1
|
Wang J, Huang B, Zhou L, Tang S, Feng H, Chan JWY, Chau SWH, Zhang J, Li SX, Mok V, Wing YK, Liu Y. Visuospatial dysfunction predicts dementia-first phenoconversion in isolated REM sleep behaviour disorder. J Neurol Neurosurg Psychiatry 2024:jnnp-2024-333865. [PMID: 38925912 DOI: 10.1136/jnnp-2024-333865] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2024] [Accepted: 05/31/2024] [Indexed: 06/28/2024]
Abstract
OBJECTIVE While isolated rapid eye movement sleep behaviour disorder (iRBD) is known as a prodrome of α-synucleinopathies, the prediction for its future phenoconversion to parkinsonism-first or dementia-first subtype remains a challenge. This study aimed to investigate whether visuospatial dysfunction predicts dementia-first phenoconversion in iRBD. METHODS Patients with iRBD and control subjects were enrolled in this prospective cohort study. Baseline neuropsychological assessment included the Unified Parkinson's Disease Rating Scale part III, Montreal Cognitive Assessment (MoCA), Rey-Osterrieth complex figure (ROCF), Colour Trails test (CTT), Farnsworth-Munsell 100-hue test and Digit Span test. The anterior and posterior subscores of MoCA as well as their modified versions were explored. A composite score derived from ROCF and CTT was also explored. Regular follow-up was conducted to determine the phenoconversion status of iRBD patients. RESULTS The study included 175 iRBD patients and 98 controls. During a mean follow-up of 5.1 years, 25.7% of patients experienced phenoconversion. Most of the neuropsychological tests could differentiate dementia-first but not parkinsonism-first convertors from non-convertors. The modified posterior subscore of MoCA, by integrating the Alternating Trail Making and Clock Drawing components into original the posterior subscore, which mainly reflects visuospatial function, was the strongest predictor for dementia-first phenoconversion (adjusted HR 5.48, 95% CI 1.67 to 17.98). CONCLUSION Visuospatial dysfunction, as reflected mainly by the modified posterior subscore of MoCA, is a predictive factor for dementia-first phenoconversion in iRBD, suggesting its potential for being a biomarker for clinical prognostic prediction and potential neuroprotective trials aiming to delay or prevent dementia.
Collapse
Affiliation(s)
- Jing Wang
- Center for Sleep and Circadian Medicine, Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
- Li Chiu Kong Family Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, Guangdong, China
- Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education, Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Bei Huang
- Li Chiu Kong Family Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, Guangdong, China
- Li Ka Shing Institute of Health Sciences, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, Guangdong, China
| | - Li Zhou
- Li Chiu Kong Family Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, Guangdong, China
| | - Shi Tang
- Li Chiu Kong Family Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, Guangdong, China
| | - Hongliang Feng
- Center for Sleep and Circadian Medicine, Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
- Li Chiu Kong Family Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, Guangdong, China
- Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education, Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Joey W Y Chan
- Li Chiu Kong Family Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, Guangdong, China
| | - Steven W H Chau
- Li Chiu Kong Family Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, Guangdong, China
| | - Jihui Zhang
- Center for Sleep and Circadian Medicine, Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
- Li Chiu Kong Family Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, Guangdong, China
- Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education, Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Shirley X Li
- Department of Psychology and the State Key Laboratory of Brain and Cognitive Sciences, University of Hong Kong, Hong Kong SAR, Guangdong, China
| | - Vincent Mok
- Li Ka Shing Institute of Health Sciences, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, Guangdong, China
- Margaret K.L. Cheung Research Centre for Management of Parkinsonism, Division of Neurology, Department of Medicine and Therapeutics, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, Guangdong, China
| | - Yun Kwok Wing
- Li Chiu Kong Family Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, Guangdong, China
- Li Ka Shing Institute of Health Sciences, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, Guangdong, China
| | - Yaping Liu
- Center for Sleep and Circadian Medicine, Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
- Li Chiu Kong Family Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, Guangdong, China
- Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education, Guangzhou Medical University, Guangzhou, Guangdong, China
| |
Collapse
|
2
|
Werner JK. Is neurotrauma-related rapid eye movement behavior disorder a harbinger of synucleinopathy? Sleep 2024; 47:zsae060. [PMID: 38436612 DOI: 10.1093/sleep/zsae060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2024] [Indexed: 03/05/2024] Open
Affiliation(s)
- J Kent Werner
- Department of Neurology, Uniformed Services University, Bethesda, MD, USA
- Department of Neurology, Walter Reed National Military Medical Center, Bethesda, MD, USA
- Department of Neurology, Johns Hopkins University, Baltimore, MD, USA
| |
Collapse
|
3
|
Elliott JE, Ligman BR, Bryant-Ekstrand MD, Keil AT, Powers K, Olivo C, Neilson LE, Postuma RB, Pelletier A, Gagnon JF, Gan-Or Z, Yu E, Liu L, St Louis EK, Forsberg LK, Fields JA, Ross OA, Huddleston DE, Bliwise DL, Avidan AY, Howell MJ, Schenck CH, McLeland J, Criswell SR, Videnovic A, During EH, Miglis MG, Shprecher DR, Lee-Iannotti JK, Boeve BF, Ju YES, Lim MM. Comorbid neurotrauma increases neurodegenerative-relevant cognitive, motor, and autonomic dysfunction in patients with rapid eye movement sleep behavior disorder: a substudy of the North American Prodromal Synucleinopathy Consortium. Sleep 2024; 47:zsae007. [PMID: 38181205 DOI: 10.1093/sleep/zsae007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Revised: 12/13/2023] [Indexed: 01/07/2024] Open
Abstract
STUDY OBJECTIVES Rapid eye movement sleep behavior disorder (RBD) is strongly associated with phenoconversion to an overt synucleinopathy, e.g. Parkinson's disease (PD), Lewy body dementia, and related disorders. Comorbid traumatic brain injury (TBI) and posttraumatic stress disorder (PTSD)-henceforth "neurotrauma" (NT)-increase the odds of RBD by ~2.5-fold and are associated with an increased rate of service-connected PD in Veterans. Thus, RBD and NT are both independently associated with PD; however, it is unclear how NT influences neurological function in patients with RBD. METHODS Participants ≥18 years with overnight polysomnogram-confirmed RBD were enrolled between 8/2018 to 4/2021 through the North American Prodromal Synucleinopathy Consortium. Standardized assessments for RBD, TBI, and PTSD history, as well as cognitive, motor, sensory, and autonomic function, were completed. This cross-sectional analysis compared cases (n = 24; RBD + NT) to controls (n = 96; RBD), matched for age (~60 years), sex (15% female), and years of education (~15 years). RESULTS RBD + NT reported earlier RBD symptom onset (37.5 ± 11.9 vs. 52.2 ± 15.1 years of age) and a more severe RBD phenotype. Similarly, RBD + NT reported more severe anxiety and depression, greater frequency of hypertension, and significantly worse cognitive, motor, and autonomic function compared to RBD. No differences in olfaction or color vision were observed. CONCLUSIONS This cross-sectional, matched case:control study shows individuals with RBD + NT have significantly worse neurological measures related to common features of an overt synucleinopathy. Confirmatory longitudinal studies are ongoing; however, these results suggest RBD + NT may be associated with more advanced neurological symptoms related to an evolving neurodegenerative process.
Collapse
Affiliation(s)
- Jonathan E Elliott
- VA Portland Health Care System, Research Service, Portland, OR, USA
- Oregon Health and Science University, Department of Neurology, Portland, OR, USA
| | | | | | - Allison T Keil
- VA Portland Health Care System, Research Service, Portland, OR, USA
- McGill University, Montreal Neurological Institute and Department of Neurology and Neurosurgery, Montréal, QC, Canada
| | - Katherine Powers
- VA Portland Health Care System, Research Service, Portland, OR, USA
| | - Cosette Olivo
- VA Portland Health Care System, Research Service, Portland, OR, USA
| | - Lee E Neilson
- VA Portland Health Care System, Research Service, Portland, OR, USA
- Oregon Health and Science University, Department of Neurology, Portland, OR, USA
| | - Ronald B Postuma
- McGill University, Montreal Neurological Institute and Department of Neurology and Neurosurgery, Montréal, QC, Canada
- Université du Québec à Montréal, Département of Psychology, Montréal, QC, Canada
- Hôpital du Sacré-Coeur de Montréal, Center for Advanced Research in Sleep Medicine, Montréal, QC, Canada
- Research Institute of the McGill University Health Centre, Montreal, QC, Canada
| | - Amélie Pelletier
- Hôpital du Sacré-Coeur de Montréal, Center for Advanced Research in Sleep Medicine, Montréal, QC, Canada
- Research Institute of the McGill University Health Centre, Montreal, QC, Canada
| | - Jean-François Gagnon
- Université du Québec à Montréal, Département of Psychology, Montréal, QC, Canada
- Hôpital du Sacré-Coeur de Montréal, Center for Advanced Research in Sleep Medicine, Montréal, QC, Canada
| | - Ziv Gan-Or
- McGill University, Montreal Neurological Institute and Department of Neurology and Neurosurgery, Montréal, QC, Canada
- McGill University, Department of Human Genetics, Montréal, QC, Canada
| | - Eric Yu
- McGill University, Montreal Neurological Institute and Department of Neurology and Neurosurgery, Montréal, QC, Canada
- McGill University, Department of Human Genetics, Montréal, QC, Canada
| | - Lang Liu
- McGill University, Montreal Neurological Institute and Department of Neurology and Neurosurgery, Montréal, QC, Canada
- McGill University, Department of Human Genetics, Montréal, QC, Canada
| | | | | | | | - Owen A Ross
- Mayo Clinic, Neurology and Medicine, Rochester, MN, USA
| | | | | | - Alon Y Avidan
- University of California Los Angeles, Neurology, Sleep Disorders Center, Los Angeles, CA, USA
| | - Michael J Howell
- University of Minnesota Medical Center, Department of Neurology, Minneapolis, MN, USA
- Hennepin County Medical Center, Minnesota Regional Sleep Disorders Center, Minneapolis, MN, USA
| | - Carlos H Schenck
- University of Minnesota Medical Center, Department of Neurology, Minneapolis, MN, USA
| | - Jennifer McLeland
- Washington University School of Medicine, Department of Neurology, Saint Louis, MO, USA
| | | | - Aleksandar Videnovic
- Massachusetts General Hospital, Movement Disorders Unit, Division of Sleep Medicine, Boston, MA, USA
- Harvard Medical School, Neurological Clinical Research Institute, Boston, MA, USA
| | - Emmanuel H During
- Stanford University, Psychiatry and Behavioral Sciences, Redwood City, CA, USA
- Stanford University, Neurology and Neurological Sciences, Palo Alto, CA, USA
- Mt Sinai School of Medicine, Department of Neurology, New York, NY, USA
| | - Mitchell G Miglis
- Stanford University, Psychiatry and Behavioral Sciences, Redwood City, CA, USA
- Stanford University, Neurology and Neurological Sciences, Palo Alto, CA, USA
| | - David R Shprecher
- Banner University Medical Center, Department of Neurology, Phoenix, AZ, USA
| | | | - Bradley F Boeve
- Mayo Clinic, Neurology and Medicine, Rochester, MN, USA
- NAPS Consortium Co-principal Investigators
| | - Yo-El S Ju
- Washington University School of Medicine, Department of Neurology, Saint Louis, MO, USA
- NAPS Consortium Co-principal Investigators
| | - Miranda M Lim
- Oregon Health and Science University, Department of Neurology, Portland, OR, USA
- Oregon Health and Science University, Department of Behavioral Neuroscience; Department of Pulmonary and Critical Care Medicine; Oregon Institute of Occupational Health Sciences, Portland, OR, USA
- VA Portland Health Care System, Mental Illness Research Education and Clinical Center; Neurology; National Center for Rehabilitative Auditory Research, Portland, OR, USA
| |
Collapse
|
4
|
Chen G, Wang W, Wu H, Zhao X, Kang X, Ren J, Zhang J, Sun Y, He J, Sun S, Zhong Z, Shang D, Fan M, Cheng J, Zhang D, Su C, Lin J. Disrupted topological properties of structural brain networks present a glutamatergic neuropathophysiology in people with narcolepsy. Sleep 2024; 47:zsae002. [PMID: 38173348 DOI: 10.1093/sleep/zsae002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Revised: 11/18/2023] [Indexed: 01/05/2024] Open
Abstract
STUDY OBJECTIVES Growing evidences have documented various abnormalities of the white matter bundles in people with narcolepsy. We sought to evaluate topological properties of brain structural networks, and their association with symptoms and neuropathophysiological features in people with narcolepsy. METHODS Diffusion tensor imaging was conducted for people with narcolepsy (n = 30) and matched healthy controls as well as symptoms assessment. Structural connectivity for each participant was generated to analyze global and regional topological properties and their correlations with narcoleptic features. Further human brain transcriptome was extracted and spatially registered for connectivity vulnerability. Genetic functional enrichment analysis was performed and further clarified using in vivo emission computed tomography data. RESULTS A wide and dramatic decrease in structural connectivities was observed in people with narcolepsy, with descending network degree and global efficiency. These metrics were not only correlated with sleep latency and awakening features, but also reflected alterations of sleep macrostructure in people with narcolepsy. Network-based statistics identified a small hyperenhanced subnetwork of cingulate gyrus that was closely related to rapid eye movement sleep behavior disorder (RBD) in narcolepsy. Further imaging genetics analysis suggested glutamatergic signatures were responsible for the preferential vulnerability of connectivity alterations in people with narcolepsy, while additional PET/SPECT data verified that structural alteration was significantly correlated with metabotropic glutamate receptor 5 (mGlutR5) and N-methyl-D-aspartate receptor (NMDA). CONCLUSIONS People with narcolepsy endured a remarkable decrease in the structural architecture, which was not only closely related to narcolepsy symptoms but also glutamatergic signatures.
Collapse
Affiliation(s)
- Guoyan Chen
- Department of Neurology, The Second Affiliated Hospital of Air Force Medical University, Xi'an, China
| | - Wen Wang
- Department of Radiology, The Second Affiliated Hospital of Air Force Medical University, Xi'an, China
| | - Haoyang Wu
- Basic Medicine School, Air Force Medical University, Xi'an, China
| | - Xianchao Zhao
- Department of Neurology, The Second Affiliated Hospital of Air Force Medical University, Xi'an, China
| | - Xiaopeng Kang
- School of Artificial Intelligence, University of Chinese Academy of Sciences, Beijing, China
| | - Jiafeng Ren
- Department of Neurology, The Second Affiliated Hospital of Air Force Medical University, Xi'an, China
| | - Jun Zhang
- Department of Neurology, The Second Affiliated Hospital of Air Force Medical University, Xi'an, China
| | - Yingzhi Sun
- Department of Radiology, The Second Affiliated Hospital of Air Force Medical University, Xi'an, China
| | - Jiaxiu He
- Department of Neurology, The Second Affiliated Hospital of Air Force Medical University, Xi'an, China
| | - Shihui Sun
- Department of Neurology, The Second Affiliated Hospital of Air Force Medical University, Xi'an, China
| | - Zhao Zhong
- Department of Neurology, The Second Affiliated Hospital of Air Force Medical University, Xi'an, China
| | - Danqing Shang
- Department of Neurology, The Second Affiliated Hospital of Air Force Medical University, Xi'an, China
| | - Mengmeng Fan
- Department of Neurology, The Second Affiliated Hospital of Air Force Medical University, Xi'an, China
| | - Jinxiang Cheng
- Department of Neurology, The Second Affiliated Hospital of Air Force Medical University, Xi'an, China
| | - Dan Zhang
- Department of Neurology, The Second Affiliated Hospital of Air Force Medical University, Xi'an, China
| | - Changjun Su
- Department of Neurology, The Second Affiliated Hospital of Air Force Medical University, Xi'an, China
| | - Jiaji Lin
- Department of Neurology, The Second Affiliated Hospital of Air Force Medical University, Xi'an, China
- Department of Radiology, Chinese PLA General Hospital/Medical School of Chinese PLA, Beijing, China
| |
Collapse
|
5
|
Pérez-Carbonell L, Iranzo A. REM sleep and neurodegeneration. J Sleep Res 2024:e14263. [PMID: 38867555 DOI: 10.1111/jsr.14263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2024] [Revised: 05/20/2024] [Accepted: 05/27/2024] [Indexed: 06/14/2024]
Abstract
Several brainstem, subcortical and cortical areas are involved in the generation of rapid eye movement (REM) sleep. The alteration of these structures as a result of a neurodegenerative process may therefore lead to REM sleep anomalies. REM sleep behaviour disorder is associated with nightmares, dream-enacting behaviours and increased electromyographic activity in REM sleep. Its isolated form is a harbinger of synucleinopathies such as Parkinson's disease or dementia with Lewy bodies, and neuroprotective interventions are advocated. This link might also be present in patients taking antidepressants, with post-traumatic stress disorder, or with a history of repeated traumatic head injury. REM sleep likely contributes to normal memory processes. Its alteration has also been proposed to be part of the neuropathological changes occurring in Alzheimer's disease.
Collapse
Affiliation(s)
- Laura Pérez-Carbonell
- Sleep Disorders Centre, Guy's and St Thomas' NHS Foundation Trust, King's College London, London, UK
| | - Alex Iranzo
- Neurology Service, Sleep Disorders Centre, Hospital Clínic de Barcelona, IDIBAPS, CIBERNED, University of Barcelona, Barcelona, Spain
| |
Collapse
|
6
|
Mayer-Suess L, Ibrahim A, Moelgg K, Cesari M, Knoflach M, Högl B, Stefani A, Kiechl S, Heidbreder A. Sleep disorders as both risk factors for, and a consequence of, stroke: A narrative review. Int J Stroke 2024; 19:490-498. [PMID: 37885093 PMCID: PMC11134986 DOI: 10.1177/17474930231212349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Accepted: 10/18/2023] [Indexed: 10/28/2023]
Abstract
BACKGROUND AND PURPOSE Sleep disorders are increasingly implicated as risk factors for stroke, as well as a determinant of stroke outcome. They can also occur secondary to the stroke itself. In this review, we describe the variety of different sleep disorders associated with stroke and analyze their effect on stroke risk and outcome. METHODS A search term-based literature review ("sleep," "insomnia," "narcolepsy," "restless legs syndrome," "periodic limb movements during sleep," "excessive daytime sleepiness" AND "stroke" OR "cerebrovascular" in PubMed; "stroke" and "sleep" in ClinicalTrials.gov) was performed. English articles from 1990 to March 2023 were considered. RESULTS Increasing evidence suggests that sleep disorders are risk factors for stroke. In addition, sleep disturbance has been reported in half of all stroke sufferers; specifically, an increase is not only sleep-related breathing disorders but also periodic limb movements during sleep, narcolepsy, rapid eye movement (REM) sleep behavior disorder, insomnia, sleep duration, and circadian rhythm sleep-wake disorders. Poststroke sleep disturbance has been associated with worse outcome. CONCLUSION Sleep disorders are risk factors for stroke and associated with worse stroke outcome. They are also a common consequence of stroke. Recent guidelines suggest screening for sleep disorders after stroke. It is possible that treatment of sleep disorders could both reduce stroke risk and improve stroke outcome, although further data from clinical trials are required.
Collapse
Affiliation(s)
- Lukas Mayer-Suess
- Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria
| | - Abubaker Ibrahim
- Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria
| | - Kurt Moelgg
- Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria
| | - Matteo Cesari
- Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria
| | - Michael Knoflach
- Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria
- VASCage—Research Centre on Clinical Stroke Research, Innsbruck, Austria
| | - Birgit Högl
- Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria
| | - Ambra Stefani
- Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria
- Neurological Clinical Research Institute, Massachusetts General Hospital, Boston, MA, USA
| | - Stefan Kiechl
- Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria
- VASCage—Research Centre on Clinical Stroke Research, Innsbruck, Austria
| | - Anna Heidbreder
- Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria
- Department of Neurology, Johannes Kepler University Linz, Linz, Austria
| |
Collapse
|
7
|
Álvarez-García HB, Jiménez-Correa U. Brief Psychoeducational and Cognitive Therapy for Nightmare Disorder (BPCT-ND). Sleep Sci 2024; 17:e216-e220. [PMID: 38846595 PMCID: PMC11152622 DOI: 10.1055/s-0043-1777707] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Accepted: 08/28/2023] [Indexed: 06/09/2024] Open
Abstract
In adults, nightmare disorder is related to sleep deprivation, drug consumption or abuse, or other comorbid sleep disorders such as insomnia or insufficient sleep syndrome. Behavioral treatment has solid scientific evidence in disorders such as insomnia and, more recently, parasomnias. The aim of the present study was to investigate the clinical effectiveness of a Brief Behavioral Telemedicine Therapy in Nightmare Disorder in a 23-year-old female patient. The procedure consisted of the case study, with pre and posttreatment measures as well as follow-up after 1 month; and the Epworth Sleepiness Scale, Pittsburgh Sleep Quality Index, Paris Arousal Disorders Severity Scale, and a sleep diary were applied. In parallel with changes recorded in the sleep diary, a decrease in nightmares, sleepiness, and insomnia symptoms was observed when the intervention was finished. The behavioral intervention was clinically effective; therefore, the present case report provides information on behavioral treatments for nightmare disorder.
Collapse
Affiliation(s)
- Horacio Balam Álvarez-García
- Research Division, Medicine Faculty, Sleep Disorder Clinic, National Autonomous University of Mexico UNAM, Ciudad de Mexico, Mexico
- Master's and Doctoral Program in Medical, Dental and Health Sciences, Faculty of Medicine, National Autonomous University of Mexico UNAM, Ciudad de Mexico, Mexico
| | - Ulises Jiménez-Correa
- Research Division, Medicine Faculty, Sleep Disorder Clinic, National Autonomous University of Mexico UNAM, Ciudad de Mexico, Mexico
- Master's and Doctoral Program in Medical, Dental and Health Sciences, Faculty of Medicine, National Autonomous University of Mexico UNAM, Ciudad de Mexico, Mexico
- Continuing Education and Innovation Division, National School of Higher Education, Leon Unit, National Autonomous University of Mexico UNAM, Leon, Guanajuato, Mexico
| |
Collapse
|
8
|
Sringean J, Udomsirithamrong O, Bhidayasiri R. Too little or too much nocturnal movements in Parkinson's disease: A practical guide to managing the unseen. Clin Park Relat Disord 2024; 10:100258. [PMID: 38845753 PMCID: PMC11153921 DOI: 10.1016/j.prdoa.2024.100258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2024] [Revised: 05/13/2024] [Accepted: 05/21/2024] [Indexed: 06/09/2024] Open
Abstract
Nocturnal and sleep-related motor disorders in people with Parkinson's disease (PD) have a wide spectrum of manifestations and present a complex clinical picture. Problems can arise due to impaired movement ability (hypokinesias), e.g. nocturnal hypokinesia or early-morning akinesia, or to excessive movement (hyperkinesias), e.g. end-of-the-day dyskinesia, parasomnias, periodic limb movement during sleep and restless legs syndrome. These disorders can have a significant negative impact on the sleep, daytime functional ability, and overall quality of life of individuals with PD and their carers. The debilitating motor issues are often accompanied by a combination of non-motor symptoms, including pain and cramping, which add to the overall burden. Importantly, nocturnal motor disorders encompass a broader timeline than just the period of sleep, often starting in the evening, as well as occurring throughout the night and on awakening, and are not just limited to problems of insomnia or sleep fragmentation. Diagnosis can be challenging as, in many cases, the 'gold standard' assessment method is video polysomnography, which may not be available in all settings. Various validated questionnaires are available to support evaluation, and alternative approaches, using wearable sensors and digital technology, are now being developed to facilitate early diagnosis and monitoring. This review sets out the parameters of what can be considered normal nocturnal movement and describes the clinical manifestations, usual clinical or objective assessment methods, and evidence for optimal management strategies for the common nocturnal motor disorders that neurologists will encounter in people with PD in their clinical practice.
Collapse
Affiliation(s)
- Jirada Sringean
- Chulalongkorn Centre of Excellence for Parkinson’s Disease & Related Disorders, Department of Medicine, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok 10330, Thailand
| | - Ornanong Udomsirithamrong
- Chulalongkorn Centre of Excellence for Parkinson’s Disease & Related Disorders, Department of Medicine, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok 10330, Thailand
| | - Roongroj Bhidayasiri
- Chulalongkorn Centre of Excellence for Parkinson’s Disease & Related Disorders, Department of Medicine, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok 10330, Thailand
- The Academy of Science, The Royal Society of Thailand, Bangkok 10330, Thailand
| |
Collapse
|
9
|
Gu SC, Yuan XL, Yin P, Li YY, Wang CD, Gu MJ, Xu LM, Gao C, Wu Y, Hu YQ, Yuan CX, Cao Y, Ye Q. Association of body mass index with rapid eye movement sleep behavior disorder in Parkinson's disease. Front Neurol 2024; 15:1388131. [PMID: 38846031 PMCID: PMC11155480 DOI: 10.3389/fneur.2024.1388131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2024] [Accepted: 04/30/2024] [Indexed: 06/09/2024] Open
Abstract
Background The association between body mass index (BMI) and rapid eye-movement (REM) sleep-related behavioral disorder (RBD) in Parkinson's disease (PD) remains unknown. Our study was to investigate the association of BMI with RBD in PD patients. Methods In this cross-sectional study, a total of 1,115 PD participants were enrolled from Parkinson's Progression Markers Initiative (PPMI) database. BMI was calculated as weight divided by height squared. RBD was defined as the RBD questionnaire (RBDSQ) score with the cutoff of 5 or more assessed. Univariable and multivariable logistic regression models were performed to examine the associations between BMI and the prevalence of RBD. Non-linear correlations were explored with use of restricted cubic spline (RCS) analysis. And the inflection point was determined by the two-line piecewise linear models. Results We identified 426 (38.2%) RBD. The proportion of underweight, normal, overweight and obese was 2.61, 36.59, 40.36, and 20.44%, respectively. In the multivariate logistic regression model with full adjustment for confounding variables, obese individuals had an odds ratio of 1.77 (95% confidence interval: 1.21 to 2.59) with RBD compared with those of normal weight. In the RCS models with three knots, BMI showed a non-linear association with RBD. The turning points of BMI estimated from piecewise linear models were of 28.16 kg/m2, 28.10 kg/m2, and 28.23 kg/m2 derived from univariable and multivariable adjusted logistic regression models. The effect modification by depression on the association between BMI and RBD in PD was also found in this study. Furthermore, the sensitivity analyses linked with cognition, education, and ethnic groups indicated the robustness of our results. Conclusion The current study found a significant dose-response association between BMI and RBD with a depression-based difference in the impact of BMI on RBD in PD patients.
Collapse
Affiliation(s)
- Si-Chun Gu
- Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Xiao-Lei Yuan
- Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Ping Yin
- Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Yuan-Yuan Li
- Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Chang-De Wang
- Shanghai TCM-integrated Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Min-Jue Gu
- Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Li-Min Xu
- Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Chen Gao
- Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - You Wu
- Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Yu-Qing Hu
- Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Can-Xing Yuan
- Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Yang Cao
- Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Qing Ye
- Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| |
Collapse
|
10
|
Schenck CH. REM sleep behaviour disorder (RBD): Personal perspectives and research priorities. J Sleep Res 2024:e14228. [PMID: 38782758 DOI: 10.1111/jsr.14228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2024] [Revised: 04/08/2024] [Accepted: 04/16/2024] [Indexed: 05/25/2024]
Abstract
The formal identification and naming of rapid eye movement (REM) sleep behaviour disorder (RBD) in 1985-1987 is described; the historical background of RBD from 1966 to 1985 is briefly discussed; and RBD milestones are presented. Current knowledge on RBD is identified with reference to recent comprehensive reviews, allowing for a focus on research priorities for RBD: factors and predictors of neurodegenerative phenoconversion from isolated RBD and patient enrolment in neuroprotective trials; isolated RBD clinical research cohorts; epidemiology of RBD; traumatic brain injury, post-traumatic stress disorder, RBD and neurodegeneration; depression, RBD and synucleinopathy; evolution of prodromal RBD to neurodegeneration; gut microbiome dysbiosis and colonic synuclein histopathology in isolated RBD; other alpha-synuclein research in isolated RBD; narcolepsy-RBD; dreams and nightmares in RBD; phasic REM sleep in isolated RBD; RBD, periodic limb movements, periodic limb movement disorder pseudo-RBD; other neurophysiology research in RBD; cardiac scintigraphy (123I-MIBG) in isolated RBD; brain magnetic resonance imaging biomarkers in isolated RBD; microRNAs as biomarkers in isolated RBD; actigraphic, other automated digital monitoring and machine learning research in RBD; prognostic counselling and ethical considerations in isolated RBD; and REM sleep basic science research. RBD research is flourishing, and is strategically situated at an ever-expanding crossroads of clinical (sleep) medicine, neurology, psychiatry and neuroscience.
