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Turner M, Bartlett D, Poudel G, Zaenker P, Laws S, Lo J, Ziman M, Cruickshank T. Associations between Sleep Quality and Serum Levels of Neurofilament Light in Individuals with Premanifest Huntington Disease. Sleep Sci 2024; 17:e199-e202. [PMID: 38846594 PMCID: PMC11152634 DOI: 10.1055/s-0043-1777783] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Accepted: 09/11/2023] [Indexed: 06/09/2024] Open
Abstract
Objectives To evaluate the associations between sleep quality and serum levels of neurofilament light (NfL) protein in individuals with premanifest Huntington disease (HD). Materials and Methods We recruited 28 individuals with premanifest HD from a pre-existing database (of the Huntington's Environmental Research Optimisation Scheme, HEROs). The participants filled out the Pittsburgh Sleep Quality Index (PSQI), a subjective measure of sleep quality, and blood was collected via routine venepuncture to measure peripheral NfL levels. Results The PSQI scores (median: 5.0; interquartile range: 4.0-7.5) indicated poor sleep quality. General linear modelling revealed no significant ( p = 0.242) association between PSQI scores and NfL levels. No significant differences were found between individuals with good and poor sleep quality for any demographic variable collected. Discussion Contrary to studies on other neurological conditions, there was no association between sleep quality and NfL levels in individuals with premanifest HD. This was unexpected, given the influence of environmental factors (such as social network size) on neurodegeneration in individuals with premanifest HD.
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Affiliation(s)
- Mitchell Turner
- Centre for Precision Health, Edith Cowan University, Perth, WA, Australia
- School of Medical and Health Sciences, Edith Cowan University, Perth, WA, Australia
| | - Danielle Bartlett
- School of Medical and Health Sciences, Edith Cowan University, Perth, WA, Australia
| | - Govinda Poudel
- Mary Mackillop Institute for Health Research, Australian Catholic University, Melbourne, VIC, Australia
| | - Pauline Zaenker
- Centre for Precision Health, Edith Cowan University, Perth, WA, Australia
- School of Medical and Health Sciences, Edith Cowan University, Perth, WA, Australia
| | - Simon Laws
- Centre for Precision Health, Edith Cowan University, Perth, WA, Australia
- School of Medical and Health Sciences, Edith Cowan University, Perth, WA, Australia
| | - Johnny Lo
- School of Science, Edith Cowan University, Perth, WA, Australia
| | - Mel Ziman
- School of Medical and Health Sciences, Edith Cowan University, Perth, WA, Australia
| | - Travis Cruickshank
- Centre for Precision Health, Edith Cowan University, Perth, WA, Australia
- School of Medical and Health Sciences, Edith Cowan University, Perth, WA, Australia
- Perron Institute for Neurological and Translational Sciences, Perth, WA, Australia
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Bilal H, Harding IH, Stout JC. The relationship between disease-specific psychosocial stressors and depressive symptoms in Huntington's disease. J Neurol 2024; 271:289-299. [PMID: 37695532 PMCID: PMC10769991 DOI: 10.1007/s00415-023-11982-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Revised: 08/30/2023] [Accepted: 08/31/2023] [Indexed: 09/12/2023]
Abstract
BACKGROUND Huntington's disease (HD) is an inherited neurodegenerative disease involving motor abnormalities, cognitive decline, and psychological difficulties. Depression is among the most common psychological difficulties in HD. People with HD encounter numerous stressors related to their diagnosis and the impact of HD on their daily lives. Understanding the relationship between HD-specific psychosocial stressors and depression symptoms is critical for optimising treatment and developing a holistic, disease-specific model of depression in HD. METHODS Fifty-seven adults with the HD gene expansion (33 pre-symptomatic, 24 symptomatic) completed a self-report depression questionnaire and rated how much stress they experienced in relation to 20 psychosocial challenges commonly associated with HD. We examined associations between depression symptoms and each stressor individually, and after clustering using principal components analysis. RESULTS Depression symptoms were significantly associated with most of the psychosocial stressors assessed. Clustering with principal components analysis revealed that higher depression scores had significant independent associations with greater stress related to the future implications of HD (β = .44, p = .001) and sleep and psychological difficulties (β = .28, p = .005), but not with stress related to functional limitations (β = .11, p = .33) or interpersonal issues caused by HD (β = .15, p = .21). CONCLUSIONS Stressful experiences associated with HD constitute an important risk factor for depression in HD. Our findings support the use of more psychologically informed models of depression in HD and necessitate further research on tailored psychosocial interventions for HD patients with depression.
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Affiliation(s)
- Hiba Bilal
- School of Psychological Sciences, and Turner Institute for Brain and Mental Health, Monash University, 18 Innovation Walk, Clayton, VIC, 3800, Australia
| | - Ian H Harding
- Monash Biomedical Imaging, Monash University, Clayton, VIC, Australia
- Department of Neuroscience, Central Clinical School, Monash University, Prahran, VIC, Australia
| | - Julie C Stout
- School of Psychological Sciences, and Turner Institute for Brain and Mental Health, Monash University, 18 Innovation Walk, Clayton, VIC, 3800, Australia.
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Jiménez-Jiménez FJ, Alonso-Navarro H, García-Martín E, Agúndez JAG. Sleep Disorders in Patients with Choreic Syndromes. Curr Neurol Neurosci Rep 2023; 23:361-379. [PMID: 37269451 DOI: 10.1007/s11910-023-01274-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/16/2023] [Indexed: 06/05/2023]
Abstract
PURPOSE OF REVIEW Patients with different types of choreic syndromes, specially those with Huntington's (HD) and Wilson's (WD) diseases, report frequent sleep complaints. This review focuses on the main findings of studies addressing the sleep features in these diseases, and other less frequent causes of chorea associated with sleep disorders, including a new syndrome described in the last decade associated with IgLON5 antibodies. RECENT FINDINGS Patients with HD and WD showed a bad quality of sleep and high frequency of insomnia and excessive daytime somnolence. WD patients also showed high scores on a specific scale for rapid eye movement sleep behavior disorders. HD and WD share decreased sleep efficiency and increased REM sleep latencies, percentage of sleep stage N1, and wake after sleep onset (WASO) among their polysomnographic features. Patients with HD and WD showed a high prevalence of different sleep disorders. Patients with other causes of chorea, including neuroacanthocytosis, parasomnia with sleep breathing disorder associated with antibodies to IgLON5, Sydenham's chorea, and choreic syndromes associated to certain genetic mutations show sleep disorders as well.
