Slow Wave Sleep and EEG Delta Spectral Power are Associated with Cognitive Function in Parkinson’s Disease

Background: Cognitive and sleep dysfunction are common non-motor symptoms in Parkinson’s disease (PD). Objective: Determine the relationship between slow wave sleep (SWS) and cognitive performance in PD. Methods: Thirty-two PD participants were evaluated with polysomnography and a comprehensive level II neurocognitive battery, as defined by the Movement Disorders Society Task Force for diagnosis of PD-mild cognitive impairment. Raw scores for each test were transformed into z-scores using normative data. Z-scores were averaged to obtain domain scores, and domain scores were averaged to determine the Composite Cognitive Score (CCS), the primary outcome. Participants were grouped by percent of SWS into High SWS and Low SWS groups and compared on CCS and other outcomes using 2-sided t-tests or Mann-Whitney U. Correlations of cognitive outcomes with sleep architecture and EEG spectral power were performed. Results: Participants in the High SWS group demonstrated better global cognitive function (CCS) (p = 0.01, effect size: r = 0.45). In exploratory analyses, the High SWS group showed better performance in domains of executive function (effect size: Cohen’s d = 1.05), language (d = 0.95), and processing speed (d = 1.12). Percentage of SWS was correlated with global cognition and executive function, language, and processing speed. Frontal EEG delta power during N3 was correlated with the CCS and executive function. Cognition was not correlated with subjective sleep quality. Conclusion: Increased SWS and higher delta spectral power are associated with better cognitive performance in PD. This demonstrates the significant relationship between sleep and cognitive function and suggests that interventions to improve sleep might improve cognition in individuals with PD.

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Abstract 29: Olfactory Function and Neurocognitive Outcomes in Old Age: the Atherosclerosis Risk in Communities Neurocognitive Study (ARIC-NCS)

Circulation ◽

10.1161/circ.135.suppl_1.29 ◽

2017 ◽

Vol 135 (suppl_1) ◽

Author(s):

Priya Palta ◽

Honglei Chen ◽

Jennifer A Deal ◽

David Knopman ◽

Michael Griswold ◽

...

Keyword(s):

Executive Function ◽

Cognitive Function ◽

Processing Speed ◽

Mean Difference ◽

Z Score ◽

Sense Of Smell ◽

Z Scores ◽

Olfactory Impairment ◽

Global Cognition ◽

Domain Scores

Introduction: Impairment in the sense of smell is associated with plaques and tangles in the olfactory region of the brain, which connects to the hippocampus where neuropathologic changes related to mild cognitive impairment (MCI) and dementia due to Alzheimer’s disease are first sited. Olfactory impairments may thus be a marker for poor cognitive function and MCI. We assessed olfaction and cognitive function in 6055 White and Black men and women aged 60-99 years. Methods: Sense of smell was measured in ARIC-NCS participants (2011-2013) by the 12-item Sniffin’ Sticks screening test (score range: 0-12, median: 10). A clinically validated threshold (smell score <6) defined olfactory impairment (OI). A multidimensional neuropsychological assessment (10 tests) ascertained performance in domains of memory, language, executive function/processing speed, and global cognition. For relative comparisons across the tests, raw cognitive test scores were standardized to z scores and averaged to yield domain scores. Following review of neuropsychological assessments, medical history, cerebral magnetic resonance imaging, and physical examinations, MCI was classified by a neurologist and neuropsychologist, and adjudicated by a third reviewer. Multivariable linear regression estimated the mean difference in domain-specific z scores among participants with and without OI. Logistic regression was used to quantify the prevalence odds of MCI in participants with vs. those without OI. Models were adjusted for age, sex, race, education, ARIC study center, hypertension, diabetes, smoking, and ApoE4. Race and sex were explored as effect modifiers. Results: The participants’ mean age was 76 years; 41% were male and 23% Black. The prevalence of olfactory impairment was 14%. Compared to participants with no OI, those with OI had a statistically significantly lower mean z score across all cognitive domains [memory: Beta= -0.37 (95% confidence interval [CI]: -0.45, -0.30); language: Beta= -0.39 (95% CI: -0.46, -0.33); executive function/processing speed: Beta= -0.24 (95% CI: -0.32, -0.17); global cognition: Beta= -0.34 (95% CI: -0.41, -0.26). Effect modification by race was observed in the domain of language. Blacks with OI had a greater mean difference in language z score compared to Blacks without OI (Beta= -0.57 (95% CI: -0.70, -0.44)). OI was associated with MCI in Whites, but not Blacks: white participants with OI had greater odds of MCI (Odds Ratio [OR] =1.76, 95% CI: 1.40, 2.21). Sex did not modify these associations. Conclusions: Compared to average cognitive aging (annual rate of decline of 0.04-0.05 standard deviation units/year) relatively large differences in standardized cognitive domain scores are observed between those with and without olfactory impairment among older adults. An impaired sense of smell may serve as a readily accessible early marker of neurodegeneration.

