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Erschienen in: Sleep and Breathing 2/2020

30.11.2019 | Neurology • Original Article

Sleep spindles, K-complexes, limb movements and sleep stage proportions may be biomarkers for amnestic mild cognitive impairment and Alzheimer’s disease

verfasst von: Shunjie Liu, Junhao Pan, Ke Tang, Qingfeng Lei, Lu He, Yangyang Meng, Xiaodong Cai, Zhong Li

Erschienen in: Sleep and Breathing | Ausgabe 2/2020

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Abstract

Purpose

Sleep disturbances are common in Alzheimer’s disease (AD) and mild cognitive impairment (MCI) patients. Non-rapid eye movement stage 3 (N3), rapid eye movement stage (REM), spindle density, and K-complex (KC) density are decreased in MCI and AD patients. Periodic limb movements in sleep (PLMS) are increased in other neurodegenerative diseases. We aimed to distinguish amnestic mild cognitive impairment (aMCI) patients from the overall population of MCI patients by comparing the N3 and REM proportions, the morphological characteristics of spindles and KCs and the periodic limb movement index (PLMI) among control, aMCI and AD subjects.

Methods

In 92 subjects (30 controls, 32 aMCI and 30 AD), sleep stages, spindles, KCs and PLMS were recorded during the second of two nights of polysomnography (PSG). We compared the above parameters among the three groups.

Results

AD and aMCI subjects had lower proportions of N3 and REM, poorer spindle and KC activities and more frequent PLMS than controls. These alterations were associated with decreased Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA) scores. We determined cut-off values for distinguishing aMCI and AD using logistic regression and receiver operating characteristic (ROC) analyses.

