Peking University China-Japan Friendship School of Clinical Medicine.
Department of Neurology, China-Japan Friendship Hospital, Beijing, China.
Neuroreport. 2021 Aug 4;32(11):942-948. doi: 10.1097/WNR.0000000000001689.
Sleep disturbances are one of the preventive factors to delay the onset and progression of Alzheimer's disease. Early identification of Alzheimer's disease patients prone to develop sleep disturbances to offer early medical intervention is important. Resting-state functional MRI is a widely used method to investigate the neural mechanisms and find neuroimaging biomarkers in neuropsychiatric diseases. In this study, we applied percent amplitude of fluctuation (PerAF) and mPerAF (divided by global mean PerAF) to test the strength of intrinsic brain activity in 38 mild Alzheimer's disease patients with sleep disturbances (ADSD) and 21 mild Alzheimer's disease patients without sleep disturbances (ADNSD). Compared with ADNSD, we found decreased intrinsic brain activity in the calcarine gyrus, the lingual gyrus, the fusiform gyrus extending to the parahippocampal gyrus, the precentral gyrus, the postcentral gyrus (all in the left hemisphere) and the left brainstem. Conclusively, ADSD exhibited reduced neural activity in specific brain regions related to the sensorimotor network and the visual network, which indicated the contribution of sleep disturbances to the progression of Alzheimer's disease. Especially, the ventral visual pathway to the hippocampus might serve for the memory impaired by sleep disturbances in Alzheimer's disease, and the brainstem might be critical in the initiation of sleep disturbances in Alzheimer's disease. These findings further elucidate the interactions between Alzheimer's disease and sleep disturbances and could help with the early recognition of Alzheimer's disease patients who tend to develop sleep disturbances.
睡眠障碍是延缓阿尔茨海默病发病和进展的预防因素之一。早期识别易发生睡眠障碍的阿尔茨海默病患者并提供早期医学干预非常重要。静息态功能磁共振成像(rs-fMRI)是一种广泛用于研究神经精神疾病神经机制和寻找神经影像学生物标志物的方法。在这项研究中,我们应用了百分比幅度波动(PerAF)和 mPerAF(除以全局平均 PerAF)来测试 38 例有睡眠障碍的轻度阿尔茨海默病患者(ADSD)和 21 例无睡眠障碍的轻度阿尔茨海默病患者(ADNSD)的大脑固有活动强度。与 ADNSD 相比,我们发现 ADSD 患者在左侧的楔前回、舌回、梭状回延伸至海马旁回、中央前回、中央后回(均在左侧)和左侧脑干部位的大脑固有活动减少。总之,ADSD 表现出与感觉运动网络和视觉网络相关的特定脑区的神经活动减少,这表明睡眠障碍对阿尔茨海默病的进展有贡献。特别是,到海马的腹侧视觉通路可能与阿尔茨海默病的睡眠障碍引起的记忆受损有关,而脑干部位可能在阿尔茨海默病的睡眠障碍的发生中起关键作用。这些发现进一步阐明了阿尔茨海默病与睡眠障碍之间的相互作用,并有助于早期识别易发生睡眠障碍的阿尔茨海默病患者。