Dement Neurocogn Disord.  2017 Sep;16(3):72-77. 10.12779/dnd.2017.16.3.72.

Associations between Brain Perfusion and Sleep Disturbance in Patients with Alzheimer's Disease

• Im JJ
• Jeong HS
• Park JS
• Na SH
• Chung YA
• Yang Y
• Song IU

• KMID: 2442819
• DOI: http://doi.org/10.12779/dnd.2017.16.3.72

Abstract

BACKGROUND AND PURPOSE
Although sleep disturbances are common and considered a major burden for patients with Alzheimer's disease (AD), the fundamental mechanisms underlying the development and maintenance of sleep disturbance in AD patients have yet to be elucidated. The aim of this study was to examine the correlation between regional cerebral blood flow (rCBF) and sleep disturbance in AD patients using technetium-99m hexamethylpropylene amine oxime single-photon emission computed tomography (SPECT).
METHODS
A total of 140 AD patients were included in this cross-sectional study. Seventy patients were assigned to the AD with sleep loss (SL) group and the rest were assigned to the AD without SL group. SL was measured using the sleep subscale of the Neuropsychiatric Inventory. A whole-brain voxel-wise analysis of brain SPECT data was conducted to compare the rCBF between the two groups.
RESULTS
The two groups did not differ in demographic characteristics, severity of dementia, general cognitive function, and neuropsychiatric symptoms, with the exception of sleep disturbances. The SPECT imaging analysis displayed decreased perfusion in the bilateral inferior frontal gyrus, bilateral temporal pole, and right precentral gyrus in the AD patients with SL group compared with the AD patients without SL group. It also revealed increased perfusion in the right precuneus, right occipital pole, and left middle occipital gyrus in the AD with SL group compared with the AD without SL group.
CONCLUSIONS
The AD patients who experienced sleep disturbance had notably decreased perfusion in the frontal and temporal lobes and increased rCBF in the parietal and occipital regions. The findings of this study suggest that functional alterations in these brain areas may be the underlying neural correlates of sleep disturbance in AD patients.

Keyword

Alzheimer's disease; sleep loss; single photon computed tomography; brain perfusion

MeSH Terms

Alzheimer Disease*
Brain*
Cerebrovascular Circulation
Cognition
Cross-Sectional Studies
Dementia
Frontal Lobe
Humans
Occipital Lobe
Parietal Lobe
Perfusion*
Prefrontal Cortex
Rabeprazole
Temporal Lobe
Tomography, Emission-Computed
Tomography, Emission-Computed, Single-Photon

Figure

• 

  Fig. 1 Differences in the regional cerebral blood flow between patients with AD with SL and without SL. At each voxel, increases or decreases in the regional brain perfusion in the AD with SL group appear in red-yellow or blue-green, respectively. The images are shown in a neurological convention and color bars represent voxel-level t-values. AD: Alzheimer's disease, SL: sleep loss.

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