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Affiliation(s)
- Félix Javier Jiménez-Jiménez
- Section of Neurology, Hospital Universitario del Sureste, Ronda del Sur 10 E-28500, Arganda del Rey, Madrid, Spain.
| | - Hortensia Alonso-Navarro
- Section of Neurology, Hospital Universitario del Sureste, Ronda del Sur 10 E-28500, Arganda del Rey, Madrid, Spain
| | - Elena García-Martín
- Universidad de Extremadura, University Institute of Molecular Pathology Biomarkers, Cáceres, Spain
| | - José A G Agúndez
- Universidad de Extremadura, University Institute of Molecular Pathology Biomarkers, Cáceres, Spain
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The temporal dynamics of mood and their association with depressive symptoms in Huntington's disease. J Affect Disord 2023; 328:22-28. [PMID: 36791969 DOI: 10.1016/j.jad.2023.02.035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Revised: 02/07/2023] [Accepted: 02/09/2023] [Indexed: 02/15/2023]
Abstract
BACKGROUND Huntington's disease (HD) is an inherited neurodegenerative disorder characterised by progressive motor abnormalities, cognitive decline, and neuropsychiatric disturbances. Depression is among the most common neuropsychiatric syndromes in HD. Research in neurologically healthy samples has shown that depression is associated with distinct patterns of short-term fluctuations in mood, which may exacerbate negative effects on psychological wellbeing. The short-term dynamics of mood and their relationship with depression have not yet been investigated in HD. METHODS Fifty-five adults with the HD CAG expansion (33 pre-manifest, 22 manifest) completed single timepoint measures of depression, demographic factors, and clinical disease outcomes on day 1, then rated their mood daily for 28 consecutive days. Average mood, mood variability, and mood inertia (auto-correlation) were calculated across the 28 days. RESULTS Depression severity on day 1 was significantly associated with average mood across the 28 days, but not with day-to-day mood variability or inertia. Additionally, female HD CAG expansion carriers experienced more day-to-day variability in mood compared to males. LIMITATIONS Our sample did not include HD CAG expansion carriers with severe depressive symptoms or advanced HD, which limits the generalisability of the findings. Additionally, findings may have been affected by antidepressant and antipsychotic medication use among many participants. CONCLUSIONS In HD, short-term patterns of change in mood appear to be relatively independent of depression severity. Moreover, in female CAG-expansion carriers particularly, mood variability may warrant further clinical attention. These findings should be replicated in larger and more diverse samples, with different timescales and measures for assessing mood.
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Fitzgerald ES, Stout JC, Glikmann-Johnston Y, Anderson C, Jackson ML. Sleep, Circadian Rhythms, and Cognitive Dysfunction in Huntington's Disease. J Huntingtons Dis 2023; 12:293-304. [PMID: 37599535 DOI: 10.3233/jhd-230578] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/22/2023]
Abstract
BACKGROUND In healthy people, sleep and circadian disruption are linked to cognitive deficits. People with Huntington's disease (HD), who have compromised brain function and sleep and circadian disturbances, may be even more susceptible to these cognitive effects. OBJECTIVE To conduct a comprehensive review and synthesis of the literature in HD on the associations of cognitive dysfunction with disturbed sleep and circadian rhythms. METHODS We searched MEDLINE via OVID, CINAHL Plus, EMBASE via OVID, and PubMed in May 2023. The first author then screened by title and abstract and conducted a full review of remaining articles. RESULTS Eight studies investigating the influence of sleep and/or circadian rhythms on cognitive function in HD were found. In manifest HD, poorer sleep was associated with worse cognitive function. For behavioral 24-hour (circadian) rhythms, two studies indicated that later wake times correlated with poorer cognitive function. No reported studies in HD examined altered physiological 24-hour (circadian) rhythms and cognitive impairment. CONCLUSION Some associations exist between poor sleep and cognitive dysfunction in manifest HD, yet whether these associations are present before clinical diagnosis is unknown. Whether circadian disturbances relate to cognitive impairment in HD also remains undetermined. To inform sleep and circadian interventions aimed at improving cognitive symptoms in HD, future research should include a range of disease stages, control for external factors, and utilize robust cognitive batteries targeted to the aspects of cognitive function known to be adversely affected in HD.
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Affiliation(s)
- Emily S Fitzgerald
- School of Psychological Sciences, and Turner Institute for Brain and Mental Health, Monash University, Clayton, VIC, Australia
| | - Julie C Stout
- School of Psychological Sciences, and Turner Institute for Brain and Mental Health, Monash University, Clayton, VIC, Australia
| | - Yifat Glikmann-Johnston
- School of Psychological Sciences, and Turner Institute for Brain and Mental Health, Monash University, Clayton, VIC, Australia
| | - Clare Anderson
- School of Psychological Sciences, and Turner Institute for Brain and Mental Health, Monash University, Clayton, VIC, Australia
| | - Melinda L Jackson
- School of Psychological Sciences, and Turner Institute for Brain and Mental Health, Monash University, Clayton, VIC, Australia
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Morgan-Jones P, Jones A, Busse M, Mills L, Pallmann P, Drew C, Arnesen A, Wood F. Monitoring and Managing Lifestyle Behaviors Using Wearable Activity Trackers: Mixed Methods Study of Views From the Huntington Disease Community. JMIR Form Res 2022; 6:e36870. [PMID: 35767346 PMCID: PMC9280464 DOI: 10.2196/36870] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Revised: 05/18/2022] [Accepted: 05/18/2022] [Indexed: 11/17/2022] Open
Abstract
Background There are early indications that lifestyle behaviors, specifically physical activity and sleep, may be associated with the onset and progression of Huntington disease (HD). Wearable activity trackers offer an exciting opportunity to collect long-term activity data to further investigate the role of lifestyle, physical activity, and sleep in disease modification. Given how wearable devices rely on user acceptance and long-term adoption, it is important to understand users’ perspectives on how acceptable any device might be and how users might engage over the longer term. Objective This study aimed to explore the perceptions, motivators, and potential barriers relating to the adoption of wearable activity trackers by people with HD for monitoring and managing their lifestyle and sleep. This information intended to guide the selection of wearable activity trackers for use in a longitudinal observational clinical study. Methods We conducted a mixed methods study; this allowed us to draw on the potential strengths of both quantitative and qualitative methods. Opportunistic participant recruitment occurred at 4 Huntington’s Disease Association meetings, including 1 international meeting and 3 United Kingdom–based regional meetings. Individuals with HD, their family members, and carers were invited to complete a user acceptance questionnaire and participate in a focus group discussion. The questionnaire consisted of 35 items across 8 domains using a 0 to 4 Likert scale, along with some additional demographic questions. Average questionnaire responses were recorded as positive (score>2.5), negative (score<1.5), or neutral (score between 1.5 and 2.5) opinions for each domain. Differences owing to demographics were explored using the Kruskal-Wallis and Wilcoxon rank sum tests. Focus group discussions (conducted in English) were driven by a topic guide, a vignette scenario, and an item ranking exercise. The discussions were audio recorded and then analyzed using thematic analysis. Results A total of 105 completed questionnaires were analyzed (47 people with HD and 58 family members or carers). All sections of the questionnaire produced median scores >2.5, indicating a tendency toward positive opinions on wearable activity trackers, such as the devices being advantageous, easy and enjoyable to use, and compatible with lifestyle and users being able to understand the information from trackers and willing to wear them. People with HD reported a more positive attitude toward wearable activity trackers than their family members or caregivers (P=.02). A total of 15 participants participated in 3 focus groups. Device compatibility and accuracy, data security, impact on relationships, and the ability to monitor and self-manage lifestyle behaviors have emerged as important considerations in device use and user preferences. Conclusions Although wearable activity trackers were broadly recognized as acceptable for both monitoring and management, various aspects of device design and functionality must be considered to promote acceptance in this clinical cohort.
