Objective: To investigate the effects of 12 weeks of multimodal training on sleep architecture in an individual with corticobasal syndrome (CBS).

Background: CBS is a rare tauopathy characterized by rigidity, dystonia and apraxia, cortical sensory deficit and cognitive abnormalities¹. Alterations in sleep architecture are poorly documented but can be present in CBS². Chronic exercise can help manage the symptoms of the disease³ and improve sleep architecture in other Parkinsonian disorders⁴. However, research in CBS is limited, and, to the best of our knowledge, no studies have examined the effects of chronic exercise on sleep architecture in this clinical population.

Method: One male individual with CBS (50.83y; levodopa equivalent daily doses= 600 mg/d; Physical Activity Scale for Individuals with Physical Disabilities= 10.51 METs h/d) was recruited. Sleep architecture was evaluated before and after 12 weeks of multimodal training at moderate-vigorous intensity (45 min, three times/week). Polysomnography was conducted using a standard montage with frontal, central, parietal, and occipital electrodes referenced to the mastoids. An expert sleep technician, blinded to the study, manually scored the recordings. In addition to macro sleep architecture parameters, slow wave and sleep spindle features during artifact-free N2/N3 were examined using Snooz Toolbox⁵.

Results: The participant completed 34 training sessions (tot.: 25h21min; avg. rate of perceived exertion=16). Exercise increased total sleep time (195.0 to 462.5 min), sleep efficiency (71.2 to 94.6%) and reduced sleep onset latency (33.0 to 9.0 min). While no major changes in N1% (4.4 to 3.7%) and N3% (1.8 to 1.0%) were found, there was a reduction in N2% (83.9 to 72.6%) and wake time (28.8 to 5.4%), and an increase in REM% (9.8 to 22.8%). Finally, slow wave density (avg. across channels: 2.8 to 1.0 count/min) and average frequency (avg. across channels: 1.33 to 0.97 Hz) decreased, while sleep spindle density increased (avg. across channels: 0.58 to 2.20 count/min).

Conclusion: Although we cannot rule out a possible first-night effect, our findings suggest that exercise may influence macro-/micro-sleep architecture in an individual with CBS. These results reinforce the notion that exercise can be used as an adjuvant therapy for sleep abnormalities in neurodegenerative disorders^4,6. The potential motor and cognitive benefits further warrant investigation.

References: 1. Jankovic J, Hallett M, Okun MS, Comella C, Fahn S, Goldman J. Chapter 9 – Atypical parkinsonism, parkinsonism-plus syndromes and secondary parkinsonian disorders. In: Jankovic J, Hallett M, Okun MS, Comella C, Fahn S, Goldman J, eds. Principles and Practice of Movement Disorders (Third Edition). London: Elsevier; 2021:249-295.e217.
2. Roche S, Jacquesson JM, Destée A, Defebvre L, Derambure P, Monaca C. Sleep and vigilance in corticobasal degeneration: A descriptive study. Neurophysiologie Clinique/Clinical Neurophysiology. 2007/08/01/ 2007;37(4):261-264.
3. Bluett B, Pantelyat AY, Litvan I, et al. Best Practices in the Clinical Management of Progressive Supranuclear Palsy and Corticobasal Syndrome: A Consensus Statement of the CurePSP Centers of Care. Frontiers in Neurology. 2021-July-01 2021;12.
4. Amara AW, Wood KH, Joop A, et al. Randomized, controlled trial of exercise on objective and subjective sleep in Parkinson’s disease. Mov Disord. 2020; [Epub ahead of print].
5. CARSM Montreal. Welcome to Snooz Toolbox documentation! Snooz Toolbox is a Python software for the analysis of sleep recordings (Polysomnography). Available at: https://snooz-toolbox-documentation.readthedocs.io/latest/index.html.
6. Amara AW, Memon AA, Catiul C, et al. Effects of exercise on sleep spindles in Parkinson’s Disease. Frontiers in Rehabilitation Sciences.173.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/the-effects-of-multimodal-training-on-sleep-architecture-in-corticobasal-syndrome-a-case-report/