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Association between healthy eating index-2015 and various cognitive domains in US adults aged 60 years or older: the National Health and Nutrition Examination Survey (NHANES) 2011–2014

BMC Public Health ◽

10.1186/s12889-021-11914-2 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Yameng Fan ◽

Yinyin Zhang ◽

Jiaqiao Li ◽

Yamei Liu ◽

Huan Chang ◽

...

Keyword(s):

Cognitive Function ◽

Cognitive Performance ◽

Healthy Eating ◽

Processing Speed ◽

Healthy Eating Index ◽

Nutrition Examination Survey ◽

Cognitive Domains ◽

Health And Nutrition ◽

The Us ◽

Z Scores

Abstract Background Diet, as a modifiable factor, plays an important role in cognitive function. However, the association between adherence to the 2015–2020 Dietary Guidelines for Americans (DGA), measured by Healthy Eating Index (HEI)-2015, and cognitive function remains unclear. This study aims to explore whether HEI-2015 is associated with various cognitive domains and whether such association is modified by age, gender, or ethnicity in the US adults aged 60 years or older using data from the National Health and Nutrition Examination Survey (NHANES) 2011–2014. Methods HEI-2015 scores were calculated from 24-h dietary recall interviews. Cognitive function was evaluated by Digit Symbol Substitution Test (DSST, a measure of processing speed), Animal Fluency Test (AFT, a measure of executive function), a subtest from Consortium to Establish a Registry for Alzheimer’s disease (CERAD, a measure of memory), and a composite-z score calculated by summing z scores of individual tests. The associations between HEI-2015 scores and cognitive performance were explored using multiple linear regression models. Results A total of 2450 participants aged 60 years or older were included. Participants with higher HEI-2015 scores were more likely to have higher DSST, AFT as well as composite-z scores (P<0.05). Significant interaction effects were identified between HEI-2015 and ethnicity in specific cognitive domains (Pinteraction<0.05). Among HEI-2015 components, higher intakes of whole fruits and seafood and plant protein were associated with better cognitive performance (P<0.05). Conclusion Higher adherence to DGA is associated with better cognitive performance, especially regarding processing speed and executive function among the US adults aged 60 years or older.

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Acoustic slow wave sleep enhancement via a novel, automated device improves executive function in middle-aged men

SLEEP ◽

10.1093/sleep/zsz197 ◽

2019 ◽

Cited By ~ 3

Author(s):

Charmaine Diep ◽

Suzanne Ftouni ◽

Jessica E Manousakis ◽

Christian L Nicholas ◽

Sean P A Drummond ◽

...

