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Lahlou S, Kaminska M, Doyon J, Carrier J, Sharp M. Sleep spindle density and temporal clustering are associated with sleep-dependent memory consolidation in Parkinson's disease. J Clin Sleep Med 2024; 20:1153-1162. [PMID: 38427318 PMCID: PMC11217638 DOI: 10.5664/jcsm.11080] [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: 11/01/2023] [Revised: 02/20/2024] [Accepted: 02/20/2024] [Indexed: 03/02/2024]
Abstract
STUDY OBJECTIVES Sleep is required for successful memory consolidation. Sleep spindles, bursts of oscillatory activity occurring during non-rapid eye movement sleep, are known to be crucial for this process and, recently, it has been proposed that the temporal organization of spindles into clusters might additionally play a role in memory consolidation. In Parkinson's disease, spindle activity is reduced, and this reduction has been found to be predictive of cognitive decline. However, it remains unknown whether alterations in sleep spindles in Parkinson's disease are predictive of sleep-dependent cognitive processes such as memory consolidation, leaving open questions about the possible mechanisms linking sleep and a more general cognitive state in Parkinson's patients. METHODS The current study sought to fill this gap by recording overnight polysomnography and measuring overnight declarative memory consolidation in a sample of 35 patients with Parkinson's. Memory consolidation was measured using a verbal paired-associates task administered before and after the night of recorded sleep. RESULTS We found that lower sleep spindle density at frontal leads during non-rapid eye movement stage 3 was associated with worse overnight declarative memory consolidation. We also found that patients who showed less temporal clustering of spindles exhibited worse declarative memory consolidation. CONCLUSIONS These results suggest alterations to sleep spindles, which are known to be a consequence of Parkinson's disease, might represent a mechanism by which poor sleep leads to worse cognitive function in Parkinson's patients. CITATION Lahlou S, Kaminska M, Doyon J, Carrier J, Sharp M. Sleep spindle density and temporal clustering are associated with sleep-dependent memory consolidation in Parkinson's disease. J Clin Sleep Med. 2024;20(7):1153-1162.
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Affiliation(s)
- Soraya Lahlou
- Department of Neurology and Neurosurgery, Montreal Neurological Institute, McGill University, Montreal, Canada
| | - Marta Kaminska
- Department of Medicine, McGill University, Montreal, Canada
| | - Julien Doyon
- Department of Neurology and Neurosurgery, Montreal Neurological Institute, McGill University, Montreal, Canada
| | - Julie Carrier
- Department of Psychology, Université de Montréal, Montreal, Canada
| | - Madeleine Sharp
- Department of Neurology and Neurosurgery, Montreal Neurological Institute, McGill University, Montreal, Canada
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Hauser RA, Videnovic A, Soares-da-Silva P, Liang GS, Olson K, Jen E, Rocha JF, Klepitskaya O. OFF-times before, during, and after nighttime sleep periods in Parkinson's disease patients with motor fluctuations and the effects of opicapone: A post hoc analysis of diary data from BIPARK-1 and -2. Parkinsonism Relat Disord 2024; 123:106971. [PMID: 38631081 DOI: 10.1016/j.parkreldis.2024.106971] [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: 02/09/2024] [Revised: 04/05/2024] [Accepted: 04/07/2024] [Indexed: 04/19/2024]
Abstract
INTRODUCTION In BIPARK-1 and BIPARK-2, addition of once-daily opicapone to levodopa/carbidopa significantly reduced daily "OFF"-time relative to placebo in adults with Parkinson's disease (PD) and motor fluctuations. Diary data from these studies were pooled and analyzed post hoc to characterize "OFF"-times around nighttime sleep and to explore the effects of opicapone 50 mg. METHODS "OFF" before sleep (OBS), "OFF during the nighttime sleep period" (ODNSP), early morning "OFF" (EMO), and duration of nighttime sleep and awake periods were analyzed descriptively at baseline. Mean changes from baseline to Week 14/15 (end of double-blind treatment) were analyzed using two-sided t-tests in participants with data for both visits. RESULTS At baseline, 88.3 % (454/514) of participants reported having OBS (34.0 %), ODNSP (17.1 %), or EMO (79.6 %). Those with ODNSP had substantially shorter mean duration of uninterrupted sleep (4.4 h) than the overall pooled population (7.1 h). At Week 14/15, mean decrease from baseline in ODNSP duration was significantly greater with opicapone than with placebo (-0.9 vs. -0.4 h, P < 0.05). In participants with ODNSP at baseline, the decrease in total time spent awake during the night-time sleep period was significantly greater with opicapone than with placebo (-1.0 vs. -0.4 h, P < 0.05), as was the reduction in percent time spent awake during the night-time sleep period (-12.8 % vs. -4.5 %, P < 0.05). CONCLUSION "OFF"-times around nighttime sleep were common in BIPARK-1 and BIPARK-2. Opicapone may improve sleep by decreasing the amount of time spent awake during the night in patients with PD who have night-time sleep period "OFF" episodes.
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Affiliation(s)
- Robert A Hauser
- University of South Florida, Parkinson's Disease & Movement Disorders Center, 4001 E. Fletcher Ave, 6th Floor, Tampa, FL, 33613, USA.
| | - Aleksandar Videnovic
- Department of Neurology, Harvard Medical School, Massachusetts General Hospital, 165 Cambridge Street, Suite 650, Boston, MA, 02214, USA
| | - Patrício Soares-da-Silva
- BIAL-Portela & C(a), S.A., À Avenida da Siderurgia Nacional, 4745-457, Coronado, Portugal; University of Porto, Praça Gomes Teixeira, 4099-002, Porto, Portugal
| | - Grace S Liang
- Neurocrine Biosciences, Inc., 12780 El Camino Real, San Diego, CA, 92130, USA
| | - Kurt Olson
- Neurocrine Biosciences, Inc., 12780 El Camino Real, San Diego, CA, 92130, USA
| | - Eric Jen
- Neurocrine Biosciences, Inc., 12780 El Camino Real, San Diego, CA, 92130, USA
| | - José-Francisco Rocha
- BIAL-Portela & C(a), S.A., À Avenida da Siderurgia Nacional, 4745-457, Coronado, Portugal
| | - Olga Klepitskaya
- Neurocrine Biosciences, Inc., 12780 El Camino Real, San Diego, CA, 92130, USA
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Obayashi K, Saeki K, Tai Y, Yamagami Y, Esaki Y, Yoshikawa T, Sugie K, Kataoka H. Daily light exposure profiles and the association with objective sleep quality in patients with Parkinson's disease: The PHASE study. Sleep 2024:zsae036. [PMID: 38330229 DOI: 10.1093/sleep/zsae036] [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: 07/22/2023] [Indexed: 02/10/2024] Open
Abstract
STUDY OBJECTIVES Light information crucially influences the sleep initiation and continuity. The purpose of this study was to compare daily light exposure between patients with Parkinson's disease (PD) and non-PD older adults and evaluate the association of daily light exposure with objective sleep measures in patients with PD. METHODS In this cross-sectional study of 189 outpatients with PD and 1101 community dwelling older adults (controls), daily light exposure was measured using wrist light meters during the daytime and light meters set in the bedrooms during the nighttime, and objective sleep quality was measured by wrist actigraphy. RESULTS The median duration of exposure to ≥1000 lux light was significantly shorter in patients with PD than in controls. The median nighttime light intensity was higher in patients with PD than in controls. Among patients with PD, multivariable analysis suggested that the highest quartile of exposure to ≥1000 lux light during the daytime was linked to significantly higher sleep efficiency by 8.0% and shorter wake after sleep onset (WASO) by 36.9 min than the lowest quartile. During the nighttime, the highest quartile of mean light intensity had significantly lower sleep efficiency by 6.8%, longer WASO by 24.1 min, longer sleep onset latency, and higher fragmentation index, than the lowest quartile. Importantly, daytime and nighttime light levels were independently associated with objective sleep measures. CONCLUSION The present study illustrated that greater daytime light exposure and lower nighttime light exposure are significantly associated with better objective sleep measures in patients with PD.
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Affiliation(s)
- Kenji Obayashi
- Department of Epidemiology, Nara Medical University School of Medicine, Nara, Japan
| | - Keigo Saeki
- Department of Epidemiology, Nara Medical University School of Medicine, Nara, Japan
| | - Yoshiaki Tai
- Department of Epidemiology, Nara Medical University School of Medicine, Nara, Japan
| | - Yuki Yamagami
- Department of Epidemiology, Nara Medical University School of Medicine, Nara, Japan
| | - Yuichi Esaki
- Department of Psychiatry, Fujita Medical University School of Medicine, Aichi, Japan
| | - Tadanobu Yoshikawa
- Department of Ophthalmology, Nara Medical University School of Medicine, Nara, Japan
| | - Kazuma Sugie
- Department of Neurology, Nara Medical University School of Medicine, Nara, Japan
| | - Hiroshi Kataoka
- Department of Neurology, Nara Medical University School of Medicine, Nara, Japan
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Yin Z, Ma R, An Q, Xu Y, Gan Y, Zhu G, Jiang Y, Zhang N, Yang A, Meng F, Kühn AA, Bergman H, Neumann WJ, Zhang J. Pathological pallidal beta activity in Parkinson's disease is sustained during sleep and associated with sleep disturbance. Nat Commun 2023; 14:5434. [PMID: 37669927 PMCID: PMC10480217 DOI: 10.1038/s41467-023-41128-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Accepted: 08/23/2023] [Indexed: 09/07/2023] Open
Abstract
Parkinson's disease (PD) is associated with excessive beta activity in the basal ganglia. Brain sensing implants aim to leverage this biomarker for demand-dependent adaptive stimulation. Sleep disturbance is among the most common non-motor symptoms in PD, but its relationship with beta activity is unknown. To investigate the clinical potential of beta activity as a biomarker for sleep quality in PD, we recorded pallidal local field potentials during polysomnography in PD patients off dopaminergic medication and compared the results to dystonia patients. PD patients exhibited sustained and elevated beta activity across wakefulness, rapid eye movement (REM), and non-REM sleep, which was correlated with sleep disturbance. Simulation of adaptive stimulation revealed that sleep-related beta activity changes remain unaccounted for by current algorithms, with potential negative outcomes in sleep quality and overall quality of life for patients.
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Affiliation(s)
- Zixiao Yin
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Ruoyu Ma
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Qi An
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Yichen Xu
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Yifei Gan
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Guanyu Zhu
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Yin Jiang
- Department of Functional Neurosurgery, Beijing Neurosurgical Institute, Capital Medical University, Beijing, China
| | - Ning Zhang
- Department of Neuropsychiatry, Behavioral Neurology and Sleep Center, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Anchao Yang
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Fangang Meng
- Department of Functional Neurosurgery, Beijing Neurosurgical Institute, Capital Medical University, Beijing, China
| | - Andrea A Kühn
- Department of Neurology, Movement Disorders and Neuromodulation Unit, Charité - Universitätsmedizin Berlin, Chariteplatz 1, 10117, Berlin, Germany
- Exzellenzcluster - NeuroCure, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Hagai Bergman
- The Edmond and Lily Safra Center for Brain Sciences, The Hebrew University, Jerusalem, Israel
- Department of Medical Neurobiology (Physiology), Institute of Medical Research - Israel Canada (IMRIC), Faculty of Medicine, The Hebrew University, Jerusalem, Israel
- Department of Neurosurgery, Hadassah Medical Center, Jerusalem, Israel
| | - Wolf-Julian Neumann
- Department of Neurology, Movement Disorders and Neuromodulation Unit, Charité - Universitätsmedizin Berlin, Chariteplatz 1, 10117, Berlin, Germany.
| | - Jianguo Zhang
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
- Department of Functional Neurosurgery, Beijing Neurosurgical Institute, Capital Medical University, Beijing, China.
- Beijing Key Laboratory of Neurostimulation, Beijing, China.
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Liu Z, Lemus J, Smirnova IV, Liu W. Rehabilitation for non-motor symptoms for patients with Parkinson's disease from an α-synuclein perspective: a narrative review. EXPLORATION OF NEUROPROTECTIVE THERAPY 2023; 3:235-257. [PMID: 37920444 PMCID: PMC10621781 DOI: 10.37349/ent.2023.00049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Accepted: 06/22/2023] [Indexed: 11/04/2023]
Abstract
Parkinson's disease (PD) is a common neurodegenerative disorder affecting aged population around the world. PD is characterized by neuronal Lewy bodies present in the substantia nigra of the midbrain and the loss of dopaminergic neurons with various motor and non-motor symptoms associated with the disease. The protein α-synuclein has been extensively studied for its contribution to PD pathology, as α-synuclein aggregates form the major component of Lewy bodies, a hallmark of PD. In this narrative review, the authors first focus on a brief explanation of α-synuclein aggregation and circumstances under which aggregation can occur, then present a hypothesis for PD pathogenesis in the peripheral nervous system (PNS) and how PD can spread to the central nervous system from the PNS via the transport of α-synuclein aggregates. This article presents arguments both for and against this hypothesis. It also presents various non-pharmacological rehabilitation approaches and management techniques for both motor and non-motor symptoms of PD and the related pathology. This review seeks to examine a possible hypothesis of PD pathogenesis and points to a new research direction focus on rehabilitation therapy for patients with PD. As various non-motor symptoms of PD appear to occur earlier than motor symptoms, more focus on the treatment of non-motor symptoms as well as a better understanding of the biochemical mechanisms behind those non-motor symptoms may lead to better long-term outcomes for patients with PD.
