Department of Neurology, Memory and Aging Center, Weill Institute for Neurosciences, University of California San Francisco, San Francisco, California, USA.
Global Brain Health Institute, University of California San Francisco, San Francisco, California, USA.
Alzheimers Dement. 2021 Aug;17(8):1403-1406. doi: 10.1002/alz.12304. Epub 2021 Mar 12.
Although, the clinical variants of Alzheimer's disease (AD) show distinct patterns of cognitive and behavioral decline, disease progression, and neuropathological features, it is unclear if this clinical heterogeneity extends to sleep-wake patterns. Sleep and wake disturbances are frequent in typical AD, often preceding memory loss and negatively impacting the quality of life of patients and caregivers alike. Still, sleep and wake disorders are often misdiagnosed and undertreated in typical AD. Better characterization of sleep-wake features in AD clinical variants is an unmet gap of high importance because these differing patterns may require tailored treatment strategies. Moreover, as wake-promoting neurons are located in subcortical nuclei and degenerate early in typical AD, contrasting the profiles of sleep-wake patterns in typical and atypical AD aids diagnosis and brings a unique opportunity to uncover the mechanisms underlying AD clinical variants at the subcortical level and mechanisms for selective neuronal vulnerability.
尽管阿尔茨海默病（AD）的临床变异型表现出明显不同的认知和行为衰退、疾病进展和神经病理学特征，但尚不清楚这种临床异质性是否会延伸到睡眠-觉醒模式。在典型的 AD 中，睡眠和觉醒障碍很常见，通常在记忆丧失之前出现，并对患者和护理人员的生活质量产生负面影响。尽管如此，睡眠和觉醒障碍在典型 AD 中经常被误诊和治疗不足。更好地描述 AD 临床变异型的睡眠-觉醒特征是一个未满足的高度重要的差距，因为这些不同的模式可能需要定制的治疗策略。此外，由于促进觉醒的神经元位于皮质下核，并且在典型 AD 中早期退化，因此对比典型和非典型 AD 的睡眠-觉醒模式特征有助于诊断，并为在皮质下水平揭示 AD 临床变异型的机制以及选择性神经元易损性的机制提供了独特的机会。
