Chu Kochen Honors College of Zhejiang University, Hangzhou, Zhejiang 310058, China.
Department of Neurology, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang 310003, China.
Neuroscience. 2024 Oct 4;557:12-23. doi: 10.1016/j.neuroscience.2024.08.008. Epub 2024 Aug 11.
Alzheimer's disease (AD) is the most prevalent dementia, pathologically featuring abnormal accumulation of amyloid-β (Aβ) and hyperphosphorylated tau, while sleep, divided into rapid eye movement sleep (REM) and nonrapid eye movement sleep (NREM), plays a key role in consolidating social and spatial memory. Emerging evidence has revealed that sleep disorders such as circadian disturbances and disruption of neuronal rhythm activity are considered as both candidate risks and consequence of AD, suggesting a bidirectional relationship between sleep and AD. This review will firstly grasp basic knowledge of AD pathogenesis, then highlight macrostructural and microstructural alteration of sleep along with AD progression, explain the interaction between accumulation of Aβ and hyperphosphorylated tau, which are two critical neuropathological processes of AD, as well as neuroinflammation and sleep, and finally introduce several methods of sleep enhancement as strategies to reduce AD-associated neuropathology. Although theories about the bidirectional relationship and relevant therapeutic methods in mice have been well developed in recent years, the knowledge in human is still limited. More studies on how to effectively ameliorate AD pathology in patients by sleep enhancement and what specific roles of sleep play in AD are needed.
阿尔茨海默病(AD)是最常见的痴呆症,其病理学特征为淀粉样β(Aβ)异常积累和过度磷酸化的 tau,而睡眠分为快速眼动睡眠(REM)和非快速眼动睡眠(NREM),在巩固社交和空间记忆方面起着关键作用。新出现的证据表明,睡眠障碍,如昼夜节律紊乱和神经元节律活动中断,被认为是 AD 的候选风险因素和后果,这表明睡眠与 AD 之间存在双向关系。这篇综述将首先掌握 AD 发病机制的基础知识,然后强调随着 AD 进展,睡眠的宏观和微观结构改变,解释 Aβ和过度磷酸化 tau 的积累之间的相互作用,这是 AD 的两个关键神经病理学过程,以及神经炎症和睡眠,最后介绍几种增强睡眠的方法作为减轻 AD 相关神经病理学的策略。尽管近年来关于这种双向关系及其在小鼠中的相关治疗方法的理论已经得到很好的发展,但人类的相关知识仍然有限。需要更多的研究来了解如何通过增强睡眠有效改善患者的 AD 病理学,以及睡眠在 AD 中具体发挥的作用。