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1. The relationship between thermoregulation and REM sleep behaviour disorder in Parkinson's disease.

Author

George Zhong, Samuel Bolitho, Ronald Grunstein, Sharon Linda Naismith, and Simon John Geoffrey Lewis

Subjects
Medicine, Science
Abstract

BackgroundThis study explored the relationship between symptoms of rapid eye movement sleep behaviour disorder, thermoregulation and sleep in Parkinson's Disease.MethodsThe study group comprised 12 patients with Parkinson's Disease and 11 healthy age-matched controls. We investigated markers of thermoregulation (core-body temperature profile), circadian rhythm (locomotor actigraphy) and sleep (polysomnography).ResultsThe mesor (the mean value around which the core temperature rhythm oscillates) of the core-body temperature in patients with Parkinson's Disease was significantly lower than that of controls. In addition, the nocturnal fall in CBT (the difference between the mesor and the nadir temperature) was also significantly reduced in PD patients relative to controls. Furthermore, in patients the reduction in the amplitude of their core-body temperature profile was strongly correlated with the severity of self-reported rapid eye movement sleep behaviour disorder symptom, reduction in the percentage of REM sleep and prolonged sleep latency. By contrast, these disturbances of thermoregulation and sleep architecture were not found in controls and were not related to other markers of circadian rhythm or times of sleep onset and offset.ConclusionsThese findings suggest that the brainstem pathology associated with disruption of thermoregulation in Parkinson's disease may also contribute to rapid eye movement sleep behavioural disorder. It is possible that detailed analysis of the core-body temperature profile in at risk populations such as those patients with idiopathic rapid eye movement sleep behaviour disorder might help identify those who are at high risk of transitioning to Parkinson's Disease.

Published
2013
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2. A Pilot Study Evaluating the Development and Implementation of a Feasible, Evidence-based, Group Cognitive Training Program Within an Older People’s Mental Health Service

Author

Claudia Woolf, Danielle Gately, Leanne Kaplan, Zeeshan Shahnawaz, Louisa Margaret Norrie, David Burke, Sharon Linda Naismith, and Loren Mowszowski

Abstract

Background and objectivesIn the absence of a cure for dementia, investigation of novel strategies aimed at delaying or preventing the onset of dementia are gaining momentum. In this regard, using the RE-AIM framework, we outline steps taken to adapt and implement an evidence-based cognitive training program for older adults ‘at risk’ of developing dementia within a clinical setting of a major metropolitan hospital. The primary aim was to explore feasibility (or ‘reach’), tolerability (or ‘implementation’), and acceptability (or ‘adoption’). The secondary aim was to explore the most sensitive clinical outcomes and measurement tools (i.e. ‘efficacy’) to inform a subsequent formal feasibility randomised controlled trial. MethodThis was an exploratory feasibility pilot study, using a pre-post single-arm study design. We conducted this study within the Older People’s Mental Health Service at St Vincent’s Hospital, Sydney, Australia. Seventy-nine participants, with a mean age of 78 years (SD=5.8, range=67-94) were enrolled. All enrolled participants engaged in ‘Club Connect’ an adaptation of a 10-week, group-based multifaceted program, comprised of psychoeducation and computer-based cognitive training. At baseline and follow-up, all participants completed a battery of neuropsychological tests and several questionnaires related to mood and psychosocial functioning. ResultsImplementing cognitive training within a clinical setting was feasible, well tolerated and accepted by participants. Further, cognitive training was associated with large to very large effect size improvements in verbal learning, memory for verbal and visual information, and semantic fluency, as well as quality of life, and reductions in anxiety and stress. We also found small to medium effect size improvements for other cognitive and psychosocial outcomes. ConclusionsOur preliminary findings support the feasibility of translating a group-based cognitive training program into the clinical setting, and provide key data to facilitate the next phase of implementation.

Published
2021
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