pathology. A thematic synthesis of evidence based on the extracted content was applied and presented in a narrative way. RESULTS In total, 70 original research articles were included and were grouped as following: a) Protein aggregation and toxicity, after sleep deprivation, along with its effects on sleep architecture, b) Glymphatic Sequalae in SDB, yielding potential glymphatic markers c) Circadian Dysregulation, d) Possible Interventions. CONCLUSIONS this review sought to provide insight into the role of sleep disturbances in AD pathogenesis, in the context of the glymphatic disruption.
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Affiliation(s)
- Kyriaki Astara
- Department of Psychiatry, Faculty of Medicine, University of Thessaly, Larissa, Greece; Department of Neurology, 417 Army Equity Fund Hospital (NIMTS), Athens, Greece
| | - Alexandros Tsimpolis
- Department of Pharmacology, Medical School, University of Crete & Institute of Molecular Biology and Biotechnology, Foundation of Research and Technology Hellas, Heraklion, Crete, Greece
| | - Konstantinos Kalafatakis
- Faculty of Medicine & Dentistry (Malta campus), Queen Mary University of London, VCT 2520, Victoria, Gozo, Malta.
| | - George D Vavougios
- Department of Neurology, Faculty of Medicine, University of Cyprus, Lefkosia, Cyprus; Department of Respiratory Medicine, Faculty of Medicine, University of Thessaly, Larissa, Greece; Department of Neurology, Athens Naval Hospital, Athens, Greece
| | - Georgia Xiromerisiou
- Department of Neurology, University Hospital of Larissa, Faculty of Medicine, School of Health Sciences, University of Thessaly, 41110 Larissa, Greece
| | - Efthimios Dardiotis
- Department of Neurology, University Hospital of Larissa, Faculty of Medicine, School of Health Sciences, University of Thessaly, 41110 Larissa, Greece
| | - Nikos G Christodoulou
- Department of Psychiatry, Faculty of Medicine, University of Thessaly, Larissa, Greece; Medical School, University of Nottingham, Lenton, Nottingham, UK
| | - Myrto T Samara
- Department of Psychiatry, Faculty of Medicine, University of Thessaly, Larissa, Greece
| | - Andreas S Lappas
- Department of Psychiatry, Faculty of Medicine, University of Thessaly, Larissa, Greece; Aneurin Bevan University Health Board, Wales, UK
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12
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Burman R, Alperin N. CSF-to-blood toxins clearance is modulated by breathing through cranio-spinal CSF oscillation. J Sleep Res 2024; 33:e14029. [PMID: 37734843 DOI: 10.1111/jsr.14029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Revised: 07/14/2023] [Accepted: 08/16/2023] [Indexed: 09/23/2023]
Abstract
Clearance of brain toxins occurs during sleep, although the mechanism remains unknown. Previous studies implied that the intracranial aqueductal cerebrospinal fluid (CSF) oscillations are involved, but no mechanism was suggested. The rationale for focusing on the aqueductal CSF oscillations is unclear. This study focuses on the cranio-spinal CSF oscillation and the factors that modulate this flow. We propose a mechanism where increased cranio-spinal CSF movements enhance CSF-to-blood metabolic waste clearance through the spinal CSF re-absorption sites. A recent study demonstrating that disturbed sleep impairs CSF-to-blood but not brain-to-CSF clearance, supports the fundamentals of our proposed mechanism. Eight healthy subjects underwent phase-contrast magnetic resonance imaging to quantify the effect of respiration on the cranio-spinal CSF oscillations. Maximal CSF volume displaced from the cranium to the spinal canal during each respiration and cardiac cycle were derived as measures of cranio-spinal CSF mixing level. Transition from normal to slow and abdominal breathing resulted in a 56% increase in the maximal displaced CSF volume. Maximal change in the arterial-venous blood volume, which is the driving force of the CSF oscillations, was increased by 41% during slow abdominal breathing. Cranio-spinal CSF oscillations are driven by the momentary difference between arterial inflow and venous outflow. Breathing modulates the CSF oscillation through changes in the venous outflow. The amount of toxins being transferred to the spinal canal during each respiratory cycle is significantly increased during slow and deeper abdominal breathing, which explains enhanced CSF-to-blood toxins clearance during slow-wave sleep and poor clearance during disrupted sleep.
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Affiliation(s)
- Ritambhar Burman
- Department of Biomedical Engineering, University of Miami, Miami, Florida, USA
| | - Noam Alperin
- Department of Biomedical Engineering, University of Miami, Miami, Florida, USA
- Department of Radiology, Miller School of Medicine, University of Miami, Miami, Florida, USA
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13
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Cook JD, Malik A, Plante DT, Norton D, Langhough Koscik R, Du L, Bendlin BB, Kirmess KM, Holubasch MS, Meyer MR, Venkatesh V, West T, Verghese PB, Yarasheski KE, Thomas KV, Carlsson CM, Asthana S, Johnson SC, Gleason CE, Zuelsdorff M. Associations of sleep duration and daytime sleepiness with plasma amyloid beta and cognitive performance in cognitively unimpaired, middle-aged and older African Americans. Sleep 2024; 47:zsad302. [PMID: 38011629 PMCID: PMC10782500 DOI: 10.1093/sleep/zsad302] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2023] [Revised: 09/01/2023] [Indexed: 11/29/2023] Open
Abstract
STUDY OBJECTIVES Given the established racial disparities in both sleep health and dementia risk for African American populations, we assess cross-sectional and longitudinal associations of self-report sleep duration (SRSD) and daytime sleepiness with plasma amyloid beta (Aβ) and cognition in an African American (AA) cohort. METHODS In a cognitively unimpaired sample drawn from the African Americans Fighting Alzheimer's in Midlife (AA-FAiM) study, data on SRSD, Epworth Sleepiness Scale, demographics, and cognitive performance were analyzed. Aβ40, Aβ42, and the Aβ42/40 ratio were quantified from plasma samples. Cross-sectional analyses explored associations between baseline predictors and outcome measures. Linear mixed-effect regression models estimated associations of SRSD and daytime sleepiness with plasma Aβ and cognitive performance levels and change over time. RESULTS One hundred and forty-seven participants comprised the cross-sectional sample. Baseline age was 63.2 ± 8.51 years. 69.6% self-identified as female. SRSD was 6.4 ± 1.1 hours and 22.4% reported excessive daytime sleepiness. The longitudinal dataset included 57 participants. In fully adjusted models, neither SRSD nor daytime sleepiness is associated with cross-sectional or longitudinal Aβ. Associations with level and trajectory of cognitive test performance varied by measure of sleep health. CONCLUSIONS SRSD was below National Sleep Foundation recommendations and daytime sleepiness was prevalent in this cohort. In the absence of observed associations with plasma Aβ, poorer self-reported sleep health broadly predicted poorer cognitive function but not accelerated decline. Future research is necessary to understand and address modifiable sleep mechanisms as they relate to cognitive aging in AA at disproportionate risk for dementia. CLINICAL TRIAL INFORMATION Not applicable.
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Affiliation(s)
- Jesse D Cook
- Department of Psychology, University of Wisconsin-Madison, Madison, WI, USA
- Department of Psychiatry, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI, USA
- Madison VA GRECC, William S. Middleton Memorial Hospital, Madison, WI, USA
| | - Ammara Malik
- Madison VA GRECC, William S. Middleton Memorial Hospital, Madison, WI, USA
| | - David T Plante
- Department of Psychology, University of Wisconsin-Madison, Madison, WI, USA
- Department of Psychiatry, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI, USA
| | - Derek Norton
- Wisconsin Alzheimer’s Disease Research Center, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI, USA
- Department of Biostatistics and Medical Informatics, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI, USA
| | - Rebecca Langhough Koscik
- Department of Medicine, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI, USA
- Wisconsin Alzheimer’s Institute, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI, USA
- Wisconsin Alzheimer’s Disease Research Center, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI, USA
| | - Lianlian Du
- Wisconsin Alzheimer’s Disease Research Center, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI, USA
- Department of Biostatistics and Medical Informatics, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI, USA
| | - Barbara B Bendlin
- Department of Medicine, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI, USA
- Wisconsin Alzheimer’s Institute, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI, USA
- Wisconsin Alzheimer’s Disease Research Center, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI, USA
| | | | | | | | | | - Tim West
- C2N Diagnostics, St. Louis, MO, USA
| | | | | | - Kevin V Thomas
- Department of Medicine, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI, USA
| | - Cynthia M Carlsson
- Madison VA GRECC, William S. Middleton Memorial Hospital, Madison, WI, USA
- Department of Medicine, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI, USA
- Wisconsin Alzheimer’s Institute, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI, USA
- Wisconsin Alzheimer’s Disease Research Center, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI, USA
| | - Sanjay Asthana
- Madison VA GRECC, William S. Middleton Memorial Hospital, Madison, WI, USA
- Department of Medicine, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI, USA
- Wisconsin Alzheimer’s Institute, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI, USA
- Wisconsin Alzheimer’s Disease Research Center, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI, USA
| | - Sterling C Johnson
- Madison VA GRECC, William S. Middleton Memorial Hospital, Madison, WI, USA
- Department of Medicine, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI, USA
- Wisconsin Alzheimer’s Institute, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI, USA
- Wisconsin Alzheimer’s Disease Research Center, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI, USA
| | - Carey E Gleason
- Madison VA GRECC, William S. Middleton Memorial Hospital, Madison, WI, USA
- Department of Medicine, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI, USA
- Wisconsin Alzheimer’s Disease Research Center, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI, USA
| | - Megan Zuelsdorff
- Wisconsin Alzheimer’s Disease Research Center, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI, USA
- School of Nursing, University of Wisconsin-Madison, Madison, WI, USA
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14
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Liu X, Xu P, Wei R, Cheng B, Sun L, Yang L, Chen G. Gender-and age-specific associations of sleep duration and quality with cognitive impairment in community-dwelling older adults in Anhui Province, China. Front Public Health 2024; 11:1047025. [PMID: 38249381 PMCID: PMC10796606 DOI: 10.3389/fpubh.2023.1047025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2022] [Accepted: 12/11/2023] [Indexed: 01/23/2024] Open
Abstract
Objective To examine associations of sleep duration and quality with cognitive impairment in older adults and the moderating role of gender and age in these associations. Methods This community-based cross-sectional study included 4,837 participants aged 60 years and above. Cognitive function was assessed using the Chinese version of the Mini-Mental State Examination (MMSE), and the participants were grouped based on the presence of cognitive impairment. The duration and quality of sleep were assessed using the Pittsburgh Sleep Quality Index (PSQI). Multivariate logistic regression models were used to analyze associations of sleep duration and quality with cognitive impairment. The role of age and gender in these associations have also been explored. Results The age (mean ± SD) of the participants was 71.13 ± 5.50 years. Of all older adults, 1,811 (37.44%) were detected as cognitive impairment, and 1755 (36.8%) had poor sleep quality. Among those with cognitive impairment, 51.09% were female. The proportion of the participants with cognitive impairment is significantly higher in those with symptoms of depression (49.73%, 273/549) (χ2 = 41.275, p < 0.001) than in those without depressive symptoms. After adjustment for multiple confounding factors and the crucial covariate (depressive symptoms), the odds ratios (OR) (95% confidence interval [CI]) of cognitive impairment (with 7-7.9 h regarded as the reference group) for individuals with a sleep duration of <6, 6-6.9, 8-8.9, and ≥ 9 h were 1.280 (1.053-1.557), 1.425 (1.175-1.728), 1.294 (1.068-1.566), and 1.360 (1.109-1.668), respectively. Subgroup analysis showed a V-shaped association between night sleep duration and cognitive impairment in males (p ≤ 0.05), and the association was stronger for individuals aged 60-80 years. With regard to sleep quality, the fully adjusted OR (95%CI) of cognitive impairment were 1.263 (1.108-1.440). According to scores of subscales in the PSQI, daytime dysfunction was associated with an increased risk of cognitive impairment (OR: 1.128, 95%CI: 1.055-1.207). Subgroup analysis also revealed a statistically significant correlation between poor sleep quality (including daytime dysfunction) and cognitive impairment in different gender and age groups, with the association being stronger in females (OR: 1.287, 95%CI: 1.080-1.534) and those aged 81-97 years (OR: 2.128, 95%CI: 1.152-3.934). For cognitive impairment, the group aged 81-97 years with daytime dysfunction was associated with a higher odds ratio than other age groups. Conclusion The present study showed that inadequate or excessive sleep was associated with cognitive impairment, especially in males, who exhibited a V-shaped association. Cognitive impairment was also associated with poor sleep quality as well as daytime dysfunction, with females and individuals aged 81-97 years exhibiting the strongest association.
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Affiliation(s)
- Xuechun Liu
- Department of Neurology, The Second People’s Hospital of Hefei, Hefei, China
| | - Peiru Xu
- Anhui Provincial Center for Disease Control and Prevention, Hefei, China
| | - Rong Wei
- Outpatient Department of the Second Hospital of Anhui Medical University, Hefei, China
| | - Beijing Cheng
- School of Public Health, Anhui Medical University, Hefei, China
| | - Liang Sun
- Fuyang Center of Disease Control and Prevention, Fuyang, China
| | - Linsheng Yang
- School of Public Health, Anhui Medical University, Hefei, China
| | - Guihai Chen
- Department of Neurology (Sleep Disorders), The Affiliated Chaohu Hospital of Anhui Medical University, Hefei, China
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15
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Carpi M, Fernandes M, Mercuri NB, Liguori C. Sleep Biomarkers for Predicting Cognitive Decline and Alzheimer's Disease: A Systematic Review of Longitudinal Studies. J Alzheimers Dis 2024; 97:121-143. [PMID: 38043016 DOI: 10.3233/jad-230933] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2023]
Abstract
BACKGROUND Sleep disturbances are considered a hallmark of dementia, and strong evidence supports the association between alterations in sleep parameters and cognitive decline in patients with mild cognitive impairment and Alzheimer's disease (AD). OBJECTIVE This systematic review aims to summarize the existing evidence on the longitudinal association between sleep parameters and cognitive decline, with the goal of identifying potential sleep biomarkers of AD-related neurodegeneration. METHODS Literature search was conducted in PubMed, Web of Science, and Scopus databases from inception to 28 March 2023. Longitudinal studies investigating the association between baseline objectively-measured sleep parameters and cognitive decline were assessed for eligibility. RESULTS Seventeen studies were included in the qualitative synthesis. Sleep fragmentation, reduced sleep efficiency, reduced REM sleep, increased light sleep, and sleep-disordered breathing were identified as predictors of cognitive decline. Sleep duration exhibited a U-shaped relation with subsequent neurodegeneration. Additionally, several sleep microstructural parameters were associated with cognitive decline, although inconsistencies were observed across studies. CONCLUSIONS These findings suggest that sleep alterations hold promise as early biomarker of cognitive decline, but the current evidence is limited due to substantial methodological heterogeneity among studies. Further research is necessary to identify the most reliable sleep parameters for predicting cognitive impairment and AD, and to investigate interventions targeting sleep that can assist clinicians in the early recognition and treatment of cognitive decline. Standardized procedures for longitudinal studies evaluating sleep and cognition should be developed and the use of continuous sleep monitoring techniques, such as actigraphy or EEG headband, might be encouraged.
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Affiliation(s)
- Matteo Carpi
- Sleep Medicine Centre, Neurology Unit, University Hospital Tor Vergata, Rome, Italy
| | - Mariana Fernandes
- Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Nicola Biagio Mercuri
- Sleep Medicine Centre, Neurology Unit, University Hospital Tor Vergata, Rome, Italy
- Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Claudio Liguori
- Sleep Medicine Centre, Neurology Unit, University Hospital Tor Vergata, Rome, Italy
- Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
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16
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Johnson CE, Duncan MJ, Murphy MP. Sex and Sleep Disruption as Contributing Factors in Alzheimer's Disease. J Alzheimers Dis 2024; 97:31-74. [PMID: 38007653 PMCID: PMC10842753 DOI: 10.3233/jad-230527] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2023]
Abstract
Alzheimer's disease (AD) affects more women than men, with women throughout the menopausal transition potentially being the most under researched and at-risk group. Sleep disruptions, which are an established risk factor for AD, increase in prevalence with normal aging and are exacerbated in women during menopause. Sex differences showing more disrupted sleep patterns and increased AD pathology in women and female animal models have been established in literature, with much emphasis placed on loss of circulating gonadal hormones with age. Interestingly, increases in gonadotropins such as follicle stimulating hormone are emerging to be a major contributor to AD pathogenesis and may also play a role in sleep disruption, perhaps in combination with other lesser studied hormones. Several sleep influencing regions of the brain appear to be affected early in AD progression and some may exhibit sexual dimorphisms that may contribute to increased sleep disruptions in women with age. Additionally, some of the most common sleep disorders, as well as multiple health conditions that impair sleep quality, are more prevalent and more severe in women. These conditions are often comorbid with AD and have bi-directional relationships that contribute synergistically to cognitive decline and neuropathology. The association during aging of increased sleep disruption and sleep disorders, dramatic hormonal changes during and after menopause, and increased AD pathology may be interacting and contributing factors that lead to the increased number of women living with AD.
