Memon Adeel A, Catiul Corina, Irwin Zachary, Pilkington Jennifer, Memon Raima A, Joop Allen, Wood Kimberly H, Cutter Gary, Miocinovic Svjetlana, Amara Amy W
Department of Neurology, University of Alabama at Birmingham, Birmingham, AL, United States.
Department of Neurology, West Virginia University, Morgantown, WV, United States.
Front Neurol. 2023 Sep 7;14:1223974. doi: 10.3389/fneur.2023.1223974. eCollection 2023.
Parkinson's disease (PD) patients with REM sleep behavior disorder (RBD) are at greater risk for cognitive decline and RBD has been associated with alterations in sleep-related EEG oscillations. This study evaluates differences in sleep quantitative EEG (qEEG) and cognition in PD participants with (PD-RBD) and without RBD (PD-no-RBD).
In this cross-sectional study, polysomnography (PSG)-derived qEEG and a comprehensive level II neuropsychological assessment were compared between PD-RBD ( = 21) and PD-no-RBD ( = 31). Following artifact rejection, qEEG analysis was performed in the frontal and central leads. Measures included Scalp-slow wave (SW) density, spindle density, morphological properties of SW and sleep spindles, SW-spindle phase-amplitude coupling, and spectral power analysis in NREM and REM. The neurocognitive battery had at least two tests per domain, covering five cognitive domains as recommended by the Movement Disorders Society Task Force for PD-MCI diagnosis. Differences in qEEG features and cognitive performance were compared between the two groups. Stepwise linear regression was performed to evaluate predictors of cognitive performance. Multiple comparisons were corrected using the Benjamini-Hochberg method.
Spindle density and SW-spindle co-occurrence percent were lower in participants with PD-RBD compared to PD-no-RBD. The PD-RBD group also demonstrated higher theta spectral power during REM. Sleep spindles and years of education, but not RBD, were predictors of cognitive performance.
PD participants with RBD have alterations in sleep-related qEEG compared to PD participants without RBD. Although PD-RBD participants had worse cognitive performance compared to PD-no-RBD, regression models suggest that lower sleep spindle density, rather than presence of RBD, predicts worse comprehensive cognitive score. Future studies should include longitudinal evaluation to determine whether sleep-related qEEG alterations are associated with more rapid cognitive decline in PD-RBD.
患有快速眼动睡眠行为障碍（RBD）的帕金森病（PD）患者认知功能下降的风险更高，且RBD与睡眠相关脑电图振荡的改变有关。本研究评估了伴有RBD（PD-RBD）和不伴有RBD（PD-no-RBD）的PD参与者在睡眠定量脑电图（qEEG）和认知方面的差异。
在这项横断面研究中，对PD-RBD组（n = 21）和PD-no-RBD组（n = 31）进行了多导睡眠图（PSG）衍生的qEEG和全面的二级神经心理学评估比较。在去除伪迹后，对额叶和中央导联进行qEEG分析。测量指标包括头皮慢波（SW）密度、纺锤波密度、SW和睡眠纺锤波的形态学特性、SW-纺锤波相位-振幅耦合以及非快速眼动（NREM）和快速眼动（REM）期的频谱功率分析。神经认知测试组合在每个领域至少有两项测试，涵盖运动障碍协会帕金森病轻度认知障碍（PD-MCI）诊断特别工作组推荐的五个认知领域。比较了两组之间qEEG特征和认知表现的差异。进行逐步线性回归以评估认知表现的预测因素。使用Benjamini-Hochberg方法对多重比较进行校正。
与PD-no-RBD参与者相比，PD-RBD参与者的纺锤波密度和SW-纺锤波同时出现的百分比更低。PD-RBD组在REM期也表现出更高的θ频段频谱功率。睡眠纺锤波和受教育年限是认知表现的预测因素，而RBD不是。
与不伴有RBD的PD参与者相比，伴有RBD的PD参与者在睡眠相关qEEG方面存在改变。尽管与PD-no-RBD参与者相比，PD-RBD参与者的认知表现更差，但回归模型表明，较低的睡眠纺锤波密度而非RBD的存在可预测较差的综合认知评分。未来的研究应包括纵向评估，以确定睡眠相关qEEG改变是否与PD-RBD患者更快速的认知衰退有关。
