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Maillart E, Redolfi S, Louapre C, Houot M, Chaugne E, Laveneziana P, Ungureanu A, Stankoff B, Arnulf I, Papeix C, Bodini B, Similowski T, Lubetzki C, Morélot-Panzini C. Clinical correlates of respiratory disorders in patients with severe multiple sclerosis: A cross-sectional cohort. Mult Scler 2024:13524585241238840. [PMID: 38519434 DOI: 10.1177/13524585241238840] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/24/2024]
Abstract
BACKGROUND Respiratory disorders remain incompletely described in multiple sclerosis (MS), even though they are a frequent cause of death. METHODS The objective was to describe respiratory disorders in MS patients with Expanded Disability Status Score (EDSS) ⩾ 6.5. Diaphragm dysfunction was defined by at least two of the seven criteria: clinical signs, inspiratory recruitment of neck muscles during wakefulness, reduced upright vital capacity (VC) < 80%, upright-to-supine VC ⩾ 15% of upright VC, decrease in Maximal Inspiratory Pressure < 60%, phasic activation of inspiratory neck muscles during sleep, and opposition of thoracic and abdominal movements during sleep. Cough weakness was defined by a peak cough flow < 270 L/min and/or need for cough assist. Sleep apnea syndrome was defined by an apnea-hypopnea index ⩾ 15. RESULTS Notably, 71 MS patients were included: median age 54 [48, 61] years; median disease duration 21.4 [16.0, 31.4] years. Of these, 52 patients had one or more respiratory disorders; diaphragm dysfunction was the most frequent (n = 34). Patients with diaphragm dysfunction and cough weakness were more disabled. The fatigue score and the cognitive evaluations did not differ between the groups. Five patients required non-invasive ventilation. CONCLUSION Respiratory disorders are frequent in severe MS, mostly diaphragm dysfunction. Of interest, instrumental interventions are available to address these disorders.
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Affiliation(s)
- Elisabeth Maillart
- Department of Neurology, AP-HP, Hôpital Pitié-Salpêtrière, Multiple Sclerosis Center, Paris, France
| | - Stefania Redolfi
- Sleep Disorders Unit, AP-HP, Hôpital Pitié-Salpêtrière, Paris, France
| | - Céline Louapre
- Department of Neurology, AP-HP, Hôpital Pitié-Salpêtrière, Multiple Sclerosis Center, Paris, France
| | - Marion Houot
- Centre of Excellence of Neurodegenerative Disease (CoEN), Salpetriere Hospital, Paris, France
- Institute of Memory and Alzheimer's Disease (IM2A), Department of Neurology, Salpetriere Hospital, AP-HP, Paris, France; Clinical Investigation Centre, Paris Brain Institute (ICM), Pitié-Salpêtrière Hospital, Paris, France
| | - Emeline Chaugne
- Department of Neurology, Fondation A. de Rothshchild Hospital, Paris, France
| | - Pierantonio Laveneziana
- AP-HP, Groupe Hospitalier Universitaire APHP-Sorbonne Université, Hôpitaux Pitié-Salpêtrière, Saint-Antoine et Tenon, Service des Explorations Fonctionnelles de la Respiration, de l'Exercice et de la Dyspnée (Département R3S), Paris, France
- Sorbonne Université, INSERM, UMRS1158 Neurophysiologie Respiratoire Expérimentale et Clinique, Paris, France
- AP-HP, Groupe Hospitalier Universitaire APHP-Sorbonne Université, Hôpital Pitié-Salpêtrière, Centre de Référence Maladies Rares "Syndrome d'Ondine" (Département R3S), Paris, France
| | - Aurelian Ungureanu
- Department of Neurology, AP-HP, Hôpital Pitié-Salpêtrière, Multiple Sclerosis Center, Paris, France
| | - Bruno Stankoff
- Paris Brain Institute (ICM), AP-HP Sorbonne University, Paris, France
- Department of Neurology, Saint-Antoine Hospital, Paris, France
| | - Isabelle Arnulf
- Sleep Disorders Unit, AP-HP, Hôpital Pitié-Salpêtrière, Paris, France