Keyword(s):

Executive Function ◽

Cognitive Function ◽

Slow Wave ◽

Slow Wave Sleep ◽

Healthy Adult ◽

Acoustic Stimulation ◽

Trial Registration ◽

Cognitive Capacity ◽

Adult Males ◽

Middle Aged

Abstract Study Objectives As slow-wave activity (SWA) is critical for cognition, SWA-enhancing technologies provide an exciting opportunity to improve cognitive function. We focus on improving cognitive function beyond sleep-dependent memory consolidation, using an automated device, and in middle-aged adults, who have depleted SWA yet a critical need for maximal cognitive capacity in work environments. Methods Twenty-four healthy adult males aged 35–48 years participated in a randomized, double-blind, cross-over study. Participants wore an automated acoustic stimulation device that monitored real-time sleep EEG. Following an adaptation night, participants were exposed to either acoustic tones delivered on the up phase of the slow-wave (STIM) or inaudible “tones” during equivalent periods of stimulation (SHAM). An executive function test battery was administered after the experimental night. Results STIM resulted in an increase in delta (0.5–4 Hz) activity across the full-night spectra, with enhancement being maximal at 1 Hz. SWA was higher for STIM relative to SHAM. Although no group differences were observed in any cognitive outcomes, due to large individual differences in SWA enhancement, higher SWA responders showed significantly improved verbal fluency and working memory compared with nonresponders. Significant positive associations were found between SWA enhancement and improvement in these executive function outcomes. Conclusions Our study suggests that (1) an automated acoustic device enhances SWA; (2) SWA enhancement improves executive function; (3) SWA enhancement in middle-aged men may be an important therapeutic target for enhancing cognitive function; and (4) there is a need to examine interindividual responses to acoustic stimulation and its effect on subsequent cognitive function. Clinical trial registration This study has been registered with the Australian New Zealand Clinical Trials Registry. “The efficacy of acoustic tones in slow-wave sleep enhancement and cognitive function in healthy adult males”. https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=371548&isReview=true Registration ACTRN12617000399392.

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Comprehensive Assessment of Cognitive Function in Patients with Sickle Cell Disease Reveals Deficits in Memory and Processing Speed

Blood ◽

10.1182/blood-2021-151576 ◽

2021 ◽

Vol 138 (Supplement 1) ◽

pp. 975-975

Author(s):

Gerard Portela ◽

Meryl Butters ◽

Maria M Brooks ◽

Leticia Candra ◽

Caterina Rosano ◽

...

Keyword(s):

