Â鶹´«Ã½Ó³»­

Â鶹´«Ã½Ó³»­

Explore the latest content from across our publications
Join The Â鶹´«Ã½Ó³»­

Log In

Forgot Password?
Create New Account

Loading... please wait

Abstract Details

Non-REM Sleep with Hypertonia: A Potential Prodromal Biomarker for a-Synuclein-Related Neurodegenerative Disease
Aging, Dementia, and Behavioral Neurology
Aging and Dementia Posters (7:00 AM-5:00 PM)
078

Explore non-REM Sleep with Hypertonia (NRSH) as a biomarker in alpha-synuclein related diseases.
REM sleep without atonia (RSWA) is the principal electrophysiological sleep biomarker associated with alpha-synuclein conditions [i.e., REM sleep behavior disorder (RBD), Parkinson’s disease with Dementia (PDD) and Dementia with Lewy Bodies (DLB)].  Whether hypertonia also occurs in NREM sleep in synucleinopathies remains unclear.

Data were acquired during a multi-site study that included subjects with normal cognition (NC: n=65;age=64+8.9), and patients diagnosed with mild cognitive impairment (MCI: n=33;age=70+8.3), Alzheimer’s disease dementia (AD: n=16;age=73+7.2), RBD (n=22;age=65+10.3) and DLB/PDD (n=10;age=71+4.7).  Patients with RBD were studied during laboratory-PSG with simultaneous Sleep ProfilerTM (SP), all others self-applied the SP in-home with 82% recording two-nights.   

The records were auto-staged with SP and then technically reviewed.  NRSH, i.e., persistent, periodic episodes of elevated frontalis muscle EMG activity, was auto-detected using an algorithm that included comparisons of delta vs. theta power, and both relative to the power >40 Hz.  Analyses were performed using multiple logistic regression, Pearson correlation, and Chi-squared Fisher Exact Probability tests.

NRSH was predictive of NC vs. DLB/PDD plus RBD (p=0.02;odds=1.14;95%CI 1.03-1.26), but not NC vs. AD or MCI.

%NRSH had strong night-to-night reliability (ICC=0.79;p<0.0001;n=100;NC=59;MCI=22;AD=9;DLB/PDD=10) and significant one-year test-retest reliability in NC (ICC=0.51;p=0.007;n=26).  

Median distributions of %NRSH (+IQR) were: DLB/PDD=9.5(5.4-17.0), RBD=9.0(0.8-16.4), MCI=1.2(0.0-4.4), AD=0.9(0.2-3.3), and NC=1.4(0.0-4.2).   

The within-group distributions with >5% NRSH were significantly greater for DLB/PDD=70.0% and RBD=68.2% vs. NC=18.5%, MCI=21.2%, AD=12.5% [DLB/PDD vs. NC (p=0.002;odds=10.3;95%CI=2.3-45.8), MCI (p=0.007;odds=8.7;95%CI=1.8-42.5) and AD (p<0.005,odds=16.3;95%CI=2.2-121.4)][RBD vs. NC (p<0.0001;odds=9.5;95%CI=3.2-28.3), MCI (p<0.001;odds=8.0;95%CI=2.3-27.1) and AD (p<0.001,odds=15.0;95%CI=2.7-84.8)].

