{"doi":"10.1016/j.sleep.2022.09.025","title":"Non-REM sleep with hypertonia in Parkinsonian Spectrum Disorders: A pilot investigation","abstract":"INTRODUCTION: From an ongoing multicenter effort toward differentiation of Parkinsonian spectrum disorders (PSD) from other types of neurodegenerative disorders, the sleep biomarker non-rapid-eye-movement sleep with hypertonia (NRH) emerged. METHODS: This study included in the PSD group patients with dementia with Lewy bodies/Parkinson disease dementia (DLB/PDD = 16), Parkinson disease (PD = 16), and progressive supranuclear palsy (PSP = 13). The non-PSD group included patients with Alzheimer disease dementia (AD = 24), mild cognitive impairment (MCI = 35), and a control group with normal cognition (CG = 61). In-home, multi-night Sleep Profiler studies were conducted in all participants. Automated algorithms detected NRH, characterized by elevated frontopolar electromyographic power. Between-group differences in NRH were evaluated using Logistic regression, Mann-Whitney U and Chi-squared tests. RESULTS: NRH was greater in the PSD group compared to non-PSD (13.9 ± 11.0% vs. 3.1 ± 4.7%, P < 0.0001). The threshold NRH≥5% provided the optimal between-group differentiation (AUC = 0.78, P < 0.001). NRH was independently associated with the PSD group after controlling for age, sex, and SSRI/SNRI use (P < 0.0001). The frequencies of abnormal NRH by subgroup were PSP = 92%, DLB/PDD = 81%, PD = 56%, MCI = 26%, AD = 17%, and CG = 16%. The odds of abnormal NRH in each PSD subgroup ranged from 3.7 to 61.2 compared to each non-PSD subgroup. The night-to-night and test-retest intraclass correlations were excellent (0.78 and 0.84, both P < 0.0001). CONCLUSIONS: In this pilot study, NRH appeared to be a novel candidate sleep biomarker for PSD-related neurodegeneration. Future studies in larger cohorts are needed to confirm these findings, understand the etiology of NRH magnitude/duration, and determine whether it is an independent prodromal marker for specific neurodegenerative pathologies.","journal":"Sleep Medicine","year":2022,"id":272133,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":12,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.5787,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2022-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":256691,"name":"Christine M. Walsh","orcid":null,"position":1,"is_corresponding":false},{"id":108587,"name":"Bradley F. Boeve","orcid":"0000-0002-4153-8187","position":2,"is_corresponding":false},{"id":108610,"name":"Debby W. Tsuang","orcid":"0000-0002-4716-1894","position":3,"is_corresponding":false},{"id":622514,"name":"Joanne M. Hamilton","orcid":null,"position":4,"is_corresponding":false},{"id":63221,"name":"David H. Salat","orcid":"0000-0002-2246-9657","position":5,"is_corresponding":false},{"id":621493,"name":"Chris Berka","orcid":"0000-0003-1566-2907","position":6,"is_corresponding":false},{"id":681834,"name":"Joyce Lee‐Iannotti","orcid":"0000-0003-2710-3133","position":7,"is_corresponding":false},{"id":438276,"name":"David Shprecher","orcid":"0000-0002-4217-0097","position":8,"is_corresponding":false},{"id":938679,"name":"Philip R. Westbrook","orcid":null,"position":9,"is_corresponding":false},{"id":938680,"name":"Gandis Mazeika","orcid":null,"position":10,"is_corresponding":false},{"id":938083,"name":"Leslie Yack","orcid":"0000-0002-3477-4683","position":11,"is_corresponding":false},{"id":938681,"name":"Sarah Payne","orcid":null,"position":12,"is_corresponding":false},{"id":491221,"name":"Paul Timm","orcid":null,"position":13,"is_corresponding":false},{"id":392841,"name":"Thomas C. Neylan","orcid":"0000-0002-1572-2626","position":14,"is_corresponding":false},{"id":428950,"name":"Erik K. St. Louis","orcid":"0000-0002-2833-8826","position":15,"is_corresponding":false},{"id":938082,"name":"Daniel J. Levendowski","orcid":"0000-0003-1278-6349","position":0,"is_corresponding":true}],"reference_count":55,"raw_metadata":null,"created_at":"2026-07-19T00:27:43.806977Z","pmid":"36274383","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}