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Affiliation(s)
| | - Annabel Jones
- Division of Population Medicine, Cardiff University, Cardiff, United Kingdom
| | - Monica Busse
- Centre for Trials Research, Cardiff University, Cardiff, United Kingdom
| | - Laura Mills
- Centre for Trials Research, Cardiff University, Cardiff, United Kingdom
| | - Philip Pallmann
- Centre for Trials Research, Cardiff University, Cardiff, United Kingdom
| | - Cheney Drew
- Centre for Trials Research, Cardiff University, Cardiff, United Kingdom
| | | | - Fiona Wood
- Division of Population Medicine, Cardiff University, Cardiff, United Kingdom
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Maffi S, Scaricamazza E, Migliore S, Casella M, Ceccarelli C, Squitieri F. Sleep Quality and Related Clinical Manifestations in Huntington Disease. J Pers Med 2022; 12:jpm12060864. [PMID: 35743649 PMCID: PMC9224745 DOI: 10.3390/jpm12060864] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Revised: 05/20/2022] [Accepted: 05/23/2022] [Indexed: 02/04/2023] Open
Abstract
(1) Background: Sleep patterns are frequently disrupted in neurodegenerative disorders such as Huntington disease (HD); however, they are still poorly understood, especially their association with clinic features. Our study aimed to explore potential correlations between sleep features and motor, cognitive, behavioural and functional changes in manifest HD subjects. (2) Methods: We enrolled 42 patients who were assessed by the Pittsburgh Sleep Quality Index (PSQI) and Insomnia Severity Index (ISI) questionnaires; clinical features were evaluated by the validated ENROLL-HD platform assay, including the Unified Huntington’s Disease Rating Scale (UHDRS) and the Problem Behaviours Assessment Short Form (PBA-s). (3) Results: We found a significant association between the patients’ perception of sleep abnormalities and scores of impaired independence, cognitive and motor performances. Specifically, sleep efficiency (PSQI—C4 subscores) and the use of sleep medications (PSQI—C6 subscores) seem to be more frequently associated with the severity of the disease progression. (4) Conclusion: sleep abnormalities represent an important part of the HD clinical profile and can impair patients’ quality of life by affecting their level of independence, cognition performance and mental well-being.
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Affiliation(s)
- Sabrina Maffi
- Huntington and Rare Diseases Unit, Fondazione IRCCS Casa Sollievo della Sofferenza Hospital, 71013 San Giovanni Rotondo, Italy; (S.M.); (E.S.); (S.M.)
| | - Eugenia Scaricamazza
- Huntington and Rare Diseases Unit, Fondazione IRCCS Casa Sollievo della Sofferenza Hospital, 71013 San Giovanni Rotondo, Italy; (S.M.); (E.S.); (S.M.)
| | - Simone Migliore
- Huntington and Rare Diseases Unit, Fondazione IRCCS Casa Sollievo della Sofferenza Hospital, 71013 San Giovanni Rotondo, Italy; (S.M.); (E.S.); (S.M.)
| | - Melissa Casella
- Italian League for Research on Huntington (LIRH) Foundation, 00185 Rome, Italy; (M.C.); (C.C.)
| | - Consuelo Ceccarelli
- Italian League for Research on Huntington (LIRH) Foundation, 00185 Rome, Italy; (M.C.); (C.C.)
| | - Ferdinando Squitieri
- Huntington and Rare Diseases Unit, Fondazione IRCCS Casa Sollievo della Sofferenza Hospital, 71013 San Giovanni Rotondo, Italy; (S.M.); (E.S.); (S.M.)
- Correspondence:
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Bilal H, Warren N, Dahanayake P, Kelso W, Sarah F, Stout JC. The Lived Experiences of Depression in Huntington's Disease: A Qualitative Study. J Huntingtons Dis 2022; 11:321-335. [PMID: 35570497 DOI: 10.3233/jhd-220537] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Depression is a common neuropsychiatric syndrome in Huntington's disease (HD) and has debilitating consequences, including poorer sleep, exacerbation of cognitive and functional decline, and suicidality. To date, no published studies have documented the lived experience of depression in HD, despite clinical evidence that depression may be experienced differently in HD compared to the general population. OBJECTIVE The aim of this study was to investigate the lived experiences of depression in people with the CAG expansion for HD using qualitative methods. METHODS We conducted semi-structured interviews with HD CAG expansion carriers who had current or previous experiences of depression, until data saturation was achieved. This resulted in interviews from 17 HD CAG expansion carriers (11 premanifest, 6 manifest) which were analyzed using thematic analysis. RESULTS The four key themes that emerged related to the temporal characteristics of depression in HD, the qualitative changes associated with depression, psychosocial stressors perceived to contribute to depression, and the perception of depression as an endogenous feature of HD. CONCLUSION This study provides an enriched understanding of the unique characteristics of depression in HD, and the attributions that CAG expansion carriers make for their depression symptoms. The themes identified in this study can be used to guide more targeted assessment and treatment of depression in HD.