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Affiliation(s)
- Carrie E. Johnson
- University of Kentucky, College of Medicine, Department of Molecular and Cellular Biochemistry, Lexington, KY, USA
| | - Marilyn J. Duncan
- University of Kentucky, College of Medicine, Department of Neuroscience, Lexington, KY, USA
| | - M. Paul Murphy
- University of Kentucky, College of Medicine, Department of Molecular and Cellular Biochemistry, Lexington, KY, USA
- University of Kentucky, Sanders-Brown Center on Aging, Lexington, KY, USA
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17
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Du L, Hermann BP, Jonaitis EM, Cody KA, Rivera-Rivera L, Rowley H, Field A, Eisenmenger L, Christian BT, Betthauser TJ, Larget B, Chappell R, Janelidze S, Hansson O, Johnson SC, Langhough R. Harnessing cognitive trajectory clusterings to examine subclinical decline risk factors. Brain Commun 2023; 5:fcad333. [PMID: 38107504 PMCID: PMC10724051 DOI: 10.1093/braincomms/fcad333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Revised: 10/23/2023] [Accepted: 11/30/2023] [Indexed: 12/19/2023] Open
Abstract
Cognitive decline in Alzheimer's disease and other dementias typically begins long before clinical impairment. Identifying people experiencing subclinical decline may facilitate earlier intervention. This study developed cognitive trajectory clusters using longitudinally based random slope and change point parameter estimates from a Preclinical Alzheimer's disease Cognitive Composite and examined how baseline and most recently available clinical/health-related characteristics, cognitive statuses and biomarkers for Alzheimer's disease and vascular disease varied across these cognitive clusters. Data were drawn from the Wisconsin Registry for Alzheimer's Prevention, a longitudinal cohort study of adults from late midlife, enriched for a parental history of Alzheimer's disease and without dementia at baseline. Participants who were cognitively unimpaired at the baseline visit with ≥3 cognitive visits were included in trajectory modelling (n = 1068). The following biomarker data were available for subsets: positron emission tomography amyloid (amyloid: n = 367; [11C]Pittsburgh compound B (PiB): global PiB distribution volume ratio); positron emission tomography tau (tau: n = 321; [18F]MK-6240: primary regions of interest meta-temporal composite); MRI neurodegeneration (neurodegeneration: n = 581; hippocampal volume and global brain atrophy); T2 fluid-attenuated inversion recovery MRI white matter ischaemic lesion volumes (vascular: white matter hyperintensities; n = 419); and plasma pTau217 (n = 165). Posterior median estimate person-level change points, slopes' pre- and post-change point and estimated outcome (intercepts) at change point for cognitive composite were extracted from Bayesian Bent-Line Regression modelling and used to characterize cognitive trajectory groups (K-means clustering). A common method was used to identify amyloid/tau/neurodegeneration/vascular biomarker thresholds. We compared demographics, last visit cognitive status, health-related factors and amyloid/tau/neurodegeneration/vascular biomarkers across the cognitive groups using ANOVA, Kruskal-Wallis, χ2, and Fisher's exact tests. Mean (standard deviation) baseline and last cognitive assessment ages were 58.4 (6.4) and 66.6 (6.6) years, respectively. Cluster analysis identified three cognitive trajectory groups representing steep, n = 77 (7.2%); intermediate, n = 446 (41.8%); and minimal, n = 545 (51.0%) cognitive decline. The steep decline group was older, had more females, APOE e4 carriers and mild cognitive impairment/dementia at last visit; it also showed worse self-reported general health-related and vascular risk factors and higher amyloid, tau, neurodegeneration and white matter hyperintensity positive proportions at last visit. Subtle cognitive decline was consistently evident in the steep decline group and was associated with generally worse health. In addition, cognitive trajectory groups differed on aetiology-informative biomarkers and risk factors, suggesting an intimate link between preclinical cognitive patterns and amyloid/tau/neurodegeneration/vascular biomarker differences in late middle-aged adults. The result explains some of the heterogeneity in cognitive performance within cognitively unimpaired late middle-aged adults.
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Affiliation(s)
- Lianlian Du
- Wisconsin Alzheimer’s Institute, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI 53792, USA
- Wisconsin Alzheimer’s Disease Research Center, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI 53792, USA
- Department of Medicine, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI 53792, USA
| | - Bruce P Hermann
- Wisconsin Alzheimer’s Institute, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI 53792, USA
- Department of Neurology, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI 53705, USA
| | - Erin M Jonaitis
- Wisconsin Alzheimer’s Institute, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI 53792, USA
- Wisconsin Alzheimer’s Disease Research Center, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI 53792, USA
- Department of Medicine, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI 53792, USA
| | - Karly Alex Cody
- Wisconsin Alzheimer’s Institute, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI 53792, USA
- Wisconsin Alzheimer’s Disease Research Center, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI 53792, USA
- Department of Medicine, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI 53792, USA
| | - Leonardo Rivera-Rivera
- Wisconsin Alzheimer’s Disease Research Center, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI 53792, USA
- Department of Medical Physics, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI 53705, USA
| | - Howard Rowley
- Department of Radiology, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI 53792, USA
| | - Aaron Field
- Department of Radiology, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI 53792, USA
| | - Laura Eisenmenger
- Department of Radiology, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI 53792, USA
| | - Bradley T Christian
- Wisconsin Alzheimer’s Disease Research Center, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI 53792, USA
- Department of Medical Physics, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI 53705, USA
- Waisman Laboratory for Brain Imaging and Behavior, University of Wisconsin-Madison, Madison, WI 53705, USA
| | - Tobey J Betthauser
- Wisconsin Alzheimer’s Institute, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI 53792, USA
- Wisconsin Alzheimer’s Disease Research Center, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI 53792, USA
- Department of Medicine, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI 53792, USA
| | - Bret Larget
- Department of Statistics, University of Wisconsin-Madison, Madison, WI 53706, USA
| | - Rick Chappell
- Wisconsin Alzheimer’s Disease Research Center, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI 53792, USA
- Department of Biostatistics and Medical Informatics, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI 53726, USA
| | | | - Oskar Hansson
- Clinical Memory Research Unit, Lund University, Lund 205 02, Sweden
| | - Sterling C Johnson
- Wisconsin Alzheimer’s Institute, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI 53792, USA
- Wisconsin Alzheimer’s Disease Research Center, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI 53792, USA
- Department of Medicine, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI 53792, USA
| | - Rebecca Langhough
- Wisconsin Alzheimer’s Institute, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI 53792, USA
- Wisconsin Alzheimer’s Disease Research Center, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI 53792, USA
- Department of Medicine, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI 53792, USA
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18
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Kimura N, Sasaki Y, Masuda T, Ataka T, Eguchi A, Kakuma T, Matsubara E. Objective sleep was longitudinally associated with brain amyloid burden in mild cognitive impairment. Ann Clin Transl Neurol 2023; 10:2266-2275. [PMID: 37776077 PMCID: PMC10723246 DOI: 10.1002/acn3.51912] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Revised: 08/24/2023] [Accepted: 08/26/2023] [Indexed: 10/01/2023] Open
Abstract
OBJECTIVE Understanding the longitudinal association of objective sleep and physical activity with brain amyloid burden and cortical glucose metabolism has critical clinical and public health implications for dementia prevention in later life. METHODS We enrolled 118 individuals aged ≥65 years with mild cognitive impairment, who were followed up on from August 2015 to September 2019. All participants continuously wore an accelerometer sensor for 7 consecutive days every 3 months and received annual 11 C-Pittsburgh compound-B and 18 F-fluorodeoxyglucose positron emission tomography (PET). Sleep and physical activity parameters were assessed using accelerometer sensor data and PET imaging was quantified using a standardized uptake-value ratio. Fifty-seven participants (48.3%) completed a lifestyle factor assessment and PET imaging over the 3-year period. A linear mixed-effects model was applied to examine the longitudinal association of sleep and physical activity parameters with PET imaging over the 3-year period, controlling for potential confounders. RESULTS Sleep efficiency was inversely associated with amyloid uptake in the frontal lobe. Although sleep duration was positively associated with global amyloid uptake, particularly in the frontal lobe, their impact was extremely small. However, physical activity parameters were not significantly associated with the 11 C-Pittsburgh compound-B-uptake. Furthermore, sleep and physical activity parameters were not significantly associated with cortical glucose metabolism. INTERPRETATION Lower sleep efficiency could be an early symptom of greater brain amyloid burden at the mild cognitive impairment stage. Therefore, the assessment of sleep may be useful for identifying individuals at higher risk for brain amyloid burden. Future longer term observational studies are required to confirm these findings.
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Affiliation(s)
- Noriyuki Kimura
- Department of Neurology, Faculty of MedicineOita UniversityOitaJapan
| | - Yuuki Sasaki
- Department of Neurology, Faculty of MedicineOita UniversityOitaJapan
| | - Teruaki Masuda
- Department of Neurology, Faculty of MedicineOita UniversityOitaJapan
| | - Takuya Ataka
- Department of Neurology, Faculty of MedicineOita UniversityOitaJapan
| | - Atsuko Eguchi
- Department of Neurology, Faculty of MedicineOita UniversityOitaJapan
| | | | - Etsuro Matsubara
- Department of Neurology, Faculty of MedicineOita UniversityOitaJapan
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19
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Mayer G, Stenmanns C, Doeppner TR, Hermann DM, Gronewold J. [Sleep and dementia]. Z Gerontol Geriatr 2023; 56:556-560. [PMID: 37676320 DOI: 10.1007/s00391-023-02237-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/10/2023] [Indexed: 09/08/2023]
Abstract
Aging is associated with changes in sleep structure and cerebral deposition of amyloid beta and tau proteins. Sleep disturbances precede the onset of dementia by years. Comorbid sleep disorders, such as insomnia and sleep-disordered breathing, a family history of dementia and epigenetic factors can contribute to the development of dementia. This article explores the question of the interaction between sleep and dementia based on the existing literature. Alterations caused by slow wave sleep lead to changes in the glymphatic clearance of amyloid beta, tau proteins and other proteins. Transient and chronic sleep disorders cause disturbances in the brain areas responsible for cognition and behavior. Sleep-regulating brain areas are the first to be affected in the neurodegenerative process and accelerate the risk of dementia. Circadian age-related changes in amyloid beta and tau proteins affect the amount and depth of sleep and vice versa. Amyloid beta in cerebrospinal fluid shows an inverse correlation with sleep. Orexins modulate amyloid beta and sleep.
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Affiliation(s)
- Geert Mayer
- Philipps-Universität Marburg, Marburg, Deutschland.
- , Privatweg 2, 34582, Borken, Deutschland.
| | - Carla Stenmanns
- Klinik für Orthopädie und Unfallchirurgie, Altersmedizin, Heinrich-Heine-Universität Düsseldorf, Düsseldorf, Deutschland
| | - Thorsten R Doeppner
- Klinik für Neurologie, Universitätsklinkum Gießen und Marburg, Gießen, Deutschland
| | - Dirk M Hermann
- Klinik für Neurologie, Universitätsklinikum Essen, Essen, Deutschland
| | - Janine Gronewold
- Klinik für Neurologie, Universitätsklinikum Essen, Essen, Deutschland
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20
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Sharma A, Feng L, Muresanu DF, Tian ZR, Lafuente JV, Buzoianu AD, Nozari A, Bryukhovetskiy I, Manzhulo I, Wiklund L, Sharma HS. Sleep deprivation enhances amyloid beta peptide, p-tau and serotonin in the brain: Neuroprotective effects of nanowired delivery of cerebrolysin with monoclonal antibodies to amyloid beta peptide, p-tau and serotonin. INTERNATIONAL REVIEW OF NEUROBIOLOGY 2023; 171:125-162. [PMID: 37783554 DOI: 10.1016/bs.irn.2023.05.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
Sleep deprivation is quite frequent in military during combat, intelligence gathering or peacekeeping operations. Even one night of sleep deprivation leads to accumulation of amyloid beta peptide burden that would lead to precipitation of Alzheimer's disease over the years. Thus, efforts are needed to slow down or neutralize accumulation of amyloid beta peptide (AβP) and associated Alzheimer's disease brain pathology including phosphorylated tau (p-tau) within the brain fluid environment. Sleep deprivation also alters serotonin (5-hydroxytryptamine) metabolism in the brain microenvironment and impair upregulation of several neurotrophic factors. Thus, blockade or neutralization of AβP, p-tau and serotonin in sleep deprivation may attenuate brain pathology. In this investigation this hypothesis is examined using nanodelivery of cerebrolysin- a balanced composition of several neurotrophic factors and active peptide fragments together with monoclonal antibodies against AβP, p-tau and serotonin (5-hydroxytryptamine, 5-HT). Our observations suggest that sleep deprivation induced pathophysiology is significantly reduced following nanodelivery of cerebrolysin together with monoclonal antibodies to AβP, p-tau and 5-HT, not reported earlier.
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Affiliation(s)
- Aruna Sharma
- International Experimental Central Nervous System Injury & Repair (IECNSIR), Dept. of Surgical Sciences, Anesthesiology & Intensive Care Medicine, Uppsala University Hospital, Uppsala University, Uppsala, Sweden.
| | - Lianyuan Feng
- Department of Neurology, Bethune International Peace Hospital, Zhongshan Road (West), Shijiazhuang, Hebei Province, P.R. China
| | - Dafin F Muresanu
- Dept. Clinical Neurosciences, University of Medicine & Pharmacy, Cluj-Napoca, Romania; "RoNeuro" Institute for Neurological Research and Diagnostic, Mircea Eliade Street, Cluj-Napoca, Romania
| | - Z Ryan Tian
- Dept. Chemistry & Biochemistry, University of Arkansas, Fayetteville, AR, United States
| | - José Vicente Lafuente
- LaNCE, Dept. Neuroscience, University of the Basque Country (UPV/EHU), Leioa, Bizkaia, Spain
| | - Anca D Buzoianu
- Department of Clinical Pharmacology and Toxicology, "Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Ala Nozari
- Department of Anesthesiology, Boston University, Albany str, Boston MA, USA
| | - Igor Bryukhovetskiy
- Department of Fundamental Medicine, School of Biomedicine, Far Eastern Federal University, Vladivostok, Russia; Laboratory of Pharmacology, National Scientific Center of Marine Biology, Far East Branch of the Russian Academy of Sciences, Vladivostok, Russia
| | - Igor Manzhulo
- Laboratory of Pharmacology, National Scientific Center of Marine Biology, Far East Branch of the Russian Academy of Sciences, Vladivostok, Russia
| | - Lars Wiklund
- International Experimental Central Nervous System Injury & Repair (IECNSIR), Dept. of Surgical Sciences, Anesthesiology & Intensive Care Medicine, Uppsala University Hospital, Uppsala University, Uppsala, Sweden
| | - Hari Shanker Sharma
- International Experimental Central Nervous System Injury & Repair (IECNSIR), Dept. of Surgical Sciences, Anesthesiology & Intensive Care Medicine, Uppsala University Hospital, Uppsala University, Uppsala, Sweden.
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21
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Emert SE, Taylor DJ, Gartenberg D, Schade MM, Roberts DM, Nagy SM, Russell M, Huskey A, Mueller M, Gamaldo A, Buxton OM. A non-pharmacological multi-modal therapy to improve sleep and cognition and reduce mild cognitive impairment risk: Design and methodology of a randomized clinical trial. Contemp Clin Trials 2023; 132:107275. [PMID: 37380020 DOI: 10.1016/j.cct.2023.107275] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Revised: 06/23/2023] [Accepted: 06/25/2023] [Indexed: 06/30/2023]
Abstract
Aging populations are at increased risk of sleep deficiencies (e.g., insomnia) that are associated with a variety of chronic health risks, including Alzheimer's disease and related dementias (ADRD). Insomnia medications carry additional risk, including increased drowsiness and falls, as well as polypharmacy risks. The recommended first-line treatment for insomnia is cognitive behavioral therapy for insomnia (CBTi), but access is limited. Telehealth is one way to increase access, particularly for older adults, but to date telehealth has been typically limited to simple videoconferencing portals. While these portals have been shown to be non-inferior to in-person treatment, it is plausible that telehealth could be significantly improved. This work describes a protocol designed to evaluate whether a clinician-patient dashboard inclusive of several user-friendly features (e.g., patterns of sleep data from ambulatory devices, guided relaxation resources, and reminders to complete in-home CBTi practice) could improve CBTi outcomes for middle- to older-aged adults (N = 100). Participants were randomly assigned to one of three telehealth interventions delivered through 6-weekly sessions: (1) CBTi augmented with a clinician-patient dashboard, smartphone application, and integrated smart devices; (2) standard CBTi (i.e., active comparator); or (3) sleep hygiene education (i.e., active control). All participants were assessed at screening, pre-study evaluation, baseline, throughout treatment, and at 1-week post-treatment. The primary outcome is the Insomnia Severity Index. Secondary and exploratory outcomes span sleep diary, actiwatch and Apple watch assessed sleep parameters (e.g., efficiency, duration, timing, variability), psychosocial correlates (e.g., fatigue, depression, stress), cognitive performance, treatment adherence, and neurodegenerative and systemic inflammatory biomarkers.