Collapse
Affiliation(s)
- Carlos H Schenck
- Minnesota Regional Sleep Disorders Center, Department of Psychiatry, Hennepin County Medical Center and University of Minnesota Medical School, Minneapolis, Minnesota, USA
| |
Collapse
|
11
|
Xu P, Wei Y, Wu H, Zhang L. Genetic associations between Rapid Eye Movement (REM) sleep behavior disorder and cardiovascular diseases. PLoS One 2024; 19:e0301112. [PMID: 38771893 PMCID: PMC11108173 DOI: 10.1371/journal.pone.0301112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Accepted: 03/11/2024] [Indexed: 05/23/2024] Open
Abstract
BACKGROUND Previous studies revealed that sleep disorders are potential risk factors for cardiovascular diseases, such as obstructive sleep apnea and rapid eye movement (REM) sleep behavior disorder (RBD). However, the causal associations between RBD and cardiovascular diseases remained unknown. MATERIALS AND METHODS We used the latest and largest summary-level genome-wide association studies of RBD, stroke and its subtypes, coronary artery disease (CAD), myocardial infarction (MI), and heart failure (HF) to select genetic variants as the instrumental variables. Mendelian randomization (MR) analysis was performed to test the causal associations between RBD and the cardiovascular diseases above. Inverse variance weighted method was used as the main analysis. RESULTS After multiple comparisons, genetically predicted RBD was significantly associated with the risk of HF [odds ratio (OR) = 1.033, 95% CI 1.013-1.052, p = 0.001]. Leave-one-out analysis further supported the robustness of the causal association. Furthermore, we identified a suggestive association between genetically predicted MI and RBD (OR = 0.716, 95% CI 0.546-0.940, p = 0.016). However, in our study no associations were identified of RBD with CAD or stroke and its subtypes. CONCLUSION Our study highlighted the potential associations between RBD and cardiovascular diseases at genetic level, including HF and MI. More studies were required to clarify the biological mechanisms involved the associations.
Collapse
Affiliation(s)
- Pengfei Xu
- Department of Neurosurgery, Nanyang Central Hospital, Nanyang, Henan, China
| | - Yitong Wei
- Department of Neurosurgery, Nanyang Central Hospital, Nanyang, Henan, China
| | - Haibo Wu
- Department of Neurology, Nanyang Central Hospital, Nanyang, Henan, China
| | - Li Zhang
- Department of Neurology, Nanyang Central Hospital, Nanyang, Henan, China
| |
Collapse
|
12
|
Zhong R, Gan C, Sun H, Zhang K. Sleep disturbances, cognitive decline, and AD biomarkers alterations in early Parkinson's disease. Ann Clin Transl Neurol 2024. [PMID: 38764318 DOI: 10.1002/acn3.52089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2024] [Revised: 03/11/2024] [Accepted: 04/25/2024] [Indexed: 05/21/2024] Open
Abstract
OBJECTIVE We aimed to investigate whether each type of sleep disturbances (i.e., pRBD, EDS, and insomnia) is specifically associated with faster decline in global cognition and different cognitive domains among de novo PD patients. We also assessed the influence of sleep disturbances on core AD CSF biomarkers alterations and conversion to dementia. METHODS Prospectively longitudinal data were obtained from the PPMI cohort. Sleep disturbances and cognition ability were assessed by questionnaires at baseline and follow-up visits. Generalized linear mixed models were utilized to assess the effect of sleep disturbances on cognitive decline and core AD CSF biomarkers change. The associations between sleep disturbances and conversion to dementia were analyzed using Cox regression analysis. RESULTS Baseline pRBD was associated with faster decline in global cognition and all cognitive domains, including verbal episodic memory, visuospatial ability, executive function, language, and processing speed. EDS was associated with faster decline in three cognitive domains, including verbal episodic memory, executive function/working memory, and processing speed. Insomnia was associated with faster decline in global cognition and verbal episodic memory. Meanwhile, pRBD and EDS were associated with longitudinal decrease of CSF Aβ42. Baseline pRBD increased the risk of conversion to dementia. The risk of dementia in PD patients with multiple sleep disturbances also increased compared with those without sleep disturbance. INTERPRETATION Sleep disturbances (i.e., pRBD, EDS, and insomnia) were associated with cognitive decline in early PD. EDS and pRBD were associated with decrease of CSF Aβ42. Moreover, pRBD was associated with conversion to dementia.
Collapse
Affiliation(s)
- Rui Zhong
- Department of Neurology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China
| | - Caiting Gan
- Department of Neurology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China
| | - Huimin Sun
- Department of Neurology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China
| | - Kezhong Zhang
- Department of Neurology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China
| |
Collapse
|
13
|
Unadkat P, Vo A, Ma Y, Peng S, Nguyen N, Niethammer M, Tang CC, Dhawan V, Ramdhani R, Fenoy A, Caminiti SP, Perani D, Eidelberg D. Deep brain stimulation of the subthalamic nucleus for Parkinson's disease: A network imaging marker of the treatment response. RESEARCH SQUARE 2024:rs.3.rs-4178280. [PMID: 38766007 PMCID: PMC11100869 DOI: 10.21203/rs.3.rs-4178280/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2024]
Abstract
Subthalamic nucleus deep brain stimulation (STN-DBS) alleviates motor symptoms of Parkinson's disease (PD), thereby improving quality of life. However, quantitative brain markers to evaluate DBS responses and select suitable patients for surgery are lacking. Here, we used metabolic brain imaging to identify a reproducible STN-DBS network for which individual expression levels increased with stimulation in proportion to motor benefit. Of note, measurements of network expression from metabolic and BOLD imaging obtained preoperatively predicted motor outcomes determined after DBS surgery. Based on these findings, we computed network expression in 175 PD patients, with time from diagnosis ranging from 0 to 21 years, and used the resulting data to predict the outcome of a potential STN-DBS procedure. While minimal benefit was predicted for patients with early disease, the proportion of potential responders increased after 4 years. Clinically meaningful improvement with stimulation was predicted in 18.9 - 27.3% of patients depending on disease duration.
Collapse
Affiliation(s)
| | - An Vo
- The Feinstein Institutes for Medical Research
| | - Yilong Ma
- Center for Neurosciences, Institute of Molecular Medicine, The Feinstein Institutes for Medical Research, Manhasset, New York, USA
| | - Shichun Peng
- Center for Neurosciences, Institute of Molecular Medicine, The Feinstein Institutes for Medical Research, Manhasset, New York, USA
| | | | | | | | | | - Ritesh Ramdhani
- Donald and Barbara Zucker School of Medicine at Hofstra/Northwell
| | | | | | | | | |
Collapse
|
14
|
Antonioni A, Raho EM, Sensi M, Di Lorenzo F, Fadiga L, Koch G. A new perspective on positive symptoms: expression of damage or self-defence mechanism of the brain? Neurol Sci 2024; 45:2347-2351. [PMID: 38353846 PMCID: PMC11021333 DOI: 10.1007/s10072-024-07395-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Accepted: 02/05/2024] [Indexed: 04/17/2024]
Abstract
Usually, positive neurological symptoms are considered as the consequence of a mere, afinalistic and abnormal increase in function of specific brain areas. However, according to the Theory of Active Inference, which argues that action and perception constitute a loop that updates expectations according to a Bayesian model, the brain is rather an explorer that formulates hypotheses and tests them to assess the correspondence between internal models and reality. Moreover, the cerebral cortex is characterised by a continuous "conflict" between different brain areas, which constantly attempt to expand in order to acquire more of the limited available computational resources, by means of their dopamine-induced neuroplasticity. Thus, it has recently been suggested that dreams, during rapid eye movement sleep (REMS), protect visual brain areas (deprived of their stimuli during rest) from being conquered by other normally stimulated ones. It is therefore conceivable that positive symptoms also have a functional importance for the brain. We evaluate supporting literature data of a 'defensive' role of positive symptoms and the relevance of dopamine-induced neuroplasticity in the context of neurodegenerative and psychiatric diseases. Furthermore, the possible functional significance of idiopathic REMS-related behavioural disorder as well as phantom limb syndrome is examined. We suggest that positive neurological symptoms are not merely a passive expression of a damage, but active efforts, related to dopamine-induced plasticity, to maintain a correct relationship between the external world and its brain representation, thus preventing healthy cortical areas from ousting injured ones.
Collapse
Affiliation(s)
- Annibale Antonioni
- Doctoral Program in Translational Neurosciences and Neurotechnologies, Department of Neuroscience and Rehabilitation, University of Ferrara, Via Ludovico Ariosto 35, 44121, Ferrara, Italy.
| | - Emanuela Maria Raho
- Department of Neuroscience and Rehabilitation, University Unit of Neurology, University of Ferrara, 44121, Ferrara, Italy
| | - Mariachiara Sensi
- Unit of Neurology, Interdistrict Health Care Department of Neuroscience, S. Anna Ferrara University Hospital, 44124, Ferrara, Italy
| | - Francesco Di Lorenzo
- Non Invasive Brain Stimulation Unit, Istituto Di Ricovero E Cura a Carattere Scientifico Santa Lucia, 00179, Rome, Italy
| | - Luciano Fadiga
- Center for Translational Neurophysiology, Istituto Italiano Di Tecnologia, 44121, Ferrara, Italy
- Section of Physiology, Department of Neuroscience and Rehabilitation, University of Ferrara, 44121, Ferrara, Italy
| | - Giacomo Koch
- Non Invasive Brain Stimulation Unit, Istituto Di Ricovero E Cura a Carattere Scientifico Santa Lucia, 00179, Rome, Italy
- Center for Translational Neurophysiology, Istituto Italiano Di Tecnologia, 44121, Ferrara, Italy
- Section of Physiology, Department of Neuroscience and Rehabilitation, University of Ferrara, 44121, Ferrara, Italy
| |
Collapse
|
15
|
Park G, Jo H, Chai Y, Park HR, Lee H, Joo EY, Kim H. Static and dynamic brain morphological changes in isolated REM sleep behavior disorder compared to normal aging. Front Neurosci 2024; 18:1365307. [PMID: 38751861 PMCID: PMC11094219 DOI: 10.3389/fnins.2024.1365307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2024] [Accepted: 04/16/2024] [Indexed: 05/18/2024] Open
Abstract
Objective/background To assess whether cerebral structural alterations in isolated rapid eye movement sleep behavior disorder (iRBD) are progressive and differ from those of normal aging and whether they are related to clinical symptoms. Patients/methods In a longitudinal study of 18 patients with iRBD (age, 66.1 ± 5.7 years; 13 males; follow-up, 1.6 ± 0.6 years) and 24 age-matched healthy controls (age, 67.0 ± 4.9 years; 12 males; follow-up, 2.0 ± 0.9 years), all participants underwent multiple extensive clinical examinations, neuropsychological tests, and magnetic resonance imaging at baseline and follow-up. Surface-based cortical reconstruction and automated subcortical structural segmentation were performed on T1-weighted images. We used mixed-effects models to examine the differences between the groups and the differences in anatomical changes over time. Results None of the patients with iRBD demonstrated phenoconversion during the follow-up. Patients with iRBD had thinner cortices in the frontal, occipital, and temporal regions, and more caudate atrophy, compared to that in controls. In similar regions, group-by-age interaction analysis revealed that patients with iRBD demonstrated significantly slower decreases in cortical thickness and caudate volume with aging than that observed in controls. Patients with iRBD had lower scores on the Korean version of the Mini-Mental Status Examination (p = 0.037) and frontal and executive functions (p = 0.049) at baseline than those in controls; however, no significant group-by-age interaction was identified. Conclusion Patients with iRBD show brain atrophy in the regions that are overlapped with the areas that have been documented to be affected in early stages of Parkinson's disease. Such atrophy in iRBD may not be progressive but may be slower than that in normal aging. Cognitive impairment in iRBD is not progressive.
Collapse
Affiliation(s)
- Gilsoon Park
- USC Stevens Neuroimaging and Informatics Institute, Keck School of Medicine of USC, University of Southern California, Los Angeles, CA, United States
| | - Hyunjin Jo
- Department of Neurology, Neuroscience Center, Samsung Medical Center, Samsung Biomedical Research Institute, School of Medicine, Sungkyunkwan University, Seoul, Republic of Korea
- Medical Research Institute, Sungkyunkwan University School of Medicine, Suwon, Republic of Korea
| | - Yaqiong Chai
- USC Stevens Neuroimaging and Informatics Institute, Keck School of Medicine of USC, University of Southern California, Los Angeles, CA, United States
| | - Hea Ree Park
- Department of Neurology, Inje University College of Medicine, Ilsan Paik Hospital, Goyang, Republic of Korea
| | - Hanul Lee
- Department of Neurology, Neuroscience Center, Samsung Medical Center, Samsung Biomedical Research Institute, School of Medicine, Sungkyunkwan University, Seoul, Republic of Korea
| | - Eun Yeon Joo
- Department of Neurology, Neuroscience Center, Samsung Medical Center, Samsung Biomedical Research Institute, School of Medicine, Sungkyunkwan University, Seoul, Republic of Korea
| | - Hosung Kim
- USC Stevens Neuroimaging and Informatics Institute, Keck School of Medicine of USC, University of Southern California, Los Angeles, CA, United States
| |
Collapse
|
16
|
Feng H, Qiao QC, Luo QF, Zhou JY, Lei F, Chen Y, Wen SY, Chen WH, Pang YJ, Hu ZA, Jiang YB, Zhang XY, Zhou TY, Zhang XY, Yang N, Zhang J, Hu R. Orexin Neurons to Sublaterodorsal Tegmental Nucleus Pathway Prevents Sleep Onset REM Sleep-Like Behavior by Relieving the REM Sleep Pressure. RESEARCH (WASHINGTON, D.C.) 2024; 7:0355. [PMID: 38694202 PMCID: PMC11062508 DOI: 10.34133/research.0355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/07/2024] [Accepted: 03/25/2024] [Indexed: 05/04/2024]
Abstract
Proper timing of vigilance states serves fundamental brain functions. Although disturbance of sleep onset rapid eye movement (SOREM) sleep is frequently reported after orexin deficiency, their causal relationship still remains elusive. Here, we further study a specific subgroup of orexin neurons with convergent projection to the REM sleep promoting sublaterodorsal tegmental nucleus (OXSLD neurons). Intriguingly, although OXSLD and other projection-labeled orexin neurons exhibit similar activity dynamics during REM sleep, only the activation level of OXSLD neurons exhibits a significant positive correlation with the post-inter-REM sleep interval duration, revealing an essential role for the orexin-sublaterodorsal tegmental nucleus (SLD) neural pathway in relieving REM sleep pressure. Monosynaptic tracing reveals that multiple inputs may help shape this REM sleep-related dynamics of OXSLD neurons. Genetic ablation further shows that the homeostatic architecture of sleep/wakefulness cycles, especially avoidance of SOREM sleep-like transition, is dependent on this activity. A positive correlation between the SOREM sleep occurrence probability and depression states of narcoleptic patients further demonstrates the possible significance of the orexin-SLD pathway on REM sleep homeostasis.
Collapse
Affiliation(s)
- Hui Feng
- Department of Neurobiology,
Army Medical University, 400038 Chongqing, P.R. China
- Department of Neurosurgery and Key Laboratory of Neurotrauma, Southwest Hospital,
Army Medical University, 400038 Chongqing, P.R. China
| | - Qi-Cheng Qiao
- Department of Physiology,
Army Medical University, 400038 Chongqing, P.R. China
| | - Qi-Fa Luo
- Department of Physiology,
Army Medical University, 400038 Chongqing, P.R. China
| | - Jun-Ying Zhou
- Sleep Medicine Center, West China Hospital,
Sichuan University, 610000 Chengdu, Sichuan, P.R. China
| | - Fei Lei
- Sleep Medicine Center, West China Hospital,
Sichuan University, 610000 Chengdu, Sichuan, P.R. China
| | - Yao Chen
- Department of Physiology,
Army Medical University, 400038 Chongqing, P.R. China
| | - Si-Yi Wen
- Department of Physiology,
Army Medical University, 400038 Chongqing, P.R. China
| | - Wen-Hao Chen
- Department of Physiology,
Army Medical University, 400038 Chongqing, P.R. China
| | - Yu-Jie Pang
- Department of Physiology,
Army Medical University, 400038 Chongqing, P.R. China
| | - Zhi-An Hu
- Department of Physiology,
Army Medical University, 400038 Chongqing, P.R. China
| | - Yi-Bin Jiang
- Department of Neurosurgery and Key Laboratory of Neurotrauma, Southwest Hospital,
Army Medical University, 400038 Chongqing, P.R. China
| | - Xu-Yang Zhang
- Department of Neurosurgery and Key Laboratory of Neurotrauma, Southwest Hospital,
Army Medical University, 400038 Chongqing, P.R. China
| | - Teng-Yuan Zhou
- Department of Neurosurgery and Key Laboratory of Neurotrauma, Southwest Hospital,
Army Medical University, 400038 Chongqing, P.R. China
| | - Xin-Yan Zhang
- Sleep Medicine Center, West China Hospital,
Sichuan University, 610000 Chengdu, Sichuan, P.R. China
| | - Nian Yang
- Department of Physiology,
Army Medical University, 400038 Chongqing, P.R. China
| | - Jun Zhang
- Department of Neurobiology,
Army Medical University, 400038 Chongqing, P.R. China
- Department of Physiology,
Army Medical University, 400038 Chongqing, P.R. China
| | - Rong Hu
- Department of Neurosurgery and Key Laboratory of Neurotrauma, Southwest Hospital,
Army Medical University, 400038 Chongqing, P.R. China
| |
Collapse
|
17
|
Chen H, Zhao D, Guo Z, Ma D, Wu Y, Chen G, Liu Y, Kong T, Wang F. U-shaped relationship between lights-out time and nocturnal oxygen saturation during the first trimester: An analysis based on the nuMOM2b-SDB data. Heliyon 2024; 10:e29494. [PMID: 38681541 PMCID: PMC11053181 DOI: 10.1016/j.heliyon.2024.e29494] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2024] [Revised: 04/08/2024] [Accepted: 04/09/2024] [Indexed: 05/01/2024] Open
Abstract
Objective Preventing adverse events due to unstable oxygen saturation (SpO2) at night in pregnant women is of utmost importance. Poor sleep has been demonstrated to impact SpO2 levels. Nowadays, many gravida have a habit of prolonged exposure to light before sleep, which can disrupt their sleep. Therefore, this study aimed at investigate the relationship between lights-out time, sleep parameters and SpO2, exploring the underlying mechanisms. Methods The data of 2881 eligible subjects from the Nulliparous Pregnancy Outcomes Study Monitoring Mothers-to-be and Sleep Disordered Breathing (nuMOM2b-SDB) database were analyzed. Multiple linear regression models were used to investigate the relationship between lights-out time and SpO2. In addition, restricted cubic splines (RCS) were employed to fit the nonlinear correlation between the two variables. The smoothing curve method was further utilized to depict the relationship between lights-out time and SpO2 based on various subgroup variables. Results All participants were categorized according to race/ethnicity. A negative correlation was observed between nighttime lights-out time and average value of SpO2 (Avg-SpO2) (β = -0.05, p = 0.010). RCS revealed a U-shaped relationship between lights-out time and Avg-SpO2, with the turning point at 22:00. The subcomponent stratification results indicated that the Avg-SpO2 and minimum value of SpO2(Min-SpO2) of advanced maternal age decreased as the lights-out time was delayed. Furthermore, overweight and obese gravida showed lower Avg-SpO2 and Min-SpO2 levels than normal weight. Conclusions A U-shaped relationship was identified between lights-out time and nocturnal Avg-SpO2 during early pregnancy, with the inflection at 22:00. Notably, later lights-out times are associated with lower levels of Min-SpO2 for advanced maternal age. The findings suggest that appropriately adjusting the duration of light exposure before sleep and maintaining a relatively restful state may be more beneficial for the stability of SpO2 in pregnant women. Conversely, deviations from these practices could potentially lead to pathological alterations in SpO2 levels.
Collapse
Affiliation(s)
- Hongxu Chen
- School of Public Health, Xinjiang Medical University, Urumqi, 830063, China
| | - Danyang Zhao
- Medical Neurobiology Lab, Inner Mongolia Medical University, Huhhot, 010110, China
| | - Zixuan Guo
- Medical Neurobiology Lab, Inner Mongolia Medical University, Huhhot, 010110, China
| | - Duo Ma
- Department of Ultrasonography, The Second Affiliated Hospital of Xiamen Medical College, Xiamen, China
| | - Yan Wu
- Beijing Hui-Long-Guan Hospital, Peking University, Beijing, 100096, China
| | - Guangxue Chen
- Department of Gynaecology and Obstetrics, Beijing Jishuitan Hospital, Beijing, 102208, China
| | - Yanlong Liu
- School of Mental Health, Wenzhou Medical University, Wenzhou, 325035, China
| | - Tiantian Kong
- Xinjiang Key Laboratory of Neurological Disorder Research, The Second Affiliated Hospital of Xinjiang Medical University, Urumqi, 830063, China
| | - Fan Wang
- Beijing Hui-Long-Guan Hospital, Peking University, Beijing, 100096, China
| |
Collapse
|
18
|
Barone DA. Secondary RBD: Not just neurodegeneration. Sleep Med Rev 2024; 76:101938. [PMID: 38657360 DOI: 10.1016/j.smrv.2024.101938] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2024] [Revised: 03/20/2024] [Accepted: 04/11/2024] [Indexed: 04/26/2024]
Abstract
Rapid eye movement sleep behavior disorder is a parasomnia characterized by excessive muscle activity during rapid eye movement sleep (rapid eye movement sleep without atonia), along with dream enactment behavior. Isolated rapid eye movement sleep behavior disorder tends to occur in older males and is of concern due to the known link to Parkinson's disease and other synucleinopathies. When rapid eye movement sleep behavior disorder occurs in association with other neurological or general medical conditions, or resulting from the use of various substances, it is called secondary rapid eye movement sleep behavior disorder; the most common cause is neurodegenerative illness, specifically the synucleinopathies. Here, the focus will be on the subset of secondary rapid eye movement sleep behavior disorder in which there is no neurodegenerative disease.
Collapse
Affiliation(s)
- Daniel A Barone
- Weill Cornell Center for Sleep Medicine, 425 East 61st Street, New York, NY, 10065, USA.
| |
Collapse
|
19
|
Liu P, Chen L, He X, Mao L. Predictors of the Rapid Progression in Prodromal Parkinson's Disease: A Longitudinal Follow-Up Study. Gerontology 2024; 70:595-602. [PMID: 38565088 DOI: 10.1159/000538515] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Accepted: 03/21/2024] [Indexed: 04/04/2024] Open
Abstract
INTRODUCTION Parkinson's disease (PD) is characterized by a prodromal phase preceding the onset of classic motor symptoms. The duration and clinical manifestations of prodromal PD vary widely, indicating underlying heterogeneity within this stage. This discrepancy prompts the question of whether specific factors contribute to the divergent rates of progression in prodromal PD. METHODS This study included prodromal PD patients from the Parkinson's progression marker initiative. They were followed up to assess the disease progression. The data collected during the follow-up period were analyzed to identify potential predictors of rapid disease progression in prodromal PD. RESULTS In this study, 61 individuals with prodromal PD were enrolled. Among them, 43 patients presented with both RBD and hyposmia, 17 had hyposmia alone, and 1 had RBD alone at baseline. 13 (21.3%) prodromal PD participants exhibited rapid disease progression, with two of these cases advancing to non-neurological diseases. Significant differences were observed between the rapid progression group and no rapid progression group in terms of MDS-UPDRS II score and UPSIT score. Longitudinal analysis showed a significant increase in the MDS-UPDRS III score and MDS-UPDRS total score in the rapid progression group. Regression analyses identified the MDS-UPDRS II score and UPSIT score as predictors of rapid disease progression in prodromal PD. CONCLUSION Our study findings suggest that the MDS-UPDRS II score and UPSIT score may serve as clinical markers associated with rapid disease progression. Further research and development of precise biomarkers and advanced assessment methods are needed to enhance our understanding of prodromal PD and its progression patterns.
Collapse
Affiliation(s)
- Peng Liu
- Department of Neurology, Taizhou Central Hospital, Taizhou University Hospital, Taizhou, China
| | - Linxi Chen
- Department of Neurology, Taizhou Central Hospital, Taizhou University Hospital, Taizhou, China
- Department of Pathology, Taizhou Central Hospital, Taizhou University Hospital, Taizhou, China
| | - Xinwei He
- Department of Neurology, Taizhou Central Hospital, Taizhou University Hospital, Taizhou, China
| | - Lingqun Mao
- Department of Neurology, Taizhou Central Hospital, Taizhou University Hospital, Taizhou, China
| |
Collapse
|
20
|
Mombelli S, Ricordeau F, Gillard L, Lecca R, Vidal T, Pereira B, Beudin P, Vitello N, Bastuji H, Peter-Derex L, Fantini ML. Psychobehavioural profile in narcolepsy type 1 with and without REM sleep behaviour disorder. J Sleep Res 2024; 33:e13925. [PMID: 37222001 DOI: 10.1111/jsr.13925] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Revised: 04/20/2023] [Accepted: 04/24/2023] [Indexed: 05/25/2023]
Abstract
REM sleep behaviour disorder (RBD) is common in narcolepsy type 1 (NT1). Abnormalities in the reward system have been observed in NT1, possibly related to impaired orexin projections towards the mesolimbic reward system, but also in RBD when associated with Parkinson's disease. Our study aimed to explore the psychobehavioural profile of NT1 patients with and without RBD compared with healthy controls (HC). Forty patients with NT1 were compared with 20 sex- and age-matched HC. All patients with NT1 underwent a video-polysomnography including a measure of REM sleep without atonia (RSWA). The following neuropsychobehavioural variables were assessed: apathy, impulsivity, depression, cognition, subjective and objective attention, sensation-seeking, and behavioural addictions. The patient population included 22 patients with NT1-RBD and 18 patients with NT1-noRBD. Compared with the healthy controls, patients with NT1 had higher scores of apathy, impulsivity, and depression; a lower score on global cognition, and poorer self-perceived attention. No differences were found between patients with NT1 with and without RBD in all neuropsychological variables, except for impaired objective attention in patients with NT1-RBD. In patients with NT1, a positive correlation was observed between RSWA and both apathy and impulsivity subscale. Moreover, in patients with NT1-RBD, RSWA was positively correlated with depression. Patients with NT1 showed higher depression, apathy, and impulsivity compared with controls. These measures correlate with the severity of RSWA, suggesting a transdiagnostic association between RBD and abnormalities of the reward system at least for patients with NT1.
Collapse
Affiliation(s)
- Samantha Mombelli
- Sleep and EEG, Neurophysiology Unit, Neurology Department, University Hospital and UMR 6602-Université Clermont Auvergne, CNRS, Institute Pascal, Clermont-Ferrand, France
- Department of Clinical Neurosciences, Neurology - Sleep Disorders Center, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - François Ricordeau
- Sleep and EEG, Neurophysiology Unit, Neurology Department, University Hospital and UMR 6602-Université Clermont Auvergne, CNRS, Institute Pascal, Clermont-Ferrand, France
- Center for Sleep Medicine and Respiratory Diseases, Lyon University Hospital, Lyon 1 University, Lyon, France
| | - Léa Gillard
- Sleep and EEG, Neurophysiology Unit, Neurology Department, University Hospital and UMR 6602-Université Clermont Auvergne, CNRS, Institute Pascal, Clermont-Ferrand, France
| | - Rosa Lecca
- Sleep and EEG, Neurophysiology Unit, Neurology Department, University Hospital and UMR 6602-Université Clermont Auvergne, CNRS, Institute Pascal, Clermont-Ferrand, France
- Sleep Disorder Research Center, Department of Medical Science and Public Health, University of Cagliari, Cagliari, Italy
| | - Tiphaine Vidal
- CMRR, Neurology Department, University Hospital - Université Clermont Auvergne, CNRS, Institute Pascal, Clermont-Ferrand, France
| | - Bruno Pereira
- Clinical Research and Innovation Direction, CHU Clermont-Ferrand, Clermont-Ferrand, France
| | - Patricia Beudin
- Sleep and EEG, Neurophysiology Unit, Neurology Department, University Hospital and UMR 6602-Université Clermont Auvergne, CNRS, Institute Pascal, Clermont-Ferrand, France
| | - Nicolas Vitello
- Biostatistics Unit (DRCI) CHU Clermont-Ferrand, Clermont-Ferrand, France
| | - Helene Bastuji
- Center for Sleep Medicine and Respiratory Diseases, Lyon University Hospital, Lyon 1 University, Lyon, France
- Lyon Neuroscience Research Center, CNRS UMR 5292, INSERM U1028 - Neuropain Team, Lyon, France
| | - Laure Peter-Derex
- Center for Sleep Medicine and Respiratory Diseases, Lyon University Hospital, Lyon 1 University, Lyon, France
- Lyon Neuroscience Research Center, CNRS UMR 5292, INSERM U1028 - PAM Team, Lyon, France
| | - Maria Livia Fantini
- Sleep and EEG, Neurophysiology Unit, Neurology Department, University Hospital and UMR 6602-Université Clermont Auvergne, CNRS, Institute Pascal, Clermont-Ferrand, France
| |
Collapse
|
21
|
Taha HB, Bogoniewski A. Analysis of biomarkers in speculative CNS-enriched extracellular vesicles for parkinsonian disorders: a comprehensive systematic review and diagnostic meta-analysis. J Neurol 2024; 271:1680-1706. [PMID: 38103086 PMCID: PMC10973014 DOI: 10.1007/s00415-023-12093-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Revised: 10/31/2023] [Accepted: 11/01/2023] [Indexed: 12/17/2023]
Abstract
BACKGROUND AND OBJECTIVE Parkinsonian disorders, including Parkinson's disease (PD), multiple system atrophy (MSA), dementia with Lewy bodies (DLB), progressive supranuclear palsy (PSP), and corticobasal syndrome (CBS), exhibit overlapping early-stage symptoms, complicating definitive diagnosis despite heterogeneous cellular and regional pathophysiology. Additionally, the progression and the eventual conversion of prodromal conditions such as REM behavior disorder (RBD) to PD, MSA, or DLB remain challenging to predict. Extracellular vesicles (EVs) are small, membrane-enclosed structures released by cells, playing a vital role in communicating cell-state-specific messages. Due to their ability to cross the blood-brain barrier into the peripheral circulation, measuring biomarkers in blood-isolated speculative CNS enriched EVs has become a popular diagnostic approach. However, replication and independent validation remain challenging in this field. Here, we aimed to evaluate the diagnostic accuracy of speculative CNS-enriched EVs for parkinsonian disorders. METHODS We conducted a PRISMA-guided systematic review and meta-analysis, covering 18 studies with a total of 1695 patients with PD, 253 with MSA, 21 with DLB, 172 with PSP, 152 with CBS, 189 with RBD, and 1288 HCs, employing either hierarchical bivariate models or univariate models based on study size. RESULTS Diagnostic accuracy was moderate for differentiating patients with PD from HCs, but revealed high heterogeneity and significant publication bias, suggesting an inflation of the perceived diagnostic effectiveness. The bias observed indicates that studies with non-significant or lower effect sizes were less likely to be published. Although results for differentiating patients with PD from those with MSA or PSP and CBS appeared promising, their validity is limited due to the small number of involved studies coming from the same research group. Despite initial reports, our analyses suggest that using speculative CNS-enriched EV biomarkers may not reliably differentiate patients with MSA from HCs or patients with RBD from HCs, due to their lesser accuracy and substantial variability among the studies, further complicated by substantial publication bias. CONCLUSION Our findings underscore the moderate, yet unreliable diagnostic accuracy of biomarkers in speculative CNS-enriched EVs in differentiating parkinsonian disorders, highlighting the presence of substantial heterogeneity and significant publication bias. These observations reinforce the need for larger, more standardized, and unbiased studies to validate the utility of these biomarkers but also call for the development of better biomarkers for parkinsonian disorders.