| | - Caroline Papeix
- Department of Neurology, Fondation A. de Rothshchild Hospital, Paris, France
| | - Benedetta Bodini
- Paris Brain Institute (ICM), AP-HP Sorbonne University, Paris, France
- Department of Neurology, Saint-Antoine Hospital, Paris, France
| | - Thomas Similowski
- Sorbonne Université, INSERM, UMRS1158 Neurophysiologie Respiratoire Expérimentale et Clinique, Paris, France
- AP-HP, Groupe Hospitalier Universitaire APHP-Sorbonne Université, Hôpital Pitié-Salpêtrière, Centre de Référence Maladies Rares "Syndrome d'Ondine" (Département R3S), Paris, France
| | - Catherine Lubetzki
- Department of Neurology, AP-HP, Hôpital Pitié-Salpêtrière, Multiple Sclerosis Center, Paris, France
| | - Capucine Morélot-Panzini
- Sorbonne Université, INSERM, UMRS1158 Neurophysiologie Respiratoire Expérimentale et Clinique, Paris, France
- AP-HP, Groupe Hospitalier Universitaire APHP-Sorbonne Université, Hôpital Pitié-Salpêtrière, Centre de Référence Maladies Rares "Syndrome d'Ondine" (Département R3S), Paris, France
- AP-HP, Groupe Hospitalier Universitaire APHP-Sorbonne Université, Hôpital Pitié-Salpêtrière, Service de Pneumologie, Paris, France
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Dodet P, Houot M, Leu-Semenescu S, Corvol JC, Lehéricy S, Mangone G, Vidailhet M, Roze E, Arnulf I. Sleep disorders in Parkinson's disease, an early and multiple problem. NPJ Parkinsons Dis 2024; 10:46. [PMID: 38424131 PMCID: PMC10904863 DOI: 10.1038/s41531-024-00642-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2023] [Accepted: 01/15/2024] [Indexed: 03/02/2024] Open
Abstract
In Parkinson's disease (PD), it remains unclear whether sleep disorders including insomnia, REM sleep behavior disorder (RBD), excessive daytime sleepiness (EDS), restless legs syndrome (RLS) and sleep-disordered breathing (SDB), are isolated or combined, interact with each other and are associated with clinical factors. We sought to determine the prevalence and combinations of the main sleep disorders, and their clinical and polysomnographic associations in early stage PD. Sleep disorders were systematically diagnosed after medical interview and video-polysomnography in 162 participants with early stage PD and 58 healthy controls from the baseline of the longitudinal ICEBERG cohort. Demographic, clinical (motor, cognitive, autonomic, psychological and sensory tests), therapeutic and polysomnographic associations of sleep disorders were investigated. Sleep disorders were frequent (71%) and combined in half of the patients. The number of sleep disorders increased with disease duration and dysautonomia. Insomnia was the most common (41%), followed by definite RBD (25%), EDS (25%), and RLS (16%). These disorders were more frequent than in controls whereas SDB was rare, moderate and similar in both groups. In patients, insomnia (mainly difficulties maintaining sleep) was associated with female gender, shorter sleep time and RLS, but not with motor or psychological symptoms. RBD was associated with dysautonomia and advanced age, but not with motor and cognitive measures. EDS was associated with psychiatric and motor symptoms as well as the sedative effects of dopamine agonists but not with other sleep disturbances. Sleep disturbances are frequent and combined in early patients with PD. Their determinants and markers are more organic than psychological.
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Affiliation(s)
- Pauline Dodet
- Service des Pathologies du Sommeil et Centre de Référence National des Narcolepsies et Hypersomnies rares, Assistance Publique-Hôpitaux de Paris-Sorbonne (AP-HP-Sorbonne), Hôpital la Pitié-Salpêtrière, Paris, France.
