title: Rest-activity rhythm disruption in progressive supranuclear palsy.
abstract: The brainstem is among the first regions affected in progressive supranuclear palsy (PSP) and is part of the sleep/circadian regulation network. In two small studies, blood pressure and core body temperature circadian patterns were disrupted in PSP; however, it is unclear if circadian activity rhythms are also affected. Our objective was to perform circadian analyses of the rest-activity rhythms in PSP and determine the association with increasing disease severity.
  
  
  
  Individuals with a clinical PSP diagnosis (n = 17; nine men) and healthy older adults (n = 17; nine men) were selected for this study. Participants wore actigraphy wristbands and completed sleep diaries for up to 14 consecutive days. Data were analyzed to assess circadian activity strength (amplitude, mesor, f-ratio), phase (acrophase), and circadian stability (intradaily variability, interdaily stability, relative amplitude). Analyses controlled for sleep fragmentation, cognition, and self-reported depression. The association between disease severity using the PSP rating scale and circadian activity rhythm disruption was assessed.
  
  
  
  Individuals with PSP had significantly lower circadian activity mesor (p ≤ 0.001), amplitude (p ≤ 0.001), robustness (f-ratio, p <0.01), relative amplitude (p ≤ 0.001), and interdaily stability (p ≤ 0.01), with increased intradaily variability (p <0.05). CAR remained weaker in PSP after controlling for sleep fragmentation, and again when also controlling for cognitive impairment and depression. Weaker circadian activity (mesor, amplitude, f-ratio, and relative amplitude) was associated with increased disease severity.
  
  
  
  Circadian activity rhythms are disrupted in individuals with PSP as compared to controls, and worsen with disease severity. This is the first study of its kind to describe circadian activity rhythms in PSP.
authors.affiliation: Memory & Aging Center, Department of Neurology, University of California San Francisco, 675 Nelson Rising Lane, Suite 190, San Francisco, CA 94158, USA. Electronic address: christine.walsh@ucsf.edu.
authors.forename: Christine M
authors.initials: CM
authors.lastname: Walsh
authors.affiliation: Stress & Health Research Program, Department of Mental Health, San Francisco VA Medical Center, 4150 Clement Street 116P Building 8, San Francisco, CA 94121, USA.
authors.forename: Leslie
authors.initials: L
authors.lastname: Ruoff
authors.affiliation: Stress & Health Research Program, Department of Mental Health, San Francisco VA Medical Center, 4150 Clement Street 116P Building 8, San Francisco, CA 94121, USA.
authors.forename: Jonathan
authors.initials: J
authors.lastname: Varbel
authors.affiliation: Memory & Aging Center, Department of Neurology, University of California San Francisco, 675 Nelson Rising Lane, Suite 190, San Francisco, CA 94158, USA.
authors.forename: Kathleen
authors.initials: K
authors.lastname: Walker
authors.affiliation: Memory & Aging Center, Department of Neurology, University of California San Francisco, 675 Nelson Rising Lane, Suite 190, San Francisco, CA 94158, USA.
authors.forename: Lea T
authors.initials: LT
authors.lastname: Grinberg
authors.affiliation: Memory & Aging Center, Department of Neurology, University of California San Francisco, 675 Nelson Rising Lane, Suite 190, San Francisco, CA 94158, USA.
authors.forename: Adam L
authors.initials: AL
authors.lastname: Boxer
authors.affiliation: Memory & Aging Center, Department of Neurology, University of California San Francisco, 675 Nelson Rising Lane, Suite 190, San Francisco, CA 94158, USA; Department of Psychiatry, University of California San Francisco, 401 Parnassus Ave, San Francisco, CA 94143, USA.
authors.forename: Joel H
authors.initials: JH
authors.lastname: Kramer
authors.affiliation: Memory & Aging Center, Department of Neurology, University of California San Francisco, 675 Nelson Rising Lane, Suite 190, San Francisco, CA 94158, USA.
authors.forename: Bruce L
authors.initials: BL
authors.lastname: Miller
authors.affiliation: Stress & Health Research Program, Department of Mental Health, San Francisco VA Medical Center, 4150 Clement Street 116P Building 8, San Francisco, CA 94121, USA; Department of Psychiatry, University of California San Francisco, 401 Parnassus Ave, San Francisco, CA 94143, USA.
authors.forename: Thomas C
authors.initials: TC
authors.lastname: Neylan
mesh_terms: D056044:Actigraphy; D000368:Aged; D002940:Circadian Rhythm / Q000502:physiology*; D005260:Female; D006801:Humans; D008297:Male; D009043:Motor Activity / Q000502:physiology; D012146:Rest; D012307:Risk Factors; D012890:Sleep / Q000502:physiology*; D013494:Supranuclear Palsy, Progressive / Q000150:complications* / Q000188:drug therapy
keywords: Actigraphy; Circadian rhythms; Progressive supranuclear palsy; Sleep