Isolated REM sleep behavior disorder is associated with altered 24-h rest-activity measures
IntroductionIsolated REM sleep behavior disorder (iRBD), the loss of motor inhibition during REM sleep, is a symptom of prodromal Lewy body disease, with over 80% of iRBD patients progressing to Parkinson's disease or dementia with Lewy bodies. Disruption of rest-activity patterns, an establish...
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Frontiers Media S.A.
2023-10-01
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| Series: | Frontiers in Sleep |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/frsle.2023.1286124/full |
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| author | Joseph R. Winer Renske Lok Adrian Ekelmans Flavia Bueno Kathleen L. Poston Jamie M. Zeitzer Jamie M. Zeitzer Emmanuel H. During Emmanuel H. During Emmanuel H. During |
| author_facet | Joseph R. Winer Renske Lok Adrian Ekelmans Flavia Bueno Kathleen L. Poston Jamie M. Zeitzer Jamie M. Zeitzer Emmanuel H. During Emmanuel H. During Emmanuel H. During |
| author_sort | Joseph R. Winer |
| collection | DOAJ |
| description | IntroductionIsolated REM sleep behavior disorder (iRBD), the loss of motor inhibition during REM sleep, is a symptom of prodromal Lewy body disease, with over 80% of iRBD patients progressing to Parkinson's disease or dementia with Lewy bodies. Disruption of rest-activity patterns, an established predictor of Parkinson's disease, has not been well characterized in patients with iRBD. Here, we tested the hypothesis that accelerometer-based measures of 24-h activity would indicate greater fragmentation and variability in patients with iRBD relative to matched healthy controls.Materials and methodsPatients with iRBD (N = 38) had 24-h activity monitored for (mean ± SD) 24.6 ± 8.8 days using an Axivity wrist-worn accelerometer. Age, sex, and body mass index matched healthy older adults (N = 119) were selected as controls. Raw accelerometer data were processed and nonparametric and cosinor measures of 24-h activity were calculated. Functional principal component analyses (fPCA) were applied to detect differences in 24-h activity patterns.ResultsCompared to matched controls, individuals with iRBD had significantly lower cosine amplitude, mesor, and activity during their most active 10 hours, reflecting overall lower levels of activity and disrupted activity. They also had significantly increased movement during the night (L5). FPCA indicated that decreased daytime and increased nighttime activity may explain overall differences observed in iRBD.ConclusionMultiple metrics of rest-activity rhythms support the hypothesis that 24-h activity measures are altered in iRBD. This dysfunction may reflect degeneration of sleep-wake regulating circuits, representing a symptom of iRBD and indicating the early stages of Lewy body disease. |
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| institution | Directory Open Access Journal |
| issn | 2813-2890 |
| language | English |
| last_indexed | 2025-03-21T01:06:16Z |
| publishDate | 2023-10-01 |
| publisher | Frontiers Media S.A. |
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| series | Frontiers in Sleep |
| spelling | doaj.art-b093e9012a8a4f6495e53cdd807cc5f22024-08-03T03:26:27ZengFrontiers Media S.A.Frontiers in Sleep2813-28902023-10-01210.3389/frsle.2023.12861241286124Isolated REM sleep behavior disorder is associated with altered 24-h rest-activity measuresJoseph R. Winer0Renske Lok1Adrian Ekelmans2Flavia Bueno3Kathleen L. Poston4Jamie M. Zeitzer5Jamie M. Zeitzer6Emmanuel H. During7Emmanuel H. During8Emmanuel H. During9Department of Neurology and Neurological Sciences, Stanford University, Stanford, CA, United StatesDepartment of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, United StatesDepartment of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, United StatesDepartment of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, United StatesDepartment of Neurology and Neurological Sciences, Stanford University, Stanford, CA, United StatesDepartment of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, United StatesMental Illness Research Education and Clinical Center, VA Palo Alto Health Care System, Palo Alto, CA, United StatesDepartment of Neurology and Neurological Sciences, Stanford University, Stanford, CA, United StatesDepartment of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, United StatesDepartment of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, United StatesIntroductionIsolated REM sleep behavior disorder (iRBD), the loss of motor inhibition during REM sleep, is a symptom of prodromal Lewy body disease, with over 80% of iRBD patients progressing to Parkinson's disease or dementia with Lewy bodies. Disruption of rest-activity patterns, an established predictor of Parkinson's disease, has not been well characterized in patients with iRBD. Here, we tested the hypothesis that accelerometer-based measures of 24-h activity would indicate greater fragmentation and variability in patients with iRBD relative to matched healthy controls.Materials and methodsPatients with iRBD (N = 38) had 24-h activity monitored for (mean ± SD) 24.6 ± 8.8 days using an Axivity wrist-worn accelerometer. Age, sex, and body mass index matched healthy older adults (N = 119) were selected as controls. Raw accelerometer data were processed and nonparametric and cosinor measures of 24-h activity were calculated. Functional principal component analyses (fPCA) were applied to detect differences in 24-h activity patterns.ResultsCompared to matched controls, individuals with iRBD had significantly lower cosine amplitude, mesor, and activity during their most active 10 hours, reflecting overall lower levels of activity and disrupted activity. They also had significantly increased movement during the night (L5). FPCA indicated that decreased daytime and increased nighttime activity may explain overall differences observed in iRBD.ConclusionMultiple metrics of rest-activity rhythms support the hypothesis that 24-h activity measures are altered in iRBD. This dysfunction may reflect degeneration of sleep-wake regulating circuits, representing a symptom of iRBD and indicating the early stages of Lewy body disease.https://www.frontiersin.org/articles/10.3389/frsle.2023.1286124/fullREM sleep behavior disorderParkinson'sdementiaactigraphyrest-activity rhythmsprodrome |
| spellingShingle | Joseph R. Winer Renske Lok Adrian Ekelmans Flavia Bueno Kathleen L. Poston Jamie M. Zeitzer Jamie M. Zeitzer Emmanuel H. During Emmanuel H. During Emmanuel H. During Isolated REM sleep behavior disorder is associated with altered 24-h rest-activity measures Frontiers in Sleep REM sleep behavior disorder Parkinson's dementia actigraphy rest-activity rhythms prodrome |
| title | Isolated REM sleep behavior disorder is associated with altered 24-h rest-activity measures |
| title_full | Isolated REM sleep behavior disorder is associated with altered 24-h rest-activity measures |
| title_fullStr | Isolated REM sleep behavior disorder is associated with altered 24-h rest-activity measures |
| title_full_unstemmed | Isolated REM sleep behavior disorder is associated with altered 24-h rest-activity measures |
| title_short | Isolated REM sleep behavior disorder is associated with altered 24-h rest-activity measures |
| title_sort | isolated rem sleep behavior disorder is associated with altered 24 h rest activity measures |
| topic | REM sleep behavior disorder Parkinson's dementia actigraphy rest-activity rhythms prodrome |
| url | https://www.frontiersin.org/articles/10.3389/frsle.2023.1286124/full |
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