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Parkinson's disease (PD) is viewed primarily as a motor disorder. However, recent researches suggest that there is also a variety of communication deficits associated with this disorder. In this paper, we review some of these researches and provide a set of recommendations designed to improve communicative outcomes when interacting with people who have PD. A variety of comprehension deficits have been documented in PD, including syntactic, pragmatic, and semantic deficits, as well as an impaired ability to recognize emotions. People with PD are also impaired in terms of language production, possibly in part because of their comprehension deficits. Major production deficits include reduced informational content, longer and more frequent pauses and associated turn-taking disruption, inappropriate levels of politeness, and deficits in various nonverbal accompaniments. Awareness of these deficits, and simple, common sense communicative adjustments, can greatly improve communication with people with PD.

Introduction About 50% of patients with Duchenne muscular dystrophy (DMD) exhibit learning and memory deficits. Sleep issues are also common in DMD, and their potential relevance to cognitive deficits is unexplored. In this pilot study, we investigate the effect of DMD on sleep-dependent consolidation of episodic memory, with a focus on the role of sleep-brain dynamics. Methods We studied boys aged 6–15 years who were typically developing (TD) or had DMD. First, we compared memory performance in an episodic memory task during a day of wake versus a night of sleep within subjects (Phase 1, n = 13), including a one-week sleep diary, and parent-rated, memory, and cognitive assessments. In Phase 2, we measured memory improvement in the same task across a night with polysomnography (24 head electrodes). Sleep was scored with AASM criteria. Slow oscillations (SO) (0.5-1.5 Hz) and spindles (10-16Hz) were detected algorithmically, assessing density, amplitude, and coordination. Results In Phase 1, data confirmed sleep-specific gains in memory performance when task difficulty was adjusted to our extended age range (mean accuracy change: 7% sleep, 0% wake). The DMD participant in Phase 1 exhibited worse immediate recall compared to TD peers (independent samples t-test; t(9) = -4.38, p =.02) and worse parent-rated sleep habits (t(9) = 4.01, p = .03 on Children Sleep Health Questionnaire). Phase 2 showed a physiological range of SOs and spindles density, amplitude, and duration in both groups, with potential differences in overall sleep quality. Conclusion This pilot study established the feasibility of a sleep-memory experiment including polysomnography in controls and DMD patients in the context of a pediatric research hospital. Data suggests the need for adaptive recruitment approaches for the DMD population in expanding the study. Sleep EEG analysis suggests the potential for subtle differences in DMD sleep brain dynamics that need to be investigated in a larger sample size. Support (if any) Center for Clinical and Translational Science voucher support to MW and Neurodevelopmental Research Affinity Group Pilot Award to PM

Purpose of Review Sleep is dynamic across the lifespan, influenced by brain maturation, neurophysiology, hormones, and cognitive processes. Sleep behaviors influenced by physiological and external factors can also impact sleep health. As sleep plays a mechanistic role in health across the lifespan, understanding when and how to intervene to benefit health is essential. Recent Findings Recent research has advanced our understanding of sleep across three domains: patterns, neurophysiology, and behaviors. Highlights include (1) Early childhood nap cessation is thought to relate to medial temporal lobe network maturation and underlie long-term hippocampal-dependent memory development. (2) Chronotype misalignment is a key factor in sleep deficits and social jetlag. (3) Older adult daytime sleep has complex effects on health, at times beneficial while others, potentially maladaptive. (4) Longitudinal sleep oscillation trajectories are starting to be investigated and indicate neurophysiology could be interpreted as indicative of brain maturation in development. (5) In adults, sleep quality and macrostructure trajectories show high variability, emphasizing distinctive traits in shaping sleep and its lifespan trajectories. (6) Neighborhood and socioeconomic factors influence sleep health across all ages. (7) In older adults, associations between loneliness and poor sleep are being unpacked. Summary This recent research, while comprehensively describing our current understanding of sleep trajectories across the lifespan, emphasizes the need to expand current approaches to longitudinal measurement studies that cross age-spans. Expanding will enhance our ability to mechanistically determine the temporal and causal relations between the multiple dimensions of sleep (i.e., patterns, behaviors, and physiology) and outcomes in sleep health.

Brain oscillations of non-rapid eye movement sleep, including slow oscillations (SO, 0.5–1.5 Hz) and spindles (10–16 Hz), mirror underlying brain maturation across development and are associated with cognition. Hence, age-associated emergence and changes in the electrophysiological properties of these rhythms can lend insight into cortical development, specifically in comparisons between pediatric populations and typically developing peers. We previously evaluated age-associated changes in SOs in male patients with Duchenne muscular dystrophy (DMD), finding a significant age-related decline between 4 and 18 years. While primarily a muscle disorder, male patients with DMD can also have sleep, cognitive, and cortical abnormalities, thought to be driven by altered dystrophin expression in the brain. In this follow-up study, we characterized the age-associated changes in sleep spindles. We found that age-dependent spindle characteristics in patients with DMD, including density, frequency, amplitude, and duration, were consistent with age-associated trends reported in the literature for typically developing controls. Combined with our prior finding of age-associated decline in SOs, our results suggest that SOs, but not spindles, are a candidate intervention target to enhance sleep in patients with DMD.