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Affiliation(s)
- Zhaoyang Liu
- Department of Physical Therapy, Rehabilitation Science, and Athletic Training, University of Kansas Medical Center, Kansas City, KS 66160, USA
- Department of Orthopedic Surgery and Sports Medicine, University of Kansas Medical Center, Kansas City, KS 66160, USA
| | - Jessica Lemus
- Department of Physical Therapy, Rehabilitation Science, and Athletic Training, University of Kansas Medical Center, Kansas City, KS 66160, USA
| | - Irina V. Smirnova
- Department of Physical Therapy, Rehabilitation Science, and Athletic Training, University of Kansas Medical Center, Kansas City, KS 66160, USA
| | - Wen Liu
- Department of Physical Therapy, Rehabilitation Science, and Athletic Training, University of Kansas Medical Center, Kansas City, KS 66160, USA
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Yin Z, Jiang Y, Merk T, Neumann WJ, Ma R, An Q, Bai Y, Zhao B, Xu Y, Fan H, Zhang Q, Qin G, Zhang N, Ma J, Zhang H, Liu H, Shi L, Yang A, Meng F, Zhu G, Zhang J. Pallidal activities during sleep and sleep decoding in dystonia, Huntington's, and Parkinson's disease. Neurobiol Dis 2023; 182:106143. [PMID: 37146835 DOI: 10.1016/j.nbd.2023.106143] [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: 03/07/2023] [Revised: 04/09/2023] [Accepted: 05/01/2023] [Indexed: 05/07/2023] Open
Abstract
BACKGROUND Sleep disturbances are highly prevalent in movement disorders, potentially due to the malfunctioning of basal ganglia structures. Pallidal deep brain stimulation (DBS) has been widely used for multiple movement disorders and been reported to improve sleep. We aimed to investigate the oscillatory pattern of pallidum during sleep and explore whether pallidal activities can be utilized to differentiate sleep stages, which could pave the way for sleep-aware adaptive DBS. METHODS We directly recorded over 500 h of pallidal local field potentials during sleep from 39 subjects with movement disorders (20 dystonia, 8 Huntington's disease, and 11 Parkinson's disease). Pallidal spectrum and cortical-pallidal coherence were computed and compared across sleep stages. Machine learning approaches were utilized to build sleep decoders for different diseases to classify sleep stages through pallidal oscillatory features. Decoding accuracy was further associated with the spatial localization of the pallidum. RESULTS Pallidal power spectra and cortical-pallidal coherence were significantly modulated by sleep-stage transitions in three movement disorders. Differences in sleep-related activities between diseases were identified in non-rapid eye movement (NREM) and REM sleep. Machine learning models using pallidal oscillatory features can decode sleep-wake states with over 90% accuracy. Decoding accuracies were higher in recording sites within the internus-pallidum than the external-pallidum, and can be precited using structural (P < 0.0001) and functional (P < 0.0001) whole-brain neuroimaging connectomics. CONCLUSION Our findings revealed strong sleep-stage dependent distinctions in pallidal oscillations in multiple movement disorders. Pallidal oscillatory features were sufficient for sleep stage decoding. These data may facilitate the development of adaptive DBS systems targeting sleep problems that have broad translational prospects.
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Affiliation(s)
- Zixiao Yin
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Yin Jiang
- Department of Functional Neurosurgery, Beijing Neurosurgical Institute, Capital Medical University, Beijing, China; Beijing Key Laboratory of Neurostimulation, Beijing, China
| | - Timon Merk
- Movement Disorder and Neuromodulation Unit, Department of Neurology, Charité - Campus Mitte, Charite - Universitatsmedizin Berlin, Chariteplatz 1, 10117 Berlin, Germany
| | - Wolf-Julian Neumann
- Movement Disorder and Neuromodulation Unit, Department of Neurology, Charité - Campus Mitte, Charite - Universitatsmedizin Berlin, Chariteplatz 1, 10117 Berlin, Germany
| | - Ruoyu Ma
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Qi An
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Yutong Bai
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Baotian Zhao
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Yichen Xu
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Houyou Fan
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Quan Zhang
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Guofan Qin
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Ning Zhang
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China; Department of Neuropsychiatry, Behavioral Neurology and Sleep Center, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Jun Ma
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China; Department of Neuropsychiatry, Behavioral Neurology and Sleep Center, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Hua Zhang
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Huanguang Liu
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Lin Shi
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Anchao Yang
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Fangang Meng
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Guanyu Zhu
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
| | - Jianguo Zhang
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China; Department of Functional Neurosurgery, Beijing Neurosurgical Institute, Capital Medical University, Beijing, China; Beijing Key Laboratory of Neurostimulation, Beijing, China.
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Abstract
Despite sleep's fundamental role in maintaining and improving physical and mental health, many people get less than the recommended amount of sleep or suffer from sleeping disorders. This review highlights sleep's instrumental biological functions, various sleep problems, and sleep hygiene and lifestyle interventions that can help improve sleep quality. Quality sleep allows for improved cardiovascular health, mental health, cognition, memory consolidation, immunity, reproductive health, and hormone regulation. Sleep disorders, such as insomnia, sleep apnea, and circadian-rhythm-disorders, or disrupted sleep from lifestyle choices, environmental conditions, or other medical issues can lead to significant morbidity and can contribute to or exacerbate medical and psychiatric conditions. The best treatment for long-term sleep improvement is proper sleep hygiene through behavior and sleep habit modification. Recommendations to improve sleep include achieving 7 to 9 h of sleep, maintaining a consistent sleep/wake schedule, a regular bedtime routine, engaging in regular exercise, and adopting a contemplative practice. In addition, avoiding many substances late in the day can help improve sleep. Caffeine, alcohol, heavy meals, and light exposure later in the day are associated with fragmented poor-quality sleep. These sleep hygiene practices can promote better quality and duration of sleep, with corresponding health benefits.
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Low Levels of Adenosine and GDNF Are Potential Risk Factors for Parkinson's Disease with Sleep Disorders. Brain Sci 2023; 13:brainsci13020200. [PMID: 36831743 PMCID: PMC9953846 DOI: 10.3390/brainsci13020200] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2022] [Revised: 01/10/2023] [Accepted: 01/17/2023] [Indexed: 01/26/2023] Open
Abstract
Sleep disturbances are the most prevalent non-motor symptoms in the preclinical stage of Parkinson's disease (PD). Adenosine, glial-derived neurotrophic factor (GDNF), and associated neurotransmitters are crucial in the control of sleep arousal. This study aimed to detect the serum levels of adenosine, GDNF, and associated neurotransmitters and explored their correlations with PD with sleep disorders. Demographic characteristics and clinical information of PD patients and healthy participants were assessed. Serum concentrations of adenosine, GDNF, and related neurotransmitters were detected by ELISA and LC-MS. The correlation between serum levels of adenosine, GDNF, and associated neurotransmitters and sleep disorders was explored using logistic regression. PD patients with sleep disorders had higher scores of HAMA, HAMD, ESS, UPDRS-III, and H-Y stage. Lower levels of adenosine, GDNF, and γ-GABA were observed in PD patients who had sleep problems. Logistic regression analysis showed adenosine and GDNF were protective factors for preventing sleep disorders. Adenosine combined with GDNF had a higher diagnostic efficiency in predicting PD with sleep disorders by ROC analysis. This study revealed low adenosine and GDNF levels may be risk factors for sleep disorders in PD. The decrease of serum adenosine and GDNF levels may contribute to the diagnosis of PD with sleep disturbances.
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Standlee J, Malkani R. Sleep Dysfunction in Movement Disorders: a Window to the Disease Biology. Curr Neurol Neurosci Rep 2022; 22:565-576. [PMID: 35867306 DOI: 10.1007/s11910-022-01220-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/24/2022] [Indexed: 11/03/2022]
Abstract
PURPOSE OF REVIEW To comprehensively summarize the sleep pathologies associated with movement disorders, focusing on neurodegenerative diseases. RECENT FINDINGS Mounting evidence has further implicated both sleep and circadian disruption in the pathophysiology of many movement disorders. In particular, recent data illuminate the mechanisms by which poor sleep quality and circadian dysfunction can exacerbate neurodegeneration. In addition, anti-IgLON5 disease is a recently described autoimmune disease with various symptoms that can feature prominent sleep disruption and parasomnia. Many movement disorders are associated with sleep and circadian rhythm disruption. Motor symptoms can cause sleep fragmentation, resulting in insomnia and excessive daytime sleepiness. Many neurodegenerative movement disorders involve brainstem pathology in regions close to or affecting nuclei that regulate sleep and wake. Further, commonly used movement medications may exacerbate sleep concerns. Providers should screen for and address these sleep symptoms to improve function and quality of life for patients and caregivers.
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Affiliation(s)
- Jordan Standlee
- Department of Neurology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Roneil Malkani
- Department of Neurology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA. .,Jesse Brown Veterans Affairs Medical Center, Neurology Service, 820 S Damen Ave, Damen Building, 9th floor, Chicago, IL, 60612, USA.
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10
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Abdulrazzaq YM, Bastaki SMA, Adeghate E. Histamine H3 receptor antagonists - Roles in neurological and endocrine diseases and diabetes mellitus. Biomed Pharmacother 2022; 150:112947. [PMID: 35447544 DOI: 10.1016/j.biopha.2022.112947] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Revised: 03/28/2022] [Accepted: 04/08/2022] [Indexed: 11/02/2022] Open
Abstract
Human histamine H3 receptor (H3R) was initially described in the brain of rat in 1983 and cloned in 1999. It can be found in the human brain and functions as a regulator of histamine synthesis and release. H3 receptors are predominantly resident in the presynaptic region of neurons containing histamine, where they modulate the synthesis and release of histamine (autoreceptor) or other neurotransmitters such as dopamine, norepinephrine, gamma-aminobutyric acid (GABA), glutamate, acetylcholine and serotonin (all heteroreceptors). The human histamine H3 receptor has twenty isoforms of which eight are functional. H3 receptor expression is seen in the cerebral cortex, neurons of the basal ganglia and hippocampus, which are important for process of cognition, sleep and homoeostatic regulation. In addition, histamine H3R antagonists stimulate insulin release, through inducing the release of acetylcholine and cause significant reduction in total body weight and triglycerides in obese subjects by causing a feeling of satiety in the hypothalamus. The ability of histamine H3R antagonist to reduce diabetes-induced hyperglycaemia is comparable to that of metformin. It is reasonable therefore, to claim that H3 receptor antagonists may play an important role in the therapy of disorders of cognition, the ability to sleep, oxidative stress, inflammation and anomaly of glucose homoeostasis. A large number of H3R antagonists are being developed by pharmaceutical companies and university research centres. As examples of these new drugs, this review will discuss a number of drugs, including the first histamine H3R receptor antagonist produced.
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Affiliation(s)
- Yousef M Abdulrazzaq
- Department of Paediatrics, College of Medicine and Health Sciences, United Arab Emirates University, P.O. Box 15551, Al Ain, United Arab Emirates
| | - Salim M A Bastaki
- Department of Pharmacology, College of Medicine and Health Sciences, United Arab Emirates University, P.O. Box 15551, Al Ain, United Arab Emirates
| | - Ernest Adeghate
- Department of Anatomy, College of Medicine and Health Sciences, United Arab Emirates University, P.O. Box 15551, Al Ain, United Arab Emirates; Zayed Centre for Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates.
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11
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Oscillatory waveform sharpness asymmetry changes in motor thalamus and motor cortex in a rat model of Parkinson's disease. Exp Neurol 2022; 354:114089. [DOI: 10.1016/j.expneurol.2022.114089] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Revised: 04/01/2022] [Accepted: 04/17/2022] [Indexed: 11/23/2022]
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12
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Mizrahi-Kliger AD, Feldmann LK, Kühn AA, Bergman H. Etiologies of insomnia in Parkinson's disease - Lessons from human studies and animal models. Exp Neurol 2022; 350:113976. [PMID: 35026228 DOI: 10.1016/j.expneurol.2022.113976] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Revised: 10/27/2021] [Accepted: 01/06/2022] [Indexed: 12/28/2022]
Abstract
Sleep disorders are integral to Parkinson's disease (PD). Insomnia, an inability to maintain stable sleep, affects most patients and is widely rated as one of the most debilitating facets of this disease. PD insomnia is often perceived as a multifactorial entity - a consequence of several of the disease symptoms, comorbidities and therapeutic strategies. Yet, this view evolved against a backdrop of a relative scarcity of works trying to directly dissect the underlying neural correlates and mechanisms in animal models. The last years have seen the emergence of a wealth of new evidence regarding the neural underpinnings of insomnia in PD. Here, we review early and recent reports from patients and animal models evaluating the etiology of PD insomnia. We start by outlining the phenomenology of PD insomnia and continue to analyze the evidence supporting insomnia as emanating from four distinct subdivisions of etiologies - the symptoms and comorbidities of the disease, the medical therapy, the degeneration of non-dopaminergic cell groups and subsequent alterations in circadian rhythms, and the degeneration of dopaminergic neurons in the brainstem and its resulting effect on the basal ganglia. Finally, we review emerging neuromodulation-based therapeutic avenues for PD insomnia.
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Affiliation(s)
- Aviv D Mizrahi-Kliger
- Department of Neurobiology, Institute of Medical Research Israel-Canada, Hadassah Medical School, The Hebrew University of Jerusalem, Jerusalem 91120, Israel.
| | - Lucia K Feldmann
- Department of Neurology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, and Berlin Institute of Health, Charitéplatz 1, Berlin 10117, Germany
| | - Andrea A Kühn
- Department of Neurology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, and Berlin Institute of Health, Charitéplatz 1, Berlin 10117, Germany; NeuroCure Cluster of Excellence, Charité - Universitätsmedizin Berlin, Charitéplatz 1, Berlin 10117, Germany; Deutsches Zentrum für Neurodegenerative Erkrankungen, Berlin, Germany
| | - Hagai Bergman
- Department of Neurobiology, Institute of Medical Research Israel-Canada, Hadassah Medical School, The Hebrew University of Jerusalem, Jerusalem 91120, Israel; The Edmond and Lily Safra Center for Brain Sciences, The Hebrew University, Jerusalem 91904, Israel; Department of Neurosurgery, Hadassah University Hospital, Jerusalem 91120, Israel
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13
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Morawska MM, Moreira CG, Ginde VR, Valko PO, Weiss T, Büchele F, Imbach LL, Masneuf S, Kollarik S, Prymaczok N, Gerez JA, Riek R, Baumann CR, Noain D. Slow-wave sleep affects synucleinopathy and regulates proteostatic processes in mouse models of Parkinson's disease. Sci Transl Med 2021; 13:eabe7099. [PMID: 34878820 DOI: 10.1126/scitranslmed.abe7099] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
[Figure: see text].