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Affiliation(s)
- Sarah E Emert
- The University of Arizona, Department of Psychology, Tucson, AZ, United States
| | - Daniel J Taylor
- The University of Arizona, Department of Psychology, Tucson, AZ, United States.
| | | | - Margeaux M Schade
- The Pennsylvania State University, Department of Biobehavioral Health, University Park, PA, United States
| | - Daniel M Roberts
- Proactive Life, Inc. (DBA SleepSpace), New York, NY, United States; The Pennsylvania State University, Department of Biobehavioral Health, University Park, PA, United States
| | - Samantha M Nagy
- The University of Arizona, Department of Psychology, Tucson, AZ, United States
| | - Michael Russell
- The Pennsylvania State University, Department of Biobehavioral Health, University Park, PA, United States
| | - Alisa Huskey
- The University of Arizona, Department of Psychology, Tucson, AZ, United States
| | - Melissa Mueller
- Proactive Life, Inc. (DBA SleepSpace), New York, NY, United States
| | - Alyssa Gamaldo
- The Pennsylvania State University, Department of Biobehavioral Health, University Park, PA, United States
| | - Orfeu M Buxton
- The Pennsylvania State University, Department of Biobehavioral Health, University Park, PA, United States
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22
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Rhea EM, Leclerc M, Yassine HN, Capuano AW, Tong H, Petyuk VA, Macauley SL, Fioramonti X, Carmichael O, Calon F, Arvanitakis Z. State of the Science on Brain Insulin Resistance and Cognitive Decline Due to Alzheimer's Disease. Aging Dis 2023:AD.2023.0814. [PMID: 37611907 DOI: 10.14336/ad.2023.0814] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Accepted: 08/14/2023] [Indexed: 08/25/2023] Open
Abstract
Type 2 diabetes mellitus (T2DM) is common and increasing in prevalence worldwide, with devastating public health consequences. While peripheral insulin resistance is a key feature of most forms of T2DM and has been investigated for over a century, research on brain insulin resistance (BIR) has more recently been developed, including in the context of T2DM and non-diabetes states. Recent data support the presence of BIR in the aging brain, even in non-diabetes states, and found that BIR may be a feature in Alzheimer's disease (AD) and contributes to cognitive impairment. Further, therapies used to treat T2DM are now being investigated in the context of AD treatment and prevention, including insulin. In this review, we offer a definition of BIR, and present evidence for BIR in AD; we discuss the expression, function, and activation of the insulin receptor (INSR) in the brain; how BIR could develop; tools to study BIR; how BIR correlates with current AD hallmarks; and regional/cellular involvement of BIR. We close with a discussion on resilience to both BIR and AD, how current tools can be improved to better understand BIR, and future avenues for research. Overall, this review and position paper highlights BIR as a plausible therapeutic target for the prevention of cognitive decline and dementia due to AD.
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Affiliation(s)
- Elizabeth M Rhea
- Geriatric Research Education and Clinical Center, Veterans Affairs Puget Sound Health Care System, Seattle, WA 98108, USA
- Department of Medicine, Division of Gerontology and Geriatric Medicine, University of Washington, Seattle, WA 98195, USA
| | - Manon Leclerc
- Faculty of Pharmacy, Laval University, Quebec, Quebec, Canada
- Neuroscience Axis, CHU de Québec Research Center - Laval University, Quebec, Quebec, Canada
| | - Hussein N Yassine
- Departments of Neurology and Medicine, University of Southern California, Los Angeles, CA 90033, USA
| | - Ana W Capuano
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL 60612, USA
| | - Han Tong
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL 60612, USA
| | - Vladislav A Petyuk
- Biological Sciences Division, Pacific Northwest National Laboratory, Richland, WA 99352, USA
| | - Shannon L Macauley
- Department of Physiology, University of Kentucky, Lexington, KY 40508, USA
| | - Xavier Fioramonti
- Univ. Bordeaux, INRAE, Bordeaux INP, NutriNeuro, UMR 1286, F-33000 Bordeaux, France
- International Associated Laboratory OptiNutriBrain, Bordeaux, France and Quebec, Canada
| | - Owen Carmichael
- Pennington Biomedical Research Center, Baton Rouge, LA 70808, USA
| | - Frederic Calon
- Faculty of Pharmacy, Laval University, Quebec, Quebec, Canada
- Neuroscience Axis, CHU de Québec Research Center - Laval University, Quebec, Quebec, Canada
- International Associated Laboratory OptiNutriBrain, Bordeaux, France and Quebec, Canada
| | - Zoe Arvanitakis
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL 60612, USA
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23
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Fernandes M, Chiaravalloti A, Nuccetelli M, Placidi F, Izzi F, Camedda R, Bernardini S, Sancesario G, Schillaci O, Mercuri NB, Liguori C. Sleep Dysregulation Is Associated with 18F-FDG PET and Cerebrospinal Fluid Biomarkers in Alzheimer's Disease. J Alzheimers Dis Rep 2023; 7:845-854. [PMID: 37662614 PMCID: PMC10473116 DOI: 10.3233/adr-220111] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Accepted: 07/11/2023] [Indexed: 09/05/2023] Open
Abstract
Background Sleep impairment has been commonly reported in Alzheimer's disease (AD) patients. The association between sleep dysregulation and AD biomarkers has been separately explored in mild cognitive impairment (MCI) and AD patients. Objective The present study investigated cerebrospinal-fluid (CSF) and 18F-fluoro-deoxy-glucose positron emission tomography (18F-FDG-PET) biomarkers in MCI and AD patients in order to explore their association with sleep parameters measured with polysomnography (PSG). Methods MCI and AD patients underwent PSG, 18F-FDG-PET, and CSF analysis for detecting and correlating these biomarkers with sleep architecture. Results Thirty-five patients were included in the study (9 MCI and 26 AD patients). 18F-FDG uptake in left Brodmann area 31 (owing to the posterior cingulate cortex) correlated negatively with REM sleep latency (p = 0.013) and positively with REM sleep (p = 0.033). 18F-FDG uptake in the hippocampus was negatively associated with sleep onset latency (p = 0.041). Higher CSF orexin levels were associated with higher sleep onset latency (p = 0.042), Non-REM stage 1 of sleep (p = 0.031), wake after sleep onset (p = 0.028), and lower sleep efficiency (p = 0.045). CSF levels of Aβ42 correlated negatively with the wake bouts index (p = 0.002). CSF total-tau and phosphorylated tau levels correlated positively with total sleep time (p = 0.045) and time in bed (p = 0.031), respectively. Conclusion Sleep impairment, namely sleep fragmentation, REM sleep dysregulation, and difficulty in initiating sleep correlates with AD biomarkers, suggesting an effect of sleep on the pathological processes in different AD stages. Targeting sleep for counteracting the AD pathological processes represents a timely need for clinicians and researchers.
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Affiliation(s)
- Mariana Fernandes
- Department of Systems Medicine, University of Rome “Tor Vergata”, Rome, Italy
| | - Agostino Chiaravalloti
- Department of Biomedicine and Prevention, University of Rome “Tor Vergata”, Rome, Italy
- IRCCS Neuromed, Pozzilli, Italy
| | - Marzia Nuccetelli
- Department of Clinical Biochemistry and Molecular Biology, University of Rome “Tor Vergata”, Rome, Italy
| | - Fabio Placidi
- Department of Systems Medicine, University of Rome “Tor Vergata”, Rome, Italy
- Sleep Medicine Centre, Neurology Unit, University Hospital of Rome “Tor Vergata”, Rome, Italy
| | - Francesca Izzi
- Sleep Medicine Centre, Neurology Unit, University Hospital of Rome “Tor Vergata”, Rome, Italy
| | - Riccardo Camedda
- Department of Biomedicine and Prevention, University of Rome “Tor Vergata”, Rome, Italy
| | - Sergio Bernardini
- Department of Clinical Biochemistry and Molecular Biology, University of Rome “Tor Vergata”, Rome, Italy
| | - Giuseppe Sancesario
- Sleep Medicine Centre, Neurology Unit, University Hospital of Rome “Tor Vergata”, Rome, Italy
| | - Orazio Schillaci
- Department of Biomedicine and Prevention, University of Rome “Tor Vergata”, Rome, Italy
| | - Nicola Biagio Mercuri
- Department of Systems Medicine, University of Rome “Tor Vergata”, Rome, Italy
- Sleep Medicine Centre, Neurology Unit, University Hospital of Rome “Tor Vergata”, Rome, Italy
| | - Claudio Liguori
- Department of Systems Medicine, University of Rome “Tor Vergata”, Rome, Italy
- Sleep Medicine Centre, Neurology Unit, University Hospital of Rome “Tor Vergata”, Rome, Italy
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24
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Jouvencel A, Baillet M, Meyer M, Dilharreguy B, Lamare F, Pérès K, Helmer C, Dartigues J, Amieva H, Mayo W, Catheline G. Night-to-night variability in sleep and amyloid beta burden in normal aging. ALZHEIMER'S & DEMENTIA (AMSTERDAM, NETHERLANDS) 2023; 15:e12460. [PMID: 37745892 PMCID: PMC10512442 DOI: 10.1002/dad2.12460] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Revised: 05/25/2023] [Accepted: 06/27/2023] [Indexed: 09/26/2023]
Abstract
INTRODUCTION Alzheimer's disease is associated with sleep disturbances and accumulation of cerebral amyloid beta. The objective was to examine whether actigraphy-detected sleep parameters might be biomarkers for early amyloid burden. METHODS Participants underwent a week of actigraphy and an amyloid positron emission tomography (PET) scan. Sleep duration and continuity disruption (sleep fragmentation and nocturnal awakenings) were extracted and compared between amyloid-positive and amyloid-negative participants. Then multiple linear regressions were used between mean or night-to-night intra-individual variability (standard deviation) of sleep parameters and brain amyloid burden in a voxel-wise analysis. RESULTS Eighty-six subjects were included (80.3 ± 5.4 years; 48.8% of women). Amyloid-positive participants had a higher variability of sleep fragmentation compared to amyloid-negative participants. This parameter was associated with a higher amyloid burden in the frontal and parietal regions, and in the precuneus, in the whole sample. DISCUSSION This study highlights the relevance of using variability in sleep continuity as a potential biomarker of early amyloid pathogenesis.
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Affiliation(s)
| | - Marion Baillet
- GIGA‐CRC‐In Vivo Imaging Research UnitUniversity of LiègeLiègeBelgium
| | - Marie Meyer
- INCIA, EPHE, Université PSLUniv BordeauxCNRSBordeauxFrance
- Nuclear Medicine DepartmentUniversity Hospital of BordeauxBordeauxFrance
| | | | - Frederic Lamare
- INCIA, EPHE, Université PSLUniv BordeauxCNRSBordeauxFrance
- Nuclear Medicine DepartmentUniversity Hospital of BordeauxBordeauxFrance
| | - Karine Pérès
- INSERMBordeaux Population Health Research CenterUniversity of BordeauxUMR U1219BordeauxFrance
| | - Catherine Helmer
- INSERMBordeaux Population Health Research CenterUniversity of BordeauxUMR U1219BordeauxFrance
| | - Jean‐François Dartigues
- INSERMBordeaux Population Health Research CenterUniversity of BordeauxUMR U1219BordeauxFrance
| | - Hélène Amieva
- INSERMBordeaux Population Health Research CenterUniversity of BordeauxUMR U1219BordeauxFrance
| | - Willy Mayo
- INCIA, EPHE, Université PSLUniv BordeauxCNRSBordeauxFrance
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Astell-Burt T, Navakatikyan MA, Feng X. Why might urban tree canopy reduce dementia risk? A causal mediation analysis of 109,688 adults with 11 years of hospital and mortality records. Health Place 2023; 82:103028. [PMID: 37182375 DOI: 10.1016/j.healthplace.2023.103028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Revised: 04/11/2023] [Accepted: 04/12/2023] [Indexed: 05/16/2023]
Abstract
Urban tree canopy is associated with lower dementia risk, but no mediation analysis has been attempted to reveal potential mechanisms. We examined 3,639 dementia diagnoses in 109,688 participants of the Sax Institute's 45 and Up Study. Adjusted models indicated ≥20% tree canopy lowered the odds of developing dementia by 14% over 11 years (Odds Ratio = 0.86, 95%CI = 0.79-0.93). Association between tree canopy and dementia was partially mediated by physical activity (4.5%) and absences of psychological distress (5.7%), social support (2.9%), sleep duration (2.3%) and diabetes (1.8%). Social loneliness and absence of heart disease or hypertension did not mediate the tree canopy-dementia association.
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Affiliation(s)
- Thomas Astell-Burt
- Population Wellbeing and Environment Research Lab (PowerLab), NSW, Australia; School of Health and Society, University of Wollongong, Northfields Avenue, Wollongong, Australia.
| | - Michael A Navakatikyan
- Population Wellbeing and Environment Research Lab (PowerLab), NSW, Australia; School of Health and Society, University of Wollongong, Northfields Avenue, Wollongong, Australia
| | - Xiaoqi Feng
- Population Wellbeing and Environment Research Lab (PowerLab), NSW, Australia; School of Population Health, University of New South Wales, Sydney, Australia; The George Institute of Global Health, Sydney, NSW, Australia
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Coughlan GT, Betthauser TJ, Boyle R, Koscik RL, Klinger HM, Chibnik LB, Jonaitis EM, Yau WYW, Wenzel A, Christian BT, Gleason CE, Saelzler UG, Properzi MJ, Schultz AP, Hanseeuw BJ, Manson JE, Rentz DM, Johnson KA, Sperling R, Johnson SC, Buckley RF. Association of Age at Menopause and Hormone Therapy Use With Tau and β-Amyloid Positron Emission Tomography. JAMA Neurol 2023; 80:462-473. [PMID: 37010830 PMCID: PMC10071399 DOI: 10.1001/jamaneurol.2023.0455] [Citation(s) in RCA: 23] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Accepted: 12/16/2022] [Indexed: 04/04/2023]
Abstract
Importance Postmenopausal females represent around 70% of all individuals with Alzheimer disease. Previous literature shows elevated levels of tau in cognitively unimpaired postmenopausal females compared with age-matched males, particularly in the setting of high β-amyloid (Aβ). The biological mechanisms associated with higher tau deposition in female individuals remain elusive. Objective To examine the extent to which sex, age at menopause, and hormone therapy (HT) use are associated with regional tau at a given level of Aβ, both measured with positron emission tomography (PET). Design, Setting, and Participants This cross-sectional study included participants enrolled in the Wisconsin Registry for Alzheimer Prevention. Cognitively unimpaired males and females with at least 1 18F-MK-6240 and 11C-Pittsburgh compound B PET scan were analyzed. Data were collected between November 2006 and May 2021. Exposures Premature menopause (menopause at younger than 40 years), early menopause (menopause at age 40-45 years), and regular menopause (menopause at older than 45 years) and HT user (current/past use) and HT nonuser (no current/past use). Exposures were self-reported. Main Outcomes and Measures Seven tau PET regions that show sex differences across temporal, parietal, and occipital lobes. Primary analyses examined the interaction of sex, age at menopause or HT, and Aβ PET on regional tau PET in a series of linear regressions. Secondary analyses investigated the influence of HT timing in association with age at menopause on regional tau PET. Results Of 292 cognitively unimpaired individuals, there were 193 females (66.1%) and 99 males (33.9%). The mean (range) age at tau scan was 67 (49-80) years, 52 (19%) had abnormal Aβ, and 106 (36.3%) were APOEε4 carriers. There were 98 female HT users (52.2%) (past/current). Female sex (standardized β = -0.41; 95% CI, -0.97 to -0.32; P < .001), earlier age at menopause (standardized β = -0.38; 95% CI, -0.14 to -0.09; P < .001), and HT use (standardized β = 0.31; 95% CI, 0.40-1.20; P = .008) were associated with higher regional tau PET in individuals with elevated Aβ compared with male sex, later age at menopause, and HT nonuse. Affected regions included medial and lateral regions of the temporal and occipital lobes. Late initiation of HT (>5 years following age at menopause) was associated with higher tau PET compared with early initiation (β = 0.49; 95% CI, 0.27-0.43; P = .001). Conclusions and Relevance In this study, females exhibited higher tau compared with age-matched males, particularly in the setting of elevated Aβ. In females, earlier age at menopause and late initiation of HT were associated with increased tau vulnerability especially when neocortical Aβ elevated. These observational findings suggest that subgroups of female individuals may be at higher risk of pathological burden.