- Paris Brain Institute (ICM), Sorbonne University, Inserm U1227, CNRS 7225, Paris, France.
| | - Marion Houot
- Center of Excellence of Neurodegenerative Disease (CoEN), AP-HP, Pitié-Salpêtrière Hospital, Paris, France
- Department of Neurology, Institute of Memory and Alzheimer's Disease (IM2A), AP-HP, Pitié-Salpêtrière Hospital, Paris, France
- Assistance Publique Hôpitaux de Paris, Inserm, Clinical Investigation Centre (CIC) Neuroscience, Paris Brain Institute - ICM, Pitié-Salpêtrière Hospital, Paris, France
| | - Smaranda Leu-Semenescu
- Service des Pathologies du Sommeil et Centre de Référence National des Narcolepsies et Hypersomnies rares, Assistance Publique-Hôpitaux de Paris-Sorbonne (AP-HP-Sorbonne), Hôpital la Pitié-Salpêtrière, Paris, France
- Paris Brain Institute (ICM), Sorbonne University, Inserm U1227, CNRS 7225, Paris, France
| | - Jean-Christophe Corvol
- Paris Brain Institute (ICM), Sorbonne University, Inserm U1227, CNRS 7225, Paris, France
- Center of Excellence of Neurodegenerative Disease (CoEN), AP-HP, Pitié-Salpêtrière Hospital, Paris, France
- Assistance Publique Hôpitaux de Paris, Inserm, Clinical Investigation Centre (CIC) Neuroscience, Paris Brain Institute - ICM, Pitié-Salpêtrière Hospital, Paris, France
| | - Stéphane Lehéricy
- Paris Brain Institute (ICM), Sorbonne University, Inserm U1227, CNRS 7225, Paris, France
- Assistance Publique Hôpitaux de Paris, Hôpital Pitié -Salpêtrière, Department of Neuroradiology, 75013, Paris, France
| | - Graziella Mangone
- Paris Brain Institute (ICM), Sorbonne University, Inserm U1227, CNRS 7225, Paris, France
| | - Marie Vidailhet
- Paris Brain Institute (ICM), Sorbonne University, Inserm U1227, CNRS 7225, Paris, France
- Center of Excellence of Neurodegenerative Disease (CoEN), AP-HP, Pitié-Salpêtrière Hospital, Paris, France
| | - Emmanuel Roze
- Paris Brain Institute (ICM), Sorbonne University, Inserm U1227, CNRS 7225, Paris, France
- Center of Excellence of Neurodegenerative Disease (CoEN), AP-HP, Pitié-Salpêtrière Hospital, Paris, France
| | - Isabelle Arnulf
- Service des Pathologies du Sommeil et Centre de Référence National des Narcolepsies et Hypersomnies rares, Assistance Publique-Hôpitaux de Paris-Sorbonne (AP-HP-Sorbonne), Hôpital la Pitié-Salpêtrière, Paris, France
- Paris Brain Institute (ICM), Sorbonne University, Inserm U1227, CNRS 7225, Paris, France
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Perretti C, Gales A, Leu-Semenescu S, Dodet P, Bianquis C, Groos E, Puligheddu M, Maranci JB, Arnulf I. Latency To N3 Interruption In Arousal Disorders. Sleep 2024:zsae033. [PMID: 38306685 DOI: 10.1093/sleep/zsae033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Indexed: 02/04/2024] Open
Abstract
STUDY OBJECTIVES To help expert witnesses in criminal cases using the "sleepwalking defense", we studied the time of first and last interruptions from stage N3 in patients with arousal disorders, including sexsomnia, as well as their determinants. METHODS The epochs of lights off, sleep onset, first N3 interruption (with and without behaviors), and last N3 interruption were determined by videopolysomnography on two consecutive nights in 163 adults with disorders of arousal, including 46 with and 117 without sexsomnia. RESULTS The first N3 interruption (independently of concomitant behavior) occurred as early as 8 minutes after sleep onset and within 100 minutes of falling asleep in 95% of cases. The first motor arousal from N3 occurred as early as 25 min after lights off time, a timing more variable between participants (between 30 and 60 minutes after lights off time in 25% of participants and within 60 minutes of falling asleep in 50%). These latencies did not differ between the groups with and without sexsomnia. No correlation was found between these latencies and the young age, sex or clinical severity. The latency of motor arousals was shorter when they were associated with a fast-wave EEG profile and were not preceded by another type of N3 arousal. CONCLUSION The first motor arousal may occur early in the night in patients with arousal disorders, with or without sexsomnia, suggesting that abnormal behaviors occurring as early as 25 min after lights off time in clinical and criminal cases can be a parasomnia manifestation.