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Affiliation(s)
- Marta M Morawska
- Department of Neurology, University Hospital Zurich (USZ), Frauenklinikstrasse 26, Zurich 8091, Switzerland.,University of Zurich (UZH), Neuroscience Center Zurich (ZNZ), Winterthurerstrasse 190, Zurich 8057, Switzerland
| | - Carlos G Moreira
- Department of Neurology, University Hospital Zurich (USZ), Frauenklinikstrasse 26, Zurich 8091, Switzerland.,ETH Zurich, Neuroscience Center Zurich (ZNZ), Winterthurerstrasse 190, Zurich 8057, Switzerland
| | - Varun R Ginde
- Department of Neurology, University Hospital Zurich (USZ), Frauenklinikstrasse 26, Zurich 8091, Switzerland
| | - Philipp O Valko
- Department of Neurology, University Hospital Zurich (USZ), Frauenklinikstrasse 26, Zurich 8091, Switzerland
| | - Tobias Weiss
- Department of Neurology, University Hospital Zurich (USZ), Frauenklinikstrasse 26, Zurich 8091, Switzerland
| | - Fabian Büchele
- Department of Neurology, University Hospital Zurich (USZ), Frauenklinikstrasse 26, Zurich 8091, Switzerland
| | - Lukas L Imbach
- Department of Neurology, University Hospital Zurich (USZ), Frauenklinikstrasse 26, Zurich 8091, Switzerland
| | - Sophie Masneuf
- Department of Neurology, University Hospital Zurich (USZ), Frauenklinikstrasse 26, Zurich 8091, Switzerland
| | - Sedef Kollarik
- Department of Neurology, University Hospital Zurich (USZ), Frauenklinikstrasse 26, Zurich 8091, Switzerland.,University of Zurich (UZH), Neuroscience Center Zurich (ZNZ), Winterthurerstrasse 190, Zurich 8057, Switzerland
| | - Natalia Prymaczok
- ETH Zurich, Laboratory of Physical Chemistry, Department of Chemistry and Applied Biosciences, Vladimir-Prelog-Weg 2, Zurich 8093, Switzerland
| | - Juan A Gerez
- ETH Zurich, Laboratory of Physical Chemistry, Department of Chemistry and Applied Biosciences, Vladimir-Prelog-Weg 2, Zurich 8093, Switzerland
| | - Roland Riek
- ETH Zurich, Laboratory of Physical Chemistry, Department of Chemistry and Applied Biosciences, Vladimir-Prelog-Weg 2, Zurich 8093, Switzerland
| | - Christian R Baumann
- Department of Neurology, University Hospital Zurich (USZ), Frauenklinikstrasse 26, Zurich 8091, Switzerland.,University of Zurich (UZH), Neuroscience Center Zurich (ZNZ), Winterthurerstrasse 190, Zurich 8057, Switzerland.,Center of Competence Sleep and Health Zurich, University of Zurich, Frauenklinikstrasse 26, Zurich 8091, Switzerland
| | - Daniela Noain
- Department of Neurology, University Hospital Zurich (USZ), Frauenklinikstrasse 26, Zurich 8091, Switzerland.,University of Zurich (UZH), Neuroscience Center Zurich (ZNZ), Winterthurerstrasse 190, Zurich 8057, Switzerland.,Center of Competence Sleep and Health Zurich, University of Zurich, Frauenklinikstrasse 26, Zurich 8091, Switzerland
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14
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McCusker MC, Wiesman AI, Spooner RK, Santamaria PM, McKune J, Heinrichs-Graham E, Wilson TW. Altered neural oscillations during complex sequential movements in patients with Parkinson's disease. Neuroimage Clin 2021; 32:102892. [PMID: 34911196 PMCID: PMC8645515 DOI: 10.1016/j.nicl.2021.102892] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Revised: 11/01/2021] [Accepted: 11/19/2021] [Indexed: 11/20/2022]
Abstract
The sequelae of Parkinson's disease (PD) includes both motor- and cognitive-related symptoms. Although traditionally considered a subcortical disease, there is increasing evidence that PD has a major impact on cortical function as well. Prior studies have reported alterations in cortical neural function in patients with PD during movement, but to date such studies have not examined whether the complexity of multicomponent movements modulate these alterations. In this study, 23 patients with PD (medication "off" state) and 27 matched healthy controls performed simple and complex finger tapping sequences during magnetoencephalography (MEG), and the resulting MEG data were imaged to identify the cortical oscillatory dynamics serving motor performance. The patients with PD were significantly slower than controls at executing the sequences overall, and both groups took longer to complete the complex sequences than the simple. In terms of neural differences, patients also exhibited weaker beta complexity-related effects in the right medial frontal gyrus and weaker complexity-related alpha activity in the right posterior and inferior parietal lobules, suggesting impaired motor sequence execution. Characterizing the cortical pathophysiology of PD could inform current and future therapeutic interventions that address both motor and cognitive symptoms.
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Affiliation(s)
- Marie C McCusker
- Institute for Human Neuroscience, Boys Town National Research Hospital, Boys Town, NE, USA; Interdepartmental Neuroscience Program, Yale University School of Medicine, New Haven, CT, USA
| | - Alex I Wiesman
- College of Medicine, University of Nebraska Medical Center, Omaha, NE, USA; The Montreal Neurological Institute, McGill University, Montreal, Canada
| | - Rachel K Spooner
- Institute for Human Neuroscience, Boys Town National Research Hospital, Boys Town, NE, USA; College of Medicine, University of Nebraska Medical Center, Omaha, NE, USA; Institute of Clinical Neuroscience and Medical Psychology, Heinrich-Heine University Düsseldorf, Düsseldorf, Germany
| | | | - Jennifer McKune
- Department of Physical Therapy, Nebraska Medicine, Omaha, NE, USA
| | - Elizabeth Heinrichs-Graham
- Institute for Human Neuroscience, Boys Town National Research Hospital, Boys Town, NE, USA; College of Medicine, University of Nebraska Medical Center, Omaha, NE, USA.
| | - Tony W Wilson
- Institute for Human Neuroscience, Boys Town National Research Hospital, Boys Town, NE, USA; College of Medicine, University of Nebraska Medical Center, Omaha, NE, USA
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15
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Orso B, Famà F, Giorgetti L, Mattioli P, Donniaquio A, Girtler N, Brugnolo A, Massa F, Peira E, Pardini M, Morbelli S, Nobili F, Arnaldi D. Polysomnographic correlates of sleep disturbances in de novo, drug naïve Parkinson's Disease. Neurol Sci 2021; 43:2531-2536. [PMID: 34586541 PMCID: PMC8918173 DOI: 10.1007/s10072-021-05622-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Accepted: 09/17/2021] [Indexed: 11/29/2022]
Abstract
Background Sleep disturbances
are common non-motor symptoms of Parkinson’s Disease (PD). Methods The aim of this study was to investigate the polysomnographic correlates of sleep changes, as investigated by the Parkinson’s Disease Sleep Scale-2 (PDSS-2), in a cohort of sixty-two consecutive de novo, drug naïve PD patients (71.40 ± 7.84 y/o). Results PDSS-2 total score showed a direct correlation with stage shifts (p = 0.008). Fragmented sleep showed an inverse correlation with sleep efficiency (p = 0.012). Insomnia symptoms showed an inverse correlation with wake after sleep onset (p = 0.005) and direct correlation with periodic leg movements (p = 0.006) and stage shift indices (p = 0.003). Motor Symptoms showed a direct correlation with Apnoea-Hypopnoea (AHI; p = 0.02) and awakenings indices (p = 0.003). Dream distressing showed a direct correlation with REM without atonia (RWA, p = 0.042) and an inverse correlation with AHI (p = 0.012). Sleep quality showed an inverse correlation with RWA (p = 0.008). Conclusion PDSS-2 features are significantly correlated with polysomnography objective findings, thus further supporting its reliability to investigate sleep disturbances in PD patients.
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Affiliation(s)
- Beatrice Orso
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genoa, Genoa, Italy
| | - Francesco Famà
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genoa, Genoa, Italy.,IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | | | - Pietro Mattioli
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genoa, Genoa, Italy
| | - Andrea Donniaquio
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genoa, Genoa, Italy
| | - Nicola Girtler
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genoa, Genoa, Italy.,IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Andrea Brugnolo
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genoa, Genoa, Italy.,IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Federico Massa
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genoa, Genoa, Italy
| | - Enrico Peira
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genoa, Genoa, Italy.,National Institute of Nuclear Physics (INFN), Genoa section, Via Dodecaneso 33, 16146, Genoa, Italy
| | - Matteo Pardini
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genoa, Genoa, Italy.,IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Silvia Morbelli
- IRCCS Ospedale Policlinico San Martino, Genoa, Italy.,Department of Health Science (DISSAL), University of Genoa, Genoa, Italy
| | - Flavio Nobili
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genoa, Genoa, Italy.,IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Dario Arnaldi
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genoa, Genoa, Italy. .,IRCCS Ospedale Policlinico San Martino, Genoa, Italy.
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16
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Mc Carthy CE. Sleep Disturbance, Sleep Disorders and Co-Morbidities in the Care of the Older Person. Med Sci (Basel) 2021; 9:medsci9020031. [PMID: 34063838 PMCID: PMC8162526 DOI: 10.3390/medsci9020031] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2021] [Revised: 05/17/2021] [Accepted: 05/18/2021] [Indexed: 01/14/2023] Open
Abstract
Sleep complaints can be both common and complex in the older patient. Their consideration is an important aspect of holistic care, and may have an impact on quality of life, mortality, falls and disease risk. Sleep assessment should form part of the comprehensive geriatric assessment. If sleep disturbance is brought to light, consideration of sleep disorders, co-morbidity and medication management should form part of a multifaceted approach. Appreciation of the bi-directional relationship and complex interplay between co-morbidity and sleep in older patients is an important element of patient care. This article provides a brief overview of sleep disturbance and sleep disorders in older patients, in addition to their association with specific co-morbidities including depression, heart failure, respiratory disorders, gastro-oesophageal reflux disease, nocturia, pain, Parkinson's disease, dementia, polypharmacy and falls. A potential systematic multidomain approach to assessment and management is outlined, with an emphasis on non-pharmacological treatment where possible.
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Affiliation(s)
- Christine E. Mc Carthy
- Department of Geriatric Medicine, University Hospital Galway, Galway, Ireland;
- HRB-Clinical Research Facility, National University of Ireland, Galway, Co., Galway, Ireland
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17
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Vinner Harduf E, Matzner A, Belelovsky K, Bar-Gad I. Dissociation of tic generation from tic expression during the sleep-wake cycle. iScience 2021; 24:102380. [PMID: 33981969 PMCID: PMC8081921 DOI: 10.1016/j.isci.2021.102380] [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: 11/04/2020] [Revised: 03/01/2021] [Accepted: 03/29/2021] [Indexed: 10/26/2022] Open
Abstract
Motor tics, the hallmark of Tourette syndrome (TS), are modulated by different behavioral and environmental factors. A major modulating factor is the sleep-wake cycle in which tics are attenuated to a large extent during sleep. This study demonstrates a similar reduction in tic expression during sleep in an animal model of chronic tic disorders and investigates the underlying neural mechanism. We recorded the neuronal activity during spontaneous sleep-wake cycles throughout continuous GABAA antagonist infusion into the striatum. Analysis of video streams and concurrent kinematic assessments indicated tic reduction during sleep in both frequency and intensity. Extracellular recordings in the striatum revealed a state-dependent dissociation between motor tic expression and their macro-level neural correlates ("LFP spikes") during the sleep-wake cycle. Local field potential (LFP) spikes, which are highly correlated with tic expression during wakefulness, persisted during tic-free sleep and did not change their properties despite the reduced behavioral expression. Local, micro-level, activity near the infusion site was time-locked to the LFP spikes during wakefulness, but this locking decreased significantly during sleep. These results suggest that whereas LFP spikes encode motor tic generation and feasibility, the behavioral expression of tics requires local striatal neural activity entrained to the LFP spikes, leading to the propagation of the activity to downstream targets and consequently their motor expression. These findings point to a possible mechanism for the modulation of tic expression in patients with TS during sleep and potentially during other behavioral states.
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Affiliation(s)
- Esther Vinner Harduf
- The Leslie & Susan Goldschmied (Gonda) Multidisciplinary Brain Research Center, Bar-Ilan University, Ramat-Gan 52900, Israel
| | - Ayala Matzner
- The Leslie & Susan Goldschmied (Gonda) Multidisciplinary Brain Research Center, Bar-Ilan University, Ramat-Gan 52900, Israel
| | - Katya Belelovsky
- The Leslie & Susan Goldschmied (Gonda) Multidisciplinary Brain Research Center, Bar-Ilan University, Ramat-Gan 52900, Israel
| | - Izhar Bar-Gad
- The Leslie & Susan Goldschmied (Gonda) Multidisciplinary Brain Research Center, Bar-Ilan University, Ramat-Gan 52900, Israel
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18
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Efficacy and Safety of Pramipexole Sustained Release versus Immediate Release Formulation for Nocturnal Symptoms in Chinese Patients with Advanced Parkinson's Disease: A Pilot Study. PARKINSONS DISEASE 2021; 2021:8834950. [PMID: 33763199 PMCID: PMC7946461 DOI: 10.1155/2021/8834950] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Revised: 12/24/2020] [Accepted: 01/13/2021] [Indexed: 11/25/2022]
Abstract
Objective To explore the efficacy and safety of pramipexole sustained release (SR) versus pramipexole immediate release (IR) in treating nocturnal symptoms in levodopa-treated Chinese patients with advanced Parkinson's disease (PD) and sleep disturbances. Method SUSTAIN was an open-label, randomised, active-controlled parallel group exploratory pilot study (NCT03521635). A total of 98 patients were randomly allocated (1 : 1) to either pramipexole SR (n = 49) or pramipexole IR (n = 49) groups. The primary endpoint was a change from baseline in PD Sleep Scale 2nd version (PDSS-2) total score at 18 weeks. A reduction in score represents improvement. Secondary endpoints included Nocturnal Hypokinesia Questionnaire, Scales for Outcomes in PD Sleep Scale, Early Morning Off (EMO), Epworth Sleepiness Scale, PD Questionnaire-8, and responder rates as measured by PDSS-2 total score (<18), EMO scores (≥1 point change), Clinical Global Impression Improvement scale, and Patient Global Impression-Improvement scale. Other endpoints included motor complications (MDS-UPDRS part IV) score. Adverse events were evaluated for each group. Results The mean pramipexole dose for both groups was 1.5 mg/day at week 18, and the mean changes in PDSS-2 total score for pramipexole SR and IR were –13.7 (95% CI –16.0 to –11.4) and –14.4 (–16.8 to –12.0) (difference of 0.7; p=0.688). Change from baseline for both groups achieved the minimal clinical important difference threshold (MCID = –3.44). No significant difference was observed in change from baseline for other measures of sleep-related disturbances or responder rates. For motor complications, a greater improvement in MDS-UPDRS part IV score was observed in pramipexole SR over IR (–3.4 vs –2.3; treatment group difference: –1.1; p=0.036). Both groups had comparable safety profiles. Conclusion In Chinese patients with advanced PD and sleep disturbances, pramipexole SR and IR have similar benefits in the treatment of nocturnal symptoms and safety, and an improvement from baseline in nocturnal symptoms was observed regardless of pramipexole formulation.
