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Abstract Details

Cortical Phase Amplitude Coupling and Pathologic Synchronization during Sleep in Parkinson’s Disease
Movement Disorders
S10 - Biomarkers in Movement Disorders (4:03 PM-4:14 PM)
004

Excessive synchronization of neuronal discharge activity is now a well-recognized feature of PD.  One manifestation of this abnormal synchrony is heightened coupling of gamma band amplitude to the phase of beta band oscillations.  This elevated phase-amplitude coupling (PAC) strongly correlates with the presence of akinesia and has been proposed as a potential therapeutic target for closed-loop control of deep brain stimulation (DBS) parameters.  Yet, optimizing PAC as a therapeutic measure necessitates an improved understanding of its phenomenology in various states of arousal. 

To characterize the behavior of cortical phase amplitude coupling (PAC) during various sleep stages in a Parkinson’s disease (PD) population. 

Polysomnography (PSG) electroencephalography (EEG) recordings of PD patients were post-processed and quantitatively analyzed using custom Matlab scripts.  For each patient, electrode recordings close to the primary motor cortex (M1) were used to calculate average PAC modulation for each of the following arousal stages (S): waking (S0), light sleep (S1, S2), slow wave sleep (S3), and rapid eye movement (REM) sleep.  Power spectral analyses were also performed.  Statistical comparisons were conducted using repeated measures ANOVA.  

Among 15 PD patients (10M:5W; mean(sd) age=64.8(10.7)), there was heightened M1 cortical PAC in REM sleep (mean=3.6E-05) compared to S0 (mean=3.0E-05) and other sleep stages (mean S1=3.1E-05, S2=3.0E-05, S3=3.0E-05).  Though these results were not significant by ANOVA (p=0.11), greater patient numbers may reinforce this finding.  In sub-group analysis, REM PAC was greater in subjects with observed dream enactment (mean=5.1E-05) during PSG (n=9) than in patients without documented dream enactment (mean=3.8E-05).  Beta and gamma power levels remained stable across sleep stages, including REM.

Our results suggest PD patients feature elevated cortical PAC levels during REM sleep compared to the waking state and other sleep stages.  This heightened REM PAC may be enhanced by the presence of dream enactment. 

Authors/Disclosures
Lenora A. Higginbotham, MD (Emory University)
PRESENTER 		The institution of Dr. Higginbotham has received research support from NIH/NINDS . The institution of Dr. Higginbotham has received research support from Bright Focus Foundation. The institution of Dr. Higginbotham has received research support from 好色先生.
LynnMarie Trotti, MD (Emory University School of Medicine) Dr. Trotti has received personal compensation in the range of $10,000-$49,999 for serving as an officer or member of the Board of Directors for American Academy of Sleep Medicine. Dr. Trotti has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for American Association of Chest Physicians. The institution of Dr. Trotti has received research support from NIH. The institution of Dr. Trotti has received research support from American Academy of Sleep Medicine Foundation . Dr. Trotti has received personal compensation in the range of $5,000-$9,999 for serving as a Speaker with AASM, CHEST, Medscape, SRS Foundation, PER CME, Haymarket CME. Dr. Trotti has received personal compensation in the range of $0-$499 for serving as a DSMB member with NIH. Dr. Trotti has received personal compensation in the range of $0-$499 for serving as a Reviewer with Lancet journals. Dr. Trotti has a non-compensated relationship as a Medical advisory board member with Hypersomnia Foundation that is relevant to AAN interests or activities. Dr. Trotti has a non-compensated relationship as a Board member with AASM Foundation that is relevant to AAN interests or activities. Dr. Trotti has a non-compensated relationship as a Board member with ABSM that is relevant to AAN interests or activities.
No disclosure on file
Svjetlana Miocinovic, MD, PhD (Emory University) Dr. Miocinovic has nothing to disclose.