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Resting-state functional connectivity changes in older adults with sleep disturbance and the role of amyloid burden

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Abstract

Sleep and related disorders could lead to changes in various brain networks, but little is known about the role of amyloid β (Aβ) burden—a key Alzheimer’s disease (AD) biomarker—in the relationship between sleep disturbance and altered resting state functional connectivity (rsFC) in older adults. This cross-sectional study examined the association between sleep disturbance, Aβ burden, and rsFC using a large-scale dataset from the Alzheimer’s Disease Neuroimaging Initiative (ADNI). Sample included 489 individuals (53.6% cognitively normal, 32.5% mild cognitive impairment, and 13.9% AD) who had completed sleep measures (Neuropsychiatric Inventory), PET Aβ data, and resting-state fMRI scans at baseline. Within and between rsFC of the Salience (SN), the Default Mode (DMN) and the Frontal Parietal network (FPN) were compared between participants with sleep disturbance versus without sleep disturbance. The interaction between Aβ positivity and sleep disturbance was evaluated using the linear regressions, controlling for age, diagnosis status, gender, sedatives and hypnotics use, and hypertension. Although no significant main effect of sleep disturbance was found on rsFC, a significant interaction term emerged between sleep disturbance and Aβ burden on rsFC of SN (β = 0.11, P = 0.006). Specifically, sleep disturbance was associated with SN hyperconnectivity, only with the presence of Aβ burden. Sleep disturbance may lead to altered connectivity in the SN when Aβ is accumulated in the brain. Individuals with AD pathology may be at increased risk for sleep-related aberrant rsFC; therefore, identifying and treating sleep problems in these individuals may help prevent further disease progression.

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Fig. 1: Flow chart of the study sample.
Fig. 2: Interaction between sleep disturbance and amyloid beta positivity on the salience network connectivity.

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Data availability

ADNI datasets are available to the research community upon request at www.adni.loni.usc.edu. The processed imaging data are available for the qualified investigators upon request at seonjoo.lee@nyspi.columbia.edu.

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Acknowledgements

The authors thank all ADNI participants. This study is supported by the National Institute of Health (Grants 5T32MH020004, R01-AG062578-01A1). Data collection and sharing for this project was funded by the Alzheimer’s Disease Neuroimaging Initiative (ADNI) (National Institutes of Health Grant U01 AG024904) and DOD ADNI (Department of Defense award number W81XWH-12-2-0012). ADNI is funded by the National Institute on Aging, the National Institute of Biomedical Imaging and Bioengineering, and through generous contributions from the following: AbbVie, Alzheimer’s Association; Alzheimer’s Drug Discovery Foundation; Araclon Biotech; BioClinica, Inc.; Biogen; Bristol-Myers Squibb Company; CereSpir, Inc.; Cogstate; Eisai Inc.; Elan Pharmaceuticals, Inc.; Eli Lilly and Company; EuroImmun; F. Hoffmann-La Roche Ltd and its affiliated company Genentech, Inc.; Fujirebio; GE Healthcare; IXICO Ltd.; Janssen Alzheimer Immunotherapy Research &Development, LLC.; Johnson & Johnson Pharmaceutical Research & Development LLC.; Lumosity; Lundbeck; Merck & Co., Inc.; Meso Scale Diagnostics, LLC.; NeuroRx Research; Neurotrack Technologies; Novartis Pharmaceuticals Corporation; Pfizer Inc.; Piramal Imaging; Servier; Takeda Pharmaceutical Company; and Transition Therapeutics. The Canadian Institutes of Health Research is providing funds to support ADNI clinical sites in Canada. Private sector contributions are facilitated by the Foundation for the National Institutes of Health (www.fnih.org). The grantee organization is the Northern California Institute for Research and Education, and the study is coordinated by the Alzheimer’s Therapeutic Research Institute at the University of Southern California. ADNI data are disseminated by the Laboratory for Neuro Imaging at the University of Southern California. Dr. Zhu is supported by the National Institute of Health (Grant K01 MH122774).

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Author notes

  1. Sophie A. Bell

    Present address: Department of Psychology, University of Virginia, Charlottesville, VA, USA

Authors and Affiliations

  1. Department of Psychiatry, Columbia University Irving Medical Center, New York, NY, USA

    Hyun Kim, Xi Zhu, D. P. Devanand, Terry E. Goldberg & Seonjoo Lee

  2. Area Brain Aging and Mental Health, New York State Psychiatric Institute, New York, NY, USA

    Hyun Kim, Sophie A. Bell, Daniel Cohen, D. P. Devanand, Terry E. Goldberg & Seonjoo Lee

  3. Division of Anxiety, Mood, Eating, and Related Disorders, New York State Psychiatric Institute, New York, NY, USA

    Xi Zhu

  4. Department of Biostatistics, Mailman School of Public Health, Columbia University, New York, NY, USA

    Yiming Zhao & Seonjoo Lee

  5. Department of Psychiatry, Perelman School of Medicine of the University of Pennsylvania, Philadelphia, PA, USA

    Philip R. Gehrman

  6. Michael J. Crescenz VA Medical Center, Philadelphia, PA, USA

    Philip R. Gehrman

  7. Department of Neurology, Columbia University Irving Medical Center, New York, NY, USA

    D. P. Devanand

  8. Department of Anesthesiology, Columbia University Irving Medical Center, New York, NY, USA

    Terry E. Goldberg

  9. Division of Mental Health Data Science, New York State Psychiatric Institute, New York, NY, USA

    Seonjoo Lee

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Alzheimer’s Disease Neuroimaging Initiative

Contributions

H.K. and S.A.B. drafted the manuscript; S.L. obtained datasets; Y.Z. and S.L. conducted statistical analyses and revised the Statistical Analyses section; X.Z. preprocessed fMRI data; X.Z., P.R.G., D.C., D.P.D., and T.G. provided support with interpretation of the findings and manuscript revision.

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Correspondence to Hyun Kim.

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Kim, H., Zhu, X., Zhao, Y. et al. Resting-state functional connectivity changes in older adults with sleep disturbance and the role of amyloid burden. Mol Psychiatry 28, 4399–4406 (2023). https://doi.org/10.1038/s41380-023-02214-9

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