Pharmacological enhancement of slow-wave activity improves cognition and reduces amyloidosis at an early stage in a mouse model of Alzheimer's disease

Improving sleep in murine Alzheimers disease (AD) is associated with reduced brain amyloidosis. However, the window of opportunity for successful sleep-targeted interventions regarding reduction of pathological hallmarks and related cognitive performance remains poorly characterized. Here, we enhanced slow-wave activity (SWA) during sleep via sodium oxybate (SO) oral administration for 2 weeks at early (6 months old) or moderately late (11 months old) disease stages in Tg2576 mice, and evaluated resulting neuropathology and behavioral performance. We observed that cognitive performance of 6 months old Tg2576 mice significantly improved upon SO treatment, whereas no change was observed in 11 months old mice. Histochemical assessment of amyloid plaques demonstrated that SO-treated 11 months old Tg2576 mice had significantly less plaque burden than placebo-treated ones, whereas ELISA of insoluble protein fractions from 6 months old Tg2576 mice brains indicated lower A{beta}-42/A{beta}-40 ratio in SO-treated group vs. placebo-treated controls. Altogether, our results suggest that SWA-dependent reduction of brain amyloidosis leads to alleviated behavioral impairment in Tg2576 mice only if administered early in the disease course, potentially highlighting the key importance of early sleep-based interventions in clinical cohorts. Significance statementA staggering amount of people worldwide live with AD. Despite extensive efforts from academy and industry, no cure is available to date. Sleep may be a modifiable factor involved in onset, progression and potentially also treatment of AD. However, knowledge regarding important aspects of sleep-targeted treatments is missing, e.g. adequate window of opportunity for their efficacious application, their minimal duration or their effect onto both pathology and cognition. We found that pharmacologically enhanced sleep depth is associated with reduced amyloid neuropathology in AD mice brains at both early- and moderately advanced-stage disease. However, only early-stage disease mice significantly benefited from sleep-enhancing treatment. Our results strongly encourage further mechanistic research and the launch of larger scale preclinical investigations in early AD populations.