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Barone DA. Secondary RBD: Not just neurodegeneration. Sleep Med Rev 2024; 76:101938. [PMID: 38657360 DOI: 10.1016/j.smrv.2024.101938] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2024] [Revised: 03/20/2024] [Accepted: 04/11/2024] [Indexed: 04/26/2024]
Abstract
Rapid eye movement sleep behavior disorder is a parasomnia characterized by excessive muscle activity during rapid eye movement sleep (rapid eye movement sleep without atonia), along with dream enactment behavior. Isolated rapid eye movement sleep behavior disorder tends to occur in older males and is of concern due to the known link to Parkinson's disease and other synucleinopathies. When rapid eye movement sleep behavior disorder occurs in association with other neurological or general medical conditions, or resulting from the use of various substances, it is called secondary rapid eye movement sleep behavior disorder; the most common cause is neurodegenerative illness, specifically the synucleinopathies. Here, the focus will be on the subset of secondary rapid eye movement sleep behavior disorder in which there is no neurodegenerative disease.
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Affiliation(s)
- Daniel A Barone
- Weill Cornell Center for Sleep Medicine, 425 East 61st Street, New York, NY, 10065, USA.
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2
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Chew G, Mai AS, Ouyang JF, Qi Y, Chao Y, Wang Q, Petretto E, Tan EK. Transcriptomic imputation of genetic risk variants uncovers novel whole-blood biomarkers of Parkinson's disease. NPJ Parkinsons Dis 2024; 10:99. [PMID: 38719867 PMCID: PMC11078960 DOI: 10.1038/s41531-024-00698-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2023] [Accepted: 03/28/2024] [Indexed: 05/12/2024] Open
Abstract
Blood-based gene expression signatures could potentially be used as biomarkers for PD. However, it is unclear whether genetically-regulated transcriptomic signatures can provide novel gene candidates for use as PD biomarkers. We leveraged on the Genotype-Tissue Expression (GTEx) database to impute whole-blood transcriptomic expression using summary statistics of three large-scale PD GWAS. A random forest classifier was used with the consensus whole-blood imputed gene signature (IGS) to discriminate between cases and controls. Outcome measures included Area under the Curve (AUC) of Receiver Operating Characteristic (ROC) Curve. We demonstrated that the IGS (n = 37 genes) is conserved across PD GWAS studies and brain tissues. IGS discriminated between cases and controls in an independent whole-blood RNA-sequencing study (1176 PD, 254 prodromal, and 860 healthy controls) with mean AUC and accuracy of 64.8% and 69.4% for PD cohort, and 78.8% and 74% for prodromal cohort. PATL2 was the top-performing imputed gene in both PD and prodromal PD cohorts, whose classifier performance varied with biological sex (higher performance for males and females in the PD and prodromal PD, respectively). Single-cell RNA-sequencing studies (scRNA-seq) of healthy humans and PD patients found PATL2 to be enriched in terminal effector CD8+ and cytotoxic CD4+ cells, whose proportions are both increased in PD patients. We demonstrated the utility of GWAS transcriptomic imputation in identifying novel whole-blood transcriptomic signatures which could be leveraged upon for PD biomarker derivation. We identified PATL2 as a potential biomarker in both clinical and prodromic PD.
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Affiliation(s)
- Gabriel Chew
- Duke-National University of Singapore Medical School, Singapore, Singapore
- Department of Neurology, National Neuroscience Institute, Singapore, Singapore
| | - Aaron Shengting Mai
- Department of Neurology, National Neuroscience Institute, Singapore, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - John F Ouyang
- Duke-National University of Singapore Medical School, Singapore, Singapore
| | - Yueyue Qi
- Duke-National University of Singapore Medical School, Singapore, Singapore
- Department of Neurology, National Neuroscience Institute, Singapore, Singapore
| | - Yinxia Chao
- Duke-National University of Singapore Medical School, Singapore, Singapore
- Department of Neurology, National Neuroscience Institute, Singapore, Singapore
- Department of Neurology, Singapore General Hospital, Singapore, Singapore
| | - Qing Wang
- Department of Neurology, Zhujiang Hospital, Southern Medical University, Guangzhou, China
| | - Enrico Petretto
- Duke-National University of Singapore Medical School, Singapore, Singapore
| | - Eng-King Tan
- Duke-National University of Singapore Medical School, Singapore, Singapore.
- Department of Neurology, National Neuroscience Institute, Singapore, Singapore.
- Department of Neurology, Singapore General Hospital, Singapore, Singapore.
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3
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Goldstein DS, Holmes C, Sullivan P, Lopez G, Gelsomino J, Moore S, Isonaka R, Wu T, Sharabi Y. Cardiac noradrenergic deficiency revealed by 18F-dopamine positron emission tomography identifies preclinical central Lewy body diseases. J Clin Invest 2024; 134:e172460. [PMID: 37883190 PMCID: PMC10760969 DOI: 10.1172/jci172460] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2023] [Accepted: 10/23/2023] [Indexed: 10/27/2023] Open
Abstract
BACKGROUND In Lewy body diseases (LBDs) Parkinson disease (PD), and dementia with Lewy bodies (DLB), by the time parkinsonism or cognitive dysfunction manifests clinically, substantial neurodegeneration has already occurred. Biomarkers are needed to identify central LBDs in a preclinical phase, when neurorescue strategies might forestall symptomatic disease. This phase may involve catecholamine deficiency in the autonomic nervous system. We analyzed data from the prospective, observational, long-term PDRisk study to assess the predictive value of low versus normal cardiac 18F-dopamine positron emission tomography (PET), an index of myocardial content of the sympathetic neurotransmitter norepinephrine, in at-risk individuals. METHODS Participants self-reported risk factor information (genetics, olfactory dysfunction, dream enactment behavior, and orthostatic intolerance or hypotension) at a protocol-specific website. Thirty-four with 3 or more confirmed risk factors underwent serial cardiac 18F-dopamine PET at 1.5-year intervals for up to 7.5 years or until PD was diagnosed. RESULTS Nine participants had low initial myocardial 18F-dopamine-derived radioactivity (<6,000 nCi-kg/cc-mCi) and 25 had normal radioactivity. At 7 years of follow-up, 8 of 9 with low initial radioactivity and 1 of 11 with normal radioactivity were diagnosed with a central LBD (LBD+) (P = 0.0009 by Fisher's exact test). Conversely, all 9 LBD+ participants had low 18F-dopamine-derived radioactivity before or at the time of diagnosis of a central LBD, whereas among 25 participants without a central LBD only 1 (4%) had persistently low radioactivity (P < 0.0001 by Fisher's exact test). CONCLUSION Cardiac 18F-dopamine PET highly efficiently distinguishes at-risk individuals who are diagnosed subsequently with a central LBD from those who are not. TRIAL REGISTRATION CLINICALTRIALS gov NCT00775853. FUNDING Division of Intramural Research, NIH, NINDS.
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Affiliation(s)
- David S. Goldstein
- Autonomic Medicine Section, Clinical Neurosciences Program, Division of Intramural Research (DIR), National Institute of Neurological Disorders and Stroke (NINDS)
| | - Courtney Holmes
- Autonomic Medicine Section, Clinical Neurosciences Program, Division of Intramural Research (DIR), National Institute of Neurological Disorders and Stroke (NINDS)
| | - Patti Sullivan
- Autonomic Medicine Section, Clinical Neurosciences Program, Division of Intramural Research (DIR), National Institute of Neurological Disorders and Stroke (NINDS)
| | - Grisel Lopez
- Molecular Neurogenetics Section, National Human Genome Research Institute, and
| | - Janna Gelsomino
- Autonomic Medicine Section, Clinical Neurosciences Program, Division of Intramural Research (DIR), National Institute of Neurological Disorders and Stroke (NINDS)
| | - Sarah Moore
- Autonomic Medicine Section, Clinical Neurosciences Program, Division of Intramural Research (DIR), National Institute of Neurological Disorders and Stroke (NINDS)
| | - Risa Isonaka
- Autonomic Medicine Section, Clinical Neurosciences Program, Division of Intramural Research (DIR), National Institute of Neurological Disorders and Stroke (NINDS)
| | - Tianxia Wu
- Clinical Trials Unit, Office of the Clinical Director, DIR, NINDS, NIH, Bethesda, Maryland, USA
| | - Yehonatan Sharabi
- Chaim Sheba Medical Center, Tel-Aviv University, Tel-Hashomer, Israel
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Baroreflex-sympathoneural dysfunction characterizes at-risk individuals with preclinical central Lewy body diseases. Clin Auton Res 2023; 33:41-49. [PMID: 36507976 DOI: 10.1007/s10286-022-00912-y] [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: 10/15/2022] [Accepted: 11/27/2022] [Indexed: 12/15/2022]
Abstract
PURPOSE In central Lewy body diseases (LBDs) such as Parkinson's disease (PD) and dementia with Lewy bodies (DLB), by the time parkinsonism or cognitive dysfunction becomes manifest, substantial central neurodegeneration has already occurred. Cardiovascular autonomic biomarkers might detect preclinical central LBDs in at-risk individuals, enabling possibly effective disease-modifying treatment. METHODS In the prospective, longitudinal PDRisk study, 59 participants provided information about family history of PD, olfactory dysfunction, dream enactment behavior, and orthostatic intolerance or hypotension at a protocol-specific website and were screened as outpatients. Thirty-four had three or more confirmed risk factors and were followed until PD was diagnosed or up to 7.5 years. Dependent measures included assessments of baroreflex-sympathoneural function, via the blood pressure recovery time (PRT) after release of the Valsalva maneuver and baroreflex areas; and baroreflex-cardiovagal function, via heart rate variability in the time and frequency domains and Valsalva baroslopes. Data were compared from groups with or without a subsequent diagnosis of a central LBD (LBD+, N = 9; LBD-, N = 25) and PDRisk participants with fewer than three confirmed risk factors (PDRisk-, N = 25). RESULTS The LBD+ group had larger orthostatic falls in systolic blood pressure than did the LBD- and PDRisk- groups (p < 0.0001 each). The LBD+ group had increased PRTs (p = 0.0114 versus LBD-, p = 0.0094 versus PDRisk-) and baroreflex areas after the Valsalva maneuver (p = 0.0225 versus LBD-, p = 0.0028 versus PDRisk-), whereas the groups did not differ in indices of baroreflex-cardiovagal function. CONCLUSION Orthostatic hypotension and baroreflex-sympathoneural dysfunction characterize at-risk individuals who go on to be diagnosed with a central LBD during longitudinal follow-up.