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Affiliation(s)
- Gillian T. Coughlan
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston
| | - Tobey J. Betthauser
- Wisconsin Alzheimer’s Disease Research Center, University of Wisconsin, School of Medicine and Public Health, Madison
- Department of Medicine, University of Wisconsin–Madison, Madison
| | - Rory Boyle
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston
| | - Rebecca L. Koscik
- Wisconsin Alzheimer’s Disease Research Center, University of Wisconsin, School of Medicine and Public Health, Madison
- Department of Medicine, University of Wisconsin–Madison, Madison
| | - Hannah M. Klinger
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston
| | - Lori B. Chibnik
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston
- Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, and the Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Erin M. Jonaitis
- Wisconsin Alzheimer’s Disease Research Center, University of Wisconsin, School of Medicine and Public Health, Madison
- Department of Medicine, University of Wisconsin–Madison, Madison
| | - Wai-Ying Wendy Yau
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston
| | - Allen Wenzel
- Department of Medicine, University of Wisconsin–Madison, Madison
| | - Bradley T. Christian
- Wisconsin Alzheimer’s Disease Research Center, University of Wisconsin, School of Medicine and Public Health, Madison
| | - Carey E. Gleason
- Wisconsin Alzheimer’s Disease Research Center, University of Wisconsin, School of Medicine and Public Health, Madison
| | - Ursula G. Saelzler
- Department of Psychiatry, University of California, San Diego, San Diego
| | - Michael J. Properzi
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston
| | - Aaron P. Schultz
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston
- Center for Alzheimer Research and Treatment, Brigham and Women’s Hospital, Boston, Massachusetts
| | - Bernard J. Hanseeuw
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston
- Center for Alzheimer Research and Treatment, Brigham and Women’s Hospital, Boston, Massachusetts
- Department of Neurology, Cliniques Universitaires Saint-Luc, Woluwe-Saint-Lambert, Belgium
- Gordon Center for Medical Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston
- Institute of Neuroscience, Université Catholique de Louvain, Brussels, Belgium
| | - JoAnn E. Manson
- Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, and the Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Dorene M. Rentz
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston
- Center for Alzheimer Research and Treatment, Brigham and Women’s Hospital, Boston, Massachusetts
| | - Keith A. Johnson
- Center for Alzheimer Research and Treatment, Brigham and Women’s Hospital, Boston, Massachusetts
- Gordon Center for Medical Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston
| | - Reisa Sperling
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston
- Center for Alzheimer Research and Treatment, Brigham and Women’s Hospital, Boston, Massachusetts
| | - Sterling C. Johnson
- Wisconsin Alzheimer’s Disease Research Center, University of Wisconsin, School of Medicine and Public Health, Madison
- Department of Medicine, University of Wisconsin–Madison, Madison
| | - Rachel F. Buckley
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston
- Center for Alzheimer Research and Treatment, Brigham and Women’s Hospital, Boston, Massachusetts
- Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, Victoria, Australia
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Ennis GE, Betthauser TJ, Koscik RL, Chin NA, Christian BT, Asthana S, Johnson SC, Bendlin BB. The relationship of insulin resistance and diabetes to tau PET SUVR in middle-aged to older adults. Alzheimers Res Ther 2023; 15:55. [PMID: 36932429 PMCID: PMC10022314 DOI: 10.1186/s13195-023-01180-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Accepted: 01/31/2023] [Indexed: 03/19/2023]
Abstract
BACKGROUND Insulin resistance (IR) and type 2 diabetes have been found to increase the risk for Alzheimer's clinical syndrome in epidemiologic studies but have not been associated with tau tangles in neuropathological research and have been inconsistently associated with cerebrospinal fluid P-tau181. IR and type 2 diabetes are well-recognized vascular risk factors. Some studies suggest that cardiovascular risk may act synergistically with cortical amyloid to increase tau measured using tau PET. Utilizing data from largely nondemented middle-aged and older adult cohorts enriched for AD risk, we investigated the association of IR and diabetes to tau PET and whether amyloid moderated those relationships. METHODS Participants were enrolled in either the Wisconsin Registry for Alzheimer's Prevention (WRAP) or Wisconsin Alzheimer's Disease Research Center (WI-ADRC) Clinical Core. Two partially overlapping samples were studied: a sample characterized using HOMA-IR (n=280 WRAP participants) and a sample characterized on diabetic status (n=285 WRAP and n=109 WI-ADRC). IR was measured using the homeostasis model assessment of insulin resistance (HOMA-IR). Tau PET employing the radioligand 18F-MK-6240 was used to detect AD-specific aggregated tau. Linear regression tested the relationship of IR and diabetic status to tau PET standardized uptake value ratio (SUVR) within the entorhinal cortex and whether relationships were moderated by amyloid assessed by amyloid PET distribution volume ratio (DVR) and amyloid PET positivity status. RESULTS Neither HOMA-IR nor diabetic status was significantly associated with tau PET SUVR. The relationship between IR and tau PET SUVR was not moderated by amyloid PET DVR or positivity status. The association between diabetic status and tau PET SUVR was not significantly moderated by amyloid PET DVR but was significantly moderated by amyloid PET positivity status. Among the amyloid PET-positive participants, the estimated marginal tau PET SUVR mean was higher in the diabetic (n=6) relative to the nondiabetic group (n=88). CONCLUSION Findings indicate that IR may not be related to tau in generally healthy middle-aged and older adults who are in the early stages of the AD clinicopathologic continuum but suggest the need for additional research to investigate whether a synergistic relationship between type 2 diabetes and amyloid is associated with increased tau levels.
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Affiliation(s)
- Gilda E Ennis
- Wisconsin Alzheimer's Disease Research Center, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI, USA.
| | - Tobey J Betthauser
- Wisconsin Alzheimer's Disease Research Center, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI, USA
- Division of Geriatrics and Gerontology, Department of Medicine, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI, USA
| | - Rebecca Langhough Koscik
- Wisconsin Alzheimer's Disease Research Center, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI, USA
- Wisconsin Alzheimer's Institute, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI, USA
| | - Nathaniel A Chin
- Wisconsin Alzheimer's Disease Research Center, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI, USA
- Division of Geriatrics and Gerontology, Department of Medicine, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI, USA
- Wisconsin Alzheimer's Institute, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI, USA
| | - Bradley T Christian
- Wisconsin Alzheimer's Disease Research Center, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI, USA
- Waisman Laboratory for Brain Imaging and Behavior, University of Wisconsin-Madison, Madison, WI, USA
- Department of Medical Physics, University of Wisconsin-Madison, Madison, WI, USA
| | - Sanjay Asthana
- Wisconsin Alzheimer's Disease Research Center, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI, USA
- Division of Geriatrics and Gerontology, Department of Medicine, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI, USA
- Wisconsin Alzheimer's Institute, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI, USA
- Geriatric Research Education and Clinical Center, William S. Middleton Hospital Department of Veterans Affairs, Madison, WI, USA
| | - Sterling C Johnson
- Wisconsin Alzheimer's Disease Research Center, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI, USA
- Division of Geriatrics and Gerontology, Department of Medicine, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI, USA
- Wisconsin Alzheimer's Institute, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI, USA
- Geriatric Research Education and Clinical Center, William S. Middleton Hospital Department of Veterans Affairs, Madison, WI, USA
| | - Barbara B Bendlin
- Wisconsin Alzheimer's Disease Research Center, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI, USA
- Division of Geriatrics and Gerontology, Department of Medicine, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI, USA
- Wisconsin Alzheimer's Institute, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI, USA
- Geriatric Research Education and Clinical Center, William S. Middleton Hospital Department of Veterans Affairs, Madison, WI, USA
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Zaheed AB, Chervin RD, Spira AP, Zahodne LB. Mental and physical health pathways linking insomnia symptoms to cognitive performance 14 years later. Sleep 2023; 46:zsac262. [PMID: 36309871 PMCID: PMC9995792 DOI: 10.1093/sleep/zsac262] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Revised: 09/27/2022] [Indexed: 12/04/2022] Open
Abstract
STUDY OBJECTIVES Insomnia may be a modifiable risk factor for later-life cognitive impairment. We investigated: (1) which insomnia symptoms are associated with subsequent cognitive functioning across domains; (2) whether insomnia-cognition associations are mediated by mental and physical health; and (3) whether these associations are modified by gender. METHODS Participants included 2595 adults ages 51-88 at baseline (Mage=64.00 ± 6.66, 64.5% women) in the Health and Retirement Study. The frequency of insomnia symptoms (difficulty initiating sleep, night time awakenings, early awakenings, and feeling unrested upon awakening) at baseline (2002) were quantified using a modified Jenkins Sleep Questionnaire. Cognition was assessed in 2016 via the Harmonized Cognitive Assessment Protocol and operationalized with factor scores corresponding to five domains. Depressive symptoms and vascular conditions in 2014 were assessed via self-report. Structural equation models estimated total, indirect, and direct effects of insomnia symptoms on subsequent cognition through depressive symptoms and vascular diseases, controlling for baseline sociodemographic and global cognition. RESULTS Frequent difficulty initiating sleep was associated with poorer episodic memory, executive function, language, visuoconstruction, and processing speed 14 years later (-0.06 ≤ β ≤ -0.04; equivalent to 2.2-3.4 years of aging). Depressive symptoms explained 12.3%-19.5% of these associations and vascular disease explained 6.3%-14.6% of non-memory associations. No other insomnia symptoms were associated with cognition, and no associations were modified by gender. CONCLUSIONS Difficulty initiating sleep in later life may predict future cognitive impairment through multiple pathways. Future research with longitudinal assessments of insomnia, insomnia treatments, and cognition is needed to evaluate insomnia as a potential intervention target to optimize cognitive aging.
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Affiliation(s)
- Afsara B Zaheed
- Department of Psychology, University of Michigan, Ann Arbor, MI 48109, USA
| | - Ronald D Chervin
- Sleep Disorders Center and Department of Neurology, University of Michigan, Ann Arbor, MI 48109, USA
| | - Adam P Spira
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD 21287, USA
- Johns Hopkins Center on Aging and Health, Baltimore, MD 21205, USA
| | - Laura B Zahodne
- Department of Psychology, University of Michigan, Ann Arbor, MI 48109, USA
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29
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Du L, Langhough R, Hermann BP, Jonaitis E, Betthauser TJ, Cody KA, Mueller K, Zuelsdorff M, Chin N, Ennis GE, Bendlin BB, Gleason CE, Christian BT, Plante DT, Chappell R, Johnson SC. Associations between self-reported sleep patterns and health, cognition and amyloid measures: results from the Wisconsin Registry for Alzheimer's Prevention. Brain Commun 2023; 5:fcad039. [PMID: 36910417 PMCID: PMC9999364 DOI: 10.1093/braincomms/fcad039] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Revised: 12/09/2022] [Accepted: 02/22/2023] [Indexed: 02/25/2023] Open
Abstract
Previous studies suggest associations between self-reported sleep problems and poorer health, cognition, Alzheimer's disease pathology and dementia-related outcomes. It is important to develop a deeper understanding of the relationship between these complications and sleep disturbance, a modifiable risk factor, in late midlife, a time when Alzheimer's disease pathology may be accruing. The objectives of this study included application of unsupervised machine learning procedures to identify distinct subgroups of persons with problematic sleep and the association of these subgroups with concurrent measures of mental and physical health, cognition and PET-identified amyloid. Dementia-free participants from the Wisconsin Registry for Alzheimer's Prevention (n = 619) completed sleep questionnaires including the Insomnia Severity Index, Epworth Sleepiness Scale and Medical Outcomes Study Sleep Scale. K-means clustering analysis identified discrete sleep problem groups who were then compared across concurrent health outcomes (e.g. depression, self-rated health and insulin resistance), cognitive composite indices including episodic memory and executive function and, in a subset, Pittsburgh Compound B PET imaging to assess amyloid burden. Significant omnibus tests (P < 0.05) were followed with pairwise comparisons. Mean (SD) sample baseline sleep assessment age was 62.6 (6.7). Cluster analysis identified three groups: healthy sleepers [n = 262 (42.3%)], intermediate sleepers [n = 229 (37.0%)] and poor sleepers [n = 128 (20.7%)]. All omnibus tests comparing demographics and health measures across sleep groups were significant except for age, sex and apolipoprotein E e4 carriers; the poor sleepers group was worse than one or both of the other groups on all other measures, including measures of depression, self-reported health and memory complaints. The poor sleepers group had higher average body mass index, waist-hip ratio and homeostatic model assessment of insulin resistance. After adjusting for covariates, the poor sleepers group also performed worse on all concurrent cognitive composites except working memory. There were no differences between sleep groups on PET-based measures of amyloid. Sensitivity analyses indicated that while different clustering approaches resulted in different group assignments for some (predominantly the intermediate group), between-group patterns in outcomes were consistent. In conclusion, distinct sleep characteristics groups were identified with a sizable minority (20.7%) exhibiting poor sleep characteristics, and this group also exhibited the poorest concurrent mental and physical health and cognition, indicating substantial multi-morbidity; sleep group was not associated with amyloid PET estimates. Precision-based management of sleep and related factors may provide an opportunity for early intervention that could serve to delay or prevent clinical impairment.
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Affiliation(s)
- Lianlian Du
- Wisconsin Alzheimer’s Institute, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI 53726, USA
- Department of Biostatistics and Medical Informatics, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI 53792, USA
| | - Rebecca Langhough
- Wisconsin Alzheimer’s Institute, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI 53726, USA
- Wisconsin Alzheimer’s Disease Research Center, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI 53792, USA
- Department of Medicine, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI 53726, USA
| | - Bruce P Hermann
- Wisconsin Alzheimer’s Institute, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI 53726, USA
- Department of Neurology, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI 53726, USA
| | - Erin Jonaitis
- Wisconsin Alzheimer’s Institute, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI 53726, USA
- Wisconsin Alzheimer’s Disease Research Center, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI 53792, USA
- Department of Medicine, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI 53726, USA
| | - Tobey J Betthauser
- Wisconsin Alzheimer’s Institute, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI 53726, USA
- Wisconsin Alzheimer’s Disease Research Center, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI 53792, USA
- Department of Medicine, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI 53726, USA
| | - Karly Alex Cody
- Wisconsin Alzheimer’s Institute, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI 53726, USA
- Wisconsin Alzheimer’s Disease Research Center, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI 53792, USA
- Department of Medicine, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI 53726, USA
| | - Kimberly Mueller
- Wisconsin Alzheimer’s Institute, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI 53726, USA
- Wisconsin Alzheimer’s Disease Research Center, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI 53792, USA
- Department of Medicine, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI 53726, USA
| | - Megan Zuelsdorff
- Wisconsin Alzheimer’s Disease Research Center, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI 53792, USA
- University of Wisconsin-Madison School of Nursing, Madison, WI 53705, USA
| | - Nathaniel Chin
- Wisconsin Alzheimer’s Disease Research Center, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI 53792, USA
- Department of Medicine, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI 53726, USA
| | - Gilda E Ennis
- Wisconsin Alzheimer’s Disease Research Center, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI 53792, USA
- Department of Medicine, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI 53726, USA
| | - Barbara B Bendlin
- Wisconsin Alzheimer’s Institute, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI 53726, USA
- Wisconsin Alzheimer’s Disease Research Center, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI 53792, USA
- Department of Medicine, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI 53726, USA
- Madison VA GRECC, William S. Middleton Memorial Hospital, Madison, WI 53705, USA
| | - Carey E Gleason
- Wisconsin Alzheimer’s Institute, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI 53726, USA
- Wisconsin Alzheimer’s Disease Research Center, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI 53792, USA
- Madison VA GRECC, William S. Middleton Memorial Hospital, Madison, WI 53705, USA
| | - Bradley T Christian
- Wisconsin Alzheimer’s Disease Research Center, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI 53792, USA
- Department of Medical Physics, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI 53705, USA
| | - David T Plante
- Department of Psychiatry, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI 53719, USA
| | - Rick Chappell
- Department of Biostatistics and Medical Informatics, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI 53792, USA
- Wisconsin Alzheimer’s Disease Research Center, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI 53792, USA
| | - Sterling C Johnson
- Wisconsin Alzheimer’s Institute, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI 53726, USA
- Wisconsin Alzheimer’s Disease Research Center, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI 53792, USA
- Department of Medicine, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI 53726, USA
- Madison VA GRECC, William S. Middleton Memorial Hospital, Madison, WI 53705, USA
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Sangalli L, Boggero IA. The impact of sleep components, quality and patterns on glymphatic system functioning in healthy adults: A systematic review. Sleep Med 2023; 101:322-349. [PMID: 36481512 DOI: 10.1016/j.sleep.2022.11.012] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Revised: 07/04/2022] [Accepted: 11/13/2022] [Indexed: 11/24/2022]
Abstract
OBJECTIVE The glymphatic system is thought to be responsible for waste clearance in the brain. As it is primarily active during sleep, different components of sleep, subjective sleep quality, and sleep patterns may contribute to glymphatic functioning. This systematic review aimed at exploring the effect of sleep components, sleep quality, and sleep patterns on outcomes associated with the glymphatic system in healthy adults. METHODS PubMed®, Scopus, and Web of Science were searched for studies published in English until December 2021. Articles subjectively or objectively investigating sleep components (total sleep time, time in bed, sleep efficiency, sleep onset latency, wake-up after sleep onset, sleep stage, awakenings), sleep quality, or sleep pattern in healthy individuals, on outcomes associated with glymphatic system (levels of amyloid-β, tau, α-synuclein; cerebrospinal fluid, perivascular spaces; apolipoprotein E) were selected. RESULTS Out of 8359 records screened, 51 studies were included. Overall, contradictory findings were observed according to different sleep assessment method. The most frequently assessed sleep parameters were total sleep time, sleep quality, and sleep efficiency. No association was found between sleep efficiency and amyloid-β, and between slow-wave activity and tau. Most of the studies did not find any correlation between total sleep time and amyloid-β nor tau level. Opposing results correlated sleep quality with amyloid-β and tau. CONCLUSIONS This review highlighted inconsistent results across the studies; as such, the specific association between the glymphatic system and sleep parameters in healthy adults remains poorly understood. Due to the heterogeneity of sleep assessment methods and the self-reported data representing the majority of the observations, future studies with universal study design and sleep methodology in healthy individuals are advocated.
