Effects of exercise on sleep spindles in Parkinson's disease.

• Type of Material: Article
• Authors: Adeel A Memon, University of Alabama at Birmingham; Corina Catiul, University of Alabama at Birmingham; Zachary Irwin, University of Alabama at Birmingham; Jennifer Pilkington, University of Alabama at Birmingham; Raima A Memon, University of Alabama at Birmingham; Allen Joop, University of Alabama at Birmingham; Kimberly H Wood, University of Alabama at Birmingham; Gary Cutter, University of Alabama at Birmingham; Marcas Bamman, University of Alabama at Birmingham; Svjetlana Miocinovic, Emory University; Amy W Amara, University of Alabama at Birmingham
• Language: English
• Date: 2022
• Publisher: Frointiers
• Publication Version: Final Published Version
• Copyright Statement: © 2022 Memon, Catiul, Irwin, Pilkington, Memon, Joop, Wood, Cutter, Bamman, Miocinovic and Amara.
• License: Creative Commons Attribution 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.3389/fresc.2022.952289
• Title of Journal or Parent Work: Front Rehabil Sci
• Volume: 3
• Start Page: 952289
• End Page: 952289
• Grant/Funding Information: AM received funding from NINDS R25NS079188 Training Fellowship; KW received funding from NIH T32 HD071866 Training Fellowship; AWA received funding from NIH (K23NS080912 and R01HD100670). SM received funding from NIH (K23NS097576).
• Keywords: exercise; cognition; Parkinson’s disease; sleep; sleep spindles
• Research Categories: Health Sciences, Pathology; Health Sciences, Medicine and Surgery

Abstract

BACKGROUND: In a randomized, controlled trial, we showed that high-intensity rehabilitation, combining resistance training and body-weight interval training, improves sleep efficiency in Parkinson's disease (PD). Quantitative sleep EEG (sleep qEEG) features, including sleep spindles, are altered in aging and in neurodegenerative disease. OBJECTIVE: The objective of this post-hoc analysis was to determine the effects of exercise, in comparison to a sleep hygiene, no-exercise control group, on the quantitative characteristics of sleep spindle morphology in PD. METHODS: We conducted an exploratory post-hoc analysis of 24 PD participants who were randomized to exercise (supervised 3 times/week for 16 weeks) versus 26 PD participants who were assigned to a sleep hygiene, no-exercise control group. At baseline and post-intervention, all participants completed memory testing and underwent polysomnography (PSG). PSG-derived sleep EEG central leads (C3 and C4) were manually inspected, with rejection of movement and electrical artifacts. Sleep spindle events were detected based on the following parameters: (1) frequency filter = 11-16 Hz, (2) event duration = 0.5-3 s, and (3) amplitude threshold 75% percentile. We then calculated spindle morphological features, including density and amplitude. These characteristics were computed and averaged over non-rapid eye movement (NREM) sleep stages N2 and N3 for the full night and separately for the first and second halves of the recording. Intervention effects on these features were analyzed using general linear models with group x time interaction. Significant interaction effects were evaluated for correlations with changes in performance in the memory domain. RESULTS: A significant group x time interaction effect was observed for changes in sleep spindle density due to exercise compared to sleep hygiene control during N2 and N3 during the first half of the night, with a moderate effect size. This change in spindle density was positively correlated with changes in performance on memory testing in the exercise group. CONCLUSIONS: This study is the first to demonstrate that high-intensity exercise rehabilitation has a potential role in improving sleep spindle density in PD and leading to better cognitive performance in the memory domain. These findings represent a promising advance in the search for non-pharmacological treatments for this common and debilitating non-motor symptom.