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19
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Earle FS, Ullman MT. Deficits of Learning in Procedural Memory and Consolidation in Declarative Memory in Adults With Developmental Language Disorder. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2021; 64:531-541. [PMID: 33524264 PMCID: PMC8632504 DOI: 10.1044/2020_jslhr-20-00292] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Revised: 08/06/2020] [Accepted: 10/23/2020] [Indexed: 06/12/2023]
Abstract
Purpose This study examined procedural and declarative learning and consolidation abilities in adults with developmental language disorder (DLD) relative to their typical language (TD) peers. Method A total of 100 young adults (age 18-24 years) with (n = 21) and without (n = 79) DLD participated across two sites. Performance measures on a recognition memory task and a serial reaction time task were used to assess declarative and procedural memory, respectively. Performance was measured shortly after learning (8 a.m.) and again after a 12-hr, overnight delay (8 a.m.). Results Linear mixed-effects modeling was used to examine the effects of time and group membership on task performance. For the serial reaction time task, there were significant effects of group (TD > DLD) and time (Day 1 > Day 2), but no interaction between them. For the recognition memory task, there was a significant interaction between group and time, driven by overnight gains in the TD group, combined with stable performance across days by those with DLD. Conclusions In procedural memory, adults with DLD demonstrate a learning deficit relative to adults without DLD, but appear to have comparable retention of learned information. In declarative memory, adults with DLD demonstrate a deficit in the overnight enhancement of memory retrieval, despite typical-like learning exhibited when tested shortly after encoding. Supplemental Material https://doi.org/10.23641/asha.13626485.
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Affiliation(s)
- F. Sayako Earle
- Department of Communication Sciences and Disorders, University of Delaware, Newark
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20
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Rukavina K, Batzu L, Boogers A, Abundes-Corona A, Bruno V, Chaudhuri KR. Non-motor complications in late stage Parkinson's disease: recognition, management and unmet needs. Expert Rev Neurother 2021; 21:335-352. [PMID: 33522312 DOI: 10.1080/14737175.2021.1883428] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Introduction: The burden of non-motor symptoms (NMS) is a major determinant of health-related quality of life in Parkinson's disease (PD), particularly at its late stage.Areas covered: The late stage is usually defined as the period from unstable advanced to the palliative stage, characterized by a combination of emerging treatment-resistant axial motor symptoms (freezing of gait, postural instability, falls and dysphagia), as well as both non-dopaminergic and dopaminergic NMS: cognitive decline, neuropsychiatric symptoms, aspects of dysautonomia, pain and sleep disturbances (insomnia and excessive day-time sleepiness). Here, the authors summarize the current knowledge on NMS dominating the late stage of PD and propose a pragmatic and clinically focused approach for their recognition and treatment.Expert opinion: The NMS progression pattern is complex and remains under-researched. While dopamine-dependent NMS may improve with dopamine replacement therapy, non-dopamine dependent NMS worsen progressively and culminate at the late stages of PD. Furthermore, some PD specific features could interact negatively with other comorbidities, multiple medication use and frailty - the evaluation of these aspects is important in the creation of personalized management plans in the late stage of PD.
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Affiliation(s)
- Katarina Rukavina
- Department of Basic and Clinical Neuroscience, Institute of Psychiatry, Psychology & Neuroscience at King's College and King's College Hospital NHS Foundation Trust, London, UK.,Parkinson Foundation Centre of Excellence, King's College Hospital, London, UK
| | - Lucia Batzu
- Department of Basic and Clinical Neuroscience, Institute of Psychiatry, Psychology & Neuroscience at King's College and King's College Hospital NHS Foundation Trust, London, UK.,Parkinson Foundation Centre of Excellence, King's College Hospital, London, UK
| | - Alexandra Boogers
- Department of Neurology, University Hospital Leuven, Leuven, U.Z, Belgium
| | - Arturo Abundes-Corona
- Department of Neurology, Clinical Laboratory of Neurodegenerative Diseases, National Institute of Neurology and Neurosurgery, Mexico City, México.,Neurology Department, American British Cowdray Medical Center IAP, Mexico City, Mexico
| | - Veronica Bruno
- Department of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.,Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada
| | - K Ray Chaudhuri
- Department of Basic and Clinical Neuroscience, Institute of Psychiatry, Psychology & Neuroscience at King's College and King's College Hospital NHS Foundation Trust, London, UK.,Parkinson Foundation Centre of Excellence, King's College Hospital, London, UK
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21
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Hasegawa H, Selway R, Gnoni V, Beniczky S, Williams SCR, Kryger M, Ferini-Strambi L, Goadsby P, Leschziner GD, Ashkan K, Rosenzweig I. The subcortical belly of sleep: New possibilities in neuromodulation of basal ganglia? Sleep Med Rev 2020; 52:101317. [PMID: 32446196 PMCID: PMC7679363 DOI: 10.1016/j.smrv.2020.101317] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2019] [Revised: 02/22/2020] [Accepted: 03/09/2020] [Indexed: 12/30/2022]
Abstract
Early studies posited a relationship between sleep and the basal ganglia, but this relationship has received little attention recently. It is timely to revisit this relationship, given new insights into the functional anatomy of the basal ganglia and the physiology of sleep, which has been made possible by modern techniques such as chemogenetic and optogenetic mapping of neural circuits in rodents and intracranial recording, functional imaging, and a better understanding of human sleep disorders. We discuss the functional anatomy of the basal ganglia, and review evidence implicating their role in sleep. Whilst these studies are in their infancy, we suggest that the basal ganglia may play an integral role in the sleep-wake cycle, specifically by contributing to a thalamo-cortical-basal ganglia oscillatory network in slow-wave sleep which facilitates neural plasticity, and an active state during REM sleep which enables the enactment of cognitive and emotional networks. A better understanding of sleep mechanisms may pave the way for more effective neuromodulation strategies for sleep and basal ganglia disorders.
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Affiliation(s)
- Harutomo Hasegawa
- Sleep and Brain Plasticity Centre, Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London (KCL), UK; Department of Neurosurgery, King's College Hospital, London, UK
| | - Richard Selway
- Department of Neurosurgery, King's College Hospital, London, UK
| | - Valentina Gnoni
- Sleep and Brain Plasticity Centre, Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London (KCL), UK; Sleep Disorders Centre, Guy's and St Thomas' Hospital, London, UK
| | - Sandor Beniczky
- Danish Epilepsy Centre, Dianalund, Denmark; Aarhus University Hospital, Aarhus, Denmark
| | | | - Meir Kryger
- Pulmonary, Critical Care and Sleep Medicine, Yale School of Medicine, Connecticut, USA
| | | | - Peter Goadsby
- NIHR-Wellcome Trust Clinical Research Facility, SLaM Biomedical Research Centre, King's College London, London, UK
| | - Guy D Leschziner
- Sleep and Brain Plasticity Centre, Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London (KCL), UK; Sleep Disorders Centre, Guy's and St Thomas' Hospital, London, UK; Department of Neurology, Guy's and St Thomas' Hospital (GSTT) & Clinical Neurosciences, KCL, UK
| | | | - Ivana Rosenzweig
- Sleep and Brain Plasticity Centre, Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London (KCL), UK; Sleep Disorders Centre, Guy's and St Thomas' Hospital, London, UK.
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22
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Subcortical atrophy correlates with the perturbational complexity index in patients with disorders of consciousness. Brain Stimul 2020; 13:1426-1435. [PMID: 32717393 DOI: 10.1016/j.brs.2020.07.012] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2019] [Revised: 05/26/2020] [Accepted: 07/21/2020] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND The complexity of neurophysiological brain responses to direct cortical stimulation, referred to as the perturbational complexity index (PCI), has been shown able to discriminate between consciousness and unconsciousness in patients surviving severe brain injury as well as several other conditions (e.g., wake, dreamless sleep, sleep and ketamine dreaming, anesthesia). OBJECTIVE This study asks whether, in patients with a disorder of consciousness (DOC), the complexity of the neurophysiological response to cortical stimulation is preferentially associated with atrophy within specific brain structures. METHODS We perform a retrospective analysis of 40 DOC patients and correlate their maximal PCI to MR-based measurements of cortical thinning and subcortical atrophy. RESULTS PCI was systematically and inversely associated with the degree of local atrophy within the globus pallidus, a region previously linked to electrocortical and behavioral arousal. Conversely, we fail to detect any association between variance in cortical ribbon thickness and PCI. CONCLUSION These findings corroborate the previously reported association between pallidal atrophy and low behavioral arousal and suggest that this region's role in maintaining the overall balance of excitation and inhibition may critically affect the emergence of complex cortical interactions in chronic disorders of consciousness. This finding thus also suggests a target for potential neuromodulatory intervention in DOC patients.
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23
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Choi JH, Kim JM, Yang HK, Lee HJ, Shin CM, Jeong SJ, Kim WS, Han JW, Yoon IY, Song YS, Bae YJ. Clinical Perspectives of Parkinson's Disease for Ophthalmologists, Otorhinolaryngologists, Cardiologists, Dentists, Gastroenterologists, Urologists, Physiatrists, and Psychiatrists. J Korean Med Sci 2020; 35:e230. [PMID: 32686370 PMCID: PMC7371452 DOI: 10.3346/jkms.2020.35.e230] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Accepted: 05/27/2020] [Indexed: 12/29/2022] Open
Abstract
Parkinson's disease (PD) is a multisystemic disorder characterized by various non-motor symptoms (NMS) in addition to motor dysfunction. NMS include sleep, ocular, olfactory, throat, cardiovascular, gastrointestinal, genitourinary, or musculoskeletal disorders. A range of NMS, particularly hyposmia, sleep disturbances, constipation, and depression, can even appear prior to the motor symptoms of PD. Because NMS can affect multiple organs and result in major disabilities, the recognition and multidisciplinary and collaborative management of NMS by physicians is essential for patients with PD. Therefore, the aim of this review article is to provide an overview of the organs that are affected by NMS in PD together with a brief review of pathophysiology and treatment options.
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Affiliation(s)
- Ji Hyun Choi
- Department of Neurology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - Jong Min Kim
- Department of Neurology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea.
| | - Hee Kyung Yang
- Department of Ophthalmology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - Hyo Jung Lee
- Department of Dentistry, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - Cheol Min Shin
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - Seong Jin Jeong
- Department of Urology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - Won Seok Kim
- Department of Rehabilitation Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - Ji Won Han
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - In Young Yoon
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - Yoo Sung Song
- Department of Nuclear Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - Yun Jung Bae
- Department of Radiology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
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Jiang S, Berger S, Hu Y, Bartsch D, Tian Y. Alterations of the Motor and Olfactory Functions Related to Parkinson's Disease in Transgenic Mice With a VMAT2-Deficiency in Dopaminergic Neurons. Front Neurosci 2020; 14:356. [PMID: 32410942 PMCID: PMC7198702 DOI: 10.3389/fnins.2020.00356] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2019] [Accepted: 03/24/2020] [Indexed: 12/26/2022] Open
Abstract
Parkinson's disease (PD) is one of the most common neurodegenerative diseases, with approximately six million people affected worldwide. Vesicular monoamine transporter 2 (VMAT2) dysfunction has recently become a hot topic in the pathophysiology of PD, and the advent of transgenic mice has also accelerated the development of behavioral studies in animal models. However, there are only a few systematic behavioral tests that embrace abundant motor and non-motor performance in a unique mutant mouse model which correspond to the varied symptoms observed in human PD. The aim of this study is to evaluate the responsibility of the unique reduction of dopamine in the varied motor and non-motor symptoms of PD via a transgenic mice model. We analyzed neurotransmitter concentrations in the brain tissue of 18-month-old mutant mice, with selective inactivation of one allele of Vmat2 in dopaminergic neurons (VMAT2DATcre-HET) to confirm the selective reduction of dopamine, and then examined behavioral functions. Neurochemical tests showed lower dopamine concentrations in specific brain regions of VMAT2DATcre-HET mice, especially the ventral tegmental area/substantia nigra and striatum, together with relatively unchanging concentrations of norepinephrine and serotonin, demonstrating the dopaminergic specificity of this mouse model. Behavioral tasks showed impairments in several motor functions and major defects in olfactory abilities in the VMAT2DATcre-HET mice. However, no significant changes were found in the majority of non-motor tests, such as emotional performance and sleep patterns. We concluded from this study that the selective inactivation of one allele of the Vmat2 gene in dopaminergic neurons was related to dopamine reduction, resulting in phenotypes resembling some of the major deficits in PD, especially those of motor symptoms and olfactory functions.
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Affiliation(s)
- Song Jiang
- Department of Neurology, First Affiliated Hospital of Anhui Medical University, Hefei, China.,Department of Molecular Biology, Central Institute of Mental Health, Heidelberg University Faculty of Medicine in Mannheim, Mannheim, Germany
| | - Stefan Berger
- Department of Molecular Biology, Central Institute of Mental Health, Heidelberg University Faculty of Medicine in Mannheim, Mannheim, Germany
| | - Yajuan Hu
- Department of Neurology, First Affiliated Hospital of Anhui Medical University, Hefei, China.,Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Anhui Medical University, Hefei, China
| | - Dusan Bartsch
- Department of Molecular Biology, Central Institute of Mental Health, Heidelberg University Faculty of Medicine in Mannheim, Mannheim, Germany
| | - Yanghua Tian
- Department of Neurology, First Affiliated Hospital of Anhui Medical University, Hefei, China.,Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Anhui Medical University, Hefei, China.,Collaborative Innovation Center of Neuropsychiatric Disorders and Mental Health, Hefei, China
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25
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Zhang Y, Ren R, Sanford LD, Yang L, Zhou J, Tan L, Li T, Zhang J, Wing YK, Shi J, Lu L, Tang X. Sleep in Parkinson's disease: A systematic review and meta-analysis of polysomnographic findings. Sleep Med Rev 2020; 51:101281. [PMID: 32135452 DOI: 10.1016/j.smrv.2020.101281] [Citation(s) in RCA: 71] [Impact Index Per Article: 17.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2019] [Revised: 01/21/2020] [Accepted: 01/23/2020] [Indexed: 02/08/2023]
Abstract
Polysomnographic studies have been conducted to explore sleep changes in Parkinson's disease (PD), but the relationships between sleep disturbances and PD are imperfectly understood. We conducted a systematic review of the literature exploring polysomnographic differences between PD patients and controls in EMBASE, MEDLINE, All EBM databases, CINAHL, and PsycIFNO. 67 studies were identified for systematic review, 63 of which were used for meta-analysis. Meta-analyses revealed significant reductions in total sleep time, sleep efficiency, N2 percentage, slow wave sleep, rapid eye movement sleep (REM) percentage, and increases in wake time after sleep onset, N1 percentage, REM latency, apnea hypopnea index, and periodic limb movement index in PD patients compared with controls. There were no remarkable differences in sleep continuity or sleep architecture between PD patients with and without REM sleep behavior disorder (RBD). Our study suggests that PD patients have poor sleep quality and quantity. Sex, age, disease duration, presence of RBD, medication status, cognitive impairment, and adaptation night are factors that contributed to heterogeneity between studies.
