Slow Wave Sleep and EEG Delta Spectral Power are Associated with Cognitive Function in Parkinson’s Disease

Article type: Research Article

Authors: Wood, Kimberly H.^{a; b; c} | Memon, Adeel A.^a | Memon, Raima A.^d | Joop, Allen^a | Pilkington, Jennifer^a | Catiul, Corina^a | Gerstenecker, Adam^a | Triebel, Kristen^a | Cutter, Gary^e | Bamman, Marcas M.^{b; f} | Miocinovic, Svjetlana^g | Amara, Amy W.^a

Affiliations: [a] Department of Neurology, University of Alabama at Birmingham, Birmingham, AL, USA | [b] Department of Cell, Developmental, and Integrative Biology, University of Alabama at Birmingham, Birmingham, AL, USA | [c] Department of Psychology, Samford University, Birmingham, AL, USA | [d] Department of Pathology, University of Alabama at Birmingham, Birmingham, AL, USA | [e] Department of Biostatistics, University of Alabama at Birmingham, Birmingham, AL, USA | [f] Geriatric Research, Education, and Clinical Center, Birmingham VA Medical Center, Birmingham, AL, USA | [g] Department of Neurology, Emory University, Atlanta, GA, USA

Correspondence: [*] Correspondence to: Amy W. Amara, MD, PhD, University of Alabama at Birmingham, SC 360A, 1720 2nd Avenue South, Birmingham, AL 35294 0017, USA. E-mail: [email protected].

Abstract: Background:Cognitive and sleep dysfunction are common non-motor symptoms in Parkinson’s disease (PD). Objective:Determine the relationship between slow wave sleep (SWS) and cognitive performance in PD. Methods:Thirty-two PD participants were evaluated with polysomnography and a comprehensive level II neurocognitive battery, as defined by the Movement Disorders Society Task Force for diagnosis of PD-mild cognitive impairment. Raw scores for each test were transformed into z-scores using normative data. Z-scores were averaged to obtain domain scores, and domain scores were averaged to determine the Composite Cognitive Score (CCS), the primary outcome. Participants were grouped by percent of SWS into High SWS and Low SWS groups and compared on CCS and other outcomes using 2-sided t-tests or Mann-Whitney U. Correlations of cognitive outcomes with sleep architecture and EEG spectral power were performed. Results:Participants in the High SWS group demonstrated better global cognitive function (CCS) (p = 0.01, effect size: r = 0.45). In exploratory analyses, the High SWS group showed better performance in domains of executive function (effect size: Cohen’s d = 1.05), language (d = 0.95), and processing speed (d = 1.12). Percentage of SWS was correlated with global cognition and executive function, language, and processing speed. Frontal EEG delta power during N3 was correlated with the CCS and executive function. Cognition was not correlated with subjective sleep quality. Conclusion:Increased SWS and higher delta spectral power are associated with better cognitive performance in PD. This demonstrates the significant relationship between sleep and cognitive function and suggests that interventions to improve sleep might improve cognition in individuals with PD.

Keywords: Parkinson’s disease, slow wave sleep, sleep, cognition

DOI: 10.3233/JPD-202215

Journal: Journal of Parkinson's Disease, vol. 11, no. 2, pp. 703-714, 2021