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      Acoustic enhancement of sleep slow oscillations in mild cognitive impairment

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          Abstract

          Objective

          Slow‐wave activity ( SWA) during sleep is reduced in people with amnestic mild cognitive impairment ( aMCI) and is related to sleep‐dependent memory consolidation. Acoustic stimulation of slow oscillations has proven effective in enhancing SWA and memory in younger and older adults. In this study we aimed to determine whether acoustic stimulation during sleep boosts SWA and improves memory performance in people with aMCI.

          Methods

          Nine adults with aMCI (72 ± 8.7 years) completed one night of acoustic stimulation (stim) and one night of sham stimulation (sham) in a blinded, randomized crossover study. Acoustic stimuli were delivered phase‐locked to the upstate of the endogenous sleep slow‐waves. Participants completed a declarative recall task with 44 word‐pairs before and after sleep.

          Results

          During intervals of acoustic stimulation, SWA increased by >10% over sham intervals ( P < 0.01), but memory recall increased in only five of the nine patients. The increase in SWA with stimulation was associated with improved morning word recall ( r = 0.78, P = 0.012).

          Interpretation

          Acoustic stimulation delivered during slow‐wave sleep over one night was effective for enhancing SWA in individuals with aMCI. Given established relationships between SWA and memory, a larger or more prolonged enhancement may be needed to consistently improve memory in aMCI.

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          Most cited references31

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          2018 Alzheimer's disease facts and figures

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            Auditory closed-loop stimulation of the sleep slow oscillation enhances memory.

            Brain rhythms regulate information processing in different states to enable learning and memory formation. The <1 Hz sleep slow oscillation hallmarks slow-wave sleep and is critical to memory consolidation. Here we show in sleeping humans that auditory stimulation in phase with the ongoing rhythmic occurrence of slow oscillation up states profoundly enhances the slow oscillation rhythm, phase-coupled spindle activity, and, consequently, the consolidation of declarative memory. Stimulation out of phase with the ongoing slow oscillation rhythm remained ineffective. Closed-loop in-phase stimulation provides a straight-forward tool to enhance sleep rhythms and their functional efficacy. Copyright © 2013 Elsevier Inc. All rights reserved.
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              The Alzheimer's Disease Centers' Uniform Data Set (UDS): the neuropsychologic test battery.

              The neuropsychologic test battery from the Uniform Data Set (UDS) of the Alzheimer's Disease Centers (ADC) program of the National Institute on Aging consists of brief measures of attention, processing speed, executive function, episodic memory, and language. This paper describes development of the battery and preliminary data from the initial UDS evaluation of 3268 clinically cognitively normal men and women collected over the first 24 months of utilization. The subjects represent a sample of community-dwelling, individuals who volunteer for studies of cognitive aging. Subjects were considered "clinically cognitively normal" based on clinical assessment, including the Clinical Dementia Rating scale and the Functional Assessment Questionnaire. The results demonstrate performance on tests sensitive to cognitive aging and to the early stages of Alzheimer disease in a relatively well-educated sample. Regression models investigating the impact of age, education, and sex on test scores indicate that these variables will need to be incorporated in subsequent normative studies. Future plans include: (1) determining the psychometric properties of the battery; (2) establishing normative data, including norms for different ethnic minority groups; and (3) conducting longitudinal studies on cognitively normal subjects, individuals with mild cognitive impairment, and individuals with Alzheimer disease and other forms of dementia.
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                Author and article information

                Contributors
                r-malkani@northwestern.edu
                Journal
                Ann Clin Transl Neurol
                Ann Clin Transl Neurol
                10.1002/(ISSN)2328-9503
                ACN3
                Annals of Clinical and Translational Neurology
                John Wiley and Sons Inc. (Hoboken )
                2328-9503
                01 July 2019
                July 2019
                : 6
                : 7 ( doiID: 10.1002/acn3.2019.6.issue-7 )
                : 1191-1201
                Affiliations
                [ 1 ] Department of Neurology Northwestern University Feinberg School of Medicine Chicago Illinois
                [ 2 ] Center for Circadian and Sleep Medicine Northwestern University Feinberg School of Medicine Chicago Illinois
                [ 3 ] Mesulam Center for Cognitive Neurology and Alzheimer's Disease, Northwestern University Feinberg School of Medicine Chicago Illinois
                [ 4 ] Department of Psychiatry and Behavioral Sciences Northwestern University Feinberg School of Medicine Chicago Illinois
                [ 5 ] DeepWave Technologies Encinitas California
                [ 6 ] Department of Psychology Northwestern University Evanston Illinois
                Author notes
                [*] [* ] Correspondence

                Roneil Malkani, Northwestern University, 710 N. Lake Shore Drive 5th floor, Chicago, IL 60611. Tel: 312‐503‐1530; Fax: 312-908-5073; E‐mail: r-malkani@ 123456northwestern.edu

                Author information
                https://orcid.org/0000-0002-6183-7635
                Article
                ACN3796
                10.1002/acn3.796
                6649400
                31353857
                392c7e20-f33b-4e12-a577-857cc7e71590
                © 2019 The Authors. Annals of Clinical and Translational Neurology published by Wiley Periodicals, Inc on behalf of American Neurological Association.

                This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.

                History
                : 15 April 2019
                : 26 April 2019
                Page count
                Figures: 5, Tables: 1, Pages: 11, Words: 6553
                Funding
                Funded by: Alzheimer's Association
                Award ID: NIRG 15-364483
                Funded by: Illinois Department of Public Health
                Award ID: 63282002D
                Funded by: National Institute on Aging
                Award ID: P01AG11412 (PI: Zee)
                Award ID: P30AG013854 (PI: Mesulam)
                Funded by: National Institutes of Health
                Award ID: T32NS047987
                Funded by: National Science Foundation Graduate Research Fellowship Program
                Award ID: DGE‐1324585
                Funded by: Northwestern University Center for Circadian and Sleep Medicine
                This work was funded by Alzheimer's Association grant NIRG 15-364483; Illinois Department of Public Health grant 63282002D; National Institute on Aging grants P01AG11412 (PI: Zee) and P30AG013854 (PI: Mesulam); National Institutes of Health grant T32NS047987; National Science Foundation Graduate Research Fellowship Program grant DGE‐1324585; Northwestern University Center for Circadian and Sleep Medicine grant .
                Categories
                Research Article
                Research Articles
                Custom metadata
                2.0
                acn3796
                July 2019
                Converter:WILEY_ML3GV2_TO_NLMPMC version:5.6.6.2 mode:remove_FC converted:23.07.2019

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