Conclusions

AD and aMCI patients have abnormal sleep stage proportions, spindles, KCs and PLMS. The combination of the above alterations may distinguish aMCI and AD patients from controls with high specificity and sensitivity.
Literatur
1.
Zurück zum Zitat Gutierrez A, Vitorica J (2018) Toward a new concept of Alzheimer's disease models: a perspective from neuroinflammation. J Alzheimers Dis 64(s1):S329–S338 Gutierrez A, Vitorica J (2018) Toward a new concept of Alzheimer's disease models: a perspective from neuroinflammation. J Alzheimers Dis 64(s1):S329–S338
2.
Zurück zum Zitat Wimo A, Jonsson L, Bond J, Prince M, Winblad B (2013) The worldwide economic impact of dementia 2010. Alzheimers Dement 9(1):1–11 Wimo A, Jonsson L, Bond J, Prince M, Winblad B (2013) The worldwide economic impact of dementia 2010. Alzheimers Dement 9(1):1–11
3.
Zurück zum Zitat Gunn DG, Naismith SL, Terpening Z, Lewis SJ (2014) The relationships between poor sleep efficiency and mild cognitive impairment in Parkinson disease. J Geriatr Psychiatry Neurol 27(2):77–84 Gunn DG, Naismith SL, Terpening Z, Lewis SJ (2014) The relationships between poor sleep efficiency and mild cognitive impairment in Parkinson disease. J Geriatr Psychiatry Neurol 27(2):77–84
4.
Zurück zum Zitat Malone C, Deason RG, Palumbo R, Heyworth N, Tat M, Budson AE (2018) False memories in patients with mild cognitive impairment and mild Alzheimer's disease dementia: can cognitive strategies help? J Clin Exp Neuropsychol 41(2):204–218 Malone C, Deason RG, Palumbo R, Heyworth N, Tat M, Budson AE (2018) False memories in patients with mild cognitive impairment and mild Alzheimer's disease dementia: can cognitive strategies help? J Clin Exp Neuropsychol 41(2):204–218
5.
Zurück zum Zitat Ansai JH, Andrade LP, Rossi PG, Takahashi ACM, Vale FAC, Rebelatto JR (2017) Gait, dual task and history of falls in elderly with preserved cognition, mild cognitive impairment, and mild Alzheimer's disease. Braz J Phys Ther 21(2):144–151 Ansai JH, Andrade LP, Rossi PG, Takahashi ACM, Vale FAC, Rebelatto JR (2017) Gait, dual task and history of falls in elderly with preserved cognition, mild cognitive impairment, and mild Alzheimer's disease. Braz J Phys Ther 21(2):144–151
6.
Zurück zum Zitat Mander BA, Winer JR, Walker MP (2017) Sleep and human aging. Neuron 94(1):19–36 Mander BA, Winer JR, Walker MP (2017) Sleep and human aging. Neuron 94(1):19–36
7.
Zurück zum Zitat Hu M, Zhang P, Li C, Tan Y, Li G, Xu D, Chen L (2017) Sleep disturbance in mild cognitive impairment: a systematic review of objective measures. Neurol Sci 38(8):1363–1371 Hu M, Zhang P, Li C, Tan Y, Li G, Xu D, Chen L (2017) Sleep disturbance in mild cognitive impairment: a systematic review of objective measures. Neurol Sci 38(8):1363–1371
8.
Zurück zum Zitat Mander BA, Winer JR, Jagust WJ, Walker MP (2016) Sleep: a novel mechanistic pathway, biomarker, and treatment target in the pathology of Alzheimer's disease? Trends Neurosci 39(8):552–566 Mander BA, Winer JR, Jagust WJ, Walker MP (2016) Sleep: a novel mechanistic pathway, biomarker, and treatment target in the pathology of Alzheimer's disease? Trends Neurosci 39(8):552–566
9.
Zurück zum Zitat Westerberg CE, Mander BA, Florczak SM, Weintraub S, Mesulam MM, Zee PC, Paller KA (2012) Concurrent impairments in sleep and memory in amnestic mild cognitive impairment. J Int Neuropsychol Soc 18(03):490–500 Westerberg CE, Mander BA, Florczak SM, Weintraub S, Mesulam MM, Zee PC, Paller KA (2012) Concurrent impairments in sleep and memory in amnestic mild cognitive impairment. J Int Neuropsychol Soc 18(03):490–500
10.
