Objective: To assess rest-activity and circadian rhythm stability in Dementia with Lewy bodies (DLB) and their relationship with cognitive, behavioural, and quality of life measures.

Background: Sleep-wake disturbances are a commonly reported non-motor symptom in patients with Lewy body disorders¹. Home-based wrist actigraphy offers a low-burden, cost-effective option to measure sleep disturbances over time and has demonstrated alterations in rest-activity patterns and circadian phase in other synucleinopathies². This study reports both parametric and non-parametric actigraphy variables in DLB and investigates their associations with cognitive, behavioural, and quality of life measures.

Method: Eleven participants with DLB (10:1, M:F) and 7 age-matched healthy controls (5:2, M:F) were recruited. A cross-sectional design was utilized. Participants completed a battery of neuropsychological and cognitive assessments, a motor assessment, and were given a wrist actigraphy device for two weeks. Mann-Whitney U tests were used to compare group differences and Spearman’s correlation was used to assess the relationship between actigraphy and cognitive, behavioural and quality of life measures.

Results: DLB patients reported significantly lower scores in cognitive (p=0.002), motor function (p<0.001) and non-motor function (p=0.001), along with increased depression (p=0.014) and self-reported RBD (p=0.015). There were no significant differences between groups for time in bed, total sleep time, or percentage of time awake. However, compared to controls, DLB patients reported higher interdaily variability (transitions between rest and activity) (p=0.015) and lower relative amplitude (the difference between the leave active 5-hour and most active 10-hour patterns in an average 24-hour period) (p=0.011).  Furthermore, interdaily stability (the relationship between rest-activity rhythm and the zeitgeber) was positively correlated with depression, hallucinations, and cognitive fluctuations.

Conclusion: Wrist actigraphy and its non-parametric measures may serve as a valuable tool for investigating sleep-wake disturbances in patients with DLB and help better understand the pathophysiological role of rest-activity and circadian rhythm disruption in this condition.

References: 1. Bohnen NI, Hu M. Sleep disturbance as potential risk and progression factor for Parkinson’s disease. Journal of Parkinson’s disease. 2019 Jan 1;9(3):603-14.
2. Madrid-Navarro CJ, Escamilla-Sevilla F, Mínguez-Castellanos A, Campos M, Madrid JA, Rol MA. Multidimensional circadian monitoring by wearable biosensors in Parkinson’s disease. Frontiers in neurology. 2018 Mar 26;9:335498.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/understanding-sleep-wake-disturbances-in-dementia-with-lewy-bodies-using-parametric-and-non-parametric-measures-in-wrist-actigraphy/