Circadian Misalignment and Sleep Disruption in Mild Cognitive Impairment
Circadian Misalignment and Sleep Disruption in Mild Cognitive Impairment
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DOI：
10.3233/jad-131217
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发表时间：
2014-01-01
影响因子：
4
通讯作者：
Lewis, Simon J. G.
中科院分区：
文献类型：
--
作者：
Naismith, Sharon L.;Hickie, Ian B.;Lewis, Simon J. G.
背景资料：虽然阿尔茨海默病与睡眠紊乱和昼夜节律有关，但这种变化在老年人中的程度是显而易见的，这是一个未知数。目的：在这项研究中，我们的目的是确定轻度认知障碍（MCI）患者是否表现出褪黑激素分泌开始的时间和数量以及睡眠结构的显着改变。30例MCI患者和28例年龄匹配的对照组进行了精神、医学和神经心理学评估，随后进行了夜间多导睡眠图和昏暗灯光褪黑激素起效评估。参与者还在实验室中进行了情景记忆任务。使用标准化算法计算昏暗光褪黑激素起始，并计算褪黑激素分泌的曲线下面积。睡眠结构的措施，包括唤醒后的睡眠发作和快速眼动sleep.Results的潜伏期：MCI患者的褪黑激素分泌的发病时间相对于对照组提前，但褪黑激素分泌的水平没有组间差异。MCI组也有更大的觉醒后，睡眠开始和增加快速眼动睡眠潜伏期。昏暗的光褪黑激素的发病和认知两组之间有差异的关联，与较早的昏暗的光褪黑激素的发病与记忆性能较差MCI patients.Conclusion：昼夜节律失调和睡眠中断是明显的MCI患者，并与阿尔茨海默病中观察到的变化是一致的。这些发现可能是疾病轨迹的标志，甚至可能与疾病发病机制有关。
Background: While it is evident that Alzheimer's disease is associated with disturbed sleep and circadian rhythms, the extent to which such changes are evident in older people 'at risk' of developing dementia is unknown.Objective: In this study, we aimed to determine whether patients with mild cognitive impairment (MCI) demonstrated significant alterations in the timing of melatonin secretion onset and amount, as well as sleep architecture.Methods: Thirty patients with MCI and 28 age-matched controls underwent psychiatric, medical, and neuropsychological assessment, followed by overnight polysomnography and dim light melatonin onset assessment. Participants also performed an episodic memory task while in the laboratory. Dim light melatonin onset was computed using a standardized algorithm, and area under the curve was computed for melatonin secretion. Sleep architecture measures including wake after sleep onset and latency to rapid eye movement sleep were derived.Results: Patients with MCI had advanced timing of their melatonin secretion onset relative to controls, but the levels of melatonin secreted did not differ between groups. The MCI group also had greater wake after sleep onset and increased rapid eye movement sleep latency. There were differential associations between dim light melatonin onset and cognition between the two groups, with earlier dim light melatonin onset being associated with poorer memory performance in MCI patients.Conclusion: Circadian misalignment and sleep disruption is evident in patients with MCI, and is consistent with changes observed in Alzheimer's disease. Such findings could be a marker for disease trajectory, and may even be implicated in disease pathogenesis.