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5
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Motor and non-motor circuit disturbances in early Parkinson disease: which happens first? Nat Rev Neurosci 2022; 23:115-128. [PMID: 34907352 DOI: 10.1038/s41583-021-00542-9] [Citation(s) in RCA: 83] [Impact Index Per Article: 41.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/12/2021] [Indexed: 12/15/2022]
Abstract
For the last two decades, pathogenic concepts in Parkinson disease (PD) have revolved around the toxicity and spread of α-synuclein. Thus, α-synuclein would follow caudo-rostral propagation from the periphery to the central nervous system, first producing non-motor manifestations (such as constipation, sleep disorders and hyposmia), and subsequently impinging upon the mesencephalon to account for the cardinal motor features before reaching the neocortex as the disease evolves towards dementia. This model is the prevailing theory of the principal neurobiological mechanism of disease. Here, we scrutinize the temporal evolution of motor and non-motor manifestations in PD and suggest that, even though the postulated bottom-up mechanisms are likely to be involved, early involvement of the nigrostriatal system is a key and prominent pathophysiological mechanism. Upcoming studies of detailed clinical manifestations with newer neuroimaging techniques will allow us to more closely define, in vivo, the role of α-synuclein aggregates with respect to neuronal loss during the onset and progression of PD.
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Sato H, Nakaaki S, Sato J, Shikimoto R, Furukawa TA, Mimura M, Akechi T. Caregiver self-efficacy and associated factors among caregivers of patients with dementia with Lewy bodies and caregivers of patients with Alzheimer's disease. Psychogeriatrics 2021; 21:783-794. [PMID: 34216184 DOI: 10.1111/psyg.12740] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2021] [Revised: 05/24/2021] [Accepted: 06/20/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND Dementia with Lewy bodies (DLB) is characterized by neuropsychiatric symptoms, which can be distressing to caregivers. However, little is known about their subjective distress in terms of caregiver self-efficacy. Thus, we examined the differences in caregiver self-efficacy and their associated factors between DLB and Alzheimer's disease (AD) caregivers. METHODS We conducted a comprehensive questionnaire for DLB and AD caregivers. Caregiver self-efficacy was evaluated using three domains (Self-Efficacy for Obtaining Respite: SE-OR, Self-Efficacy for Responding to Disruptive Patient Behaviours: SE-RDPB, Self-Efficacy for Controlling Upsetting Thoughts about Caregiving: SE-CUT) of the Revised Scale for Caregiving Self-Efficacy (RSCSE). In addition, data on the following features of caregivers were assessed: depression, sleep disturbance, caregiver burden, executive function, loneliness, social support, and distress associated with neuropsychiatric symptoms. The patients were assessed for general cognitive tasks, executive function, and neuropsychiatric symptoms. RESULTS Compared with AD caregivers, DLB caregivers experienced a significantly higher burden in terms of not only various clinical factors, but also all three domains of caregiver self-efficacy. Among the caregiver-associated factors, different domains were predictors of self-efficacy in DLB and AD caregivers (distress due to sleep disturbances in DLB patients; distress due to delusions in AD patients). Among the patient-associated factors, different domains were also predictors of self-efficacy in DLB and AD caregivers (sleep disturbances in DLB patients; delusions in AD patients). Among both the caregivers and the patients, executive function was a significant predictor of one RSCSE domain (SE-CUT). CONCLUSIONS A reduction in caregiver self-efficacy may contribute to a severe subjective burden among DLB caregivers. Furthermore, two neuropsychiatric symptoms (delusions and sleep disturbances) affected caregiver self-efficacy differently depending on whether care was being provided to a DLB or AD patient. Understanding the association between specific neuropsychiatric symptoms and caregiver self-efficacy may be useful for conducting interventions for DLB patients.
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Affiliation(s)
- Hirofumi Sato
- Department of Psychiatry and Cognitive-Behavioral Medicine, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Shutaro Nakaaki
- Department of Psychiatry and Cognitive-Behavioral Medicine, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan.,Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
| | - Junko Sato
- Speech Language Hearing Therapy, School of Rehabilitation Science Seirei Christopher University, Shizuoka, Japan
| | - Ryo Shikimoto
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
| | - Toshi A Furukawa
- Department of Health Promotion and Human Behavior (Cognitive-Behavioral Medicine), Kyoto University Graduate School of Medicine/School of Public Health, Kyoto, Japan
| | - Masaru Mimura
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
| | - Tatsuo Akechi
- Department of Psychiatry and Cognitive-Behavioral Medicine, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
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Tilley BS, Patel SR, Goldfinger MH, Pearce RKB, Gentleman SM. Locus Coeruleus Pathology Indicates a Continuum of Lewy Body Dementia. JOURNAL OF PARKINSONS DISEASE 2021; 11:1641-1650. [PMID: 34334423 DOI: 10.3233/jpd-212748] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Lewy body dementia (LBD) has two main phenotypes of LBD, Parkinson's disease dementia (PDD) and dementia with Lewy bodies (DLB), separated by the 'one-year-rule'. They also show different symptom profiles: core DLB features include fluctuating cognition, REM-sleep behaviur disorder, and visual hallucinations. These symptoms are sometimes present in PDD, representing an intermediate 'PDD-DLB' phenotype. OBJECTIVE DLB-like features may reflect deficits in the functions of the noradrenergic nucleus locus coeruleus (LC). Therefore, we compared the LC in the LBD phenotypes, PD, and controls. METHODS 38 PD, 56 PDD, 22 DLB, and 11 age-matched control cases from the Parkinson's UK tissue bank were included. LC tissue sections were immunostained for tyrosine-hydroxylase (TH), α-synuclein, tau, and amyloid-β. TH-neurons were quantified and pathologic burden calculated by %-coverage method. RESULTS The LC shows a stepwise reduction in neuron count from controls, PD, PDD, to DLB. PDD-DLB cases showed an intermediate clinical phenotype that was reflected pathologically. Cell counts were significantly reduced in DLB compared to PDD after correction for demographic factors. LC degeneration contributed significantly to the onset of all DLB symptoms. While α-synuclein was not significantly different between PDD and DLB cases, DLB exhibited significantly less tau pathology. CONCLUSION DLB and DLB-like symptoms represent noradrenergic deficits resulting from neuronal loss in the LC. PDD and DLB are likely to represent a clinical continuum based on the presence or absence of DLB-like symptoms mirrored by a pathological continuum in the LC.
