Memon Adeel Ali, Catiul Corina, Irwin Zachary, Pilkington Jennifer, Memon Raima A, Joop Allen, Wood Kimberly H, Cutter Gary, Bamman Marcas, Miocinovic Svjetlana, Amara Amy W
Department of Neurology, University of Alabama at Birmingham, Birmingham, AL, United States.
Department of Neurosurgery, University of Alabama at Birmingham, Birmingham, AL, United States.
Front Rehabil Sci. 2022 Aug 11;3:952289. doi: 10.3389/fresc.2022.952289. eCollection 2022.
In a randomized, controlled trial, we showed that high-intensity rehabilitation, combining resistance training and body-weight interval training, improves sleep efficiency in Parkinson's disease (PD). Quantitative sleep EEG (sleep qEEG) features, including sleep spindles, are altered in aging and in neurodegenerative disease.
The objective of this post-hoc analysis was to determine the effects of exercise, in comparison to a sleep hygiene, no-exercise control group, on the quantitative characteristics of sleep spindle morphology in PD.
We conducted an exploratory post-hoc analysis of 24 PD participants who were randomized to exercise (supervised 3 times/week for 16 weeks) versus 26 PD participants who were assigned to a sleep hygiene, no-exercise control group. At baseline and post-intervention, all participants completed memory testing and underwent polysomnography (PSG). PSG-derived sleep EEG central leads (C3 and C4) were manually inspected, with rejection of movement and electrical artifacts. Sleep spindle events were detected based on the following parameters: (1) frequency filter = 11-16 Hz, (2) event duration = 0.5-3 s, and (3) amplitude threshold 75% percentile. We then calculated spindle morphological features, including density and amplitude. These characteristics were computed and averaged over non-rapid eye movement (NREM) sleep stages N2 and N3 for the full night and separately for the first and second halves of the recording. Intervention effects on these features were analyzed using general linear models with group x time interaction. Significant interaction effects were evaluated for correlations with changes in performance in the memory domain.
A significant group x time interaction effect was observed for changes in sleep spindle density due to exercise compared to sleep hygiene control during N2 and N3 during the first half of the night, with a moderate effect size. This change in spindle density was positively correlated with changes in performance on memory testing in the exercise group.
This study is the first to demonstrate that high-intensity exercise rehabilitation has a potential role in improving sleep spindle density in PD and leading to better cognitive performance in the memory domain. These findings represent a promising advance in the search for non-pharmacological treatments for this common and debilitating non-motor symptom.
在一项随机对照试验中，我们发现高强度康复训练，即结合抗阻训练和体重区间训练，可提高帕金森病（PD）患者的睡眠效率。包括睡眠纺锤波在内的定量睡眠脑电图（睡眠qEEG）特征在衰老和神经退行性疾病中会发生改变。
这项事后分析的目的是确定与睡眠卫生、无运动对照组相比，运动对PD患者睡眠纺锤波形态定量特征的影响。
我们对24名随机分配至运动组（每周监督3次，共16周）的PD参与者与26名分配至睡眠卫生、无运动对照组的PD参与者进行了探索性事后分析。在基线和干预后，所有参与者均完成记忆测试并接受多导睡眠图（PSG）检查。对PSG得出的睡眠脑电图中央导联（C3和C4）进行人工检查，排除运动和电伪迹。根据以下参数检测睡眠纺锤波事件：（1）频率滤波=11 - 16 Hz，（2）事件持续时间=0.5 - 3 s，（3）幅度阈值为第75百分位数。然后我们计算纺锤波形态特征，包括密度和幅度。这些特征在整个夜间的非快速眼动（NREM）睡眠阶段N2和N3进行计算并求平均值，同时分别对记录的前半段和后半段进行计算。使用具有组×时间交互作用的一般线性模型分析干预对这些特征的影响。对显著的交互作用效应进行评估，以确定其与记忆领域表现变化的相关性。
与睡眠卫生对照组相比，在夜间前半段的N2和N3睡眠阶段，运动导致睡眠纺锤波密度变化存在显著的组×时间交互作用效应，效应大小中等。运动组中这种纺锤波密度变化与记忆测试表现的变化呈正相关。
本研究首次表明高强度运动康复在改善PD患者睡眠纺锤波密度及提高记忆领域认知表现方面具有潜在作用。这些发现代表了在寻找针对这种常见且使人衰弱的非运动症状的非药物治疗方法方面取得的有前景的进展。
