Commentary on the link between brain disease and sleep-wake systems

By August 15, 2019 Commentary, In the News

Contributed by Bryce Mander, PhD

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Our colleagues at UCSF recently published findings in the journal Alzheimer’s and Dementia examining how tau pathology in different brain diseases – Alzheimer’s disease, progressive supranuclear palsy, and corticobasal degeneration – impacts brain cells that are in charge of keeping us awake.

This study reported several important findings:

  • In all three diseases, there was a reduction in brain cells that help promote cortical arousal.

  • In all three diseases, tau pathology was quite substantial in several of the wake-promoting cells in the brainstem region.

  • Tau pathology in the brainstem in Alzheimer’s disease was associated with a much greater loss of wake-promoting cells compared to the two other brain diseases.

This last point may help explain different sleep-wake symptoms we observe in these neurodegenerative diseases. For example, while Alzheimer’s disease is associated with fragmented sleep-wake behavior and excessive daytime sleepiness, supranuclear palsy is typically associated with hyperarousal and significantly reduced nighttime sleep (2-4 hours per night).

These findings highlight the importance of considering the brainstem in neurodegenerative disease research and open the door for the development of new treatments aimed to balance sleep-wake systems in patients.


Bryce Mander, PhD is Assistant Professor of Psychiatry and Human Behavior. Dr. Mander is a leading expert in the neuroscience of sleep and brain health. His research looks at how sleep disturbance impacts brain function, thinking, and memory in older adults, particularly those at risk for dementia.