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Affiliation(s)
- Ye Zhang
- Sleep Medicine Center, Department of Respiratory and Critical Care Medicine, Mental Health Center, Translational Neuroscience Center, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, China
| | - Rong Ren
- Sleep Medicine Center, Department of Respiratory and Critical Care Medicine, Mental Health Center, Translational Neuroscience Center, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, China
| | - Larry D Sanford
- Sleep Research Laboratory, Center for Integrative Neuroscience and Inflammatory Diseases, Department of Pathology and Anatomy, Eastern Virginia Medical School, Norfolk, VA, USA.
| | - Linghui Yang
- Sleep Medicine Center, Department of Respiratory and Critical Care Medicine, Mental Health Center, Translational Neuroscience Center, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, China
| | - Junying Zhou
- Sleep Medicine Center, Department of Respiratory and Critical Care Medicine, Mental Health Center, Translational Neuroscience Center, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, China
| | - Lu Tan
- Sleep Medicine Center, Department of Respiratory and Critical Care Medicine, Mental Health Center, Translational Neuroscience Center, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, China
| | - Taomei Li
- Sleep Medicine Center, Department of Respiratory and Critical Care Medicine, Mental Health Center, Translational Neuroscience Center, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, China
| | - Jihui Zhang
- Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong Special Administrative Region of China
| | - Yun-Kwok Wing
- Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong Special Administrative Region of China
| | - Jie Shi
- National Institute on Drug Dependence, Peking University Sixth Hospital, Peking University, Beijing 100191, China
| | - Lin Lu
- National Institute on Drug Dependence, Peking University Sixth Hospital, Peking University, Beijing 100191, China
| | - Xiangdong Tang
- Sleep Medicine Center, Department of Respiratory and Critical Care Medicine, Mental Health Center, Translational Neuroscience Center, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, China.
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26
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Kataoka H, Saeki K, Kurumatani N, Sugie K, Obayashi K. Objective sleep measures between patients with Parkinson's disease and community-based older adults. Sleep Med 2020; 68:110-114. [PMID: 32035300 DOI: 10.1016/j.sleep.2019.09.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2019] [Revised: 09/18/2019] [Accepted: 09/19/2019] [Indexed: 10/25/2022]
Abstract
OBJECTIVES Previous studies comparing objective sleep measures between patients with Parkinson's disease (PD) and control participants were limited by their small sample size. The purpose of this study was to compare objective sleep measures between large-scale cohorts of PD outpatients and community-based older adults. METHODS In this cross-sectional study, we measured sleep parameters for 157 PD patients using an actigraph on the non-dominant wrist for six consecutive nights (95 Hoehn-Yahr stage I/II; 62 Hoehn-Yahr stage III-V). Moreover, two consecutive nights of actigraphy were performed on 1101 community-based control participants aged ≥60 years. RESULTS In multivariable analysis, sleep efficiency (SE) was significantly lower in patients with late-stage PD by 17.5% [95% confidence interval: 15.3%-19.7%] and early-stage PD by 9.4% [7.6%-11.1%] compared to the controls (67.1% and 75.3% vs. 84.6%, respectively). Similar results were observed for wake after sleep onset (WASO) and fragmentation index (FI). Total sleep time and sleep onset latency (SOL) were significantly shorter in patients with late- and early-stage PD stage compared to the controls. Among PD patients, significant association trends between advancement of individual Hoehn-Yahr stages and worsened sleep measures of SE, WASO, and FI were observed independently of age, gender, levodopa equivalent dose, and motor function parameter. CONCLUSION This study demonstrated significant and quantitative differences in objective sleep quality and quantity between PD patients and control participants. Furthermore, with advancement of disease stages, objectively measured sleep quality worsened in PD patients.
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Affiliation(s)
- Hiroshi Kataoka
- Department of Neurology, Nara Medical University School of Medicine, Nara, Japan.
| | - Keigo Saeki
- Department of Epidemiology, Nara Medical University School of Medicine, Nara, Japan
| | - Norio Kurumatani
- Department of Epidemiology, Nara Medical University School of Medicine, Nara, Japan
| | - Kazuma Sugie
- Department of Neurology, Nara Medical University School of Medicine, Nara, Japan
| | - Kenji Obayashi
- Department of Epidemiology, Nara Medical University School of Medicine, Nara, Japan.
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27
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Stefani A, Högl B. Sleep in Parkinson's disease. Neuropsychopharmacology 2020; 45:121-128. [PMID: 31234200 PMCID: PMC6879568 DOI: 10.1038/s41386-019-0448-y] [Citation(s) in RCA: 90] [Impact Index Per Article: 22.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2019] [Revised: 05/26/2019] [Accepted: 06/13/2019] [Indexed: 11/09/2022]
Abstract
Sleep disturbances are common in Parkinson's disease and comprise the entire spectrum of sleep disorders. On the one hand regulation of sleep and wakefulness is affected in Parkinson's disease, leading to the development of disorders, such as insomnia and daytime sleepiness. While on the other hand control of motor activity during sleep is impaired, with subsequent manifestation of parasomnias (mainly REM sleep behavior disorders, but also, albeit more rarely, sleepwalking, and overlap parasomnia). Restless legs syndrome has been reported to be frequent in patients with Parkinson's disease, although there is no consensus on whether it is more frequent in Parkinson's disease than in the general population. The same is true for sleep-related breathing disorders. Regarding the diagnosis of sleep disorders in patients with Parkinson's disease, one of the main challenges is correctly identifying excessive daytime sleepiness as there are many potential confounding factors, for example it is necessary to distinguish sleep-related breathing disorders from medication effects, and to distinguish restless legs syndrome from the concomitant presence of potential mimics specific to Parkinson's disease, such as akathisia, nocturnal leg cramps, nocturnal hypokinesia, early morning dystonia, etc. The correct diagnosis of REM sleep behavior disorder is also not always easy, and video-polysomnography should be performed in order to exclude mimic-like movements at the end of sleep apneas or violent periodic leg movements of sleep. These aspects and specific considerations about diagnosis and treatment of sleep disorders in patients with Parkinson's disease will be reviewed.
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Affiliation(s)
- Ambra Stefani
- Department of Neurology, Medical University Innsbruck, Anichstrasse 35, 6020, Innsbruck, Austria.
| | - Birgit Högl
- Department of Neurology, Medical University Innsbruck, Anichstrasse 35, 6020, Innsbruck, Austria
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28
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Iyer V, Vo Q, Mell A, Chinniah S, Zenerovitz A, Venkiteswaran K, Kunselman AR, Fang J, Subramanian T. Acute levodopa dosing around-the-clock ameliorates REM sleep without atonia in hemiparkinsonian rats. NPJ PARKINSONS DISEASE 2019; 5:27. [PMID: 31815176 PMCID: PMC6884572 DOI: 10.1038/s41531-019-0096-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/15/2019] [Accepted: 10/21/2019] [Indexed: 01/08/2023]
Abstract
Rapid-eye-movement (REM) sleep without atonia (RSWA), a marker of REM sleep behavior disorder (RBD), is frequently comorbid with Parkinson's disease (PD). Although rodent models are commonly used for studying PD, the neurobiological and behavioral correlates of RBD remain poorly understood. Therefore, we developed a behavior-based criteria to identify RSWA in the hemiparkinsonian rat model of PD. Video recordings of rats were analyzed, to develop a criteria consisting of behavioral signs that occurred during polysomnographically confirmed epochs of sleep-wake stages. The sleep-slouch, a postural shift of the body or head caused only by gravity, was identified as a unique behavioral sign of REM sleep onset and was altered in hemiparkinsonian rats during RSWA. There was a significant correlation between the behavior-based criteria and polysomnograms for all sleep-wake stages in control but not hemiparkinsonian rats indicating a deterioration of sleep-wake architecture in parkinsonism. We then tested the efficacy of levodopa in ameliorating RSWA using intermittent and around-the-clock (ATC) dosing regimens. ATC levodopa dosing at 4 mg/kg for 48 h caused a significant reduction of RSWA as measured by polysomnography and the behavioral-based criteria along with an amelioration of forelimb motor deficits. Our findings show that the phenomenological correlates of RSWA can be reliably characterized in the hemiparkinsonian rat model. ATC levodopa administration ameliorates RSWA in this model without deleterious consequences to the overall sleep-wake architecture and therapeutic benefits for parkinsonian motor deficits. These findings suggest that further study may allow for the application of a similar approach to treat RBD in PD patients.
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Affiliation(s)
- Vishakh Iyer
- 1Program in Neuroscience, Department of Psychological and Brain Sciences, Indiana University, Bloomington, IN USA
| | - Quynh Vo
- 2Department of Neurology, West Virginia University School of Medicine, Morgantown, WV USA
| | - Anthony Mell
- 3Department of Neurology and Neural and Behavioral Sciences, The Pennsylvania State University College of Medicine, Hershey, PA USA
| | - Siven Chinniah
- 3Department of Neurology and Neural and Behavioral Sciences, The Pennsylvania State University College of Medicine, Hershey, PA USA
| | - Ashley Zenerovitz
- 3Department of Neurology and Neural and Behavioral Sciences, The Pennsylvania State University College of Medicine, Hershey, PA USA
| | - Kala Venkiteswaran
- 3Department of Neurology and Neural and Behavioral Sciences, The Pennsylvania State University College of Medicine, Hershey, PA USA
| | - Allen R Kunselman
- 4Department of Public Health Sciences, The Pennsylvania State University College of Medicine, Hershey, PA USA
| | - Jidong Fang
- 5Department of Psychiatry, The Pennsylvania State University College of Medicine, Hershey, PA USA
| | - Thyagarajan Subramanian
- 3Department of Neurology and Neural and Behavioral Sciences, The Pennsylvania State University College of Medicine, Hershey, PA USA
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Murueta-Goyena A, Andikoetxea A, Gómez-Esteban JC, Gabilondo I. Contribution of the GABAergic System to Non-Motor Manifestations in Premotor and Early Stages of Parkinson's Disease. Front Pharmacol 2019; 10:1294. [PMID: 31736763 PMCID: PMC6831739 DOI: 10.3389/fphar.2019.01294] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2019] [Accepted: 10/09/2019] [Indexed: 12/13/2022] Open
Abstract
Non-motor symptoms are common in Parkinson’s disease (PD) and they represent a major source of disease burden. Several non-motor manifestations, such as rapid eye movement sleep behavior disorder, olfactory loss, gastrointestinal abnormalities, visual alterations, cognitive and mood disorders, are known to precede the onset of motor signs. Nonetheless, the mechanisms mediating these alterations are poorly understood and probably involve several neurotransmitter systems. The dysregulation of GABAergic system has received little attention in PD, although the spectrum of non-motor symptoms might be linked to this pathway. This Mini Review aims to provide up-to-date information about the involvement of the GABAergic system for explaining non-motor manifestations in early stages of PD. Therefore, special attention is paid to the clinical data derived from patients with isolated REM sleep behavior disorder or drug-naïve patients with PD, as they represent prodromal and early stages of the disease, respectively. This, in combination with animal studies, might help us to understand how the disturbance of the GABAergic system is related to non-motor manifestations of PD.
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Affiliation(s)
- Ane Murueta-Goyena
- Neurodegenerative Diseases Group, Biocruces Bizkaia Health Research Institute, Barakaldo, Spain
| | - Ane Andikoetxea
- Neurodegenerative Diseases Group, Biocruces Bizkaia Health Research Institute, Barakaldo, Spain
| | - Juan Carlos Gómez-Esteban
- Neurodegenerative Diseases Group, Biocruces Bizkaia Health Research Institute, Barakaldo, Spain.,Department of Neuroscience, University of the Basque Country (UPV/EHU), Leioa, Spain
| | - Iñigo Gabilondo
- Neurodegenerative Diseases Group, Biocruces Bizkaia Health Research Institute, Barakaldo, Spain.,IKERBASQUE Basque Foundation for Science, Bilbao, Spain
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30
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Kataoka H, Saeki K, Yamagami Y, Sugie K, Obayashi K. Quantitative associations between objective sleep measures and early-morning mobility in Parkinson’s disease: cross-sectional analysis of the PHASE study. Sleep 2019; 43:5573905. [DOI: 10.1093/sleep/zsz203] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2019] [Revised: 07/24/2019] [Indexed: 11/14/2022] Open
Abstract
Abstract
Study Objectives
Previous studies have suggested associations between sleep measures and early-morning akinesia; however, objective evidence is limited. The purpose of this study was to evaluate the associations between objective sleep measures and morning mobility among patients with Parkinson’s disease (PD).
Methods
In this cross-sectional study, we measured objective sleep parameters and morning mobility in 157 patients with PD (mean age, 71.4 years) for six consecutive days using an actigraph placed on the nondominant wrist. Low morning mobility was defined as less than 100 counts/min within the first 2 hours after rising.
Results
The mean duration of low morning mobility was 55.7 minutes (SD, 23.8), and the mean sleep parameters were as follows: sleep efficiency (SE), 72.1% (13.6); wake after sleep onset (WASO), 104.7 minutes (57.9); total sleep time (TST), 343.6 minutes (104.0); and fragmentation index (FI), 3.5 (3.4). Multivariable linear regression analysis adjusted for potential confounders demonstrated significant associations between better objective sleep measures and shorter low morning mobility (SE per %: β, −0.419; 95% CI = −0.635 to −0.204; p < 0.001; WASO per min: β, 0.056; 95% CI = 0.003 to 0.109; p = 0.039; and FI per unit; β, 1.161; 95% CI = 0.300 to 2.023; p = 0.009) but not TST (p = 0.78). These findings were not altered by different cutoff values of mobility (50 counts/min) or duration (1 h after rising).