Zurück zum Zitat Mander BA, Zhu AH, Lindquist JR, Villeneuve S, Rao V, Lu B, Saletin JM, Ancoli-Israel S, Jagust WJ, Walker MP (2017) White matter structure in older adults moderates the benefit of sleep spindles on motor memory consolidation. J Neurosci 37(48):11675–11687 Mander BA, Zhu AH, Lindquist JR, Villeneuve S, Rao V, Lu B, Saletin JM, Ancoli-Israel S, Jagust WJ, Walker MP (2017) White matter structure in older adults moderates the benefit of sleep spindles on motor memory consolidation. J Neurosci 37(48):11675–11687
11.
Zurück zum Zitat Ju YS, Ooms SJ, Sutphen C, Macauley SL, Zangrilli MA, Jerome G, Fagan AM, Mignot E, Zempel JM, Claassen JAHR, Holtzman DM (2017) Slow wave sleep disruption increases cerebrospinal fluid amyloid-β levels. Brain 140(8):2104–2111 Ju YS, Ooms SJ, Sutphen C, Macauley SL, Zangrilli MA, Jerome G, Fagan AM, Mignot E, Zempel JM, Claassen JAHR, Holtzman DM (2017) Slow wave sleep disruption increases cerebrospinal fluid amyloid-β levels. Brain 140(8):2104–2111
12.
Zurück zum Zitat Mander BA, Marks SM, Vogel JW, Rao V, Lu B, Saletin JM, Ancoli-Israel S, Jagust WJ, Walker MP (2015) β-amyloid disrupts human NREM slow waves and related hippocampus-dependent memory consolidation. Nat Neurosci 18(7):1051–1057 Mander BA, Marks SM, Vogel JW, Rao V, Lu B, Saletin JM, Ancoli-Israel S, Jagust WJ, Walker MP (2015) β-amyloid disrupts human NREM slow waves and related hippocampus-dependent memory consolidation. Nat Neurosci 18(7):1051–1057
13.
Zurück zum Zitat De Gennaro L, Ferrara M (2003) Sleep spindles: an overview. Sleep Med Rev 7(5):423–440 De Gennaro L, Ferrara M (2003) Sleep spindles: an overview. Sleep Med Rev 7(5):423–440
14.
Zurück zum Zitat Crowley K, Trinder J, Colrain IM (2002) An examination of evoked K-complex amplitude and frequency of occurrence in the elderly. J Sleep Res 11(2):129–140 Crowley K, Trinder J, Colrain IM (2002) An examination of evoked K-complex amplitude and frequency of occurrence in the elderly. J Sleep Res 11(2):129–140
15.
Zurück zum Zitat Cairney SA, Guttesen AÁV, El Marj N, Staresina BP (2018) Memory consolidation is linked to spindle-mediated information processing during sleep. Curr Biol 28(6):948–954 Cairney SA, Guttesen AÁV, El Marj N, Staresina BP (2018) Memory consolidation is linked to spindle-mediated information processing during sleep. Curr Biol 28(6):948–954
16.
Zurück zum Zitat Gorgoni M, Lauri G, Truglia I, Cordone S, Sarasso S, Scarpelli S, Mangiaruga A, Atri DA et al (2016) Parietal fast sleep spindle density decrease in Alzheimer’s disease and amnesic mild cognitive impairmenT. Neural Plast 2016:1–10 Gorgoni M, Lauri G, Truglia I, Cordone S, Sarasso S, Scarpelli S, Mangiaruga A, Atri DA et al (2016) Parietal fast sleep spindle density decrease in Alzheimer’s disease and amnesic mild cognitive impairmenT. Neural Plast 2016:1–10
17.
Zurück zum Zitat Reda F, Gorgoni M, Lauri G, Truglia I, Cordone S, Scarpelli S, Mangiaruga A, D'Atri A et al (2017) In Search of sleep biomarkers of Alzheimer’s disease: K-complexes do not discriminate between patients with mild cognitive impairment and healthy controls. Brain Sci 7(12):51 Reda F, Gorgoni M, Lauri G, Truglia I, Cordone S, Scarpelli S, Mangiaruga A, D'Atri A et al (2017) In Search of sleep biomarkers of Alzheimer’s disease: K-complexes do not discriminate between patients with mild cognitive impairment and healthy controls. Brain Sci 7(12):51
18.
Zurück zum Zitat De Gennaro L, Gorgoni M, Reda F, Lauri G, Truglia I, Cordone S, Scarpelli S, Mangiaruga A et al (2017) The fall of sleep K-complex in Alzheimer disease. Sci Rep 7(1):39688 De Gennaro L, Gorgoni M, Reda F, Lauri G, Truglia I, Cordone S, Scarpelli S, Mangiaruga A et al (2017) The fall of sleep K-complex in Alzheimer disease. Sci Rep 7(1):39688
19.