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Affiliation(s)
- Hiba Bilal
- School of Psychological Sciences, and Turner Institute for Brain and Mental Health, Monash University, Clayton, Victoria, Australia
| | - Narelle Warren
- School of Social Sciences, Monash University, Clayton, Victoria, Australia
| | - Pinithi Dahanayake
- School of Psychological Sciences, and Turner Institute for Brain and Mental Health, Monash University, Clayton, Victoria, Australia
| | - Wendy Kelso
- Neuropsychiatry Unit, Royal Melbourne Hospital, Parkville, Victoria, Australia
| | - Farrand Sarah
- Neuropsychiatry Unit, Royal Melbourne Hospital, Parkville, Victoria, Australia
| | - Julie C Stout
- School of Psychological Sciences, and Turner Institute for Brain and Mental Health, Monash University, Clayton, Victoria, Australia
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Ogilvie AC, Nopoulos PC, Schultz JL. Sleep disturbances by disease type and stage in Huntington's disease. Parkinsonism Relat Disord 2021; 91:13-18. [PMID: 34450461 DOI: 10.1016/j.parkreldis.2021.08.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Revised: 08/18/2021] [Accepted: 08/19/2021] [Indexed: 01/16/2023]
Abstract
INTRODUCTION Sleep disturbances are a common symptom in patients with Huntington's disease (HD). However, it is unclear when in the disease course of HD sleep disturbances become more frequent compared to the general population. This study investigated the frequency and odds of developing sleep disturbances between adults with HD or at-risk for HD and non-HD controls. METHODS Participants from the Enroll-HD study were split by both disease type and disease severity using CAG length, diagnostic confidence level, and total functional capacity score. Multivariate logistic regression was used to calculate odds ratios adjusted for age, sex, tobacco and alcohol use, depression and psychosis scores, and cognition to compare HD groups to non-HD controls. Cox proportional hazards models and Kaplan Meier curves were used to determine differences in probabilities of developing sleep disturbances and how sleep disturbances are related to age at motor onset. RESULTS There were significant differences between HD participants and non-HD controls in both the disease type and disease stage analyses (p < 0.001). The odds of a sleep disturbance increased with worsening disease stage and was highest in those with juvenile HD. The development of a sleep disorder in manifest HD participants was observed to be around the time of disease onset. CONCLUSIONS Sleep disturbances are more frequent in HD patients than those without HD. There are also differences based on disease type and stage. This is supplemented by the finding that the onset of sleep disturbances occurs near the time of motor onset of HD.
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Affiliation(s)
- Amy C Ogilvie
- Department of Psychiatry, The Carver College of Medicine at the University of Iowa, 200 Hawkins Drive, Iowa City, IA, 52242, USA; Department of Epidemiology, The College of Public Health at the University of Iowa, 145 N Riverside Drive, Iowa City, IA, 52242, USA.
| | - Peg C Nopoulos
- Department of Psychiatry, The Carver College of Medicine at the University of Iowa, 200 Hawkins Drive, Iowa City, IA, 52242, USA; Department of Neurology, The Carver College of Medicine at the University of Iowa, 200 Hawkins Drive, Iowa City, IA, 52242, USA; Stead Family Department of Pediatrics, The University of Iowa Hospitals and Clinics, 200 Hawkins Drive, Iowa City, IA, 52242, USA.
| | - Jordan L Schultz
- Department of Psychiatry, The Carver College of Medicine at the University of Iowa, 200 Hawkins Drive, Iowa City, IA, 52242, USA; Department of Neurology, The Carver College of Medicine at the University of Iowa, 200 Hawkins Drive, Iowa City, IA, 52242, USA; Division of Pharmacy Practice and Sciences, The College of Pharmacy at the University of Iowa, 180 South Grand Avenue, Iowa City, IA, 52242, USA.
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Kuang H, Zhu YG, Zhou ZF, Yang MW, Hong FF, Yang SL. Sleep disorders in Alzheimer's disease: the predictive roles and potential mechanisms. Neural Regen Res 2021; 16:1965-1972. [PMID: 33642368 PMCID: PMC8343328 DOI: 10.4103/1673-5374.308071] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Sleep disorders are common in patients with Alzheimer's disease, and can even occur in patients with amnestic mild cognitive impairment, which appears before Alzheimer's disease. Sleep disorders further impair cognitive function and accelerate the accumulation of amyloid-β and tau in patients with Alzheimer's disease. At present, sleep disorders are considered as a risk factor for, and may be a predictor of, Alzheimer's disease development. Given that sleep disorders are encountered in other types of dementia and psychiatric conditions, sleep-related biomarkers to predict Alzheimer's disease need to have high specificity and sensitivity. Here, we summarize the major Alzheimer's disease-specific sleep changes, including abnormal non-rapid eye movement sleep, sleep fragmentation, and sleep-disordered breathing, and describe their ability to predict the onset of Alzheimer's disease at its earliest stages. Understanding the mechanisms underlying these sleep changes is also crucial if we are to clarify the role of sleep in Alzheimer's disease. This paper therefore explores some potential mechanisms that may contribute to sleep disorders, including dysregulation of the orexinergic, glutamatergic, and γ-aminobutyric acid systems and the circadian rhythm, together with amyloid-β accumulation. This review could provide a theoretical basis for the development of drugs to treat Alzheimer's disease based on sleep disorders in future work.
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Affiliation(s)
- Huang Kuang
- Department of Physiology, College of Medicine, Nanchang University, Nanchang, Jiangxi Province, China
| | - Yu-Ge Zhu
- Department of Physiology, College of Medicine, Nanchang University, Nanchang, Jiangxi Province, China
| | - Zhi-Feng Zhou
- Department of Physiology, College of Medicine, Nanchang University, Nanchang, Jiangxi Province, China
| | - Mei-Wen Yang
- Department of Nurse, Nanchang University Hospital, Nanchang, Jiangxi Province, China
| | - Fen-Fang Hong
- Department of Experimental Teaching Center, Nanchang University, Nanchang, Jiangxi Province, China
| | - Shu-Long Yang
- Department of Physiology, College of Medicine, Nanchang University, Nanchang, Jiangxi Province, China
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Vas S, Casey JM, Schneider WT, Kalmar L, Morton AJ. Wake-Promoting and EEG Spectral Effects of Modafinil After Acute or Chronic Administration in the R6/2 Mouse Model of Huntington's Disease. Neurotherapeutics 2020; 17:1075-1086. [PMID: 32297185 PMCID: PMC7609772 DOI: 10.1007/s13311-020-00849-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
Abstract
Huntington's disease (HD) is characterised by progressive symptoms including cognitive deficits and sleep/wake disturbances reflected in an abnormal electroencephalography (EEG). Modafinil, a wake-promoting and cognitive-enhancing drug, has been considered as a treatment for HD. We used HD (R6/2) mice to investigate the potential for using modafinil to treat sleep-wake disturbance in HD. R6/2 mice show sleep-wake and EEG changes similar to those seen in HD patients, with increased rapid eye movement sleep (REMS), decreased wakefulness/increased non-REMS (NREMS), and pathological changes in EEG spectra, particularly an increase in gamma power. We recorded EEG from R6/2 and wild-type mice treated with modafinil acutely (with single doses between 25 and 100 mg/kg; at 12 and 16 weeks of age), or chronically (64 mg/kg modafinil/day from 6 to 15 weeks). Acutely, modafinil increased wakefulness in R6/2 mice and restored NREMS to wild-type levels at 12 weeks. It also suppressed the pathologically increased REMS. This was accompanied by decreased delta power, increased peak frequency of theta, and increased gamma power. At 16 weeks, acute modafinil also restored wakefulness and NREMS to wild-type levels. However, whilst REMS decreased, it did not return to normal levels. By contrast, in the chronic treatment group, modafinil-induced wakefulness was maintained at 15 weeks (after 9 weeks of treatment). Interestingly, chronic modafinil also caused widespread suppression of power across the EEG spectra, including a reduction in gamma that increases pathologically in R6/2 mice. The complex EEG effects of modafinil in R6/2 mice should provide a baseline for further studies to investigate the translatability of these result to clinical practice.
