Anderson Jack, Chiu Nicholas K H, Pye Jonathon E, Comas-Soberats Maria, Lam Aaron, Grunstein Ronald R, Lewis Simon J G, Matar Elie
Faculty of Medicine and Health, Central Clinical School, The University of Sydney, Sydney, New South Wales, Australia.
Centre for Integrated Research and Understanding of Sleep (CIRUS), Woolcock Institute of Medical Research, Sydney, New South Wales, Australia.
Mov Disord Clin Pract. 2025 Aug;12(8):1140-1145. doi: 10.1002/mdc3.70052. Epub 2025 Mar 25.
Sleep-wake disturbances are a clinically important and poorly studied feature of dementia with Lewy bodies (DLB) due to the challenges of in-laboratory polysomnography in this population.
To compare rest-activity rhythms in DLB, Parkinson's disease (PD), and age-matched controls using home-based wrist actigraphy and examine their relationship with core clinical DLB features.
Eleven DLB patients, 12 PD patients, and 11 age-matched controls underwent clinical assessment. Actigraphy data were obtained over 14 days and analyzed using nonparametric methods.
DLB patients demonstrated higher rest-activity rhythm fragmentation (P = 0.002) than controls and lower circadian amplitude (P = 0.011) than both PD and controls. Instability of rest-activity rhythm was positively correlated with hallucinations (P = 0.009) and cognitive fluctuations (P = 0.016) in DLB, and reduced daytime activity correlated with severity of motor parkinsonism (P = 0.013). No such correlations were observed in PD.
Actigraphy detects distinct rest-activity rhythm disruptions in DLB, differentiating it from PD and controls. These measures are associated with the severity of core clinical features in DLB.
由于对路易体痴呆（DLB）患者进行实验室多导睡眠图检查存在挑战，睡眠-觉醒障碍是DLB临床上重要但研究较少的一个特征。
使用基于家庭的腕部活动记录仪比较DLB、帕金森病（PD）和年龄匹配的对照组的静息-活动节律，并研究它们与DLB核心临床特征的关系。
11例DLB患者、12例PD患者和11例年龄匹配的对照者接受了临床评估。通过14天获取活动记录仪数据，并使用非参数方法进行分析。
DLB患者的静息-活动节律碎片化程度高于对照组（P = 0.002），昼夜节律幅度低于PD患者和对照组（P = 0.011）。DLB患者静息-活动节律的不稳定性与幻觉（P = 0.009）和认知波动（P = 0.016）呈正相关，白天活动减少与帕金森运动症状的严重程度相关（P = 0.013）。在PD患者中未观察到此类相关性。
活动记录仪检测到DLB患者存在明显的静息-活动节律紊乱，将其与PD和对照组区分开来。这些指标与DLB核心临床特征的严重程度相关。
