Cerebrospinal Fluid Hypocretin and Nightmares in Dementia Syndromes.

IF 1.4 Q4 CLINICAL NEUROLOGY Dementia and Geriatric Cognitive Disorders Extra Pub Date : 2021-02-16 eCollection Date: 2021-01-01 DOI:10.1159/000509585
Lynn Marie Trotti, Donald L Bliwise, Glenda L Keating, David B Rye, William T Hu
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引用次数: 5

Abstract

Background/aims: Hypocretin promotes wakefulness and modulates REM sleep. Alterations in the hypocretin system are increasingly implicated in dementia. We evaluated relationships among hypocretin, dementia biomarkers, and sleep symptoms in elderly participants, most of whom had dementia.

Methods: One-hundred twenty-six adults (mean age 66.2 ± 8.4 years) were recruited from the Emory Cognitive Clinic. Diagnoses were Alzheimer disease (AD; n = 60), frontotemporal dementia (FTD; n = 21), and dementia with Lewy bodies (DLB; n = 20). We also included cognitively normal controls (n = 25). Participants and/or caregivers completed sleep questionnaires and lumbar puncture was performed for cerebrospinal fluid (CSF) assessments.

Results: Except for sleepiness (worst in DLB) and nocturia (worse in DLB and FTD) sleep symptoms did not differ by diagnosis. CSF hypocretin concentrations were available for 87 participants and normal in 70, intermediate in 16, and low in 1. Hypocretin levels did not differ by diagnosis. Hypocretin levels correlated with CSF total τ levels only in men (r = 0.34; p = 0.02). Lower hypocretin levels were related to frequency of nightmares (203.9 ± 29.8 pg/mL in those with frequent nightmares vs. 240.4 ± 46.1 pg/mL in those without; p = 0.05) and vivid dreams (209.1 ± 28.3 vs. 239.5 ± 47.8 pg/mL; p = 0.014). Cholinesterase inhibitor use was not associated with nightmares or vivid dreaming.

Conclusion: Hypocretin levels did not distinguish between dementia syndromes. Disturbing dreams in dementia patients may be related to lower hypocretin concentrations in CSF.

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脑脊液下丘脑分泌素与痴呆综合征的噩梦
背景/目的:下丘脑泌素促进觉醒并调节快速眼动睡眠。下丘脑分泌素系统的改变与痴呆的关系越来越密切。我们评估了老年参与者中下丘脑泌素、痴呆生物标志物和睡眠症状之间的关系,其中大多数患有痴呆。方法:从Emory认知诊所招募126名成年人(平均年龄66.2±8.4岁)。诊断为阿尔茨海默病;n = 60),额颞叶痴呆(FTD;n = 21),伴路易体痴呆(DLB;N = 20)。我们还纳入了认知正常的对照组(n = 25)。参与者和/或护理人员完成睡眠问卷,并进行腰椎穿刺以进行脑脊液(CSF)评估。结果:除嗜睡(DLB患者最严重)和夜尿(DLB和FTD患者最严重)外,不同诊断的睡眠症状无差异。87名受试者的脑脊液下丘脑泌素浓度正常,70人正常,16人中等,1人低。下丘脑泌素水平没有因诊断而异。下丘脑分泌素水平仅在男性中与CSF总τ水平相关(r = 0.34;P = 0.02)。较低的下丘脑分泌素水平与噩梦频率有关(频繁噩梦组为203.9±29.8 pg/mL,无噩梦组为240.4±46.1 pg/mL);p = 0.05)、生动梦(209.1±28.3∶239.5±47.8 pg/mL);P = 0.014)。胆碱酯酶抑制剂的使用与噩梦或生动的梦无关。结论:下丘脑泌素水平不能区分痴呆综合征。痴呆患者的扰梦可能与脑脊液下丘脑分泌素浓度降低有关。
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来源期刊
Dementia and Geriatric Cognitive Disorders Extra
Dementia and Geriatric Cognitive Disorders Extra Medicine-Psychiatry and Mental Health
CiteScore
4.30
自引率
0.00%
发文量
18
审稿时长
9 weeks
期刊介绍: This open access and online-only journal publishes original articles covering the entire spectrum of cognitive dysfunction such as Alzheimer’s and Parkinson’s disease, Huntington’s chorea and other neurodegenerative diseases. The journal draws from diverse related research disciplines such as psychogeriatrics, neuropsychology, clinical neurology, morphology, physiology, genetic molecular biology, pathology, biochemistry, immunology, pharmacology and pharmaceutics. Strong emphasis is placed on the publication of research findings from animal studies which are complemented by clinical and therapeutic experience to give an overall appreciation of the field. Dementia and Geriatric Cognitive Disorders Extra provides additional contents based on reviewed and accepted submissions to the main journal Dementia and Geriatric Cognitive Disorders Extra .
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