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Original Article
Dementia and Neurocognitive Disorders 2017: 16: 3: 72-77

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Associations between Brain Perfusion and Sleep Disturbance in Patients with Alzheimer’s Disease
Jooyeon J. Im,1* Hyeonseok S. Jeong,1* Jong-Sik Park,2 Seung-Hee Na,2Yong-An Chung,1 YoungSoon Yang,3 In-Uk Song2
Departments of 1Radiology and 2Neurology, Incheon St. Mary’s Hospital, The Catholic University of Korea, Incheon, Korea 3Department of Neurology, Veterans Hospital, Seoul Medical Center, Seoul, Korea
Associations between Brain Perfusion and Sleep Disturbance in Patients with Alzheimer’s Disease
Jooyeon J. Im,1* Hyeonseok S. Jeong,1* Jong-Sik Park,2 Seung-Hee Na,2Yong-An Chung,1 YoungSoon Yang,3 In-Uk Song2
Departments of 1Radiology and 2Neurology, Incheon St. Mary’s Hospital, The Catholic University of Korea, Incheon, Korea 3Department of Neurology, Veterans Hospital, Seoul Medical Center, Seoul, Korea
Background and Purpose: Although sleep disturbances are common and considered a major burden for patients with Alzheimer’s disease (AD), the fundamental mechanisms underlying the development and maintenance of sleep disturbance in AD patients have yet to be elucidated. The aim of this study was to examine the correlation between regional cerebral blood flow (rCBF) and sleep disturbance in AD patients using technetium-99m hexamethylpropylene amine oxime single-photon emission computed tomography (SPECT).
Methods: A total of 140 AD patients were included in this cross-sectional study. Seventy patients were assigned to the AD with sleep loss (SL) group and the rest were assigned to the AD without SL group. SL was measured using the sleep subscale of the Neuropsychiatric Inventory. A wholebrain voxelwise analysis of brain SPECT data was conducted to compare the rCBF between the two groups
Results: The two groups did not differ in demographic characteristics, severity of dementia, general cognitive function, and neuropsychiatric symptoms, with the exception of sleep disturbances. The SPECT imaging analysis displayed decreased perfusion in the bilateral inferior frontal gyrus, bilateral temporal pole, and right precentral gyrus in the AD patients with SL group compared with the AD patients without SL group. It
also revealed increased perfusion in the right precuneus, right occipital pole, and left middle occipital gyrus in the AD with SL group compared with the AD without SL group.
Conclusions: The AD patients who experienced sleep disturbance had notably decreased perfusion in the frontal and temporal lobes and increased rCBF in the parietal and occipital regions. The findings of this study suggest that functional alterations in these brain areas may be the underlying neural correlates of sleep disturbance in AD patients.
Key Words: Alzheimers disease, sleep loss, single photon computed tomography, brain perfusion.