Study Objectives: To clarify whether sleep disturbance would alter the patterns of structural and functional networks underlying cognitive dysfunction in patients with Parkinson's disease (PD). Methods: Among the 180 patients with nondemented PD in our cohort, 45 patients were classified as the group with sleep disturbance according to the 5-item scales for outcomes in Parkinson's disease nighttime scale. Based on propensity scores, another 45 PD patients without sleep disturbance were matched to this group. We performed a comparative analysis of cortical thickness, diffusion tensor imaging-based white matter integrity, resting-state functional connectivity, and cognitive performance between PD patients with and without sleep disturbance. Results: PD patients with sleep disturbance showed poorer performance in attention and working memory and a tendency toward a lower score in frontal executive function relative to those without sleep disturbance. The PD with sleep disturbance group exhibited widespread white matter disintegration compared to the PD without sleep disturbance group, although there were no significant differences in cortical thickness between the PD subgroups. On functional network analysis, PD patients with sleep disturbance exhibited less severely decreased cortical functional connectivity within the default mode network, central executive network, and dorsal attention network when compared to those without sleep disturbance. Conclusions: The present study suggests that sleep disturbance in PD patients could be associated with white matter and functional network alterations in conjunction with cognitive impairment.
Bibliographical noteFunding Information:
This research was supported by a grant from the Korea Health Technology RandD Project through the Korea Health Industry Development Institute (KHIDI), funded by the Ministry of Health and Welfare, Republic of Korea (grant number: HI16C1118), and by the Brain Research Program through the National Research Foundation of Korea (NRF) funded by the Ministry of Science, ICT and Future Planning (NRF-2014M3C71A1046050). The authors would like to thank all the participants who have taken part in this study. Author contributions: S.J. Chung and P.H. Lee conducted the study design. S.J. Chung, H.S. Yoo, and S.H. Moon included participants. S.J. Chung, Y.H. Choi, H. Kwon, Y.H. Park, H.J. Yun, and S.H. Moon performed the statistical analyses. Y.H. Choi, H. Kwon, Y.H. Park, H.J. Yun, and J.M. Lee performed the imaging data processing and analyses. S.J. Chung, Y.H. Choi, H. Kown, Y.H. Park, and H.J. Yun wrote the manuscript, which was co-edited by H.S. Yoo, B.S. Ye, Y.H. Sohn, J.M. Lee, and P.H. Lee.
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All Science Journal Classification (ASJC) codes
- Clinical Neurology
- Physiology (medical)