When compared to AD, MCI or NC, patients with RBD and DLB/PDD exhibited the greatest proportion of NRSH, similar to patterns of RSWA in α-synucleinopathy-related neurodegenerative diseases.   Further exploration of associations between NRSH and RSWA frequency and duration, and whether NRSH may aid distinction between different synucleinopathy phenotypes is planned.
Authors/Disclosures
Daniel Levendowski (Advanced Brain Monitoring, Inc.)
PRESENTER 		Daniel Levendowski has received personal compensation for serving as an employee of Advanced Brain Monitoring, Inc.. Daniel Levendowski has received personal compensation in the range of $0-$499 for serving as an officer or member of the Board of Directors for Advanced Brain Monitoring, Inc. Daniel Levendowski has received stock or an ownership interest from Advanced Brain Monitoring, Inc. The institution of Daniel Levendowski has received research support from National Institute of Health . Daniel Levendowski has received intellectual property interests from a discovery or technology relating to health care.
Bradley F. Boeve, MD, FÂ鶹´«Ã½Ó³»­ (Mayo Clinic) Dr. Boeve has received personal compensation in the range of $10,000-$49,999 for serving as an officer or member of the Board of Directors for Rainwater Charitable Foundation. The institution of Dr. Boeve has received research support from Alector. The institution of Dr. Boeve has received research support from EIP Pharma. The institution of Dr. Boeve has received research support from Transposon. The institution of Dr. Boeve has received research support from Cognition Therapeutics. Dr. Boeve has received publishing royalties from a publication relating to health care.
David Shprecher, DO, FÂ鶹´«Ã½Ó³»­ (Banner Sun Health Research Institute) Dr. Shprecher has received personal compensation for serving as an employee of Banner Health. Dr. Shprecher has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Amneal. Dr. Shprecher has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Sanders+Parks. Dr. Shprecher has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Neurocrine. Dr. Shprecher has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Abbvie. Dr. Shprecher has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Kyowa Kirin. Dr. Shprecher has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Medplace. The institution of Dr. Shprecher has received research support from MJFF. The institution of Dr. Shprecher has received research support from Cognition Therapeutics. The institution of Dr. Shprecher has received research support from Biogen. The institution of Dr. Shprecher has received research support from Neuraly. The institution of Dr. Shprecher has received research support from Jazz Pharmaceuticals. The institution of Dr. Shprecher has received research support from Sanofi Aventis. The institution of Dr. Shprecher has received research support from Annovis. The institution of Dr. Shprecher has received research support from Neurocrine. The institution of Dr. Shprecher has received research support from Teva. The institution of Dr. Shprecher has received research support from Nuvelution. The institution of Dr. Shprecher has received research support from EIP Pharma. Dr. Shprecher has received personal compensation in the range of $500-$4,999 for serving as a Speaker with International Parkinson's and MDS. Dr. Shprecher has received personal compensation in the range of $5,000-$9,999 for serving as a Speaker with Parkinson's Movement Disorder Alliance.
Joyce K. Lee-Iannotti, MD, FÂ鶹´«Ã½Ó³»­ (Barrow's Neurological Institute) Dr. Lee-Iannotti has nothing to disclose.
David H. Salat David H. Salat has or had stock in Niji.David H. Salat has or had stock in Smart Ion. The institution of David H. Salat has received research support from Renew.
Joanne M. Hamilton The institution of an immediate family member of Ms. Hamilton has received research support from Department of Veterans Affairs.
Thomas Neylan (University of California, San Francisco) The institution of Thomas Neylan has received research support from National Institutes of Aging.
Christine M. Walsh, PhD (UCSF) Dr. Walsh has nothing to disclose.
Debby W. Tsuang, MD (VAMC 116 MHC) Dr. Tsuang has nothing to disclose.
No disclosure on file
No disclosure on file
Gandis G. Mazeika, MD (Sound Sleep Health) Dr. Mazeika has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Jazz Pharmaceuticals. Dr. Mazeika has received personal compensation in the range of $10,000-$49,999 for serving as an Expert Witness for Brain Injury Law of Seattle. Dr. Mazeika has received personal compensation in the range of $10,000-$49,999 for serving as an Expert Witness for Edward K. Le Attorney.
No disclosure on file
No disclosure on file
No disclosure on file
Erik K. St. Louis, MD (Mayo Clinic) The institution of Dr. St. Louis has received research support from NIH. Dr. St. Louis has received publishing royalties from a publication relating to health care. Dr. St. Louis has received publishing royalties from a publication relating to health care.