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Affiliation(s)
- Bension S Tilley
- Neuropathology Unit, Department of Brain Sciences, Imperial College London, London, UK
| | - Shivani R Patel
- Neuropathology Unit, Department of Brain Sciences, Imperial College London, London, UK
| | - Marc H Goldfinger
- Neuropathology Unit, Department of Brain Sciences, Imperial College London, London, UK
| | - Ronald K B Pearce
- Neuropathology Unit, Department of Brain Sciences, Imperial College London, London, UK
| | - Steve M Gentleman
- Neuropathology Unit, Department of Brain Sciences, Imperial College London, London, UK
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Korotun M, Quintero L, Hahn SS. Rapid Eye Movement Behavior Disorder and Other Parasomnias. Clin Geriatr Med 2021; 37:483-490. [PMID: 34210452 DOI: 10.1016/j.cger.2021.04.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Rapid eye movement (REM) behavior disorder (RBD) is characterized by loss of skeletal muscle atonia that can lead to dream enactment. This condition can cause harm to patients and their bed partners if appropriate safety measures are not ensured. This condition is often the initial presenting symptom in a group of complex neurodegenerative processes. Definitive diagnosis requires a thorough history and an in-laboratory polysomnogram to look for evidence of REM sleep without atonia. Treatment options are limited but consist of sleep safety measures and pharmacotherapy. Patients diagnosed with idiopathic RBD associated with alpha-synucleinopathy are likely to have progression of disease.
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Affiliation(s)
- Maksim Korotun
- Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine, Donald and Barbara Zucker School of Medicine-Northwell, 410 Lakeville Road, Suite 107, New Hyde Park, NY 11042, USA.
| | - Luis Quintero
- Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine, Donald and Barbara Zucker School of Medicine-Northwell, 410 Lakeville Road, Suite 107, New Hyde Park, NY 11042, USA
| | - Stella S Hahn
- Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine, Donald and Barbara Zucker School of Medicine-Northwell, 410 Lakeville Road, Suite 107, New Hyde Park, NY 11042, USA
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9
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Armstrong RA. Visual signs and symptoms of dementia with Lewy bodies. Clin Exp Optom 2021; 95:621-30. [DOI: 10.1111/j.1444-0938.2012.00770.x] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2011] [Revised: 01/31/2012] [Accepted: 04/03/2012] [Indexed: 11/28/2022] Open
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10
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Sumi Y, Nakayama C, Kadotani H, Matsuo M, Ozeki Y, Kinoshita T, Goto Y, Kano M, Yamakawa T, Hasegawa-Ohira M, Ogawa K, Fujiwara K. Resting Heart Rate Variability Is Associated With Subsequent Orthostatic Hypotension: Comparison Between Healthy Older People and Patients With Rapid Eye Movement Sleep Behavior Disorder. Front Neurol 2020; 11:567984. [PMID: 33329309 PMCID: PMC7719719 DOI: 10.3389/fneur.2020.567984] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Accepted: 10/12/2020] [Indexed: 11/13/2022] Open
Abstract
Background: Orthostatic hypotension (OH) caused by autonomic dysfunction is a common symptom in older people and patients with idiopathic rapid eye movement sleep behavior disorder (iRBD). The orthostatic challenge test is a standard autonomic function test that measures a decrease of blood pressure during a postural change from supine to standing positions. Although previous studies have reported that changes in heart rate variability (HRV) are associated with autonomic dysfunction, no study has investigated the relationship between HRV before standing and the occurrence of OH in an orthostatic challenge test. This study aims to examine the connection between HRV in the supine position and the occurrence of OH in an orthostatic challenge test. Methods: We measured the electrocardiograms of patients with iRBD and healthy older people during an orthostatic challenge test, in which the supine and standing positions were held for 15 min, respectively. The subjects were divided into three groups: healthy controls (HC), OH-negative iRBD [OH (-) iRBD], and OH-positive iRBD [OH (+) iRBD]. HRV measured in the supine position during the test were calculated by time-domain analysis and Poincaré plots to evaluate the autonomic dysfunction. Results: Forty-two HC, 12 OH (-) iRBD, and nine OH (+) iRBD subjects were included. HRV indices in the OH (-) and the OH (+) iRBD groups were significantly smaller than those in the HC group. The multivariate logistic regression analysis for OH identification for the iRBD groups showed the model whose inputs were the HRV indices, i.e., standard deviation 2 (SD2) and the percentage of adjacent intervals that varied by more than 50 ms (pNN50), had a receiver operating characteristic curve with area under the curve of 0.840, the sensitivity to OH (+) of 1.000, and the specificity to OH (-) of 0.583 (p = 0.023). Conclusions: This study showed the possibility that short-term HRV indices in the supine position would predict subsequent OH in iRBD patients. Our results are of clinical importance in terms of showing the possibility that OH can be predicted using only HRV in the supine position without an orthostatic challenge test, which would improve the efficiency and safety of testing.
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Affiliation(s)
- Yukiyoshi Sumi
- Department of Psychiatry, Shiga University of Medical Science, Otsu, Japan
| | - Chikao Nakayama
- Department of Systems Science, Kyoto University, Kyoto, Japan
| | - Hiroshi Kadotani
- Department of Sleep and Behavioral Sciences, Shiga University of Medical Science, Otsu, Japan
| | - Masahiro Matsuo
- Department of Psychiatry, Shiga University of Medical Science, Otsu, Japan
| | - Yuji Ozeki
- Department of Psychiatry, Shiga University of Medical Science, Otsu, Japan
| | | | - Yuki Goto
- Department of Systems Science, Kyoto University, Kyoto, Japan
| | - Manabu Kano
- Department of Systems Science, Kyoto University, Kyoto, Japan
| | - Toshitaka Yamakawa
- Department of Priority Organization for Innovation and Excellence, Kumamoto University, Kumamoto, Japan
| | | | - Keiko Ogawa
- Graduate School of Humanities and Social Sciences, Hiroshima University, Higashihiroshima, Japan
| | - Koichi Fujiwara
- Department of Systems Science, Kyoto University, Kyoto, Japan.,Department of Materials Process Engineering, Nagoya University, Nagoya, Japan
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Malattia a corpi di Lewy. Neurologia 2020. [DOI: 10.1016/s1634-7072(20)44006-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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12
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Kass JS, Rose RV. Criminal Culpability for Acts Committed During a Possible Episode of REM Sleep Behavior Disorder. Continuum (Minneap Minn) 2020; 26:1070-1074. [DOI: 10.1212/con.0000000000000875] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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13
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Filardi M, Stefani A, Holzknecht E, Pizza F, Plazzi G, Högl B. Objective rest–activity cycle analysis by actigraphy identifies isolated rapid eye movement sleep behavior disorder. Eur J Neurol 2020; 27:1848-1855. [DOI: 10.1111/ene.14386] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2020] [Accepted: 06/02/2020] [Indexed: 12/19/2022]
Affiliation(s)
- M. Filardi
- Department of Biomedical and Neuromotor Sciences (DIBINEM) University of Bologna Bologna Italy
| | - A. Stefani
- Sleep Disorders Unit Department of Neurology Medical University of Innsbruck Innsbruck Austria
| | - E. Holzknecht
- Sleep Disorders Unit Department of Neurology Medical University of Innsbruck Innsbruck Austria
| | - F. Pizza
- Department of Biomedical and Neuromotor Sciences (DIBINEM) University of Bologna Bologna Italy
- IRCCS Istituto delle Scienze Neurologiche di Bologna Bologna Italy
| | - G. Plazzi
- Department of Biomedical and Neuromotor Sciences (DIBINEM) University of Bologna Bologna Italy
- IRCCS Istituto delle Scienze Neurologiche di Bologna Bologna Italy
| | - B. Högl
- Sleep Disorders Unit Department of Neurology Medical University of Innsbruck Innsbruck Austria
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Wilson S, Anderson K, Baldwin D, Dijk DJ, Espie A, Espie C, Gringras P, Krystal A, Nutt D, Selsick H, Sharpley A. British Association for Psychopharmacology consensus statement on evidence-based treatment of insomnia, parasomnias and circadian rhythm disorders: An update. J Psychopharmacol 2019; 33:923-947. [PMID: 31271339 DOI: 10.1177/0269881119855343] [Citation(s) in RCA: 149] [Impact Index Per Article: 29.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
This British Association for Psychopharmacology guideline replaces the original version published in 2010, and contains updated information and recommendations. A consensus meeting was held in London in October 2017 attended by recognised experts and advocates in the field. They were asked to provide a review of the literature and identification of the standard of evidence in their area, with an emphasis on meta-analyses, systematic reviews and randomised controlled trials where available, plus updates on current clinical practice. Each presentation was followed by discussion, aiming to reach consensus where the evidence and/or clinical experience was considered adequate, or otherwise to flag the area as a direction for future research. A draft of the proceedings was circulated to all speakers for comments, which were incorporated into the final statement.