Collapse
Affiliation(s)
- Hash Brown Taha
- Department of Integrative Biology and Physiology, University of California Los Angeles, Los Angeles, CA, USA.
| | - Aleksander Bogoniewski
- Department of Molecular and Medical Pharmacology, University of California Los Angeles, Los Angeles, CA, USA
| |
Collapse
|
22
|
Castelnovo A, Schraemli M, Schenck CH, Manconi M. The parasomnia defense in sleep-related homicide: A systematic review and a critical analysis of the medical literature. Sleep Med Rev 2024; 74:101898. [PMID: 38364685 DOI: 10.1016/j.smrv.2024.101898] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Revised: 12/27/2023] [Accepted: 01/08/2024] [Indexed: 02/18/2024]
Abstract
This review critically analyzes the forensic application of the Parasomnia Defense in homicidal incidents, drawing from medical literature on disorders of arousal (DOA) and rapid-eye-movement sleep behavior disorder (RBD). A systematic search of PubMed, Scopus, Embase, and Cochrane databases was conducted until October 16, 2022. We screened English-language articles in peer-reviewed journals discussing murders committed during sleep with a Parasomnia Defense. We followed PRISMA guidelines, extracting event details, diagnosis methods, factors influencing the acts, perpetrator behavior, timing, motives, concealment, mental experiences, victim demographics, and court verdicts. Three sleep experts evaluated each case. We selected ten homicides, four attempted homicides, and one homicide/attempted homicide that met inclusion/exclusion criteria. Most cases were suspected DOA as unanimously confirmed by experts. RBD cases were absent. Among aggressors, a minority reported dream-like experiences. Victims were primarily female family members killed in or near the bed by hands and/or with sharp objects. Objective sleep data and important crime scene details were often missing. Verdicts were ununiform. Homicides during DOA episodes, though rare, are documented, validating the Parasomnia Defense's use in forensics. RBD-related fatal aggression seems very uncommon. However, cases often lack diagnostic clarity. We propose updated guidelines to enhance future reporting and understanding of such incidents.
Collapse
Affiliation(s)
- Anna Castelnovo
- Neurocenter of Italian Switzerland, Ente Ospedaliero Cantonale, Ospedale Civico, Lugano, Switzerland; Faculty of Biomedical Sciences, Università della Svizzera Italiana, Lugano, Switzerland; University Hospital of Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland.
| | - Matthias Schraemli
- Faculty of Biomedical Sciences, Università della Svizzera Italiana, Lugano, Switzerland
| | - Carlos H Schenck
- Minnesota Regional Sleep Disorders Center, Departments of Psychiatry, Hennepin County Medical Center, And University of Minnesota Medical School, Minneapolis, MN, United States.
| | - Mauro Manconi
- Neurocenter of Italian Switzerland, Ente Ospedaliero Cantonale, Ospedale Civico, Lugano, Switzerland; Faculty of Biomedical Sciences, Università della Svizzera Italiana, Lugano, Switzerland; Department of Neurology, University Hospital, Inselspital, Bern, Switzerland
| |
Collapse
|
23
|
Zheng Y, Li Y, Cai H, Kou W, Yang C, Li S, Wang J, Zhang N, Feng T. Alterations of Peripheral Lymphocyte Subsets in Isolated Rapid Eye Movement Sleep Behavior Disorder. Mov Disord 2024. [PMID: 38529776 DOI: 10.1002/mds.29798] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2024] [Revised: 03/05/2024] [Accepted: 03/07/2024] [Indexed: 03/27/2024] Open
Abstract
BACKGROUND Adaptive immune dysfunction may play a crucial role in Parkinson's disease (PD) development. Isolated rapid eye movement sleep behavior disorder (iRBD) represents the prodromal stage of synucleinopathies, including PD. Elucidating the peripheral adaptive immune system is crucial in iRBD, but current knowledge remains limited. OBJECTIVE This study aimed to characterize peripheral lymphocyte profiles in iRBD patients compared with healthy control subjects (HCs). METHODS This cross-sectional study recruited polysomnography-confirmed iRBD patients and age- and sex-matched HCs. Venous blood was collected from each participant. Flow cytometry was used to evaluate surface markers and intracellular cytokine production in peripheral blood mononuclear cells. RESULTS Forty-four iRBD patients and 36 HCs were included. Compared with HCs, patients with iRBD exhibited significant decreases in absolute counts of total lymphocytes and CD3+ T cells. In terms of T cell subsets, iRBD patients showed higher frequencies and counts of proinflammatory T helper 1 cells and INF-γ+ CD8+ T cells, along with lower frequencies and counts of anti-inflammatory T helper 2 cells. A significant increase in the frequency of central memory T cells in CD8+ T cells was also observed in iRBD. Regarding B cells, iRBD patients demonstrated reduced frequencies and counts of double-negative memory B cells compared with control subjects. CONCLUSIONS This study demonstrated alterations in the peripheral adaptive immune system in iRBD, specifically in CD4+ and INF-γ+ CD8+ T cell subsets. An overall shift toward a proinflammatory state of adaptive immunity was already evident in iRBD. These observations might provide insights into the optimal timing for initiating immune interventions in PD. © 2024 The Authors. Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.
Collapse
Affiliation(s)
- Yuanchu Zheng
- Center for Movement Disorders, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Yatong Li
- Department of Neurology, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Huihui Cai
- Center for Movement Disorders, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Wenyi Kou
- Center for Movement Disorders, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Chen Yang
- Center for Movement Disorders, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Siming Li
- Center for Movement Disorders, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Jiawei Wang
- Department of Neurology, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Ning Zhang
- Department of Neuropsychiatry and Behavioral Neurology and Clinical Psychology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Tao Feng
- Center for Movement Disorders, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- China National Clinical Research Center for Neurological Diseases, Beijing, China
| |
Collapse
|
24
|
Wang F, Zhu Z, Zhou C, Zhu Y, Zhu Y, Liang C, Chen J, Liu B, Ren H, Yang X. MRI brain structural and functional networks changes in Parkinson disease with REM sleep behavior disorders. Front Aging Neurosci 2024; 16:1364727. [PMID: 38560024 PMCID: PMC10978796 DOI: 10.3389/fnagi.2024.1364727] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2024] [Accepted: 03/05/2024] [Indexed: 04/04/2024] Open
Abstract
Background Rapid eye movement sleep behavior disorder (RBD) is common in individuals with Parkinson's disease (PD). In spite of that, the precise mechanism underlying the pathophysiology of RBD among PD remains unclear. Objective The aim of the present study was to analyze gray matter volumes (GMVs) as well as the changes of functional connectivity (FC) among PD patients with RBD (PD-RBD) by employing a combination of voxel-based morphometry (VBM) and FC methods. Methods A total of 65 PD patients and 21 healthy control (HC) subjects were included in this study. VBM analyses were performed on all subjects. Subsequently, regions with significant different GMVs between PD patients with and without RBD (PD-nRBD) were selected for further analysis of FC. Correlations between altered GMVs and FC values with RBD scores were also investigated. Additionally, receiver operating characteristic (ROC) curves were employed for the evaluation of the predictive value of GMVs and FC in identifying RBD in PD. Results PD-RBD patients exhibited lower GMVs in the left middle temporal gyrus (MTG) and bilateral cuneus. Furthermore, we observed higher FC between the left MTG and the right postcentral gyrus (PoCG), as well as lower FC between the bilateral cuneus (CUN) and the right middle frontal gyrus (MFG) among PD-RBD patients in contrast with PD-nRBD patients. Moreover, the GMVs of MTG (extending to the right PoCG) was positively correlated with RBD severity [as measured by REM Sleep Behavior Disorder Screening Questionnaire (RBDSQ) score]. Conversely, the FC value between the bilateral CUN and the right MTG in PD-RBD patients was negatively correlated with RBDSQ score. Conclusion This study revealed the presence replace with GMV and FC changes among PD-RBD patients, which were closely linked to the severity of RBD symptoms. Furthermore, the combination of basic clinical characteristics, GMVs and FC values effectively predicted RBD for individuals with PD.
Collapse
Affiliation(s)
- Fang Wang
- Department of Neurology, First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, China
| | - Zhigang Zhu
- Department of Neurology, First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, China
| | - Chuanbin Zhou
- Department of Geriatrics, The Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Yongyun Zhu
- Department of Neurology, First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, China
| | - Yangfan Zhu
- Department of Neurology, First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, China
| | - Chunyu Liang
- Department of Neurology, First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, China
| | - Jieyu Chen
- Department of Neurology, First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, China
| | - Bin Liu
- Department of Neurology, First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, China
| | - Hui Ren
- Department of Neurology, First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, China
| | - Xinglong Yang
- Department of Neurology, First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, China
| |
Collapse
|
25
|
Summa KC, Jiang P, González-Rodríguez P, Huang X, Lin X, Vitaterna MH, Dan Y, Surmeier DJ, Turek FW. Disrupted sleep-wake regulation in the MCI-Park mouse model of Parkinson's disease. NPJ Parkinsons Dis 2024; 10:54. [PMID: 38467673 PMCID: PMC10928107 DOI: 10.1038/s41531-024-00670-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Accepted: 02/26/2024] [Indexed: 03/13/2024] Open
Abstract
Disrupted sleep has a profound adverse impact on lives of Parkinson's disease (PD) patients and their caregivers. Sleep disturbances are exceedingly common in PD, with substantial heterogeneity in type, timing, and severity. Among the most common sleep-related symptoms reported by PD patients are insomnia, excessive daytime sleepiness, and sleep fragmentation, characterized by interruptions and decreased continuity of sleep. Alterations in brain wave activity, as measured on the electroencephalogram (EEG), also occur in PD, with changes in the pattern and relative contributions of different frequency bands of the EEG spectrum to overall EEG activity in different vigilance states consistently observed. The mechanisms underlying these PD-associated sleep-wake abnormalities are poorly understood, and they are ineffectively treated by conventional PD therapies. To help fill this gap in knowledge, a new progressive model of PD - the MCI-Park mouse - was studied. Near the transition to the parkinsonian state, these mice exhibited significantly altered sleep-wake regulation, including increased wakefulness, decreased non-rapid eye movement (NREM) sleep, increased sleep fragmentation, reduced rapid eye movement (REM) sleep, and altered EEG activity patterns. These sleep-wake abnormalities resemble those identified in PD patients. Thus, this model may help elucidate the circuit mechanisms underlying sleep disruption in PD and identify targets for novel therapeutic approaches.
Collapse
Affiliation(s)
- K C Summa
- Department of Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.
- Center for Sleep & Circadian Biology, Northwestern University, Evanston, IL, USA.
| | - P Jiang
- Center for Sleep & Circadian Biology, Northwestern University, Evanston, IL, USA
- Department of Neurobiology, Weinberg College of Arts and Sciences, Northwestern University, Evanston, IL, USA
- Neuroscience Discovery, Informatics and Predictive Sciences, Bristol Myers Squibb, Cambridge, MA, USA
| | - P González-Rodríguez
- Department of Neuroscience, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
- Instituto de Biomedicina de Sevilla, Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla and CIBERNED, Seville, Spain
| | - X Huang
- Department of Molecular & Cell Biology, University of California Berkeley, Berkeley, CA, USA
| | - X Lin
- Center for Sleep & Circadian Biology, Northwestern University, Evanston, IL, USA
- Department of Neurobiology, Weinberg College of Arts and Sciences, Northwestern University, Evanston, IL, USA
| | - M H Vitaterna
- Center for Sleep & Circadian Biology, Northwestern University, Evanston, IL, USA
- Department of Neurobiology, Weinberg College of Arts and Sciences, Northwestern University, Evanston, IL, USA
| | - Y Dan
- Department of Molecular & Cell Biology, University of California Berkeley, Berkeley, CA, USA
- Aligning Science Across Parkinson's (ASAP) Collaborative Research Network, Chevy Chase, MD, 20815, USA
| | - D J Surmeier
- Department of Neuroscience, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
- Aligning Science Across Parkinson's (ASAP) Collaborative Research Network, Chevy Chase, MD, 20815, USA
| | - F W Turek
- Center for Sleep & Circadian Biology, Northwestern University, Evanston, IL, USA
- Department of Neurobiology, Weinberg College of Arts and Sciences, Northwestern University, Evanston, IL, USA
- The Ken & Ruth Davee Department of Neurology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
- Department of Psychiatry & Behavioral Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| |
Collapse
|
26
|
See QR, Raheel K, Duncan I, Biabani N, Di Giulio I, Romigi A, Kumari V, O’Regan D, Cairney S, Urso D, Chaudhuri KR, Gnoni V, Drakatos P, Rosenzweig I. Dreaming Characteristics in Non-Rapid Eye Movement Parasomnia and Idiopathic Rapid Eye Movement Sleep Behaviour Disorder: Similarities and Differences. Nat Sci Sleep 2024; 16:263-277. [PMID: 38482468 PMCID: PMC10933526 DOI: 10.2147/nss.s435201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Accepted: 01/31/2024] [Indexed: 03/21/2024] Open
Abstract
Background Speech graph analysis (SGA) of dreams has recently shown promise as an objective and language-invariant diagnostic tool that can aid neuropsychiatric diagnosis. Whilst the notion that dreaming mentations reflect distinct physiologic processes is not new, such studies in patients with sleep disorders remain exceptionally scarce. Here, using SGA and other dream content analyses, we set to investigate structural and thematic differences in morning dream recalls of patients diagnosed with Non-Rapid Eye Movement Parasomnia (NREMP) and Idiopathic REM Sleep Behavior Disorder (iRBD). Methods A retrospective cross-sectional study of morning dream recalls of iRBD and NREMP patients was undertaken. Traditional dream content analyses, such as Orlinsky and Hall and Van de Castle analyses, were initially conducted. Subsequently, SGA was performed in order to objectively quantify structural speech differences between the dream recalls of the two patient groups. Results Comparable rate of morning recall of dreams in the sleep laboratory was recorded; 25% of iRBD and 18.35% of NREMP patients. Aggression in dreams was recorded by 28.57% iRBD versus 20.00% in NREMP group. iRBD patients were more likely to recall dreams (iRBD vs NREMP; P = 0.007), but they also had more white dreams, ie having a feeling of having dreamt, but with no memory of it. Visual and quantitative graph speech analyses of iRBD dreams suggested stable sequential structure, reflecting the linearity of the chronological narrative. Conversely, NREMP dream reports displayed more recursive, less stable systems, with significantly higher scores of graph connectivity measures. Conclusion The findings of our exploratory study suggest that iRBD and NREMP patients may not only differ on what is recalled in their dreams but also, perhaps more strikingly, on how dreams are recalled. It is hoped that future SGA-led dream investigations of larger groups of patients will help discern distinct mechanistic underpinnings and any associated clinical implications.
Collapse
Affiliation(s)
- Qi Rui See
- Sleep and Brain Plasticity Centre, Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King’s College London, London, U.K
| | - Kausar Raheel
- Sleep and Brain Plasticity Centre, Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King’s College London, London, U.K
| | - Iain Duncan
- Sleep and Brain Plasticity Centre, Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King’s College London, London, U.K
| | - Nazanin Biabani
- Sleep and Brain Plasticity Centre, Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King’s College London, London, U.K
| | - Irene Di Giulio
- School of Basic and Medical Biosciences, Faculty of Life Science and Medicine, King’s College London, London, U.K
| | - Andrea Romigi
- IRCCS Neuromed Istituto Neurologico Mediterraneo Pozzilli (IS), Pozzilli, Italy
| | - Veena Kumari
- Sleep and Brain Plasticity Centre, Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King’s College London, London, U.K
- Centre for Cognitive Neuroscience, College of Health, Medicine and Life Sciences, Brunel University London, Uxbridge, U.K
| | - David O’Regan
- Sleep and Brain Plasticity Centre, Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King’s College London, London, U.K
- School of Basic and Medical Biosciences, Faculty of Life Science and Medicine, King’s College London, London, U.K
- Sleep Disorders Centre, Guy’s and St Thomas’ NHS Foundation Trust, London, U.K
| | - Scott Cairney
- Department of Psychology, University of York and York Biomedical Research Institute, University of York, York, U.K
| | - Daniele Urso
- Center for Neurodegenerative Diseases and the Aging Brain, Department of Clinical Research in Neurology, University of Bari ‘Aldo Moro’, “Pia Fondazione Cardinale G. Panico”, Tricase, Lecce, Italy
- Movement Disorders Unit, King’s College Hospital and Department of Clinical and Basic Neurosciences, Institute of Psychiatry, Psychology & Neuroscience and Parkinson Foundation Centre of Excellence, King’s College London, London, U.K
| | - K Ray Chaudhuri
- Movement Disorders Unit, King’s College Hospital and Department of Clinical and Basic Neurosciences, Institute of Psychiatry, Psychology & Neuroscience and Parkinson Foundation Centre of Excellence, King’s College London, London, U.K
| | - Valentina Gnoni
- Sleep and Brain Plasticity Centre, Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King’s College London, London, U.K
- Center for Neurodegenerative Diseases and the Aging Brain, Department of Clinical Research in Neurology, University of Bari ‘Aldo Moro’, “Pia Fondazione Cardinale G. Panico”, Tricase, Lecce, Italy
| | - Panagis Drakatos
- Sleep and Brain Plasticity Centre, Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King’s College London, London, U.K
- School of Basic and Medical Biosciences, Faculty of Life Science and Medicine, King’s College London, London, U.K
- Sleep Disorders Centre, Guy’s and St Thomas’ NHS Foundation Trust, London, U.K
| | - Ivana Rosenzweig
- Sleep and Brain Plasticity Centre, Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King’s College London, London, U.K
- Sleep Disorders Centre, Guy’s and St Thomas’ NHS Foundation Trust, London, U.K
| |
Collapse
|
27
|
Xiao X, Rui Y, Jin Y, Chen M. Relationship of Sleep Disorder with Neurodegenerative and Psychiatric Diseases: An Updated Review. Neurochem Res 2024; 49:568-582. [PMID: 38108952 DOI: 10.1007/s11064-023-04086-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Revised: 12/08/2023] [Accepted: 12/09/2023] [Indexed: 12/19/2023]
Abstract
Sleep disorders affect many people worldwide and can accompany neurodegenerative and psychiatric diseases. Sleep may be altered before the clinical manifestations of some of these diseases appear. Moreover, some sleep disorders affect the physiological organization and function of the brain by influencing gene expression, accelerating the accumulation of abnormal proteins, interfering with the clearance of abnormal proteins, or altering the levels of related hormones and neurotransmitters, which can cause or may be associated with the development of neurodegenerative and psychiatric diseases. However, the detailed mechanisms of these effects are unclear. This review mainly focuses on the relationship between and mechanisms of action of sleep in Alzheimer's disease, depression, and anxiety, as well as the relationships between sleep and Parkinson's disease, Huntington's disease, and amyotrophic lateral sclerosis. This summary of current research hotspots may provide researchers with better clues and ideas to develop treatment solutions for neurodegenerative and psychiatric diseases associated with sleep disorders.
Collapse
Affiliation(s)
- Xiao Xiao
- School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, Anhui, China
- Department of Pharmacology, School of Basic Medical Sciences, Anhui Medical University, Hefei, Anhui, China
| | - Yimin Rui
- School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, Anhui, China
- Department of Pharmacology, School of Basic Medical Sciences, Anhui Medical University, Hefei, Anhui, China
| | - Yu Jin
- Department of Pharmacology, School of Basic Medical Sciences, Anhui Medical University, Hefei, Anhui, China
| | - Ming Chen
- Department of Pharmacology, School of Basic Medical Sciences, Anhui Medical University, Hefei, Anhui, China.
| |
Collapse
|
28
|
Di Laudo F, Mainieri G, Provini F. Parasomnias During the COVID-19 Pandemic. Sleep Med Clin 2024; 19:177-187. [PMID: 38368064 DOI: 10.1016/j.jsmc.2023.10.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/19/2024]
Abstract
COVID-19 had a massive impact on sleep, resulting in overall increase of sleep disturbances. During lockdown many factors contributed to sleep disturbances, in particular changes in sleep-wake habits and stress. This article will describe the frequency and features of the principal parasomnias and the impact of the pandemic and the government restriction measures on sleep. Among different pathophysiological hypotheses, we will discuss the role of stress, considered as an expression of the allostatic load. Finally, during the pandemic, parasomnias were mainly investigated by questionnaires, with controversial results; video-polysomnographic studies are crucial to obtain a definitive diagnosis, even in critical conditions.
Collapse
Affiliation(s)
- Felice Di Laudo
- Department of Biomedical and NeuroMotor Sciences (DiBiNeM), University of Bologna, Via Massarenti, 9, Pad. 11, Bologna 40138, Italy
| | - Greta Mainieri
- Department of Biomedical and NeuroMotor Sciences (DiBiNeM), University of Bologna, Via Massarenti, 9, Pad. 11, Bologna 40138, Italy; IRCCS Istituto delle Scienze Neurologiche di Bologna, Via Altura, 3, Bologna 40139, Italy
| | - Federica Provini
- Department of Biomedical and NeuroMotor Sciences (DiBiNeM), University of Bologna, Via Massarenti, 9, Pad. 11, Bologna 40138, Italy; IRCCS Istituto delle Scienze Neurologiche di Bologna, Via Altura, 3, Bologna 40139, Italy.
| |
Collapse
|
29
|
Suzuki K, Suzuki S, Haruyama Y, Funakoshi K, Fujita H, Sakuramoto H, Hamaguchi M, Kobashi G, Hirata K. Associations between the burdens of comorbid sleep problems, central sensitization, and headache-related disability in patients with migraine. Front Neurol 2024; 15:1373574. [PMID: 38601337 PMCID: PMC11006273 DOI: 10.3389/fneur.2024.1373574] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2024] [Accepted: 02/15/2024] [Indexed: 04/12/2024] Open
Abstract
Objective Sleep disturbances are common in migraine patients and affect quality of life. Central sensitization (CS) is likely to play a role in the increased severity and chronicity of migraine. We hypothesized that the number of comorbid sleep problems would affect headache-related disability through the effects of central sensitization (CS). Methods We performed a cross-sectional study including 215 consecutive patients with migraine. Insomnia was defined as a Pittsburgh Sleep Quality Index (PSQI) global score greater than 5. Probable REM sleep behavior disorder (pRBD) was defined as an RBD screening score of 5 or greater. Excessive daytime sleepiness (EDS) was defined as an Epworth Sleepiness Scale score of 10 or higher. Suspected sleep apnea (SA) was defined as patients with snoring or sleep apnea witnessed 3 or more nights a week. CS was assessed by the Central Sensitization Inventory (CSI). Results Restless legs syndrome, insomnia, EDS, SA and pRBD were observed in 25.6%, 71.6%, 34.4%, 10.2%, and 21.4%, respectively, of the patients. At least one sleep problem was present in 87.0% of the patients. According to the results of the multinomial logistic regression analysis with no sleep problems as a reference, after we corrected for adjustment factors, the Migraine Disability Assessment (MIDAS) score significantly increased when three or more comorbid sleep problems were present. According to our mediation analysis, an increased number of sleep problems had a direct effect on the MIDAS score after we adjusted for other variables, and the CSI score was indirectly involved in this association. Conclusion The present study showed an association between migraine-related disability and the burden of multiple sleep problems, which was partially mediated by CS.
Collapse
Affiliation(s)
- Keisuke Suzuki
- Department of Neurology, Dokkyo Medical University, Mibu, Japan
| | - Shiho Suzuki
- Department of Neurology, Dokkyo Medical University, Mibu, Japan
| | - Yasuo Haruyama
- Integrated Research Faculty for Advanced Medical Sciences, Dokkyo Medical University, Mibu, Japan
| | - Kei Funakoshi
- Department of Neurology, Dokkyo Medical University, Mibu, Japan
| | - Hiroaki Fujita
- Department of Neurology, Dokkyo Medical University, Mibu, Japan
| | | | - Mai Hamaguchi
- Department of Neurology, Dokkyo Medical University, Mibu, Japan
| | - Gen Kobashi
- Department of Public Health, Dokkyo Medical University, Mibu, Japan
| | - Koichi Hirata
- Department of Neurology, Dokkyo Medical University, Mibu, Japan
| |
Collapse
|
30
|
Yamakado H, Takahashi R. Experimental Animal Models of Prodromal Parkinson's Disease. JOURNAL OF PARKINSON'S DISEASE 2024:JPD230393. [PMID: 38427504 DOI: 10.3233/jpd-230393] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/03/2024]
Abstract
There is an estimated 35-45% loss of striatal dopamine at the time of diagnosis of Parkinson's disease (PD), and cases clinically diagnosed in the early stages may already be pathologically in advanced stages. Recent large-scale clinical trials of disease-modifying therapies (DMT) also suggest the necessity of targeting patients at earlier stages of the disease. From this perspective, the prodromal phase of PD is currently the focus of attention, emphasizing the need for a prodromal mouse model that accurately reflects the pathophysiology, along with early biomarkers. To establish prodromal animal model of PD with high face validity that reflects the disease state, the model must possess high construct validity that accurately incorporates clinical and pathological features in the prodromal phase. Furthermore, as a preclinical model of DMT, the model must possess high predictive validity to accurately evaluate the response to intervention. This review provides an overview of animal models which reflect the characteristics of prodromal PD, including alpha-synuclein (aS) accumulation and associated early non-motor symptoms, with a focus on the aS propagation model and genetic model. In addition, we discuss the challenges associated with these models. The genetic model often fails to induce motor symptoms, while aS propagation models skip the crucial step of initial aS aggregate formation, thereby not fully replicating the entire natural course of the disease. Identifying factors that induce the transition from prodromal to symptomatic phase is important as a preclinical model for DMT to prevent or delay the onset of the disease.