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Affiliation(s)
- Szilvia Vas
- Department of Physiology, Development and Neuroscience, University of Cambridge, Downing Street, Cambridge, CB2 3DY, UK
| | - Jackie M Casey
- Department of Physiology, Development and Neuroscience, University of Cambridge, Downing Street, Cambridge, CB2 3DY, UK
| | - Will T Schneider
- Department of Physiology, Development and Neuroscience, University of Cambridge, Downing Street, Cambridge, CB2 3DY, UK
| | - Lajos Kalmar
- Department of Veterinary Medicine, University of Cambridge, Madingley Road, Cambridge, CB3 0ES, UK
| | - A Jennifer Morton
- Department of Physiology, Development and Neuroscience, University of Cambridge, Downing Street, Cambridge, CB2 3DY, UK.
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Memon AA, Coleman JJ, Amara AW. Effects of exercise on sleep in neurodegenerative disease. Neurobiol Dis 2020; 140:104859. [PMID: 32243913 PMCID: PMC7497904 DOI: 10.1016/j.nbd.2020.104859] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2019] [Revised: 03/22/2020] [Accepted: 03/30/2020] [Indexed: 02/07/2023] Open
Abstract
As the population ages, the incidence and prevalence of neurodegenerative disorders will continue to increase. Persons with neurodegenerative disease frequently experience sleep disorders, which not only affect quality of life, but potentially accelerate progression of the disease. Unfortunately, pharmacological interventions are often futile or have adverse effects. Therefore, investigation of non-pharmacological interventions has the potential to expand the treatment landscape for these disorders. The last decade has observed increasing recognition of the beneficial role of exercise in brain diseases, and neurodegenerative disorders in particular. In this review, we will focus on the therapeutic role of exercise for sleep dysfunction in four neurodegenerative diseases, namely Alzheimer's disease, Parkinson's disease, Huntington's disease, and amyotrophic lateral sclerosis. Available data suggest that exercise may have the potential to improve sleep disorders and attenuate neurodegeneration, particularly in Alzheimer's disease and Parkinson's disease. However, additional research is required in order to understand the most effective exercise therapy for these indications; the best way to monitor the response to interventions; the influence of exercise on sleep dysfunction in Huntington's disease and amyotrophic lateral sclerosis; and the mechanisms underlying exercise-induced sleep modifications.
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Affiliation(s)
- Adeel A Memon
- Department of Neurology, University of Alabama at Birmingham, Birmingham, AL 35294, United States of America
| | - Juliana J Coleman
- Department of Neurology, University of Alabama at Birmingham, Birmingham, AL 35294, United States of America
| | - Amy W Amara
- Department of Neurology, University of Alabama at Birmingham, Birmingham, AL 35294, United States of America; UAB Center for Exercise Medicine, Birmingham, AL 35205, United States of America; UAB Sleep and Circadian Research Core, United States of America.
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13
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Bartlett DM, Poudel G, Maddison KJ, Lampit A, Dann L, Eastwood PR, Lazar AS, Ziman MR, Cruickshank TM. Effect of multidisciplinary rehabilitation on sleep outcomes in individuals with preclinical Huntington disease: An exploratory study. Ann Phys Rehabil Med 2019; 63:570-573. [PMID: 31778841 DOI: 10.1016/j.rehab.2019.11.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2019] [Revised: 10/16/2019] [Accepted: 11/01/2019] [Indexed: 02/02/2023]
Affiliation(s)
- Danielle M Bartlett
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia.
| | - Govinda Poudel
- Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, Australia
| | - Kathleen J Maddison
- Centre for Sleep Science, School of Human Sciences, University of Western Australia, Crawley, Western Australia; Department of Pulmonary Physiology and Sleep Medicine, Sir Charles Gairdner Hospital, Nedlands, Western Australia
| | - Amit Lampit
- Department of Psychiatry, University of Melbourne, Melbourne Australia; Department of Neurology, Charité-Universitätsmedizin Berlin, Berlin Germany
| | - Linda Dann
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia
| | - Peter R Eastwood
- Centre for Sleep Science, School of Human Sciences, University of Western Australia, Crawley, Western Australia; Department of Pulmonary Physiology and Sleep Medicine, Sir Charles Gairdner Hospital, Nedlands, Western Australia
| | - Alpar S Lazar
- Faculty of Medicine and Health Sciences, University of East Anglia, Norwich, Norfolk, United Kingdom
| | - Mel R Ziman
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia; School of Biomedical Science, University of Western Australia, Crawley, Western Australia
| | - Travis M Cruickshank
- Exercise Medicine Research Institute, Edith Cowan University, Perth, Australia; Perron Institute for Neurological and Translational Science, Perth, Western Australia
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14
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Zhang Y, Ren R, Yang L, Zhou J, Li Y, Shi J, Lu L, Sanford LD, Tang X. Sleep in Huntington's disease: a systematic review and meta-analysis of polysomongraphic findings. Sleep 2019; 42:zsz154. [PMID: 31328779 PMCID: PMC6783889 DOI: 10.1093/sleep/zsz154] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2018] [Revised: 04/21/2019] [Indexed: 02/05/2023] Open
Abstract
STUDY OBJECTIVES Disturbed overnight sleep is a prominent feature of advanced stage Huntington's disease (HD). Several polysomnography (PSG) studies have reported significant changes of sleep in HD patients, but the findings are not unequivocal. To date, no meta-analysis has investigated the PSG changes in HD patients. The present study meta-analyzed results from studies examining the PSG changes in HD patients compared with controls. METHODS A literature search performed in MEDLINE, EMBASE, All EBM databases, PsycINFO, and CINAHL databases identified seven studies involving 152 HD patients and 144 controls which were included in our meta-analysis. RESULTS Pooled results indicated decreased sleep efficiency, percentage of slow wave sleep and rapid eye movement sleep, and increased percentage of N1 sleep, wake time after sleep onset, and rapid eye movement sleep latency in HD patients compared with controls. We found high heterogeneity in the effect sizes and no indication of systematic publication biases across studies. Meta-regression analyses showed that some of the heterogeneity was explained by age, body mass index (BMI), CAG repeat length, and disease severity of HD patients. CONCLUSIONS Our study showed that polysomnographic abnormalities are present in HD. Our findings also underscore the need for a comprehensive PSG assessment of sleep changes in patients with HD. Furthermore, the effects of age, BMI and CAG repeat length on sleep changes should be carefully considered and closely monitored in the management of HD.
