Sleep Disruption and Mild Cognitive Impairment in Veterans

退伍军人的睡眠中断和轻度认知障碍

• 批准号: 8391102
• 负责人: Cynthia Holden Phelan
• 金额: --
• 依托单位: WM S. MIDDLETON MEMORIAL VETERANS HOSP
• 依托单位国家: 美国
• 财政年份: 2011
• 资助国家: 美国
• 起止时间: 2011-10-01 至 2015-09-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8391102
• 关键词: Adult; Affect; Age; Aging; Alzheimer' s Disease; Area; Attention; Brain; Caring; Characteristics; Classification; Clinic; Clinical; Clinical dementia rating scale; Cognitive; Control Groups; Dementia; Deterioration; Education; Elderly; Electroencephalogram; Electroencephalography; Enrollment; Financial cost; Frequencies; Gender; Homeostasis; Impaired cognition; Impairment; Incidence; Individual; Intelligence; Investigation; Lead; Link; Literature; Logistic Regressions; Logit Models; Magnetic Resonance Imaging; Measurement; Measures; Medial; Memory; Modality; Motivation; Neurocognitive; Neuropsychological Tests; Observational Study; Outcome; Participant; Performance; Physiology; Play; Polysomnography; Process; Questionnaires; Race; Recording of previous events; Recruitment Activity; Reporting; Research; Research Design; Research Personnel; Risk; Risk Factors; Role; Severities; Sleep; Sleep Architecture; Sleep disturbances; Slow-Wave Sleep; Source; Speed; Symptoms; Synapses; Technology; Temporal Lobe; Testing; Time; Travel; Veterans; Wakefulness; Wisconsin; Work; actigraphy; age related; base; cognitive function; comparative efficacy; cost; density; diaries; frontal lobe; human old age (65+); innovation; meetings; memory process; mild cognitive impairment; morphometry; neurocognitive test; neurophysiology; neuropsychological; new technology; non rapid eye movement; normal aging; sleep onset; standard measure

DESCRIPTION (provided by applicant): Numerous studies indicate there is a strong relationship between sleep quality and neurocognitive functioning in adults. Sleep slow waves, an electrophysiological characteristic of non-REM sleep, are considered a reliable marker for sleep homeostasis and have been linked to the beneficial effects of sleep on neurocognitive performance. Yet sleep slow waves and overall sleep architecture have received little attention in older adults and have not been examined in older adults in amnestic mild cognitive impairment (aMCI). We will focus our investigation on amnestic MCI as these individuals have a greater risk for progression to Alzheimer's disease - approximately 40% go on to develop Alzheimer's disease within 4 years (Gauthier et al., 2006; Saykin & Wishart, 2003). Electrophysiologic measurements during sleep (such as polysomnography and high-density EEG) provide a unique modality for investigating brain function as they minimize many factors that may interfere with assessing cognitive function during wakefulness, (e.g., a subject's intelligence, attention, and/or motivation). In this investigation, we will use polysomnography to examine the macrostructure of sleep architecture and night time high-density EEG (hd-EEG) to examine the microstructure of sleep slow waves. We intend to harness the state-of-the-art expertise of the Wisconsin Sleep Center researchers (leaders in sleep physiology) and the VA expertise in dementia research to study sleep slow waves as a predictor of cognitive outcomes in aMCI. We predict that characteristics of sleep slow waves will be associated with symptom severity in aMCI and will be useful as a predictor of subsequent cognitive decline in aMCI. Aims: The aims of this investigation are: (1) To determine whether older Veterans with aMCI will demonstrate significant changes in their sleep architecture (via polysomnography) as compare to non-impaired Veterans at baseline and over time. (2) To determine whether older Veterans with aMCI will demonstrate significant changes in the synaptic strength and quality of sleep slow waves as compared to non-impaired Veterans with aMCI at baseline and over time. 2A.To determine if sleep slow wave synaptic strength (as measured by slow wave amplitude and slope via hd-EEG) is reduced in older Veterans with aMCI and non- impaired controls at baseline and over time. 2B. To determine if the source of the sleep slow waves and the speed of the traveling waves (as measured by hd-EEG) are reduced in areas of the brain known to be affected by aMCI, in Veterans with aMCI as compared to non-impaired controls at baseline and over time. (3) To examine the relationship between changes in the characteristics of sleep slow waves (amplitude, slope, and the origin and speed of traveling waves) and neuropsychological functioning in aMCI and non-impaired Veterans over time. Study Design: This is a 4-year longitudinal, observational study of sleep and neurocognitive functioning of Veterans with aMCI as compared to a cognitively-normal control group of Veterans. All participants will undergo testing at baseline and 2 years later. Veterans (N=70), 65 years and older, will be invited to participate in the study. Two groups, Veterans meeting the criteria for aMCI (n = 41) and non-MCI controls (n = 29) (matched for age, education, race, and gender), will be enrolled. Subjects will undergo a history/physical exam, neuropsychological testing, and MRI to confirm aMCI and non-MCI status. Subjects meeting study requirements will complete questionnaires, two weeks of actigraphy/sleep diaries, and overnight hd- EEG/polysomnography at baseline. MRI, neuropsychological testing, and sleep studies will be repeated two years later. The application of hd-EEG represents significant scientific innovation in advanced neurophysiological assessment of sleep. Our findings will clarify the degree to which changes in the characteristics of sleep slow waves are due to normal aging or are evidence of early cognitive impairment. It is hoped that this line of research will ultimately lead to better clinical predictors of cognitive decline.

