睡眠障碍与阿尔茨海默病交互作用机制

Progress in studies of the reciprocal interaction between sleep disorders and Alzheimer's disease

阿尔茨海默病是好发于老年人群的中枢神经系统退行性病变,为痴呆常见病因。流行病学调查结果显示,44%的阿尔茨海默病患者伴睡眠紊乱和(或)昼夜节律紊乱。越来越多的证据表明,脑组织β淀粉样蛋白(Aβ)波动具有昼夜节律性,睡眠障碍可加速Aβ沉积,提示二者之间可能存在交互作用,其机制尚未完全明确。睡眠障碍可能与阿尔茨海默病发病过程中睡眠觉醒调节系统和昼夜节律系统受累有关;睡眠障碍亦可影响神经元活性、神经递质分泌,并作为一种应激原影响Aβ的生成和代谢,加速阿尔茨海默病之病理生理过程。本文拟就其交互作用及可能机制的研究进展进行阐述。

Alzheimer＇s disease （AD） is a common neurodegenerative disease in the elderly, and is the most common cause of dementia. Epidemiologieal studies have discovered that, 44% of patients with AD are associated with sleep disorders and （or） circadian rhythm disorders. Now there are growing evidences indicating that interstitial fluid amyloid-β protein （A β） levels exhibit circadian rhythm fluctuation, and sleep disorders will accelerate the process of Aβ deposition, which may act as a risk factor of AD, suggesting the possible reciprocal interaction between sleep disorders and AD. The mechanism is not yet completely clear. Sleep disorders may be related with the impairments of both sleep- wake regulating system, circadian rhythm regulating system and the change of zeitgeber in AD. Sleep disorders would affect neuronal activity, neurotransmitter secretion, and as a stressor affecting A β processing and metabolism, thus accelerate the pathological process of AD. This paper reviewed the progress in the studies of recinrocal interaction between sleep disorders and Alzheimer＇s disease and the possible mechanisms.