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Affiliation(s)
- C Perretti
- Sleep Clinic, Pitie-Salpetriere Hospital, APHP-Sorbonne, Paris, France
- Sleep Disorder Research Center, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - A Gales
- Sleep Clinic, Pitie-Salpetriere Hospital, APHP-Sorbonne, Paris, France
| | - S Leu-Semenescu
- Sleep Clinic, Pitie-Salpetriere Hospital, APHP-Sorbonne, Paris, France
- Paris Brain Institute (ICM), INSERM, CNRS, Paris, France
| | - P Dodet
- Sleep Clinic, Pitie-Salpetriere Hospital, APHP-Sorbonne, Paris, France
- Sorbonne University, Paris, France
- Paris Brain Institute (ICM), INSERM, CNRS, Paris, France
| | - C Bianquis
- Sleep Clinic, Pitie-Salpetriere Hospital, APHP-Sorbonne, Paris, France
| | - E Groos
- Sleep Clinic, Pitie-Salpetriere Hospital, APHP-Sorbonne, Paris, France
| | - M Puligheddu
- Sleep Disorder Research Center, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - J B Maranci
- Sleep Clinic, Pitie-Salpetriere Hospital, APHP-Sorbonne, Paris, France
- Sorbonne University, Paris, France
- Paris Brain Institute (ICM), INSERM, CNRS, Paris, France
| | - I Arnulf
- Sleep Clinic, Pitie-Salpetriere Hospital, APHP-Sorbonne, Paris, France
- Sorbonne University, Paris, France
- Paris Brain Institute (ICM), INSERM, CNRS, Paris, France
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Valentin R, Niérat M, Wattiez N, Jacq O, Decavèle M, Arnulf I, Similowski T, Attali V. Neurophysiological basis of respiratory discomfort improvement by mandibular advancement in awake OSA patients. Physiol Rep 2024; 12:e15951. [PMID: 38373738 PMCID: PMC10984610 DOI: 10.14814/phy2.15951] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Revised: 01/23/2024] [Accepted: 01/31/2024] [Indexed: 02/21/2024] Open
Abstract
Patients with obstructive sleep apneas (OSA) do not complain from dyspnea during resting breathing. Placement of a mandibular advancement device (MAD) can lead to a sense of improved respiratory comfort ("pseudo-relief") ascribed to a habituation phenomenon. To substantiate this conjecture, we hypothesized that, in non-dyspneic awake OSA patients, respiratory-related electroencephalographic figures, abnormally present during awake resting breathing, would disappear or change in parallel with MAD-associated pseudo-relief. In 20 patients, we compared natural breathing and breathing with MAD on: breathing discomfort (transitional visual analog scale, VAS-2); upper airway mechanics, assessed in terms of pressure peak/time to peak (TTP) ratio respiratory-related electroencephalography (EEG) signatures, including slow event-related preinspiratory potentials; and a between-state discrimination based on continuous connectivity evaluation. MAD improved breathing and upper airway mechanics. The 8 patients in whom the EEG between-state discrimination was considered effective exhibited higher Peak/TTP improvement and transitional VAS ratings while wearing MAD than the 12 patients where it was not. These results support the notion of habituation to abnormal respiratory-related afferents in OSA patients and fuel the causative nature of the relationship between dyspnea, respiratory-related motor cortical activity and impaired upper airway mechanics in this setting.
