{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,6]],"date-time":"2026-09-06T14:30:07Z","timestamp":1788705007161,"version":"build-2803163510"},"reference-count":56,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2021,6,23]],"date-time":"2021-06-23T00:00:00Z","timestamp":1624406400000},"content-version":"vor","delay-in-days":173,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2021,1,1]],"date-time":"2021-01-01T00:00:00Z","timestamp":1609459200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["alz-journals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Alz &amp; Dem Diag Ass &amp; Dis Mo"],"published-print":{"date-parts":[[2021,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Degradation in fractal motor activity regulation (FMAR), a measure of multiscale self\u2010similarity of motor control, occurs in aging and accelerates with clinical progression to Alzheimer's disease (AD). Whether FMAR changes occur during the pre\u2010symptomatic phase of the disease in women and men remains unknown.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>FMAR was assessed in cognitively normal participants (n\u00a0=\u00a0178) who underwent 7 to 14 days of home actigraphy. Preclinical AD pathology was determined by amyloid imaging\u2010Pittsburgh compound B (PiB) and cerebrospinal fluid (CSF) phosphorylated\u2010tau181 (p\u2010tau) to amyloid beta 42 (A\u03b242) ratio.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Degradation in daytime FMAR was overall significantly associated with preclinical amyloid plaque pathology via PiB+ imaging (beta coefficient\n                      <jats:italic>\u03b2<\/jats:italic>\n                      \u00a0=\u00a00.217, standard error [SE]\u00a0=\u00a00.101,\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0=\u00a0.034) and increasing CSF tau181\u2010A\u03b242 ratio (\n                      <jats:italic>\u03b2<\/jats:italic>\n                      \u00a0=\u00a00.220, SE\u00a0=\u00a00.084,\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0=\u00a0.009). In subset analysis by sex, the effect sizes were significant in women for PiB+ (\n                      <jats:italic>\u03b2<\/jats:italic>\n                      \u00a0=\u00a00.279, SE\u00a0=\u00a00.112,\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0=\u00a0.015) and CSF (\n                      <jats:italic>\u03b2<\/jats:italic>\n                      \u00a0=\u00a00.245, SE\u00a0=\u00a00.094,\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0=\u00a0.011) but not in men (both\n                      <jats:italic>P<\/jats:italic>\n                      s\u00a0&gt;\u00a0.05). These associations remained after inclusion of daily activity level, apolipoprotein E \u03b54 carrier status, and rest\/activity patterns.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>Changes in daytime FMAR from actigraphy appear to be present in women early in preclinical AD. This may be a combination of earlier pathology changes in females reflected in daytime FMAR, and a relatively underpowered male group. Further studies are warranted to test FMAR as an early noncognitive physiological biomarker that precedes the onset of cognitive symptoms.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/dad2.12211","type":"journal-article","created":{"date-parts":[[2021,6,23]],"date-time":"2021-06-23T07:00:34Z","timestamp":1624431634000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":24,"title":["Fractal motor activity regulation and sex differences in preclinical Alzheimer's disease pathology"],"prefix":"10.1002","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1476-1460","authenticated-orcid":false,"given":"Lei","family":"Gao","sequence":"first","affiliation":[{"name":"Department of Anesthesia, Critical Care and Pain Medicine Massachusetts General Hospital Harvard Medical School  Boston Massachusetts USA"},{"name":"Medical Biodynamics Program Brigham and Women's Hospital  Boston Massachusetts 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Disorders Washington University School of Medicine  St. Louis Missouri USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yo\u2010El S.","family":"Ju","sequence":"additional","affiliation":[{"name":"Department of Neurology Washington University School of Medicine  St. Louis Missouri USA"},{"name":"Hope Center for Neurological Disorders Washington University School of Medicine  St. Louis Missouri USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kun","family":"Hu","sequence":"additional","affiliation":[{"name":"Medical Biodynamics Program Brigham and Women's Hospital  Boston Massachusetts USA"},{"name":"Division of Sleep Medicine Harvard Medical School  Boston Massachusetts 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