Dement Neurocogn Disord.  2021 Oct;20(4):99-107. 10.12779/dnd.2021.20.4.99.

Amyloid Burden in Alzheimer's Disease Patients Is Associated with Alterations in Circadian Rhythm

  • 1Liberty University College of Osteopathic Medicine, Lynchburg, VA, USA
  • 2Department of Nuclear Medicine, Hanyang University, Seoul, Korea
  • 3Department of Nuclear Medicine, Asan Medical Center, Seoul, Korea
  • 4Department of Neurology, College of Medicine, Hanyang University, Seoul, Korea


Background and Purpose
In this study we evaluated the relationship between amyloid-beta (Aβ) deposition and 3 aspects of sleep quality in a group of clinically diagnosed Alzheimer's disease (AD) patients.
We used self-report questionnaires to assess the quality of sleep using 3 previously established surveys: the Glasgow Sleep Effort Scale (GSES), the Pittsburgh Sleep Quality Index (PSQI), and the Morningness-Eveningness Questionnaire (MEQ). These questionnaires focused on the sleep effort, sleep efficiency, and circadian rhythm patterns of each participant. Also, we evaluated the regional distribution of Aβ in the brain by amyloid positron emission tomography-computed tomography (PET-CT) standardized uptake value ratios (SUVRs) in healthy normal (HN), mild cognitive impairment (MCI), and AD dementia groups. The MCI and AD dementia groups were combined to form the group with cognitive impairment due to AD (CIAD).
GSES and MEQ scores differed significantly between the HN, MCI, and AD dementia groups (p<0.037), whereas PSQI scores were similar across the groups (p=0.129). GSES and MEQ scores also differed between the HN and CIAD groups (p<0.018). Circadian rhythm scores positively correlated with amyloid PET-CT SUVR in posterior cingulate cortices (p<0.049).
Sleep effort and abnormal shifts in circadian rhythm were more significant in the CIAD group than in the HN group. At the same time, HN subjects had minimal sleep disturbance, irrespective of clinical status. Thus, alterations in circadian rhythm may be indicative of neurodegeneration due to Aβ deposition.


Alzheimer's Disease; Amyloid Plaques; Sleep; Mild Cognitive Impairment; Sleep Quality
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