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Affiliation(s)
- Ye Zhang
- Sleep Medicine Center, Department of Respiratory and Critical Care Medicine, Mental Health Center, Translational Neuroscience Center, and State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, China
| | - Rong Ren
- Sleep Medicine Center, Department of Respiratory and Critical Care Medicine, Mental Health Center, Translational Neuroscience Center, and State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, China
| | - Linghui Yang
- Sleep Medicine Center, Department of Respiratory and Critical Care Medicine, Mental Health Center, Translational Neuroscience Center, and State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, China
| | - Junying Zhou
- Sleep Medicine Center, Department of Respiratory and Critical Care Medicine, Mental Health Center, Translational Neuroscience Center, and State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, China
| | - Yun Li
- Sleep Medicine Center, Shantou University Medical College, Shantou, China
| | - Jie Shi
- National Institute on Drug Dependence, Peking University Sixth Hospital, Peking University, Beijing, China
| | - Lin Lu
- National Institute on Drug Dependence, Peking University Sixth Hospital, Peking University, Beijing, China
| | - Larry D Sanford
- Sleep Research Laboratory, Department of Pathology and Anatomy, Eastern Virginia Medical School, Norfolk, VA
| | - Xiangdong Tang
- Sleep Medicine Center, Department of Respiratory and Critical Care Medicine, Mental Health Center, Translational Neuroscience Center, and State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, China
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15
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Herzog–Krzywoszanska R, Krzywoszanski L. Sleep Disorders in Huntington's Disease. Front Psychiatry 2019; 10:221. [PMID: 31031659 PMCID: PMC6474183 DOI: 10.3389/fpsyt.2019.00221] [Citation(s) in RCA: 47] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2018] [Accepted: 03/26/2019] [Indexed: 12/13/2022] Open
Abstract
Huntington's chorea (Huntington's disease, HD) is a genetic disorder caused by autosomal dominant mutation, leading to progressive neurodegenerative changes in the central nervous system. Involuntary movements such as chorea occur typically in HD patients, accompanied by progressive cognitive and psychiatric disturbances. Other common symptoms of HD are circadian and sleep abnormalities, which are observed from the earliest stages of the disease or even before the occurrence of clinical symptoms. The most common sleep problems reported by HD patients include insomnia, difficulties in falling asleep, frequent nocturnal awakenings, and excessive daytime sleepiness. Also, specific changes in sleep architecture have been identified in HD. In this paper, we review studies on sleep and circadian rhythm disorders in HD. We outline findings concerning sleep patterns and disturbances of circadian rhythms in HD patients, as well as the role of psychiatric disorders and motor disorders in HD patients' sleep problems. We also discuss problems related to the different methods of diagnosing sleep disorders in HD. Furthermore, the adverse effects of medication used for the treatment of core HD symptoms as one of the sources of sleep disturbances in HD are emphasized. In conclusion, the diversity and complexity of the determinants of sleep and circadian rhythm disorders in HD are highlighted. Finally, the relevance of effective treatment to improve patients' functioning and quality of life as well as the potential relief of their cognitive and emotional symptoms is addressed.
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Affiliation(s)
| | - Lukasz Krzywoszanski
- Neurocognitive Psychology Unit, Chair of Psychology, Faculty of Pedagogy, Pedagogical University of Krakow, Krakow, Poland
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16
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Testa CM, Jankovic J. Huntington disease: A quarter century of progress since the gene discovery. J Neurol Sci 2019; 396:52-68. [DOI: 10.1016/j.jns.2018.09.022] [Citation(s) in RCA: 44] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2018] [Revised: 09/14/2018] [Accepted: 09/18/2018] [Indexed: 01/21/2023]
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17
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Bartlett DM, Domínguez D JF, Reyes A, Zaenker P, Feindel KW, Newton RU, Hannan AJ, Slater JA, Eastwood PR, Lazar AS, Ziman M, Cruickshank T. Investigating the relationships between hypothalamic volume and measures of circadian rhythm and habitual sleep in premanifest Huntington's disease. Neurobiol Sleep Circadian Rhythms 2018; 6:1-8. [PMID: 31236517 PMCID: PMC6586591 DOI: 10.1016/j.nbscr.2018.07.001] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2018] [Revised: 06/28/2018] [Accepted: 07/02/2018] [Indexed: 01/01/2023] Open
Abstract
Objective Pathological changes within the hypothalamus have been proposed to mediate circadian rhythm and habitual sleep disturbances in individuals with Huntington's disease (HD). However, investigations examining the relationships between hypothalamic volume and circadian rhythm and habitual sleep in individuals with HD are sparse. This study aimed to comprehensively evaluate the relationships between hypothalamic pathology and circadian rhythm and habitual sleep disturbances in individuals with premanifest HD. Methods Thirty-two individuals with premanifest HD and twenty-nine healthy age- and gender-matched controls participated in this dual-site, cross-sectional study. Magnetic resonance imaging scans were performed to evaluate hypothalamic volume. Circadian rhythm and habitual sleep were assessed via measurement of morning and evening cortisol and melatonin levels, wrist-worn actigraphy, the Consensus Sleep Diary and sleep questionnaires. Information on mood, physical activity levels and body composition were also collected. Results Compared to healthy controls, individuals with premanifest HD displayed significantly reduced grey matter volume in the hypothalamus, decreased habitual sleep efficiency and increased awakenings; however, no alterations in morning cortisol or evening melatonin release were noted in individuals with premanifest HD. While differences in the associations between hypothalamic volume and cortisol and melatonin output existed in individuals with premanifest HD compared to healthy controls, no consistent associations were observed between hypothalamic volume and circadian rhythm or habitual sleep outcomes. Conclusion While significant differences in associations between hypothalamic volume and cortisol and melatonin existed between individuals with premanifest HD and healthy controls, no differences in circadian markers were observed between the groups. This suggests that circadian regulation is maintained despite hypothalamic pathology, perhaps via neural compensation. Longitudinal studies are required to further understand the relationships between the hypothalamus and circadian rhythm and habitual sleep disturbances in HD as the disease course lengthens.