Zurück zum Zitat Taillard J, Sagaspe P, Berthomier C, Brandewinder M, Amieva H, Dartigues J, Rainfray M, Harston S et al (2019) Non-REM sleep characteristics predict early cognitive impairment in an aging population. Front Neurol 10:197 Taillard J, Sagaspe P, Berthomier C, Brandewinder M, Amieva H, Dartigues J, Rainfray M, Harston S et al (2019) Non-REM sleep characteristics predict early cognitive impairment in an aging population. Front Neurol 10:197
20.
Zurück zum Zitat Schilling C, Schlipf M, Spietzack S, Rausch F, Eisenacher S, Englisch S, Reinhard I, Haller L, Grimm O, Deuschle M, Tost H, Zink M, Meyer-Lindenberg A, Schredl M (2017) Fast sleep spindle reduction in schizophrenia and healthy first-degree relatives: association with impaired cognitive function and potential intermediate phenotype. Eur Arch Psychiatry Clin Neurosci 267(3):213–224 Schilling C, Schlipf M, Spietzack S, Rausch F, Eisenacher S, Englisch S, Reinhard I, Haller L, Grimm O, Deuschle M, Tost H, Zink M, Meyer-Lindenberg A, Schredl M (2017) Fast sleep spindle reduction in schizophrenia and healthy first-degree relatives: association with impaired cognitive function and potential intermediate phenotype. Eur Arch Psychiatry Clin Neurosci 267(3):213–224
21.
Zurück zum Zitat Gorgoni M, Reda F, D'Atri A, Scarpelli S, Ferrara M, De Gennaro L (2019) The heritability of the human K-complex: a twin study. Sleep 42(6) Gorgoni M, Reda F, D'Atri A, Scarpelli S, Ferrara M, De Gennaro L (2019) The heritability of the human K-complex: a twin study. Sleep 42(6)
22.
Zurück zum Zitat Natarajan R (2010) Review of periodic limb movement and restless leg syndrome. J Postgrad Med 56(2):157–162 Natarajan R (2010) Review of periodic limb movement and restless leg syndrome. J Postgrad Med 56(2):157–162
23.
Zurück zum Zitat Wu M, Tseng P, Chen T, Chen Y, Liou L, Lin P, Hsu C (2018) The efficacy and tolerability of rotigotine on patients with periodic limb movement in sleep: a systematic review and meta-analysis. PLoS One 13(4):e195473 Wu M, Tseng P, Chen T, Chen Y, Liou L, Lin P, Hsu C (2018) The efficacy and tolerability of rotigotine on patients with periodic limb movement in sleep: a systematic review and meta-analysis. PLoS One 13(4):e195473
24.
Zurück zum Zitat Högl B, Stefani A (2017) Restless legs syndrome and periodic leg movements in patients with movement disorders: specific considerations. Mov Disord 32(5):669–681 Högl B, Stefani A (2017) Restless legs syndrome and periodic leg movements in patients with movement disorders: specific considerations. Mov Disord 32(5):669–681
25.
Zurück zum Zitat Chwiszczuk L, Breitve M, Hynninen M, Gjerstad MD, Aarsland D, Rongve A (2016) Higher frequency and complexity of sleep disturbances in dementia with Lewy bodies as compared to Alzheimer's disease. Neurodegener Dis 16(3-4):152–160 Chwiszczuk L, Breitve M, Hynninen M, Gjerstad MD, Aarsland D, Rongve A (2016) Higher frequency and complexity of sleep disturbances in dementia with Lewy bodies as compared to Alzheimer's disease. Neurodegener Dis 16(3-4):152–160
26.
Zurück zum Zitat Albers JA, Chand P, Anch AM (2017) Multifactorial sleep disturbance in Parkinson's disease. Sleep Med 35:41–48 Albers JA, Chand P, Anch AM (2017) Multifactorial sleep disturbance in Parkinson's disease. Sleep Med 35:41–48
27.
Zurück zum Zitat Petersen RC (2004) Mild cognitive impairment as a diagnostic entity. J Intern Med 256(3):183–194 Petersen RC (2004) Mild cognitive impairment as a diagnostic entity. J Intern Med 256(3):183–194
28.
Zurück zum Zitat Association AP (2013) Diagnostic and statistical manual of mental disorders, 5th edn. American Psychiatric Publishing, Washington Association AP (2013) Diagnostic and statistical manual of mental disorders, 5th edn. American Psychiatric Publishing, Washington
29.
