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Thalamic pulvinar metabolism, sleep disturbances, and hallucinations in dementia with Lewy bodies: Positron emission tomography and actigraphy study
Author(s) -
Kanemoto Hideki,
Kazui Hiroaki,
Adachi Hiroyoshi,
Yoshiyama Kenji,
Wada Tamiki,
Nomura Keiko T.,
Shimosegawa Eku,
Ikeda Manabu
Publication year - 2020
Publication title -
international journal of geriatric psychiatry
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.28
H-Index - 129
eISSN - 1099-1166
pISSN - 0885-6230
DOI - 10.1002/gps.5315
Subject(s) - actigraphy , statistical parametric mapping , dementia with lewy bodies , thalamus , positron emission tomography , medicine , dementia , rem sleep behavior disorder , orbitofrontal cortex , temporal cortex , psychology , statistical significance , audiology , nuclear medicine , neuroscience , parkinson's disease , circadian rhythm , magnetic resonance imaging , prefrontal cortex , radiology , disease , cognition
Objectives Although sleep disturbances are prevalent among patients with dementia with Lewy bodies (DLB), their neural substrates remain unclear. We aimed to clarify the neural substrates of sleep disturbances in patients with DLB. Methods We evaluated sleep disturbances, neuropsychiatric symptoms, and brain glucose metabolism in 22 patients with probable DLB using actigraphy, the Neuropsychiatric Inventory (NPI), and 18 F‐fluorodeoxyglucose (FDG) positron emission tomography, respectively. Total sleep time (TST) and average activity count per minute (AAC) during sleep were calculated for seven consecutive days via actigraphy. We investigated associations between FDG uptake and the actigraphy parameters using Statistical Parametric Mapping version 12b. Spearman's rank correlation coefficients were used to investigate associations among TST, AAC, and clinical symptoms. The level of statistical significance was set at P < .05. P values were adjusted using the Benjamini‐Hochberg method for multiple comparisons. This study was registered with ClinicalTrials.gov (NCT00776347). Results TST exhibited a significant positive association with FDG uptake in the bilateral orbitofrontal cortex and left thalamus, while AAC exhibited a significant negative association with FDG uptake in the left thalamus and the left parieto‐occipital region. FDG uptake in the left pulvinar was associated with both TST and AAC. In addition, TST exhibited a significant negative association with the NPI hallucinations score ( r = −0.66, P = .001), while AAC exhibited significant positive associations with the NPI delusions ( r = 0.70, P < .001) and hallucinations ( r = 0.63, P = .002) scores. Conclusions TST and bodily activity during sleep are associated with dysfunction of the left pulvinar and the severity of hallucinations in patients with DLB.