TY - JOUR
T1 - Poor sleep quality is associated with cognitive, mobility, and anxiety disability that underlie freezing of gait in Parkinson's disease
AU - de Almeida, Filipe Oliveira
AU - Ugrinowitsch, Carlos
AU - Brito, Leandro C.
AU - Milliato, Angelo
AU - Marquesini, Raquel
AU - Moreira-Neto, Acácio
AU - Barbosa, Egberto Reis
AU - Horak, Fay B.
AU - Mancini, Martina
AU - Silva-Batista, Carla
N1 - Funding Information:
Participants from Movement Disorders Clinic from School of Medicine of the University of São Paulo and Brazil Parkinson Association for their commitment to study, FAPESP, CNPq, and CAPES. This study was funded by Fundação de Amparo à Pesquisa do Estado de São Paulo (grant numbers 2013/04970-4 , 2016/13115-9 and 2018/16909-1 ), Conselho Nacional de Desenvolvimento Científico e Tecnológico (grant numbers 406609/2015-2 and 03085/2015-0 ), National Institutes of Health (award number R01AG006457) and Department of Veterans Affairs Merit Award (number 5I01RX001075).
Publisher Copyright:
© 2021 Elsevier B.V.
PY - 2021/3
Y1 - 2021/3
N2 - Background: Individuals with Parkinson's disease (PD) who report freezing of gait (FOG) have poorer sleep quality than those without FOG. Cognitive, anxiety, and mobility disability are components of the FOG phenotype, however, no study has investigated if poor sleep quality is associated with all three components that underlie FOG in PD. Research question: Are there associations among sleep quality and all three components of the FOG phenotype? Methods: Forty and 39 individuals with and without FOG (PD + FOG and PD-FOG), respectively, and 31 age-matched healthy controls (HC) participated in this study. Self-reported FOG (new-FOG questionnaire-NFOGQ), sleep quality (Pittsburgh Sleep Quality Index-PSQI), cognitive function (Montreal Cognitive Assessment-MoCA), anxiety (subscale from Hospital Anxiety and Depression Scale-HADS-A), and mobility (timed-up-and-go test-TUG) were assessed. Results and Significance: PSQI scores were correlated with the scores of NFOGQ, MoCA, HADS-A, and TUG time in PD + FOG (P ≤ 0.0038). The multiple regression analysis identified the PSQI scores as the only predictor of the variance of the NFOGQ scores (R2 = 0.46, P <.0001). The variance in the PSQI scores were explained (69 %) by MoCA scores, NFOGQ scores, TUG time, and HADS-A scores (P ≤ 0.05). Although PD + FOG had a higher disease severity compared to PD-FOG (P < 0.001), disease severity did not enter in the regression model to explain PSQI scores and NFOGQ scores. We also observed associations of PSQI scores with the MoCA scores and TUG time for HC (P ≤ 0.0038), whereas there was no association between PSQI scores and any variable in PD-FOG (P > 0.05). Finally, PD + FOG presented worse scores of PSQI, MoCA, HADS-A, and TUG time than PD-FOG and HC (P < 0.05). Thus, poor sleep quality is associated with FOG and all three components that underlie FOG, regardless of the disease severity. Therefore, treatments useful to decrease FOG should be targeted to ameliorate sleep quality, cognition, anxiety, and mobility.
AB - Background: Individuals with Parkinson's disease (PD) who report freezing of gait (FOG) have poorer sleep quality than those without FOG. Cognitive, anxiety, and mobility disability are components of the FOG phenotype, however, no study has investigated if poor sleep quality is associated with all three components that underlie FOG in PD. Research question: Are there associations among sleep quality and all three components of the FOG phenotype? Methods: Forty and 39 individuals with and without FOG (PD + FOG and PD-FOG), respectively, and 31 age-matched healthy controls (HC) participated in this study. Self-reported FOG (new-FOG questionnaire-NFOGQ), sleep quality (Pittsburgh Sleep Quality Index-PSQI), cognitive function (Montreal Cognitive Assessment-MoCA), anxiety (subscale from Hospital Anxiety and Depression Scale-HADS-A), and mobility (timed-up-and-go test-TUG) were assessed. Results and Significance: PSQI scores were correlated with the scores of NFOGQ, MoCA, HADS-A, and TUG time in PD + FOG (P ≤ 0.0038). The multiple regression analysis identified the PSQI scores as the only predictor of the variance of the NFOGQ scores (R2 = 0.46, P <.0001). The variance in the PSQI scores were explained (69 %) by MoCA scores, NFOGQ scores, TUG time, and HADS-A scores (P ≤ 0.05). Although PD + FOG had a higher disease severity compared to PD-FOG (P < 0.001), disease severity did not enter in the regression model to explain PSQI scores and NFOGQ scores. We also observed associations of PSQI scores with the MoCA scores and TUG time for HC (P ≤ 0.0038), whereas there was no association between PSQI scores and any variable in PD-FOG (P > 0.05). Finally, PD + FOG presented worse scores of PSQI, MoCA, HADS-A, and TUG time than PD-FOG and HC (P < 0.05). Thus, poor sleep quality is associated with FOG and all three components that underlie FOG, regardless of the disease severity. Therefore, treatments useful to decrease FOG should be targeted to ameliorate sleep quality, cognition, anxiety, and mobility.
KW - Affective
KW - Cognition
KW - Daytime dysfunction
KW - Freezers
KW - Gait disturbances
KW - Postural instability
UR - http://www.scopus.com/inward/record.url?scp=85100698535&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85100698535&partnerID=8YFLogxK
U2 - 10.1016/j.gaitpost.2021.01.026
DO - 10.1016/j.gaitpost.2021.01.026
M3 - Article
C2 - 33578308
AN - SCOPUS:85100698535
SN - 0966-6362
VL - 85
SP - 157
EP - 163
JO - Gait and Posture
JF - Gait and Posture
ER -