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Affiliation(s)
- L Sangalli
- Department of Oral Health Science, Division of Orofacial Pain, University of Kentucky, College of Dentistry, Lexington, Kentucky, USA; College of Dental Medicine - Illinois, Downers Grove, Illinois, USA.
| | - I A Boggero
- Department of Oral Health Science, Division of Orofacial Pain, University of Kentucky, College of Dentistry, Lexington, Kentucky, USA; Department of Psychology, University of Kentucky, Lexington, Kentucky, USA
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Yao D, Li R, Kora M, Huang H, Liu X, Gong S. Activation of ventral tegmental area vesicular GABA transporter (Vgat) neurons alleviates social defeat stress-induced anxiety in APP/PS1 mice. Front Aging Neurosci 2023; 15:1142055. [PMID: 37032820 PMCID: PMC10076796 DOI: 10.3389/fnagi.2023.1142055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Accepted: 03/01/2023] [Indexed: 04/11/2023] Open
Abstract
Introduction Alzheimer's disease (AD) is a progressive neurodegenerative disease that results in cognitive impairment and is often accompanied by anxiety. In this study, we investigated whether the activation of VTAVgat neurons could reduce anxiety in APP/PS1 mice. We hypothesized that acute social defeat stress (SDS) would lead to anxiety in APP/PS1 mice, and that the activation of VTAVgat neurons would alleviate this anxiety. Methods We exposed APP/PS1 mice to acute SDS and assessed anxiety using the open field test and elevated plus-arm test. Activated VTAVgat neurons was tested by cfos staining. Sleep quality was detected using electroencephalogram after SDS or non-SDS procedure. Sleep duration, sleep latency, and non-rapid eye movement (NREM) percentage were analyzed. VTAVgat neurons were chemogenetically activated by deschloroclozapine. Results Our results showed that acute SDS led to anxiety in APP/PS1 mice, as evidenced by increased anxiety-related behaviors in the open field and elevated plus-arm tests. Activation of VTAVgat neurons by SDS led to an increase in sleep duration, primarily due to a decrease in sleep latency and an increase in NREMs. However, the quality of sleep was poor. Chemogenetical activation of VTAVgat neurons improved sleep quality and relieved SDS-induced anxiety. Furthermore, the anxiety state correlated negatively with sleep duration and NREM percentage and correlated positively with theta power density in APP/PS1 mice. Discussion Our study provides evidence that the activation of VTAVgat neurons alleviates SDS-induced anxiety in APP/PS1 mice, suggesting that poor sleep quality may exacerbate anxiety in AD. These findings may have important implications for the treatment of anxiety in AD, as targeting VTAVgat neurons could be a potential therapeutic approach.
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Affiliation(s)
- Di Yao
- Trauma Centre/Department of Emergency and Trauma Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
- Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Rong Li
- Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
- Department of Pediatrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Musa Kora
- School of Basic Medicine, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Hongqing Huang
- Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Xinghua Liu
- Trauma Centre/Department of Emergency and Trauma Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
- *Correspondence: Xinghua Liu,
| | - Song Gong
- Trauma Centre/Department of Emergency and Trauma Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
- Song Gong,
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Mondino A, Catanzariti M, Mateos DM, Khan M, Ludwig C, Kis A, Gruen ME, Olby NJ. Sleep and cognition in aging dogs. A polysomnographic study. Front Vet Sci 2023; 10:1151266. [PMID: 37187924 PMCID: PMC10175583 DOI: 10.3389/fvets.2023.1151266] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Accepted: 03/17/2023] [Indexed: 05/17/2023] Open
Abstract
Introduction Sleep is fundamental for cognitive homeostasis, especially in senior populations since clearance of amyloid beta (key in the pathophysiology of Alzheimer's disease) occurs during sleep. Some electroencephalographic characteristics of sleep and wakefulness have been considered a hallmark of dementia. Owners of dogs with canine cognitive dysfunction syndrome (a canine analog to Alzheimer's disease) report that their dogs suffer from difficulty sleeping. The aim of this study was to quantify age-related changes in the sleep-wakefulness cycle macrostructure and electroencephalographic features in senior dogs and to correlate them with their cognitive performance. Methods We performed polysomnographic recordings in 28 senior dogs during a 2 h afternoon nap. Percentage of time spent in wakefulness, drowsiness, NREM, and REM sleep, as well as latency to the three sleep states were calculated. Spectral power, coherence, and Lempel Ziv Complexity of the brain oscillations were estimated. Finally, cognitive performance was evaluated by means of the Canine Dementia Scale Questionnaire and a battery of cognitive tests. Correlations between age, cognitive performance and sleep-wakefulness cycle macrostructure and electroencephalographic features were calculated. Results Dogs with higher dementia scores and with worse performance in a problem-solving task spent less time in NREM and REM sleep. Additionally, quantitative electroencephalographic analyses showed differences in dogs associated with age or cognitive performance, some of them reflecting shallower sleep in more affected dogs. Discussion Polysomnographic recordings in dogs can detect sleep-wakefulness cycle changes associated with dementia. Further studies should evaluate polysomnography's potential clinical use to monitor the progression of canine cognitive dysfunction syndrome.
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Affiliation(s)
- Alejandra Mondino
- Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC, United States
| | - Magaly Catanzariti
- Instituto de Matemática Aplicada del Litoral, Consejo Nacional de Investigaciones Científicas y Técninas, Universidad Nacional del Litoral, Santa Fe, Argentina
| | - Diego Martin Mateos
- Instituto de Matemática Aplicada del Litoral, Consejo Nacional de Investigaciones Científicas y Técninas, Universidad Nacional del Litoral, Santa Fe, Argentina
- Physics Department, Universidad Autónoma de Entre Ríos (UADER), Oro Verde, Entre Ríos, Argentina
| | - Michael Khan
- Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC, United States
| | - Claire Ludwig
- Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC, United States
| | - Anna Kis
- Research Centre for Natural Sciences, Institute of Cognitive Neuroscience and Psychology, Budapest, Hungary
| | - Margaret E. Gruen
- Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC, United States
| | - Natasha J. Olby
- Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC, United States
- *Correspondence: Natasha J. Olby
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Burke S, Grudzien A, Li T, Abril M, Spadola C, Barnes C, Hanson K, Grandner M, DeKosky S. Correlations between sleep disturbance and brain structures associated with neurodegeneration in the National Alzheimer's Coordinating Center Uniform Data Set. J Clin Neurosci 2022; 106:204-212. [PMID: 35970678 PMCID: PMC9671822 DOI: 10.1016/j.jocn.2022.07.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Revised: 06/23/2022] [Accepted: 07/13/2022] [Indexed: 10/15/2022]
Abstract
This study aimed to 1) determine the association between sleep disturbance and brain structure volumes, 2) the moderation effect of apolipoprotein ε4 genotype on sleep disturbance and brain structures, and 3) the moderation effect of sleep disturbance on cognitive status and regional brain volumes. Using the National Alzheimer's Coordinating Center Uniform Data Set (n = 1,533), multiple linear regressions were used to evaluate the association between sleep disturbance and brain volumes. Sleep disturbance was measured using one question from the NPI-Q. After controlling for intracranial volume, age, sex, years of education, race, ethnicity, and applying the FDR correction, total cerebrospinal fluid volume, left lateral ventricle volume, total lateral ventricle volume, and total third ventricle volume demonstrated significantly higher means for those with sleep disturbance. Total brain volume, total white and gray matter volume, total cerebrum brain volume (including gray but not white matter), left hippocampus volume, total hippocampal volume, the left, right, and total frontal lobe cortical gray matter volume, and the left, right, and total temporal lobe cortical gray matter volume demonstrated significantly lower mean volumes for those with sleep disturbance. Sleep disturbance moderated the association between cognitive status and lateral ventricular volumes. These findings suggest that disrupted sleep is associated with atrophy across multiple brain regions and ventricular hydrocephalus ex vacuo.
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Affiliation(s)
- Shanna Burke
- School of Social Work, Florida International University, Robert Stempel College of Public Health and Social Work, 11200 SW 8th St. Miami, FL 33199, United States.
| | - Adrienne Grudzien
- School of Social Work, Florida International University, Robert Stempel College of Public Health and Social Work, 11200 SW 8th St. Miami, FL 33199, United States.
| | - Tan Li
- Department of Biostatistics, Robert Stempel College of Public Health and Social Work, Florida International University, 11200 S.W. 8th Street, Miami, FL 33199, United States.
| | - Marlou Abril
- Department of Biostatistics, Robert Stempel College of Public Health and Social Work, Florida International University, 11200 S.W. 8th Street, Miami, FL 33199, United States.
| | - Christine Spadola
- The University of Texas at Arlington, School of Social Work, 211 S. Cooper Street, Box 19129, Arlington, TX 76019-0129, United States.
| | - Christopher Barnes
- Clinical and Translational Science Informatics and Technology, University of Florida Clinical and Translational Science Institute, College of Medicine, University of Florida, Gainesville, FL 32610, United States.
| | - Kevin Hanson
- Clinical and Translational Science Institute, Integrated Data Repository, College of Medicine, University of Florida, Gainesville, FL 32610, United States.
| | - Michael Grandner
- Behavioral Sleep Medicine Clinic, University of Arizona College of Medicine, 1501 N Campbell Avenue, Tucson, AZ 85724-5002, United States.
| | - Steven DeKosky
- McKnight Brain Institute, Aerts-Cosper Professor of Alzheimer's Research, Associate Director, 1Florida Alzheimer's Disease Center, Professor of Neurology and Neuroscience, University of Florida, College of Medicine, United States.
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Forte N, Fernández-Rilo AC, Palomba L, Marfella B, Piscitelli F, De Girolamo P, Di Costanzo A, Di Marzo V, Cristino L. Positive association between plasmatic levels of orexin A and the endocannabinoid-derived 2-arachidonoyl lysophosphatidic acid in Alzheimer’s disease. Front Aging Neurosci 2022; 14:1004002. [DOI: 10.3389/fnagi.2022.1004002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Accepted: 10/04/2022] [Indexed: 11/17/2022] Open
Abstract
A regular sleep-wake cycle plays a positive function that preserves synaptic plasticity and brain activity from neuropathological injuries. The hypothalamic neuropeptide orexin-A (OX-A) is central in sleep-wake regulation and has been found to be over-expressed in the cerebrospinal fluid (CSF) of patients with Alzheimer’s disease (AD) suffering from sleep disturbances. OX-A promotes the biosynthesis of 2-arachidonoylglycerol (2-AG), which, in turn, could be phosphorylated to 2-arachidonoyl lysophosphatidic acid (2-AGP). The reorganization of the actin cytoskeleton during neurite retraction is one of the best-characterized effects of lysophosphatidic acids. However, less information is available regarding the reorganization of the neuronal microtubule network in response to OX-A-induced 2-AG and, possibly consequent, 2-AGP production in AD patients. This is of special relevance also considering that higher 2-AG levels are reported in the CSF of AD patients. Here, we found a positive correlation between OX-A and 2-AGP concentrations in the plasma, and an increase of 2-AGP levels in the CSF of AD patients. Furthermore, a negative correlation between the plasmatic 2-AGP levels and the mini-mental state examination score is also revealed in AD patients. By moving from the human patients to in vitro and in vivo models of AD we investigated the molecular pathway linking OX-A, 2-AG and 2-AGP to the phosphorylation of pT231-Tau, which is a specific early plasma biomarker of this disorder. By LC-MS analysis we show that OX-A, via OX-1R, induces 2-AG biosynthesis via DAGLα, and in turn 2-AG is converted to 2-AGP in primary hippocampal neurons. By confocal microscopy and western blotting assay we found an OX-A- or 2-AGP-mediated phosphorylation of Tau at threonine 231 residue, in a manner prevented by LPA1R (2-AGP receptor) or OX1R (OX-A receptor) antagonism with AM095 or SB334867, respectively. Finally, by patch-clamp recording we documented that 2-AGP-mediated pT231-Tau phosphorylation impairs glutamatergic transmission in the mouse hippocampus. Although further additional research is still required to clarify the potential role of orexin signaling in neurodegeneration, this study provides evidence that counteraction of aberrant OX-A signaling, also via LPA-1R antagonism, may be beneficial in the mild-to-moderate age-related cognitive decline associated with sleep disturbances.
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Boeve A, Halpin A, Michaud S, Fagan M, MacAulay RK. Specific Sleep Health Domains as Predictors of Executive Function in Older Adults. J Neuropsychiatry Clin Neurosci 2022; 34:422-427. [PMID: 35272490 DOI: 10.1176/appi.neuropsych.21040112] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
OBJECTIVES Sleep health and executive function are multifaceted constructs that decline with age. Some evidence suggests that poor sleep health may underlie declines in executive function, but this relationship is not consistently found in cognitively normal older adults. The authors systematically investigated distinct sleep health domain associations with specific aspects of executive function. METHODS Community-dwelling older adults completed clinical interviews, comprehensive neuropsychological assessments, and subjective sleep measures. Four sleep health domains were investigated: satisfaction/quality, sleep efficiency, sleep duration, and daytime sleepiness/fatigue. Hierarchical multiple regression analyses, adjusting for significant covariates, examined whether the sleep health domains differentially predicted executive function. RESULTS Separate analyses found that greater sleep efficiency was associated with better response inhibition, while greater daytime sleepiness/fatigue was associated with worse cognitive flexibility. Categorical differences in sleep duration indicated that average durations, compared with short and long durations, had better executive function performance across measures. Sleep satisfaction/quality was not statistically associated with executive function. CONCLUSIONS These findings have implications for sleep assessment and its intervention. Routine screening of sleep duration, efficiency, and daytime fatigue may be particularly useful in identifying those at greater risk of executive dysfunction. Targeting specific problems in sleep may serve to improve cognitive control and efficiency in older adults. Future research is warranted to establish the optimal hours of sleep duration for cognitive health.
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Affiliation(s)
| | - Amy Halpin
- Department of Psychology, University of Maine, Orono
| | | | - Michael Fagan
- Department of Psychology, University of Maine, Orono
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Cody KA, Koscik RL, Erickson CM, Berman SE, Jonaitis EM, Williams VJ, Mueller KD, Christian BT, Chin NA, Clark LR, Betthauser TJ, Johnson SC. Associations of the Lifestyle for Brain Health index with longitudinal cognition and brain amyloid beta in clinically unimpaired older adults: Findings from the Wisconsin Registry for Alzheimer's Prevention. ALZHEIMER'S & DEMENTIA (AMSTERDAM, NETHERLANDS) 2022; 14:e12351. [PMID: 36110432 PMCID: PMC9464997 DOI: 10.1002/dad2.12351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Revised: 07/13/2022] [Accepted: 07/20/2022] [Indexed: 01/25/2023]
Abstract
Introduction Modifiable health and lifestyle factors increase risk of dementia, but whether modifiable factors, when measured in late-midlife, impact the emergence or progression of Alzheimer's disease (AD) pathophysiologic or cognitive changes remains unresolved. Methods In initially cognitively unimpaired, late middle-aged participants (N = 1215; baseline age, M [standard deviation] = 59.3 [6.7] years) from the Wisconsin Registry for Alzheimer's Prevention (WRAP), we investigated the influence of the Lifestyle for Brain Health (LIBRA) index, a lifestyle-based dementia risk score, on AD-related cognitive trajectories and amyloid beta (Aβ) plaque accumulation. Results Overall, lower baseline LIBRA, denoting healthier lifestyle and lower dementia risk, was related to better overall cognitive performance, but did not moderate apolipoprotein E ε4 or Aβ-related longitudinal cognitive trajectories. LIBRA was not significantly associated with Aβ accumulation or estimated age of Aβ onset. Discussion In WRAP, late-midlife LIBRA scores were related to overall cognitive performance, but not AD-related cognitive decline or Aβ accumulation in the preclinical timeframe. Highlights The Lifestyle for Brain Health (LIBRA) index was associated with cognitive performance in late-midlife.LIBRA did not moderate apolipoprotein E ε4 or amyloid-related cognitive decline.LIBRA was not associated with the onset or accumulation of amyloid plaques.