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Affiliation(s)
- Rémi Valentin
- INSERM, UMRS1158 Neurophysiologie Respiratoire Expérimentale et CliniqueSorbonne UniversitéParisFrance
- Hôpital Pitié‐Salpêtrière, Département R3S, Service des Pathologies du Sommeil (Département R3S)AP‐HP, Groupe Hospitalier Universitaire APHP‐Sorbonne UniversitéParisFrance
- Institut de Biomécanique Humaine Georges CharpakÉcole Nationale Supérieure des Arts et MétiersParisFrance
| | - Marie‐Cécile Niérat
- INSERM, UMRS1158 Neurophysiologie Respiratoire Expérimentale et CliniqueSorbonne UniversitéParisFrance
| | - Nicolas Wattiez
- INSERM, UMRS1158 Neurophysiologie Respiratoire Expérimentale et CliniqueSorbonne UniversitéParisFrance
| | - Olivier Jacq
- INSERM, UMRS1158 Neurophysiologie Respiratoire Expérimentale et CliniqueSorbonne UniversitéParisFrance
| | - Maxens Decavèle
- INSERM, UMRS1158 Neurophysiologie Respiratoire Expérimentale et CliniqueSorbonne UniversitéParisFrance
- Service de Médecine Intensive et Réanimation (Département R3S)Groupe Hospitalier Universitaire APHP‐Sorbonne UniversitéParisFrance
| | - Isabelle Arnulf
- Hôpital Pitié‐Salpêtrière, Département R3S, Service des Pathologies du Sommeil (Département R3S)AP‐HP, Groupe Hospitalier Universitaire APHP‐Sorbonne UniversitéParisFrance
- Paris Brain Institute (ICM)Sorbonne UniversitéParisFrance
| | - Thomas Similowski
- INSERM, UMRS1158 Neurophysiologie Respiratoire Expérimentale et CliniqueSorbonne UniversitéParisFrance
- Hôpital, Pitié‐Salpêtrière, Département R3SAP‐HP, Groupe Hospitalier APHP‐Sorbonne UniversitéParisFrance
| | - Valérie Attali
- INSERM, UMRS1158 Neurophysiologie Respiratoire Expérimentale et CliniqueSorbonne UniversitéParisFrance
- Hôpital Pitié‐Salpêtrière, Département R3S, Service des Pathologies du Sommeil (Département R3S)AP‐HP, Groupe Hospitalier Universitaire APHP‐Sorbonne UniversitéParisFrance
- Institut de Biomécanique Humaine Georges CharpakÉcole Nationale Supérieure des Arts et MétiersParisFrance
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Jeantin L, Gales A, Berzero G, Leu S, Proust J, Giry M, Valyraki NE, Birzu C, Alentorn A, Vidailhet M, Psimaras D, Arnulf I. Hypersomnia in anti-glutamic acid decarboxylase 65 (GAD65) associated neurological syndromes: A pilot study. Eur J Neurol 2024; 31:e16125. [PMID: 37922501 DOI: 10.1111/ene.16125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Revised: 09/28/2023] [Accepted: 10/18/2023] [Indexed: 11/05/2023]
Abstract
BACKGROUND AND PURPOSE Despite their detrimental impact on the quality of life in autoimmune encephalitis, sleep disorders have not been investigated in anti-glutamic acid decarboxylase (GAD65) associated neurological syndromes. METHODS Six consecutive adult patients diagnosed with anti-GAD65-associated neurological syndromes (four with limbic encephalitis and two with stiff-person syndrome) and 12 healthy controls were enrolled. Participants underwent sleep interviews and sleep studies including night-time video-polysomnography, followed by five daytime multiple sleep latency tests (MSLTs, to assess propensity to fall asleep) and an 18 h bed rest polysomnography (to assess excessive sleep need). RESULTS Patients reported the need for daily naps and that their cognition and quality of life were altered by sleepiness, but they had normal scores on the Epworth sleepiness scale. Compared with controls, sleep latencies during the MSLT were shorter in the patient group (median 5.8 min, interquartile range [IQR] 4.5, 6.0 vs. 17.7 min, IQR 16.3, 19.7, p = 0.001), and the arousal index was reduced (2.5/h, IQR 2.3, 3.0 vs. 22.3/h, IQR 13.8, 30.0, p = 0.002), although total sleep time was similar between groups (621 min, IQR 464, 651 vs. 542.5 min, IQR 499, 582, p = 0.51). Remarkably, all six patients had MSLT latencies ≤8 min, indicating severe sleepiness. No parasomnia or sleep-disordered breathing was detected. CONCLUSION Central hypersomnia is a relevant characteristic of anti-GAD65-associated neurological syndromes.
