Abstract
Purpose
Sleep disturbances are common in Alzheimer’s disease (AD) and mild cognitive impairment (MCI) patients. Non-rapid eye movement stage 3 (N3), rapid eye movement stage (REM), spindle density, and K-complex (KC) density are decreased in MCI and AD patients. Periodic limb movements in sleep (PLMS) are increased in other neurodegenerative diseases. We aimed to distinguish amnestic mild cognitive impairment (aMCI) patients from the overall population of MCI patients by comparing the N3 and REM proportions, the morphological characteristics of spindles and KCs and the periodic limb movement index (PLMI) among control, aMCI and AD subjects.
Methods
In 92 subjects (30 controls, 32 aMCI and 30 AD), sleep stages, spindles, KCs and PLMS were recorded during the second of two nights of polysomnography (PSG). We compared the above parameters among the three groups.
Results
AD and aMCI subjects had lower proportions of N3 and REM, poorer spindle and KC activities and more frequent PLMS than controls. These alterations were associated with decreased Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA) scores. We determined cut-off values for distinguishing aMCI and AD using logistic regression and receiver operating characteristic (ROC) analyses.
Conclusions
AD and aMCI patients have abnormal sleep stage proportions, spindles, KCs and PLMS. The combination of the above alterations may distinguish aMCI and AD patients from controls with high specificity and sensitivity.
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Abbreviations
- AD:
-
Alzheimer’s disease
- aMCI:
-
mild cognitive impairment
- NC:
-
normal elderly control subjects
- ANOVA:
-
analysis of variance
- EEG:
-
electroencephalography
- PLMS:
-
Periodic limb movements in sleep
- NREM:
-
non-rapid eye movement sleep
- REM:
-
rapid eye movement sleep
- TST:
-
total sleep time
- SL:
-
sleep latency
- REML:
-
rapid eye movement sleep latency
- WASO:
-
wakefulness after sleep onset
- EOG:
-
electrooculography
- ECG:
-
electrocardiography
- CSF:
-
cerebrospinal fluid
- Aβ1-42 :
-
amyloid β-protein 1–42
- t-tau:
-
total tau
- p-tau181 :
-
phosphorylated tau 181
- ROC:
-
receiver operating characteristic
- AUC:
-
area under the curve
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Acknowledgments
We thank all the subjects for participating in this study and the support by The Sixth Affiliated Hospital of Sun Yat-Sen University.
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The ethical committee of The Sixth Affiliated Hospital of Sun Yat-Sen University approved this study, and the study was carried out in accordance with the Declaration of Helsinki.
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The work is interesting and creates the potential in the field for new Biomarkers for Amnestic Mild Cognitive Impairment and Alzheimer’s disease. Based on this work, more signal processing advances could be applied and generalize further the findings.
Leontios Hadjileontiadis
Thessaloniki, Greece
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Liu, S., Pan, J., Tang, K. et al. Sleep spindles, K-complexes, limb movements and sleep stage proportions may be biomarkers for amnestic mild cognitive impairment and Alzheimer’s disease. Sleep Breath 24, 637–651 (2020). https://doi.org/10.1007/s11325-019-01970-9
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DOI: https://doi.org/10.1007/s11325-019-01970-9