Details

Autor(en) / Beteiligte

• Carvalho, DZ
• St. Louis, EK
• Boeve, BF
• Knopman, DS
• Lowe, VJ
• Roberts, RO
• Mielke, MM
• Przybelski, SA
• Petersen, RC
• Jack, CR
• Vemuri, P

Titel

0273 BASELINE EXCESSIVE DAYTIME SLEEPINESS ASSOCIATED WITH AN INCREASE IN BRAIN METABOLISM IN NON-DEMENTED ELDERLY: A LONGITUDINAL FDG-PET STUDY

Ist Teil von

• Sleep (New York, N.Y.), 2017-04, Vol.40 (suppl_1), p.A100-A101

Ort / Verlag

US: Oxford University Press

Erscheinungsjahr

2017

Quelle

Oxford Journals 2020 Medicine

Beschreibungen/Notizen

• Abstract Introduction: Excessive daytime sleepiness (EDS) increases with aging, and may be associated with cognitive decline in the elderly. As Alzheimer’s Disease dementia (AD) has been linked to metabolic changes particularly in areas involved with the default mode network (DMN), we investigated whether EDS is associated with metabolic changes in those regions. Methods: From the population-based sample of Mayo Clinic Study of Aging, we identified 277 non-demented individuals aged 70 and older who had at least two serial FDG-PET scans and completed sleep questionnaires. EDS was defined as Epworth Sleepiness Scale score ≥10. Multiple linear regression models were fit in 7 AD-vulnerable regions also part of the DMN (orbitofrontal, prefrontal, anterior cingulate, cingulate-precuneus, medial temporal, lateral temporal, and parietal) to explore whether baseline EDS predicted variability in regional brain metabolism as measured by annualized change in FDG-PET signal using two scans. We controlled for baseline age, sex, APOE4, education, cardiovascular comorbidities (obesity, hypertension, hyperlipidemia, diabetes), reduced sleep duration, sleep-disorder breathing symptoms (snoring and/or witnessed apneas), depression, and baseline FDG-PET signal. Results: Age, male sex, and APOE4 were associated with significant metabolic reductions in multiple regions. On the other hand, EDS was associated with a longitudinal increase in FDG-PET signal in all regions, especially in the prefrontal (0.024, 95% CI: 0.008–0.041, p=0.003), cingulate/precuneus (0.022, 95% CI: 0.004–0.039, p=0.014), and orbitofrontal (0.021, 95% CI: 0.009–0.034, p=0.001) areas. A post-hoc analysis showed similar trends throughout the brain. Conclusion: Baseline EDS was associated with a longitudinal increase in FDG-PET signal. This hypermetabolism may represent a compensatory mechanism in response to efficiency loss in the setting of overloaded synaptic activity. This hypothesis is consistent with previous findings suggesting increased blood flow at the end of the waking day when compared to blood flow after a night of sleep. However, the increase predicted by EDS does not imply an overall increase in brain metabolism, because the magnitude of the reduction predicted by baseline age is higher than the increase in FDG-PET signal predicted by EDS in all regions. Support (If Any): NIH.