Tamburrino Ludovica, Tafuri Benedetta, Gnoni Valentina, Nigro Salvatore, Giugno Alessia, Urso Daniele, Zoccolella Stefano, Filardi Marco, Logroscino Giancarlo
Department of Translational Biomedicine and Neurosciences (DiBraiN), University of Bari Aldo Moro, Bari, Italy; Center for Neurodegenerative Diseases and the Aging Brain, University of Bari Aldo Moro, "Pia Fondazione Cardinale G. Panico", Tricase, Lecce, Italy.
Center for Neurodegenerative Diseases and the Aging Brain, University of Bari Aldo Moro, "Pia Fondazione Cardinale G. Panico", Tricase, Lecce, Italy.
Sleep Med. 2025 Feb;126:178-184. doi: 10.1016/j.sleep.2024.12.009. Epub 2024 Dec 10.
Actigraphy is increasingly being used to assess sleep in patients with neurodegenerative diseases. However, information on its accuracy relative to polysomnography (PSG) in this clinical population remains scarce. This study investigates the performance of actigraphy compared to PSG in patients with behavioral variant frontotemporal dementia (bvFTD), which is the leading form of early-onset dementia.
Eighteen patients with bvFTD (10 males, mean age 70.50 ± 8.48 years) underwent overnight, in-home PSG while concurrently wearing an actigraph on their non-dominant wrist. Actigraphy performance was assessed through discrepancy analysis, Bland-Altman plots, and epoch-by-epoch analysis (EBE). Analyses were conducted separately for the Cole-Kripke and UCSD scoring algorithms.
Discrepancy analysis highlighted that the Cole-Kripke and UCSD algorithms overestimate total sleep time (by 43 and 60 min, respectively) and sleep efficiency (by 7.13 % and 10.33 %, respectively). The Cole-Kripke algorithm also overestimates sleep onset latency (by 7.75 min). Wake after sleep onset (WASO) showed a negative proportional bias for both algorithms, indicating that actigraphy underestimates WASO for subjects with longer PSG-measured WASO. In the EBE analysis, the Cole-Kripke algorithm shows an accuracy of 84 % (sensitivity 93 %, specificity 62 %) and the UCSD algorithm an accuracy of 85 % (sensitivity 96 %, specificity 57 %).
In patients with bvFTD, actigraphy significantly overestimates total sleep time, sleep latency, and sleep efficiency, while underestimating WASO. Clinicians and researchers using actigraphy to study sleep in bvFTD must carefully consider these measurement biases and correct for them based on the results of previous comparison studies.
活动记录仪越来越多地用于评估神经退行性疾病患者的睡眠情况。然而，关于其在这一临床群体中相对于多导睡眠图（PSG）的准确性的信息仍然很少。本研究调查了活动记录仪与PSG相比在行为变异型额颞叶痴呆（bvFTD）患者中的表现，bvFTD是早发性痴呆的主要形式。
18例bvFTD患者（10例男性，平均年龄70.50±8.48岁）在家中进行夜间PSG监测，同时在其非优势手腕上佩戴活动记录仪。通过差异分析、Bland-Altman图和逐段分析（EBE）评估活动记录仪的性能。分别对Cole-Kripke和加州大学圣地亚哥分校（UCSD）评分算法进行分析。
差异分析表明，Cole-Kripke和UCSD算法分别高估了总睡眠时间（分别为43分钟和60分钟）和睡眠效率（分别为7.13%和10.33%）。Cole-Kripke算法还高估了入睡潜伏期（7.75分钟）。两种算法的睡眠后觉醒（WASO）均显示负比例偏差，表明活动记录仪低估了PSG测量的WASO较长的受试者的WASO。在EBE分析中，Cole-Kripke算法的准确率为84%（敏感性93%，特异性62%），UCSD算法的准确率为85%（敏感性96%，特异性57%）。
在bvFTD患者中，活动记录仪显著高估了总睡眠时间、睡眠潜伏期和睡眠效率，同时低估了WASO。使用活动记录仪研究bvFTD患者睡眠的临床医生和研究人员必须仔细考虑这些测量偏差，并根据先前比较研究的结果进行校正。
