Toward understanding cognitive impairment in patients with myotonic dystrophy type 1.
Cognitive dysfunction and sleep disruption are two frequent but underestimated features of adult onset myotonic dystrophy type 1 (MD1). In order to investigate the MD1 cognitive profile and its relationship with sleep disruption, 23 patients with genetically proved MD1 (mild-moderate in severity) underwent neuropsychological (nps) and polysomnography assessment. Patients scored lower than controls on almost all nps tests but cognitive impairments were mostly observed in executive functions (z-score = -2.14), with complex attention (z-score = -1.04), memory (z-score = -0.65), constructions (z-score = -1.29), and reasoning (z-score = -0.75) being slightly affected. Moderate-severe sleep apnea (apnea-hypopnea index [AHI] > or =15) was very frequent with most of the apneas being of the obstructive type. However, we found hardly any evidence of association between subjective, objective sleep parameters, and nps performance (p > .001). Thus, in our cohort of 23 adult MD1 patients, mild cognitive dysfunction, which is mostly related to the dysfunction of frontal association cortex and its underlying neural networks, does not seem to be significantly influenced by sleep disruption, which is mainly caused by obstructive apnea events.
First Department of Neurology, Eginition Hospital, National University of Athens, Greece. zalonis@eginitio.uoa.gr <zalonis@eginitio.uoa.gr>
Ioannis
I
Zalonis
Anastasios
A
Bonakis
Fotini
F
Christidi
Emmanouil
E
Vagiakis
Sokratis G
SG
Papageorgiou
Nikolaos
N
Kalfakis
Panagiota
P
Manta
Dimitrios
D
Vassilopoulos
D000328:Adult; D000368:Aged; D015982:Bias; D003072:Cognition Disorders / Q000175:diagnosis* / Q000523:psychology; D004185:Disability Evaluation; D006970:Disorders of Excessive Somnolence / Q000175:diagnosis / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009223:Myotonic Dystrophy / Q000175:diagnosis* / Q000523:psychology; D009483:Neuropsychological Tests / Q000706:statistics & numerical data*; D017286:Polysomnography; D011594:Psychometrics; D015203:Reproducibility of Results; D012893:Sleep Wake Disorders / Q000175:diagnosis / Q000523:psychology; D055815:Young Adult