Disruption of Sleep Microarchitecture Is a Sensitive and Early Marker of Parkinson’s Disease

Article type: Research Article

Authors: Doppler, Christopher E.J.^{a; b} | Smit, Julia^b | Hommelsen, Maximilian^a | Seger, Aline^{a; b} | Okkels, Niels^{c; d; e} | Horsager, Jacob^c | Kinnerup, Martin^c | Hansen, Allan K.^c | Fedorova, Tatyana D.^c | Knudsen, Karoline^c | Otto, Marit^{d; f} | Nahimi, Adjmal^g | Fink, Gereon R.^{a; b} | Borghammer, Per^c | Sommerauer, Michael^{a; b; c; *}

Affiliations: [a] Institute of Neuroscience and Medicine (INM-3), Forschungszentrum Jülich, Jülich, Germany | [b] Department of Neurology, University Hospital Cologne, Faculty of Medicine, University of Cologne, Köln, Germany | [c] Department of Nuclear Medicine and PET Centre, Aarhus University Hospital, Aarhus, Denmark | [d] Department of Neurology, Aarhus University Hospital, Aarhus, Denmark | [e] Department of Clinical Medicine, Aarhus University, Aarhus, Denmark | [f] Department of Clinical Neurophysiology, Aarhus University Hospital, Aarhus, Denmark | [g] Department of Neurology, Rehabilitation Medicine, Memory Disorders, and Geriatrics, Skåne University Hospital, Lund, Sweden

Correspondence: [*] Correspondence to: Michael Sommerauer, MD, Institute of Neuroscience and Medicine (INM-3), Forschungszentrum Jülich D-52425 Jülich, Germany. E-mail: m.sommerauer@fz-juelich.de.

Abstract: Background:Although sleep disturbances are highly prevalent in patients with Parkinson’s disease, sleep macroarchitecture metrics show only minor changes. Objective:To assess alterations of the cyclic alternating pattern (CAP) as a critical feature of sleep microarchitecture in patients with prodromal, recent, and established Parkinson’s disease. Methods:We evaluated overnight polysomnography for classic sleep macroarchitecture and CAP metrics in 68 patients at various disease stages and compared results to 22 age- and sex-matched controls. Results:Already at the prodromal stage, patients showed a significantly reduced CAP rate as a central characteristic of sleep microarchitecture. Temporal characteristics of CAP showed a gradual change over disease stages and correlated with motor performance. In contrast, the sleep macroarchitecture metrics did not differ between groups. Conclusion:Data suggest that alterations of sleep microarchitecture are an early and more sensitive characteristic of Parkinson’s disease than changes in sleep macroarchitecture.

Keywords: REM sleep behavior disorder, Parkinson’s disease, cyclic alternating pattern, microsleep, polysomnography

DOI: 10.3233/JPD-223442

Journal: Journal of Parkinson's Disease, vol. 12, no. 8, pp. 2555-2560, 2022