Executive Function ◽

Cognitive Function ◽

Sickle Cell Disease ◽

Sickle Cell ◽

Processing Speed ◽

Severe Disease ◽

Cognitive Domain ◽

Cell Disease ◽

History Of ◽

Domain Scores

Abstract Cognitive impairment (CI) is a serious complication of sickle cell disease (SCD) and can cause significant functional and social limitations. To date, there are only a few studies characterizing CI in adults with SCD. In this study, we comprehensively assessed cognitive function in a cross-sectional sample of patients with SCD compared to healthy controls across ten memory and processing speed domains. Patients with SCD (HbSS, HbSC and HbS/beta thalassemia) ages 18 years and older were recruited from the University of Pittsburgh Medical Center Adult Sickle Cell Program, and sex- and age-matched controls were recruited from the community and by SCD patient referral. Unlike previous studies, we did not restrict participation to patients with HbSS only and we included all SCD comorbidities. All participants underwent neurocognitive assessments using measures that are validated and accurate in discriminating CI from dementia and normal cognition. We conducted linear regression analyses to estimate the difference in each cognitive domain score between patients and controls. We also contrasted pairwise comparisons between controls and patients with and without stroke, with and without chronic blood transfusions, and classified by disease severity based on genotype. Among 86 SCD patients and 66 controls, 43% were male and the average age was 36.2 years. SCD patients had fewer years of education on average (13.3 vs. 14.2) and a higher percent had a history of smoking (46% vs. 29%). Additionally, 45% of patients had milder disease (HbSC or HbSb +-thalassemia) with the rest having severe disease (HbSS or HbSb 0-thalassemia)), 14% had a history of stroke, and 20% were receiving chronic exchange transfusions. Patients with SCD had significantly lower scores on five out of ten cognitive domains: language (b=-5.88, P=0.014), attention/processing (b=-14.47, P<0.001), RBANS total score (b=-7.55, P<0.001), executive function (b=-1.60, P<0.001), and DSST scaled score (b=-2.08, P<0.001). Adjusting for pre-morbid verbal IQ (VIQ), hemoglobin level, and smoking history, attention/processing (b=-10.70, P=0.001), RBANS total (b=-7.27, P=0.003), and DSST scaled scores (b=-1.54, P=0.019) were significantly lower among patients compared to controls. In adjusted models, there were no significant differences in cognitive domain scores between patients with mild disease compared to patients with severe disease; both mild and severe disease subgroups had lower attention/processing scores compared to controls (both P<0.05). Patients with SCD and a history of stroke had significantly lower attention/processing, executive function, RBANS total, and DSST scaled scores (all P<0.01) compared to controls, and SCD patients who did not have a history of stroke had lower attention/processing and RBANS total scores than controls (both P<0.05). Patients with a history of stroke had significantly lower executive function (b=-1.65, P=0.012), RBANS total (b=-8.64, P=0.020), and DSST scaled scores (b=-2.43, P=0.015) than patients without a history of stroke. There were no significant differences in cognitive domain scores between patients receiving chronic transfusions and those not receiving transfusions. To our knowledge, this is the most inclusive real-life study of adult patients with SCD to investigate cognition to date, further characterizing CI among this patient population. Many of the disparities in cognitive function between patients and controls are not explained by pre-morbid VIQ, hemoglobin levels or smoking, indicating further research is needed to understand the pathogenesis of CI in SCD. Figure 1 Figure 1. Disclosures Novelli: Novartis Pharmaceuticals: Consultancy.

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P120 The Relationship Between Sleep Architecture And Cognition In Late-Life Depression

SLEEP Advances ◽

10.1093/sleepadvances/zpab014.161 ◽

2021 ◽

Vol 2 (Supplement_1) ◽

pp. A60-A60

Author(s):

A Ricciardiello ◽

L Mowszowski ◽

H LaMonica ◽

F Kumfor ◽

R Wassing ◽

...

Keyword(s):

Executive Function ◽

Depressive Symptoms ◽

Older People ◽

Slow Wave ◽

Slow Wave Sleep ◽

Depression Scale ◽

Sleep Architecture ◽

Late Life Depression ◽

Significant Group ◽

Rem Density

Abstract Introduction Depression in older people is associated with changes in sleep, however associations between sleep architecture and cognition have not yet been delineated. We examined sleep architecture in older people with and without depressive symptoms, and relationships with neuropsychological performance. Methods Adults over 50 years underwent overnight polysomnography and memory and executive function tests. Depression and controls groups were defined by a Geriatric Depression Scale-15 cut off score of 6. Sleep architectural outcomes included amount of slow wave sleep (SWS), rapid eye movement (REM) sleep, REM onset latency (ROL), NREM slow wave activity (SWA, 0.5–4 Hz), N2 sleep spindle density and REM density. Results The sample comprised of 71 participants with depressive symptoms and 101 controls (mean age both groups = 64, mean GDS-15 dep= 9.3, con= 1.8). There were no significant group differences in time spent in SWS, REM, REM density or SWA. Those with depressive symptoms had later ROL (p=.008) and less N2 sleep spindles (p=.03) compared to controls. A differential association was observed with less SWS being associated with poor memory recall in the depression group only (z=.342, p=0.008). No associations between sleep and executive function performance were observed. Discussion The link between less time in SWS and poorer memory in those with depressive symptoms could suggest that SWS is particularly pertinent for cognition in depression or that both sleep and cognition mechanisms are influenced by depressive state. Further studies are needed to determine if changes in sleep are linked with underlying neurobiological changes.

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Cognitive performance along the migraine cycle: A negative exploratory study

Cephalalgia Reports ◽

10.1177/2515816320951136 ◽

2020 ◽

Vol 3 ◽

pp. 251581632095113

Author(s):

Maria Ana Quadros ◽

Marta Granadeiro ◽

Amparo Ruiz-Tagle ◽

Carolina Maruta ◽

Raquel Gil-Gouveia ◽

...

