UK Dementia Research Institute at UCL, London, UK.
Adv Exp Med Biol. 2021;1344:169-188. doi: 10.1007/978-3-030-81147-1_10.
It is becoming increasingly recognized that patients with a variety of neurodegenerative diseases exhibit disordered sleep/wake patterns. While sleep impairments have typically been thought of as sequelae of underlying neurodegenerative processes in sleep-wake cycle regulating brain regions, including the brainstem, hypothalamus, and basal forebrain, emerging evidence now indicates that sleep deficits may also act as pathophysiological drivers of brain-wide disease progression. Specifically, recent work has indicated that impaired sleep can impact on neuronal activity, brain clearance mechanisms, pathological build-up of proteins, and inflammation. Altered sleep patterns may therefore be novel (potentially reversible) dynamic functional markers of proteinopathies and modifiable targets for early therapeutic intervention using non-invasive stimulation and behavioral techniques. Here we highlight research describing a potentially reciprocal interaction between impaired sleep and circadian patterns and the accumulation of pathological signs and features in Alzheimer's disease, the most prevalent neurodegenerative disease in the elderly.
越来越多的人认识到，患有各种神经退行性疾病的患者表现出睡眠/觉醒模式紊乱。虽然睡眠障碍通常被认为是睡眠-觉醒周期调节脑区（包括脑干、下丘脑和基底前脑）中潜在神经退行性过程的后遗症，但现在有新的证据表明，睡眠不足也可能是大脑广泛疾病进展的病理生理驱动因素。具体来说，最近的研究表明，睡眠障碍会影响神经元活动、大脑清除机制、蛋白质的病理性堆积和炎症。因此，改变的睡眠模式可能是蛋白病的新型（潜在可逆）动态功能标志物，也是使用非侵入性刺激和行为技术进行早期治疗干预的可调节靶点。在这里，我们重点介绍描述睡眠障碍和昼夜节律紊乱与阿尔茨海默病中病理迹象和特征积累之间可能存在的相互作用的研究，阿尔茨海默病是老年人中最常见的神经退行性疾病。
