Department of Radiology, University of Miami Miller School of Medicine, Miami, FL.
Department of Neurology, University of Miami Miller School of Medicine, Miami, FL.
Sleep. 2019 Mar 1;42(3). doi: 10.1093/sleep/zsy254.
This study aims to evaluate the extent to which sleep quality impacts amnestic mild cognitive impairment (aMCI)-related brain regions in a cognitively normal cohort of individuals.
Seventy-four participants were rigorously evaluated using a battery of cognitive tests and a detailed clinical assessment to verify normal cognitive status. We then screened for sleep quality using the Pittsburgh Sleep Quality Index (PSQI) and depressive symptoms using the Geriatric Depression Scale (GDS). Five subjects were excluded due to mild depression. Overall 38 individuals with mean age 70.7 ± 7 were classified as poor sleepers and 31 with mean age of 69.6 ± 6 years as normal sleepers. Structural MRI and Freesurfer brain parcellation were used to measure aMCI-related brain regions.
Relative to normal sleepers, poor sleepers exhibited significant reductions in cortical and subcortical volumes bilaterally in the hippocampi, as well as in the superior parietal lobules and left amygdala. The effects were strongest in the left superior parietal lobule (p < .015), followed by the hippocampi. Diffuse patterns of cortical thinning were observed in the frontal lobes, but significant effects were concentrated in the right mesial frontal cortex. Lower sleep duration was most correlated with cortical volume and thickness reductions among all subjects.
Atrophy related to poor sleep quality impacted a number of regions implicated in aMCI and Alzheimer's disease (AD). As such, interventions targeted towards improving sleep quality amongst the elderly may prove an effective tool for modulating the course of aMCI and AD.
本研究旨在评估睡眠质量对认知正常个体中与遗忘型轻度认知障碍(aMCI)相关的脑区的影响程度。
74 名参与者接受了一系列认知测试和详细的临床评估,以严格评估其认知状态。然后,我们使用匹兹堡睡眠质量指数(PSQI)筛查睡眠质量,使用老年抑郁量表(GDS)筛查抑郁症状。有 5 名受试者因轻度抑郁而被排除在外。共有 38 名平均年龄为 70.7 ± 7 岁的受试者被归类为睡眠质量差的人群,31 名平均年龄为 69.6 ± 6 岁的受试者被归类为睡眠质量正常的人群。我们使用结构 MRI 和 Freesurfer 脑分割来测量与 aMCI 相关的脑区。
与睡眠质量正常的人群相比,睡眠质量差的人群双侧海马、顶叶上回和左侧杏仁核的皮质和皮质下体积显著减少。左侧顶叶上回的影响最强(p <.015),其次是海马。额叶观察到弥漫性皮质变薄模式,但显著的影响集中在右侧内侧额叶皮质。所有受试者中,睡眠时间较短与皮质体积和厚度减少的相关性最强。
与睡眠质量差相关的萎缩影响了多个与 aMCI 和阿尔茨海默病(AD)相关的区域。因此,针对改善老年人睡眠质量的干预措施可能被证明是调节 aMCI 和 AD 进程的有效工具。