描述（由申请人提供）： 大量研究表明，成年人的睡眠质量与神经认知功能之间存在牢固的关系。睡眠缓慢的波浪是非REM睡眠的电生理特征，被认为是睡眠体内稳态的可靠标记，并且与睡眠对神经认知性能的有益作用有关。然而，睡眠缓慢的波浪和整体睡眠结构在老年人中很少受到关注，并且在饱受宽松的轻度认知障碍（AMCI）中尚未对老年人进行检查。我们将调查将调查重点放在Amnestic MCI上，因为这些人有更大的进展到阿尔茨海默氏病的风险 - 大约40％的人在4年内继续发展阿尔茨海默氏病（Gauthier等，2006； Saykin＆Wishart，2003）。睡眠期间的电生理测量值（例如多个学术摄影和高密度EEG）为研究脑功能提供了独特的方式，因为它们可以最大程度地减少可能干扰清醒期间评估认知功能的许多因素（例如，受试者的智力，注意力，注意力和/或动机）。在这项研究中，我们将使用多渗透学检查来检查睡眠结构的宏观结构和夜间高密度脑电图（HD-EEG）来检查睡眠慢波的微观结构。我们打算利用威斯康星州睡眠中心研究人员（睡眠生理学领导者）和痴呆症研究的VA专业知识的最先进的专业知识，以研究睡眠慢波，以预测AMCI认知结果的预测指标。我们预测，睡眠慢波的特征将与AMCI的症状严重程度有关，并且可以作为随后AMCI认知能力下降的预测指标。 目的：这项调查的目的是：（1）确定AMCI的老年退伍军人是否会显示出其睡眠结构（通过多聚术）的重大变化，与基线和随着时间的时间时期不受影响的退伍军人相比。 （2）确定与AMCI的老年退伍军人相比在基线和随着时间的时间时具有AMCI的未受损的退伍军人相比，睡眠慢波的突触强度和质量是否会显着变化。 2A.确定睡眠慢波突触强度（通过慢波振幅和通过HD-EEG坡度测量）在基线和随着时间的时间时，具有AMCI和非受损对照的老年退伍军人中会降低。 2b。为了确定在已知的大脑区域中，与基线和随着时间的时间时期不受影响的对照组相比，在已知受AMCI影响的大脑区域中，慢慢的波浪和行进波的速度是否降低。 （3）检查睡眠慢波（振幅，斜率以及行进波的起源和速度）与AMCI中神经心理功能的变化与随着时间的流逝而不受影响的退伍军人之间的关系。 研究设计：与认知上正常的对照组相比，这是对退伍军人的睡眠和神经认知功能的4年纵向，观察性研究。所有参与者将在基线和两年后进行测试。退伍军人（n = 70），65岁及以上，将邀请参加研究。两组将符合AMCI（n = 41）和非MCI对照组（n = 29）的退伍军人（与年龄，教育，种族和性别匹配）。受试者将接受病史/身体检查，神经心理学测试和MRI，以确认AMCI和非MCI状态。满足研究要求的受试者将完成问卷调查，两周的行为/睡眠日记以及基线时过夜的HD- EEG/多聚会。 MRI，神经心理学测试和睡眠研究将在两年后重复。 HD-EEG的应用代表了晚期神经生理学评估的大量科学创新。我们的发现将阐明睡眠慢波特征变化的程度是由于正常衰老引起的，或者是早期认知障碍的证据。希望这项研究最终能够为认知能力下降的更好的临床预测指标。