Keyword(s):

Cognitive Performance ◽

Processing Speed ◽

Test Performance ◽

Episodic Migraine ◽

Individual Variability ◽

Control Performance ◽

Set Shifting ◽

Attack Frequency ◽

Cognitive Difficulties ◽

Z Scores

Migraine patients frequently report cognitive difficulties in the proximity and during migraine attacks. We performed an exploratory comparison of executive functioning across the four stages of the migraine cycle. Consecutive patients with episodic migraine undertook cognitive tests for attention, processing speed, set-shifting, and inhibitory control. Performance was compared between patients in different migraine stages, controlling for attack frequency and prophylactic medication. One hundred forty-three patients (142 women, average age 36.2 ± 9.9 years) were included, 28 preictal (≤48 h before the attack), 21 ictal (during the attack), 18 postictal (≤24 h after attack), and 76 interictal. Test performance (age and literacy adjusted z-scores) was not significantly different across migraine phases, despite a tendency for a decline before the attack. This negative study shows that cognitive performance fluctuates as patients approach the attack. To control for individual variability, this comparison needs to be better characterized longitudinally with a within-patient design.

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Slow-wave sleep and waking cognitive performance II

Physiology & Behavior ◽

10.1016/s0031-9384(00)00238-9 ◽

2000 ◽

Vol 70 (1-2) ◽

pp. 127-134 ◽

Cited By ~ 32

Author(s):

Jack D Edinger ◽

D.Michael Glenn ◽

Lori A Bastian ◽

Gail R Marsh

Keyword(s):

Cognitive Performance ◽

Slow Wave ◽

Slow Wave Sleep

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Associations between plasma nucleoside reverse transcriptase inhibitors concentrations and cognitive function in people with HIV

PLoS ONE ◽

10.1371/journal.pone.0253861 ◽

2021 ◽

Vol 16 (7) ◽

pp. e0253861

Author(s):

Davide De Francesco ◽

Xinzhu Wang ◽

Laura Dickinson ◽

Jonathan Underwood ◽

Emmanouil Bagkeris ◽

...

Keyword(s):

Cognitive Function ◽

Cognitive Performance ◽

Trough Concentration ◽

Reverse Transcriptase Inhibitors ◽

Plasma Exposure ◽

Time Curve ◽

Rank Regression ◽

Beneficial Effects ◽

Concentration Time ◽

Z Scores

Objectives To investigate the associations of plasma lamivudine (3TC), abacavir (ABC), emtricitabine (FTC) and tenofovir (TFV) concentrations with cognitive function in a cohort of treated people with HIV (PWH). Methods Pharmacokinetics (PK) and cognitive function (Cogstate, six domains) data were obtained from PWH recruited in the POPPY study on either 3TC/ABC or FTC/tenofovir disoproxil fumarate (TDF)-containing regimens. Association between PK parameters (AUC0-24: area under the concentration-time curve over 24 hours, Cmax: maximum concentration and Ctrough: trough concentration) and cognitive scores (standardized into z-scores) were evaluated using rank regression adjusting for potential confounders. Results Median (IQR) global cognitive z-scores in the 83 PWH on 3TC/ABC and 471 PWH on FTC/TDF were 0.14 (-0.27, 0.38) and 0.09 (-0.28, 0.42), respectively. Higher 3TC AUC0-24 and Ctrough were associated with better global z-scores [rho = 0.29 (p = 0.02) and 0.27 (p = 0.04), respectively], whereas higher 3TC Cmax was associated with poorer z-scores [rho = -0.31 (p<0.01)], independently of ABC concentrations. Associations of ABC PK parameters with global and domain z-scores were non-significant after adjustment for confounders and 3TC concentrations (all p’s>0.05). None of the FTC and TFV PK parameters were associated with global or domain cognitive scores. Conclusions Whilst we found no evidence of either detrimental or beneficial effects of ABC, FTC and TFV plasma exposure on cognitive function of PWH, higher plasma 3TC exposures were generally associated with better cognitive performance although higher peak concentrations were associated with poorer performance.

