scholarly journals 1127 Utility of Quantitative EEG During Sleep as a Potential Biomarker of Lewy Body Disease Progression

SLEEP ◽  
2020 ◽  
Vol 43 (Supplement_1) ◽  
pp. A429-A429
Author(s):  
E Matar ◽  
K A Ehgoetz Martens ◽  
R R Grunstein ◽  
A D’Rozario ◽  
S J Lewis
Keyword(s):  
Rem Sleep ◽  
Lewy Body ◽  
Sleep Disturbances ◽  
Rem Sleep Behavior Disorder ◽  
Lewy Body Disease ◽  
Quantitative Eeg ◽  
Sleep Regulation ◽  
Disease Spectrum ◽  
Potential Biomarker ◽  
Increased Risk

Abstract Introduction Sleep disturbances are common among patients with Lewy body disorders. Idiopathic REM sleep behavior disorder (iRBD) has been identified as a prodromal Lewy body condition with a significantly increased risk of conversion to either Parkinson’s disease (PD) or Dementia with Lewy Bodies (DLB). Pathological involvement of thalamic and brainstem structures involved in sleep regulation has been reported in these disorders, especially in later stages. We hypothesized that progression along the Lewy body disease spectrum may be associated with unique changes in spindle density and EEG power spectra during sleep reflecting involvement of these deep brain structures. Methods A cross-sectional design was used. 9 polysomnography confirmed iRBD, 18 early PD, 23 DLB and 13 controls underwent overnight polysomnography, neurological and neuropsychological assessment. Power spectrum analysis during NREM and REM sleep was undertaken using a previously validated quantitative EEG algorithm and compared between groups. Following artefact and outlier removal, results were analysed using the Cz derivation. Groups were statistically compared with a non-parametric Jonckheree-Terpstra test for ordered alternatives, controlling for age and sex. Results We found a significant and ordered reduction in power in the spindle frequency band (12-15 Hz) in NREM sleep across the Lewy body disease spectrum compared to controls (Controls > iRBD > early PD > DLB; TJT = 521.00, z = -2.902. p<0.001). In REM sleep we found a shift in power to slower frequencies with increased power in the theta (4.5-8 Hz) band in order of disease severity (DLB > early PD > iRBD > Controls; TJT = 950.00, z = 2.253. p=0.024). No differences were found across the other frequency bands in NREM or REM sleep. Conclusion There is a significant and progressive reduction in spindle density and corresponding slowing in REM sleep frequencies during sleep with clinical Lewy body staging. Thus, such measures have the potential to be useful biomarkers of progression towards Lewy body dementia from prodromal stages. Support This work was supported by a NHMRC Dementia Team Grant (#1095127), the NHMRC Postgraduate Scholarship and the University of Sydney Research Excellence Initiative 2020 grant.

Incidental Lewy body disease in a patient with REM sleep behavior disorder

Neurology ◽  
1995 ◽  
Vol 45 (4) ◽  
pp. 709-712 ◽  
Author(s):  
M. Uchiyama ◽  
K. Isse ◽  
K. Tanaka ◽  
N. Yokota ◽  
M. Hamamoto ◽  
...  
Keyword(s):  
Rem Sleep ◽  
Lewy Body ◽  
Rem Sleep Behavior Disorder ◽  
Behavior Disorder ◽  
Lewy Body Disease ◽  
Sleep Behavior ◽  
Incidental Lewy Body Disease

Probable diffuse Lewy body disease presenting as REM sleep behavior disorder

Neurology ◽  
1997 ◽  
Vol 49 (2) ◽  
pp. 523-527 ◽  
Author(s):  
R. S. Turner ◽  
R. D. Chervin ◽  
K. A. Frey ◽  
S. Minoshima ◽  
D. E. Kuhl
Keyword(s):  
Rem Sleep ◽  
Lewy Body ◽  
Rem Sleep Behavior Disorder ◽  
Behavior Disorder ◽  
Lewy Body Disease ◽  
Diffuse Lewy Body Disease ◽  
Sleep Behavior

scholarly journals Insights into REM sleep behavior disorder pathophysiology in brainstem-predominant Lewy body disease

2007 ◽  
Vol 8 (1) ◽  
pp. 60-64 ◽  
Author(s):  
B.F. Boeve ◽  
D.W. Dickson ◽  
E.J. Olson ◽  
J.W. Shepard ◽  
M.H. Silber ◽  
...  
Keyword(s):  
Rem Sleep ◽  
Lewy Body ◽  
Rem Sleep Behavior Disorder ◽  
Behavior Disorder ◽  
Lewy Body Disease ◽  
Sleep Behavior

scholarly journals REM sleep muscle activity in idiopathic REM sleep behavior disorder predicts phenoconversion

Neurology ◽  
2019 ◽  
Vol 93 (12) ◽  
pp. e1171-e1179 ◽  
Author(s):  
Stuart J. McCarter ◽  
David J. Sandness ◽  
Allison R. McCarter ◽  
John C. Feemster ◽  
Luke N. Teigen ◽  
...  
Keyword(s):  
Rem Sleep ◽  
Muscle Activity ◽  
Rem Sleep Behavior Disorder ◽  
Behavior Disorder ◽  
Sleep Behavior ◽  
Kaplan Meier ◽  
Potential Biomarker ◽  
Increased Risk ◽  
Rem Sleep Without Atonia ◽  
Rem Atonia