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Affiliation(s)
- Danielle M Bartlett
- School of Medical and Health Sciences, Edith Cowan University, 270 Joondalup Drive, Joondalup, Western Australia 6027, Australia
| | - Juan F Domínguez D
- School of Psychology, Australian Catholic University, Melbourne, Victoria, Australia
| | - Alvaro Reyes
- Facultad de Ciencias de la Rehabilitacion, Universidad Andres Bello, Santiago, Chile
| | - Pauline Zaenker
- School of Medical and Health Sciences, Edith Cowan University, 270 Joondalup Drive, Joondalup, Western Australia 6027, Australia
| | - Kirk W Feindel
- Centre for Microscopy, Characterisation and Analysis, University of Western Australia, Crawley, Western Australia, Australia
| | - Robert U Newton
- Exercise Medicine Research Institute, School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia.,University of Queensland Centre for Clinical Research, University of Queensland, Brisbane, Queensland, Australia
| | - Anthony J Hannan
- The Florey Institute of Neuroscience and Mental Health, University of Melbourne, Parkville, Victoria, Australia
| | - James A Slater
- Centre for Sleep Science, School of Human Sciences, Faculty of Science, University of Western Australia, Crawley, Western Australia, Australia
| | - Peter R Eastwood
- Centre for Sleep Science, School of Human Sciences, Faculty of Science, University of Western Australia, Crawley, Western Australia, Australia
| | - Alpar S Lazar
- Faculty of Medicine and Health Sciences, University of East Anglia, Norwich, Norfolk, United Kingdom
| | - Mel Ziman
- School of Medical and Health Sciences, Edith Cowan University, 270 Joondalup Drive, Joondalup, Western Australia 6027, Australia.,School of Biomedical Science, University of Western Australia, Crawley, Western Australia, Australia
| | - Travis Cruickshank
- School of Medical and Health Sciences, Edith Cowan University, 270 Joondalup Drive, Joondalup, Western Australia 6027, Australia.,Peron Institute for Neurological and Translational Science, Perth, Western Australia, Australia
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18
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Rodríguez-Blázquez C, Forjaz MJ, Kurtis MM, Balestrino R, Martinez-Martin P. Rating Scales for Movement Disorders With Sleep Disturbances: A Narrative Review. Front Neurol 2018; 9:435. [PMID: 29951032 PMCID: PMC6008651 DOI: 10.3389/fneur.2018.00435] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2018] [Accepted: 05/23/2018] [Indexed: 12/11/2022] Open
Abstract
Introduction: In recent years, a wide variety of rating scales and questionnaires for movement disorders have been developed and published, making reviews on their contents, and attributes convenient for the potential users. Sleep disorders are frequently present in movement disorders, and some movement disorders are accompanied by specific sleep difficulties. Aim: The aim of this study is to perform a narrative review of the most frequently used rating scales for movement disorders with sleep problems, with special attention to those recommended by the International Parkinson and Movement Disorders Society. Methods: Online databases (PubMed, SCOPUS, Web of Science, Google Scholar), related references from papers and websites and personal files were searched for information on comprehensive or global rating scales which assessed sleep disturbances in the following movement disorders: akathisia, chorea, dystonia, essential tremor, myoclonus, multiple system atrophy, Parkinson's disease, progressive supranuclear palsy, and tics and Tourette syndrome. For each rating scale, its objective and characteristics, as well as a summary of its psychometric properties and recommendations of use are described. Results: From 22 rating scales identified for the selected movement disorders, only 5 included specific questions on sleep problems. Movement Disorders Society-Unified Parkinson's Disease Rating scale (MDS-UPDRS), Non-Motor Symptoms Scale and Questionnaire (NMSS and NMSQuest), Scales for Outcomes in Parkinson's Disease (SCOPA)-Autonomic and Progressive Supranuclear Palsy Rating Scale (PSPRS) were the only rating scales that included items for assessing sleep disturbances. Conclusions: Despite sleep problems are frequent in movement disorders, very few of the rating scales addresses these specific symptoms. This may contribute to an infra diagnosis and mistreatment of the sleep problems in patients with movement disorders.
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Affiliation(s)
| | - Maria João Forjaz
- National School of Public Health and REDISSEC, Institute of Health Carlos III, Madrid, Spain
| | - Monica M. Kurtis
- Movement Disorders Unit, Neurology Department, Hospital Ruber International, Madrid, Spain
| | - Roberta Balestrino
- Department of Neuroscience “Rita Levi Montalcini, ” University of Turin, Turin, Italy
| | - Pablo Martinez-Martin
- National Center of Epidemiology and CIBERNED, Institute of Health Carlos III, Madrid, Spain
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19
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Diago EB, Martínez-Horta S, Lasaosa SS, Alebesque AV, Pérez-Pérez J, Kulisevsky J, del Val JL. Circadian Rhythm, Cognition, and Mood Disorders in Huntington’s Disease. J Huntingtons Dis 2018; 7:193-198. [DOI: 10.3233/jhd-180291] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Affiliation(s)
- Elena Bellosta Diago
- Department of Neurology, Hospital Clínico Universitario Lozano Blesa, Zaragoza, Spain
- Research group of Movement Disorders and Headache (GIIS070), Aragon Institute of Health Sciences, Zaragoza, Spain
| | - Saül Martínez-Horta
- Department of Neurology, Movement Disorders Unit, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
- Biomedical Research Institute Sant Pau (IIB-Sant Pau), Barcelona, Spain
| | - Sonia Santos Lasaosa
- Department of Neurology, Hospital Clínico Universitario Lozano Blesa, Zaragoza, Spain
- Research group of Movement Disorders and Headache (GIIS070), Aragon Institute of Health Sciences, Zaragoza, Spain
| | - Alejandro Viloria Alebesque
- Department of Neurology, Hospital Clínico Universitario Lozano Blesa, Zaragoza, Spain
- Research group of Movement Disorders and Headache (GIIS070), Aragon Institute of Health Sciences, Zaragoza, Spain
| | - Jesús Pérez-Pérez
- Department of Neurology, Movement Disorders Unit, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
- Biomedical Research Institute Sant Pau (IIB-Sant Pau), Barcelona, Spain
| | - Jaime Kulisevsky
- Department of Neurology, Movement Disorders Unit, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
- Biomedical Research Institute Sant Pau (IIB-Sant Pau), Barcelona, Spain
| | - Javier López del Val
- Department of Neurology, Hospital Clínico Universitario Lozano Blesa, Zaragoza, Spain
- Research group of Movement Disorders and Headache (GIIS070), Aragon Institute of Health Sciences, Zaragoza, Spain
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20
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Maskevich S, Jumabhoy R, Dao PDM, Stout JC, Drummond SPA. Pilot Validation of Ambulatory Activity Monitors for Sleep Measurement in Huntington's Disease Gene Carriers. J Huntingtons Dis 2018; 6:249-253. [PMID: 28968241 DOI: 10.3233/jhd-170251] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Sleep disturbance occurs early in Huntington's disease (HD). Consumer- and research-grade activity monitors may enable routine assessment of sleep disturbances in HD. We compared Actiwatch Spectrum Pro, Jawbone UP2 and Fitbit One to the gold standard, polysomnography, in four late presymptomatic and three early HD participants. Compared to polysomnography, all ambulatory monitors overestimated total sleep time by >60 minutes and sleep efficiency by ∼15%. Thus, for assessment of specific sleep parameters in HD, none of the activity monitors are sufficiently accurate to replace polysomnography, although they may be sufficient for estimating overall sleep-wake patterns. Larger sample replication is required.