Collapse
Affiliation(s)
- Hodaka Yamakado
- Department of Therapeutics for Multiple System Atrophy, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Ryosuke Takahashi
- Department of Neurology, Kyoto University Graduate School of Medicine, Kyoto, Japan
| |
Collapse
|
31
|
Choudhury P, Lee-Iannotti JK, Busicescu AO, Rangan P, Fantini ML, Avidan AY, Bliwise DL, Criswell SR, During EH, Elliott JE, Fields JA, Gagnon JF, Howell MJ, Huddleston DE, McLeland J, Mignot E, Miglis MG, Lim MM, Pelletier A, Schenck CH, Shprecher D, St Louis EK, Videnovic A, Ju YES, Boeve BF, Postuma R. Validation of the RBD Symptom Severity Scale in the North American Prodromal Synucleinopathy Consortium. Neurology 2024; 102:e208008. [PMID: 38181331 PMCID: PMC11097765 DOI: 10.1212/wnl.0000000000208008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Accepted: 10/13/2023] [Indexed: 01/07/2024] Open
Abstract
BACKGROUND AND OBJECTIVES REM sleep behavior disorder (RBD) is a parasomnia characterized by dream enactment. The International RBD Study Group developed the RBD Symptom Severity Scale (RBDSSS) to assess symptom severity for clinical or research use. We assessed the psychometric and clinimetric properties of the RBDSSS in participants enrolled in the North American Prodromal Synucleinopathy (NAPS) Consortium for RBD. METHODS NAPS participants, who have polysomnogram-confirmed RBD, and their bedpartners completed the RBDSSS (participant and bedpartner versions). The RBDSSS contains 8 questions to assess the frequency and severity/impact of (1) dream content, (2) vocalizations, (3) movements, and (4) injuries associated with RBD. Total scores for participant (maximum score = 54) and bedpartner (maximum score = 38) questionnaires were derived by multiplying frequency and severity scores for each question. The Clinical Global Impression Scale of Severity (CGI-S) and RBD symptom frequency were assessed by a physician during a semistructured clinical interview with participants and, if available, bedpartners. Descriptive analyses, correlations between overall scores, and subitems were assessed, and item response analysis was performed to determine the scale's validity. RESULTS Among 261 study participants, the median (interquartile range) score for the RBDSSS-PT (participant) was 10 (4-18) and that for the RBDSSS-BP (bedpartner) was 8 (4-15). The median CGI-S was 3 (3-4), indicating moderate severity. RBDSSS-BP scores were significantly lower in women with RBD (6 vs 9, p = 0.02), while there were no sex differences in RBDSSS-PT scores (8 vs 10.5, p = 0.615). Positive correlations were found between RBDSSS-PT vs RBDSSS-BP (Spearman rs = 0.561), RBDSSS-PT vs CGI-S (rs = 0.556), and RBDSSS-BP vs CGI-S (rs = 0.491, all p < 0.0001). Item response analysis showed a high discriminatory value (range 1.40-2.12) for the RBDSSS-PT and RBDSSS-BP (1.29-3.47). DISCUSSION We describe the RBDSSS with adequate psychometric and clinimetric properties to quantify RBD symptom severity and good concordance between participant and bedpartner questionnaires and between RBDSSS scores and clinician-assessed global severity.
Collapse
Affiliation(s)
- Parichita Choudhury
- From the Cleo Roberts Memory and Movement Clinic (D.S., P.C.), Banner Sun Health Research Institute, Sun City; Division of Neurology (J.K.L.-I.) and Division of Neurology, Sleep Disorders Center (P.R.), Banner University Medical Center, Phoenix; College of Medicine (A.O.B.), University of Arizona, Tucson; Neurophysiology Unit (M.L.F.), Neurology Department, Clermont-Ferrand University Hospital, Institut Pascal, CNRS, Université Clermont Auvergne, France; Department of Neurology (A.Y.A.), University of California Los Angeles; Department of Neurology (D.L.B., D.E.H.), Emory University School of Medicine, Atlanta, GA; Department of Neurology (S.R.C., J.M., Y.-E.S.J.), Washington University School of Medicine, St. Louis, MO; Department of Neurology (E.H.D., M.G.M.), Stanford University; Department of Neurology (J.E.E., M.M.L.), VA Portland Health Care System and Oregon Health & Science University; Department of Psychiatry and Psychology (J.A.F.), Mayo Clinic, Rochester, MN; Department of Psychology (J.-F.G.), Université du Québec à Montréal, Canada; Department of Neurology (M.J.H., C.H.S.), University of Minnesota Medical Center, Minneapolis; Center of Sleep Sciences (E.M.), Stanford University, CA; Research Institute of the McGill University Health Centre (A.P.), Montréal; Center for Advanced Research in Sleep Medicine (A.P.), Hôpital du Sacré-Coeur de Montréal, Québec, Canada; Department of Neurology (E.K.S.L., B.F.B.), Mayo Clinic, Rochester, NY; Department of Neurology (A.V.), Harvard Medical School, Boston, MA; and Department of Neurology (R.P.), McGill University, Montréal, Canada
| | - Joyce K Lee-Iannotti
- From the Cleo Roberts Memory and Movement Clinic (D.S., P.C.), Banner Sun Health Research Institute, Sun City; Division of Neurology (J.K.L.-I.) and Division of Neurology, Sleep Disorders Center (P.R.), Banner University Medical Center, Phoenix; College of Medicine (A.O.B.), University of Arizona, Tucson; Neurophysiology Unit (M.L.F.), Neurology Department, Clermont-Ferrand University Hospital, Institut Pascal, CNRS, Université Clermont Auvergne, France; Department of Neurology (A.Y.A.), University of California Los Angeles; Department of Neurology (D.L.B., D.E.H.), Emory University School of Medicine, Atlanta, GA; Department of Neurology (S.R.C., J.M., Y.-E.S.J.), Washington University School of Medicine, St. Louis, MO; Department of Neurology (E.H.D., M.G.M.), Stanford University; Department of Neurology (J.E.E., M.M.L.), VA Portland Health Care System and Oregon Health & Science University; Department of Psychiatry and Psychology (J.A.F.), Mayo Clinic, Rochester, MN; Department of Psychology (J.-F.G.), Université du Québec à Montréal, Canada; Department of Neurology (M.J.H., C.H.S.), University of Minnesota Medical Center, Minneapolis; Center of Sleep Sciences (E.M.), Stanford University, CA; Research Institute of the McGill University Health Centre (A.P.), Montréal; Center for Advanced Research in Sleep Medicine (A.P.), Hôpital du Sacré-Coeur de Montréal, Québec, Canada; Department of Neurology (E.K.S.L., B.F.B.), Mayo Clinic, Rochester, NY; Department of Neurology (A.V.), Harvard Medical School, Boston, MA; and Department of Neurology (R.P.), McGill University, Montréal, Canada
| | - Andrea O Busicescu
- From the Cleo Roberts Memory and Movement Clinic (D.S., P.C.), Banner Sun Health Research Institute, Sun City; Division of Neurology (J.K.L.-I.) and Division of Neurology, Sleep Disorders Center (P.R.), Banner University Medical Center, Phoenix; College of Medicine (A.O.B.), University of Arizona, Tucson; Neurophysiology Unit (M.L.F.), Neurology Department, Clermont-Ferrand University Hospital, Institut Pascal, CNRS, Université Clermont Auvergne, France; Department of Neurology (A.Y.A.), University of California Los Angeles; Department of Neurology (D.L.B., D.E.H.), Emory University School of Medicine, Atlanta, GA; Department of Neurology (S.R.C., J.M., Y.-E.S.J.), Washington University School of Medicine, St. Louis, MO; Department of Neurology (E.H.D., M.G.M.), Stanford University; Department of Neurology (J.E.E., M.M.L.), VA Portland Health Care System and Oregon Health & Science University; Department of Psychiatry and Psychology (J.A.F.), Mayo Clinic, Rochester, MN; Department of Psychology (J.-F.G.), Université du Québec à Montréal, Canada; Department of Neurology (M.J.H., C.H.S.), University of Minnesota Medical Center, Minneapolis; Center of Sleep Sciences (E.M.), Stanford University, CA; Research Institute of the McGill University Health Centre (A.P.), Montréal; Center for Advanced Research in Sleep Medicine (A.P.), Hôpital du Sacré-Coeur de Montréal, Québec, Canada; Department of Neurology (E.K.S.L., B.F.B.), Mayo Clinic, Rochester, NY; Department of Neurology (A.V.), Harvard Medical School, Boston, MA; and Department of Neurology (R.P.), McGill University, Montréal, Canada
| | - Pooja Rangan
- From the Cleo Roberts Memory and Movement Clinic (D.S., P.C.), Banner Sun Health Research Institute, Sun City; Division of Neurology (J.K.L.-I.) and Division of Neurology, Sleep Disorders Center (P.R.), Banner University Medical Center, Phoenix; College of Medicine (A.O.B.), University of Arizona, Tucson; Neurophysiology Unit (M.L.F.), Neurology Department, Clermont-Ferrand University Hospital, Institut Pascal, CNRS, Université Clermont Auvergne, France; Department of Neurology (A.Y.A.), University of California Los Angeles; Department of Neurology (D.L.B., D.E.H.), Emory University School of Medicine, Atlanta, GA; Department of Neurology (S.R.C., J.M., Y.-E.S.J.), Washington University School of Medicine, St. Louis, MO; Department of Neurology (E.H.D., M.G.M.), Stanford University; Department of Neurology (J.E.E., M.M.L.), VA Portland Health Care System and Oregon Health & Science University; Department of Psychiatry and Psychology (J.A.F.), Mayo Clinic, Rochester, MN; Department of Psychology (J.-F.G.), Université du Québec à Montréal, Canada; Department of Neurology (M.J.H., C.H.S.), University of Minnesota Medical Center, Minneapolis; Center of Sleep Sciences (E.M.), Stanford University, CA; Research Institute of the McGill University Health Centre (A.P.), Montréal; Center for Advanced Research in Sleep Medicine (A.P.), Hôpital du Sacré-Coeur de Montréal, Québec, Canada; Department of Neurology (E.K.S.L., B.F.B.), Mayo Clinic, Rochester, NY; Department of Neurology (A.V.), Harvard Medical School, Boston, MA; and Department of Neurology (R.P.), McGill University, Montréal, Canada
| | - Maria Livia Fantini
- From the Cleo Roberts Memory and Movement Clinic (D.S., P.C.), Banner Sun Health Research Institute, Sun City; Division of Neurology (J.K.L.-I.) and Division of Neurology, Sleep Disorders Center (P.R.), Banner University Medical Center, Phoenix; College of Medicine (A.O.B.), University of Arizona, Tucson; Neurophysiology Unit (M.L.F.), Neurology Department, Clermont-Ferrand University Hospital, Institut Pascal, CNRS, Université Clermont Auvergne, France; Department of Neurology (A.Y.A.), University of California Los Angeles; Department of Neurology (D.L.B., D.E.H.), Emory University School of Medicine, Atlanta, GA; Department of Neurology (S.R.C., J.M., Y.-E.S.J.), Washington University School of Medicine, St. Louis, MO; Department of Neurology (E.H.D., M.G.M.), Stanford University; Department of Neurology (J.E.E., M.M.L.), VA Portland Health Care System and Oregon Health & Science University; Department of Psychiatry and Psychology (J.A.F.), Mayo Clinic, Rochester, MN; Department of Psychology (J.-F.G.), Université du Québec à Montréal, Canada; Department of Neurology (M.J.H., C.H.S.), University of Minnesota Medical Center, Minneapolis; Center of Sleep Sciences (E.M.), Stanford University, CA; Research Institute of the McGill University Health Centre (A.P.), Montréal; Center for Advanced Research in Sleep Medicine (A.P.), Hôpital du Sacré-Coeur de Montréal, Québec, Canada; Department of Neurology (E.K.S.L., B.F.B.), Mayo Clinic, Rochester, NY; Department of Neurology (A.V.), Harvard Medical School, Boston, MA; and Department of Neurology (R.P.), McGill University, Montréal, Canada
| | - Alon Y Avidan
- From the Cleo Roberts Memory and Movement Clinic (D.S., P.C.), Banner Sun Health Research Institute, Sun City; Division of Neurology (J.K.L.-I.) and Division of Neurology, Sleep Disorders Center (P.R.), Banner University Medical Center, Phoenix; College of Medicine (A.O.B.), University of Arizona, Tucson; Neurophysiology Unit (M.L.F.), Neurology Department, Clermont-Ferrand University Hospital, Institut Pascal, CNRS, Université Clermont Auvergne, France; Department of Neurology (A.Y.A.), University of California Los Angeles; Department of Neurology (D.L.B., D.E.H.), Emory University School of Medicine, Atlanta, GA; Department of Neurology (S.R.C., J.M., Y.-E.S.J.), Washington University School of Medicine, St. Louis, MO; Department of Neurology (E.H.D., M.G.M.), Stanford University; Department of Neurology (J.E.E., M.M.L.), VA Portland Health Care System and Oregon Health & Science University; Department of Psychiatry and Psychology (J.A.F.), Mayo Clinic, Rochester, MN; Department of Psychology (J.-F.G.), Université du Québec à Montréal, Canada; Department of Neurology (M.J.H., C.H.S.), University of Minnesota Medical Center, Minneapolis; Center of Sleep Sciences (E.M.), Stanford University, CA; Research Institute of the McGill University Health Centre (A.P.), Montréal; Center for Advanced Research in Sleep Medicine (A.P.), Hôpital du Sacré-Coeur de Montréal, Québec, Canada; Department of Neurology (E.K.S.L., B.F.B.), Mayo Clinic, Rochester, NY; Department of Neurology (A.V.), Harvard Medical School, Boston, MA; and Department of Neurology (R.P.), McGill University, Montréal, Canada
| | - Donald L Bliwise
- From the Cleo Roberts Memory and Movement Clinic (D.S., P.C.), Banner Sun Health Research Institute, Sun City; Division of Neurology (J.K.L.-I.) and Division of Neurology, Sleep Disorders Center (P.R.), Banner University Medical Center, Phoenix; College of Medicine (A.O.B.), University of Arizona, Tucson; Neurophysiology Unit (M.L.F.), Neurology Department, Clermont-Ferrand University Hospital, Institut Pascal, CNRS, Université Clermont Auvergne, France; Department of Neurology (A.Y.A.), University of California Los Angeles; Department of Neurology (D.L.B., D.E.H.), Emory University School of Medicine, Atlanta, GA; Department of Neurology (S.R.C., J.M., Y.-E.S.J.), Washington University School of Medicine, St. Louis, MO; Department of Neurology (E.H.D., M.G.M.), Stanford University; Department of Neurology (J.E.E., M.M.L.), VA Portland Health Care System and Oregon Health & Science University; Department of Psychiatry and Psychology (J.A.F.), Mayo Clinic, Rochester, MN; Department of Psychology (J.-F.G.), Université du Québec à Montréal, Canada; Department of Neurology (M.J.H., C.H.S.), University of Minnesota Medical Center, Minneapolis; Center of Sleep Sciences (E.M.), Stanford University, CA; Research Institute of the McGill University Health Centre (A.P.), Montréal; Center for Advanced Research in Sleep Medicine (A.P.), Hôpital du Sacré-Coeur de Montréal, Québec, Canada; Department of Neurology (E.K.S.L., B.F.B.), Mayo Clinic, Rochester, NY; Department of Neurology (A.V.), Harvard Medical School, Boston, MA; and Department of Neurology (R.P.), McGill University, Montréal, Canada
| | - Susan R Criswell
- From the Cleo Roberts Memory and Movement Clinic (D.S., P.C.), Banner Sun Health Research Institute, Sun City; Division of Neurology (J.K.L.-I.) and Division of Neurology, Sleep Disorders Center (P.R.), Banner University Medical Center, Phoenix; College of Medicine (A.O.B.), University of Arizona, Tucson; Neurophysiology Unit (M.L.F.), Neurology Department, Clermont-Ferrand University Hospital, Institut Pascal, CNRS, Université Clermont Auvergne, France; Department of Neurology (A.Y.A.), University of California Los Angeles; Department of Neurology (D.L.B., D.E.H.), Emory University School of Medicine, Atlanta, GA; Department of Neurology (S.R.C., J.M., Y.-E.S.J.), Washington University School of Medicine, St. Louis, MO; Department of Neurology (E.H.D., M.G.M.), Stanford University; Department of Neurology (J.E.E., M.M.L.), VA Portland Health Care System and Oregon Health & Science University; Department of Psychiatry and Psychology (J.A.F.), Mayo Clinic, Rochester, MN; Department of Psychology (J.-F.G.), Université du Québec à Montréal, Canada; Department of Neurology (M.J.H., C.H.S.), University of Minnesota Medical Center, Minneapolis; Center of Sleep Sciences (E.M.), Stanford University, CA; Research Institute of the McGill University Health Centre (A.P.), Montréal; Center for Advanced Research in Sleep Medicine (A.P.), Hôpital du Sacré-Coeur de Montréal, Québec, Canada; Department of Neurology (E.K.S.L., B.F.B.), Mayo Clinic, Rochester, NY; Department of Neurology (A.V.), Harvard Medical School, Boston, MA; and Department of Neurology (R.P.), McGill University, Montréal, Canada
| | - Emmanuel H During
- From the Cleo Roberts Memory and Movement Clinic (D.S., P.C.), Banner Sun Health Research Institute, Sun City; Division of Neurology (J.K.L.-I.) and Division of Neurology, Sleep Disorders Center (P.R.), Banner University Medical Center, Phoenix; College of Medicine (A.O.B.), University of Arizona, Tucson; Neurophysiology Unit (M.L.F.), Neurology Department, Clermont-Ferrand University Hospital, Institut Pascal, CNRS, Université Clermont Auvergne, France; Department of Neurology (A.Y.A.), University of California Los Angeles; Department of Neurology (D.L.B., D.E.H.), Emory University School of Medicine, Atlanta, GA; Department of Neurology (S.R.C., J.M., Y.-E.S.J.), Washington University School of Medicine, St. Louis, MO; Department of Neurology (E.H.D., M.G.M.), Stanford University; Department of Neurology (J.E.E., M.M.L.), VA Portland Health Care System and Oregon Health & Science University; Department of Psychiatry and Psychology (J.A.F.), Mayo Clinic, Rochester, MN; Department of Psychology (J.-F.G.), Université du Québec à Montréal, Canada; Department of Neurology (M.J.H., C.H.S.), University of Minnesota Medical Center, Minneapolis; Center of Sleep Sciences (E.M.), Stanford University, CA; Research Institute of the McGill University Health Centre (A.P.), Montréal; Center for Advanced Research in Sleep Medicine (A.P.), Hôpital du Sacré-Coeur de Montréal, Québec, Canada; Department of Neurology (E.K.S.L., B.F.B.), Mayo Clinic, Rochester, NY; Department of Neurology (A.V.), Harvard Medical School, Boston, MA; and Department of Neurology (R.P.), McGill University, Montréal, Canada
| | - Jonathan E Elliott
- From the Cleo Roberts Memory and Movement Clinic (D.S., P.C.), Banner Sun Health Research Institute, Sun City; Division of Neurology (J.K.L.-I.) and Division of Neurology, Sleep Disorders Center (P.R.), Banner University Medical Center, Phoenix; College of Medicine (A.O.B.), University of Arizona, Tucson; Neurophysiology Unit (M.L.F.), Neurology Department, Clermont-Ferrand University Hospital, Institut Pascal, CNRS, Université Clermont Auvergne, France; Department of Neurology (A.Y.A.), University of California Los Angeles; Department of Neurology (D.L.B., D.E.H.), Emory University School of Medicine, Atlanta, GA; Department of Neurology (S.R.C., J.M., Y.-E.S.J.), Washington University School of Medicine, St. Louis, MO; Department of Neurology (E.H.D., M.G.M.), Stanford University; Department of Neurology (J.E.E., M.M.L.), VA Portland Health Care System and Oregon Health & Science University; Department of Psychiatry and Psychology (J.A.F.), Mayo Clinic, Rochester, MN; Department of Psychology (J.-F.G.), Université du Québec à Montréal, Canada; Department of Neurology (M.J.H., C.H.S.), University of Minnesota Medical Center, Minneapolis; Center of Sleep Sciences (E.M.), Stanford University, CA; Research Institute of the McGill University Health Centre (A.P.), Montréal; Center for Advanced Research in Sleep Medicine (A.P.), Hôpital du Sacré-Coeur de Montréal, Québec, Canada; Department of Neurology (E.K.S.L., B.F.B.), Mayo Clinic, Rochester, NY; Department of Neurology (A.V.), Harvard Medical School, Boston, MA; and Department of Neurology (R.P.), McGill University, Montréal, Canada
| | - Julie A Fields
- From the Cleo Roberts Memory and Movement Clinic (D.S., P.C.), Banner Sun Health Research Institute, Sun City; Division of Neurology (J.K.L.-I.) and Division of Neurology, Sleep Disorders Center (P.R.), Banner University Medical Center, Phoenix; College of Medicine (A.O.B.), University of Arizona, Tucson; Neurophysiology Unit (M.L.F.), Neurology Department, Clermont-Ferrand University Hospital, Institut Pascal, CNRS, Université Clermont Auvergne, France; Department of Neurology (A.Y.A.), University of California Los Angeles; Department of Neurology (D.L.B., D.E.H.), Emory University School of Medicine, Atlanta, GA; Department of Neurology (S.R.C., J.M., Y.-E.S.J.), Washington University School of Medicine, St. Louis, MO; Department of Neurology (E.H.D., M.G.M.), Stanford University; Department of Neurology (J.E.E., M.M.L.), VA Portland Health Care System and Oregon Health & Science University; Department of Psychiatry and Psychology (J.A.F.), Mayo Clinic, Rochester, MN; Department of Psychology (J.-F.G.), Université du Québec à Montréal, Canada; Department of Neurology (M.J.H., C.H.S.), University of Minnesota Medical Center, Minneapolis; Center of Sleep Sciences (E.M.), Stanford University, CA; Research Institute of the McGill University Health Centre (A.P.), Montréal; Center for Advanced Research in Sleep Medicine (A.P.), Hôpital du Sacré-Coeur de Montréal, Québec, Canada; Department of Neurology (E.K.S.L., B.F.B.), Mayo Clinic, Rochester, NY; Department of Neurology (A.V.), Harvard Medical School, Boston, MA; and Department of Neurology (R.P.), McGill University, Montréal, Canada
| | - Jean-Francois Gagnon
- From the Cleo Roberts Memory and Movement Clinic (D.S., P.C.), Banner Sun Health Research Institute, Sun City; Division of Neurology (J.K.L.-I.) and Division of Neurology, Sleep Disorders Center (P.R.), Banner University Medical Center, Phoenix; College of Medicine (A.O.B.), University of Arizona, Tucson; Neurophysiology Unit (M.L.F.), Neurology Department, Clermont-Ferrand University Hospital, Institut Pascal, CNRS, Université Clermont Auvergne, France; Department of Neurology (A.Y.A.), University of California Los Angeles; Department of Neurology (D.L.B., D.E.H.), Emory University School of Medicine, Atlanta, GA; Department of Neurology (S.R.C., J.M., Y.-E.S.J.), Washington University School of Medicine, St. Louis, MO; Department of Neurology (E.H.D., M.G.M.), Stanford University; Department of Neurology (J.E.E., M.M.L.), VA Portland Health Care System and Oregon Health & Science University; Department of Psychiatry and Psychology (J.A.F.), Mayo Clinic, Rochester, MN; Department of Psychology (J.-F.G.), Université du Québec à Montréal, Canada; Department of Neurology (M.J.H., C.H.S.), University of Minnesota Medical Center, Minneapolis; Center of Sleep Sciences (E.M.), Stanford University, CA; Research Institute of the McGill University Health Centre (A.P.), Montréal; Center for Advanced Research in Sleep Medicine (A.P.), Hôpital du Sacré-Coeur de Montréal, Québec, Canada; Department of Neurology (E.K.S.L., B.F.B.), Mayo Clinic, Rochester, NY; Department of Neurology (A.V.), Harvard Medical School, Boston, MA; and Department of Neurology (R.P.), McGill University, Montréal, Canada
| | - Michael J Howell
- From the Cleo Roberts Memory and Movement Clinic (D.S., P.C.), Banner Sun Health Research Institute, Sun City; Division of Neurology (J.K.L.-I.) and Division of Neurology, Sleep Disorders Center (P.R.), Banner University Medical Center, Phoenix; College of Medicine (A.O.B.), University of Arizona, Tucson; Neurophysiology Unit (M.L.F.), Neurology Department, Clermont-Ferrand University Hospital, Institut Pascal, CNRS, Université Clermont Auvergne, France; Department of Neurology (A.Y.A.), University of California Los Angeles; Department of Neurology (D.L.B., D.E.H.), Emory University School of Medicine, Atlanta, GA; Department of Neurology (S.R.C., J.M., Y.-E.S.J.), Washington University School of Medicine, St. Louis, MO; Department of Neurology (E.H.D., M.G.M.), Stanford University; Department of Neurology (J.E.E., M.M.L.), VA Portland Health Care System and Oregon Health & Science University; Department of Psychiatry and Psychology (J.A.F.), Mayo Clinic, Rochester, MN; Department of Psychology (J.-F.G.), Université du Québec à Montréal, Canada; Department of Neurology (M.J.H., C.H.S.), University of Minnesota Medical Center, Minneapolis; Center of Sleep Sciences (E.M.), Stanford University, CA; Research Institute of the McGill University Health Centre (A.P.), Montréal; Center for Advanced Research in Sleep Medicine (A.P.), Hôpital du Sacré-Coeur de Montréal, Québec, Canada; Department of Neurology (E.K.S.L., B.F.B.), Mayo Clinic, Rochester, NY; Department of Neurology (A.V.), Harvard Medical School, Boston, MA; and Department of Neurology (R.P.), McGill University, Montréal, Canada
| | - Daniel E Huddleston
- From the Cleo Roberts Memory and Movement Clinic (D.S., P.C.), Banner Sun Health Research Institute, Sun City; Division of Neurology (J.K.L.-I.) and Division of Neurology, Sleep Disorders Center (P.R.), Banner University Medical Center, Phoenix; College of Medicine (A.O.B.), University of Arizona, Tucson; Neurophysiology Unit (M.L.F.), Neurology Department, Clermont-Ferrand University Hospital, Institut Pascal, CNRS, Université Clermont Auvergne, France; Department of Neurology (A.Y.A.), University of California Los Angeles; Department of Neurology (D.L.B., D.E.H.), Emory University School of Medicine, Atlanta, GA; Department of Neurology (S.R.C., J.M., Y.-E.S.J.), Washington University School of Medicine, St. Louis, MO; Department of Neurology (E.H.D., M.G.M.), Stanford University; Department of Neurology (J.E.E., M.M.L.), VA Portland Health Care System and Oregon Health & Science University; Department of Psychiatry and Psychology (J.A.F.), Mayo Clinic, Rochester, MN; Department of Psychology (J.-F.G.), Université du Québec à Montréal, Canada; Department of Neurology (M.J.H., C.H.S.), University of Minnesota Medical Center, Minneapolis; Center of Sleep Sciences (E.M.), Stanford University, CA; Research Institute of the McGill University Health Centre (A.P.), Montréal; Center for Advanced Research in Sleep Medicine (A.P.), Hôpital du Sacré-Coeur de Montréal, Québec, Canada; Department of Neurology (E.K.S.L., B.F.B.), Mayo Clinic, Rochester, NY; Department of Neurology (A.V.), Harvard Medical School, Boston, MA; and Department of Neurology (R.P.), McGill University, Montréal, Canada
| | - Jennifer McLeland
- From the Cleo Roberts Memory and Movement Clinic (D.S., P.C.), Banner Sun Health Research Institute, Sun City; Division of Neurology (J.K.L.-I.) and Division of Neurology, Sleep Disorders Center (P.R.), Banner University Medical Center, Phoenix; College of Medicine (A.O.B.), University of Arizona, Tucson; Neurophysiology Unit (M.L.F.), Neurology Department, Clermont-Ferrand University Hospital, Institut Pascal, CNRS, Université Clermont Auvergne, France; Department of Neurology (A.Y.A.), University of California Los Angeles; Department of Neurology (D.L.B., D.E.H.), Emory University School of Medicine, Atlanta, GA; Department of Neurology (S.R.C., J.M., Y.-E.S.J.), Washington University School of Medicine, St. Louis, MO; Department of Neurology (E.H.D., M.G.M.), Stanford University; Department of Neurology (J.E.E., M.M.L.), VA Portland Health Care System and Oregon Health & Science University; Department of Psychiatry and Psychology (J.A.F.), Mayo Clinic, Rochester, MN; Department of Psychology (J.-F.G.), Université du Québec à Montréal, Canada; Department of Neurology (M.J.H., C.H.S.), University of Minnesota Medical Center, Minneapolis; Center of Sleep Sciences (E.M.), Stanford University, CA; Research Institute of the McGill University Health Centre (A.P.), Montréal; Center for Advanced Research in Sleep Medicine (A.P.), Hôpital du Sacré-Coeur de Montréal, Québec, Canada; Department of Neurology (E.K.S.L., B.F.B.), Mayo Clinic, Rochester, NY; Department of Neurology (A.V.), Harvard Medical School, Boston, MA; and Department of Neurology (R.P.), McGill University, Montréal, Canada
| | - Emmanuel Mignot
- From the Cleo Roberts Memory and Movement Clinic (D.S., P.C.), Banner Sun Health Research Institute, Sun City; Division of Neurology (J.K.L.-I.) and Division of Neurology, Sleep Disorders Center (P.R.), Banner University Medical Center, Phoenix; College of Medicine (A.O.B.), University of Arizona, Tucson; Neurophysiology Unit (M.L.F.), Neurology Department, Clermont-Ferrand University Hospital, Institut Pascal, CNRS, Université Clermont Auvergne, France; Department of Neurology (A.Y.A.), University of California Los Angeles; Department of Neurology (D.L.B., D.E.H.), Emory University School of Medicine, Atlanta, GA; Department of Neurology (S.R.C., J.M., Y.-E.S.J.), Washington University School of Medicine, St. Louis, MO; Department of Neurology (E.H.D., M.G.M.), Stanford University; Department of Neurology (J.E.E., M.M.L.), VA Portland Health Care System and Oregon Health & Science University; Department of Psychiatry and Psychology (J.A.F.), Mayo Clinic, Rochester, MN; Department of Psychology (J.-F.G.), Université du Québec à Montréal, Canada; Department of Neurology (M.J.H., C.H.S.), University of Minnesota Medical Center, Minneapolis; Center of Sleep Sciences (E.M.), Stanford University, CA; Research Institute of the McGill University Health Centre (A.P.), Montréal; Center for Advanced Research in Sleep Medicine (A.P.), Hôpital du Sacré-Coeur de Montréal, Québec, Canada; Department of Neurology (E.K.S.L., B.F.B.), Mayo Clinic, Rochester, NY; Department of Neurology (A.V.), Harvard Medical School, Boston, MA; and Department of Neurology (R.P.), McGill University, Montréal, Canada