Zurück zum Zitat McKhann GM, Knopman DS, Chertkow H, Hyman BT, Jack CJ, Kawas CH, Klunk WE, Koroshetz WJ et al (2011) The diagnosis of dementia due to Alzheimer's disease: recommendations from the National Institute on Aging-Alzheimer's Association workgroups on diagnostic guidelines for Alzheimer's disease. Alzheimers Dement 7(3):263–269 McKhann GM, Knopman DS, Chertkow H, Hyman BT, Jack CJ, Kawas CH, Klunk WE, Koroshetz WJ et al (2011) The diagnosis of dementia due to Alzheimer's disease: recommendations from the National Institute on Aging-Alzheimer's Association workgroups on diagnostic guidelines for Alzheimer's disease. Alzheimers Dement 7(3):263–269
30.
Zurück zum Zitat Hamilton M (1967) Development of a rating scale for primary depressive illness. Br J Soc Clin Psychol 4(6):278–296 Hamilton M (1967) Development of a rating scale for primary depressive illness. Br J Soc Clin Psychol 4(6):278–296
31.
Zurück zum Zitat Klem GH, Luders HO, Jasper HH, Elger C (1999) The ten-twenty electrode system of the International Federation. The International Federation of Clinical Neurophysiology. Electroencephalogr Clin Neurophysiol Suppl 52:3–6 Klem GH, Luders HO, Jasper HH, Elger C (1999) The ten-twenty electrode system of the International Federation. The International Federation of Clinical Neurophysiology. Electroencephalogr Clin Neurophysiol Suppl 52:3–6
32.
Zurück zum Zitat Iber C, Ancoli-Israel S, Chesson A, Quan S (2007) for the American Academyof Sleep Medicine. The AASM manual for the scoring of sleep and associated events; rules, terminology and technical specifcations, 1st edn. American Academy of Sleep Medicine, Westchester Iber C, Ancoli-Israel S, Chesson A, Quan S (2007) for the American Academyof Sleep Medicine. The AASM manual for the scoring of sleep and associated events; rules, terminology and technical specifcations, 1st edn. American Academy of Sleep Medicine, Westchester
33.
Zurück zum Zitat Molle M, Marshall L, Gais S, Born J (2002) Grouping of spindle activity during slow oscillations in human non-rapid eye movement sleep. J Neurosci 22(24):10941–10947 Molle M, Marshall L, Gais S, Born J (2002) Grouping of spindle activity during slow oscillations in human non-rapid eye movement sleep. J Neurosci 22(24):10941–10947
34.
Zurück zum Zitat Bastien CH, St-Jean G, Turcotte I, Morin CM, Lavallee M, Carrier J, Forget D (2009) Spontaneous K-complexes in chronic psychophysiological insomnia. J Psychosom Res 67(2):117–125 Bastien CH, St-Jean G, Turcotte I, Morin CM, Lavallee M, Carrier J, Forget D (2009) Spontaneous K-complexes in chronic psychophysiological insomnia. J Psychosom Res 67(2):117–125
35.
Zurück zum Zitat Crowley K, Trinder J, Kim Y, Carrington M, Colrain IM (2002) The effects of normal aging on sleep spindle and K-complex production. Clin Neurophysiol 113(10):1615–1622 Crowley K, Trinder J, Kim Y, Carrington M, Colrain IM (2002) The effects of normal aging on sleep spindle and K-complex production. Clin Neurophysiol 113(10):1615–1622
36.
Zurück zum Zitat Hashemi NS, Dehnavi F, Moghimi S, Ghorbani M (2019) Slow spindles are associated with cortical high frequency activity. Neuroimage 189:71–84 Hashemi NS, Dehnavi F, Moghimi S, Ghorbani M (2019) Slow spindles are associated with cortical high frequency activity. Neuroimage 189:71–84
37.
Zurück zum Zitat Molle M, Bergmann TO, Marshall L, Born J (2011) Fast and slow spindles during the sleep slow oscillation: disparate coalescence and engagement in memory processing. Sleep 34(10):1411–1421 Molle M, Bergmann TO, Marshall L, Born J (2011) Fast and slow spindles during the sleep slow oscillation: disparate coalescence and engagement in memory processing. Sleep 34(10):1411–1421
38.
Zurück zum Zitat Guo S, Huang J, Jiang H, Han C, Li J, Xu X, Zhang G, Lin Z et al (2017) Restless legs syndrome: from pathophysiology to clinical diagnosis and management. Front Aging Neurosci 9:171 Guo S, Huang J, Jiang H, Han C, Li J, Xu X, Zhang G, Lin Z et al (2017) Restless legs syndrome: from pathophysiology to clinical diagnosis and management. Front Aging Neurosci 9:171
