Abstract

Alzheimer’s disease (AD), which accounts for most of the dementia cases, is, aside from cognitive deterioration, often characterized by the presence of non-cognitive symptoms such as activity and sleep disturbances. AD patients typically experience increased sleep fragmentation, excessive daytime sleepiness and night-time insomnia. Here, we sought to investigate the link between sleep architecture, cognition and amyloid pathology in the APP23 amyloidosis mouse model for AD. By means of polysomnographic recordings the sleep-wake cycle of freely-moving APP23 and wild-type (WT) littermates of 3, 6 and 12 months of age was examined. In addition, ambulatory cage activity was assessed by interruption of infrared beams surrounding the home cage. To assess visuo-spatial learning and memory a hidden-platform Morris-type Water Maze (MWM) experiment was performed. We found that sleep architecture is only slightly altered at early stages of pathology, but significantly deteriorates from 12 months of age, when amyloid plaques become diffusely present. APP23 mice of 12 months old had quantitative reductions of NREM and REM sleep and were more awake during the dark phase compared to WT littermates. These findings were confirmed by increased ambulatory cage activity during that phase of the light-dark cycle. No quantitative differences in sleep parameters were observed during the light phase. However, during this light phase, the sleep pattern of APP23 mice was more fragmented from 6 months of age, the point at which also cognitive abilities started to be affected in the MWM. Sleep time also positively correlated with MWM performance. We also found that spectral components in the EEG started to alter at the age of 6 months. To conclude, our results indicate that sleep architectural changes arise around the time the first amyloid plaques start to form and cognitive deterioration becomes apparent. These changes start subtle, but gradually worsen with age, adequately mimicking the clinical condition.

Highlights

  • World’s leading cause of dementia, Alzheimer’s disease (AD), is a progressive, neurodegenerative disorder affecting an increasing aged population

  • At 12 months of age, when amyloid plaques are diffusely present in the neocortex and hippocampus, Non-rapid eye movement (NREM) and rapid eye movement (REM) sleep time were significantly reduced, while wakefulness was significantly increased

  • Sleep fragmentation is apparent from 6 months onwards, when Morris-type Water Maze (MWM) performance is severely affected

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Summary

Introduction

World’s leading cause of dementia, Alzheimer’s disease (AD), is a progressive, neurodegenerative disorder affecting an increasing aged population. Apart from the characteristic cognitive decline, up to 60% of AD patients experience sleep and circadian rhythm disturbances [1,2]. AD is associated with increased sleep fragmentation, excessive daytime sleepiness and night-time insomnia [3,4,5,6,7]. Non-rapid eye movement (NREM) and rapid eye movement (REM) sleep are quantitatively reduced, resulting in a reduced total sleep time (TST) [6]. Circadian dysrhythmia might lead to the emergence of the ‘sundowning’ phenomenon, which can lead to a complete reversal of the day-night cycle in these patients. Sleep disorders and sundowning decrease the self-care ability of AD patients, are among the main reasons for caregiver exhaustion, and greatly impact the rate of institutionalization [8,9]

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