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Affiliation(s)
- Sue Wilson
- 1 Centre for Psychiatry, Imperial College London, London, UK
| | - Kirstie Anderson
- 2 Regional Sleep Service, Freeman Hospital, Newcastle Upon Tyne, UK
| | - David Baldwin
- 3 Clinical and Experimental Sciences, University of Southampton, Southampton, UK
| | - Derk-Jan Dijk
- 4 Sleep Research Centre, University of Surrey, Guildford, UK
| | - Audrey Espie
- 5 Psychology Department, NHS Fife, Dunfermline, UK
| | - Colin Espie
- 6 Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
| | - Paul Gringras
- 7 Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Andrew Krystal
- 8 Psychiatry and Behavioral Science, University of California, San Francisco, CA, USA
| | - David Nutt
- 1 Centre for Psychiatry, Imperial College London, London, UK
| | - Hugh Selsick
- 9 Royal London Hospital for Integrated Medicine, London, UK
| | - Ann Sharpley
- 10 Department of Psychiatry, University of Oxford, Oxford, UK
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15
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Lysen TS, Darweesh SKL, Ikram MK, Luik AI, Ikram MA. Sleep and risk of parkinsonism and Parkinson's disease: a population-based study. Brain 2019; 142:2013-2022. [PMID: 31038176 PMCID: PMC6911221 DOI: 10.1093/brain/awz113] [Citation(s) in RCA: 58] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2018] [Revised: 02/12/2019] [Accepted: 02/28/2019] [Indexed: 12/22/2022] Open
Abstract
Sleep disturbances may signal presence of prodromal parkinsonism, including Parkinson's disease. Whether general sleep quality or duration in otherwise healthy subjects is related to the risk of parkinsonism remains unclear. We hypothesized that both worse self-reported sleep quality and duration, as well as a longitudinal deterioration in these measures, are associated with the risk of parkinsonism, including Parkinson's disease. In the prospective population-based Rotterdam Study, we assessed sleep quality and duration with the Pittsburgh Sleep Quality Index in 7726 subjects (mean age 65 years, 57% female) between 2002 and 2008, and again in 5450 subjects between 2009 and 2014. Participants were followed until 2015 for a diagnosis of parkinsonism and Parkinson's disease. Outcomes were assessed using multiple modalities: interviews, physical examination, and continuous monitoring of pharmacy records and medical records of general practitioners. We used Cox regression to associate sleep, and changes in sleep over time, with incident parkinsonism and Parkinson's disease, adjusting for age, sex, education and smoking status. Over 64 855 person-years in 13 years of follow-up (mean: 8.4 years), 75 participants developed parkinsonism, of whom 47 developed Parkinson's disease. We showed that within the first 2 years of follow-up, worse sleep quality {hazard ratio (HR) 2.38 per standard deviation increase [95% confidence interval (CI 0.91-6.23)]} and shorter sleep duration [HR 0.61 per standard deviation increase (95% CI 0.31-1.21)] related to a higher risk of parkinsonism. Associations of worse sleep quality [HR 3.86 (95% CI 1.19-12.47)] and shorter sleep duration [HR 0.48 (95% CI 0.23-0.99)] with Parkinson's disease were more pronounced, and statistically significant, compared to parkinsonism. This increased risk disappeared with longer follow-up duration. Worsening of sleep quality [HR 1.76 per standard deviation increase (95% CI 1.12-2.78)], as well as shortening of sleep duration [HR 1.72 per standard deviation decrease (95% CI 1.08-2.72)], were related to Parkinson's disease risk in the subsequent 6 years. Therefore, we argue that in the general population, deterioration of sleep quality and duration are markers of the prodromal phase of parkinsonism, including Parkinson's disease.
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Affiliation(s)
- Thom S Lysen
- Department of Epidemiology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Sirwan K L Darweesh
- Department of Epidemiology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - M Kamran Ikram
- Department of Epidemiology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
- Department of Neurology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Annemarie I Luik
- Department of Epidemiology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - M Arfan Ikram
- Department of Epidemiology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
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16
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Esmaeeli S, Murphy K, Swords GM, Ibrahim BA, Brown JW, Llano DA. Visual hallucinations, thalamocortical physiology and Lewy body disease: A review. Neurosci Biobehav Rev 2019; 103:337-351. [PMID: 31195000 DOI: 10.1016/j.neubiorev.2019.06.006] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2018] [Revised: 06/03/2019] [Accepted: 06/08/2019] [Indexed: 12/22/2022]
Abstract
One of the core diagnostic criteria for Dementia with Lewy Bodies (DLB) is the presence of visual hallucinations. The presence of hallucinations, along with fluctuations in the level of arousal and sleep disturbance, point to potential pathological mechanisms at the level of the thalamus. However, the potential role of thalamic dysfunction in DLB, particularly as it relates to the presence of formed visual hallucinations is not known. Here, we review the literature on the pathophysiology of DLB with respect to modern theories of thalamocortical function and attempt to derive an understanding of how such hallucinations arise. Based on the available literature, we propose that combined thalamic-thalamic reticular nucleus and thalamocortical pathology may explain the phenomenology of visual hallucinations in DLB. In particular, diminished α7 cholinergic activity in the thalamic reticular nucleus may critically disinhibit thalamocortical activity. Further, concentrated pathological changes within the posterior regions of the thalamus may explain the predilection for the hallucinations to be visual in nature.
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Affiliation(s)
- Shooka Esmaeeli
- Department of Molecular and Integrative Physiology, University of Illinois at Urbana-Champaign, Urbana, IL, United States
| | - Kathleen Murphy
- Department of Molecular and Integrative Physiology, University of Illinois at Urbana-Champaign, Urbana, IL, United States
| | - Gabriel M Swords
- University of Illinois at Chicago College of Medicine, Chicago, IL, United States
| | - Baher A Ibrahim
- Department of Molecular and Integrative Physiology, University of Illinois at Urbana-Champaign, Urbana, IL, United States; Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign, Urbana, IL, United States
| | - Jeffrey W Brown
- University of Illinois at Chicago College of Medicine, Chicago, IL, United States
| | - Daniel A Llano
- Department of Molecular and Integrative Physiology, University of Illinois at Urbana-Champaign, Urbana, IL, United States; Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign, Urbana, IL, United States; Carle Neuroscience Institute, Urbana, IL, United States.
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17
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Abstract
Self-injurious behavior (SIB) has frequently been associated with psychiatric illness and neurological lesions as means of reducing tension or diverting from pain. However, these explanations did not capture the complexity of SIB in the case of Mr. X, a 62-year-old patient who ingested his fingers in his sleep where cognitive testing was valuable in informing diagnosis. Mr. X's SIB was severe enough that he had chewed beyond the middle phalanx for most of his fingers. Clinical symptoms included daytime sleepiness, hypnogogic hallucinations, and bradykinesia. His cognitive profile revealed declines in his intellectual functioning as well as visuospatial and executive deficits in the context of preserved attention, language, and memory. His cognitive and clinical presentation suggested that Mr. X had a neurodegenerative disorder, which may have contributed to his SIB. We believed that the most probable diagnosis may have been rapid eye movement behavioral sleep disorder in the context of Lewy bodies dementia.
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19
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Khan AU, Akram M, Daniyal M, Zainab R. Awareness and current knowledge of Parkinson’s disease: a neurodegenerative disorder. Int J Neurosci 2018; 129:55-93. [DOI: 10.1080/00207454.2018.1486837] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Affiliation(s)
- Asmat Ullah Khan
- Department of Pharmacology, Laboratory of Neuroanatomy and Neuropsychobiology, Ribeirão Preto Medical School of the University of São Paulo (FMRP-USP), São Paulo, Brazil
- Department of Eastern Medicine and Surgery, School of Medical and Health Sciences, The University of Poonch Rawalakot, Rawalakot, Pakistan
| | - Muhammad Akram
- Department of Eastern Medicine and Surgery, Directorate of Medical Sciences, Old Campus, Allama Iqbal Road, Government College University, Faisalabad, Pakistan
| | - Muhammad Daniyal
- TCM and Ethnomedicine Innovation and Development Laboratory, School of Pharmacy, Hunan University of Chinese Medicine, Changsha, China
- College of Biology, Hunan Province Key Laboratory of Plant Functional Genomics and Developmental Regulation, State Key Laboratory of Hunan University, Changsha, China
| | - Rida Zainab
- Department of Eastern Medicine and Surgery, Directorate of Medical Sciences, Old Campus, Allama Iqbal Road, Government College University, Faisalabad, Pakistan
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20
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St Louis EK, Boeve AR, Boeve BF. REM Sleep Behavior Disorder in Parkinson's Disease and Other Synucleinopathies. Mov Disord 2018; 32:645-658. [PMID: 28513079 DOI: 10.1002/mds.27018] [Citation(s) in RCA: 106] [Impact Index Per Article: 17.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2016] [Revised: 03/15/2017] [Accepted: 03/16/2017] [Indexed: 12/15/2022] Open
Abstract
Rapid eye movement sleep behavior disorder is characterized by dream enactment and complex motor behaviors during rapid eye movement sleep and rapid eye movement sleep atonia loss (rapid eye movement sleep without atonia) during polysomnography. Rapid eye movement sleep behavior disorder may be idiopathic or symptomatic and in both settings is highly associated with synucleinopathy neurodegeneration, especially Parkinson's disease, dementia with Lewy bodies, multiple system atrophy, and pure autonomic failure. Rapid eye movement sleep behavior disorder frequently manifests years to decades prior to overt motor, cognitive, or autonomic impairments as the presenting manifestation of synucleinopathy, along with other subtler prodromal "soft" signs of hyposmia, constipation, and orthostatic hypotension. Between 35% and 91.9% of patients initially diagnosed with idiopathic rapid eye movement sleep behavior disorder at a sleep center later develop a defined neurodegenerative disease. Less is known about the long-term prognosis of community-dwelling younger patients, especially women, and rapid eye movement sleep behavior disorder associated with antidepressant medications. Patients with rapid eye movement sleep behavior disorder are frequently prone to sleep-related injuries and should be treated to prevent injury with either melatonin 3-12 mg or clonazepam 0.5-2.0 mg to limit injury potential. Further evidence-based studies about rapid eye movement sleep behavior disorder are greatly needed, both to enable accurate prognostic prediction of end synucleinopathy phenotypes for individual patients and to support the application of symptomatic and neuroprotective therapies. Rapid eye movement sleep behavior disorder as a prodromal synucleinopathy represents a defined time point at which neuroprotective therapies could potentially be applied for the prevention of Parkinson's disease, dementia with Lewy bodies, multiple system atrophy, and pure autonomic failure. © 2017 International Parkinson and Movement Disorder Society.