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Affiliation(s)
- Lina Jeantin
- Sleep Disorders Unit, R3S Department, Pitié-Salpêtrière Hospital, AP-HP Sorbonne University, Paris, France
| | - Ana Gales
- Sleep Disorders Unit, R3S Department, Pitié-Salpêtrière Hospital, AP-HP Sorbonne University, Paris, France
| | - Giulia Berzero
- Neuro-Oncology Unit, Neurology Department, Pitié-Salpêtrière Hospital, AP-HP Sorbonne University, Paris, France
| | - Smaranda Leu
- Sleep Disorders Unit, R3S Department, Pitié-Salpêtrière Hospital, AP-HP Sorbonne University, Paris, France
| | - Jérémy Proust
- Sleep Disorders Unit, R3S Department, Pitié-Salpêtrière Hospital, AP-HP Sorbonne University, Paris, France
| | - Marine Giry
- Neuro-Oncology Unit, Neurology Department, Pitié-Salpêtrière Hospital, AP-HP Sorbonne University, Paris, France
| | - Nefeli Eirini Valyraki
- Neuro-Oncology Unit, Neurology Department, Pitié-Salpêtrière Hospital, AP-HP Sorbonne University, Paris, France
| | - Cristina Birzu
- Neuro-Oncology Unit, Neurology Department, Pitié-Salpêtrière Hospital, AP-HP Sorbonne University, Paris, France
| | - Agusti Alentorn
- Neuro-Oncology Unit, Neurology Department, Pitié-Salpêtrière Hospital, AP-HP Sorbonne University, Paris, France
| | - Marie Vidailhet
- Movement Disorder Unit, Neurology Department, Pitié-Salpêtrière Hospital, Paris, France
| | - Dimitri Psimaras
- Neuro-Oncology Unit, Neurology Department, Pitié-Salpêtrière Hospital, AP-HP Sorbonne University, Paris, France
| | - Isabelle Arnulf
- Sleep Disorders Unit, R3S Department, Pitié-Salpêtrière Hospital, AP-HP Sorbonne University, Paris, France
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Di Folco C, Couronné R, Arnulf I, Mangone G, Leu-Semenescu S, Dodet P, Vidailhet M, Corvol JC, Lehéricy S, Durrleman S. Charting Disease Trajectories from Isolated REM Sleep Behavior Disorder to Parkinson's Disease. Mov Disord 2024; 39:64-75. [PMID: 38006282 DOI: 10.1002/mds.29662] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Revised: 10/03/2023] [Accepted: 10/30/2023] [Indexed: 11/26/2023] Open
Abstract
BACKGROUND Clinical presentation and progression dynamics are variable in patients with Parkinson's disease (PD). Disease course mapping is an innovative disease modelling technique that summarizes the range of possible disease trajectories and estimates dimensions related to onset, sequence, and speed of progression of disease markers. OBJECTIVE To propose a disease course map for PD and investigate progression profiles in patients with or without rapid eye movement sleep behavioral disorders (RBD). METHODS Data of 919 PD patients and 88 isolated RBD patients from three independent longitudinal cohorts were analyzed (follow-up duration = 5.1; 95% confidence interval, 1.1-8.1] years). Disease course map was estimated by using eight clinical markers (motor and non-motor symptoms) and four imaging markers (dopaminergic denervation). RESULTS PD course map showed that the first changes occurred in the contralateral putamen 13 years before diagnosis, followed by changes in motor symptoms, dysautonomia, sleep-all before diagnosis-and finally cognitive decline at the time of diagnosis. The model showed earlier disease onset, earlier non-motor and later motor symptoms, more rapid progression of cognitive decline in PD patients with RBD than PD patients without RBD. This pattern was even more pronounced in patients with isolated RBD with early changes in sleep, followed by cognition and non-motor symptoms and later changes in motor symptoms. CONCLUSIONS Our findings are consistent with the presence of distinct patterns of progression between patients with and without RBD. Understanding heterogeneity of PD progression is key to decipher the underlying pathophysiology and select homogeneous subgroups of patients for precision medicine. © 2023 International Parkinson and Movement Disorder Society.