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Association Between Dual-Task Gait and Cognitive Function in Older Adults

Innovation in Aging ◽

10.1093/geroni/igab046.617 ◽

2021 ◽

Vol 5 (Supplement_1) ◽

pp. 162-162

Author(s):

Jessie VanSwearingen ◽

Mark Redfern ◽

Ervin Sejdic ◽

Andrea Rosso ◽

Anisha Suri

Keyword(s):

Older Adults ◽

Executive Function ◽

Cognitive Function ◽

Dual Task ◽

Task Effects ◽

Community Mobility ◽

Gait Quality ◽

Z Scores ◽

Global Cognition ◽

Pearson Correlations

Abstract Community mobility involves walking with physical and cognitive challenges. In older adults (N=116; results here from initial analyses: N=29, Age=75±5 years, 51% females), we assessed gait speed and smoothness (harmonic-ratio) while walking on even and uneven surfaces, with or without an alternate alphabeting dual-task (ABC). ANOVA assessed surface and dual-task effects; Pearson correlations compared gait with global cognition and executive function composite z-scores. The four conditions (even, uneven, even-ABC and uneven-ABC) affected speed(m/s) (0.97±0.14 vs 0.90±0.15 vs 0.83±0.17 vs 0.79±0.16). Smoothness (2.19±0.48 vs 1.89±0.38 vs 1.92±0.53 vs 1.7±0.43) was affected by only surface (controlled for speed). Greater speed was associated with better global cognition(ρ=0.47 to 0.49, p<0.05) for all conditions and with better executive function for even-ABC(ρ=0.39, p=0.04) and uneven-ABC(ρ=0.40, p=0.03). Executive function was associated with smoothness during even(ρp=-0.42, p=0.03) and uneven(ρp=-0.39, p=0.04) walking. Type of walking challenge differentially affects gait quality and associations with cognitive function.

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A Longitudinal 5-Year Follow-Up Study of Cognitive Function After First Episode Major Depressive Disorder: Exploring State, Scar and Trait Effects

Frontiers in Psychiatry ◽

10.3389/fpsyt.2020.575867 ◽

2020 ◽

Vol 11 ◽

Author(s):

Eivind Haga Ronold ◽

Marit Therese Schmid ◽

Ketil Joachim Oedegaard ◽

Åsa Hammar

Keyword(s):

Executive Function ◽

Depressive Symptoms ◽

Cognitive Function ◽

Cognitive Deficits ◽

Processing Speed ◽

First Episode ◽

Follow Up Study ◽

History Of ◽

Initial Episode

Major depression (MDD) is associated with cognitive deficits in processing speed and executive function (EF) following first episode (FE). It is unclear whether deficits are state or trait related. Studies following FE MDD over longer periods are lacking, making it uncertain how cognition and symptoms develop after the initial episode. The present study assessed cognitive function and symptoms 5 years following FE MDD. In addition, the study explored relationships between MDD symptoms, rumination, and cognitive deficits with regards to the trait, state, and scar perspective. Twenty-three participants with previous FE MDD, and 20 matched control participants were compared on Delis-Kaplan Executive Function System measures of processing speed and EF, in a 5-year longitudinal follow-up study. Correlations between current symptoms- and history of MDD, rumination, cognition were investigated. Findings indicated that cognitive deficits persisted with no clear signs of exacerbation after initial episode. Inhibition appeared independent of current and previous symptoms of depression. Processing speed was related to depressive- symptoms and rumination. In conclusion, results indicated persisting, stable deficits in both EFs and processing speed. Findings further suggest that depressive symptoms could be related to deficits in processing speed, indicating state effects. There was limited support for worsening of cognition after initial episode. Some aspects of EF like Inhibition could show persistent deficits independent of depressive symptoms indicating trait effects.

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