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Affiliation(s)
- Karly A. Cody
- Wisconsin Alzheimer's Disease Research CenterUniversity of Wisconsin School of Medicine and Public HealthMadisonWisconsinUSA,Department of MedicineUniversity of Wisconsin School of Medicine and Public HealthMadisonWisconsinUSA
| | - Rebecca L. Koscik
- Wisconsin Alzheimer's Disease Research CenterUniversity of Wisconsin School of Medicine and Public HealthMadisonWisconsinUSA,Department of MedicineUniversity of Wisconsin School of Medicine and Public HealthMadisonWisconsinUSA,Wisconsin Alzheimer's InstituteUniversity of Wisconsin School of Medicine and Public HealthMadisonWisconsinUSA
| | - Claire M. Erickson
- Wisconsin Alzheimer's Disease Research CenterUniversity of Wisconsin School of Medicine and Public HealthMadisonWisconsinUSA,Department of MedicineUniversity of Wisconsin School of Medicine and Public HealthMadisonWisconsinUSA
| | - Sara E. Berman
- Wisconsin Alzheimer's Disease Research CenterUniversity of Wisconsin School of Medicine and Public HealthMadisonWisconsinUSA,Department of MedicineUniversity of Wisconsin School of Medicine and Public HealthMadisonWisconsinUSA
| | - Erin M. Jonaitis
- Wisconsin Alzheimer's Disease Research CenterUniversity of Wisconsin School of Medicine and Public HealthMadisonWisconsinUSA,Department of MedicineUniversity of Wisconsin School of Medicine and Public HealthMadisonWisconsinUSA,Wisconsin Alzheimer's InstituteUniversity of Wisconsin School of Medicine and Public HealthMadisonWisconsinUSA
| | - Victoria J. Williams
- Wisconsin Alzheimer's Disease Research CenterUniversity of Wisconsin School of Medicine and Public HealthMadisonWisconsinUSA,Department of MedicineUniversity of Wisconsin School of Medicine and Public HealthMadisonWisconsinUSA
| | - Kimberly D. Mueller
- Wisconsin Alzheimer's Disease Research CenterUniversity of Wisconsin School of Medicine and Public HealthMadisonWisconsinUSA,Department of MedicineUniversity of Wisconsin School of Medicine and Public HealthMadisonWisconsinUSA,Wisconsin Alzheimer's InstituteUniversity of Wisconsin School of Medicine and Public HealthMadisonWisconsinUSA,Department of Communication Sciences & DisordersUniversity of Wisconsin–MadisonMadisonWisconsinUSA
| | - Bradley T. Christian
- Wisconsin Alzheimer's Disease Research CenterUniversity of Wisconsin School of Medicine and Public HealthMadisonWisconsinUSA,Waisman Laboratory for Brain Imaging and BehaviorUniversity of Wisconsin–MadisonMadisonWisconsinUSA,Department of Medical PhysicsUniversity of Wisconsin–MadisonMadisonWisconsinUSA
| | - Nathanial A. Chin
- Wisconsin Alzheimer's Disease Research CenterUniversity of Wisconsin School of Medicine and Public HealthMadisonWisconsinUSA
| | - Lindsay R. Clark
- Wisconsin Alzheimer's Disease Research CenterUniversity of Wisconsin School of Medicine and Public HealthMadisonWisconsinUSA,Department of MedicineUniversity of Wisconsin School of Medicine and Public HealthMadisonWisconsinUSA,Geriatric Research Education and Clinical CenterWilliam S. Middleton Veterans HospitalMadisonWisconsinUSA
| | - Tobey J. Betthauser
- Wisconsin Alzheimer's Disease Research CenterUniversity of Wisconsin School of Medicine and Public HealthMadisonWisconsinUSA,Department of MedicineUniversity of Wisconsin School of Medicine and Public HealthMadisonWisconsinUSA
| | - Sterling C. Johnson
- Wisconsin Alzheimer's Disease Research CenterUniversity of Wisconsin School of Medicine and Public HealthMadisonWisconsinUSA,Department of MedicineUniversity of Wisconsin School of Medicine and Public HealthMadisonWisconsinUSA,Wisconsin Alzheimer's InstituteUniversity of Wisconsin School of Medicine and Public HealthMadisonWisconsinUSA,Geriatric Research Education and Clinical CenterWilliam S. Middleton Veterans HospitalMadisonWisconsinUSA
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Dong R, Denier-Fields DN, Lu Q, Suridjan I, Kollmorgen G, Wild N, Betthauser TJ, Carlsson CM, Asthana S, Johnson SC, Zetterberg H, Blennow K, Engelman CD. Principal components from untargeted cerebrospinal fluid metabolomics associated with Alzheimer's disease biomarkers. Neurobiol Aging 2022; 117:12-23. [PMID: 35640460 PMCID: PMC9737218 DOI: 10.1016/j.neurobiolaging.2022.04.009] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Revised: 01/20/2022] [Accepted: 04/12/2022] [Indexed: 01/13/2023]
Abstract
Studying the correlation between cerebrospinal fluid (CSF) metabolites and the Alzheimer's Disease (AD) biomarkers may offer a window to the alterations of the brain metabolome and unveil potential biological mechanisms underlying AD. In this analysis, 308 CSF metabolites from 338 individuals of Wisconsin Registry for Alzheimer's Prevention and Wisconsin Alzheimer's Disease Research Center were included in a principal component analysis (PCA). The resulted principal components (PCs) were tested for association with CSF total tau (t-tau), phosphorylated tau (p-tau), amyloid β 42 (Aβ42), and Aβ42/40 ratio using linear regression models. Significant PCs were further tested with other CSF NeuroToolKit (NTK) and imaging biomarkers. Using a Bonferroni corrected p < 0.05, 5 PCs were significantly associated with CSF p-tau and t-tau and 3 PCs were significantly associated with CSF Aβ42. Pathway analysis suggested that these PCS were enriched in 6 pathways, including metabolism of caffeine and nicotinate and nicotinamide. This study provides evidence that CSF metabolites are associated with AD pathology through core AD biomarkers and other NTK markers and suggests potential pathways to follow up in future studies.
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Affiliation(s)
- Ruocheng Dong
- Department of Population Health Sciences, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, USA
| | - Diandra N Denier-Fields
- Department of Population Health Sciences, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, USA; Department Nutrition Science, University of Wisconsin-Madison, Madison, WI, USA
| | - Qiongshi Lu
- Department of Biostatistics and Medical Informatics, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, USA
| | | | | | | | - Tobey James Betthauser
- Department of Medicine, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, USA; Wisconsin Alzheimer's Disease Research Center, University of Wisconsin-Madison, School of Medicine and Public Health, Madison, WI, USA
| | - Cynthia M Carlsson
- Department of Medicine, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, USA; Wisconsin Alzheimer's Disease Research Center, University of Wisconsin-Madison, School of Medicine and Public Health, Madison, WI, USA; Geriatric Research Education and Clinical Center, Wm. S. Middleton Memorial VA Hospital, Madison, WI, USA
| | - Sanjay Asthana
- Department of Medicine, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, USA; Wisconsin Alzheimer's Disease Research Center, University of Wisconsin-Madison, School of Medicine and Public Health, Madison, WI, USA; Geriatric Research Education and Clinical Center, Wm. S. Middleton Memorial VA Hospital, Madison, WI, USA
| | - Sterling C Johnson
- Department of Medicine, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, USA; Wisconsin Alzheimer's Disease Research Center, University of Wisconsin-Madison, School of Medicine and Public Health, Madison, WI, USA; Geriatric Research Education and Clinical Center, Wm. S. Middleton Memorial VA Hospital, Madison, WI, USA; Wisconsin Alzheimer's Institute, University of Wisconsin-Madison, School of Medicine and Public Health, Madison, WI, USA
| | - Henrik Zetterberg
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at University of Gothenburg, Mölndal, Sweden; Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden; UK Dementia Research Institute at UCL, London, UK; Department of Neurodegenerative Disease, UCL Institute of Neurology, London, UK
| | - Kaj Blennow
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at University of Gothenburg, Mölndal, Sweden; Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden
| | - Corinne D Engelman
- Department of Population Health Sciences, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, USA; Wisconsin Alzheimer's Disease Research Center, University of Wisconsin-Madison, School of Medicine and Public Health, Madison, WI, USA; Wisconsin Alzheimer's Institute, University of Wisconsin-Madison, School of Medicine and Public Health, Madison, WI, USA.
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Liu C, Lee SH, Loewenstein DA, Galvin JE, Camargo CJ, Alperin N. Poor sleep accelerates hippocampal and posterior cingulate volume loss in cognitively normal healthy older adults. J Sleep Res 2022; 31:e13538. [PMID: 34927298 PMCID: PMC10731580 DOI: 10.1111/jsr.13538] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2021] [Revised: 11/12/2021] [Accepted: 12/03/2021] [Indexed: 01/05/2023]
Abstract
Poor sleep quality is a known risk factor for Alzheimer's disease. This longitudinal imaging study aimed to determine the acceleration in the rates of tissue loss in cognitively critical brain regions due to poor sleep in healthy elderly individuals. Cognitively-normal healthy individuals, aged ≥60 years, reported Pittsburgh Sleep Quality Index (PSQI) and underwent baseline and 2-year follow-up magnetic resonance imaging brain scans. The links between self-reported sleep quality, rates of tissue loss in cognitively-critical brain regions, and white matter hyperintensity load were assessed. A total of 48 subjects were classified into normal (n = 23; PSQI score <5) and poor sleepers (n = 25; PSQI score ≥5). The two groups were not significantly different in terms of age, gender, years of education, ethnicity, handedness, body mass index, and cognitive performance. Compared to normal sleepers, poor sleepers exhibited much faster rates of volume loss, over threefold in the right hippocampus and fivefold in the right posterior cingulate over 2 years. In contrast, there were no significant differences in the rates of volume loss in the cerebral and cerebellar grey and white matter between the two groups. Rates of volume loss in the right posterior cingulate were negatively associated with global PSQI scores. Poor sleep significantly accelerates volume loss in the right hippocampus and the right posterior cingulate cortex. These findings demonstrate that self-reported sleep quality explains inter-individual differences in the rates of volume loss in cognitively-critical brain regions in healthy older adults and provide a strong impetus to offer sleep interventions to cognitively normal older adults who are poor sleepers.
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Affiliation(s)
- Che Liu
- Department of Radiology, University of Miami Miller School of Medicine, University of Miami, Miami, FL, USA
- Department of Biomedical Engineering, University of Miami, Miami, FL, USA
| | - Sang H. Lee
- Department of Radiology, University of Miami Miller School of Medicine, University of Miami, Miami, FL, USA
| | - David A. Loewenstein
- Department of Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine, Miami, FL, USA
| | - James E. Galvin
- Department of Neurology, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Christian J. Camargo
- Department of Neurology, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Noam Alperin
- Department of Radiology, University of Miami Miller School of Medicine, University of Miami, Miami, FL, USA
- Department of Biomedical Engineering, University of Miami, Miami, FL, USA
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Harrington YA, Parisi JM, Duan D, Rojo-Wissar DM, Holingue C, Spira AP. Sex Hormones, Sleep, and Memory: Interrelationships Across the Adult Female Lifespan. Front Aging Neurosci 2022; 14:800278. [PMID: 35912083 PMCID: PMC9331168 DOI: 10.3389/fnagi.2022.800278] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Accepted: 06/09/2022] [Indexed: 01/26/2023] Open
Abstract
As the population of older adults grows, so will the prevalence of aging-related conditions, including memory impairments and sleep disturbances, both of which are more common among women. Compared to older men, older women are up to twice as likely to experience sleep disturbances and are at a higher risk of cognitive decline and Alzheimer's disease and related dementias (ADRD). These sex differences may be attributed in part to fluctuations in levels of female sex hormones (i.e., estrogen and progesterone) that occur across the adult female lifespan. Though women tend to experience the most significant sleep and memory problems during the peri-menopausal period, changes in memory and sleep have also been observed across the menstrual cycle and during pregnancy. Here, we review current knowledge on the interrelationships among female sex hormones, sleep, and memory across the female lifespan, propose possible mediating and moderating mechanisms linking these variables and describe implications for ADRD risk in later life.
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Affiliation(s)
- Yasmin A. Harrington
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
| | - Jeanine M. Parisi
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
| | - Daisy Duan
- Division of Endocrinology, Diabetes and Metabolism, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Darlynn M. Rojo-Wissar
- The Initiative on Stress, Trauma, and Resilience (STAR), Department of Psychiatry and Human Behavior, Center for Behavioral and Preventive Medicine, The Miriam Hospital, Warren Alpert Medical School of Brown University, Providence, RI, United States
| | - Calliope Holingue
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
- Center for Autism and Related Disorders, Kennedy Krieger Institute, Baltimore, MD, United States
| | - Adam P. Spira
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD, United States
- Johns Hopkins Center on Aging and Health, Baltimore, MD, United States
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40
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Mueller KD, Du L, Bruno D, Betthauser T, Christian B, Johnson S, Hermann B, Koscik RL. Item-Level Story Recall Predictors of Amyloid-Beta in Late Middle-Aged Adults at Increased Risk for Alzheimer's Disease. Front Psychol 2022; 13:908651. [PMID: 35832924 PMCID: PMC9271832 DOI: 10.3389/fpsyg.2022.908651] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Accepted: 05/31/2022] [Indexed: 11/13/2022] Open
Abstract
Background Story recall (SR) tests have shown variable sensitivity to rate of cognitive decline in individuals with Alzheimer's disease (AD) biomarkers. Although SR tasks are typically scored by obtaining a sum of items recalled, item-level analyses may provide additional sensitivity to change and AD processes. Here, we examined the difficulty and discrimination indices of each item from the Logical Memory (LM) SR task, and determined if these metrics differed by recall conditions, story version (A vs. B), lexical categories, serial position, and amyloid status. Methods n = 1,141 participants from the Wisconsin Registry for Alzheimer's Prevention longitudinal study who had item-level data were included in these analyses, as well as a subset of n = 338 who also had amyloid positron emission tomography (PET) imaging. LM data were categorized into four lexical categories (proper names, verbs, numbers, and "other"), and by serial position (primacy, middle, and recency). We calculated difficulty and discriminability/memorability by item, category, and serial position and ran separate repeated measures ANOVAs for each recall condition, lexical category, and serial position. For the subset with amyloid imaging, we used a two-sample t-test to examine whether amyloid positive (Aβ+) and amyloid negative (Aβ-) groups differed in difficulty or discrimination for the same summary metrics. Results In the larger sample, items were more difficult (less memorable) in the delayed recall condition across both story A and story B. Item discrimination was higher at delayed than immediate recall, and proper names had better discrimination than any of the other lexical categories or serial position groups. In the subsample with amyloid PET imaging, proper names were more difficult for Aβ+ than Aβ-; items in the verb and "other" lexical categories and all serial positions from delayed recall were more discriminate for the Aβ+ group compared to the Aβ- group. Conclusion This study provides empirical evidence that both LM stories are effective at discriminating ability levels and amyloid status, and that individual items vary in difficulty and discrimination by amyloid status, while total scores do not. These results can be informative for the future development of sensitive tasks or composite scores for early detection of cognitive decline.
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Affiliation(s)
- Kimberly D. Mueller
- Department of Communication Sciences and Disorders, University of Wisconsin-Madison, Madison, WI, United States
- Department of Biostatistics and Medical Informatics, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, United States
- Wisconsin Alzheimer’s Disease Research Center, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, United States
| | - Lianlian Du
- Department of Biostatistics and Medical Informatics, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, United States
| | - Davide Bruno
- School of Psychology, Liverpool John Moores University, Liverpool, United Kingdom
| | - Tobey Betthauser
- Wisconsin Alzheimer’s Disease Research Center, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, United States
| | - Bradley Christian
- Wisconsin Alzheimer’s Disease Research Center, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, United States
- Waisman Laboratory for Brain Imaging and Behavior, University of Wisconsin-Madison, Madison, WI, United States
- Department of Medical Physics, University of Wisconsin-Madison, Madison, WI, United States
| | - Sterling Johnson
- Department of Biostatistics and Medical Informatics, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, United States
- Wisconsin Alzheimer’s Disease Research Center, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, United States
- Geriatric Research Education and Clinical Center, William S. Middleton Veterans Hospital, Madison, WI, United States
| | - Bruce Hermann
- Department of Biostatistics and Medical Informatics, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, United States
- Department of Neurology, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, United States
| | - Rebecca Langhough Koscik
- Department of Biostatistics and Medical Informatics, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, United States
- Wisconsin Alzheimer’s Disease Research Center, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, United States
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Insomnia, sleep loss, and circadian sleep disturbances in mood disorders: a pathway toward neurodegeneration and neuroprogression? A theoretical review. CNS Spectr 2022; 27:298-308. [PMID: 33427150 DOI: 10.1017/s1092852921000018] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
The present paper aims at reviewing and commenting on the relationships between sleep and circadian phasing alterations and neurodegenerative/neuroprogressive processes in mood disorder. We carried out a systematic review, according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, in PubMed, PsycINFO, and Embase electronic databases for literature related to mood disorders, sleep disturbances, and neurodegenerative/neuroprogressive processes in relation to (1) neuroinflammation, (2) activation of the stress system, (3) oxidative stress, (4) accumulation of neurotoxic proteins, and (5) neuroprotection deficit. Seventy articles were collectively selected and analyzed. Experimental and clinical studies revealed that insomnia, conditions of sleep loss, and altered circadian sleep may favor neurodegeneration and neuroprogression in mood disorders. These sleep disturbances may induce a state of chronic inflammation by enhancing neuroinflammation, both directly and indirectly, via microglia and astrocytes activation. They may act as neurobiological stressors that by over-activating the stress system may negatively influence neural plasticity causing neuronal damage. In addition, sleep disturbances may favor the accumulation of neurotoxic proteins, favor oxidative stress, and a deficit in neuroprotection hence contributing to neurodegeneration and neuroprogression. Targeting sleep disturbances in the clinical practice may hold a neuroprotective value for mood disorders.
