Autonomic dysregulation during sleep in Parkinsonian spectrum disorders - A proof of concept
Year: 2023
Type: article
Study design: Observational Study
Abstract: Introduction Autonomic dysfunction is common in α-synucleinopathies such as Lewy Body dementias (LBD), Parkinson's disease (PD), and isolated REM Sleep Behavior Disorder (iRBD). We analyzed pulse-rate changes during sleep to index autonomic nervous system (ANS) dysfunction in patients with α-synucleinopathies vs. non-synucleinopathy groups expected to have normal ANS function. Methods Patients with LBD (n = 16), PD (PD, n = 14) or iRBD (n = 12) were compared to the non-synucleinopathy groups Alzheimers disease dementia (ADem, n = 26), mild cognitive impairment (MCI, n = 34) or controls (CG, n = 54). Sleep Profiler was used to derive a sleep autonomic activation index (AAI), i.e., ≥6 beat-per-minute increase/decrease, pulse rate coefficient of variation (PR-CV), and automated sleep staging with sleep-spindles and non-REM hypertonia (NRH). Analysis included statistical group comparisons and receiver operating characteristics curves to determine optimal classification of groups. Results AAI and PR-CV were moderately correlated across all recordings (r s = 0.58, P < 0.0001), except in the LBD and PD groups. AAI but not PR-CV differentiated the LBD, PD and iRBD from non-Parkinsonian groups. AAI was decreased in LBD and PD patients compared to the CG (p < 0.003) and MCI (p < 0.03). AAI decreased based on age and its receiver operating characteristic area under the curve ranged from 0.63 to 0.75. AAI had a weak negative correlation to NRH ( r s ≤ −0.26) but not sleep-spindles. Conclusion Synucleinopathy-related ANS dysfunction can reasonably discriminate prodromal and manifest PD/LBD diseased groups from non-synucleinopathies. Further studies incorporating AAI into a multivariate classifier of neurodegenerative disorders based on sleep characteristics acquired in the patient's home are planned.
Source: Parkinsonism & Related Disorders
Language: English
Subfield: Neurology
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Estimated APC paid: $3,490
Funders: Mayo Clinic, American Brain Foundation, Biogen, Little Family Foundation, Demensförbundet, Rainwater Charitable Foundation, Lewy Body Dementia Association, NASA Astrobiology Institute, National Institutes of Health, National Institute on Aging, National Center for Research Resources, National Center for Advancing Translational Sciences
Awards: G1249096266, G1518247731, G1607903957, G1701317796, G1920149463, G2080821709, G2115204312, G2362320408, G3047439003, G4065343422, G423967958, Use of wearable sensors to improve the early diagnosis of DLB, G4714069985, G7950084162, G8368175428, G8631926226, G9000000531, G9000017824, G9000019053, G9000025438, G9000036524, G9000149257, G9000159546, G9000251353, G9000338350, G9000348259, Clinical Features and Neuropathological Basis of Sleep Wake Behavior in Alzheimer's and PSP, G992556200
OpenAlex ID: W4388282476