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Actigraphy validation in behavioral variant frontotemporal dementia.

Ludovica Tamburrino1, Benedetta Tafuri1, Valentina Gnoni2

  • 1Department of Translational Biomedicine and Neurosciences (DiBraiN), University of Bari Aldo Moro, Bari, Italy; Center for Neurodegenerative Diseases and the Aging Brain, University of Bari Aldo Moro, "Pia Fondazione Cardinale G. Panico", Tricase, Lecce, Italy.

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Actigraphy overestimates sleep time and efficiency in behavioral variant frontotemporal dementia (bvFTD) patients compared to polysomnography (PSG). Researchers should account for these biases when using actigraphy for sleep studies in bvFTD.

Keywords:
ActigraphyBehavioral variant frontotemporal dementiaDiscrepancy analysisEpoch-by-epoch analysisPSGValidation

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Area of Science:

  • Neuroscience
  • Sleep Medicine
  • Gerontology

Background:

  • Actigraphy is increasingly used for sleep assessment in neurodegenerative diseases.
  • Data on actigraphy's accuracy versus polysomnography (PSG) in this population is limited.
  • Behavioral variant frontotemporal dementia (bvFTD) is a common early-onset dementia.

Purpose of the Study:

  • To evaluate actigraphy's accuracy against PSG in patients with bvFTD.
  • To identify specific biases in actigraphy sleep parameter measurements for bvFTD.
  • To inform the use of actigraphy in bvFTD research and clinical practice.

Main Methods:

  • Eighteen bvFTD patients underwent simultaneous in-home PSG and wrist actigraphy.
  • Actigraphy performance was assessed using discrepancy analysis, Bland-Altman plots, and epoch-by-epoch analysis (EBE).
  • Analyses were performed for both Cole-Kripke and UCSD actigraphy scoring algorithms.

Main Results:

  • Both algorithms overestimated total sleep time and sleep efficiency.
  • Actigraphy underestimated wake after sleep onset (WASO) for patients with longer PSG-measured WASO.
  • Epoch-by-epoch analysis showed accuracies of 84% (Cole-Kripke) and 85% (UCSD).

Conclusions:

  • Actigraphy significantly overestimates sleep time, latency, and efficiency in bvFTD patients.
  • Actigraphy underestimates WASO in this population.
  • Users of actigraphy for bvFTD sleep studies must consider and correct for these identified measurement biases.