Conclusions
In patients with PD, better objective sleep measures are significantly associated with shorter low morning mobility. Future studies investigating whether improved sleep reduces symptoms of low morning mobility are required.
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Affiliation(s)
- Hiroshi Kataoka
- Department of Neurology, Nara Medical University School of Medicine, Japan
| | - Keigo Saeki
- Department of Epidemiology, Nara Medical University School of Medicine, Japan
| | - Yuki Yamagami
- Department of Epidemiology, Nara Medical University School of Medicine, Japan
| | - Kazuma Sugie
- Department of Neurology, Nara Medical University School of Medicine, Japan
| | - Kenji Obayashi
- Department of Epidemiology, Nara Medical University School of Medicine, Japan
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31
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Melka D, Tafesse A, Bower JH, Assefa D. Prevalence of sleep disorders in Parkinson's disease patients in two neurology referral hospitals in Ethiopia. BMC Neurol 2019; 19:205. [PMID: 31438888 PMCID: PMC6706909 DOI: 10.1186/s12883-019-1431-2] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2018] [Accepted: 07/23/2019] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND Non motor symptoms (NMS) of Parkinson's disease (PD) are common and can be more disabling than motor symptoms. Sleep disorders can be seen in up to 98% of patients with Parkinson disease. Poor sleep quality has been associated with poverty and race, and yet there has been no prior report on sleep disorders in those with PD living in sub Saharan Africa. We wished to document the prevalence of sleep disorders in PD patients in Ethiopia. METHODS We conducted a cross-sectional point prevalence study from July 1 to October 30, 2015 of all patients attending the neurology outpatient department in Tikur Anbessa and Zewuditu Memorial Hospitals, Addis Ababa, Ethiopia. Demographic data, clinical history and physical examination findings were collected from participants using a structured questionnaire. We used the Parkinson's disease sleep scale version two (PDSS-2) and Epworth Sleepiness Scale (ESS) to assess the sleep symptoms. RESULTS Of the 155 patients surveyed, all patients reported some sleep problem. Over 43.9% of patients had a PDSS score > 18. The median score of ESS was 9 (IQR = 5-12), with 77/155 (49.7%) of the patients having possible or definite excessive daytime somnolence. A high EDSS score significantly associated with a Hoehn & Yahr score > 4 (p = 0.02). CONCLUSIONS In Ethiopian PD patients, the prevalence of those with severe sleep disorders is the highest reported to date. The prevalence of possible/definite EDS is amongst the highest in the world. Further investigation into whether poverty or race explains this finding is needed.
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Affiliation(s)
- Dereje Melka
- Department of Neurology, Addis Ababa University School of Medicine, P.O.Box 1176, Addis Ababa, Ethiopia
| | - Abenet Tafesse
- Department of Neurology, Addis Ababa University School of Medicine, P.O.Box 1176, Addis Ababa, Ethiopia
| | - James H. Bower
- Department of Neurology, Mayo Clinic School of Medicine, 200 First St SW, Rochester, MN USA
| | - Demeke Assefa
- Department of Health Service Management and Reproductive Health, School of Public Health College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
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Martinez-Martin P, Wetmore JB, Rodríguez-Blázquez C, Arakaki T, Bernal O, Campos-Arillo V, Cerda C, Estrada-Bellmann I, Garretto N, Ginsburg L, Máñez-Miró JU, Martínez-Castrillo JC, Pedroso I, Serrano-Dueñas M, Singer C, Rodríguez-Violante M, Vivancos F. The Parkinson's Disease Sleep Scale-2 (PDSS-2): Validation of the Spanish Version and Its Relationship With a Roommate-Based Version. Mov Disord Clin Pract 2019; 6:294-301. [PMID: 31061837 DOI: 10.1002/mdc3.12749] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2018] [Revised: 12/20/2018] [Accepted: 02/13/2019] [Indexed: 12/13/2022] Open
Abstract
Background Because of the prevalence and impact of sleep disorders in Parkinson's disease (PD), valid instruments for their evaluation and monitoring are necessary. However, some nocturnal sleep disorders may go unnoticed by patients themselves. Objectives To validate a pan-Spanish version of the Parkinson's Disease Sleep Scale Version 2 (PDSS-2) and to test the relationships between the PDSS-2 and a PDSS-2 roommate version. Methods PD patients (n = 399) from seven Spanish-speaking countries were included. In addition to the tested PDSS-2 scales, valid measures for sleep disorders and both motor and nonmotor manifestations were applied. Acceptability, dimensionality, reliability, precision, and construct validity were explored, as well as discrepancies and agreement between the PDSS-2 and the roommate version. Results PDSS-2 showed negligible floor and ceiling effects. Four factors (57% of the variance) were identified. Reliability parameters were satisfactory: alpha = 0.84; item homogeneity coefficient = 0.27; corrected item total correlation = 0.28 to 0.61; and test-retest reliability (average kappa = 0.70; intraclass correlation coefficient [ICC] = 0.83). The standard error of measurement was 5.84, and correlations with other scales assessing nocturnal sleep were high (rS = 0.62-0.56). In comparison to the patient-based total score, the by proxy total score showed no significant difference, high correlation (rS = 0.70), and acceptable agreement (ICC = 0.69), but there were discrepancies in two or more points in 18% of item scores. Conclusions The Spanish version of the PDSS-2 has shown satisfactory clinimetric attributes. Acceptability and precision data are presented for the first time. The PDSS-2 roommate version could be useful to complement the patient-based evaluation, but additional studies are needed.
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Affiliation(s)
- Pablo Martinez-Martin
- National Center of Epidemiology Carlos III Institute of Health Madrid Spain.,Network Center for Biomedical Research in Neurodegenerative Diseases (CIBERNED) Carlos III Institute of Health Madrid Spain
| | - John B Wetmore
- National Center of Epidemiology Carlos III Institute of Health Madrid Spain
| | - Carmen Rodríguez-Blázquez
- National Center of Epidemiology Carlos III Institute of Health Madrid Spain.,Network Center for Biomedical Research in Neurodegenerative Diseases (CIBERNED) Carlos III Institute of Health Madrid Spain
| | - Tomoko Arakaki
- Parkinson Disease and Other Movement Disorders Unit Hospital José María Ramos Mejía, Neurology University Center of Buenos Aires University Buenos Aires Argentina
| | - Oscar Bernal
- Movement Disorders Clinic Hospital Militar Central Bogotá Colombia
| | | | - Christopher Cerda
- Movement Disorder Clinic University Hospital Monterrey Nuevo León México
| | | | - Nélida Garretto
- Parkinson Disease and Other Movement Disorders Unit Hospital José María Ramos Mejía, Neurology University Center of Buenos Aires University Buenos Aires Argentina
| | - Letty Ginsburg
- Movement Disorders Division Miller School of Medicine, University of Miami Miami Florida USA
| | | | | | - Ivonne Pedroso
- Movement Disorders Clinic International Center for Neurological Restoration (CIREN) Havana Cuba
| | - Marcos Serrano-Dueñas
- Medicine Faculty, Pontifical Catholic University of Ecuador Movement Disorders Unit, Neurological Service, Carlos Andrade Marín Hospital Quito Ecuador
| | - Carlos Singer
- Movement Disorders Division Miller School of Medicine, University of Miami Miami Florida USA
| | | | - Francisco Vivancos
- Movement Disorders Unit, Neurology department La Paz University Hospital Madrid Spain
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Chronic sleep restriction in the rotenone Parkinson's disease model in rats reveals peripheral early-phase biomarkers. Sci Rep 2019; 9:1898. [PMID: 30760786 PMCID: PMC6374389 DOI: 10.1038/s41598-018-37657-6] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2018] [Accepted: 12/06/2018] [Indexed: 12/21/2022] Open
Abstract
Parkinson’s disease (PD) is a chronic disorder that presents a range of premotor signs, such as sleep disturbances and cognitive decline, which are key non-motor features of the disease. Increasing evidence of a possible association between sleep disruption and the neurodegenerative process suggests that sleep impairment could produce a detectable metabolic signature on the disease. In order to integrate neurocognitive and metabolic parameters, we performed untargeted and targeted metabolic profiling of the rotenone PD model in a chronic sleep restriction (SR) (6 h/day for 21 days) condition. We found that SR combined with PD altered several behavioural (reversal of locomotor activity impairment; cognitive impairment; delay of rest-activity rhythm) and metabolic parameters (branched-chain amino acids, tryptophan pathway, phenylalanine, and lipoproteins, pointing to mitochondrial impairment). If combined, our results bring a plethora of parameters that represents reliable early-phase PD biomarkers which can easily be measured and could be translated to human studies.
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Rodriguez CL, Jaimchariyatam N, Budur K. Rapid Eye Movement Sleep Behavior Disorder. Chest 2017; 152:650-662. [DOI: 10.1016/j.chest.2017.03.015] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2016] [Revised: 02/14/2017] [Accepted: 03/04/2017] [Indexed: 10/19/2022] Open
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Schapira AHV, Chaudhuri KR, Jenner P. Non-motor features of Parkinson disease. Nat Rev Neurosci 2017; 18:435-450. [PMID: 28592904 DOI: 10.1038/nrn.2017.62] [Citation(s) in RCA: 1003] [Impact Index Per Article: 143.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Many of the motor symptoms of Parkinson disease (PD) can be preceded, sometimes for several years, by non-motor symptoms that include hyposmia, sleep disorders, depression and constipation. These non-motor features appear across the spectrum of patients with PD, including individuals with genetic causes of PD. The neuroanatomical and neuropharmacological bases of non-motor abnormalities in PD remain largely undefined. Here, we discuss recent advances that have helped to establish the presence, severity and effect on the quality of life of non-motor symptoms in PD, and the neuroanatomical and neuropharmacological mechanisms involved. We also discuss the potential for the non-motor features to define a prodrome that may enable the early diagnosis of PD.
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Affiliation(s)
- Anthony H V Schapira
- Department of Clinical Neurosciences, University College London (UCL) Institute of Neurology, Royal Free Campus, Rowland Hill Street, London NW3 2PF, UK
| | - K Ray Chaudhuri
- National Parkinson Foundation International Centre of Excellence, King's College Hospital, King's College London, Camberwell Road, London SE5 9RS, UK
| | - Peter Jenner
- Neurodegenerative Diseases Research Group, Institute of Pharmaceutical Sciences, Faculty of Life Sciences and Medicine, King's College London, Newcomen Street, London SE1 1UL, UK
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Amara AW, Chahine LM, Videnovic A. Treatment of Sleep Dysfunction in Parkinson's Disease. Curr Treat Options Neurol 2017; 19:26. [PMID: 28567500 DOI: 10.1007/s11940-017-0461-6] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
OPINION STATEMENT Impaired sleep and alertness affect the majority of Parkinson's disease (PD) patients, negatively impacting safety and quality of life. The etiology of impaired sleep-wake cycle in PD is multifactorial and encompasses medication side effects, nocturnal PD motor symptoms, and presence of co-existent sleep and neuropsychiatric disorders. The primary neurodegenerative process of PD involves brain regions that regulate the sleep-wake cycle, such as brainstem and hypothalamic nuclei. Sleep disorders in PD include insomnia, REM sleep behavior disorder (RBD), sleep disordered breathing (SDB), restless legs syndrome (RLS), and circadian disruption. Despite its high prevalence in the PD population, there is a paucity of clinical studies that have investigated treatment of sleep dysfunction associated with PD. Therefore, we aim to review available evidence and outline treatment strategies for improvement of disorders of sleep and wakefulness in PD patients. Evidence supporting the efficacy of pharmacological and non-pharmacological treatment strategies in PD is limited. There is thus a great need but also opportunity for development of well-designed clinical trials for impaired sleep and alertness in PD. Providing education about sleep hygiene and strategies for its implementation represents the initial step in management. Prompt diagnosis and treatment of co-existent primary sleep and psychiatric disorders are critical, as this may significantly improve sleep and alertness. While the optimal treatment for insomnia in PD has not been established, available strategies include cognitive-behavioral therapy, medications with soporific properties, and light therapy. Safety measures, clonazepam, and melatonin are the mainstay of treatment for RBD. Continuous positive airway pressure is an effective treatment for SDB in PD. The treatment algorithm for RLS associated with PD mirrors that used for idiopathic RLS. Circadian disruption has emerged as an important etiology of impaired sleep-wake cycles in PD, and circadian-based interventions hold promise for novel treatment approaches.
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Affiliation(s)
- Amy W Amara
- Division of Movement Disorders, Department of Neurology, University of Alabama at Birmingham, SC 360A, 1720 2nd Ave S, Birmingham, AL, 35294-0017, USA.
| | - Lana M Chahine
- Parkinson's Disease and Movement Disorders Center, Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Aleksandar Videnovic
- Neurobiological Clinical Research Institute, Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
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Tufan A, Ilhan B, Bahat G, Karan MA. An under-diagnosed geriatric syndrome: sleep disorders among older adults. Afr Health Sci 2017; 17:436-444. [PMID: 29062339 PMCID: PMC5637029 DOI: 10.4314/ahs.v17i2.18] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION Sleep disorders are commonly under-diagnosed in the geriatric population. We aimed to determine the prevalence of sleep problems among older adults admitted to the geriatrics out-patient clinic. METHODS Two hundred and three patients (136 female) older than 75 years of age were included in the study. Patients underwent comprehensive geriatric assessment, including identification of sleep problems using the Sleep Disturbance Scale, Rapid eye movement (REM) sleep behavior disorder (RBD) Single-Question Screen questionnaire (RBD1Q) and The Johns Hopkins Restless Leg Syndrome Severity Scale. Demographic and clinical data including age, sex, medications, comorbid diseases, body mass index and functional scores was noted. RESULTS The mean age of the patients was 80.92±4.3 years. 35.5% of the patients had findings of REM-SBD and 32.5% of the patients had restless legs syndrome. Ninety-seven percent of the patients answered 'yes' to at least one of the sleep disturbance scale questions. There was no significant difference between male and female groups. CONCLUSION We observed that sleep disorders were common among older adults. For this reason, the course and quality of sleep should be examined in all patients as a routine part of comprehensive geriatric assessment.
