Okawa M, Mishima K, Hishikawa Y, Hozumi S
Akita University School of Medicine, Department of Neuropsychiatry.
Rinsho Shinkeigaku. 1995 Jan;35(1):18-23.
We simultaneously monitored rest-activity and body temperature (BT) rhythm in demented patients with sleep and behavior disorders using ambulatory wrist-worn actigraph and long-term monitoring system for 5-7 consecutive days. Subjects consisted of 19 patients with senile dementia of Alzheimer's type (SDAT) (M/F = 7/12, mean age = 71.7 years), 16 patients with multi-infarct dementia (MID) (M/F = 9/7, mean age = 75.2 years) and 9 normal controls (M/F = 4/5, mean age = 70.4 years). Both dementia groups showed a significant increase in percentage of nighttime activity. In the SDAT group, a significant positive correlation between the degree of dementia and total activity was observed, but not observed in the MID group. A significant high amplitude of BT rhythm was observed in the SDAT group comparing that in the MID or the control group. These findings indicate that the SDAT patients had a disrupted rest-activity rhythm with the severity of intellectual deterioration and increased night activity, while the circadian BT rhythm was remarkably well preserved, i.e. there was a dissociation between rest-activity and BT rhythms in the SDAT group. On the other hand, the disruption of the rest-activity and BT rhythm in the MID patients was characterized by a concomitant decrease of amplitude, which seems to have no relation with the severity of dementia. Different mechanisms could be involved in characteristic disruption of the circadian rhythms in the 2 dementia groups.
我们使用可穿戴式腕部活动记录仪和长期监测系统,对患有睡眠和行为障碍的痴呆患者的休息 - 活动和体温(BT)节律进行了连续5至7天的同步监测。研究对象包括19例阿尔茨海默型老年痴呆症(SDAT)患者(男/女 = 7/12,平均年龄 = 71.7岁)、16例多发梗死性痴呆(MID)患者(男/女 = 9/7,平均年龄 = 75.2岁)和9名正常对照者(男/女 = 4/5,平均年龄 = 70.4岁)。两个痴呆组的夜间活动百分比均显著增加。在SDAT组中,观察到痴呆程度与总活动量之间存在显著正相关,但在MID组中未观察到。与MID组或对照组相比,SDAT组的BT节律振幅显著较高。这些发现表明,SDAT患者的休息 - 活动节律随着智力衰退的严重程度而紊乱,夜间活动增加,而昼夜BT节律却得到了显著保留,即SDAT组的休息 - 活动节律与BT节律之间存在分离。另一方面,MID患者的休息 - 活动和BT节律紊乱的特征是振幅同时降低,这似乎与痴呆的严重程度无关。两种痴呆组昼夜节律的特征性紊乱可能涉及不同的机制。