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Affiliation(s)
- Cécile Di Folco
- Inria, Centre de Paris, Paris, France
- Paris Brain Institute-ICM, Paris, France
- Inserm, Paris, France
- CNRS, Paris, France
- Sorbonne Université, Paris, France
- AP-HP, Hôpital de la Pitié Salpêtrière, Paris, France
| | - Raphaël Couronné
- Inria, Centre de Paris, Paris, France
- Paris Brain Institute-ICM, Paris, France
- Inserm, Paris, France
- CNRS, Paris, France
- Sorbonne Université, Paris, France
- AP-HP, Hôpital de la Pitié Salpêtrière, Paris, France
| | - Isabelle Arnulf
- Paris Brain Institute-ICM, Paris, France
- Inserm, Paris, France
- CNRS, Paris, France
- Sorbonne Université, Paris, France
- AP-HP, Hôpital de la Pitié Salpêtrière, Paris, France
| | - Graziella Mangone
- Paris Brain Institute-ICM, Paris, France
- Inserm, Paris, France
- CNRS, Paris, France
- Sorbonne Université, Paris, France
- AP-HP, Hôpital de la Pitié Salpêtrière, Paris, France
| | - Smaranda Leu-Semenescu
- Paris Brain Institute-ICM, Paris, France
- Inserm, Paris, France
- CNRS, Paris, France
- Sorbonne Université, Paris, France
- AP-HP, Hôpital de la Pitié Salpêtrière, Paris, France
| | - Pauline Dodet
- Paris Brain Institute-ICM, Paris, France
- Inserm, Paris, France
- CNRS, Paris, France
- Sorbonne Université, Paris, France
- AP-HP, Hôpital de la Pitié Salpêtrière, Paris, France
| | - Marie Vidailhet
- Paris Brain Institute-ICM, Paris, France
- Inserm, Paris, France
- CNRS, Paris, France
- Sorbonne Université, Paris, France
- AP-HP, Hôpital de la Pitié Salpêtrière, Paris, France
| | - Jean-Christophe Corvol
- Paris Brain Institute-ICM, Paris, France
- Inserm, Paris, France
- CNRS, Paris, France
- Sorbonne Université, Paris, France
- AP-HP, Hôpital de la Pitié Salpêtrière, Paris, France
| | - Stéphane Lehéricy
- Paris Brain Institute-ICM, Paris, France
- Inserm, Paris, France
- CNRS, Paris, France
- Sorbonne Université, Paris, France
- AP-HP, Hôpital de la Pitié Salpêtrière, Paris, France
| | - Stanley Durrleman
- Inria, Centre de Paris, Paris, France
- Paris Brain Institute-ICM, Paris, France
- Inserm, Paris, France
- CNRS, Paris, France
- Sorbonne Université, Paris, France
- AP-HP, Hôpital de la Pitié Salpêtrière, Paris, France
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7
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Dias L, Martinot C, Vaillant G, Arnulf I. Severe night sweating treated by oxybutynin. J Clin Sleep Med 2024; 20:169-172. [PMID: 38163944 PMCID: PMC10758562 DOI: 10.5664/jcsm.10842] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Revised: 09/29/2023] [Accepted: 09/29/2023] [Indexed: 01/03/2024]
Abstract
Sleep hyperhidrosis is defined as profuse nocturnal sweating that disrupts sleep. Although the mechanism is unknown, some cases are secondary to hot flushes during the menopausal period, medical, mental and sleep disorders, and medication, while dysregulation of thermoregulation during sleep is suspected in primary cases. We present the case of a woman with severe primary sleep hyperhidrosis, occurring nightly for 23 years, which definitively resolved after brief treatment with oxybutynin (a muscarinic receptor-blocking anticholinergic). An ammoniacal odor in the sweat and a sensation of coldness on awakening during sweating episodes suggest that the mechanism of her night sweating was not an exacerbation of thermoregulation during the night but shares the mechanical properties of emotional/psychological sweating. This extreme case of sleep hyperhidrosis was treated with excellent efficacy and minimal side effects using oxybutynin, which could benefit other patients with nighttime discomfort. CITATION Dias L, Martinot C, Vaillant G, Arnulf I. Severe night sweating treated by oxybutynin. J Clin Sleep Med. 2024;20(1):169-172.