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Affiliation(s)
- Svetlana Maskevich
- School of Psychological Sciences, Monash University, Melbourne, Australia.,Monash Institute of Cognitive and Clinical Neurosciences, Melbourne, Australia
| | - Ria Jumabhoy
- School of Psychological Sciences, Monash University, Melbourne, Australia
| | - Pierre D M Dao
- School of Psychological Sciences, Monash University, Melbourne, Australia
| | - Julie C Stout
- School of Psychological Sciences, Monash University, Melbourne, Australia.,Monash Institute of Cognitive and Clinical Neurosciences, Melbourne, Australia
| | - Sean P A Drummond
- School of Psychological Sciences, Monash University, Melbourne, Australia.,Monash Institute of Cognitive and Clinical Neurosciences, Melbourne, Australia
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21
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22
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Ramos ARS, Garrett C. Huntington's Disease: Premotor Phase. NEURODEGENER DIS 2017; 17:313-322. [DOI: 10.1159/000481172] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2017] [Accepted: 08/29/2017] [Indexed: 11/19/2022] Open
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23
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Adams JL, Dinesh K, Xiong M, Tarolli CG, Sharma S, Sheth N, Aranyosi AJ, Zhu W, Goldenthal S, Biglan KM, Dorsey ER, Sharma G. Multiple Wearable Sensors in Parkinson and Huntington Disease Individuals: A Pilot Study in Clinic and at Home. Digit Biomark 2017; 1:52-63. [PMID: 32095745 DOI: 10.1159/000479018] [Citation(s) in RCA: 43] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2017] [Accepted: 06/26/2017] [Indexed: 12/24/2022] Open
Abstract
Background Clinician rating scales and patient-reported outcomes are the principal means of assessing motor symptoms in Parkinson disease and Huntington disease. However, these assessments are subjective and generally limited to episodic in-person visits. Wearable sensors can objectively and continuously measure motor features and could be valuable in clinical research and care. Methods We recruited participants with Parkinson disease, Huntington disease, and prodromal Huntington disease (individuals who carry the genetic marker but do not yet exhibit symptoms of the disease), and controls to wear 5 accelerometer-based sensors on their chest and limbs for standardized in-clinic assessments and for 2 days at home. The study's aims were to assess the feasibility of use of wearable sensors, to determine the activity (lying, sitting, standing, walking) of participants, and to survey participants on their experience. Results Fifty-six individuals (16 with Parkinson disease, 15 with Huntington disease, 5 with prodromal Huntington disease, and 20 controls) were enrolled in the study. Data were successfully obtained from 99.3% (278/280) of sensors dispatched. On average, individuals with Huntington disease spent over 50% of the total time lying down, substantially more than individuals with prodromal Huntington disease (33%, p = 0.003), Parkinson disease (38%, p = 0.01), and controls (34%; p < 0.001). Most (86%) participants were "willing" or "very willing" to wear the sensors again. Conclusions Among individuals with movement disorders, the use of wearable sensors in clinic and at home was feasible and well-received. These sensors can identify statistically significant differences in activity profiles between individuals with movement disorders and those without. In addition, continuous, objective monitoring can reveal disease characteristics not observed in clinic.
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Affiliation(s)
- Jamie L Adams
- Department of Neurology, University of Rochester Medical Center, Rochester, New York, USA.,Center for Health and Technology, University of Rochester Medical Center, Rochester, New York, USA
| | - Karthik Dinesh
- Department of Electrical and Computer Engineering, University of Rochester Medical Center, Rochester, New York, USA
| | - Mulin Xiong
- Center for Health and Technology, University of Rochester Medical Center, Rochester, New York, USA
| | - Christopher G Tarolli
- Department of Neurology, University of Rochester Medical Center, Rochester, New York, USA.,Center for Health and Technology, University of Rochester Medical Center, Rochester, New York, USA
| | - Saloni Sharma
- Center for Health and Technology, University of Rochester Medical Center, Rochester, New York, USA
| | | | | | - William Zhu
- Center for Health and Technology, University of Rochester Medical Center, Rochester, New York, USA
| | - Steven Goldenthal
- Center for Health and Technology, University of Rochester Medical Center, Rochester, New York, USA
| | - Kevin M Biglan
- Department of Neurology, University of Rochester Medical Center, Rochester, New York, USA.,Center for Health and Technology, University of Rochester Medical Center, Rochester, New York, USA
| | - E Ray Dorsey
- Department of Neurology, University of Rochester Medical Center, Rochester, New York, USA.,Center for Health and Technology, University of Rochester Medical Center, Rochester, New York, USA
| | - Gaurav Sharma
- Department of Electrical and Computer Engineering, University of Rochester Medical Center, Rochester, New York, USA.,Department of Computer Science, University of Rochester, Rochester, New York, USA
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24
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Abstract
Hypersomnia is a common complaint in many patients with neurodegenerative diseases and a major cause of decreased quality of life. This article discusses the prevalence and factors associated with hypersomnia in patients with a variety of neurodegenerative diseases affecting the central nervous system, including tauopathies, synucleinopathies, and other conditions. Common nocturnal sleep problems that may result in daytime hypersomnia are delineated. A clinical approach to hypersomnia in patients with neurodegenerative diseases, recommended diagnostic testing, and available treatment options are also discussed.
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Affiliation(s)
- Sushanth Bhat
- Division of Sleep Medicine, Department of Neuroscience, JFK Neuroscience Institute, Seton Hall University, 65 James Street, Edison, NJ 08818, USA.
| | - Sudhansu Chokroverty
- Division of Sleep Medicine, Department of Neuroscience, JFK Neuroscience Institute, Seton Hall University, 65 James Street, Edison, NJ 08818, USA
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