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Affiliation(s)
- Asli Tufan
- Marmara University Hospital, Department of Internal Medicine, Division of Geriatrics, Pendik, Istanbul, 34662, Turkey
| | - Birkan Ilhan
- Istanbul Medical School, Department of Internal Medicine, Division of Geriatrics, Istanbul University, Capa, 34093, Istanbul, Turkey
| | - Gulistan Bahat
- Istanbul Medical School, Department of Internal Medicine, Division of Geriatrics, Istanbul University, Capa, 34093, Istanbul, Turkey
| | - Mehmet Akif Karan
- Istanbul Medical School, Department of Internal Medicine, Division of Geriatrics, Istanbul University, Capa, 34093, Istanbul, Turkey
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Rutten S, Vriend C, van der Werf YD, Berendse HW, Weintraub D, van den Heuvel OA. The bidirectional longitudinal relationship between insomnia, depression and anxiety in patients with early-stage, medication-naïve Parkinson's disease. Parkinsonism Relat Disord 2017; 39:31-36. [PMID: 28365203 PMCID: PMC5441947 DOI: 10.1016/j.parkreldis.2017.01.015] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2016] [Revised: 12/24/2016] [Accepted: 01/29/2017] [Indexed: 12/11/2022]
Abstract
INTRODUCTION While anxiety, depression and insomnia frequently (co-)occur in Parkinson's disease (PD) patients, little is known about their temporal relationship. In this study, we tested two hypotheses: i) insomnia predicts an increase in symptoms of depression or anxiety and ii) anxiety or depression at baseline predicts insomnia in PD patients six months later. METHODS We used longitudinal data from a prospective cohort study of early-stage, medication-naïve PD patients. Primary outcome measures were: anxiety symptoms, measured with the State-Trait Anxiety Inventory (STAI); depressive symptoms, measured with the 15-item Geriatric Depression Scale (GDS-15); and insomnia, defined as a score ≥ 2 on item 1.7 of the Movement Disorder Society - Unified Parkinson's Disease Rating Scale. We performed linear and logistic regression analyses, correcting for baseline value of the respective outcome variable. RESULTS Baseline insomnia was not associated with GDS-15 or STAI total score at follow-up. In a post hoc analysis, we found that insomnia predicted a higher STAI State score (B(SE) = 2.50 (1.07), p < 0.05), while the association with the STAI Trait score was not significant. Baseline STAI scores (B(SE) = 0.02 (0.01), p = 0.001) and GDS-15 score (B(SE) = 0.15 (0.05), p < 0.001) were significantly associated with insomnia at follow-up. CONCLUSION Symptoms of anxiety and depression may constitute a risk factor for insomnia in PD. The relationship between insomnia and anxiety is bidirectional, which suggests that both anxiety and sleep disorders can start a negative spiral in PD patients, where one enhances the other. Independent clinical attention for these symptoms in PD patients is therefore warranted.
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Affiliation(s)
- Sonja Rutten
- Department of Psychiatry, VU University Medical Center (VUmc), The Netherlands; Department of Anatomy & Neurosciences, VUmc, The Netherlands.
| | - Chris Vriend
- Department of Psychiatry, VU University Medical Center (VUmc), The Netherlands; Department of Anatomy & Neurosciences, VUmc, The Netherlands; Amsterdam Neuroscience, Amsterdam, The Netherlands; Department of Neurology, VUmc, The Netherlands
| | - Ysbrand D van der Werf
- Department of Anatomy & Neurosciences, VUmc, The Netherlands; Amsterdam Neuroscience, Amsterdam, The Netherlands
| | - Henk W Berendse
- Amsterdam Neuroscience, Amsterdam, The Netherlands; Department of Neurology, VUmc, The Netherlands
| | - Daniel Weintraub
- Department of Psychiatry, University of Pennsylvania School of Medicine, Philadelphia, United States
| | - Odile A van den Heuvel
- Department of Psychiatry, VU University Medical Center (VUmc), The Netherlands; Department of Anatomy & Neurosciences, VUmc, The Netherlands; Amsterdam Neuroscience, Amsterdam, The Netherlands
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Masini D, Lopes-Aguiar C, Bonito-Oliva A, Papadia D, Andersson R, Fisahn A, Fisone G. The histamine H3 receptor antagonist thioperamide rescues circadian rhythm and memory function in experimental parkinsonism. Transl Psychiatry 2017; 7:e1088. [PMID: 28398338 PMCID: PMC5416699 DOI: 10.1038/tp.2017.58] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2016] [Revised: 02/10/2017] [Accepted: 02/15/2017] [Indexed: 12/19/2022] Open
Abstract
Parkinson's disease (PD) is a common neurodegenerative disorder, characterized by motor impairment and a wide range of non-motor symptoms, including sleep disorders and cognitive and affective deficits. In this study, we used a mouse model of PD based on 6-hydroxydopamine (6-OHDA) to examine the effect of thioperamide, a histamine H3 receptor antagonist, on circadian activity, recognition memory and anxiety. A partial, bilateral 6-OHDA lesion of the striatum reduces motor activity during the active phase of the 24 h cycle. In addition, the lesion disrupts the endogenous circadian rhythm observed when mice are maintained in constant darkness. Administration of thioperamide to 6-OHDA-lesion mice rescues the normal rest/activity cycle. Moreover, thioperamide counteracts the deficit of novel object recognition produced by 6-OHDA. Our experiments show that this memory impairment is accompanied by disrupted gamma oscillations in the hippocampus, which are also rescued by thioperamide. In contrast, we do not observe any modification of the anxiogenic effect of 6-OHDA in response to administration of thioperamide. Our results indicate that thioperamide may act as a multifunctional drug, able to counteract disruptions of circadian rhythm and cognitive deficits associated with PD.
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Affiliation(s)
- D Masini
- Department of Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - C Lopes-Aguiar
- Department of Physiology and Biophysics, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - A Bonito-Oliva
- Department of Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - D Papadia
- Neuronal Oscillations Laboratory, Division for Neurogeriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | - R Andersson
- Neuronal Oscillations Laboratory, Division for Neurogeriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | - A Fisahn
- Neuronal Oscillations Laboratory, Division for Neurogeriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | - G Fisone
- Department of Neuroscience, Karolinska Institutet, Stockholm, Sweden
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Bhidayasiri R, Sringean J, Rattanachaisit W, Truong DD. The sleeping brain in Parkinson's disease: A focus on REM sleep behaviour disorder and related parasomnias for practicing neurologists. J Neurol Sci 2017; 374:32-37. [PMID: 28126342 DOI: 10.1016/j.jns.2017.01.018] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2016] [Revised: 01/04/2017] [Accepted: 01/06/2017] [Indexed: 11/17/2022]
Abstract
Sleep disorders are identified as common non-motor symptoms of Parkinson's disease (PD) and recently this recognition has been expanded to include parasomnias, encompassing not only REM sleep behaviour disorder (RBD), but also other non-REM forms. RBD, a prototypical parasomnia in PD, exists even in the prodromal stage of the disease, and is characterized by the presence of dream enactment behaviours occurring alongside a loss of normal skeletal muscle atonia during REM sleep. In contrast, non-REM parasomnias are more frequently observed in the late stage PD. However, the development of these disorders often overlaps and it is not uncommon for PD patients to meet the criteria for more than one type of parasomnias, thus making a clinical distinction challenging for practicing neurologists who are not sleep specialists. Indeed, clinical recognition of the predominant form of parasomnia does not just depend on video-polysomnography, but also on an individual physician's clinical acumen in delineating pertinent clinical history to determine the most likely diagnosis and proceed accordingly. In this review article, we highlight the various forms of parasomnias that have been reported in PD, including, but not limited to, RBD, with a focus on clinical symptomatology and implications for clinical practice. In addition, we review the differences in PD-related parasomnias compared to those seen in general populations. With advances in sleep research and better technology for ambulatory home monitoring, it is likely that many unanswered questions on PD-related parasomnias will soon be resolved resulting in better management of this nocturnal challenge in PD.
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Affiliation(s)
- Roongroj Bhidayasiri
- Chulalongkorn Centre of Excellence for Parkinson's Disease & Related Disorders, Department of Medicine, Faculty of Medicine, Chulalongkorn University, King Chulalongkorn Memorial Hospital and Thai Red Cross Society, Bangkok, Thailand; Department of Rehabilitation Medicine, Juntendo University, Tokyo, Japan.
| | - Jirada Sringean
- Chulalongkorn Centre of Excellence for Parkinson's Disease & Related Disorders, Department of Medicine, Faculty of Medicine, Chulalongkorn University, King Chulalongkorn Memorial Hospital and Thai Red Cross Society, Bangkok, Thailand
| | - Watchara Rattanachaisit
- Chulalongkorn Centre of Excellence for Parkinson's Disease & Related Disorders, Department of Medicine, Faculty of Medicine, Chulalongkorn University, King Chulalongkorn Memorial Hospital and Thai Red Cross Society, Bangkok, Thailand
| | - Daniel D Truong
- Parkinson's and Movement Disorders Institute, Fountain Valley, CA, USA
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Szatmari S, Illigens BMW, Siepmann T, Pinter A, Takats A, Bereczki D. Neuropsychiatric symptoms in untreated Parkinson's disease. Neuropsychiatr Dis Treat 2017; 13:815-826. [PMID: 28352181 PMCID: PMC5360401 DOI: 10.2147/ndt.s130997] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
Abstract
Neuropsychiatric and cognitive symptoms are common in Parkinson's disease (PD) and may precede and exceed motor symptoms as major factors impacting disease course and quality of life. Neuropsychiatric symptoms (NPS) in PD are various and are attributed to pathologic changes within multiple brain regions, to psychological stress, and to adverse effects of dopamine replacement therapy. Sleep disorders and mood symptoms such as apathy, depression, and anxiety may antedate the development of motor symptoms by years, while other NPS such as impulse control disorders, psychosis, and cognitive impairment are more common in later stages of the disease. Few studies report on NPS in the early, untreated phase of PD. We reviewed the current literature on NPS in PD with a focus on the early, drug-naive stages of PD. Among these early disease stages, premotor and early motor phases were separately addressed in our review, highlighting the underlying pathophysiological mechanisms as well as epidemiological characteristics, clinical features, risk factors, and available techniques of clinical assessment.
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Affiliation(s)
- Szabolcs Szatmari
- Department of Neurology, Sibiu County Emergency Hospital, Sibiu; 2nd Department of Neurology, Targu Mures Emergency Clinical County Hospital, Targu Mures, Romania; János Szentágothai Doctoral School of Neurosciences, Semmelweis University, Budapest, Hungary
| | - Ben Min-Woo Illigens
- Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Timo Siepmann
- Center for Clinical Research and Management Education, Division of Health Care Sciences, Dresden International University; Department of Neurology, University Hospital Carl Gustav Carus, Technical University of Dresden, Dresden, Germany
| | - Alexandra Pinter
- Center for Clinical Research and Management Education, Division of Health Care Sciences, Dresden International University; Department of Family Medicine
| | - Annamaria Takats
- Department of Neurology, Semmelweis University, Budapest, Hungary
| | - Daniel Bereczki
- Department of Neurology, Semmelweis University, Budapest, Hungary
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Zhu K, van Hilten JJ, Marinus J. The course of insomnia in Parkinson's disease. Parkinsonism Relat Disord 2016; 33:51-57. [PMID: 27639814 DOI: 10.1016/j.parkreldis.2016.09.010] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2016] [Revised: 09/01/2016] [Accepted: 09/07/2016] [Indexed: 11/15/2022]
Abstract
INTRODUCTION Insomnia is a debilitating symptom in Parkinson's disease (PD) that has been scarcely investigated in a longitudinal design. Knowledge of factors associated with occurrence of insomnia may provide clues for an increased understanding of underlying pathophysiology and facilitate early detection. The objective of this study is to examine the course and factors associated with longitudinal changes in insomnia severity in patients with PD. METHODS Analyses were performed in data of the SCOPA-PROPARK cohort, a 5-year longitudinal cohort study (2003-2011) of 421 PD patients who have been examined annually. Linear mixed models were used to identify factors associated with longitudinal changes in scores of the SCOPA-SLEEP-Nighttime sleep (NS) problems section. A generalized estimating equations (GEE) analysis was performed to determine which baseline variables were associated with the different aspects of insomnia (sleep initiation or maintenance difficulty). RESULTS Baseline SCOPA-SLEEP-NS scores were available for 412 patients, of whom 110 (27%) had insomnia (i.e. score ≥ 7). Of the remaining 302 patients, 99 (33%) developed insomnia at some point during follow-up. More severe depressive symptoms, motor fluctuations, higher dopamine agonist doses and sleep medication use were independently associated with higher SCOPA-SLEEP-NS scores over time. GEE analysis did not identify an unique set of determinants that affected specific aspects of insomnia. CONCLUSION The presence of depressive symptoms, motor fluctuations and the use of higher doses of dopamine agonists are associated with more severe insomnia. Attention to these aspects could potentially contribute to a better management of insomnia symptoms in PD.
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Affiliation(s)
- Kangdi Zhu
- Department of Neurology, Leiden University Medical Center, Leiden, The Netherlands.
| | - Jacobus J van Hilten
- Department of Neurology, Leiden University Medical Center, Leiden, The Netherlands
| | - Johan Marinus
- Department of Neurology, Leiden University Medical Center, Leiden, The Netherlands
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Gulyani S, Salas R, Mari Z, Choi S, Mahajan A, Gamaldo C. Evaluating and Managing Sleep Disorders in the Parkinson's Disease Clinic. ACTA ACUST UNITED AC 2016; 6:165-172. [PMID: 27818912 DOI: 10.1016/j.baga.2016.05.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Parkinson's disease is a multi-systems neurodegenerative disorder that is characterized by a combination of motor and non-motor symptoms. Non-motor symptoms of Parkinson's disease comprise a variety of cognitive, neuropsychiatric, autonomic, sensory, and sleep complaints. Although sleep disruption represents one of the most common non-motor symptom complaints among Parkinson's disease patients, recommendations regarding effective evaluation and management strategies for this specific population remain limited. This review gives an evidence based summary of the available treatment options and management strategies for the sleep complaints commonly encountered by patients with Parkinson's disease.
