中国神经再生研究(英文版) ›› 2021, Vol. 16 ›› Issue (10): 1965-1972.doi: 10.4103/1673-5374.308071

• 综述:退行性病与再生 • 上一篇    下一篇

阿尔茨海默病的睡眠障碍:预测作用和潜在机制

  

  • 出版日期:2021-10-15 发布日期:2021-03-18

Sleep disorders in Alzheimer’s disease: the predictive roles and potential mechanisms

Huang Kuang1, #, Yu-Ge Zhu1, #, Zhi-Feng Zhou1, Mei-Wen Yang2, Fen-Fang Hong3, *, Shu-Long Yang1, *   

  1. 1Department of Physiology, College of Medicine, Nanchang University, Nanchang, Jiangxi Province, China; 2Department of Nurse, Nanchang University Hospital, Nanchang, Jiangxi Province, China; 3Department of Experimental Teaching Center, Nanchang University, Nanchang, Jiangxi Province, China
  • Online:2021-10-15 Published:2021-03-18
  • Contact: Fen-Fang Hong, MD, hongfenfang@126.com; Shu-Long Yang, PhD, shulongyang@qq.com.
  • Supported by:
    This work was funded by the National Natural Science Foundation of China, Nos. 81660151 (to FFH), 81660751 (to SLY). 

摘要:

Neural Regen Res:睡眠障碍:阿尔茨海默病的危险因素和预测因素

睡眠障碍在阿尔茨海默病患者中很常见,严重影响患者的生活质量,甚至出现在阿尔茨海默病之前的轻度认知障碍患者中。睡眠障碍损害阿尔茨海默病患者的认知功能,加速淀粉样蛋白β和tau在阿尔茨海默病中的积累。目前,睡眠障碍被认为是一个危险因素,可能是老年痴呆症发展的一个预测因素。由于睡眠障碍在其他类型的痴呆症和精神疾病中也会遇到,因此,预测阿尔茨海默病的睡眠相关生物标志物需要具有较高的特异性和敏感性。大量流行病学和实验数据表明,睡眠障碍可促进淀粉样蛋白β和tau的积累,导致记忆和认知功能的下降,从而加速阿尔茨海默病的进程,

来自南昌大学的Huang Kuang团队从睡眠对阿尔茨海默病的预测作用和可能的机制两个方面阐述了睡眠在阿尔茨海默病中的作用。单一的睡眠障碍指标预测阿尔茨海默病的敏感性和特异性都不是很高,因此今后可能需要建立一个大样本、多变量、长期队列研究,为了评价多个睡眠障碍预测因子联合应用对阿尔茨海默病早期预测的有效性,同时,在阿尔茨海默病临床前阶段干预睡眠障碍的随机对照临床试验可以间接验证睡眠障碍是预测阿尔茨海默病的生物标志物。为了解决阿尔茨海默病的预防问题,作者还对阿尔茨海默病的预防进行了研究回顾睡眠障碍的候选机制,它可以为预防阿尔茨海默病提供药物治疗靶点。

    这项成果撰写的文章发表在《中国神经再生研究(英文版)》杂志202110期。

https://orcid.org/0000-0001-6440-1311 (Fen-Fang Hong); https://orcid.org/0000-0002-1407-6255 (Shu-Long Yang)

Abstract: Sleep disorders are common in patients with Alzheimer’s disease, and can even occur in patients with amnestic mild cognitive impairment, which appears before Alzheimer’s disease. Sleep disorders further impair cognitive function and accelerate the accumulation of amyloid-β and tau in patients with Alzheimer’s disease. At present, sleep disorders are considered as a risk factor for, and may be a predictor of, Alzheimer’s disease development. Given that sleep disorders are encountered in other types of dementia and psychiatric conditions, sleep-related biomarkers to predict Alzheimer’s disease need to have high specificity and sensitivity. Here, we summarize the major Alzheimer’s disease-specific sleep changes, including abnormal non-rapid eye movement sleep, sleep fragmentation, and sleep-disordered breathing, and describe their ability to predict the onset of Alzheimer’s disease at its earliest stages. Understanding the mechanisms underlying these sleep changes is also crucial if we are to clarify the role of sleep in Alzheimer’s disease. This paper therefore explores some potential mechanisms that may contribute to sleep disorders, including dysregulation of the orexinergic, glutamatergic, and γ-aminobutyric acid systems and the circadian rhythm, together with amyloid-β accumulation. This review could provide a theoretical basis for the development of drugs to treat Alzheimer’s disease based on sleep disorders in future work.

Key words: Alzheimer’s disease, amyloid-β accumulation, circadian rhythm, GABAergic system, glutamatergic system, non-rapid eye movement sleep, orexinergic system, sleep disorders, sleep fragmentation, sleep-disordered breathing