Non-REM sleep with hypertonia in Parkinsonian Spectrum Disorders: A pilot investigation.
Document Type
Article
Abstract
INTRODUCTION: From an ongoing multicenter effort toward differentiation of Parkinsonian spectrum disorders (PSD) from other types of neurodegenerative disorders, the sleep biomarker non-rapid-eye-movement sleep with hypertonia (NRH) emerged.
METHODS: This study included in the PSD group patients with dementia with Lewy bodies/Parkinson disease dementia (DLB/PDD = 16), Parkinson disease (PD = 16), and progressive supranuclear palsy (PSP = 13). The non-PSD group included patients with Alzheimer disease dementia (AD = 24), mild cognitive impairment (MCI = 35), and a control group with normal cognition (CG = 61). In-home, multi-night Sleep Profiler studies were conducted in all participants. Automated algorithms detected NRH, characterized by elevated frontopolar electromyographic power. Between-group differences in NRH were evaluated using Logistic regression, Mann-Whitney U and Chi-squared tests.
RESULTS: NRH was greater in the PSD group compared to non-PSD (13.9 ± 11.0% vs. 3.1 ± 4.7%, P < 0.0001). The threshold NRH≥5% provided the optimal between-group differentiation (AUC = 0.78, P < 0.001). NRH was independently associated with the PSD group after controlling for age, sex, and SSRI/SNRI use (P < 0.0001). The frequencies of abnormal NRH by subgroup were PSP = 92%, DLB/PDD = 81%, PD = 56%, MCI = 26%, AD = 17%, and CG = 16%. The odds of abnormal NRH in each PSD subgroup ranged from 3.7 to 61.2 compared to each non-PSD subgroup. The night-to-night and test-retest intraclass correlations were excellent (0.78 and 0.84, both P < 0.0001).
CONCLUSIONS: In this pilot study, NRH appeared to be a novel candidate sleep biomarker for PSD-related neurodegeneration. Future studies in larger cohorts are needed to confirm these findings, understand the etiology of NRH magnitude/duration, and determine whether it is an independent prodromal marker for specific neurodegenerative pathologies.
Medical Subject Headings
Humans; Lewy Body Disease; Parkinson Disease; Pilot Projects; Dementia; Alzheimer Disease; Muscle Hypertonia; Biomarkers; Sleep
Publication Date
12-1-2022
Publication Title
Sleep medicine
ISSN
1878-5506
Volume
100
First Page
501
Last Page
510
PubMed ID
36274383
Digital Object Identifier (DOI)
10.1016/j.sleep.2022.09.025
Recommended Citation
Levendowski, Daniel J; Walsh, Christine M; Boeve, Bradley F; Tsuang, Debby; Hamilton, Joanne M; Salat, David; Berka, Chris; Lee-Iannotti, Joyce K; Shprecher, David; Westbrook, Philip R; Mazeika, Gandis; Yack, Leslie; Payne, Sarah; Timm, Paul C; Neylan, Thomas C; and St Louis, Erik K, "Non-REM sleep with hypertonia in Parkinsonian Spectrum Disorders: A pilot investigation." (2022). Neurology. 1920.
https://scholar.barrowneuro.org/neurology/1920