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Affiliation(s)
- Erik K St Louis
- Center for Sleep Medicine, Mayo Clinic College of Medicine, Rochester, Minnesota, USA.,Department of Neurology, Mayo Clinic College of Medicine, Rochester, Minnesota, USA
| | - Angelica R Boeve
- Center for Sleep Medicine, Mayo Clinic College of Medicine, Rochester, Minnesota, USA.,Department of Neurology, Mayo Clinic College of Medicine, Rochester, Minnesota, USA
| | - Bradley F Boeve
- Center for Sleep Medicine, Mayo Clinic College of Medicine, Rochester, Minnesota, USA.,Department of Neurology, Mayo Clinic College of Medicine, Rochester, Minnesota, USA
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21
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Coleman PJ, Gotter AL, Herring WJ, Winrow CJ, Renger JJ. The Discovery of Suvorexant, the First Orexin Receptor Drug for Insomnia. Annu Rev Pharmacol Toxicol 2017; 57:509-533. [PMID: 27860547 DOI: 10.1146/annurev-pharmtox-010716-104837] [Citation(s) in RCA: 87] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Historically, pharmacological therapies have used mechanisms such as γ-aminobutyric acid A (GABAA) receptor potentiation to drive sleep through broad suppression of central nervous system activity. With the discovery of orexin signaling loss as the etiology underlying narcolepsy, a disorder associated with hypersomnolence, orexin antagonism emerged as an alternative approach to attenuate orexin-induced wakefulness more selectively. Dual orexin receptor antagonists (DORAs) block the activity of orexin 1 and 2 receptors to both reduce the threshold to transition into sleep and attenuate orexin-mediated arousal. Among DORAs evaluated clinically, suvorexant has pharmacokinetic properties engineered for a plasma half-life appropriate for rapid sleep onset and maintenance at low to moderate doses. Unlike GABAA receptor modulators, DORAs promote both non-rapid eye movement (NREM) and REM sleep, do not disrupt sleep stage-specific quantitative electroencephalogram spectral profiles, and allow somnolence indistinct from normal sleep. The preservation of cognitive performance and the ability to arouse to salient stimuli after DORA administration suggest further advantages over historical therapies.
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Affiliation(s)
- Paul J Coleman
- Department of Medicinal Chemistry, Merck Research Laboratories, West Point, Pennsylvania 19486;
| | - Anthony L Gotter
- Department of Neuroscience, Merck Research Laboratories, West Point, Pennsylvania 19486
| | - W Joseph Herring
- Department of Clinical Neuroscience, Merck Research Laboratories, West Point, Pennsylvania 19486
| | - Christopher J Winrow
- Department of Neuroscience, Merck Research Laboratories, West Point, Pennsylvania 19486
| | - John J Renger
- Department of Neuroscience, Merck Research Laboratories, West Point, Pennsylvania 19486
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Aarthy M, Panwar U, Selvaraj C, Singh SK. Advantages of Structure-Based Drug Design Approaches in Neurological Disorders. Curr Neuropharmacol 2017; 15:1136-1155. [PMID: 28042767 PMCID: PMC5725545 DOI: 10.2174/1570159x15666170102145257] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2015] [Revised: 11/05/2016] [Accepted: 11/03/2016] [Indexed: 12/13/2022] Open
Abstract
OBJECTIVE The purpose of the review is to portray the theoretical concept on neurological disorders from research data. BACKGROUND The freak changes in chemical response of nerve impulse causes neurological disorders. The research evidence of the effort done in the older history suggests that the biological drug targets and their effective feature with responsive drugs could be valuable in promoting the future development of health statistics structure for improved treatment for curing the nervous disorders. METHODS In this review, we summarized the most iterative theoretical concept of structure based drug design approaches in various neurological disorders to unfathomable understanding of reported information for future drug design and development. RESULTS On the premise of reported information we analyzed the model of theoretical drug designing process for understanding the mechanism and pathology of the neurological diseases which covers the development of potentially effective inhibitors against the biological drug targets. Finally, it also suggests the management and implementation of the current treatment in improving the human health system behaviors. CONCLUSION With the survey of reported information we concluded the development strategies of diagnosis and treatment against neurological diseases which leads to supportive progress in the drug discovery.
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Affiliation(s)
- Murali Aarthy
- Computer Aided Drug Design and Molecular Modeling Lab, Department of Bioinformatics, Alagappa University, Karaikudi-630004, Tamil Nadu, India
| | - Umesh Panwar
- Computer Aided Drug Design and Molecular Modeling Lab, Department of Bioinformatics, Alagappa University, Karaikudi-630004, Tamil Nadu, India
| | - Chandrabose Selvaraj
- Department of Chemical Engineering, Konkuk University, 1 Hwayang-dong, Gwangjin-gu, Postal Code: 143-701, Seoul, Korea
| | - Sanjeev Kumar Singh
- Computer Aided Drug Design and Molecular Modeling Lab, Department of Bioinformatics, Alagappa University, Karaikudi-630004, Tamil Nadu, India
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24
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St Louis EK, Boeve BF. REM Sleep Behavior Disorder: Diagnosis, Clinical Implications, and Future Directions. Mayo Clin Proc 2017; 92:1723-1736. [PMID: 29101940 PMCID: PMC6095693 DOI: 10.1016/j.mayocp.2017.09.007] [Citation(s) in RCA: 109] [Impact Index Per Article: 15.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2017] [Revised: 09/12/2017] [Accepted: 09/21/2017] [Indexed: 12/25/2022]
Abstract
Rapid eye movement sleep behavior disorder (RBD) is diagnosed by a clinical history of dream enactment accompanied by polysomnographic rapid eye movement sleep atonia loss (rapid eye movement sleep without atonia). Rapid eye movement sleep behavior disorder is strongly associated with neurodegenerative disease, especially synucleinopathies such as Parkinson disease, dementia with Lewy bodies, and multiple system atrophy. A history of RBD may begin several years to decades before onset of any clear daytime symptoms of motor, cognitive, or autonomic impairments, suggesting that RBD is the presenting manifestation of a neurodegenerative process. Evidence that RBD is a synlucleinopathy includes the frequent presence of subtle prodromal neurodegenerative abnormalities including hyposmia, constipation, and orthostatic hypotension, as well as abnormalities on various neuroimaging, neurophysiological, and autonomic tests. Up to 90.9% of patients with idiopathic RBD ultimately develop a defined neurodegenerative disease over longitudinal follow-up, although the prognosis for younger patients and antidepressant-associated RBD is less clear. Patients with RBD should be treated with either melatonin 3 to 12 mg or clonazepam 0.5 to 2.0 mg to reduce injury potential. Prospective outcome and treatment studies of RBD are necessary to enable accurate prognosis and better evidence for symptomatic therapy and future neuroprotective strategies.