ObjectiveTo determine whether REM sleep without atonia (RSWA) during polysomnography (PSG) predicts phenoconversion in patients with idiopathic REM sleep behavior disorder (iRBD), a prodromal feature of a neurodegenerative disease.MethodsWe analyzed RSWA in 60 patients with iRBD, including manual phasic, tonic, and any muscle activity in the submentalis and anterior tibialis muscles and the automated REM atonia index in the submentals. We identified patients who developed parkinsonism or mild cognitive impairment (MCI) during at least 3 years of follow-up after PSG. Kaplan-Meier analysis was performed and receiver operator curves were calculated to determine RSWA cutoffs predicting faster phenoconversion.ResultsTwenty-six (43%) patients developed parkinsonism (n = 17) or MCI (n = 9). Phenoconverters were older at iRBD diagnosis (p = 0.02). Median time to phenoconversion was 3.9 ± 2.5 years. iRBD phenoconverters had significantly more RSWA at diagnosis. Phenoconversion risk from iRBD diagnosis was 20% and 35% at 3 and 5 years, respectively, with greater risk in patients with iRBD with >46.4% any combined RSWA, which increased further to 30% and 55% at 3 and 5 years for patients >65 years of age at diagnosis.ConclusionsPatients with iRBD with higher amounts of polysomnographic RSWA had a greater risk of developing Parkinson disease or MCI. Patients with older age and higher RSWA amounts had more rapid phenoconversion than younger patients with RBD. Our study suggests that RSWA is a potential biomarker for risk stratification of iRBD phenoconversion that could facilitate prognostication for patients with iRBD.Classification of evidenceThis study provides Class II evidence that for patients with iRBD, increased RSWA correlates with increased risk for developing parkinsonism or MCI.

FDG Uptake in the Basal Forebrain as Measured by Digital High-Resolution PET Is a Promising Marker of Basal Forebrain Degeneration in the Lewy Body Disease Spectrum

2020 ◽  
Vol 45 (4) ◽  
pp. 261-266
Author(s):  
Cansu Özden ◽  
Lars Frings ◽  
Ivayla Apostolova ◽  
Catharina Lange ◽  
Susanne Klutmann ◽  
...  
Keyword(s):  
High Resolution ◽  
Basal Forebrain ◽  
Lewy Body ◽  
Lewy Body Disease ◽  
Fdg Uptake ◽  
Disease Spectrum

scholarly journals 0789 Decreased Sigma Band Power During NREM Sleep in REM Sleep Behavior Disorder

SLEEP ◽  
2020 ◽  
Vol 43 (Supplement_1) ◽  
pp. A300-A300
Author(s):  
Y Lee ◽  
B Lee
Keyword(s):  
Rem Sleep ◽  
Spectral Power ◽  
Rem Sleep Behavior Disorder ◽  
Behavior Disorder ◽  
Nrem Sleep ◽  
Control Group ◽  
Sleep Behavior ◽  
Band Power ◽  
Potential Biomarker ◽  
Obstructive Sleep

Abstract Introduction REM sleep Behavior Disorder (RBD) is characterized by dream enacting behaviors and a loss of atonia during REM sleep. Early detection of RBD is important because it is considered premonitory symptoms neurodegenerative disorders. In this study, we investigated the slow and fast sigma band power of patients with RBD using frequency analysis. Methods Twenty patients who were diagnosed as RBD according to the ICSD-3 criteria and 20 age-matched controls who underwent polysomnography (PSG) for other sleep disorders (insomnia, snoring) and showed normal to mild obstructive sleep apnea (OSA). NREM sleep EEG data was extracted and N1 sleep data was excluded to minimize arousal artifact. Fast Fourier transform-based spectral power analysis was used to compute the power spectral densities of the EEG in the MATLAB environment. The sigma bands were divided into 2 discrete bands: slow sigma (11 to 13 Hz) and- fast sigma (13 to 15 Hz). Mann-Whitney U test by SPSS was used. Results RBD patients (61.9 ± 7.1 years old; 12 men) had a significantly lower sigma band power than the control group (61.5 ± 1.1 years old; 11 men) in central region (p = 0.028). Particularly, the slow sigma band power showed a bigger difference in all regions except O1 (F3 = 0.017, F4 = 0.027, C3 = 0.004, C4 = 0.009, O2 = 0.017). Conclusion Sigma power was lower in the RBD patients than in the control. It suggests that RBD has impaired cortical activity. Thus, decreased spindle activity during NREM sleep may be a potential biomarker of RBD. Support  

scholarly journals REM sleep without atonia and the relation with Lewy body disease

2019 ◽  
Vol 67 ◽  
pp. 90-98 ◽  
Author(s):  
Femke Dijkstra ◽  
Karlien Van den Bossche ◽  
Barbara de Bruyn ◽  
Nathan Reyn ◽  
Mineke Viaene ◽  
...  
Keyword(s):  
Rem Sleep ◽  
Lewy Body ◽  
Lewy Body Disease ◽  
Rem Sleep Without Atonia
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