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Sleep-like slow waves during resting-state: a promising EEG biomarker of amyloid and neurodegeneration in preclinical Alzheimer disease

Champetier, P.; Albero, C.; Raposo Pereira, F.; Herzog, R.; Chaumon, M.; Houot, M.; Locatelli, M.; Kas, A.; Habert, M.-O.; Teichmann, M.; Epelbaum, S.; Arnulf, I.; Oudiette, D.; Andrillon, T.; INSIGHT-preAD group,

2026-01-16 neurology
10.64898/2026.01.15.26344195
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INTRODUCTIONGrowing evidence supports a critical role of sleep slow waves (SW) in Alzheimers disease (AD). However, wake SW (sleep-like SW potentially reflecting local intrusions of sleep) remain unexplored in AD. METHODS274 older adults with subjective cognitive decline (INSIGHT-preAD cohort, 76.6 {+/-} 3.5 years) underwent i) PET scans for amyloid (A) and neurodegeneration (N), ii) high-density resting-state EEG recordings to detect wake SW, and iii) cognitive assessments. Biomarkers were reassessed two years later. We examined wake SW associations with 1) current A/N status, 2) cognition, and 3) amyloid conversion. RESULTSA+N-, A-N+ and A+N+ individuals exhibited lower delta wake SW density than A-N- participants. Wake SW amplitude 1) was higher in A+N+ than A-N- individuals, 2) correlated with poorer cognition, and 3) predicted A- to A+ conversion. DISCUSSIONWake SW represent promising early EEG biomarkers for AD pathology and amyloid conversion, facilitating risk stratification before cognitive decline onset.

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