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Affiliation(s)
- Erik K St Louis
- Center for Sleep Medicine and Department of Neurology, Mayo Clinic College of Medicine, Rochester, MN.
| | - Bradley F Boeve
- Center for Sleep Medicine and Department of Neurology, Mayo Clinic College of Medicine, Rochester, MN
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25
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Wennberg AMV, Wu MN, Rosenberg PB, Spira AP. Sleep Disturbance, Cognitive Decline, and Dementia: A Review. Semin Neurol 2017; 37:395-406. [PMID: 28837986 DOI: 10.1055/s-0037-1604351] [Citation(s) in RCA: 146] [Impact Index Per Article: 20.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
AbstractApproximately half of older people report sleep disturbances, which are associated with various health conditions, including neurodegenerative disease and dementia. Indeed, 60 to 70% of people with cognitive impairment or dementia have sleep disturbances, which are linked to poorer disease prognosis. Sleep disturbances in people with dementia have long been recognized and studied; however, in the past 10 years, researchers have begun to study disturbed sleep, including sleep fragmentation, abnormal sleep duration, and sleep disorders, as risk factors for dementia. In this review the authors summarize evidence linking sleep disturbance and dementia. They describe how specific aspects of sleep (e.g., quality, duration) and the prevalence of clinical sleep disorders (e.g., sleep-disordered breathing, rapid eye movement sleep behavior disorder) change with age; how sleep parameters and sleep disorders are associated with the risk of dementia; how sleep can be disturbed in dementia; and how disturbed sleep affects dementia prognosis. These findings highlight the potential importance of identifying and treating sleep problems and disorders in middle-aged and older adults as a strategy to prevent cognitive decline and dementia. The authors also review recent evidence linking sleep disturbances to the pathophysiology underlying dementing conditions, and briefly summarize available treatments for sleep disorders in people with dementia.
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Affiliation(s)
| | - Mark N Wu
- Department of Neurology, Johns Hopkins School of Medicine, Baltimore, Maryland.,Department of Neuroscience, Johns Hopkins School of Medicine, Baltimore, Maryland
| | - Paul B Rosenberg
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, Maryland
| | - Adam P Spira
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, Maryland.,Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.,Johns Hopkins Center on Aging and Health, Baltimore, Maryland
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26
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Al-Qassabi A, Fereshtehnejad SM, Postuma RB. Sleep Disturbances in the Prodromal Stage of Parkinson Disease. Curr Treat Options Neurol 2017; 19:22. [DOI: 10.1007/s11940-017-0458-1] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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27
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Abstract
Dementia syndromes associated with Lewy bodies are subdivided into dementia with Lewy bodies (DLB), an underdiagnosed cause of dementia in the elderly, and Parkinson disease with dementia (PDD), cognitive impairment appearing in people diagnosed with Parkinson disease. Their neuropathologic substrates are the widespread distribution of aggregates of the protein α-synuclein in neurons in cortical brain regions, accompanied by variable Alzheimer pathology. Clinical features of DLB and PDD include distinctive changes in cognition, behavior, movement, sleep, and autonomic function. Diagnostic criteria for DLB and PDD incorporate these features. Current treatment options for DLB and PDD are symptomatic.
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Affiliation(s)
- Douglas Galasko
- Department of Neurosciences, University of California, San Diego, 9500 Gilman Drive, La Jolla, CA 92093-0948, USA.
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28
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Garcia Basalo MM, Fernandez MC, Ojea Quintana M, Rojas JI, Garcia Basalo MJ, Bogliotti E, Campora N, Fernandez M, Berrios W, Cristiano E, Golimstok A. ALBA Screening Instrument (ASI): A brief screening tool for Lewy Body Dementia. Arch Gerontol Geriatr 2017; 70:67-75. [PMID: 28088604 DOI: 10.1016/j.archger.2017.01.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2015] [Revised: 12/18/2016] [Accepted: 01/02/2017] [Indexed: 11/18/2022]
Abstract
BACKGROUND Early detection of neurodegenerative diseases is essential for treatment and proper care of these patients. Screening tools available today are effective for several types of dementia. However, there is no one specific for Lewy Body Dementia (LBD). OBJECTIVES The aim of this paper is to present a tool for early detection of LBD, accessible even for non-medical staff. METHODS We stratified subjects (MMSE>20) into four groups: health controls (HC), Mild Cognitive Impairment (MCI), LBD and other dementias (Alzheimer and vascular). All subjects (age range 50-90) were examined with a comprehensive neuropsychological and neuropsychiatric evaluation, as well as neuroimaging to differentiate diagnosis between groups, fulfilling corresponding criteria. Both neurologists and neuropsychologists were blind to the performance on clinical evaluations and ASI, respectively. The sensitivity and specificity of the instrument were determined to differentiate LBD from other groups. RESULTS We evaluated 427 subjects, 91 HC, 140 with MCI and 196 with dementia. In the dementia group, 75 were diagnosed with LBD and 121 with other dementias. ASI total score was 12.7±0.4 for LBD, 2.9±0.2 for HC, 5±0.7 for MCI, and 5.4±2.6 for other causes of dementia. ROC curve analysis showed a sensitivity of 90.7% and a specificity of 93.6% stands, with 9 as the cutoff with better test performance compared against other groups. CONCLUSION ASI is a brief screening tool for LBD with high sensitivity and specificity and useful even for non-medical staff.
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Affiliation(s)
- M M Garcia Basalo
- Neurology Department of Italian Hospital of Buenos Aires, Gascón 450, C1181ACH Buenos Aires, Argentina
| | - M C Fernandez
- Neurology Department of Italian Hospital of Buenos Aires, Gascón 450, C1181ACH Buenos Aires, Argentina; Lewy Body Association Argentina (ALBA), Argentina
| | - M Ojea Quintana
- Neurology Department of Italian Hospital of Buenos Aires, Gascón 450, C1181ACH Buenos Aires, Argentina; Lewy Body Association Argentina (ALBA), Argentina
| | - J I Rojas
- Neurology Department of Italian Hospital of Buenos Aires, Gascón 450, C1181ACH Buenos Aires, Argentina
| | - M J Garcia Basalo
- Neurology Department of Italian Hospital of Buenos Aires, Gascón 450, C1181ACH Buenos Aires, Argentina; Lewy Body Association Argentina (ALBA), Argentina
| | - E Bogliotti
- Neurology Department of Italian Hospital of Buenos Aires, Gascón 450, C1181ACH Buenos Aires, Argentina
| | - N Campora
- Neurology Department of Italian Hospital of Buenos Aires, Gascón 450, C1181ACH Buenos Aires, Argentina
| | - M Fernandez
- Neurology Department of Italian Hospital of Buenos Aires, Gascón 450, C1181ACH Buenos Aires, Argentina
| | - W Berrios
- Neurology Department of Italian Hospital of Buenos Aires, Gascón 450, C1181ACH Buenos Aires, Argentina
| | - E Cristiano
- Neurology Department of Italian Hospital of Buenos Aires, Gascón 450, C1181ACH Buenos Aires, Argentina
| | - A Golimstok
- Neurology Department of Italian Hospital of Buenos Aires, Gascón 450, C1181ACH Buenos Aires, Argentina; Lewy Body Association Argentina (ALBA), Argentina.
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29
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Hypnic jerks are an underestimated sleep motor phenomenon in patients with parkinsonism. A video-polysomnographic and neurophysiological study. Sleep Med 2016; 26:37-44. [DOI: 10.1016/j.sleep.2016.07.011] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2016] [Revised: 07/20/2016] [Accepted: 07/21/2016] [Indexed: 11/20/2022]
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30
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Irfan M, Howell MJ. Rapid Eye Movement Sleep Behavior Disorder: Overview and Current Perspective. CURRENT SLEEP MEDICINE REPORTS 2016. [DOI: 10.1007/s40675-016-0038-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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31
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Naharci MI, Ozturk A, Yasar H, Cintosun U, Kocak N, Bozoglu E, Tasci I, Doruk H. Galantamine improves sleep quality in patients with dementia. Acta Neurol Belg 2015; 115:563-8. [PMID: 25777522 DOI: 10.1007/s13760-015-0453-9] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2014] [Accepted: 02/23/2015] [Indexed: 11/30/2022]
Abstract
The purpose of the study was to evaluate the influences of cholinesterase inhibitors on sleep pattern and sleep disturbance. A total of 87 mild to moderate stage dementia patients who were not on cholinesterase enzyme inhibitor and memantine treatment were included in the study. The dementia patients were treated with donepezil, galantamine or rivastigmine, depending on the preference of the clinician. Fifty-five dementia patients (63.2 %) completed the study. Twenty-three elderly subjects, who had normal cognitive functions, were included in the study as the control group. The Pittsburgh Sleep Quality Index was used for evaluating the sleep quality at the beginning and at the final assessment. The improvement in sleep quality was better with regard to changes in Pittsburgh Sleep Quality Index scores with galantamine treatment compared to the donepezil and the control groups. A significant decrease in Pittsburgh Sleep Quality Index scores was detected in the galantamine group after treatment. Although statistically not significant, rivastigmine decreased and donepezil increased the Pittsburgh Sleep Quality Index scores after treatment. Dementia patients who had a poor sleep quality (n: 36), the rate of improvement in sleep disturbance was 81.8 % in the galantamine group, 75 % in the rivastigmine, and 50 % in the donepezil group. Galantamine may be the first choice of cholinesterase inhibitor in mild to moderate dementia patients in terms of improving sleep quality.
