Bradley F. Boeve

Testing normal older people three or four times at 1- to 2-year intervals: defining normal variance.

Normative data were presented that defined the upper and lower standards for deciding if cognitive abilities show reliable change over 2 or more testing occasions when retesting occurs at 1- to 2-year intervals. The Mayo Cognitive Factor Scores (MCFS; G. E. Smith et al., 1994) were analyzed because they permit the quantitation of overall functioning in 5 clinically important cognitive domains: established verbal knowledge, nonverbal reasoning, attention and concentration, new learning, and delayed memory. To the authors knowledge, this is the first report of both group-level and individual-level data analyses derived from a respectably sized sample of normal persons who have been tested 3 or more times at clinically common test-retest intervals.

Rates of cerebral atrophy in autopsy-confirmed progressive supranuclear palsy

To determine the rates of cerebral atrophy and ventricular expansion in six patients with autopsy confirmed progressive supranuclear palsy (PSP) and multiple antemortem volumetric head MRI scans.

REM Sleep Behavior Disorder in Parkinson’s Disease, Dementia with Lewy Bodies, and Multiple System Atrophy

Rapid eye movement sleep behavior disorder (RBD) is characterized by loss of normal skeletal muscle atonia during rapid eye movement (REM) sleep with prominent motor activity and dreaming. The evolving literature and our clinical experience suggests RBD may not simply represent an interesting parasomnia, but rather reflect dysfunction in REM sleep control that has relevance for understanding certain neurodegenerative disorders. In this chapter, we first review the clinical and polysomnographic features of RBD, criteria for diagnosis of RBD, management of RBD, pathophysiologic underpinnings of RBD, and neuroimaging findings. We then view RBD in the context of certain neurodegenerative disorders. The window that RBD provides in understanding key features of REM sleep control as well as the clinical and pathophysiologic significance of REM sleep dyscontrol in neurodegenerative disorders become clear.

Sleep in Parkinson’s Disease and Dementia with Lewy Bodies

Sleep disturbance in Parkinson’s disease (PD) and dementia with Lewy bodies (DLB) is common and can have a debilitating effect on quality of life due to the effects of daytime somnolence on cognition, motor function, potential for injury and capacity to manage activities of daily living. Sources of excessive daytime sleepiness in PD and DLB often include sleep fragmentation, side effects of medications, and sleep disorders that disrupt night-time sleep continuity. The parasomnia of REM sleep behavior disorder has also been shown to be an early feature of PD and DLB and a risk factor for dementia in PD. Dysfunction of the dopamine nigrostriatal and mesolimbic systems is involved in Lewy body disease, but several other neurotransmitter systems have Lewy body pathology and neuronal loss that may be responsible for abnormal sleepiness and REM sleep behavior disorder in these conditions.

IC-P-087

degree of RvF activation, such that greater impairment was associated with greater left hippocampal (-34,-20,-20; z 2.80, p 0.003) activation to Repeated stimuli. Conclusions: These findings suggest that hippocampal responses to repeated stimuli are distinctly altered in AD and also in more impaired MCI subjects. Failure of habituation to repeated stimulus exposure may prove to be a sensitive marker of hippocampal dysfunction due to AD pathology. Research supported by NINDS K23-NS02189; NIA PO1AG04953; NIA P50-AG00513421; Academy of Finland.