| | - Mitchell G Miglis
- From the Cleo Roberts Memory and Movement Clinic (D.S., P.C.), Banner Sun Health Research Institute, Sun City; Division of Neurology (J.K.L.-I.) and Division of Neurology, Sleep Disorders Center (P.R.), Banner University Medical Center, Phoenix; College of Medicine (A.O.B.), University of Arizona, Tucson; Neurophysiology Unit (M.L.F.), Neurology Department, Clermont-Ferrand University Hospital, Institut Pascal, CNRS, Université Clermont Auvergne, France; Department of Neurology (A.Y.A.), University of California Los Angeles; Department of Neurology (D.L.B., D.E.H.), Emory University School of Medicine, Atlanta, GA; Department of Neurology (S.R.C., J.M., Y.-E.S.J.), Washington University School of Medicine, St. Louis, MO; Department of Neurology (E.H.D., M.G.M.), Stanford University; Department of Neurology (J.E.E., M.M.L.), VA Portland Health Care System and Oregon Health & Science University; Department of Psychiatry and Psychology (J.A.F.), Mayo Clinic, Rochester, MN; Department of Psychology (J.-F.G.), Université du Québec à Montréal, Canada; Department of Neurology (M.J.H., C.H.S.), University of Minnesota Medical Center, Minneapolis; Center of Sleep Sciences (E.M.), Stanford University, CA; Research Institute of the McGill University Health Centre (A.P.), Montréal; Center for Advanced Research in Sleep Medicine (A.P.), Hôpital du Sacré-Coeur de Montréal, Québec, Canada; Department of Neurology (E.K.S.L., B.F.B.), Mayo Clinic, Rochester, NY; Department of Neurology (A.V.), Harvard Medical School, Boston, MA; and Department of Neurology (R.P.), McGill University, Montréal, Canada
| | - Miranda M Lim
- From the Cleo Roberts Memory and Movement Clinic (D.S., P.C.), Banner Sun Health Research Institute, Sun City; Division of Neurology (J.K.L.-I.) and Division of Neurology, Sleep Disorders Center (P.R.), Banner University Medical Center, Phoenix; College of Medicine (A.O.B.), University of Arizona, Tucson; Neurophysiology Unit (M.L.F.), Neurology Department, Clermont-Ferrand University Hospital, Institut Pascal, CNRS, Université Clermont Auvergne, France; Department of Neurology (A.Y.A.), University of California Los Angeles; Department of Neurology (D.L.B., D.E.H.), Emory University School of Medicine, Atlanta, GA; Department of Neurology (S.R.C., J.M., Y.-E.S.J.), Washington University School of Medicine, St. Louis, MO; Department of Neurology (E.H.D., M.G.M.), Stanford University; Department of Neurology (J.E.E., M.M.L.), VA Portland Health Care System and Oregon Health & Science University; Department of Psychiatry and Psychology (J.A.F.), Mayo Clinic, Rochester, MN; Department of Psychology (J.-F.G.), Université du Québec à Montréal, Canada; Department of Neurology (M.J.H., C.H.S.), University of Minnesota Medical Center, Minneapolis; Center of Sleep Sciences (E.M.), Stanford University, CA; Research Institute of the McGill University Health Centre (A.P.), Montréal; Center for Advanced Research in Sleep Medicine (A.P.), Hôpital du Sacré-Coeur de Montréal, Québec, Canada; Department of Neurology (E.K.S.L., B.F.B.), Mayo Clinic, Rochester, NY; Department of Neurology (A.V.), Harvard Medical School, Boston, MA; and Department of Neurology (R.P.), McGill University, Montréal, Canada
| | - Amélie Pelletier
- From the Cleo Roberts Memory and Movement Clinic (D.S., P.C.), Banner Sun Health Research Institute, Sun City; Division of Neurology (J.K.L.-I.) and Division of Neurology, Sleep Disorders Center (P.R.), Banner University Medical Center, Phoenix; College of Medicine (A.O.B.), University of Arizona, Tucson; Neurophysiology Unit (M.L.F.), Neurology Department, Clermont-Ferrand University Hospital, Institut Pascal, CNRS, Université Clermont Auvergne, France; Department of Neurology (A.Y.A.), University of California Los Angeles; Department of Neurology (D.L.B., D.E.H.), Emory University School of Medicine, Atlanta, GA; Department of Neurology (S.R.C., J.M., Y.-E.S.J.), Washington University School of Medicine, St. Louis, MO; Department of Neurology (E.H.D., M.G.M.), Stanford University; Department of Neurology (J.E.E., M.M.L.), VA Portland Health Care System and Oregon Health & Science University; Department of Psychiatry and Psychology (J.A.F.), Mayo Clinic, Rochester, MN; Department of Psychology (J.-F.G.), Université du Québec à Montréal, Canada; Department of Neurology (M.J.H., C.H.S.), University of Minnesota Medical Center, Minneapolis; Center of Sleep Sciences (E.M.), Stanford University, CA; Research Institute of the McGill University Health Centre (A.P.), Montréal; Center for Advanced Research in Sleep Medicine (A.P.), Hôpital du Sacré-Coeur de Montréal, Québec, Canada; Department of Neurology (E.K.S.L., B.F.B.), Mayo Clinic, Rochester, NY; Department of Neurology (A.V.), Harvard Medical School, Boston, MA; and Department of Neurology (R.P.), McGill University, Montréal, Canada
| | - Carlos H Schenck
- From the Cleo Roberts Memory and Movement Clinic (D.S., P.C.), Banner Sun Health Research Institute, Sun City; Division of Neurology (J.K.L.-I.) and Division of Neurology, Sleep Disorders Center (P.R.), Banner University Medical Center, Phoenix; College of Medicine (A.O.B.), University of Arizona, Tucson; Neurophysiology Unit (M.L.F.), Neurology Department, Clermont-Ferrand University Hospital, Institut Pascal, CNRS, Université Clermont Auvergne, France; Department of Neurology (A.Y.A.), University of California Los Angeles; Department of Neurology (D.L.B., D.E.H.), Emory University School of Medicine, Atlanta, GA; Department of Neurology (S.R.C., J.M., Y.-E.S.J.), Washington University School of Medicine, St. Louis, MO; Department of Neurology (E.H.D., M.G.M.), Stanford University; Department of Neurology (J.E.E., M.M.L.), VA Portland Health Care System and Oregon Health & Science University; Department of Psychiatry and Psychology (J.A.F.), Mayo Clinic, Rochester, MN; Department of Psychology (J.-F.G.), Université du Québec à Montréal, Canada; Department of Neurology (M.J.H., C.H.S.), University of Minnesota Medical Center, Minneapolis; Center of Sleep Sciences (E.M.), Stanford University, CA; Research Institute of the McGill University Health Centre (A.P.), Montréal; Center for Advanced Research in Sleep Medicine (A.P.), Hôpital du Sacré-Coeur de Montréal, Québec, Canada; Department of Neurology (E.K.S.L., B.F.B.), Mayo Clinic, Rochester, NY; Department of Neurology (A.V.), Harvard Medical School, Boston, MA; and Department of Neurology (R.P.), McGill University, Montréal, Canada
| | - David Shprecher
- From the Cleo Roberts Memory and Movement Clinic (D.S., P.C.), Banner Sun Health Research Institute, Sun City; Division of Neurology (J.K.L.-I.) and Division of Neurology, Sleep Disorders Center (P.R.), Banner University Medical Center, Phoenix; College of Medicine (A.O.B.), University of Arizona, Tucson; Neurophysiology Unit (M.L.F.), Neurology Department, Clermont-Ferrand University Hospital, Institut Pascal, CNRS, Université Clermont Auvergne, France; Department of Neurology (A.Y.A.), University of California Los Angeles; Department of Neurology (D.L.B., D.E.H.), Emory University School of Medicine, Atlanta, GA; Department of Neurology (S.R.C., J.M., Y.-E.S.J.), Washington University School of Medicine, St. Louis, MO; Department of Neurology (E.H.D., M.G.M.), Stanford University; Department of Neurology (J.E.E., M.M.L.), VA Portland Health Care System and Oregon Health & Science University; Department of Psychiatry and Psychology (J.A.F.), Mayo Clinic, Rochester, MN; Department of Psychology (J.-F.G.), Université du Québec à Montréal, Canada; Department of Neurology (M.J.H., C.H.S.), University of Minnesota Medical Center, Minneapolis; Center of Sleep Sciences (E.M.), Stanford University, CA; Research Institute of the McGill University Health Centre (A.P.), Montréal; Center for Advanced Research in Sleep Medicine (A.P.), Hôpital du Sacré-Coeur de Montréal, Québec, Canada; Department of Neurology (E.K.S.L., B.F.B.), Mayo Clinic, Rochester, NY; Department of Neurology (A.V.), Harvard Medical School, Boston, MA; and Department of Neurology (R.P.), McGill University, Montréal, Canada
| | - Erik K St Louis
- From the Cleo Roberts Memory and Movement Clinic (D.S., P.C.), Banner Sun Health Research Institute, Sun City; Division of Neurology (J.K.L.-I.) and Division of Neurology, Sleep Disorders Center (P.R.), Banner University Medical Center, Phoenix; College of Medicine (A.O.B.), University of Arizona, Tucson; Neurophysiology Unit (M.L.F.), Neurology Department, Clermont-Ferrand University Hospital, Institut Pascal, CNRS, Université Clermont Auvergne, France; Department of Neurology (A.Y.A.), University of California Los Angeles; Department of Neurology (D.L.B., D.E.H.), Emory University School of Medicine, Atlanta, GA; Department of Neurology (S.R.C., J.M., Y.-E.S.J.), Washington University School of Medicine, St. Louis, MO; Department of Neurology (E.H.D., M.G.M.), Stanford University; Department of Neurology (J.E.E., M.M.L.), VA Portland Health Care System and Oregon Health & Science University; Department of Psychiatry and Psychology (J.A.F.), Mayo Clinic, Rochester, MN; Department of Psychology (J.-F.G.), Université du Québec à Montréal, Canada; Department of Neurology (M.J.H., C.H.S.), University of Minnesota Medical Center, Minneapolis; Center of Sleep Sciences (E.M.), Stanford University, CA; Research Institute of the McGill University Health Centre (A.P.), Montréal; Center for Advanced Research in Sleep Medicine (A.P.), Hôpital du Sacré-Coeur de Montréal, Québec, Canada; Department of Neurology (E.K.S.L., B.F.B.), Mayo Clinic, Rochester, NY; Department of Neurology (A.V.), Harvard Medical School, Boston, MA; and Department of Neurology (R.P.), McGill University, Montréal, Canada
| | - Aleksandar Videnovic
- From the Cleo Roberts Memory and Movement Clinic (D.S., P.C.), Banner Sun Health Research Institute, Sun City; Division of Neurology (J.K.L.-I.) and Division of Neurology, Sleep Disorders Center (P.R.), Banner University Medical Center, Phoenix; College of Medicine (A.O.B.), University of Arizona, Tucson; Neurophysiology Unit (M.L.F.), Neurology Department, Clermont-Ferrand University Hospital, Institut Pascal, CNRS, Université Clermont Auvergne, France; Department of Neurology (A.Y.A.), University of California Los Angeles; Department of Neurology (D.L.B., D.E.H.), Emory University School of Medicine, Atlanta, GA; Department of Neurology (S.R.C., J.M., Y.-E.S.J.), Washington University School of Medicine, St. Louis, MO; Department of Neurology (E.H.D., M.G.M.), Stanford University; Department of Neurology (J.E.E., M.M.L.), VA Portland Health Care System and Oregon Health & Science University; Department of Psychiatry and Psychology (J.A.F.), Mayo Clinic, Rochester, MN; Department of Psychology (J.-F.G.), Université du Québec à Montréal, Canada; Department of Neurology (M.J.H., C.H.S.), University of Minnesota Medical Center, Minneapolis; Center of Sleep Sciences (E.M.), Stanford University, CA; Research Institute of the McGill University Health Centre (A.P.), Montréal; Center for Advanced Research in Sleep Medicine (A.P.), Hôpital du Sacré-Coeur de Montréal, Québec, Canada; Department of Neurology (E.K.S.L., B.F.B.), Mayo Clinic, Rochester, NY; Department of Neurology (A.V.), Harvard Medical School, Boston, MA; and Department of Neurology (R.P.), McGill University, Montréal, Canada
| | - Yo-El S Ju
- From the Cleo Roberts Memory and Movement Clinic (D.S., P.C.), Banner Sun Health Research Institute, Sun City; Division of Neurology (J.K.L.-I.) and Division of Neurology, Sleep Disorders Center (P.R.), Banner University Medical Center, Phoenix; College of Medicine (A.O.B.), University of Arizona, Tucson; Neurophysiology Unit (M.L.F.), Neurology Department, Clermont-Ferrand University Hospital, Institut Pascal, CNRS, Université Clermont Auvergne, France; Department of Neurology (A.Y.A.), University of California Los Angeles; Department of Neurology (D.L.B., D.E.H.), Emory University School of Medicine, Atlanta, GA; Department of Neurology (S.R.C., J.M., Y.-E.S.J.), Washington University School of Medicine, St. Louis, MO; Department of Neurology (E.H.D., M.G.M.), Stanford University; Department of Neurology (J.E.E., M.M.L.), VA Portland Health Care System and Oregon Health & Science University; Department of Psychiatry and Psychology (J.A.F.), Mayo Clinic, Rochester, MN; Department of Psychology (J.-F.G.), Université du Québec à Montréal, Canada; Department of Neurology (M.J.H., C.H.S.), University of Minnesota Medical Center, Minneapolis; Center of Sleep Sciences (E.M.), Stanford University, CA; Research Institute of the McGill University Health Centre (A.P.), Montréal; Center for Advanced Research in Sleep Medicine (A.P.), Hôpital du Sacré-Coeur de Montréal, Québec, Canada; Department of Neurology (E.K.S.L., B.F.B.), Mayo Clinic, Rochester, NY; Department of Neurology (A.V.), Harvard Medical School, Boston, MA; and Department of Neurology (R.P.), McGill University, Montréal, Canada
| | - Bradley F Boeve
- From the Cleo Roberts Memory and Movement Clinic (D.S., P.C.), Banner Sun Health Research Institute, Sun City; Division of Neurology (J.K.L.-I.) and Division of Neurology, Sleep Disorders Center (P.R.), Banner University Medical Center, Phoenix; College of Medicine (A.O.B.), University of Arizona, Tucson; Neurophysiology Unit (M.L.F.), Neurology Department, Clermont-Ferrand University Hospital, Institut Pascal, CNRS, Université Clermont Auvergne, France; Department of Neurology (A.Y.A.), University of California Los Angeles; Department of Neurology (D.L.B., D.E.H.), Emory University School of Medicine, Atlanta, GA; Department of Neurology (S.R.C., J.M., Y.-E.S.J.), Washington University School of Medicine, St. Louis, MO; Department of Neurology (E.H.D., M.G.M.), Stanford University; Department of Neurology (J.E.E., M.M.L.), VA Portland Health Care System and Oregon Health & Science University; Department of Psychiatry and Psychology (J.A.F.), Mayo Clinic, Rochester, MN; Department of Psychology (J.-F.G.), Université du Québec à Montréal, Canada; Department of Neurology (M.J.H., C.H.S.), University of Minnesota Medical Center, Minneapolis; Center of Sleep Sciences (E.M.), Stanford University, CA; Research Institute of the McGill University Health Centre (A.P.), Montréal; Center for Advanced Research in Sleep Medicine (A.P.), Hôpital du Sacré-Coeur de Montréal, Québec, Canada; Department of Neurology (E.K.S.L., B.F.B.), Mayo Clinic, Rochester, NY; Department of Neurology (A.V.), Harvard Medical School, Boston, MA; and Department of Neurology (R.P.), McGill University, Montréal, Canada
| | - Ronald Postuma
- From the Cleo Roberts Memory and Movement Clinic (D.S., P.C.), Banner Sun Health Research Institute, Sun City; Division of Neurology (J.K.L.-I.) and Division of Neurology, Sleep Disorders Center (P.R.), Banner University Medical Center, Phoenix; College of Medicine (A.O.B.), University of Arizona, Tucson; Neurophysiology Unit (M.L.F.), Neurology Department, Clermont-Ferrand University Hospital, Institut Pascal, CNRS, Université Clermont Auvergne, France; Department of Neurology (A.Y.A.), University of California Los Angeles; Department of Neurology (D.L.B., D.E.H.), Emory University School of Medicine, Atlanta, GA; Department of Neurology (S.R.C., J.M., Y.-E.S.J.), Washington University School of Medicine, St. Louis, MO; Department of Neurology (E.H.D., M.G.M.), Stanford University; Department of Neurology (J.E.E., M.M.L.), VA Portland Health Care System and Oregon Health & Science University; Department of Psychiatry and Psychology (J.A.F.), Mayo Clinic, Rochester, MN; Department of Psychology (J.-F.G.), Université du Québec à Montréal, Canada; Department of Neurology (M.J.H., C.H.S.), University of Minnesota Medical Center, Minneapolis; Center of Sleep Sciences (E.M.), Stanford University, CA; Research Institute of the McGill University Health Centre (A.P.), Montréal; Center for Advanced Research in Sleep Medicine (A.P.), Hôpital du Sacré-Coeur de Montréal, Québec, Canada; Department of Neurology (E.K.S.L., B.F.B.), Mayo Clinic, Rochester, NY; Department of Neurology (A.V.), Harvard Medical School, Boston, MA; and Department of Neurology (R.P.), McGill University, Montréal, Canada
| |
Collapse
|
32
|
Zhang RY, Li FJ, Zhang Q, Xin LH, Huang JY, Zhao J. Causal associations between modifiable risk factors and isolated REM sleep behavior disorder: a mendelian randomization study. Front Neurol 2024; 15:1321216. [PMID: 38385030 PMCID: PMC10880103 DOI: 10.3389/fneur.2024.1321216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Accepted: 01/11/2024] [Indexed: 02/23/2024] Open
Abstract
Objectives This Mendelian randomization (MR) study identified modifiable risk factors for isolated rapid eye movement sleep behavior disorder (iRBD). Methods Genome-wide association study (GWAS) datasets for 29 modifiable risk factors for iRBD in discovery and replication stages were used. GWAS data for iRBD cases were obtained from the International RBD Study Group. The inverse variance weighted (IVW) method was primarily employed to explore causality, with supplementary analyses used to verify the robustness of IVW findings. Co-localization analysis further substantiated causal associations identified via MR. Genetic correlations between mental illness and iRBD were identified using trait covariance, linkage disequilibrium score regression, and co-localization analyses. Results Our study revealed causal associations between sun exposure-related factors and iRBD. Utilizing sun protection (odds ratio [OR] = 0.31 [0.14, 0.69], p = 0.004), ease of sunburn (OR = 0.70 [0.57, 0.87], p = 0.001), childhood sunburn occasions (OR = 0.58 [0.39, 0.87], p = 0.008), and phototoxic dermatitis (OR = 0.78 [0.66, 0.92], p = 0.003) decreased iRBD risk. Conversely, a deep skin color increased risk (OR = 1.42 [1.04, 1.93], p = 0.026). Smoking, alcohol consumption, low education levels, and mental illness were not risk factors for iRBD. Anxiety disorders and iRBD were genetically correlated. Conclusion Our study does not corroborate previous findings that identified smoking, alcohol use, low education, and mental illness as risk factors for iRBD. Moreover, we found that excessive sun exposure elevates iRBD risk. These findings offer new insights for screening high-risk populations and devising preventive measures.
Collapse
Affiliation(s)
- Ru-Yu Zhang
- Department of Respiratory and Critical Care Medicine, The Second Affiliated Hospital of Xuzhou Medical University, Xuzhou, China
| | - Fu-Jia Li
- Department of Neurology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, China
| | - Qian Zhang
- Department of Respiratory and Critical Care Medicine, The Second Affiliated Hospital of Xuzhou Medical University, Xuzhou, China
| | - Li-Hong Xin
- Department of Respiratory and Critical Care Medicine, The Second Affiliated Hospital of Xuzhou Medical University, Xuzhou, China
| | - Jing-Ying Huang
- Department of Respiratory and Critical Care Medicine, The Second Affiliated Hospital of Xuzhou Medical University, Xuzhou, China
| | - Jie Zhao
- Department of Respiratory and Critical Care Medicine, The Second Affiliated Hospital of Xuzhou Medical University, Xuzhou, China
| |
Collapse
|
33
|
Salsone M, Vescio B, Quattrone A, Marelli S, Castelnuovo A, Casoni F, Quattrone A, Ferini-Strambi L. Periodic Leg Movements during Sleep Associated with REM Sleep Behavior Disorder: A Machine Learning Study. Diagnostics (Basel) 2024; 14:363. [PMID: 38396401 PMCID: PMC10888394 DOI: 10.3390/diagnostics14040363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Revised: 01/20/2024] [Accepted: 02/01/2024] [Indexed: 02/25/2024] Open
Abstract
Most patients with idiopathic REM sleep behavior disorder (iRBD) present peculiar repetitive leg jerks during sleep in their clinical spectrum, called periodic leg movements (PLMS). The clinical differentiation of iRBD patients with and without PLMS is challenging, without polysomnographic confirmation. The aim of this study is to develop a new Machine Learning (ML) approach to distinguish between iRBD phenotypes. Heart rate variability (HRV) data were acquired from forty-two consecutive iRBD patients (23 with PLMS and 19 without PLMS). All participants underwent video-polysomnography to confirm the clinical diagnosis. ML models based on Logistic Regression (LR), Support Vector Machine (SVM), Random Forest (RF), and eXtreme Gradient Boosting (XGBoost) were trained on HRV data, and classification performances were assessed using Leave-One-Out cross-validation. No significant clinical differences emerged between the two groups. The RF model showed the best performance in differentiating between iRBD phenotypes with excellent accuracy (86%), sensitivity (96%), and specificity (74%); SVM and XGBoost had good accuracy (81% and 78%, respectively), sensitivity (83% for both), and specificity (79% and 72%, respectively). In contrast, LR had low performances (accuracy 71%). Our results demonstrate that ML algorithms accurately differentiate iRBD patients from those without PLMS, encouraging the use of Artificial Intelligence to support the diagnosis of clinically indistinguishable iRBD phenotypes.
Collapse
Affiliation(s)
- Maria Salsone
- Institute of Molecular Bioimaging and Physiology, National Research Council, 20054 Segrate, Italy
- Sleep Disorders Center, Division of Neuroscience, San Raffaele Scientific Institute, 20132 Milan, Italy; (S.M.); (F.C.); (L.F.-S.)
| | - Basilio Vescio
- Neuroimaging Research Unit, Institute of Molecular Bioimaging and Physiology (IBFM), National Research Council (CNR), 88100 Catanzaro, Italy;
- Biotecnomed S.C.aR.L., c/o Magna Graecia University, G Building, lev.1, 88100 Catanzaro, Italy
| | - Andrea Quattrone
- Institute of Neurology, Magna Graecia University, 88100 Catanzaro, Italy;
| | - Sara Marelli
- Sleep Disorders Center, Division of Neuroscience, San Raffaele Scientific Institute, 20132 Milan, Italy; (S.M.); (F.C.); (L.F.-S.)
| | - Alessandra Castelnuovo
- Sleep Disorders Center, Division of Neuroscience, Vita-Salute San Raffaele University, 20132 Milan, Italy;
| | - Francesca Casoni
- Sleep Disorders Center, Division of Neuroscience, San Raffaele Scientific Institute, 20132 Milan, Italy; (S.M.); (F.C.); (L.F.-S.)
| | - Aldo Quattrone
- Neuroscience Research Center, Magna Graecia University, 88100 Catanzaro, Italy
| | - Luigi Ferini-Strambi
- Sleep Disorders Center, Division of Neuroscience, San Raffaele Scientific Institute, 20132 Milan, Italy; (S.M.); (F.C.); (L.F.-S.)
- Sleep Disorders Center, Division of Neuroscience, Vita-Salute San Raffaele University, 20132 Milan, Italy;
| |
Collapse
|
34
|
Kim J, Lee HJ, Lee DA, Park KM. Sarcopenia in patients with isolated rapid eye movement sleep behavior disorder. Sleep Med 2024; 114:189-193. [PMID: 38215670 DOI: 10.1016/j.sleep.2024.01.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Revised: 12/17/2023] [Accepted: 01/03/2024] [Indexed: 01/14/2024]
Abstract
OBJECTIVES Evaluating of sarcopenia is important for promoting healthy aging, preventing functional decline, reducing the risk of falls and fractures, and improving overall quality of life. This study aimed to investigate sarcopenia in patients with isolated rapid eye movement sleep behavior disorder (RBD) using temporal muscle thickness (TMT) measurement. METHODS This investigation was retrospectively conducted at a single tertiary hospital. We recruited patients diagnosed with isolated RBD confirmed by polysomnography and clinical history and healthy participants as controls. Patients with isolated RBD and healthy controls underwent brain MRI scans, including three-dimensional T1-weighted imaging. We measured TMT, a radiographic marker of sarcopenia, based on the T1-weighted imaging. We compared the TMT between the groups and performed receiver operating characteristic (ROC) curve analysis to evaluate how well the TMT differentiated patients with isolated RBD from healthy controls. We also conducted a correlation analysis between the TMT and clinical factors. RESULTS Our study included 28 patients with isolated RBD and 30 healthy controls. There was a significant difference in the TMT of both groups. The TMT was reduced in patients with isolated RBD than in healthy controls (11.843 vs. 10.420 mm, p = 0.002). In the ROC curve analysis, the TMT exhibited good performance in differentiating patients with isolated RBD from healthy controls, with an area under the curve of 0.708. Furthermore, age was negatively correlated with TMT in patients with isolated RBD (r = -0.453, p = 0.015). CONCLUSION We demonstrate that TMT is reduced in patients with isolated RBD compared with healthy controls, confirming sarcopenia in patients with isolated RBD. The result suggests an association between neurodegeneration and sarcopenia. TMT can be used to evaluate sarcopenia in sleep disorders.
Collapse
Affiliation(s)
- Jinseung Kim
- Department of Family Medicine, Busan Paik Hospital, Inje University College of Medicine, Republic of Korea
| | - Ho-Joon Lee
- Department of Radiology, Haeundae Paik Hospital, Inje University College of Medicine, Busan, Republic of Korea
| | - Dong Ah Lee
- Department of Neurology, Haeundae Paik Hospital, Inje University College of Medicine, Busan, Republic of Korea
| | - Kang Min Park
- Department of Neurology, Haeundae Paik Hospital, Inje University College of Medicine, Busan, Republic of Korea.
| |
Collapse
|
35
|
Beach P, Lenka A. Recent updates in autonomic research: orthostatic hypotension in prodromal synucleinopathy; longitudinal morbidity and mortality in orthostatic hypotension with and without supine hypertension; a cardiac vagal sensory system underlying reflex syncope. Clin Auton Res 2024; 34:13-15. [PMID: 38281268 DOI: 10.1007/s10286-023-01011-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Accepted: 12/20/2023] [Indexed: 01/30/2024]
Affiliation(s)
- Paul Beach
- Jean and Paul Amos Parkinson's Disease and Movement Disorders Program, Department of Neurology, Emory University School of Medicine, Emory Brain Health Center, 12 Executive Park Drive, NE, Atlanta, GA, 30329, USA.
| | - Abhishek Lenka
- Parkinson's Disease Center and Movement Disorders Clinic, Department of Neurology, Baylor College of Medicine, Houston, TX, USA
| |
Collapse
|
36
|
Donzuso G, Cicero CE, Giuliano L, Squillaci R, Luca A, Palmucci S, Basile A, Lanza G, Ferri R, Zappia M, Nicoletti A. Neuroanatomical findings in isolated REM sleep behavior disorder and early Parkinson's disease: a Voxel-based morphometry study. Brain Imaging Behav 2024; 18:83-91. [PMID: 37897654 PMCID: PMC10844466 DOI: 10.1007/s11682-023-00815-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/15/2023] [Indexed: 10/30/2023]
Abstract
Isolated rapid eye movement (REM) sleep behavior disorder (iRBD) is a parasomnia characterized by loss of physiological atonia of skeletal muscles with abnormal behaviors arising during REM sleep. RBD is often the early manifestation of neurodegenerative diseases, particularly alpha-synucleinopathies, such as Parkinson's disease (PD). Both structural and functional neuroimaging studies suggest that iRBD might share, or even precede, some of the features commonly found in PD, although without a definitive conclusion. Aim of the study is to evaluate the presence of structural abnormalities involving cortical and subcortical areas in PD patients with RBD and iRBD. Patients with video-polysomnographic (VPSG)-confirmed iRBD, and patients with a diagnosis of PD were recruited. In all PD patients, the presence of probable RBD was assessed during the follow-up visits (PD/pRBD). A group of healthy controls (HC) subjects was also recruited. Each subject underwent a structural brain MRI using a 3-D T1-weighted spoiled gradient echo sequence. Twenty-three patients with iRBD, 24 PD/pRBD, and 26 HC were enrolled. Voxel-based morphometry-AnCOVA analysis revealed clusters of grey matter changes in iRBD and PD/pRBD compared to HC in several regions, involving mainly the frontal and temporal regions. The involvement of cortical brain structures associated to the control of sleep cycle and REM stage both in PD/pRBD and iRBD might suggest the presence of a common structural platform linking iRBD and PD, although this pattern may not underlie exclusively RBD-related features. Further longitudinal studies are needed to clarify the patterns of changes occurring at different time points of RBD-related neurodegeneration.