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Affiliation(s)
- Mehmet Ilkin Naharci
- Division of Geriatrics, Department of Internal Medicine, Gulhane School of Medicine, Ankara, Turkey.
- Department of Integrated Medical Sciences, Charles E. Schmidt College of Medicine, Florida Atlantic University, Boca Raton, FL, USA.
| | - Ahmet Ozturk
- Division of Geriatrics, Department of Internal Medicine, Gulhane School of Medicine, Ankara, Turkey
| | - Halit Yasar
- Department of Neurology, Mevki Military Hospital, Ankara, Turkey
| | - Umit Cintosun
- Division of Geriatrics, Department of Internal Medicine, Gulhane School of Medicine, Ankara, Turkey
| | - Necmettin Kocak
- Department of Epidemiology, Gulhane School of Medicine, Ankara, Turkey
| | - Ergun Bozoglu
- Division of Geriatrics, Department of Internal Medicine, Gulhane School of Medicine, Ankara, Turkey
| | - Ilker Tasci
- Division of Geriatrics, Department of Internal Medicine, Gulhane School of Medicine, Ankara, Turkey
| | - Huseyin Doruk
- Division of Geriatrics, Department of Internal Medicine, Gulhane School of Medicine, Ankara, Turkey
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32
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Pushpanathan ME, Loftus AM, Thomas MG, Gasson N, Bucks RS. The relationship between sleep and cognition in Parkinson's disease: A meta-analysis. Sleep Med Rev 2015; 26:21-32. [PMID: 26365136 DOI: 10.1016/j.smrv.2015.04.003] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2014] [Revised: 04/16/2015] [Accepted: 04/16/2015] [Indexed: 11/16/2022]
Abstract
It is well established that sleep disorders have neuropsychological consequences in otherwise healthy people. Studies of night-time sleep problems and cognition in Parkinson's disease (PD), however, paint a mixed picture, with many reporting no relationship between sleep problems and neuropsychological performance. This review aimed to meta-analyse this research and to examine the factors underlying these mixed results. A literature search was conducted of published and unpublished studies, resulting in 16 papers that met inclusion criteria. Data were analysed in the domains of: global cognitive function; memory (general, long-term verbal recognition, long-term verbal recall); and executive function (general, shifting, updating, inhibition, generativity, fluid reasoning). There was a significant effect of sleep on global cognitive function, long-term verbal recall, long-term verbal recognition, shifting, updating, generativity, and fluid reasoning. Although there are effects on memory and executive function associated with poor sleep in PD, the effects were driven by a small number of studies. Numerous methodological issues were identified. Further studies are needed reliably to determine whether disturbed sleep impacts on cognition via mechanisms of hypoxia, hypercapnia, sleep fragmentation, chronic sleep debt or decreased REM and/or slow wave sleep in PD, as this may have important clinical implications.
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Affiliation(s)
- Maria E Pushpanathan
- School of Psychology, University of Western Australia, Australia; ParkC Collaborative, Western Australia, Australia
| | - Andrea M Loftus
- School of Psychology and Speech Pathology, Curtin University, Australia; ParkC Collaborative, Western Australia, Australia
| | - Meghan G Thomas
- Experimental and Regenerative Neuroscience, School of Animal Biology, University of Western Australia, Australia; ParkC Collaborative, Western Australia, Australia; Parkinson's Centre, Vario Health Institute, Edith Cowan University, Australia
| | - Natalie Gasson
- School of Psychology and Speech Pathology, Curtin University, Australia; ParkC Collaborative, Western Australia, Australia
| | - Romola S Bucks
- School of Psychology, University of Western Australia, Australia; ParkC Collaborative, Western Australia, Australia.
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Cipriani G, Lucetti C, Danti S, Nuti A. Sleep disturbances and dementia. Psychogeriatrics 2015; 15:65-74. [PMID: 25515641 DOI: 10.1111/psyg.12069] [Citation(s) in RCA: 82] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2014] [Revised: 08/15/2014] [Accepted: 08/18/2014] [Indexed: 12/20/2022]
Abstract
Sleep is a complex behavioural state, the ultimate functions of which remain poorly understood. It becomes more fragmented as we age, with more night-time awakenings and greater tendency for daytime sleep. The magnitude of disordered sleep among individuals affected by dementia has been clearly demonstrated, and disturbed sleep is a major clinical problem in dementia. Comorbid insomnia and other sleep disturbances are common in patients with neurodegenerative disorders, such Alzheimer's disease and other dementing disorders. How and when sleep problems manifest themselves can depend on the type of dementia involved as well as the stage of the dementia. However, differences in sleep pattern presentation show more variation during the initial stages of dementias than they do during the later stages. Effective, pragmatic interventions are largely anecdotal and untested.
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Giles M, Thomas M, Lewin G. Ageing Intensifies the Care Needs of Adults Living with Parkinson ’s Disease and their Carers. AGEING INTERNATIONAL 2015. [DOI: 10.1007/s12126-014-9217-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Camicioli R, Gauthier S. Clinical Trials in Parkinson's Disease Dementia and Dementia with Lewy Bodies. Can J Neurol Sci 2014; 34 Suppl 1:S109-17. [PMID: 17469693 DOI: 10.1017/s0317167100005679] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Parkinson's disease with dementia (PDD) and dementia with Lewy bodies (DLB) are pathological overlapping and important causes of dementia for which clinical trials are in their infancy. Cholinesterase inhibitors may be of benefit in DLB and PDD, as suggested by placebo-controlled clinical trials of rivastigmine and donepezil. The anti-psychotic agent clozapine has been of benefit in PD and PDD, but other agents, such as quetiapine, require adequate assessment. Barriers to trials include pathological overlap that can lead to inaccuracies in clinical diagnosis, unavailability of a consensus definition for PDD, unanswered questions regarding natural history and the paucity of validated outcome measures. Motor impairment must be considered in patients with PDD and DLB; conversely, cognitive impairment should be assessed in trials targeting motor impairment in advanced PD. Potential targets for treatment include onset of dementia, cognitive impairment, behavioral impairment, functional decline, falls, nursing home placement, mortality, quality of life and economic impact. Biomarkers including neuroimaging and cerebrospinal fluid markers are not currently established. At present PDD and DLB are distinct entities by definition. Future studies, including clinical trials and biomarker studies, will help to further define the clinical and therapeutic implications of this distinction.
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Krolak-Salmon P, Xie J. Malattia a corpi di Lewy. Neurologia 2014. [DOI: 10.1016/s1634-7072(14)68870-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Preclinical polymodal hallucinations for 13 years before dementia with Lewy bodies. Behav Neurol 2014; 2014:694296. [PMID: 24868122 PMCID: PMC4020531 DOI: 10.1155/2014/694296] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2013] [Accepted: 11/29/2013] [Indexed: 01/08/2023] Open
Abstract
Objective. We describe a case of dementia with Lewy bodies (DLB) that presented long-lasting preclinical complex polymodal hallucinations. Background. Few studies have deeply investigated the characteristics of hallucinations in DLB, especially in the preclinical phase. Moreover, the clinical phenotype of mild cognitive impairment-(MCI-) DLB is poorly understood. Methods. The patient was followed for 4 years and a selective phenomenological and cognitive study was performed at the predementia stage. Results. The phenomenological study showed the presence of hypnagogic and hypnopompic hallucinations that allowed us to make a differential diagnosis between DLB and Charles Bonnet syndrome (CBS). The neuropsychological evaluation showed a multiple domain without amnesia MCI subtype with prefrontal dysexecutive, visuoperceptual, and visuospatial impairments and simultanagnosia, which has not previously been reported in MCI-DLB. Conclusions. This study extends the prognostic value of hallucinations for DLB to the preclinical phases. It supports and refines the MCI-DLB concept and identifies simultanagnosia as a possible early cognitive marker. Finally, it confirms an association between hallucinations and visuoperceptual impairments at an intermediate stage of the disease course and strongly supports the hypothesis that hallucinations in the earliest stages of DLB may reflect a narcolepsy-like REM-sleep disorder.
