Wu Jade Q, Li Peng, Stavitsky Gilbert Karina, Hu Kun, Cronin-Golomb Alice
Department of Psychological and Brain Sciences Boston University Boston Massachusetts USA.
Psychiatry and Behavioral Sciences Duke University School of Medicine Durham North Carolina USA.
Mov Disord Clin Pract. 2018 Nov 8;5(6):614-619. doi: 10.1002/mdc3.12692. eCollection 2018 Nov-Dec.
Cognitive impairment is a common and debilitating symptom of Parkinson's disease (PD), and its etiology is likely multifactorial. One candidate mechanism is circadian disruption. Although there is evidence of circadian abnormalities in PD, no studies have directly assessed their association with cognitive impairment.
Investigate whether circadian rest-activity rhythm is associated with cognitive function in PD independently of sleep.
Thirty-five participants with PD wore wrist actigraph monitors and completed sleep diaries for 7 to 10 days, then underwent neuropsychological testing. Rest-activity rhythm was characterized using nonparametric circadian rhythm analysis of actigraphy data. Objective sleep parameters were also estimated using actigraphy data. Hierarchical regression models assessed the independent contributions of sleep and rest-activity rhythm to cognitive performance.
Less stable day-to-day rest-activity rhythm was associated with poorer executive, visuospatial, and psychomotor functioning, but not with memory. Hierarchical regressions showed that interdaily stability's contribution to cognitive performance was independent of sleep's contributions. Whereas sleep contributed to executive function, but not psychomotor or visuospatial performance, rest-activity rhythm stability significantly contributed to variance in all three of these domains, uniquely accounting for 14.4% to 17.6% of their performance variance.
Our findings indicate that circadian rest-activity rhythm is associated with cognitive impairment independently of sleep. This suggests the possible utility of rest-activity rhythm as a biomarker for circadian function in PD. Future research should explore interventions to stabilize behavioral rhythms in order to strengthen circadian function, which, in turn, may reduce cognitive impairment in PD.
认知障碍是帕金森病（PD）常见且使人衰弱的症状，其病因可能是多因素的。一种可能的机制是昼夜节律紊乱。尽管有证据表明PD存在昼夜节律异常，但尚无研究直接评估其与认知障碍的关联。
研究昼夜静息-活动节律是否独立于睡眠与PD患者的认知功能相关。
35名PD患者佩戴腕部活动记录仪并完成7至10天的睡眠日记，然后接受神经心理学测试。使用活动记录仪数据的非参数昼夜节律分析来表征静息-活动节律。还使用活动记录仪数据估计客观睡眠参数。分层回归模型评估睡眠和静息-活动节律对认知表现的独立贡献。
日常静息-活动节律稳定性较差与执行功能、视觉空间功能和精神运动功能较差相关，但与记忆无关。分层回归显示，日间稳定性对认知表现的贡献独立于睡眠的贡献。虽然睡眠对执行功能有贡献，但对精神运动或视觉空间表现无贡献，静息-活动节律稳定性对这三个领域的表现差异均有显著贡献，分别独特地占其表现差异的14.4%至17.6%。
我们的研究结果表明，昼夜静息-活动节律独立于睡眠与认知障碍相关。这表明静息-活动节律作为PD昼夜功能生物标志物的潜在效用。未来的研究应探索稳定行为节律的干预措施，以增强昼夜功能，进而可能减少PD患者的认知障碍。