Collapse
Affiliation(s)
- Giulia Donzuso
- Department of Medical, Surgical Sciences and Advanced Technologies "GF Ingrassia", University of Catania, Via Santa Sofia 78, 95123, Catania, Italy
| | - Calogero E Cicero
- Department of Medical, Surgical Sciences and Advanced Technologies "GF Ingrassia", University of Catania, Via Santa Sofia 78, 95123, Catania, Italy
| | - Loretta Giuliano
- Department of Medical, Surgical Sciences and Advanced Technologies "GF Ingrassia", University of Catania, Via Santa Sofia 78, 95123, Catania, Italy
| | - Raffaele Squillaci
- Department of Medical, Surgical Sciences and Advanced Technologies "GF Ingrassia", University of Catania, Via Santa Sofia 78, 95123, Catania, Italy
| | - Antonina Luca
- Department of Medical, Surgical Sciences and Advanced Technologies "GF Ingrassia", University of Catania, Via Santa Sofia 78, 95123, Catania, Italy
| | - Stefano Palmucci
- Radiodiagnostic and Radiotherapy Unit, University Hospital "Policlinico-San Marco", Via Santa Sofia 78, 95123, Catania, Italy
| | - Antonello Basile
- Radiodiagnostic and Radiotherapy Unit, University Hospital "Policlinico-San Marco", Via Santa Sofia 78, 95123, Catania, Italy
| | - Giuseppe Lanza
- Sleep Research Center, Department of Neurology IC, Oasi Research Institute - IRCCS, Troina, Italy
- Department of Surgery and Medical-Surgical Specialties, University of Catania, 95123, Catania, Italy
| | - Raffaele Ferri
- Sleep Research Center, Department of Neurology IC, Oasi Research Institute - IRCCS, Troina, Italy
| | - Mario Zappia
- Department of Medical, Surgical Sciences and Advanced Technologies "GF Ingrassia", University of Catania, Via Santa Sofia 78, 95123, Catania, Italy
| | - Alessandra Nicoletti
- Department of Medical, Surgical Sciences and Advanced Technologies "GF Ingrassia", University of Catania, Via Santa Sofia 78, 95123, Catania, Italy.
| |
Collapse
|
37
|
Zhang P, Huang P, Li Y, Du J, Luo N, He Y, Liu J, He G, Cui S, Zhang W, Li G, Shen X, Jun L, Chen S. Relationships Between Rapid Eye Movement Sleep Behavior Disorder and Parkinson's Disease: Indication from Gut Microbiota Alterations. Aging Dis 2024; 15:357-368. [PMID: 37307829 PMCID: PMC10796088 DOI: 10.14336/ad.2023.0518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Accepted: 05/18/2023] [Indexed: 06/14/2023] Open
Abstract
Rapid eye movement sleep behavior disorder (RBD) has a close relationship with Parkinson's disease (PD) and was even regarded as the most reliable hallmark of prodromal PD. RBD might have similar changes in gut dysbiosis to PD, but the relationship between RBD and PD in gut microbial alterations is rarely studied. In this study, we aim to investigate whether there were consistent changes between RBD and PD in gut microbiota, and found some specific biomarkers in RBD that might indicate phenoconversion to PD. Alpha-diversity showed no remarkable difference and beta-diversity showed significant differences based on the unweighted (R = 0.035, P = 0.037) and weighted (R = 0.0045, P = 0.008) UniFrac analysis among idiopathic RBD (iRBD), PD with RBD, PD without RBD and normal controls (NC). Enterotype distribution indicated iRBD, PD with RBD and PD without RBD were Ruminococcus-dominant while NC were Bacteroides-dominant. 7 genera (4 increased: Aerococcus, Eubacterium, Gordonibacter and Stenotrophomonas, 3 decreased: Butyricicoccus, Faecalibacterium and Haemophilus) were consistently changed in iRBD and PD with RBD. Among them, 4 genera (Aerococcus, Eubacterium, Butyricicoccus, Faecalibacterium) remained distinctive in the comparison between PD with RBD and PD without RBD. Through clinical correlation analysis, Butyricicoccus and Faecalibacterium were found negatively correlated with the severity of RBD (RBD-HK). Functional analysis showed iRBD had similarly increased staurosporine biosynthesis to PD with RBD. Our study indicates that RBD had similar gut microbial changes to PD. Decreased Butyricicoccus and Faecalibacterium might be potential hallmarks of phenoconversion of RBD to PD.
Collapse
Affiliation(s)
- Pingchen Zhang
- Department of Neurology and Institute of Neurology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China.
| | - Pei Huang
- Department of Neurology and Institute of Neurology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China.
| | - Yuanyuan Li
- Department of Neurology and Institute of Neurology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China.
| | - Juanjuan Du
- Department of Neurology and Institute of Neurology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China.
| | - Ningdi Luo
- Department of Neurology and Institute of Neurology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China.
| | - Yixi He
- Department of Neurology and Institute of Neurology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China.
| | - Jin Liu
- Department of Neurology and Institute of Neurology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China.
| | - Guiying He
- Department of Neurology and Institute of Neurology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China.
| | - Shishuang Cui
- Department of Neurology and Institute of Neurology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China.
| | - Weishan Zhang
- Department of Neurology and Institute of Neurology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China.
| | - Gen Li
- Department of Neurology and Institute of Neurology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China.
| | - Xin Shen
- Department of Neurology and Institute of Neurology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China.
| | - Liu Jun
- Department of Neurology and Institute of Neurology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China.
| | - Shengdi Chen
- Department of Neurology and Institute of Neurology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China.
- Lab for Translational Research of Neurodegenerative Diseases, Shanghai Institute for Advanced Immunochemical Studies (SIAIS), Shanghai Tech University, Shanghai 201210, China
| |
Collapse
|
38
|
Lopez R, Dauvilliers Y. Challenges in diagnosing NREM parasomnias: Implications for future diagnostic classifications. Sleep Med Rev 2024; 73:101888. [PMID: 38150767 DOI: 10.1016/j.smrv.2023.101888] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Revised: 11/22/2023] [Accepted: 11/22/2023] [Indexed: 12/29/2023]
Abstract
NREM parasomnias are frequent and potentially disabling sleep disorders characterized by recurrent abnormal behaviors emerging from NREM sleep. Recently, several studies provided more detailed clinical and polysomnographic characterization of NREM parasomnia which may enhance the diagnostic process. Several revisions of the diagnostic criteria have been proposed in the classification of sleep disorders, the latest being ICSD-3-TR in 2023 with no changes on NREM parasomnias since ICSD-3 published in 2014. We performed an extensive literature review to assess the evidence on the procedure of its diagnosis. We dissected the inconsistencies and shortcomings in the ICSD-3-TR to propose a revision of the current diagnostic criteria. We highlighted the limits of several clinical criteria which should rather be supportive features than mandatory criteria. Infrared cameras with video-recordings with are promising tools to precisely characterize home episodes. Sensitive and specific polysomnographic markers of NREM parasomnias have been identified and should be considered in future revisions. We also suggest the use of diagnostic specifiers (clinical subtypes, clinical significance, levels of severity, age effect, levels of certainty) to define homogeneous subgroups of patients for therapeutic intervention and research purposes. In conclusion, we advocate for significant changes in the current diagnostic criteria of NREM parasomnias for future classification.
Collapse
Affiliation(s)
- Régis Lopez
- National Reference Centre for Orphan Diseases, Narcolepsy- Rare hypersomnias, Sleep Unit, Department of Neurology, CHU Montpellier, Univ Montpellier, Montpellier, France; Institute for Neurosciences of Montpellier INM, Univ Montpellier, INSERM, Montpellier, France.
| | - Yves Dauvilliers
- National Reference Centre for Orphan Diseases, Narcolepsy- Rare hypersomnias, Sleep Unit, Department of Neurology, CHU Montpellier, Univ Montpellier, Montpellier, France; Institute for Neurosciences of Montpellier INM, Univ Montpellier, INSERM, Montpellier, France.
| |
Collapse
|
39
|
Mogavero MP, Ferri R, Marelli S, Lanza G, Terzaghi M, Castelnuovo A, DelRosso LM, Schenck CH, Ferini‐Strambi L. Polysomnographic features associated with clonazepam and melatonin treatment in isolated REM sleep behavior disorder: Time for new therapeutic approaches? CNS Neurosci Ther 2024; 30:e14569. [PMID: 38421131 PMCID: PMC10850928 DOI: 10.1111/cns.14569] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Revised: 09/06/2023] [Accepted: 12/02/2023] [Indexed: 03/02/2024] Open
Abstract
AIMS Although clonazepam (CLO) and melatonin (MLT) are the most frequently used treatments for REM sleep behavior disorder, the polysomnographic features associated with their use are little known. The aim of this study was to evaluate polysomnographic and clinical parameters of patients with idiopathic/isolated REM sleep behavior disorder (iRBD) treated chronically with CLO, sustained-release MLT, alone or in combination, and in a group of drug-free iRBD patients. METHODS A total of 96 patients were enrolled: 43 drug-free, 21 with CLO (0.5-2 mg), 20 with sustained-release MLT (1-4 mg), and 12 taking a combination of them (same doses). Clinical variables and polysomnography were collected. RESULTS Although clinical improvement was reported in all groups, MLT impacted sleep architecture more than the other treatments, with significant and large increase in N3 stage, moderate reduction in N2 and REM sleep, and moderate increase in REM latency. CLO moderately increased the percentage of both REM sleep and especially N2, while reducing N1 and wakefulness. Patients treated with both CLO and MLT did not show major changes in sleep architecture. CONCLUSION These results suggest that the administration of MLT or CLO impacts (positively) on sleep parameters of iRBD patients. However, there is a need to better stratify patients, in order to treat them in a targeted manner, depending on the patient's individual sleep architecture and expected differential effects of these agents.
Collapse
Affiliation(s)
- Maria P. Mogavero
- Vita‐Salute San Raffaele UniversityMilanItaly
- Sleep Disorders Center, Division of NeuroscienceSan Raffaele Scientific InstituteMilanItaly
| | - Raffaele Ferri
- Sleep Research Centre and Clinical Neurophysiology Research UnitOasi Research Institute – IRCCSTroinaItaly
| | - Sara Marelli
- Vita‐Salute San Raffaele UniversityMilanItaly
- Sleep Disorders Center, Division of NeuroscienceSan Raffaele Scientific InstituteMilanItaly
| | - Giuseppe Lanza
- Sleep Research Centre and Clinical Neurophysiology Research UnitOasi Research Institute – IRCCSTroinaItaly
- Department of Surgery and Medical‐Surgical SpecialtiesUniversity of CataniaCataniaItaly
| | - Michele Terzaghi
- Department of Brain and Behavioral SciencesUniversity of PaviaPaviaItaly
- Unit of Sleep Medicine and EpilepsyIRCCS Mondino FoundationPaviaItaly
| | - Alessandra Castelnuovo
- Vita‐Salute San Raffaele UniversityMilanItaly
- Sleep Disorders Center, Division of NeuroscienceSan Raffaele Scientific InstituteMilanItaly
| | | | - Carlos H. Schenck
- Minnesota Regional Sleep Disorders Center, Department of Psychiatry, Hennepin County Medical CenterUniversity of Minnesota Medical SchoolMinneapolisMinnesotaUSA
| | - Luigi Ferini‐Strambi
- Vita‐Salute San Raffaele UniversityMilanItaly
- Sleep Disorders Center, Division of NeuroscienceSan Raffaele Scientific InstituteMilanItaly
| |
Collapse
|
40
|
Höglinger GU, Adler CH, Berg D, Klein C, Outeiro TF, Poewe W, Postuma R, Stoessl AJ, Lang AE. A biological classification of Parkinson's disease: the SynNeurGe research diagnostic criteria. Lancet Neurol 2024; 23:191-204. [PMID: 38267191 DOI: 10.1016/s1474-4422(23)00404-0] [Citation(s) in RCA: 16] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Revised: 09/08/2023] [Accepted: 10/06/2023] [Indexed: 01/26/2024]
Abstract
With the hope that disease-modifying treatments could target the molecular basis of Parkinson's disease, even before the onset of symptoms, we propose a biologically based classification. Our classification acknowledges the complexity and heterogeneity of the disease by use of a three-component system (SynNeurGe): presence or absence of pathological α-synuclein (S) in tissues or CSF; evidence of underlying neurodegeneration (N) defined by neuroimaging procedures; and documentation of pathogenic gene variants (G) that cause or strongly predispose to Parkinson's disease. These three components are linked to a clinical component (C), defined either by a single high-specificity clinical feature or by multiple lower-specificity clinical features. The use of a biological classification will enable advances in both basic and clinical research, and move the field closer to the precision medicine required to develop disease-modifying therapies. We emphasise the initial application of these criteria exclusively for research. We acknowledge its ethical implications, its limitations, and the need for prospective validation in future studies.
Collapse
Affiliation(s)
- Günter U Höglinger
- Department of Neurology, University Hospital, Ludwig-Maximilians-University (LMU) and German Center for Neurodegenerative Diseases, Munich, Germany; Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
| | - Charles H Adler
- Department of Neurology, Mayo Clinic College of Medicine, Mayo Clinic Arizona, Scottsdale, AZ, USA
| | - Daniela Berg
- Christian Albrechts University and University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Christine Klein
- Institute of Neurogenetics, University of Lübeck and University Hospital Schleswig-Holstein, Campus Lübeck, Lüebeck, Germany
| | - Tiago F Outeiro
- Department of Experimental Neurodegeneration, Center for Biostructural Imaging of Neurodegeneration, University Medical Center Göttingen, Göttingen, Germany; Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
| | - Werner Poewe
- Medical University Innsbruck, Innsbruck, Austria
| | - Ronald Postuma
- Department of Neurology, McGill University, Montreal Neurological Institute, Montreal, QC, Canada
| | - A Jon Stoessl
- Pacific Parkinson's Research Centre and Parkinson's Foundation Centre of Excellence, University of British Columbia, BC, Canada
| | - Anthony E Lang
- University Health Network's Krembil Brain Institute, Edmond J Safra Program in Parkinson's Disease and the Rossy PSP Centre, Toronto Western Hospital, Toronto, ON, Canada.
| |
Collapse
|
41
|
Tsuneoka Y, Funato H. Whole Brain Mapping of Orexin Receptor mRNA Expression Visualized by Branched In Situ Hybridization Chain Reaction. eNeuro 2024; 11:ENEURO.0474-23.2024. [PMID: 38199807 PMCID: PMC10883752 DOI: 10.1523/eneuro.0474-23.2024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Revised: 12/21/2023] [Accepted: 01/03/2024] [Indexed: 01/12/2024] Open
Abstract
Orexins, which are produced within neurons of the lateral hypothalamic area, play a pivotal role in the regulation of various behaviors, including sleep/wakefulness, reward behavior, and energy metabolism, via orexin receptor type 1 (OX1R) and type 2 (OX2R). Despite the advanced understanding of orexinergic regulation of behavior at the circuit level, the precise distribution of orexin receptors in the brain remains unknown. Here, we develop a new branched in situ hybridization chain reaction (bHCR) technique to visualize multiple target mRNAs in a semiquantitative manner, combined with immunohistochemistry, which provided comprehensive distribution of orexin receptor mRNA and neuron subtypes expressing orexin receptors in mouse brains. Only a limited number of cells expressing both Ox1r and Ox2r were observed in specific brain regions, such as the dorsal raphe nucleus and ventromedial hypothalamic nucleus. In many brain regions, Ox1r-expressing cells and Ox2r-expressing cells belong to different cell types, such as glutamatergic and GABAergic neurons. Moreover, our findings demonstrated considerable heterogeneity in Ox1r- or Ox2r-expressing populations of serotonergic, dopaminergic, noradrenergic, cholinergic, and histaminergic neurons. The majority of orexin neurons did not express orexin receptors. This study provides valuable insights into the mechanism underlying the physiological and behavioral regulation mediated by the orexin system, as well as the development of therapeutic agents targeting orexin receptors.
Collapse
Affiliation(s)
- Yousuke Tsuneoka
- Department of Anatomy, Faculty of Medicine, Toho University, Tokyo 145-854, Japan
| | - Hiromasa Funato
- Department of Anatomy, Faculty of Medicine, Toho University, Tokyo 145-854, Japan
- International Institutes for Integrative Sleep Medicine (WPI-IIIS), University of Tsukuba, Ibaraki 305-8575, Japan
| |
Collapse
|
42
|
Huang Y, Zhang J, You D, Chen S, Lin Z, Li B, Ling M, Tong H, Li F. Mechanisms underlying palmitic acid-induced disruption of locomotor activity and sleep behavior in Drosophila. Comp Biochem Physiol C Toxicol Pharmacol 2024; 276:109813. [PMID: 38070757 DOI: 10.1016/j.cbpc.2023.109813] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2023] [Revised: 11/25/2023] [Accepted: 12/04/2023] [Indexed: 12/19/2023]
Abstract
The globally prevalent of sleep disorders is partly attributed to unhealthy dietary habits. This study investigated the underlying mechanisms of elevated palmitic acid (PA) intake on locomotor activity and sleep behavior in Drosophila. Our results indicate that exposure to PA significantly elevated Drosophila's daytime and nighttime locomotor activity while concurrently reducing overall sleep duration. Utilizing 16S rRNA sequencing, we observed substantial alterations in the composition of the gut microbiota induced by PA, notably, characterized by a significant reduction in Lactobacillus plantarum. Furthermore, PA significantly increased the levels of inflammatory factors Upd3 and Eiger in Drosophila intestines, and downregulated the expression of Gad and Tph, as well as 5-HT1A. Conversely, Gdh and Hdc were significantly upregulated in the PA group. Supplementation with L. plantarum or lactic acid significantly ameliorated PA-induced disruptions in both locomotor activity and sleep behavior. This supplementation also suppressed the expression of intestinal inflammatory factors, thus restoring impaired neurotransmitter-mediated sleep-wake regulation. Moreover, specific knockdown of intestinal epithelial Upd3 or Eiger similarly restored disrupted neurotransmitter expression, ultimately improving PA-induced disturbances in Drosophila locomotor activity and sleep behavior. These findings provide important insights into the intricate interplay between dietary components and essential behaviors, highlighting potential avenues for addressing health challenges associated with modern dietary habits.
Collapse
Affiliation(s)
- Yumei Huang
- Department of Neonatology, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou 325000, PR China; Key Laboratory of Structural Malformations in Children of Zhejiang Province, Wenzhou 325000, PR China
| | - Jiaqi Zhang
- Zhejiang Provincial Key Laboratory for Water Environment and Marine Biological Resources Protection, College of Life and Environmental Science, Wenzhou University, Wenzhou 325000, PR China
| | - Dongdong You
- Department of Neonatology, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou 325000, PR China
| | - Shangqin Chen
- Department of Neonatology, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou 325000, PR China
| | - Zhongdong Lin
- Department of Pediatric Neurology, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou 325000, PR China
| | - Boyang Li
- Zhejiang Provincial Key Laboratory for Water Environment and Marine Biological Resources Protection, College of Life and Environmental Science, Wenzhou University, Wenzhou 325000, PR China
| | - Menglai Ling
- Zhejiang Provincial Key Laboratory for Water Environment and Marine Biological Resources Protection, College of Life and Environmental Science, Wenzhou University, Wenzhou 325000, PR China
| | - Haibin Tong
- Zhejiang Provincial Key Laboratory for Water Environment and Marine Biological Resources Protection, College of Life and Environmental Science, Wenzhou University, Wenzhou 325000, PR China.
| | - Feng Li
- Department of Pediatric Neurology, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou 325000, PR China; Key Laboratory of Structural Malformations in Children of Zhejiang Province, Wenzhou 325000, PR China.
| |
Collapse
|
43
|
Gorgoni M, De Gennaro L. Sleep in Healthy and Pathological Aging. Brain Sci 2024; 14:128. [PMID: 38391703 PMCID: PMC10886851 DOI: 10.3390/brainsci14020128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Accepted: 12/22/2023] [Indexed: 02/24/2024] Open
Abstract
Human sleep physiology is strongly affected by age [...].
Collapse
Affiliation(s)
- Maurizio Gorgoni
- Department of Psychology, Sapienza University of Rome, 00185 Rome, Italy
- IRCCS Fondazione Santa Lucia, 00179 Rome, Italy
| | - Luigi De Gennaro
- Department of Psychology, Sapienza University of Rome, 00185 Rome, Italy
- IRCCS Fondazione Santa Lucia, 00179 Rome, Italy
| |
Collapse
|
44
|
Tackey C, Slepian PM, Clarke H, Mittal N. Post-Viral Pain, Fatigue, and Sleep Disturbance Syndromes: Current Knowledge and Future Directions. Can J Pain 2024; 7:2272999. [PMID: 38239826 PMCID: PMC10795785 DOI: 10.1080/24740527.2023.2272999] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Accepted: 10/16/2023] [Indexed: 01/22/2024]
Abstract
Background Post-viral pain syndrome, also known as post-viral syndrome, is a complex condition characterized by persistent pain, fatigue, musculoskeletal pain, neuropathic pain, neurocognitive difficulties, and sleep disturbances that can occur after an individual has recovered from a viral infection. Aims This narrative review provides a summary of the sequelae of post-viral syndromes, viral agents that cause it, and the pathophysiology, treatment, and future considerations for research and targeted therapies. Methods Medline, PubMed, and Embase databases were used to search for studies on viruses associated with post-viral syndrome. Conclusion Much remains unknown regarding the pathophysiology of post-viral syndromes, and few studies have provided a comprehensive summary of the condition, agents that cause it, and successful treatment modalities. With the COVID-19 pandemic continuing to affect millions of people worldwide, the need for an understanding of the etiology of post-viral illness and how to help individuals cope with the sequalae is paramount.
Collapse
Affiliation(s)
- Caleb Tackey
- Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - P. Maxwell Slepian
- Department of Anesthesiology and Pain Medicine, University of Toronto, Toronto, Ontario, Canada
- Department of Anesthesia and Pain Management, Toronto General Hospital, University Health Network, Toronto, Ontario, Canada
| | - Hance Clarke
- Department of Anesthesiology and Pain Medicine, University of Toronto, Toronto, Ontario, Canada
- Department of Anesthesia and Pain Management, Toronto General Hospital, University Health Network, Toronto, Ontario, Canada
| | - Nimish Mittal
- Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- Department of Anesthesiology and Pain Medicine, University of Toronto, Toronto, Ontario, Canada
- Division of Physical Medicine and Rehabilitation, Department of Medicine, University of Toronto, Toronto, Ontario, Canada
- Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, Ontario, Canada
| |
Collapse
|
45
|
Dan XJ, Wang YW, Sun JY, Gao LL, Chen X, Yang XY, Xu EH, Ma JH, Yan CG, Wu T, Chan P. Reorganization of intrinsic functional connectivity in early-stage Parkinson's disease patients with probable REM sleep behavior disorder. NPJ Parkinsons Dis 2024; 10:5. [PMID: 38172178 PMCID: PMC10764752 DOI: 10.1038/s41531-023-00617-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Accepted: 12/07/2023] [Indexed: 01/05/2024] Open
Abstract
REM sleep behavior disorder (RBD) symptoms in Parkinson's disease (PD) suggest both a clinically and pathologically malignant subtype. However, whether RBD symptoms are associated with alterations in the organization of whole-brain intrinsic functional networks in PD, especially at early disease stages, remains unclear. Here we use resting-state functional MRI, coupled with graph-theoretical approaches and network-based statistics analyses, and validated with large-scale network analyses, to characterize functional brain networks and their relationship with clinical measures in early PD patients with probable RBD (PD+pRBD), early PD patients without probable RBD (PD-pRBD) and healthy controls. Thirty-six PD+pRBD, 57 PD-pRBD and 71 healthy controls were included in the final analyses. The PD+pRBD group demonstrated decreased global efficiency (t = -2.036, P = 0.0432) compared to PD-pRBD, and decreased network efficiency, as well as comprehensively disrupted nodal efficiency and whole-brain networks (all eight networks, but especially in the sensorimotor, default mode and visual networks) compared to healthy controls. The PD-pRBD group showed decreased nodal degree in right ventral frontal cortex and more affected edges in the frontoparietal and ventral attention networks compared to healthy controls. Furthermore, the assortativity coefficient was negatively correlated with Montreal cognitive assessment scores in the PD+pRBD group (r = -0.365, P = 0.026, d = 0.154). The observation of altered whole-brain functional networks and its correlation with cognitive function in PD+pRBD suggest reorganization of the intrinsic functional connectivity to maintain the brain function in the early stage of the disease. Future longitudinal studies following these alterations along disease progression are warranted.
Collapse
Affiliation(s)
- Xiao-Juan Dan
- Department of Neurology, Xuanwu Hospital of Capital Medical University, 100053, Beijing, China
- Key Laboratory on Neurodegenerative Disorders of Ministry of Education, Key Laboratory on Parkinson's Disease of Beijing, 100053, Beijing, China
| | - Yu-Wei Wang
- CAS Key Laboratory of Behavioral Science, Institute of Psychology, 100101, Beijing, China
- Department of Psychology, University of Chinese Academy of Sciences, 100101, Beijing, China
| | - Jun-Yan Sun
- Center for Movement Disorders, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, 100070, Beijing, China
| | - Lin-Lin Gao
- Department of Neurobiology, Xuanwu Hospital of Capital Medical University, 100053, Beijing, China
| | - Xiao Chen
- CAS Key Laboratory of Behavioral Science, Institute of Psychology, 100101, Beijing, China
- Department of Psychology, University of Chinese Academy of Sciences, 100101, Beijing, China
| | - Xue-Ying Yang
- CAS Key Laboratory of Behavioral Science, Institute of Psychology, 100101, Beijing, China
- Department of Psychology, University of Chinese Academy of Sciences, 100101, Beijing, China
| | - Er-He Xu
- Department of Neurology, Xuanwu Hospital of Capital Medical University, 100053, Beijing, China
| | - Jing-Hong Ma
- Department of Neurology, Xuanwu Hospital of Capital Medical University, 100053, Beijing, China
| | - Chao-Gan Yan
- CAS Key Laboratory of Behavioral Science, Institute of Psychology, 100101, Beijing, China
- Department of Psychology, University of Chinese Academy of Sciences, 100101, Beijing, China
| | - Tao Wu
- Center for Movement Disorders, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, 100070, Beijing, China.
| | - Piu Chan
- Department of Neurology, Xuanwu Hospital of Capital Medical University, 100053, Beijing, China.
- Key Laboratory on Neurodegenerative Disorders of Ministry of Education, Key Laboratory on Parkinson's Disease of Beijing, 100053, Beijing, China.
- National Clinical Research Center for Geriatric Disorders, 100053, Beijing, China.
- Beijing Institute for Brain Disorders Parkinson's Disease Center, Advanced Innovation Center for Human Brain Protection, Capital Medical University, 100069, Beijing, China.
| |
Collapse
|
46
|
Keavney JL, Mathur S, Schroeder K, Merrell R, Castillo-Torres SA, Gao V, Crotty GF, Schwarzschild MA, Poma JM. Perspectives of People At-Risk on Parkinson's Prevention Research. JOURNAL OF PARKINSON'S DISEASE 2024; 14:399-414. [PMID: 38489198 DOI: 10.3233/jpd-230436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/17/2024]
Abstract
The movement toward prevention trials in people at-risk for Parkinson's disease (PD) is rapidly becoming a reality. The authors of this article include a genetically at-risk advocate with the LRRK2 G2019 S variant and two patients with rapid eye movement sleep behavior disorder (RBD), one of whom has now been diagnosed with PD. These authors participated as speakers, panelists, and moderators in the "Planning for Prevention of Parkinson's: A Trial Design Forum" hosted by Massachusetts General Hospital in 2021 and 2022. Other authors include a young onset person with Parkinson's (PwP) and retired family physician, an expert in patient engagement in Parkinson's, and early career and veteran movement disorders clinician researchers. Several themes emerged from the at-risk participant voice concerning the importance of early intervention, the legitimacy of their input in decision-making, and the desire for transparent communication and feedback throughout the entire research study process. Challenges and opportunities in the current environment include lack of awareness among primary care physicians and general neurologists about PD risk, legal and psychological implications of risk disclosure, limited return of individual research study results, and undefined engagement and integration of individuals at-risk into the broader Parkinson's community. Incorporating the perspectives of individuals at-risk as well as those living with PD at this early stage of prevention trial development is crucial to success.