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Delgado-Rodrigues RN, Allen AN, Santos LGD, Schenck CH. Sleep Forensics: a critical review of the literature and brief comments on the Brazilian legal situation. ARQUIVOS DE NEURO-PSIQUIATRIA 2014; 72:164-9. [PMID: 24604372 DOI: 10.1590/0004-282x20130181] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/24/2013] [Accepted: 08/16/2013] [Indexed: 11/21/2022]
Abstract
Sleep medicine is a relatively new field among Medical Sciences. Its legal aspects are still obscure, either for lack of knowledge of the biological mechanisms underlying violent behaviour during sleep or the virtual absence of clear legal and uniformly accepted guidelines as to whether to punish or treat those disorders. An updated review of the pertinent literature was performed to determine the most prevalent pathological conditions involving violence and sleep and to identify their most common precipitating factors, attempting to provide some technical support to aid Brazilian medical-experts or assistants in preparing substantial and scientific-based reports in a legal environment.
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Affiliation(s)
- Raimundo Nonato Delgado-Rodrigues
- Centro de Distúrbios do Sono, Hospital Universitário de Brasília, Universidade de Brasília, BrasíliaDF, Brazil, Professor of Neurology, MD, PhD, Centro de Distúrbios do Sono, Hospital Universitário de Brasília, Universidade de Brasília, Brasília DF, Brazil
| | - Alexander N Allen
- North Central Thames Foundation School, London, England, BA, BMBCH, Foundation Doctor, North Central Thames Foundation School, London, England
| | - Leandro Galuzzi dos Santos
- Brazilian Supreme Court, BrasíliaDF, Brazil, Judge of Instruction Brazilian Supreme Court, Brasília DF, Brazil
| | - Carlos H Schenck
- University of Minnesota, Minnesota Regional Sleep Disorders Centre, Minneapolis, USA
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Ballard C, Aarsland D, Francis P, Corbett A. Neuropsychiatric symptoms in patients with dementias associated with cortical Lewy bodies: pathophysiology, clinical features, and pharmacological management. Drugs Aging 2013; 30:603-11. [PMID: 23681401 DOI: 10.1007/s40266-013-0092-x] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Dementia with Lewy bodies (DLB) and Parkinson's disease dementia (PDD) are synucleinopathies that lead to neurodegeneration and dementia. Although they result in symptoms common to Alzheimer's disease, they are associated with early emergence of parkinsonism and high frequency of neuropsychiatric symptoms, most commonly hallucinations and delusions. This review summarizes the current understanding of the underlying biology of neuropsychiatric symptoms in DLB and PDD and the evidence base for treatment to address them. Disruption to cholinergic and serotonergic neurotransmission and synapse activity are highlighted as primary pathological factors in neuropsychiatric symptoms, particularly loss of key neurotransmitter functions, alterations to neuronal receptors in the serotonergic pathway, and regionally specific structural changes that are linked to specific symptoms. Review of options for pharmacological treatment of neuropsychiatric symptoms suggests that the best evidence for the value of treatment is for cholinesterase inhibitors, with an indication that people with visual hallucinations are particularly likely to benefit. Evidence for the benefits of antipsychotics other than clozapine is limited, and there are serious safety concerns about the use of antipsychotics in these patients. Evidence to support other pharmacological interventions is very preliminary. Nonpharmacological approaches based on person-centered care and cholinesterase inhibitors should be considered as the first-line treatment for neuropsychiatric symptoms except in extreme cases.
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Affiliation(s)
- Clive Ballard
- Wolfson Centre for Age-Related Diseases, King's College London, Wolfson Building, Guy's Campus, London, SE1 1UL, UK.
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Ferri R, Zucconi M, Marelli S, Plazzi G, Schenck CH, Ferini-Strambi L. Effects of long-term use of clonazepam on nonrapid eye movement sleep patterns in rapid eye movement sleep behavior disorder. Sleep Med 2013; 14:399-406. [DOI: 10.1016/j.sleep.2013.01.007] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2012] [Revised: 01/17/2013] [Accepted: 01/25/2013] [Indexed: 11/24/2022]
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Abstract
Sleep evaluation can be essential in the treatment of dementia because sleep-related issues are common in dementia, often treatable, affect patient function, and are a major cause of caregiver distress. This article provides a practical approach to treatment of sleep in patients with dementia. Certain specific sleep disorders can be associated with certain underlying disorders and greater knowledge of these relationships is leading to more refined treatment approaches. Whether a sleep-related disorder such as obstructive sleep apnea, or limited sleep time, predisposes to the development of dementia is an active area of research.
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Affiliation(s)
- Heidi L Roth
- Department of Neurology, Cognitive Neurology and Sleep Medicine, University of North Carolina, 170 Manning Drive, CB # 7025, Chapel Hill, NC 27599-7025, USA.
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Abstract
Parkinson's disease is a progressive neurodegenerative disorder associated with Lewy body disease pathology in central and peripheral nervous system structures. Although the cause of Parkinson's disease is not fully understood, clinicopathological analyses have led to the development of a staging system for Lewy body disease-associated pathological changes. This system posits a predictable topography of progression of Lewy body disease in the CNS, beginning in olfactory structures and the medulla, then progressing rostrally from the medulla to the pons, then to midbrain and substantia nigra, limbic structures, and neocortical structures. If this topography and temporal evolution of Lewy body disease does occur, other manifestations of the disease as a result of degeneration of olfactory and pontomedullary structures could theoretically begin many years before the development of prominent nigral degeneration and the associated parkinsonian features of Parkinson's disease. One such manifestation of prodromal Parkinson's disease is rapid eye movement (REM) sleep behaviour disorder, which is a parasomnia manifested by vivid dreams associated with dream enactment behaviour during REM sleep. Findings from animal and human studies have suggested that lesions or dysfunction in REM sleep and motor control circuitry in the pontomedullary structures cause REM sleep behaviour disorder phenomenology, and degeneration of these structures might explain the presence of REM sleep behaviour disorder years or decades before the onset of parkinsonism in people who develop Parkinson's disease.
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Affiliation(s)
- Bradley F Boeve
- Department of Neurology and Center for Sleep Medicine, Mayo Clinic, Rochester, MN, USA.
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Huot P, Johnston TH, Koprich JB, Fox SH, Brotchie JM. The Pharmacology of l-DOPA-Induced Dyskinesia in Parkinson’s Disease. Pharmacol Rev 2013; 65:171-222. [DOI: 10.1124/pr.111.005678] [Citation(s) in RCA: 233] [Impact Index Per Article: 21.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
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Disrupted Daytime Activity and Altered Sleep-Wake Patterns May Predict Transition to Mild Cognitive Impairment or Dementia. Neurologist 2012; 18:426-9. [DOI: 10.1097/nrl.0b013e318272f7ef] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Abstract
Parkinson's disease is a disorder characterized by the motor findings of bradykinesia, rest tremor, cogwheel rigidity, and postural instability. As the disease progresses, most patients develop numerous nonmotor signs and symptoms, many of which play a major role in reducing quality of life. What is becoming increasingly clear is that nonmotor findings, including hyposmia, sleep disorders, autonomic abnormalities, cognitive changes, and neurobehavioral changes, often precede the motor findings.
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Affiliation(s)
- Charles H Adler
- Department of Neurology, Mayo Clinic, Scottsdale, Arizona 85259, USA.
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Zhou QP, Jung L, Richards KC. The management of sleep and circadian disturbance in patients with dementia. Curr Neurol Neurosci Rep 2012; 12:193-204. [PMID: 22314860 DOI: 10.1007/s11910-012-0249-8] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Sleep and circadian disturbances are common among patients with dementia. Symptomatic manifestations vary according to dementia subtype, with one commonly shared pattern--the irregular sleep-wake rhythm (ISWR), a circadian disorder characterized by an absence of the sleepwake cycle’s circadian synchronization. Hypothesized mechanisms of circadian rhythm disturbance include suprachiasmatic nucleus (SCN) circadian pacemaker damage, pineal gland and melatonin secretion alterations, and reduced zeitbeigers and decreased input to the SCN. Management options include prescribed sleep/wake scheduling, light therapy, melatonin, physical and social activity, and mixed modality. The mixed-modality approach is the most effective method in treating ISWR. Pharmacologic interventions are controversial, with no evidence supporting their effectiveness while associated with multiple side effects. They should be used with caution and only be considered as short-term therapy. All treatment strategies should be individualized to achieve the best outcomes.
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Affiliation(s)
- Qiuping Pearl Zhou
- School of Nursing, College of Health and Human Services, George Mason University, 4400 University Drive, MS: 3C4, Fairfax, VA 22030-4400, USA.
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Encéphalopathie d’Hashimoto. Rev Med Interne 2012; 33:390-5. [DOI: 10.1016/j.revmed.2012.02.009] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2011] [Revised: 01/28/2012] [Accepted: 02/22/2012] [Indexed: 11/21/2022]
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Dreaming and hallucinations – Continuity or discontinuity? Perspectives from dementia with Lewy bodies. Conscious Cogn 2011; 20:1016-20. [DOI: 10.1016/j.concog.2011.03.024] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2010] [Revised: 09/30/2010] [Accepted: 03/22/2011] [Indexed: 11/20/2022]
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