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Abstract Details

Normal and Abnormal Stage N3 Sleep in Patients with Cognitive Impairment and/or Neurodegenerative Diseases
Aging, Dementia, and Behavioral Neurology
Aging and Dementia Posters (7:00 AM-5:00 PM)
057
Evaluate characteristics of slow wave activity (SWA) during sleep in individuals with and without neurodegenerative disease (NDD).

SWA has been positively correlated with amyloid-β clearance and inversely related to tau pathology. However, SWA with polymorphic delta activity may instead be a marker for pathologic brain dysfunction and was associated with adverse outcomes in encephalopathic patients. 

Auto-staging N3 with Sleep Profiler (SP) was previously shown to have an 82.9% positive-percent agreement in 3705 epochs simultaneously acquired during laboratory polysomnography.   These epochs were used in combination with 3608 N3-staged epochs from 25 records of critically ill encephalopathic patients to develop a machine-learning algorithm that converted N3 to abnormal-N3 (AN3).  Generally, AN3 is characterized by low theta and sigma power relative to delta, alpha, beta and EMG.

Percent time N3 and AN3 were auto-staged in self-applied, in-home SP recordings, including patients diagnosed with mild cognitive impairment (MCI: n=33,age=70+8.3), Alzheimer’s disease dementia (AD: n=16;age=73+7.2), and DLB/PDD (n=10;age=71+4.7) and age-matched subjects with normal cognition (NC: n=44;age=69+6.5).  Abnormal-SWA was defined as sleep time with: a) >4% AN3, b) >5-minutes N3 with >50% converted to AN3, and/or c) >75% staged N3.  Analyses included intra-class correlation and Chi-squared tests.

Across 80 records, the night-to-night concordance of auto-staged %N3 and %AN3 were strong (ICC=0.96 and 0.90, both p<0.0001;NC=39;MCI=22;AD=9;DLB/PDD=10).  The test-retest reliability for %N3 and %AN3 after >365-days were also strong (ICC=0.94 and 0.97, p<0.0001, NC=13;MCI=2;AD=2;DLB/PDD=2).

 

The within-group distributions of abnormal-SWA were significantly less for NC=11% and MCI=9% compared to DLB/PDD=40% [DLB/PDD vs. NC (p<0.05;odds=5.2;95%CI=1.1-25.0) and MCI (p=0.04;odds=6.7;95%CI=1.2-37.8)] and AD=38% [AD vs. NC (p=0.03;odds=4.7;95%CI=1.2-18.5) and MCI (p<0.03;odds=6.0;95%CI=1.3-28.6)].

Abnormal-SWA showed strong test-retest reliability and was significantly greater in NDD patients, suggesting that AN3 may be a marker of pathological brain function distinguishable from N3 sleep.  Further use as an investigational sleep biomarker indicative of NDD is warranted.

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
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.