Collapse
Affiliation(s)
- Jessi L Keavney
- Parkinson's Foundation, Parkinson's Advocates in Research Program, Pendergrass, GA, USA
| | | | - Karlin Schroeder
- Parkinson's Foundation, Associate Vice President of Community Engagement, New York, NY, USA
| | | | - Sergio A Castillo-Torres
- Edmond J. Safra Fellow in Movement Disorders, Servicio de Movimientos Anormales, Fleni, Buenos Aires, Argentina
| | - Virginia Gao
- Movement Disorders Fellow, Columbia University Irving Medical Center and Weill Cornell Medicine, New York, NY, USA
| | - Grace F Crotty
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Michael A Schwarzschild
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - John M Poma
- Parkinson's Foundation, People with Parkinson's Advisory Council, Glen Allen, VA, USA
| |
Collapse
|
47
|
Zhao H, Li S, Wang Y. A case report of atypical sleep in an ischemic stroke patient with psychiatric symptoms caused by olanzapine. Front Neurol 2023; 14:1266204. [PMID: 38178881 PMCID: PMC10765984 DOI: 10.3389/fneur.2023.1266204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Accepted: 12/04/2023] [Indexed: 01/06/2024] Open
Abstract
Antipsychotics, tricyclic and 5-hydroxytryptamine reuptake inhibitors (SSRI) and 5-hydroxytryptamine and norepinephrine reuptake inhibitor (SNRI) antidepressants, and monoamine oxidase inhibitors can produce dream-rendering behaviors and/or dystonic deregulation during REM sleep. Acute episodes are also seen with withdrawal from alcohol or sedative-hypnotics, and the use of tricyclic and SSRI antidepressants. In this article, we present a case of olanzapine treatment of a patient with cerebrovascular disease with psychobehavioural symptoms. The patient was an elderly patient who developed psychobehavioural symptoms after a sudden cerebral infarction. Initially, his symptoms improved when he took olanzapine (5 mg orally once/night). However, the patient subsequently developed symptoms of hypersomnia when he continued to take olanzapine, and the symptoms of hypersomnia gradually worsened as the dose of olanzapine was gradually increased. Benzodiazepines are often used to treat anomalous sleep, and clonazepam is one of the commonly prescribed drugs. In this case, the patient's abnormal sleep behavior was alleviated after treatment with clonazepam. As an atypical antipsychotic drug, olanzapine has been reported to cause abnormal sleep behavior during clinical use, and only one case has been reported in China. Clinicians should be aware that heteromorphic sleep can occur in patients treated with olanzapine.
Collapse
Affiliation(s)
- Huixin Zhao
- Department of Pharmacy, North China University of Science and Technology Affiliated Hospital, Tangshan, China
| | - Shuang Li
- School of Public Health, North China University of Science and Technology, Tangshan, China
| | - Yanmei Wang
- Medical Security Center, The PLA 982 Hospital, Tangshan, China
| |
Collapse
|
48
|
Elliott JE, Bryant-Ekstrand MD, Keil AT, Ligman BR, Lim MM, Zitser J, During EH, Gagnon JF, St Louis EK, Fields JA, Huddleston DE, Bliwise DL, Avidan AY, Schenck CH, McLeland J, Criswell SR, Davis AA, Videnovic A, Lee-Iannotti JK, Postuma R, Boeve BF, Ju YES, Miglis MG. Frequency of Orthostatic Hypotension in Isolated REM Sleep Behavior Disorder. Neurology 2023; 101:e2545-e2559. [PMID: 37857496 PMCID: PMC10791057 DOI: 10.1212/wnl.0000000000207883] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Accepted: 09/11/2023] [Indexed: 10/21/2023] Open
Abstract
BACKGROUND AND OBJECTIVES Although orthostatic hypotension (OH) can be an early feature of autonomic dysfunction in isolated REM sleep behavior disorder (iRBD), no large-scale studies have examined the frequency of OH in iRBD. In this study, we prospectively evaluated the frequency of OH in a large multicenter iRBD cohort. METHODS Participants 18 years or older with video polysomnogram-confirmed iRBD were enrolled through the North American Prodromal Synucleinopathy consortium. All participants underwent 3-minute orthostatic stand testing to assess the frequency of OH, and a Δ heart rate/Δ systolic blood pressure (ΔHR/ΔSBP) ratio <0.5 was used to define reduced HR augmentation, suggestive of neurogenic OH. All participants completed a battery of assessments, including the Scales for Outcomes in Parkinson Disease-Autonomic Dysfunction (SCOPA-AUT) and others assessing cognitive, motor, psychiatric, and sensory domains. RESULTS Of 340 iRBD participants (65 ± 10 years, 82% male), 93 (27%) met criteria for OH (ΔHR/ΔSBP 0.37 ± 0.28; range 0.0-1.57), and of these, 72 (77%) met criteria for OH with reduced HR augmentation (ΔHR/ΔSBP 0.28 ± 0.21; range 0.0-0.5). Supine hypertension (sHTN) was present in 72% of those with OH. Compared with iRBD participants without OH, those with OH were older, reported older age of RBD symptom onset, and had worse olfaction. There was no difference in autonomic symptom scores as measured by SCOPA-AUT. DISCUSSION OH and sHTN are common in iRBD. However, as patients may have reduced autonomic symptom awareness, orthostatic stand testing should be considered in clinical evaluations. Longitudinal studies are needed to clarify the relationship between OH and phenoconversion risk in iRBD. TRIAL REGISTRATION INFORMATION ClinicalTrials.gov: NCT03623672; North American Prodromal Synucleinopathy Consortium.
Collapse
Affiliation(s)
- Jonathan E Elliott
- Department of Neurology (J.E.E., M.M.L.), Oregon Health & Science University; Research Service (J.E.E., M.D.B.-E., A.T.K., B.R.L.), Mental Illness Research Education and Clinical Center (M.M.L.), Department of Neurology (M.M.L.), and National Center for Rehabilitative Auditory Research (M.M.L.), VA Portland Health Care System; Department of Behavioral Neuroscience (M.M.L.), Oregon Health & Science University; Oregon Institute of Occupational Health Sciences (M.M.L.), Oregon Health & Science University, Portland; Tel Aviv Sourasky Medical Center (J.Z.), Israel; Department of Psychiatry and Behavioral Sciences (E.H.D., M.G.M.), Stanford University Medical Center, Redwood City; Department of Neurology & Neurological Sciences (E.H.D., M.G.M.), Stanford University, Palo Alto, CA; Department of Psychology (J.-F.G., R.P.), Université du Québec à Montréal; Center for Advanced Research in Sleep Medicine (J.-F.G.), Hôpital du Sacré-Coeur de Montréal, Quebec, Canada; Mayo Clinic College of Medicine and Science (E.K.S.L., J.A.F., B.F.B.), Rochester, MN; Department of Neurology (D.E.H., D.L.B.), Emory University, Atlanta, GA; Sleep Medicine Program (A.Y.A.), Department of Neurology, David Geffen School of Medicine, University of California Los Angeles; Department of Psychiatry (C.H.S.), University of Minnesota Medical School, Minneapolis; Department of Neurology (J.M., S.R.C., A.A.D., Y.-E.S.J.), Washington University School of Medicine, St. Louis, MO; Movement Disorders Unit (A.V.), Division of Sleep Medicine, Massachusetts General Hospital; Neurological Clinical Research Institute (A.V.), Harvard Medical School, Boston, MA; Department of Neurology (J.K.L.-I.), Banner University Medical Center, Phoenix, AZ; Banner Sun Health Research Institute (J.K.L.-I.), Sun City, AZ; and Montréal Neurologique Institute (R.P.), McGill Université, Québec, Canada
| | - Mohini D Bryant-Ekstrand
- Department of Neurology (J.E.E., M.M.L.), Oregon Health & Science University; Research Service (J.E.E., M.D.B.-E., A.T.K., B.R.L.), Mental Illness Research Education and Clinical Center (M.M.L.), Department of Neurology (M.M.L.), and National Center for Rehabilitative Auditory Research (M.M.L.), VA Portland Health Care System; Department of Behavioral Neuroscience (M.M.L.), Oregon Health & Science University; Oregon Institute of Occupational Health Sciences (M.M.L.), Oregon Health & Science University, Portland; Tel Aviv Sourasky Medical Center (J.Z.), Israel; Department of Psychiatry and Behavioral Sciences (E.H.D., M.G.M.), Stanford University Medical Center, Redwood City; Department of Neurology & Neurological Sciences (E.H.D., M.G.M.), Stanford University, Palo Alto, CA; Department of Psychology (J.-F.G., R.P.), Université du Québec à Montréal; Center for Advanced Research in Sleep Medicine (J.-F.G.), Hôpital du Sacré-Coeur de Montréal, Quebec, Canada; Mayo Clinic College of Medicine and Science (E.K.S.L., J.A.F., B.F.B.), Rochester, MN; Department of Neurology (D.E.H., D.L.B.), Emory University, Atlanta, GA; Sleep Medicine Program (A.Y.A.), Department of Neurology, David Geffen School of Medicine, University of California Los Angeles; Department of Psychiatry (C.H.S.), University of Minnesota Medical School, Minneapolis; Department of Neurology (J.M., S.R.C., A.A.D., Y.-E.S.J.), Washington University School of Medicine, St. Louis, MO; Movement Disorders Unit (A.V.), Division of Sleep Medicine, Massachusetts General Hospital; Neurological Clinical Research Institute (A.V.), Harvard Medical School, Boston, MA; Department of Neurology (J.K.L.-I.), Banner University Medical Center, Phoenix, AZ; Banner Sun Health Research Institute (J.K.L.-I.), Sun City, AZ; and Montréal Neurologique Institute (R.P.), McGill Université, Québec, Canada
| | - Allison T Keil
- Department of Neurology (J.E.E., M.M.L.), Oregon Health & Science University; Research Service (J.E.E., M.D.B.-E., A.T.K., B.R.L.), Mental Illness Research Education and Clinical Center (M.M.L.), Department of Neurology (M.M.L.), and National Center for Rehabilitative Auditory Research (M.M.L.), VA Portland Health Care System; Department of Behavioral Neuroscience (M.M.L.), Oregon Health & Science University; Oregon Institute of Occupational Health Sciences (M.M.L.), Oregon Health & Science University, Portland; Tel Aviv Sourasky Medical Center (J.Z.), Israel; Department of Psychiatry and Behavioral Sciences (E.H.D., M.G.M.), Stanford University Medical Center, Redwood City; Department of Neurology & Neurological Sciences (E.H.D., M.G.M.), Stanford University, Palo Alto, CA; Department of Psychology (J.-F.G., R.P.), Université du Québec à Montréal; Center for Advanced Research in Sleep Medicine (J.-F.G.), Hôpital du Sacré-Coeur de Montréal, Quebec, Canada; Mayo Clinic College of Medicine and Science (E.K.S.L., J.A.F., B.F.B.), Rochester, MN; Department of Neurology (D.E.H., D.L.B.), Emory University, Atlanta, GA; Sleep Medicine Program (A.Y.A.), Department of Neurology, David Geffen School of Medicine, University of California Los Angeles; Department of Psychiatry (C.H.S.), University of Minnesota Medical School, Minneapolis; Department of Neurology (J.M., S.R.C., A.A.D., Y.-E.S.J.), Washington University School of Medicine, St. Louis, MO; Movement Disorders Unit (A.V.), Division of Sleep Medicine, Massachusetts General Hospital; Neurological Clinical Research Institute (A.V.), Harvard Medical School, Boston, MA; Department of Neurology (J.K.L.-I.), Banner University Medical Center, Phoenix, AZ; Banner Sun Health Research Institute (J.K.L.-I.), Sun City, AZ; and Montréal Neurologique Institute (R.P.), McGill Université, Québec, Canada
| | - Brittany R Ligman
- Department of Neurology (J.E.E., M.M.L.), Oregon Health & Science University; Research Service (J.E.E., M.D.B.-E., A.T.K., B.R.L.), Mental Illness Research Education and Clinical Center (M.M.L.), Department of Neurology (M.M.L.), and National Center for Rehabilitative Auditory Research (M.M.L.), VA Portland Health Care System; Department of Behavioral Neuroscience (M.M.L.), Oregon Health & Science University; Oregon Institute of Occupational Health Sciences (M.M.L.), Oregon Health & Science University, Portland; Tel Aviv Sourasky Medical Center (J.Z.), Israel; Department of Psychiatry and Behavioral Sciences (E.H.D., M.G.M.), Stanford University Medical Center, Redwood City; Department of Neurology & Neurological Sciences (E.H.D., M.G.M.), Stanford University, Palo Alto, CA; Department of Psychology (J.-F.G., R.P.), Université du Québec à Montréal; Center for Advanced Research in Sleep Medicine (J.-F.G.), Hôpital du Sacré-Coeur de Montréal, Quebec, Canada; Mayo Clinic College of Medicine and Science (E.K.S.L., J.A.F., B.F.B.), Rochester, MN; Department of Neurology (D.E.H., D.L.B.), Emory University, Atlanta, GA; Sleep Medicine Program (A.Y.A.), Department of Neurology, David Geffen School of Medicine, University of California Los Angeles; Department of Psychiatry (C.H.S.), University of Minnesota Medical School, Minneapolis; Department of Neurology (J.M., S.R.C., A.A.D., Y.-E.S.J.), Washington University School of Medicine, St. Louis, MO; Movement Disorders Unit (A.V.), Division of Sleep Medicine, Massachusetts General Hospital; Neurological Clinical Research Institute (A.V.), Harvard Medical School, Boston, MA; Department of Neurology (J.K.L.-I.), Banner University Medical Center, Phoenix, AZ; Banner Sun Health Research Institute (J.K.L.-I.), Sun City, AZ; and Montréal Neurologique Institute (R.P.), McGill Université, Québec, Canada
| | - Miranda M Lim
- Department of Neurology (J.E.E., M.M.L.), Oregon Health & Science University; Research Service (J.E.E., M.D.B.-E., A.T.K., B.R.L.), Mental Illness Research Education and Clinical Center (M.M.L.), Department of Neurology (M.M.L.), and National Center for Rehabilitative Auditory Research (M.M.L.), VA Portland Health Care System; Department of Behavioral Neuroscience (M.M.L.), Oregon Health & Science University; Oregon Institute of Occupational Health Sciences (M.M.L.), Oregon Health & Science University, Portland; Tel Aviv Sourasky Medical Center (J.Z.), Israel; Department of Psychiatry and Behavioral Sciences (E.H.D., M.G.M.), Stanford University Medical Center, Redwood City; Department of Neurology & Neurological Sciences (E.H.D., M.G.M.), Stanford University, Palo Alto, CA; Department of Psychology (J.-F.G., R.P.), Université du Québec à Montréal; Center for Advanced Research in Sleep Medicine (J.-F.G.), Hôpital du Sacré-Coeur de Montréal, Quebec, Canada; Mayo Clinic College of Medicine and Science (E.K.S.L., J.A.F., B.F.B.), Rochester, MN; Department of Neurology (D.E.H., D.L.B.), Emory University, Atlanta, GA; Sleep Medicine Program (A.Y.A.), Department of Neurology, David Geffen School of Medicine, University of California Los Angeles; Department of Psychiatry (C.H.S.), University of Minnesota Medical School, Minneapolis; Department of Neurology (J.M., S.R.C., A.A.D., Y.-E.S.J.), Washington University School of Medicine, St. Louis, MO; Movement Disorders Unit (A.V.), Division of Sleep Medicine, Massachusetts General Hospital; Neurological Clinical Research Institute (A.V.), Harvard Medical School, Boston, MA; Department of Neurology (J.K.L.-I.), Banner University Medical Center, Phoenix, AZ; Banner Sun Health Research Institute (J.K.L.-I.), Sun City, AZ; and Montréal Neurologique Institute (R.P.), McGill Université, Québec, Canada
| | - Jennifer Zitser
- Department of Neurology (J.E.E., M.M.L.), Oregon Health & Science University; Research Service (J.E.E., M.D.B.-E., A.T.K., B.R.L.), Mental Illness Research Education and Clinical Center (M.M.L.), Department of Neurology (M.M.L.), and National Center for Rehabilitative Auditory Research (M.M.L.), VA Portland Health Care System; Department of Behavioral Neuroscience (M.M.L.), Oregon Health & Science University; Oregon Institute of Occupational Health Sciences (M.M.L.), Oregon Health & Science University, Portland; Tel Aviv Sourasky Medical Center (J.Z.), Israel; Department of Psychiatry and Behavioral Sciences (E.H.D., M.G.M.), Stanford University Medical Center, Redwood City; Department of Neurology & Neurological Sciences (E.H.D., M.G.M.), Stanford University, Palo Alto, CA; Department of Psychology (J.-F.G., R.P.), Université du Québec à Montréal; Center for Advanced Research in Sleep Medicine (J.-F.G.), Hôpital du Sacré-Coeur de Montréal, Quebec, Canada; Mayo Clinic College of Medicine and Science (E.K.S.L., J.A.F., B.F.B.), Rochester, MN; Department of Neurology (D.E.H., D.L.B.), Emory University, Atlanta, GA; Sleep Medicine Program (A.Y.A.), Department of Neurology, David Geffen School of Medicine, University of California Los Angeles; Department of Psychiatry (C.H.S.), University of Minnesota Medical School, Minneapolis; Department of Neurology (J.M., S.R.C., A.A.D., Y.-E.S.J.), Washington University School of Medicine, St. Louis, MO; Movement Disorders Unit (A.V.), Division of Sleep Medicine, Massachusetts General Hospital; Neurological Clinical Research Institute (A.V.), Harvard Medical School, Boston, MA; Department of Neurology (J.K.L.-I.), Banner University Medical Center, Phoenix, AZ; Banner Sun Health Research Institute (J.K.L.-I.), Sun City, AZ; and Montréal Neurologique Institute (R.P.), McGill Université, Québec, Canada
| | - Emmanuel H During
- Department of Neurology (J.E.E., M.M.L.), Oregon Health & Science University; Research Service (J.E.E., M.D.B.-E., A.T.K., B.R.L.), Mental Illness Research Education and Clinical Center (M.M.L.), Department of Neurology (M.M.L.), and National Center for Rehabilitative Auditory Research (M.M.L.), VA Portland Health Care System; Department of Behavioral Neuroscience (M.M.L.), Oregon Health & Science University; Oregon Institute of Occupational Health Sciences (M.M.L.), Oregon Health & Science University, Portland; Tel Aviv Sourasky Medical Center (J.Z.), Israel; Department of Psychiatry and Behavioral Sciences (E.H.D., M.G.M.), Stanford University Medical Center, Redwood City; Department of Neurology & Neurological Sciences (E.H.D., M.G.M.), Stanford University, Palo Alto, CA; Department of Psychology (J.-F.G., R.P.), Université du Québec à Montréal; Center for Advanced Research in Sleep Medicine (J.-F.G.), Hôpital du Sacré-Coeur de Montréal, Quebec, Canada; Mayo Clinic College of Medicine and Science (E.K.S.L., J.A.F., B.F.B.), Rochester, MN; Department of Neurology (D.E.H., D.L.B.), Emory University, Atlanta, GA; Sleep Medicine Program (A.Y.A.), Department of Neurology, David Geffen School of Medicine, University of California Los Angeles; Department of Psychiatry (C.H.S.), University of Minnesota Medical School, Minneapolis; Department of Neurology (J.M., S.R.C., A.A.D., Y.-E.S.J.), Washington University School of Medicine, St. Louis, MO; Movement Disorders Unit (A.V.), Division of Sleep Medicine, Massachusetts General Hospital; Neurological Clinical Research Institute (A.V.), Harvard Medical School, Boston, MA; Department of Neurology (J.K.L.-I.), Banner University Medical Center, Phoenix, AZ; Banner Sun Health Research Institute (J.K.L.-I.), Sun City, AZ; and Montréal Neurologique Institute (R.P.), McGill Université, Québec, Canada
| | - Jean-Francois Gagnon
- Department of Neurology (J.E.E., M.M.L.), Oregon Health & Science University; Research Service (J.E.E., M.D.B.-E., A.T.K., B.R.L.), Mental Illness Research Education and Clinical Center (M.M.L.), Department of Neurology (M.M.L.), and National Center for Rehabilitative Auditory Research (M.M.L.), VA Portland Health Care System; Department of Behavioral Neuroscience (M.M.L.), Oregon Health & Science University; Oregon Institute of Occupational Health Sciences (M.M.L.), Oregon Health & Science University, Portland; Tel Aviv Sourasky Medical Center (J.Z.), Israel; Department of Psychiatry and Behavioral Sciences (E.H.D., M.G.M.), Stanford University Medical Center, Redwood City; Department of Neurology & Neurological Sciences (E.H.D., M.G.M.), Stanford University, Palo Alto, CA; Department of Psychology (J.-F.G., R.P.), Université du Québec à Montréal; Center for Advanced Research in Sleep Medicine (J.-F.G.), Hôpital du Sacré-Coeur de Montréal, Quebec, Canada; Mayo Clinic College of Medicine and Science (E.K.S.L., J.A.F., B.F.B.), Rochester, MN; Department of Neurology (D.E.H., D.L.B.), Emory University, Atlanta, GA; Sleep Medicine Program (A.Y.A.), Department of Neurology, David Geffen School of Medicine, University of California Los Angeles; Department of Psychiatry (C.H.S.), University of Minnesota Medical School, Minneapolis; Department of Neurology (J.M., S.R.C., A.A.D., Y.-E.S.J.), Washington University School of Medicine, St. Louis, MO; Movement Disorders Unit (A.V.), Division of Sleep Medicine, Massachusetts General Hospital; Neurological Clinical Research Institute (A.V.), Harvard Medical School, Boston, MA; Department of Neurology (J.K.L.-I.), Banner University Medical Center, Phoenix, AZ; Banner Sun Health Research Institute (J.K.L.-I.), Sun City, AZ; and Montréal Neurologique Institute (R.P.), McGill Université, Québec, Canada
| | - Erik K St Louis
- Department of Neurology (J.E.E., M.M.L.), Oregon Health & Science University; Research Service (J.E.E., M.D.B.-E., A.T.K., B.R.L.), Mental Illness Research Education and Clinical Center (M.M.L.), Department of Neurology (M.M.L.), and National Center for Rehabilitative Auditory Research (M.M.L.), VA Portland Health Care System; Department of Behavioral Neuroscience (M.M.L.), Oregon Health & Science University; Oregon Institute of Occupational Health Sciences (M.M.L.), Oregon Health & Science University, Portland; Tel Aviv Sourasky Medical Center (J.Z.), Israel; Department of Psychiatry and Behavioral Sciences (E.H.D., M.G.M.), Stanford University Medical Center, Redwood City; Department of Neurology & Neurological Sciences (E.H.D., M.G.M.), Stanford University, Palo Alto, CA; Department of Psychology (J.-F.G., R.P.), Université du Québec à Montréal; Center for Advanced Research in Sleep Medicine (J.-F.G.), Hôpital du Sacré-Coeur de Montréal, Quebec, Canada; Mayo Clinic College of Medicine and Science (E.K.S.L., J.A.F., B.F.B.), Rochester, MN; Department of Neurology (D.E.H., D.L.B.), Emory University, Atlanta, GA; Sleep Medicine Program (A.Y.A.), Department of Neurology, David Geffen School of Medicine, University of California Los Angeles; Department of Psychiatry (C.H.S.), University of Minnesota Medical School, Minneapolis; Department of Neurology (J.M., S.R.C., A.A.D., Y.-E.S.J.), Washington University School of Medicine, St. Louis, MO; Movement Disorders Unit (A.V.), Division of Sleep Medicine, Massachusetts General Hospital; Neurological Clinical Research Institute (A.V.), Harvard Medical School, Boston, MA; Department of Neurology (J.K.L.-I.), Banner University Medical Center, Phoenix, AZ; Banner Sun Health Research Institute (J.K.L.-I.), Sun City, AZ; and Montréal Neurologique Institute (R.P.), McGill Université, Québec, Canada
| | - Julie A Fields
- Department of Neurology (J.E.E., M.M.L.), Oregon Health & Science University; Research Service (J.E.E., M.D.B.-E., A.T.K., B.R.L.), Mental Illness Research Education and Clinical Center (M.M.L.), Department of Neurology (M.M.L.), and National Center for Rehabilitative Auditory Research (M.M.L.), VA Portland Health Care System; Department of Behavioral Neuroscience (M.M.L.), Oregon Health & Science University; Oregon Institute of Occupational Health Sciences (M.M.L.), Oregon Health & Science University, Portland; Tel Aviv Sourasky Medical Center (J.Z.), Israel; Department of Psychiatry and Behavioral Sciences (E.H.D., M.G.M.), Stanford University Medical Center, Redwood City; Department of Neurology & Neurological Sciences (E.H.D., M.G.M.), Stanford University, Palo Alto, CA; Department of Psychology (J.-F.G., R.P.), Université du Québec à Montréal; Center for Advanced Research in Sleep Medicine (J.-F.G.), Hôpital du Sacré-Coeur de Montréal, Quebec, Canada; Mayo Clinic College of Medicine and Science (E.K.S.L., J.A.F., B.F.B.), Rochester, MN; Department of Neurology (D.E.H., D.L.B.), Emory University, Atlanta, GA; Sleep Medicine Program (A.Y.A.), Department of Neurology, David Geffen School of Medicine, University of California Los Angeles; Department of Psychiatry (C.H.S.), University of Minnesota Medical School, Minneapolis; Department of Neurology (J.M., S.R.C., A.A.D., Y.-E.S.J.), Washington University School of Medicine, St. Louis, MO; Movement Disorders Unit (A.V.), Division of Sleep Medicine, Massachusetts General Hospital; Neurological Clinical Research Institute (A.V.), Harvard Medical School, Boston, MA; Department of Neurology (J.K.L.-I.), Banner University Medical Center, Phoenix, AZ; Banner Sun Health Research Institute (J.K.L.-I.), Sun City, AZ; and Montréal Neurologique Institute (R.P.), McGill Université, Québec, Canada
| | - Daniel E Huddleston
- Department of Neurology (J.E.E., M.M.L.), Oregon Health & Science University; Research Service (J.E.E., M.D.B.-E., A.T.K., B.R.L.), Mental Illness Research Education and Clinical Center (M.M.L.), Department of Neurology (M.M.L.), and National Center for Rehabilitative Auditory Research (M.M.L.), VA Portland Health Care System; Department of Behavioral Neuroscience (M.M.L.), Oregon Health & Science University; Oregon Institute of Occupational Health Sciences (M.M.L.), Oregon Health & Science University, Portland; Tel Aviv Sourasky Medical Center (J.Z.), Israel; Department of Psychiatry and Behavioral Sciences (E.H.D., M.G.M.), Stanford University Medical Center, Redwood City; Department of Neurology & Neurological Sciences (E.H.D., M.G.M.), Stanford University, Palo Alto, CA; Department of Psychology (J.-F.G., R.P.), Université du Québec à Montréal; Center for Advanced Research in Sleep Medicine (J.-F.G.), Hôpital du Sacré-Coeur de Montréal, Quebec, Canada; Mayo Clinic College of Medicine and Science (E.K.S.L., J.A.F., B.F.B.), Rochester, MN; Department of Neurology (D.E.H., D.L.B.), Emory University, Atlanta, GA; Sleep Medicine Program (A.Y.A.), Department of Neurology, David Geffen School of Medicine, University of California Los Angeles; Department of Psychiatry (C.H.S.), University of Minnesota Medical School, Minneapolis; Department of Neurology (J.M., S.R.C., A.A.D., Y.-E.S.J.), Washington University School of Medicine, St. Louis, MO; Movement Disorders Unit (A.V.), Division of Sleep Medicine, Massachusetts General Hospital; Neurological Clinical Research Institute (A.V.), Harvard Medical School, Boston, MA; Department of Neurology (J.K.L.-I.), Banner University Medical Center, Phoenix, AZ; Banner Sun Health Research Institute (J.K.L.-I.), Sun City, AZ; and Montréal Neurologique Institute (R.P.), McGill Université, Québec, Canada
| | - Donald L Bliwise
- Department of Neurology (J.E.E., M.M.L.), Oregon Health & Science University; Research Service (J.E.E., M.D.B.-E., A.T.K., B.R.L.), Mental Illness Research Education and Clinical Center (M.M.L.), Department of Neurology (M.M.L.), and National Center for Rehabilitative Auditory Research (M.M.L.), VA Portland Health Care System; Department of Behavioral Neuroscience (M.M.L.), Oregon Health & Science University; Oregon Institute of Occupational Health Sciences (M.M.L.), Oregon Health & Science University, Portland; Tel Aviv Sourasky Medical Center (J.Z.), Israel; Department of Psychiatry and Behavioral Sciences (E.H.D., M.G.M.), Stanford University Medical Center, Redwood City; Department of Neurology & Neurological Sciences (E.H.D., M.G.M.), Stanford University, Palo Alto, CA; Department of Psychology (J.-F.G., R.P.), Université du Québec à Montréal; Center for Advanced Research in Sleep Medicine (J.-F.G.), Hôpital du Sacré-Coeur de Montréal, Quebec, Canada; Mayo Clinic College of Medicine and Science (E.K.S.L., J.A.F., B.F.B.), Rochester, MN; Department of Neurology (D.E.H., D.L.B.), Emory University, Atlanta, GA; Sleep Medicine Program (A.Y.A.), Department of Neurology, David Geffen School of Medicine, University of California Los Angeles; Department of Psychiatry (C.H.S.), University of Minnesota Medical School, Minneapolis; Department of Neurology (J.M., S.R.C., A.A.D., Y.-E.S.J.), Washington University School of Medicine, St. Louis, MO; Movement Disorders Unit (A.V.), Division of Sleep Medicine, Massachusetts General Hospital; Neurological Clinical Research Institute (A.V.), Harvard Medical School, Boston, MA; Department of Neurology (J.K.L.-I.), Banner University Medical Center, Phoenix, AZ; Banner Sun Health Research Institute (J.K.L.-I.), Sun City, AZ; and Montréal Neurologique Institute (R.P.), McGill Université, Québec, Canada
