阿尔茨海默病及遗忘型轻度认知功能障碍睡眠脑电定量分析

Quantitative analysis of sleep EEG in Alzheimer's disease and amnestic mild cognitive impairment

  • 摘要: 背景 阿尔茨海默病是一种以记忆功能损害为主要特征的老年高发病率退行性疾病,在痴呆早期阶段识别并加以 干预可以显著延缓疾病进展。目的 探究睡眠振荡特征与认知的关系及其作为评估认知障碍电生理标志物的可能性。方 法 采用子波变换、多尺度功率谱、相位平均分析方法对2021年05月至2023年1月来自天津市人民医院神经内科门诊、住 院部不同认知水平的正常对照(Normal Controls,NC)受试者、遗忘型轻度认知功能障碍(amnestic Mild cognitive impairment,aMCI)、阿尔茨海默病(Alzheimer dementia,AD)患者睡眠脑电信号进行对比,分析睡眠纺锤波微观信号在不 同认知水平的特征。结果 本研究纳入AD患者9例,平均年龄(70.11±6.17)岁;aMCI患者13例,平均年龄(67.23±5.18) 岁;NC组受试者15例,平均年龄(67.87±7.76)岁。在NC、aMCI、AD三组受试者中,随着认知功能减退,睡眠纺锤波密 度降低(F=13.209,P<0.001)、睡眠纺锤波持续时间缩短(F=44.763,P<0.01)、睡眠纺锤波相对功率降低(F=7.897,P< 0.01)、睡眠纺锤波波幅降低(H=12.556,P<0.01),而睡眠纺锤波波长与认知障碍程度无显著相关性(P>0.05)。结论 认 知功能减退与睡眠纺锤波密度、相对功率、波幅减低和持续时间缩短呈正相关,与睡眠纺锤并波长无关。密度和持续时间 特征改变在aMCI疾病阶段已显著出现。

     

    Abstract: Background Alzheimer's disease is a degenerative disease with high incidence in the elderly, mainly characterized by impairment of memory function. Identifying and intervening in the early stage of dementia can significantly delay the progression of the disease.Objective To investigate the relationship between sleep oscillation characteristics and cognition, and discuss its potential as an electrophysiological marker for assessing cognitive impairment. Methods Wavelet transform, multiscale power spectral analysis, and phase-averaging techniques were employed to comparatively analyze sleep EEG signals collected from May 2021 to January 2023. Data were obtained from normal controls (NC), amnestic mild cognitive impairment (aMCI) patients, and Alzheimer's disease (AD) patients with varying cognitive levels at the Department of Neurology, Tianjin People's Hospital (including both outpatient and inpatient populations). Sleep spindle microstructural features were systematically investigated across different cognitive states through these multimodal analytical approaches.Results Totally 9 AD patients (mean age 70.11±6.17 years), 13 aMCI patients (67.23±5.18 years), and 15 NC subjects (67.87±7.76 years) were enrolled. In the NC, aMCI, and AD groups, with the decline of cognitive function, the sleep spindle density (F=12.92, P0.000), the sleep spindle duration (F=45.62, P< 0.001), the sleep spindle relative power (F=7.897, P<0.01), and the sleep spindle amplitude all decreased (H=12.556, P<0.01), but there was no significant correlation between sleep spindle wavelength and the degree of cognitive impairment (P>0.05). Conclusion Cognitive decline is associated with reduced sleep spindle density, relative power, amplitude, and duration, but it is not positively correlated with sleep spindle wavelength. Changes in density and duration characteristics have been significantly observed in the disease stage of aMCI, providing clues for the early diagnosis of aMCI.

     

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