Autonomic dysregulation during sleep in Parkinsonian spectrum disorders - A proof of concept.

Document Type

Article

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

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.

Medical Subject Headings

Humans; Synucleinopathies; Parkinsonian Disorders; Parkinson Disease; Lewy Body Disease; REM Sleep Behavior Disorder; Alzheimer Disease; Autonomic Nervous System Diseases; Sleep

Publication Date

12-1-2023

Publication Title

Parkinsonism & related disorders

ISSN

1873-5126

Volume

117

First Page

105905

Last Page

105905

PubMed ID

37939637

Digital Object Identifier (DOI)

10.1016/j.parkreldis.2023.105905

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