Dauvilliers Yves
National Reference Centre for Orphan Diseases, Narcolepsy - Rare Hypersomnias, Sleep Unit, Department of Neurology, CHU Montpellier, University of Montpellier, Montpellier, France.
Institute for Neurosciences of Montpellier INM, University of Montpellier, INSERM, Montpellier, France.
Front Neurol Neurosci. 2021;45:139-149. doi: 10.1159/000514967. Epub 2021 May 28.
Advances in translational research provide key opportunities to explore the physiological and pathological effects of sleep in different neurodegenerative diseases. Recent findings suggest that sleep-wakefulness dysfunctions may predispose to neurodegenerative disorders such as Alzheimer's disease (AD), and vice versa. New theories on the link between sleep and β-amyloid and tau secretion, accumulation and clearance, and its interaction with hypocretins/orexins (key neuropeptides regulating wakefulness) suggest mechanistic ways to better understand the impact of sleep alterations in the pathogenesis of AD. Further studies should validate whether changes in circadian rhythm and sleep-wakefulness patterns could be used for early AD diagnosis and as prognostic markers for cognitive decline. Longitudinal studies are needed, not only to validate these biomarker interactions and to determine the cause-effect relationship and the role of sleep-wakefulness behavior in the regulation of amyloid plaque and neurofibrillary tangle formation, but also to identify the best sleep therapies and related preventive strategies for AD.
转化研究的进展为探索睡眠在不同神经退行性疾病中的生理和病理影响提供了关键契机。最近的研究结果表明，睡眠-觉醒功能障碍可能易患神经退行性疾病，如阿尔茨海默病（AD），反之亦然。关于睡眠与β-淀粉样蛋白和tau蛋白的分泌、积累和清除之间的联系，以及其与下丘脑分泌素/食欲素（调节觉醒的关键神经肽）的相互作用的新理论，提出了一些机制性方法，以更好地理解睡眠改变在AD发病机制中的影响。进一步的研究应验证昼夜节律和睡眠-觉醒模式的变化是否可用于AD的早期诊断，并作为认知衰退的预后标志物。需要进行纵向研究，不仅要验证这些生物标志物之间的相互作用，确定因果关系以及睡眠-觉醒行为在淀粉样斑块和神经原纤维缠结形成调节中的作用，还要确定针对AD的最佳睡眠疗法和相关预防策略。
