Differential circadian rhythm disturbances in men with Alzheimer disease and frontotemporal degeneration
Differential circadian rhythm disturbances in men with Alzheimer disease and frontotemporal degeneration
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DOI：
10.1001/archpsyc.58.4.353
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发表时间：
2001-04-01
影响因子：
--
通讯作者：
Volicer, L
中科院分区：
文献类型：
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作者：
Harper, DG;Stopa, EG;Volicer, L
背景：照顾者疲惫是痴呆症患者睡眠障碍和休息-活动节律紊乱的常见后果。这种疲惫是照顾者在决定将痴呆症患者送往精神病院时最常提到的原因。最近的研究表明，昼夜节律起搏器功能障碍与痴呆的病因有关。方法：我们研究了38名男性患者的活动和核心体温节律，这些患者在死前大约两年被临床诊断为阿尔茨海默病(AD)。经尸检和神经病理检查确诊为AD(n=23)、额颞叶变性(FTD)(n=9)或弥漫性路易体病(DLB)合并AD或FTD混合性病变(n=6)。结果：阿尔茨海默病患者夜间活动明显增加，核心体温和活动节律明显延迟。FTD患者的活动节律与对照组相比具有高度的碎片化和阶段性提前，与核心体温节律明显脱钩。结论：AD患者与FTD患者的活动节律和体温节律的紊乱程度不同。
Background: Caregiver Exhaustion is a frequent consequence of sleep disturbance and rest-activity rhythm disruption that occurs in dementia. This exhaustion is the causal factor most frequently cited by caregivers in making the decision to institutionalize patients with dementia. Recent studies have implicated dysfunction of the circadian pacemaker in the etiology of these disturbances in dementia.Methods: We studied the activity and core-body temperature rhythms in a cohort of 38 male patients with a clinical diagnosis of probable Alzheimer disease (AD) approximately 2 years before death. These patients were later given a confirmed diagnosis of AD (n=23), frontotemporal degeneration (FTD) (n=9), or diffuse Lewy body disease (DLB) with mixed AD or FTD pathologies (n=6) after autopsy and neuropathological Examination. Physiological rhythms of patients with AD and FTD were then compared with a group of normal, elderly men (n=8) from the community.Results: Alzheimer patients showed increased nocturnal activity and a significant phase-delay in their rhythms of core-body temperature and activity compared with patients with FTD and controls. The activity rhythm of FTD patients was highly fragmented and phase-advanced in comparison with controls and apparently uncoupled from the rhythm of core-body temperature.Conclusions: Patients with AD and patients with FTD show different disturbances in their rhythms of activity and temperature compared with each other and with normal elderly patients.