| | - Alon Y Avidan
- Department of Neurology (J.E.E., M.M.L.), Oregon Health & Science University; Research Service (J.E.E., M.D.B.-E., A.T.K., B.R.L.), Mental Illness Research Education and Clinical Center (M.M.L.), Department of Neurology (M.M.L.), and National Center for Rehabilitative Auditory Research (M.M.L.), VA Portland Health Care System; Department of Behavioral Neuroscience (M.M.L.), Oregon Health & Science University; Oregon Institute of Occupational Health Sciences (M.M.L.), Oregon Health & Science University, Portland; Tel Aviv Sourasky Medical Center (J.Z.), Israel; Department of Psychiatry and Behavioral Sciences (E.H.D., M.G.M.), Stanford University Medical Center, Redwood City; Department of Neurology & Neurological Sciences (E.H.D., M.G.M.), Stanford University, Palo Alto, CA; Department of Psychology (J.-F.G., R.P.), Université du Québec à Montréal; Center for Advanced Research in Sleep Medicine (J.-F.G.), Hôpital du Sacré-Coeur de Montréal, Quebec, Canada; Mayo Clinic College of Medicine and Science (E.K.S.L., J.A.F., B.F.B.), Rochester, MN; Department of Neurology (D.E.H., D.L.B.), Emory University, Atlanta, GA; Sleep Medicine Program (A.Y.A.), Department of Neurology, David Geffen School of Medicine, University of California Los Angeles; Department of Psychiatry (C.H.S.), University of Minnesota Medical School, Minneapolis; Department of Neurology (J.M., S.R.C., A.A.D., Y.-E.S.J.), Washington University School of Medicine, St. Louis, MO; Movement Disorders Unit (A.V.), Division of Sleep Medicine, Massachusetts General Hospital; Neurological Clinical Research Institute (A.V.), Harvard Medical School, Boston, MA; Department of Neurology (J.K.L.-I.), Banner University Medical Center, Phoenix, AZ; Banner Sun Health Research Institute (J.K.L.-I.), Sun City, AZ; and Montréal Neurologique Institute (R.P.), McGill Université, Québec, Canada
| | - Carlos H Schenck
- Department of Neurology (J.E.E., M.M.L.), Oregon Health & Science University; Research Service (J.E.E., M.D.B.-E., A.T.K., B.R.L.), Mental Illness Research Education and Clinical Center (M.M.L.), Department of Neurology (M.M.L.), and National Center for Rehabilitative Auditory Research (M.M.L.), VA Portland Health Care System; Department of Behavioral Neuroscience (M.M.L.), Oregon Health & Science University; Oregon Institute of Occupational Health Sciences (M.M.L.), Oregon Health & Science University, Portland; Tel Aviv Sourasky Medical Center (J.Z.), Israel; Department of Psychiatry and Behavioral Sciences (E.H.D., M.G.M.), Stanford University Medical Center, Redwood City; Department of Neurology & Neurological Sciences (E.H.D., M.G.M.), Stanford University, Palo Alto, CA; Department of Psychology (J.-F.G., R.P.), Université du Québec à Montréal; Center for Advanced Research in Sleep Medicine (J.-F.G.), Hôpital du Sacré-Coeur de Montréal, Quebec, Canada; Mayo Clinic College of Medicine and Science (E.K.S.L., J.A.F., B.F.B.), Rochester, MN; Department of Neurology (D.E.H., D.L.B.), Emory University, Atlanta, GA; Sleep Medicine Program (A.Y.A.), Department of Neurology, David Geffen School of Medicine, University of California Los Angeles; Department of Psychiatry (C.H.S.), University of Minnesota Medical School, Minneapolis; Department of Neurology (J.M., S.R.C., A.A.D., Y.-E.S.J.), Washington University School of Medicine, St. Louis, MO; Movement Disorders Unit (A.V.), Division of Sleep Medicine, Massachusetts General Hospital; Neurological Clinical Research Institute (A.V.), Harvard Medical School, Boston, MA; Department of Neurology (J.K.L.-I.), Banner University Medical Center, Phoenix, AZ; Banner Sun Health Research Institute (J.K.L.-I.), Sun City, AZ; and Montréal Neurologique Institute (R.P.), McGill Université, Québec, Canada
| | - Jennifer McLeland
- Department of Neurology (J.E.E., M.M.L.), Oregon Health & Science University; Research Service (J.E.E., M.D.B.-E., A.T.K., B.R.L.), Mental Illness Research Education and Clinical Center (M.M.L.), Department of Neurology (M.M.L.), and National Center for Rehabilitative Auditory Research (M.M.L.), VA Portland Health Care System; Department of Behavioral Neuroscience (M.M.L.), Oregon Health & Science University; Oregon Institute of Occupational Health Sciences (M.M.L.), Oregon Health & Science University, Portland; Tel Aviv Sourasky Medical Center (J.Z.), Israel; Department of Psychiatry and Behavioral Sciences (E.H.D., M.G.M.), Stanford University Medical Center, Redwood City; Department of Neurology & Neurological Sciences (E.H.D., M.G.M.), Stanford University, Palo Alto, CA; Department of Psychology (J.-F.G., R.P.), Université du Québec à Montréal; Center for Advanced Research in Sleep Medicine (J.-F.G.), Hôpital du Sacré-Coeur de Montréal, Quebec, Canada; Mayo Clinic College of Medicine and Science (E.K.S.L., J.A.F., B.F.B.), Rochester, MN; Department of Neurology (D.E.H., D.L.B.), Emory University, Atlanta, GA; Sleep Medicine Program (A.Y.A.), Department of Neurology, David Geffen School of Medicine, University of California Los Angeles; Department of Psychiatry (C.H.S.), University of Minnesota Medical School, Minneapolis; Department of Neurology (J.M., S.R.C., A.A.D., Y.-E.S.J.), Washington University School of Medicine, St. Louis, MO; Movement Disorders Unit (A.V.), Division of Sleep Medicine, Massachusetts General Hospital; Neurological Clinical Research Institute (A.V.), Harvard Medical School, Boston, MA; Department of Neurology (J.K.L.-I.), Banner University Medical Center, Phoenix, AZ; Banner Sun Health Research Institute (J.K.L.-I.), Sun City, AZ; and Montréal Neurologique Institute (R.P.), McGill Université, Québec, Canada
| | - Susan R Criswell
- Department of Neurology (J.E.E., M.M.L.), Oregon Health & Science University; Research Service (J.E.E., M.D.B.-E., A.T.K., B.R.L.), Mental Illness Research Education and Clinical Center (M.M.L.), Department of Neurology (M.M.L.), and National Center for Rehabilitative Auditory Research (M.M.L.), VA Portland Health Care System; Department of Behavioral Neuroscience (M.M.L.), Oregon Health & Science University; Oregon Institute of Occupational Health Sciences (M.M.L.), Oregon Health & Science University, Portland; Tel Aviv Sourasky Medical Center (J.Z.), Israel; Department of Psychiatry and Behavioral Sciences (E.H.D., M.G.M.), Stanford University Medical Center, Redwood City; Department of Neurology & Neurological Sciences (E.H.D., M.G.M.), Stanford University, Palo Alto, CA; Department of Psychology (J.-F.G., R.P.), Université du Québec à Montréal; Center for Advanced Research in Sleep Medicine (J.-F.G.), Hôpital du Sacré-Coeur de Montréal, Quebec, Canada; Mayo Clinic College of Medicine and Science (E.K.S.L., J.A.F., B.F.B.), Rochester, MN; Department of Neurology (D.E.H., D.L.B.), Emory University, Atlanta, GA; Sleep Medicine Program (A.Y.A.), Department of Neurology, David Geffen School of Medicine, University of California Los Angeles; Department of Psychiatry (C.H.S.), University of Minnesota Medical School, Minneapolis; Department of Neurology (J.M., S.R.C., A.A.D., Y.-E.S.J.), Washington University School of Medicine, St. Louis, MO; Movement Disorders Unit (A.V.), Division of Sleep Medicine, Massachusetts General Hospital; Neurological Clinical Research Institute (A.V.), Harvard Medical School, Boston, MA; Department of Neurology (J.K.L.-I.), Banner University Medical Center, Phoenix, AZ; Banner Sun Health Research Institute (J.K.L.-I.), Sun City, AZ; and Montréal Neurologique Institute (R.P.), McGill Université, Québec, Canada
| | - Albert A Davis
- Department of Neurology (J.E.E., M.M.L.), Oregon Health & Science University; Research Service (J.E.E., M.D.B.-E., A.T.K., B.R.L.), Mental Illness Research Education and Clinical Center (M.M.L.), Department of Neurology (M.M.L.), and National Center for Rehabilitative Auditory Research (M.M.L.), VA Portland Health Care System; Department of Behavioral Neuroscience (M.M.L.), Oregon Health & Science University; Oregon Institute of Occupational Health Sciences (M.M.L.), Oregon Health & Science University, Portland; Tel Aviv Sourasky Medical Center (J.Z.), Israel; Department of Psychiatry and Behavioral Sciences (E.H.D., M.G.M.), Stanford University Medical Center, Redwood City; Department of Neurology & Neurological Sciences (E.H.D., M.G.M.), Stanford University, Palo Alto, CA; Department of Psychology (J.-F.G., R.P.), Université du Québec à Montréal; Center for Advanced Research in Sleep Medicine (J.-F.G.), Hôpital du Sacré-Coeur de Montréal, Quebec, Canada; Mayo Clinic College of Medicine and Science (E.K.S.L., J.A.F., B.F.B.), Rochester, MN; Department of Neurology (D.E.H., D.L.B.), Emory University, Atlanta, GA; Sleep Medicine Program (A.Y.A.), Department of Neurology, David Geffen School of Medicine, University of California Los Angeles; Department of Psychiatry (C.H.S.), University of Minnesota Medical School, Minneapolis; Department of Neurology (J.M., S.R.C., A.A.D., Y.-E.S.J.), Washington University School of Medicine, St. Louis, MO; Movement Disorders Unit (A.V.), Division of Sleep Medicine, Massachusetts General Hospital; Neurological Clinical Research Institute (A.V.), Harvard Medical School, Boston, MA; Department of Neurology (J.K.L.-I.), Banner University Medical Center, Phoenix, AZ; Banner Sun Health Research Institute (J.K.L.-I.), Sun City, AZ; and Montréal Neurologique Institute (R.P.), McGill Université, Québec, Canada
| | - Aleksandar Videnovic
- Department of Neurology (J.E.E., M.M.L.), Oregon Health & Science University; Research Service (J.E.E., M.D.B.-E., A.T.K., B.R.L.), Mental Illness Research Education and Clinical Center (M.M.L.), Department of Neurology (M.M.L.), and National Center for Rehabilitative Auditory Research (M.M.L.), VA Portland Health Care System; Department of Behavioral Neuroscience (M.M.L.), Oregon Health & Science University; Oregon Institute of Occupational Health Sciences (M.M.L.), Oregon Health & Science University, Portland; Tel Aviv Sourasky Medical Center (J.Z.), Israel; Department of Psychiatry and Behavioral Sciences (E.H.D., M.G.M.), Stanford University Medical Center, Redwood City; Department of Neurology & Neurological Sciences (E.H.D., M.G.M.), Stanford University, Palo Alto, CA; Department of Psychology (J.-F.G., R.P.), Université du Québec à Montréal; Center for Advanced Research in Sleep Medicine (J.-F.G.), Hôpital du Sacré-Coeur de Montréal, Quebec, Canada; Mayo Clinic College of Medicine and Science (E.K.S.L., J.A.F., B.F.B.), Rochester, MN; Department of Neurology (D.E.H., D.L.B.), Emory University, Atlanta, GA; Sleep Medicine Program (A.Y.A.), Department of Neurology, David Geffen School of Medicine, University of California Los Angeles; Department of Psychiatry (C.H.S.), University of Minnesota Medical School, Minneapolis; Department of Neurology (J.M., S.R.C., A.A.D., Y.-E.S.J.), Washington University School of Medicine, St. Louis, MO; Movement Disorders Unit (A.V.), Division of Sleep Medicine, Massachusetts General Hospital; Neurological Clinical Research Institute (A.V.), Harvard Medical School, Boston, MA; Department of Neurology (J.K.L.-I.), Banner University Medical Center, Phoenix, AZ; Banner Sun Health Research Institute (J.K.L.-I.), Sun City, AZ; and Montréal Neurologique Institute (R.P.), McGill Université, Québec, Canada
| | - Joyce K Lee-Iannotti
- Department of Neurology (J.E.E., M.M.L.), Oregon Health & Science University; Research Service (J.E.E., M.D.B.-E., A.T.K., B.R.L.), Mental Illness Research Education and Clinical Center (M.M.L.), Department of Neurology (M.M.L.), and National Center for Rehabilitative Auditory Research (M.M.L.), VA Portland Health Care System; Department of Behavioral Neuroscience (M.M.L.), Oregon Health & Science University; Oregon Institute of Occupational Health Sciences (M.M.L.), Oregon Health & Science University, Portland; Tel Aviv Sourasky Medical Center (J.Z.), Israel; Department of Psychiatry and Behavioral Sciences (E.H.D., M.G.M.), Stanford University Medical Center, Redwood City; Department of Neurology & Neurological Sciences (E.H.D., M.G.M.), Stanford University, Palo Alto, CA; Department of Psychology (J.-F.G., R.P.), Université du Québec à Montréal; Center for Advanced Research in Sleep Medicine (J.-F.G.), Hôpital du Sacré-Coeur de Montréal, Quebec, Canada; Mayo Clinic College of Medicine and Science (E.K.S.L., J.A.F., B.F.B.), Rochester, MN; Department of Neurology (D.E.H., D.L.B.), Emory University, Atlanta, GA; Sleep Medicine Program (A.Y.A.), Department of Neurology, David Geffen School of Medicine, University of California Los Angeles; Department of Psychiatry (C.H.S.), University of Minnesota Medical School, Minneapolis; Department of Neurology (J.M., S.R.C., A.A.D., Y.-E.S.J.), Washington University School of Medicine, St. Louis, MO; Movement Disorders Unit (A.V.), Division of Sleep Medicine, Massachusetts General Hospital; Neurological Clinical Research Institute (A.V.), Harvard Medical School, Boston, MA; Department of Neurology (J.K.L.-I.), Banner University Medical Center, Phoenix, AZ; Banner Sun Health Research Institute (J.K.L.-I.), Sun City, AZ; and Montréal Neurologique Institute (R.P.), McGill Université, Québec, Canada
| | - Ronald Postuma
- Department of Neurology (J.E.E., M.M.L.), Oregon Health & Science University; Research Service (J.E.E., M.D.B.-E., A.T.K., B.R.L.), Mental Illness Research Education and Clinical Center (M.M.L.), Department of Neurology (M.M.L.), and National Center for Rehabilitative Auditory Research (M.M.L.), VA Portland Health Care System; Department of Behavioral Neuroscience (M.M.L.), Oregon Health & Science University; Oregon Institute of Occupational Health Sciences (M.M.L.), Oregon Health & Science University, Portland; Tel Aviv Sourasky Medical Center (J.Z.), Israel; Department of Psychiatry and Behavioral Sciences (E.H.D., M.G.M.), Stanford University Medical Center, Redwood City; Department of Neurology & Neurological Sciences (E.H.D., M.G.M.), Stanford University, Palo Alto, CA; Department of Psychology (J.-F.G., R.P.), Université du Québec à Montréal; Center for Advanced Research in Sleep Medicine (J.-F.G.), Hôpital du Sacré-Coeur de Montréal, Quebec, Canada; Mayo Clinic College of Medicine and Science (E.K.S.L., J.A.F., B.F.B.), Rochester, MN; Department of Neurology (D.E.H., D.L.B.), Emory University, Atlanta, GA; Sleep Medicine Program (A.Y.A.), Department of Neurology, David Geffen School of Medicine, University of California Los Angeles; Department of Psychiatry (C.H.S.), University of Minnesota Medical School, Minneapolis; Department of Neurology (J.M., S.R.C., A.A.D., Y.-E.S.J.), Washington University School of Medicine, St. Louis, MO; Movement Disorders Unit (A.V.), Division of Sleep Medicine, Massachusetts General Hospital; Neurological Clinical Research Institute (A.V.), Harvard Medical School, Boston, MA; Department of Neurology (J.K.L.-I.), Banner University Medical Center, Phoenix, AZ; Banner Sun Health Research Institute (J.K.L.-I.), Sun City, AZ; and Montréal Neurologique Institute (R.P.), McGill Université, Québec, Canada
| | - Bradley F Boeve
- Department of Neurology (J.E.E., M.M.L.), Oregon Health & Science University; Research Service (J.E.E., M.D.B.-E., A.T.K., B.R.L.), Mental Illness Research Education and Clinical Center (M.M.L.), Department of Neurology (M.M.L.), and National Center for Rehabilitative Auditory Research (M.M.L.), VA Portland Health Care System; Department of Behavioral Neuroscience (M.M.L.), Oregon Health & Science University; Oregon Institute of Occupational Health Sciences (M.M.L.), Oregon Health & Science University, Portland; Tel Aviv Sourasky Medical Center (J.Z.), Israel; Department of Psychiatry and Behavioral Sciences (E.H.D., M.G.M.), Stanford University Medical Center, Redwood City; Department of Neurology & Neurological Sciences (E.H.D., M.G.M.), Stanford University, Palo Alto, CA; Department of Psychology (J.-F.G., R.P.), Université du Québec à Montréal; Center for Advanced Research in Sleep Medicine (J.-F.G.), Hôpital du Sacré-Coeur de Montréal, Quebec, Canada; Mayo Clinic College of Medicine and Science (E.K.S.L., J.A.F., B.F.B.), Rochester, MN; Department of Neurology (D.E.H., D.L.B.), Emory University, Atlanta, GA; Sleep Medicine Program (A.Y.A.), Department of Neurology, David Geffen School of Medicine, University of California Los Angeles; Department of Psychiatry (C.H.S.), University of Minnesota Medical School, Minneapolis; Department of Neurology (J.M., S.R.C., A.A.D., Y.-E.S.J.), Washington University School of Medicine, St. Louis, MO; Movement Disorders Unit (A.V.), Division of Sleep Medicine, Massachusetts General Hospital; Neurological Clinical Research Institute (A.V.), Harvard Medical School, Boston, MA; Department of Neurology (J.K.L.-I.), Banner University Medical Center, Phoenix, AZ; Banner Sun Health Research Institute (J.K.L.-I.), Sun City, AZ; and Montréal Neurologique Institute (R.P.), McGill Université, Québec, Canada
| | - Yo-El S Ju
- Department of Neurology (J.E.E., M.M.L.), Oregon Health & Science University; Research Service (J.E.E., M.D.B.-E., A.T.K., B.R.L.), Mental Illness Research Education and Clinical Center (M.M.L.), Department of Neurology (M.M.L.), and National Center for Rehabilitative Auditory Research (M.M.L.), VA Portland Health Care System; Department of Behavioral Neuroscience (M.M.L.), Oregon Health & Science University; Oregon Institute of Occupational Health Sciences (M.M.L.), Oregon Health & Science University, Portland; Tel Aviv Sourasky Medical Center (J.Z.), Israel; Department of Psychiatry and Behavioral Sciences (E.H.D., M.G.M.), Stanford University Medical Center, Redwood City; Department of Neurology & Neurological Sciences (E.H.D., M.G.M.), Stanford University, Palo Alto, CA; Department of Psychology (J.-F.G., R.P.), Université du Québec à Montréal; Center for Advanced Research in Sleep Medicine (J.-F.G.), Hôpital du Sacré-Coeur de Montréal, Quebec, Canada; Mayo Clinic College of Medicine and Science (E.K.S.L., J.A.F., B.F.B.), Rochester, MN; Department of Neurology (D.E.H., D.L.B.), Emory University, Atlanta, GA; Sleep Medicine Program (A.Y.A.), Department of Neurology, David Geffen School of Medicine, University of California Los Angeles; Department of Psychiatry (C.H.S.), University of Minnesota Medical School, Minneapolis; Department of Neurology (J.M., S.R.C., A.A.D., Y.-E.S.J.), Washington University School of Medicine, St. Louis, MO; Movement Disorders Unit (A.V.), Division of Sleep Medicine, Massachusetts General Hospital; Neurological Clinical Research Institute (A.V.), Harvard Medical School, Boston, MA; Department of Neurology (J.K.L.-I.), Banner University Medical Center, Phoenix, AZ; Banner Sun Health Research Institute (J.K.L.-I.), Sun City, AZ; and Montréal Neurologique Institute (R.P.), McGill Université, Québec, Canada
| | - Mitchell G Miglis
- Department of Neurology (J.E.E., M.M.L.), Oregon Health & Science University; Research Service (J.E.E., M.D.B.-E., A.T.K., B.R.L.), Mental Illness Research Education and Clinical Center (M.M.L.), Department of Neurology (M.M.L.), and National Center for Rehabilitative Auditory Research (M.M.L.), VA Portland Health Care System; Department of Behavioral Neuroscience (M.M.L.), Oregon Health & Science University; Oregon Institute of Occupational Health Sciences (M.M.L.), Oregon Health & Science University, Portland; Tel Aviv Sourasky Medical Center (J.Z.), Israel; Department of Psychiatry and Behavioral Sciences (E.H.D., M.G.M.), Stanford University Medical Center, Redwood City; Department of Neurology & Neurological Sciences (E.H.D., M.G.M.), Stanford University, Palo Alto, CA; Department of Psychology (J.-F.G., R.P.), Université du Québec à Montréal; Center for Advanced Research in Sleep Medicine (J.-F.G.), Hôpital du Sacré-Coeur de Montréal, Quebec, Canada; Mayo Clinic College of Medicine and Science (E.K.S.L., J.A.F., B.F.B.), Rochester, MN; Department of Neurology (D.E.H., D.L.B.), Emory University, Atlanta, GA; Sleep Medicine Program (A.Y.A.), Department of Neurology, David Geffen School of Medicine, University of California Los Angeles; Department of Psychiatry (C.H.S.), University of Minnesota Medical School, Minneapolis; Department of Neurology (J.M., S.R.C., A.A.D., Y.-E.S.J.), Washington University School of Medicine, St. Louis, MO; Movement Disorders Unit (A.V.), Division of Sleep Medicine, Massachusetts General Hospital; Neurological Clinical Research Institute (A.V.), Harvard Medical School, Boston, MA; Department of Neurology (J.K.L.-I.), Banner University Medical Center, Phoenix, AZ; Banner Sun Health Research Institute (J.K.L.-I.), Sun City, AZ; and Montréal Neurologique Institute (R.P.), McGill Université, Québec, Canada
| |
Collapse
|
49
|
Qamar MA, Tall P, van Wamelen D, Wan YM, Rukavina K, Fieldwalker A, Matthew D, Leta V, Bannister K, Chaudhuri KR. Setting the clinical context to non-motor symptoms reflected by Park-pain, Park-sleep, and Park-autonomic subtypes of Parkinson's disease. INTERNATIONAL REVIEW OF NEUROBIOLOGY 2023; 174:1-58. [PMID: 38341227 DOI: 10.1016/bs.irn.2023.08.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/12/2024]
Abstract
Non-motor symptoms (NMS) of Parkinson's disease (PD) are well described in both clinical practice and the literature, enabling their management and enhancing our understanding of PD. NMS can dominate the clinical pictures and NMS subtypes have recently been proposed, initially based on clinical observations, and later confirmed in data driven analyses of large datasets and in biomarker-based studies. In this chapter, we provide an update on what is known about three common subtypes of NMS in PD. The pain (Park-pain), sleep dysfunction (Park-sleep), and autonomic dysfunction (Park-autonomic), providing an overview of their individual classification, clinical manifestation, pathophysiology, diagnosis, and potential treatments.
Collapse
Affiliation(s)
- Mubasher A Qamar
- Department of Basic and Clinical Neuroscience, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, United Kingdom; Parkinson's Foundation Centre of Excellence and Department of Neurology and Neurosciences, King's College Hospital NHS Trust, London, United Kingdom.
| | - Phoebe Tall
- Department of Basic and Clinical Neuroscience, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, United Kingdom; Parkinson's Foundation Centre of Excellence and Department of Neurology and Neurosciences, King's College Hospital NHS Trust, London, United Kingdom
| | - Daniel van Wamelen
- Parkinson's Foundation Centre of Excellence and Department of Neurology and Neurosciences, King's College Hospital NHS Trust, London, United Kingdom; Department of Neuroimaging, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom; Radboud University Medical Center, Donders Institute for Brain, Cognition and Behaviour, Department of Neurology, Centre of Expertise for Parkinson & Movement Disorders, Nijmegen, The Netherlands
| | - Yi Min Wan
- Department of Basic and Clinical Neuroscience, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, United Kingdom; Parkinson's Foundation Centre of Excellence and Department of Neurology and Neurosciences, King's College Hospital NHS Trust, London, United Kingdom; Department of Psychiatry, Ng Teng Fong General Hospital, Singapore, Singapore
| | - Katarina Rukavina
- Department of Basic and Clinical Neuroscience, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, United Kingdom; Parkinson's Foundation Centre of Excellence and Department of Neurology and Neurosciences, King's College Hospital NHS Trust, London, United Kingdom
| | - Anna Fieldwalker
- Department of Basic and Clinical Neuroscience, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, United Kingdom; Central Modulation of Pain Lab, Wolfson Centre for Age-Related Diseases, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Donna Matthew
- Department of Basic and Clinical Neuroscience, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, United Kingdom; Parkinson's Foundation Centre of Excellence and Department of Neurology and Neurosciences, King's College Hospital NHS Trust, London, United Kingdom
| | - Valentina Leta
- Department of Basic and Clinical Neuroscience, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, United Kingdom; Parkinson's Foundation Centre of Excellence and Department of Neurology and Neurosciences, King's College Hospital NHS Trust, London, United Kingdom; Department of Clinical Neurosciences, Parkinson, and Movement Disorders Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Kirsty Bannister
- Central Modulation of Pain Lab, Wolfson Centre for Age-Related Diseases, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - K Ray Chaudhuri
- Department of Basic and Clinical Neuroscience, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, United Kingdom; Parkinson's Foundation Centre of Excellence and Department of Neurology and Neurosciences, King's College Hospital NHS Trust, London, United Kingdom
| |
Collapse
|
50
|
Sobreira-Neto MA, Stelzer FG, Gitaí LLG, Alves RC, Eckeli AL, Schenck CH. REM sleep behavior disorder: update on diagnosis and management. ARQUIVOS DE NEURO-PSIQUIATRIA 2023; 81:1179-1194. [PMID: 38157884 PMCID: PMC10756822 DOI: 10.1055/s-0043-1777111] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Accepted: 09/17/2023] [Indexed: 01/03/2024]
Abstract
REM sleep behavior disorder (RBD) is characterized by a loss of atonia of skeletal muscles during REM sleep, associated with acting out behaviors during dreams. Knowledge of this pathology is important to predict neurodegenerative diseases since there is a strong association of RBD with diseases caused by the deposition of alpha-synuclein in neurons (synucleinopathies), such as Parkinson's disease (PD), multiple system atrophy (MSA), and dementia with Lewy bodies (DLB). Proper diagnosis of this condition will enable the use of future neuroprotective strategies before motor and cognitive symptoms. Diagnostic assessment should begin with a detailed clinical history with the patient and bed partner or roommate and the examination of any recorded home videos. Polysomnography (PSG) is necessary to verify the loss of sleep atonia and, when documented, the behaviors during sleep. Technical recommendations for PSG acquisition and analysis are defined in the AASM Manual for the scoring of sleep and associated events, and the PSG report should describe the percentage of REM sleep epochs that meet the criteria for RWA (REM without atonia) to better distinguish patients with and without RBD. Additionally, PSG helps rule out conditions that may mimic RBD, such as obstructive sleep apnea, non-REM sleep parasomnias, nocturnal epileptic seizures, periodic limb movements, and psychiatric disorders. Treatment of RBD involves guidance on protecting the environment and avoiding injuries to the patient and bed partner/roommate. Use of medications are also reviewed in the article. The development of neuroprotective medications will be crucial for future RBD therapy.
Collapse
Affiliation(s)
| | - Fernando Gustavo Stelzer
- Univeridade de São Paulo, Ribeirão Preto Medical School, Department of Neurosciences and Behavioral Sciences, Ribeirão Preto SP, Brazil.
| | - Lívia Leite Góes Gitaí
- Universidade Federal de Alagoas, Faculty of Medicine, Division of Neurology, Maceió AL, Brazil.
| | | | - Alan Luiz Eckeli
- Univeridade de São Paulo, Ribeirão Preto Medical School, Department of Neurosciences and Behavioral Sciences, Ribeirão Preto SP, Brazil.
| | - Carlos H. Schenck
- Minnesota Regional Sleep Disorders Center; and University of Minnesota, Medical School, Departments of Psychiatry; and Hennepin County Medical Center, Minneapolis MN, United States of America.
| |
Collapse
|