39.
Zurück zum Zitat Amelio DM, Puglisi-Allegra S, Mercuri N (2018) The role of dopaminergic midbrain in Alzheimer’s disease: translating basic science into clinical practice. Pharmacol Res 130:414–419 Amelio DM, Puglisi-Allegra S, Mercuri N (2018) The role of dopaminergic midbrain in Alzheimer’s disease: translating basic science into clinical practice. Pharmacol Res 130:414–419
40.
Zurück zum Zitat Hibi S, Yamaguchi Y, Umeda-Kameyama Y, Yamamoto H, Iijima K, Momose T, Akishita M, Ouchi Y (2012) The high frequency of periodic limb movements in patients with Lewy body dementia. J Psychiatr Res 46(12):1590–1594 Hibi S, Yamaguchi Y, Umeda-Kameyama Y, Yamamoto H, Iijima K, Momose T, Akishita M, Ouchi Y (2012) The high frequency of periodic limb movements in patients with Lewy body dementia. J Psychiatr Res 46(12):1590–1594
41.
Zurück zum Zitat Roberts RO, Knopman DS, Geda YE, Cha RH, Roger VL, Petersen RC (2010) Coronary heart disease is associated with non-amnestic mild cognitive impairment. Neurobiol Aging 31(11):1894–1902 Roberts RO, Knopman DS, Geda YE, Cha RH, Roger VL, Petersen RC (2010) Coronary heart disease is associated with non-amnestic mild cognitive impairment. Neurobiol Aging 31(11):1894–1902
42.
Zurück zum Zitat Oltra-Cucarella J, Delgado S, Duque P, Pérez-Vicente JA, Cabello-Rodríguez L (2018) Encoding deficits in low-educated individuals with non-amnestic mild cognitive impairment. Analysis of memory processes using the Item Specific Deficit Approach. Psychiatry Res 268:211–216 Oltra-Cucarella J, Delgado S, Duque P, Pérez-Vicente JA, Cabello-Rodríguez L (2018) Encoding deficits in low-educated individuals with non-amnestic mild cognitive impairment. Analysis of memory processes using the Item Specific Deficit Approach. Psychiatry Res 268:211–216
43.
Zurück zum Zitat Boyce R, Williams S, Adamantidis A (2017) REM sleep and memory. Curr Opin Neurobiol 44:167–177 Boyce R, Williams S, Adamantidis A (2017) REM sleep and memory. Curr Opin Neurobiol 44:167–177
44.
Zurück zum Zitat Skelin I, Kilianski S, McNaughton BL (2019) Hippocampal coupling with cortical and subcortical structures in the context of memory consolidation. Neurobiol Learn Mem 160:21–31 Skelin I, Kilianski S, McNaughton BL (2019) Hippocampal coupling with cortical and subcortical structures in the context of memory consolidation. Neurobiol Learn Mem 160:21–31
45.
Zurück zum Zitat Paraskevaidi M, Morais C, Halliwell DE, Mann D, Allsop D, Martin-Hirsch PL, Martin FL (2018) Raman spectroscopy to diagnose Alzheimer's disease and dementia with Lewy bodies in blood. ACS Chem Neurosci 9(11):2786–2794 Paraskevaidi M, Morais C, Halliwell DE, Mann D, Allsop D, Martin-Hirsch PL, Martin FL (2018) Raman spectroscopy to diagnose Alzheimer's disease and dementia with Lewy bodies in blood. ACS Chem Neurosci 9(11):2786–2794
46.
Zurück zum Zitat Crowley K (2004) Evoked K-complex generation: the impact of sleep spindles and age. Clin Neurophysiol 115(2):471–476 Crowley K (2004) Evoked K-complex generation: the impact of sleep spindles and age. Clin Neurophysiol 115(2):471–476
Metadaten
Titel
Sleep spindles, K-complexes, limb movements and sleep stage proportions may be biomarkers for amnestic mild cognitive impairment and Alzheimer’s disease
verfasst von
Shunjie Liu
Junhao Pan
Ke Tang
Qingfeng Lei
Lu He
Yangyang Meng
Xiaodong Cai
Zhong Li
Publikationsdatum
30.11.2019
Verlag
Springer International Publishing
Erschienen in
Sleep and Breathing / Ausgabe 2/2020
Print ISSN: 1520-9512
Elektronische ISSN: 1522-1709
DOI
https://doi.org/10.1007/s11325-019-01970-9

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