조한나 (연세대학교 의과대학, 신경과학교실, 강남세브란스병원) | 한빛사논문 > 한빛사

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연세대학교 의과대학, 신경과학교실, 강남세브란스병원

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Neurology, Oct 09 2023 | https://doi.org/10.1212/WNL.0000000000207917 Association of Sleep Disturbances With Brain Amyloid and Tau Burden, Cortical Atrophy, and Cognitive Dysfunction Across the AD Continuum.

So Hoon Yoon, MD¹, Han-Kyeol Kim², Jae-Hoon Lee³, Joong-Hyun Chun⁴, Young H Sohn⁵, Phil Hyu Lee⁵, Young Hoon Ryu³, Hanna Cho², Han Soo Yoo, MD^2,a and Chul Hyoung Lyoo, MD, PhD²

¹Department of Neurology, International St. Mary's Hospital, Catholic Kwandong University College of Medicine, Incheon, Republic of Korea

²Department of Neurology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea

³Department of Nuclear Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea

⁴Department of Nuclear Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea

⁵Department of Neurology, Yonsei University College of Medicine, Seoul, Republic of Korea

^aCorresponding Author: Han Soo Yoo, Hanna Cho

Abstract

Background and objectives: Patients with Alzheimer's disease (AD) frequently suffer from various sleep disturbances. However, how sleep disturbance is associated with AD and its progression remains poorly investigated. We investigated the association of total sleep time with brain amyloid and tau burden, cortical atrophy, cognitive dysfunction, and their longitudinal changes in the AD spectrum.

Methods: In this retrospective cohort study, we enrolled participants on the AD spectrum who were positive on 18F-florbetaben (FBB) PET. All participants underwent the Pittsburgh Sleep Quality Index, brain MRI, FBB PET, 18F-flortaucipir (FTP) PET, and detailed neuropsychological testing. In addition, a subset of participants completed follow-up assessments. We analyzed the association of total sleep time with the baseline and longitudinal FBB-standardized uptake value ratio (SUVR), FTP-SUVR, cortical thickness, and cognitive domain composite scores.

Results: We examined 138 participants on the AD spectrum (15 with preclinical AD, 62 with prodromal AD, and 61 with AD dementia; mean age 73.4 ± 8.0 years; female 58.7%). Total sleep time was longer in the AD dementia group (7.4 ± 1.6 hours) compared to the preclinical (6.5 ± 1.4 hours; p = 0.026) and prodromal groups (6.6 ± 1.4 hours; p = 0.001), while other sleep parameters did not differ between groups. Longer total sleep time was not associated with amyloid accumulation but rather with tau accumulation, especially in the amygdala, hippocampus, basal forebrain, insular, cingulate, occipital, inferior temporal cortices, and precuneus. Longer total sleep time predicted faster tau accumulation in Braak regions V-VI (β = 0.016, p = 0.007) and disease progression to mild cognitive impairment or dementia (hazard ratio = 1.554, p = 0.024). Longer total sleep time was also associated with memory deficit (β = -0.19, p = 0.008).

Discussion: Prolonged total sleep time was associated with tau accumulation in sleep-related cortical and sub-cortical areas as well as memory dysfunction. It also predicted faster disease progression with tau accumulation. Our study highlights the clinical importance of assessing total sleep time as a marker for disease severity and prognosis in the AD spectrum.

논문정보

형식Research article
게재일2023년 10월 (BRIC 등록일 2023-10-10)
연구진국내 연구진
분야 의약학 > 응용의학

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