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Guo H, Zhang Y, Wang Z, Shen H. Sleep Quality Partially Mediate the Relationship Between Depressive Symptoms and Cognitive Function in Older Chinese: A Longitudinal Study Across 10 Years. Psychol Res Behav Manag 2022; 15:785-799. [PMID: 35391717 PMCID: PMC8982800 DOI: 10.2147/prbm.s353987] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Accepted: 03/16/2022] [Indexed: 01/13/2023] Open
Affiliation(s)
- Huan Guo
- School of Human Resources, Guangdong University of Finance & Economics, Guangzhou, People’s Republic of China
- Institute of Analytical Psychology, City University of Macau, Macau, People’s Republic of China
| | - Yancui Zhang
- Postdoctoral Research Center of School of Psychology, Nanjing Normal University, Nanjing, People’s Republic of China
| | - Zhendong Wang
- School of Basic Medical Sciences, Shanghai University of Traditional Chinese Medicine, Shanghai, People’s Republic of China
| | - Heyong Shen
- Institute of Analytical Psychology, City University of Macau, Macau, People’s Republic of China
- Correspondence: Heyong Shen, Email
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Chappel-Farley MG, Mander BA, Neikrug AB, Stehli A, Nan B, Grill JD, Yassa MA, Benca RM. Symptoms of obstructive sleep apnea are associated with less frequent exercise and worse subjective cognitive function across adulthood. Sleep 2022; 45:zsab240. [PMID: 34604910 PMCID: PMC8919199 DOI: 10.1093/sleep/zsab240] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Revised: 08/15/2021] [Indexed: 02/07/2023] Open
Abstract
STUDY OBJECTIVES To determine whether subjective measures of exercise and sleep are associated with cognitive complaints and whether exercise effects are mediated by sleep. METHODS This study analyzed questionnaire data from adults (18-89) enrolled in a recruitment registry. The Cognitive Function Instrument (CFI) assessed cognitive complaints. Medical Outcomes Study Sleep Scale (MOS-SS) subscales and factor scores assessed sleep quality, daytime sleepiness, nighttime disturbance, and insomnia and obstructive sleep apnea (OSA)-like symptoms. Exercise frequency was defined as the weekly number of exercise sessions. Exercise frequency, MOS-SS subscales, and factor scores were examined as predictors of CFI score, adjusting for age, body mass index, education, sex, cancer diagnosis, antidepressant usage, psychiatric conditions, and medical comorbidities. Analyses of covariance examined the relationship between sleep duration groups (short, mid-range, and long) and CFI score, adjusting for covariates. Mediation by sleep in the exercise-CFI score relationship was tested. RESULTS Data from 2106 adults were analyzed. Exercise and MOS-SS subscales and factor scores were associated with CFI score. Higher Sleep Adequacy scores were associated with fewer cognitive complaints, whereas higher Sleep Somnolence, Sleep Disturbance, Sleep Problems Index I, Sleep Problems Index II, and factor scores were associated with more cognitive complaints. MOS-SS subscales and factor scores, except Sleep Disturbance and the insomnia factor score, mediated the association between exercise and cognitive complaints. CONCLUSIONS The relationship between exercise frequency and subjective cognitive performance is mediated by sleep. In particular, the mediation effect appears to be driven by symptoms possibly suggestive of OSA which are negatively associated with exercise engagement, sleep quality, daytime sleepiness, and subjective cognitive performance.
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Affiliation(s)
- Miranda G Chappel-Farley
- Department of Neurobiology and Behavior, University of California, Irvine, Irvine, CA, USA
- Center for the Neurobiology of Learning and Memory, University of California, Irvine, Irvine, CA, USA
| | - Bryce A Mander
- Center for the Neurobiology of Learning and Memory, University of California, Irvine, Irvine, CA, USA
- Department of Psychiatry and Human Behavior, University of California, Irvine, Irvine, CA, USA
- Institute for Memory Impairments and Neurological Disorders, University of California, Irvine, Irvine, CA, USA
- Department of Cognitive Sciences, University of California Irvine, Irvine, CA, USA
| | - Ariel B Neikrug
- Department of Psychiatry and Human Behavior, University of California, Irvine, Irvine, CA, USA
| | - Annamarie Stehli
- Department of Psychiatry and Human Behavior, University of California, Irvine, Irvine, CA, USA
| | - Bin Nan
- Center for the Neurobiology of Learning and Memory, University of California, Irvine, Irvine, CA, USA
- Institute for Memory Impairments and Neurological Disorders, University of California, Irvine, Irvine, CA, USA
- Department of Statistics, University of California, Irvine, Irvine, CA, USA
| | - Joshua D Grill
- Department of Neurobiology and Behavior, University of California, Irvine, Irvine, CA, USA
- Department of Psychiatry and Human Behavior, University of California, Irvine, Irvine, CA, USA
- Institute for Memory Impairments and Neurological Disorders, University of California, Irvine, Irvine, CA, USA
| | - Michael A Yassa
- Department of Neurobiology and Behavior, University of California, Irvine, Irvine, CA, USA
- Center for the Neurobiology of Learning and Memory, University of California, Irvine, Irvine, CA, USA
- Department of Psychiatry and Human Behavior, University of California, Irvine, Irvine, CA, USA
- Institute for Memory Impairments and Neurological Disorders, University of California, Irvine, Irvine, CA, USA
| | - Ruth M Benca
- Department of Neurobiology and Behavior, University of California, Irvine, Irvine, CA, USA
- Center for the Neurobiology of Learning and Memory, University of California, Irvine, Irvine, CA, USA
- Department of Psychiatry and Human Behavior, University of California, Irvine, Irvine, CA, USA
- Institute for Memory Impairments and Neurological Disorders, University of California, Irvine, Irvine, CA, USA
- Department of Psychiatry and Behavioral Medicine, Wake Forest University, Winston-Salem, NC, USA
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Luo Y, Qiao M, Liang Y, Chen C, Zeng L, Wang L, Wu W. Functional Brain Connectivity in Mild Cognitive Impairment With Sleep Disorders: A Study Based on Resting-State Functional Magnetic Resonance Imaging. Front Aging Neurosci 2022; 14:812664. [PMID: 35360208 PMCID: PMC8960737 DOI: 10.3389/fnagi.2022.812664] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Accepted: 01/25/2022] [Indexed: 01/07/2023] Open
Abstract
Purpose To investigate the effect of sleep disorder (SD) on the changes of brain network dysfunction in mild cognitive impairment (MCI), we compared network connectivity patterns among MCI, SD, and comorbid MCI and sleep disorders (MCI-SD) patients using resting state functional magnetic resonance imaging (RS-fMRI). Patients and Methods A total of 60 participants were included in this study, 20 each with MCI, SD, or MCI-SD. And all participants underwent structural and functional MRI scanning. The default-mode network (DMN) was extracted by independent component analysis (ICA), and regional functional connectivity strengths were calculated and compared among groups. Results Compared to MCI patients, The DMN of MCI-SD patients demonstrated weaker functional connectivity with left middle frontal gyrus, right superior marginal gyrus, but stronger connectivity with the left parahippocampus, left precuneus and left middle temporal gyrus. Compared to the SD group, MCI-SD patients demonstrated weaker functional connectivity with right transverse temporal gyrus (Heschl’s gyrus), right precentral gyrus, and left insula, but stronger connectivity with posterior cerebellum, right middle occipital gyrus, and left precuneus. Conclusion Patients with MCI-SD show unique changes in brain network connectivity patterns compared to MCI or SD alone, likely reflecting a broader functional disconnection and the need to recruit more brain regions for functional compensation.
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Affiliation(s)
- Yuxi Luo
- Department of Geriatrics, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Mengyuan Qiao
- Department of Geriatrics, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Yuqing Liang
- Department of Geriatrics, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Chongli Chen
- Department of Geriatrics, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Lichuan Zeng
- Department of Radiology, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Lin Wang
- Health Management Center, Sichuan Academy of Medical Sciences and Sichuan Provincial People’s Hospital, Chengdu, China
| | - Wenbin Wu
- Department of Geriatrics, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
- *Correspondence: Wenbin Wu, , orcid.org/0000-0001-8784-6137
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45
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Zheng L, Wang Z, Liu Y, Zhao J, Huang S. Activation of the RMTg Nucleus by Chemogenetic Techniques Alleviates the Learning and Memory Impairment in APP/PS1 Mice. Neuropsychiatr Dis Treat 2022; 18:2957-2965. [PMID: 36573138 PMCID: PMC9789721 DOI: 10.2147/ndt.s388832] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Accepted: 12/06/2022] [Indexed: 12/23/2022] Open
Abstract
OBJECTIVE There is a relationship between non-rapid eye movement (NREM) sleep and Alzheimer's disease (AD). The rostromedial tegmental nucleus (RMTg) is activated can enhance NREM. Therefore, our experiment was designed to investigate the effects of activation of RMTg by chemical genetic techniques on APP/PS1 mice learning and memory. MATERIALS AND METHODS After the AAV-hSyn-hM3Dq-mCherry virus was injected into the RMTg nucleus, CNO solution was intraperitoneally injected to activate RMTg. The new object test and Morris water maze were used to determine the learning and memory level; T2-weighted imaging (T2WI) scanning was performed to analyze the volume of hippocampus and entorhinal cortex of each group; The virus transfection status was determined by laser confocal microscope and use immunohistochemical detection to observe the deposition of Beta Amyloid 1-42 (Aβ42). RESULTS Activation of RMTg by chemical genetic techniques can reduce the escape latency and increase discrimination index (RI) and the number of crossing platform; Activation of RMTg by chemical genetic techniques reduced the atrophy of the entorhinal cortex. Aβ42 deposition in the brain was decreased after activation of RMTg. CONCLUSION Activation of the RMTg nucleus by chemogenetic techniques can improve the learning and memory impairment in APP/PS1 mice.
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Affiliation(s)
- Ling Zheng
- Rehabilitation Hospital Affiliated to Fujian University of Traditional Chinese Medicine, Fuzhou, People's Republic of China.,College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, People's Republic of China.,Fujian Key Laboratory of Rehabilitation Technology, Fuzhou, People's Republic of China
| | - Zhenjie Wang
- College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, People's Republic of China
| | - Yujia Liu
- College of Traditional Chinese Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, People's Republic of China
| | - Jiapei Zhao
- Department of Rehabilitation Medicine, Xiamen Fifth Hospital, Xiamen, People's Republic of China
| | - Saie Huang
- Rehabilitation Hospital Affiliated to Fujian University of Traditional Chinese Medicine, Fuzhou, People's Republic of China.,Fujian Key Laboratory of Rehabilitation Technology, Fuzhou, People's Republic of China
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46
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Semyachkina-Glushkovskaya O, Penzel T, Blokhina I, Khorovodov A, Fedosov I, Yu T, Karandin G, Evsukova A, Elovenko D, Adushkina V, Shirokov A, Dubrovskii A, Terskov A, Navolokin N, Tzoy M, Ageev V, Agranovich I, Telnova V, Tsven A, Kurths J. Night Photostimulation of Clearance of Beta-Amyloid from Mouse Brain: New Strategies in Preventing Alzheimer's Disease. Cells 2021; 10:3289. [PMID: 34943796 PMCID: PMC8699220 DOI: 10.3390/cells10123289] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Revised: 11/19/2021] [Accepted: 11/22/2021] [Indexed: 12/11/2022] Open
Abstract
The deposition of amyloid-β (Aβ) in the brain is a risk factor for Alzheimer's disease (AD). Therefore, new strategies for the stimulation of Aβ clearance from the brain can be useful in preventing AD. Transcranial photostimulation (PS) is considered a promising method for AD therapy. In our previous studies, we clearly demonstrated the PS-mediated stimulation of lymphatic clearing functions, including Aβ removal from the brain. There is increasing evidence that sleep plays an important role in Aβ clearance. Here, we tested our hypothesis that PS at night can stimulate Aβ clearance from the brain more effectively than PS during the day. Our results on healthy mice show that Aβ clearance from the brain occurs faster at night than during wakefulness. The PS course at night improves memory and reduces Aβ accumulation in the brain of AD mice more effectively than the PS course during the day. Our results suggest that night PS is a more promising candidate as an effective method in preventing AD than daytime PS. These data are an important informative platform for the development of new noninvasive and nonpharmacological technologies for AD therapy as well as for preventing Aβ accumulation in the brain of people with disorder of Aβ metabolism, sleep deficit, elderly age, and jet lag.
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Affiliation(s)
- Oxana Semyachkina-Glushkovskaya
- Institute of Physics, Humboldt University, Newtonstrasse 15, 12489 Berlin, Germany;
- Department of Biology, Saratov State University, Astrakhanskaya 82, 410012 Saratov, Russia; (T.P.); (I.B.); (A.K.); (I.F.); (G.K.); (A.E.); (D.E.); (V.A.); (A.S.); (A.D.); (A.T.); (N.N.); (M.T.); (V.A.); (I.A.); (V.T.); (A.T.)
| | - Thomas Penzel
- Department of Biology, Saratov State University, Astrakhanskaya 82, 410012 Saratov, Russia; (T.P.); (I.B.); (A.K.); (I.F.); (G.K.); (A.E.); (D.E.); (V.A.); (A.S.); (A.D.); (A.T.); (N.N.); (M.T.); (V.A.); (I.A.); (V.T.); (A.T.)
- Sleep Medicine Center, Charité-Universitätsmedizin Berlin, Charitéplatz 1, 10117 Berlin, Germany
| | - Inna Blokhina
- Department of Biology, Saratov State University, Astrakhanskaya 82, 410012 Saratov, Russia; (T.P.); (I.B.); (A.K.); (I.F.); (G.K.); (A.E.); (D.E.); (V.A.); (A.S.); (A.D.); (A.T.); (N.N.); (M.T.); (V.A.); (I.A.); (V.T.); (A.T.)
| | - Alexander Khorovodov
- Department of Biology, Saratov State University, Astrakhanskaya 82, 410012 Saratov, Russia; (T.P.); (I.B.); (A.K.); (I.F.); (G.K.); (A.E.); (D.E.); (V.A.); (A.S.); (A.D.); (A.T.); (N.N.); (M.T.); (V.A.); (I.A.); (V.T.); (A.T.)
| | - Ivan Fedosov
- Department of Biology, Saratov State University, Astrakhanskaya 82, 410012 Saratov, Russia; (T.P.); (I.B.); (A.K.); (I.F.); (G.K.); (A.E.); (D.E.); (V.A.); (A.S.); (A.D.); (A.T.); (N.N.); (M.T.); (V.A.); (I.A.); (V.T.); (A.T.)
| | - Tingting Yu
- Britton Chance Center for Biomedical Photonics, Wuhan National Laboratory for Optoelectronics, Huazhong University of Science and Technology, Wuhan 430074, China;
- Collaborative Innovation Center for Biomedical Engineering, MoE Key Laboratory for Biomedical Photonics, School of Engineering Sciences, Huazhong University of Science and Technology, Wuhan 430074, China
| | - Georgy Karandin
- Department of Biology, Saratov State University, Astrakhanskaya 82, 410012 Saratov, Russia; (T.P.); (I.B.); (A.K.); (I.F.); (G.K.); (A.E.); (D.E.); (V.A.); (A.S.); (A.D.); (A.T.); (N.N.); (M.T.); (V.A.); (I.A.); (V.T.); (A.T.)
| | - Arina Evsukova
- Department of Biology, Saratov State University, Astrakhanskaya 82, 410012 Saratov, Russia; (T.P.); (I.B.); (A.K.); (I.F.); (G.K.); (A.E.); (D.E.); (V.A.); (A.S.); (A.D.); (A.T.); (N.N.); (M.T.); (V.A.); (I.A.); (V.T.); (A.T.)
| | - Dariya Elovenko
- Department of Biology, Saratov State University, Astrakhanskaya 82, 410012 Saratov, Russia; (T.P.); (I.B.); (A.K.); (I.F.); (G.K.); (A.E.); (D.E.); (V.A.); (A.S.); (A.D.); (A.T.); (N.N.); (M.T.); (V.A.); (I.A.); (V.T.); (A.T.)
| | - Viktoria Adushkina
- Department of Biology, Saratov State University, Astrakhanskaya 82, 410012 Saratov, Russia; (T.P.); (I.B.); (A.K.); (I.F.); (G.K.); (A.E.); (D.E.); (V.A.); (A.S.); (A.D.); (A.T.); (N.N.); (M.T.); (V.A.); (I.A.); (V.T.); (A.T.)
| | - Alexander Shirokov
- Department of Biology, Saratov State University, Astrakhanskaya 82, 410012 Saratov, Russia; (T.P.); (I.B.); (A.K.); (I.F.); (G.K.); (A.E.); (D.E.); (V.A.); (A.S.); (A.D.); (A.T.); (N.N.); (M.T.); (V.A.); (I.A.); (V.T.); (A.T.)