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Affiliation(s)
- S Gulyani
- Human Neurosciences Unit/National Institutes on Aging/NIH. Baltimore, MD
| | - R Salas
- Johns Hopkins University, School of Medicine, Department of Neurology
| | - Z Mari
- Johns Hopkins University, School of Medicine, Department of Neurology
| | - S Choi
- Johns Hopkins University, School of Medicine, Department of Neurology
| | | | - C Gamaldo
- Johns Hopkins University, School of Medicine, Department of Neurology
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French IT, Muthusamy KA. A Review of Sleep and Its Disorders in Patients with Parkinson's Disease in Relation to Various Brain Structures. Front Aging Neurosci 2016; 8:114. [PMID: 27242523 PMCID: PMC4876118 DOI: 10.3389/fnagi.2016.00114] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2015] [Accepted: 04/29/2016] [Indexed: 11/13/2022] Open
Abstract
Sleep is an indispensable normal physiology of the human body fundamental for healthy functioning. It has been observed that Parkinson's disease (PD) not only exhibits motor symptoms, but also non-motor symptoms such as metabolic irregularities, altered olfaction, cardiovascular dysfunction, gastrointestinal complications and especially sleep disorders which is the focus of this review. A good understanding and knowledge of the different brain structures involved and how they function in the development of sleep disorders should be well comprehended in order to treat and alleviate these symptoms and enhance quality of life for PD patients. Therefore it is vital that the normal functioning of the body in relation to sleep is well understood before proceeding on to the pathophysiology of PD correlating to its symptoms. Suitable treatment can then be administered toward enhancing the quality of life of these patients, perhaps even discovering the cause for this disease.
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Affiliation(s)
- Isobel T French
- Department of Surgery, University Malaya Kuala Lumpur, Malaysia
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45
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Maiga B, Diop MS, Sangare M, Dembele K, Cisse L, Kone O, Seck LB, Landoure G, Guinto CO, Ndiaye M, Ndiaye MM. Sleep quality assessment in 35 Parkinson's disease patients in the Fann Teaching Hospital, Dakar, Senegal. Rev Neurol (Paris) 2016; 172:242-7. [PMID: 26993564 DOI: 10.1016/j.neurol.2015.11.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2015] [Revised: 10/01/2015] [Accepted: 11/02/2015] [Indexed: 10/22/2022]
Abstract
INTRODUCTION Sleep disorders are diverse in Parkinson's disease. We aimed to assess the quality of sleep in patients with Parkinson's disease in an African population. METHODS In a transversal and prospective study from April to June 2014, all parkinsonian patients followed at the Fann Teaching Hospital Neurology Clinic (Dakar, Senegal) were assessed using the Hoehn and Yahr's scale and filled out the following questionnaires: Parkinson's disease sleep scale (PDSS), the Pittsburgh Sleep Quality Index (PSQI), and the Epworth Sleepiness Scale (ESS). A PDSS score<82 (or a subscore<5) and a PSQI score>5 indicated poor quality or impaired sleep. An ESS score>10 indicated excessive daytime sleepiness. We used the Pearson coefficient to search for correlation between age, disease stage, disease duration, and the importance of sleep impairment. RESULTS Hoehn and Yahr staging was 2.42±0.90 in the 35 patients (60% male, mean age 65.7±7.4years, disease duration 32.4±23.4months). The mean total PDSS score was 99.5±24.1 and 74.3% of the patients had an abnormally high PSQI score, indicating high frequency and intensity of sleep disorders. Most frequent disorders were pain or cramps interrupting sleep, night waking to urinate and fatigue or sleepiness on waking. Patients exhibited excessive diurnal sleepiness in 22.9% of the cases; they often had an abnormal PSQI score. Both the total PDSS score and the difficulty to sleep increased with disease stage, but not with age or disease duration. CONCLUSION We found evidence of major alteration of sleep quality in Senegalese Parkinson patients.
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Affiliation(s)
- B Maiga
- Service de neurologie, centre hospitalier universitaire (CHU) du Point « G », BP 333, Bamako, Mali; Service de neurologie, centre hospitalier universitaire national (CHUN) de Fann, Dakar, Senegal.
| | - M S Diop
- Service de neurologie, centre hospitalier universitaire national (CHUN) de Fann, Dakar, Senegal
| | - M Sangare
- Faculté de médecine et d'odontostomatologie, USTTB, Mali
| | - K Dembele
- Service de neurologie, centre hospitalier universitaire (CHU) du Point « G », BP 333, Bamako, Mali
| | - L Cisse
- Service de neurologie, centre hospitalier universitaire (CHU) du Point « G », BP 333, Bamako, Mali
| | - O Kone
- Faculté de médecine et d'odontostomatologie, USTTB, Mali
| | - L B Seck
- Service de neurologie, centre hospitalier universitaire national (CHUN) de Fann, Dakar, Senegal
| | - G Landoure
- Service de neurologie, centre hospitalier universitaire (CHU) du Point « G », BP 333, Bamako, Mali
| | - C O Guinto
- Service de neurologie, centre hospitalier universitaire (CHU) du Point « G », BP 333, Bamako, Mali
| | - M Ndiaye
- Service de neurologie, centre hospitalier universitaire national (CHUN) de Fann, Dakar, Senegal
| | - M M Ndiaye
- Service de neurologie, centre hospitalier universitaire national (CHUN) de Fann, Dakar, Senegal
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Panouillères MTN, Tofaris GK, Brown P, Jenkinson N. Intact Acquisition and Short-Term Retention of Non-Motor Procedural Learning in Parkinson's Disease. PLoS One 2016; 11:e0149224. [PMID: 26906905 PMCID: PMC4764369 DOI: 10.1371/journal.pone.0149224] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2015] [Accepted: 01/28/2016] [Indexed: 11/18/2022] Open
Abstract
Procedural learning is a form of memory where people implicitly acquire a skill through repeated practice. People with Parkinson’s disease (PD) have been found to acquire motor adaptation, a form of motor procedural learning, similarly to healthy older adults but they have deficits in long-term retention. A similar pattern of normal learning on initial exposure with a deficit in retention seen on subsequent days has also been seen in mirror-reading, a form of non-motor procedural learning. It is a well-studied fact that disrupting sleep will impair the consolidation of procedural memories. Given the prevalence of sleep disturbances in PD, the lack of retention on following days seen in these studies could simply be a side effect of this well-known symptom of PD. Because of this, we wondered whether people with PD would present with deficits in the short-term retention of a non-motor procedural learning task, when the test of retention was done the same day as the initial exposure. The aim of the present study was then to investigate acquisition and retention in the immediate short term of cognitive procedural learning using the mirror-reading task in people with PD. This task involved two conditions: one where triads of mirror-inverted words were always new that allowed assessing the learning of mirror-reading skill and another one where some of the triads were presented repeatedly during the experiment that allowed assessing the word-specific learning. People with PD both ON and OFF their normal medication were compared to healthy older adults and young adults. Participants were re-tested 50 minutes break after initial exposure to probe for short-term retention. The results of this study show that all groups of participants acquired and retained the two skills (mirror-reading and word-specific) similarly. These results suggest that neither healthy ageing nor the degeneration within the basal ganglia that occurs in PD does affect the mechanisms that underpin the acquisition of these new non-motor procedural learning skills and their short-term memories.
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Affiliation(s)
- Muriel T. N. Panouillères
- Nuffield Department of Clinical Neurosciences, University of Oxford, John Radcliffe Hospital, Oxford, United Kingdom
- * E-mail:
| | - George K. Tofaris
- Nuffield Department of Clinical Neurosciences, University of Oxford, John Radcliffe Hospital, Oxford, United Kingdom
| | - Peter Brown
- Nuffield Department of Clinical Neurosciences, University of Oxford, John Radcliffe Hospital, Oxford, United Kingdom
| | - Ned Jenkinson
- Nuffield Department of Clinical Neurosciences, University of Oxford, John Radcliffe Hospital, Oxford, United Kingdom
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, United Kingdom
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Bradysomnia in Parkinson’s disease. Clin Neurophysiol 2016; 127:1403-1409. [DOI: 10.1016/j.clinph.2015.08.012] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2015] [Revised: 08/04/2015] [Accepted: 08/25/2015] [Indexed: 01/04/2023]
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Rizos A, Martinez-Martin P, Odin P, Antonini A, Kessel B, Kozul TK, Todorova A, Douiri A, Martin A, Stocchi F, Dietrichs E, Chaudhuri KR. Characterizing motor and non-motor aspects of early-morning off periods in Parkinson's disease: An international multicenter study. Parkinsonism Relat Disord 2014; 20:1231-5. [DOI: 10.1016/j.parkreldis.2014.09.013] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2014] [Revised: 08/10/2014] [Accepted: 09/04/2014] [Indexed: 10/24/2022]
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Zhou H, Shen C, Chen J, Qian H, Zheng Y, Liu Y, Xian W, Pei Z, Chen L. Tremor and clinical fluctuation are related to sleep disorders in Chinese patients with Parkinson's disease. Transl Neurodegener 2014; 3:21. [PMID: 25349692 PMCID: PMC4209517 DOI: 10.1186/2047-9158-3-21] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2014] [Accepted: 10/18/2014] [Indexed: 01/09/2023] Open
Abstract
Objective To study the relationship between sleep disturbances and symptoms in patients with Parkinson’s disease (PD). Methods The Parkinson’s Disease Sleep Scale-Chinese Version (PDSS-CV) was used to evaluate the sleep disturbances of PD patients in a cross sectional study. The Unified Parkinson’s Disease Rating Scale (UPDRS) parts II-IV, and the Hoehn & Yahr (H&Y) stage were used to determine the level of motor function in PD and the severity of PD. The Spearman correlation and a multiple regression analysis were used to identify the relationship between sleep disturbances and symptoms of PD. The quantities derived from the UPDRS and the H&Y stage and disease duration were compared between groups of patients either with or without sleep disturbances identified by the PDSS. This study was conducted from December 2011 to March 2012 at the First Affiliated Hospital of Sun Yat-sen University, in Guangzhou. Results A total of 136 PD patients were included in this study. The overall total PDSS score in PD patients was 107.58 ± 23.35 points (range: 30–146). There were significant differences in the disease duration, the H&Y stage, and the UPDRS section subscores between groups of patients either with or without sleep disturbances (Kruskal-Wallis Test, p <0.05). There were significant negative correlations between PDSS scores and the UPDRS subscores, the H&Y stage and the disease duration (Spearman correlation, p < 0.05). The multiple regression analysis indicated that sleep disturbances identified by the PDSS were only associated with daily life activity, tremor intensity and clinical fluctuation (R2 = 0.22, F(3,132) = 12.4, p < 0.001). The correlations were also significant when the contribution of the other two factors was excluded using partial correlations. Conclusions The level of daily life activity and the occurrences of tremor and clinical fluctuation are likely to be important factors that lead to PD patients’ sleep disturbances. This study may elucidate an important clue for the relationship between sleep disturbances and PD symptoms.
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Affiliation(s)
- Hongyan Zhou
- Department of Neurological Intensive Care Unit, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510080, China
| | - Cunzhou Shen
- Department of Neurological Intensive Care Unit, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510080, China
| | - Jie Chen
- Department of Internal Medicine, Nansha central Hospital, Guangzhou 511457, China
| | - Hao Qian
- Department of Neurology, The Second Affiliated Hospital of Guangdong Pharmaceutical University, Guangzhou 510300, China
| | - Yifan Zheng
- Department of Neurology, The First Affiliated Hospital of Sun Yat-sen University, NO. 58 Zhongshan Road 2, Guangzhou 510080, China
| | - Yanmei Liu
- Department of Neurology, The First Affiliated Hospital of Sun Yat-sen University, NO. 58 Zhongshan Road 2, Guangzhou 510080, China
| | - Wenbiao Xian
- Department of Neurology, The First Affiliated Hospital of Sun Yat-sen University, NO. 58 Zhongshan Road 2, Guangzhou 510080, China
| | - Zhong Pei
- Department of Neurology, The First Affiliated Hospital of Sun Yat-sen University, NO. 58 Zhongshan Road 2, Guangzhou 510080, China
| | - Ling Chen
- Department of Neurology, The First Affiliated Hospital of Sun Yat-sen University, NO. 58 Zhongshan Road 2, Guangzhou 510080, China
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Gunn DG, Naismith SL, Terpening Z, Lewis SJG. The Relationships Between Poor Sleep Efficiency and Mild Cognitive Impairment in Parkinson Disease. J Geriatr Psychiatry Neurol 2014; 27:77-84. [PMID: 24196660 DOI: 10.1177/0891988713509135] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2012] [Accepted: 09/18/2013] [Indexed: 12/20/2022]
Abstract
BACKGROUND Mild cognitive impairment (MCI) and sleep disturbances are common features in Parkinson disease (PD). This study sought to investigate whether patients with MCI in PD (PD-MCI) have more pronounced sleep disturbance compared to those without PD-MCI and whether phenotypic presentations differ according to the PD-MCI subtypes. METHODS A total of 95 patients with idiopathic PD (53 meeting criteria for PD-MCI and 42 who were not cognitively impaired) and 22 controls underwent neurological and neuropsychological examination. They wore actigraphy watches for 2 weeks, from which measures of nocturnal sleep efficiency were calculated. RESULTS Patients with PD-MCI has significantly poorer sleep efficiency compared to those without PD-MCI. This effect was particularly apparent in those with multiple-domain PD-MCI, compared to those with single-domain PD-MCI. Furthermore, patients in the PD-MCI group had significantly more nontremor features. CONCLUSIONS These data suggest that PD-MCI is associated with greater sleep disturbance and nontremor features of PD. This is further evidence for the potential role that sleep disturbance plays in the heterogeneity of PD.
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Affiliation(s)
- David G Gunn
- Parkinson's Disease Research Clinic, Aging Brain Centre, Brain & Mind Research Institute, The University of Sydney, Sydney, New South Wales, Australia
| | - Sharon L Naismith
- Parkinson's Disease Research Clinic, Aging Brain Centre, Brain & Mind Research Institute, The University of Sydney, Sydney, New South Wales, Australia
| | - Zoe Terpening
- Parkinson's Disease Research Clinic, Aging Brain Centre, Brain & Mind Research Institute, The University of Sydney, Sydney, New South Wales, Australia
| | - Simon J G Lewis
- Parkinson's Disease Research Clinic, Aging Brain Centre, Brain & Mind Research Institute, The University of Sydney, Sydney, New South Wales, Australia
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