- Saratov Scientific Centre of the Russian Academy of Sciences (IBPPM RAS), Institute of Biochemistry and Physiology of Plants and Microorganisms, Prospekt Entuziastov 13, 410049 Saratov, Russia
| | - Alexander Dubrovskii
- Department of Biology, Saratov State University, Astrakhanskaya 82, 410012 Saratov, Russia; (T.P.); (I.B.); (A.K.); (I.F.); (G.K.); (A.E.); (D.E.); (V.A.); (A.S.); (A.D.); (A.T.); (N.N.); (M.T.); (V.A.); (I.A.); (V.T.); (A.T.)
| | - Andrey Terskov
- Department of Biology, Saratov State University, Astrakhanskaya 82, 410012 Saratov, Russia; (T.P.); (I.B.); (A.K.); (I.F.); (G.K.); (A.E.); (D.E.); (V.A.); (A.S.); (A.D.); (A.T.); (N.N.); (M.T.); (V.A.); (I.A.); (V.T.); (A.T.)
| | - Nikita Navolokin
- Department of Biology, Saratov State University, Astrakhanskaya 82, 410012 Saratov, Russia; (T.P.); (I.B.); (A.K.); (I.F.); (G.K.); (A.E.); (D.E.); (V.A.); (A.S.); (A.D.); (A.T.); (N.N.); (M.T.); (V.A.); (I.A.); (V.T.); (A.T.)
- Department of Pathological Anatomy, Saratov Medical State University, Kazachaya 112, 410012 Saratov, Russia
| | - Maria Tzoy
- Department of Biology, Saratov State University, Astrakhanskaya 82, 410012 Saratov, Russia; (T.P.); (I.B.); (A.K.); (I.F.); (G.K.); (A.E.); (D.E.); (V.A.); (A.S.); (A.D.); (A.T.); (N.N.); (M.T.); (V.A.); (I.A.); (V.T.); (A.T.)
| | - Vasily Ageev
- Department of Biology, Saratov State University, Astrakhanskaya 82, 410012 Saratov, Russia; (T.P.); (I.B.); (A.K.); (I.F.); (G.K.); (A.E.); (D.E.); (V.A.); (A.S.); (A.D.); (A.T.); (N.N.); (M.T.); (V.A.); (I.A.); (V.T.); (A.T.)
| | - Ilana Agranovich
- Department of Biology, Saratov State University, Astrakhanskaya 82, 410012 Saratov, Russia; (T.P.); (I.B.); (A.K.); (I.F.); (G.K.); (A.E.); (D.E.); (V.A.); (A.S.); (A.D.); (A.T.); (N.N.); (M.T.); (V.A.); (I.A.); (V.T.); (A.T.)
| | - Valeria Telnova
- Department of Biology, Saratov State University, Astrakhanskaya 82, 410012 Saratov, Russia; (T.P.); (I.B.); (A.K.); (I.F.); (G.K.); (A.E.); (D.E.); (V.A.); (A.S.); (A.D.); (A.T.); (N.N.); (M.T.); (V.A.); (I.A.); (V.T.); (A.T.)
| | - Anna Tsven
- Department of Biology, Saratov State University, Astrakhanskaya 82, 410012 Saratov, Russia; (T.P.); (I.B.); (A.K.); (I.F.); (G.K.); (A.E.); (D.E.); (V.A.); (A.S.); (A.D.); (A.T.); (N.N.); (M.T.); (V.A.); (I.A.); (V.T.); (A.T.)
| | - Jürgen Kurths
- Institute of Physics, Humboldt University, Newtonstrasse 15, 12489 Berlin, Germany;
- Department of Biology, Saratov State University, Astrakhanskaya 82, 410012 Saratov, Russia; (T.P.); (I.B.); (A.K.); (I.F.); (G.K.); (A.E.); (D.E.); (V.A.); (A.S.); (A.D.); (A.T.); (N.N.); (M.T.); (V.A.); (I.A.); (V.T.); (A.T.)
- Department of Complexity Science, Potsdam Institute for Climate Impact Research, Telegrafenberg A31, 14473 Potsdam, Germany
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Amyloid Burden in Alzheimer's Disease Patients Is Associated with Alterations in Circadian Rhythm. Dement Neurocogn Disord 2021; 20:99-107. [PMID: 34795773 PMCID: PMC8585536 DOI: 10.12779/dnd.2021.20.4.99] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2021] [Revised: 10/23/2021] [Accepted: 10/24/2021] [Indexed: 11/27/2022] Open
Abstract
Background and Purpose In this study we evaluated the relationship between amyloid-beta (Aβ) deposition and 3 aspects of sleep quality in a group of clinically diagnosed Alzheimer's disease (AD) patients. Methods We used self-report questionnaires to assess the quality of sleep using 3 previously established surveys: the Glasgow Sleep Effort Scale (GSES), the Pittsburgh Sleep Quality Index (PSQI), and the Morningness-Eveningness Questionnaire (MEQ). These questionnaires focused on the sleep effort, sleep efficiency, and circadian rhythm patterns of each participant. Also, we evaluated the regional distribution of Aβ in the brain by amyloid positron emission tomography-computed tomography (PET-CT) standardized uptake value ratios (SUVRs) in healthy normal (HN), mild cognitive impairment (MCI), and AD dementia groups. The MCI and AD dementia groups were combined to form the group with cognitive impairment due to AD (CIAD). Results GSES and MEQ scores differed significantly between the HN, MCI, and AD dementia groups (p<0.037), whereas PSQI scores were similar across the groups (p=0.129). GSES and MEQ scores also differed between the HN and CIAD groups (p<0.018). Circadian rhythm scores positively correlated with amyloid PET-CT SUVR in posterior cingulate cortices (p<0.049). Conclusions Sleep effort and abnormal shifts in circadian rhythm were more significant in the CIAD group than in the HN group. At the same time, HN subjects had minimal sleep disturbance, irrespective of clinical status. Thus, alterations in circadian rhythm may be indicative of neurodegeneration due to Aβ deposition.
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Levin F, Jelistratova I, Betthauser TJ, Okonkwo O, Johnson SC, Teipel SJ, Grothe MJ. In vivo staging of regional amyloid progression in healthy middle-aged to older people at risk of Alzheimer's disease. Alzheimers Res Ther 2021; 13:178. [PMID: 34674764 PMCID: PMC8532333 DOI: 10.1186/s13195-021-00918-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Accepted: 10/11/2021] [Indexed: 12/28/2022]
Abstract
BACKGROUND We investigated regional amyloid staging characteristics in 11C-PiB-PET data from middle-aged to older participants at elevated risk for AD enrolled in the Wisconsin Registry for Alzheimer's Prevention. METHODS We analyzed partial volume effect-corrected 11C-PiB-PET distribution volume ratio maps from 220 participants (mean age = 61.4 years, range 46.9-76.8 years). Regional amyloid positivity was established using region-specific thresholds. We used four stages from the frequency-based staging of amyloid positivity to characterize individual amyloid deposition. Longitudinal PET data was used to assess the temporal progression of stages and to evaluate the emergence of regional amyloid positivity in participants who were amyloid-negative at baseline. We also assessed the effect of amyloid stage on longitudinal cognitive trajectories. RESULTS The staging model suggested progressive accumulation of amyloid from associative to primary neocortex and gradually involving subcortical regions. Longitudinal PET measurements supported the cross-sectionally estimated amyloid progression. In mixed-effects longitudinal analysis of cognitive follow-up data obtained over an average period of 6.5 years following the baseline PET measurement, amyloid stage II showed a faster decline in executive function, and advanced amyloid stages (III and IV) showed a faster decline across multiple cognitive domains compared to stage 0. CONCLUSIONS Overall, the 11C-PiB-PET-based staging model was generally consistent with previously derived models from 18F-labeled amyloid PET scans and a longitudinal course of amyloid accumulation. Differences in longitudinal cognitive decline support the potential clinical utility of in vivo amyloid staging for risk stratification of the preclinical phase of AD even in middle-aged to older individuals at risk for AD.
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Affiliation(s)
- Fedor Levin
- German Center for Neurodegenerative Diseases (DZNE), Rostock/Greifswald, Rostock, Germany
| | - Irina Jelistratova
- German Center for Neurodegenerative Diseases (DZNE), Rostock/Greifswald, Rostock, Germany
| | - Tobey J Betthauser
- Division of Geriatrics and Gerontology, Department of Medicine, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI, USA
- Wisconsin Alzheimer's Disease Research Center, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI, USA
| | - Ozioma Okonkwo
- Division of Geriatrics and Gerontology, Department of Medicine, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI, USA
- Wisconsin Alzheimer's Disease Research Center, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI, USA
| | - Sterling C Johnson
- Division of Geriatrics and Gerontology, Department of Medicine, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI, USA
- Wisconsin Alzheimer's Disease Research Center, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI, USA
- Wisconsin Alzheimer's Institute, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI, USA
- Geriatric Research Education and Clinical Center, William S. Middleton Memorial Veterans Hospital, Madison, WI, USA
| | - Stefan J Teipel
- German Center for Neurodegenerative Diseases (DZNE), Rostock/Greifswald, Rostock, Germany
- Department of Psychosomatic Medicine, University of Rostock, Rostock, Germany
| | - Michel J Grothe
- German Center for Neurodegenerative Diseases (DZNE), Rostock/Greifswald, Rostock, Germany.
- Unidad de Trastornos del Movimiento, Servicio de Neurología y Neurofisiología Clínica, Instituto de Biomedicina de Sevilla, Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, s/n, 41013, Seville, Spain.
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Fu Y, Wang ZT, Qu Y, Wang XT, Ma YH, Bi YL, Dong Q, Tan L, Yu JT. Sleep Characteristics and Cognitive Function in Older Adults Without Dementia: The CABLE Study. J Alzheimers Dis 2021; 84:1029-1038. [PMID: 34602483 DOI: 10.3233/jad-215017] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND The associations between sleep characteristics and cognition are complicated. Alzheimer's disease (AD) pathologies have been proven to be associated with sleep characteristics. OBJECTIVE We aimed to investigate the associations between sleep characteristics and cognitive function and examine the roles of AD pathologies in modulating the association of sleep duration with cognition. METHODS A total of 974 participants who had measurements of cerebrospinal fluid (CSF) amyloid-β (Aβ), phosphorylated tau (P-tau), total tau proteins (T-tau), cognitive function, and sleep characteristics were included from the Chinese Alzheimer's Biomarker and Lifestyle (CABLE) study. Linear regression analyses were utilized to explore the associations of sleep characteristics with cognition. Non-linear regression analyses were utilized to explore the associations of sleep habits with cognition. Causal mediation analyses were conducted to explore the mediation effects of AD pathologies on cognition. RESULTS The Pittsburgh Sleep Quality Index (PSQI) total score was significantly negatively correlated with Montreal Cognitive Assessment (MoCA) score (p = 0.0176). Long latency (p = 0.0054) and low efficiency (p = 0.0273) were associated with cognitive impairment. Habitual nap behavior was associated with lower MoCA scores (p = 0.0045). U-shaped associations were observed between sleep habits (bedtime and nocturnal sleep duration) and cognition. A causal mediation analysis indicated that P-tau/Aβ42 mediated the association of sleep duration with cognition. CONCLUSION These findings showed sleep characteristics were associated with cognitive functions. Sleep habits (duration, bedtime) had U-shaped associations with cognition. AD core pathologies might partially mediate the influence of sleep duration on cognitive impairments.
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Affiliation(s)
- Yan Fu
- Department of Neurology, Qingdao Municipal Hospital, Qingdao University, Qingdao, China
| | - Zuo-Teng Wang
- College of Medicine and Pharmaceutics, Ocean University of China, Qingdao, China
| | - Yi Qu
- Department of Neurology, Qingdao Municipal Hospital, Qingdao University, Qingdao, China
| | - Xiao-Tong Wang
- Department of Neurology, Qingdao Municipal Hospital, Qingdao University, Qingdao, China
| | - Ya-Hui Ma
- Department of Neurology, Qingdao Municipal Hospital, Qingdao University, Qingdao, China
| | - Yan-Lin Bi
- Department of Anesthesiology, Qingdao Municipal Hospital, Qingdao University, Qingdao, China
| | - Qiang Dong
- Department of Neurology and Institute of Neurology, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, China
| | - Lan Tan
- Department of Neurology, Qingdao Municipal Hospital, Qingdao University, Qingdao, China.,College of Medicine and Pharmaceutics, Ocean University of China, Qingdao, China
| | - Jin-Tai Yu
- Department of Neurology and Institute of Neurology, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, China
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50
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Winer JR, Morehouse A, Fenton L, Harrison TM, Ayangma L, Reed M, Kumar S, Baker SL, Jagust WJ, Walker MP. Tau and β-Amyloid Burden Predict Actigraphy-Measured and Self-Reported Impairment and Misperception of Human Sleep. J Neurosci 2021; 41:7687-7696. [PMID: 34290080 PMCID: PMC8425979 DOI: 10.1523/jneurosci.0353-21.2021] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Revised: 05/23/2021] [Accepted: 06/30/2021] [Indexed: 11/21/2022] Open
Abstract
Alzheimer's disease is associated with poor sleep, but the impact of tau and β-amyloid (Aβ) pathology on sleep remains largely unknown. Here, we test the hypothesis that tau and Aβ predict unique impairments in objective and self-perceived human sleep under real-life, free-living conditions. Eighty-nine male and female cognitively healthy older adults received 18F-FTP-tau and 11C-PIB-Aβ PET imaging, 7 nights of sleep actigraphy and questionnaire measures, and neurocognitive assessment. Tau burden, but not Aβ, was associated with markedly worse objective sleep. In contrast, Aβ and tau were associated with worse self-reported sleep quality. Of clinical relevance, Aβ burden predicted a unique perceptual mismatch between objective and subject sleep evaluation, with individuals underestimating their sleep. The magnitude of this mismatch was further predicted by worse executive function. Thus, early-stage tau and Aβ deposition are linked with distinct phenotypes of real-world sleep impairment, one that includes a cognitive misperception of their own sleep health.SIGNIFICANCE STATEMENT Alzheimer's disease is associated with sleep disruption, often before significant memory decline. Thus, real-life patterns of sleep behavior have the potential to serve as a window into early disease progression. In 89 cognitive healthy older adults, we found that tau burden was associated with worse wristwatch actigraphy-measured sleep quality, and that both tau and β-amyloid were independently predictive of self-reported sleep quality. Furthermore, individuals with greater β-amyloid deposition were more likely to underestimate their sleep quality, and sleep quality underestimation was associated with worse executive function. These data support the role of sleep impairment as a key marker of early Alzheimer's disease, and offer the possibility that actigraphy may be an affordable and scalable tool in quantifying Alzheimer's disease-related behavioral changes.
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Affiliation(s)
- Joseph R Winer
- Center for Human Sleep Science, Department of Psychology, University of California Berkeley, Berkeley, California 94720
| | - Allison Morehouse
- Center for Human Sleep Science, Department of Psychology, University of California Berkeley, Berkeley, California 94720
| | - Laura Fenton
- Helen Wills Neuroscience Institute, University of California Berkeley, Berkeley, California 94720
| | - Theresa M Harrison
- Helen Wills Neuroscience Institute, University of California Berkeley, Berkeley, California 94720
| | - Lylian Ayangma
- Center for Human Sleep Science, Department of Psychology, University of California Berkeley, Berkeley, California 94720
| | - Mark Reed
- Center for Human Sleep Science, Department of Psychology, University of California Berkeley, Berkeley, California 94720
| | - Samika Kumar
- Center for Human Sleep Science, Department of Psychology, University of California Berkeley, Berkeley, California 94720
| | - Suzanne L Baker
- Molecular Biophysics and Integrated Bioimaging, Lawrence Berkeley National Laboratory, Berkeley, California 94720
| | - William J Jagust
- Helen Wills Neuroscience Institute, University of California Berkeley, Berkeley, California 94720
- Molecular Biophysics and Integrated Bioimaging, Lawrence Berkeley National Laboratory, Berkeley, California 94720
| | - Matthew P Walker
- Center for Human Sleep Science, Department of Psychology, University of California Berkeley, Berkeley, California 94720
- Helen Wills Neuroscience Institute, University of California Berkeley, Berkeley, California 94720
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