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Affiliation(s)
- Leonor Dias
- Sleep Clinic, Pitie-Salpetriere University Hospital, Assistance Publique-Hôpitaux de Paris-Sorbonne, Paris, France
- Neurology Department, Centro Hospitalar Universitario de Sao Joao, EPE, Porto, Portugal
| | | | - Garance Vaillant
- Sleep Clinic, Pitie-Salpetriere University Hospital, Assistance Publique-Hôpitaux de Paris-Sorbonne, Paris, France
| | - Isabelle Arnulf
- Sleep Clinic, Pitie-Salpetriere University Hospital, Assistance Publique-Hôpitaux de Paris-Sorbonne, Paris, France
- Sorbonne University, Paris France
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8
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Strauss M, Griffon L, Elbaz M, Arnulf I, Chennaoui M, Léger D. Altered reinforcement learning in Narcolepsy type I and other central disorders of hypersomnolence. Sleep Med 2024; 113:103-110. [PMID: 37995471 DOI: 10.1016/j.sleep.2023.11.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Revised: 10/17/2023] [Accepted: 11/01/2023] [Indexed: 11/25/2023]
Abstract
Cognitive impairments are described in central disorders of hypersomnolence (CDH), but studies remain very limited and largely focused on narcolepsy type 1 (NT1). The precise nature and origin of these cognitive impairments is poorly understood. Specifically, impaired decision making under ambiguity has been reported in NT1 and suggested to be caused by dysregulation of the direct projections of hypocretin neurons to the dopamine network. However, the decision-making tasks used previously embed different cognitive functions that are difficult to isolate. This study aims to test reinforcement learning in participants with NT1 and with other (non-hypocretin deficient) CDH in a task known to directly depend on the dopamine system. Participants with NT1 (N = 27), other CDH (N = 34, including narcolepsy type 2 and idiopathic hypersomnia, matched with NT1 participants for sleepiness severity), and healthy participants (N = 34) took part in the study. Results showed that all groups had normal and similar positive reinforcement learning, a pattern not suggestive of dopamine deficiency. However, both participants with NT1 and other CDH had decreased learning abilities to avoid losses. This decreased negative reinforcement learning in participants with CDH was associated with the alteration of vigilance. This study provides new insights into the nature of decision making impairment in people with CDH and suggests that these alterations could be minimized by restoring adequate vigilance.
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Affiliation(s)
- Mélanie Strauss
- Université Paris Cité, VIFASOM ERC 7330, Sommeil-Vigilance-Fatigue et Santé Publique, 75006, Paris, France; APHP Hôtel Dieu, Centre du Sommeil et de la Vigilance, 75004, Paris, France; Neuropsychology and Functional Imaging Research Group (UR2NF) at Center for Research in Cognition and Neurosciences (CRCN) and ULB Neuroscience Institute (UNI), Université Libre de Bruxelles, 1050, Brussels, Belgium; Université libre de Bruxelles (ULB), Hôpital Universitaire de Bruxelles (H.U.B), CUB Hôpital Érasme, Service de Neurologie, Psychiatrie et Laboratoire du sommeil, Route de Lennik 808, 1070 Bruxelles, Belgium.
| | - Lucie Griffon
- Université Paris Cité, VIFASOM ERC 7330, Sommeil-Vigilance-Fatigue et Santé Publique, 75006, Paris, France; APHP Hôtel Dieu, Centre du Sommeil et de la Vigilance, 75004, Paris, France; Unité de Ventilation Non-invasive et du sommeil de l'enfant, AP-HP Hôpital Necker Enfants Malades, Paris, France
| | - Maxime Elbaz
- Université Paris Cité, VIFASOM ERC 7330, Sommeil-Vigilance-Fatigue et Santé Publique, 75006, Paris, France; APHP Hôtel Dieu, Centre du Sommeil et de la Vigilance, 75004, Paris, France
| | - Isabelle Arnulf
- APHP-Sorbonne Université, Hôpital Pitié Salpêtrière, Fédération des Pathologies du Sommeil, Paris, France; National Reference Center for Narcolepsies and Rare Hypersomnias, France
| | - Mounir Chennaoui
- Université Paris Cité, VIFASOM ERC 7330, Sommeil-Vigilance-Fatigue et Santé Publique, 75006, Paris, France; Institut de Recherche Biomédicale des Armées, Unité Fatigue et vigilance, 91220, Brétigny sur Orge, France
| | - Damien Léger
- Université Paris Cité, VIFASOM ERC 7330, Sommeil-Vigilance-Fatigue et Santé Publique, 75006, Paris, France; APHP Hôtel Dieu, Centre du Sommeil et de la Vigilance, 75004, Paris, France
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9
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Türker B, Musat EM, Chabani E, Fonteix-Galet A, Maranci JB, Wattiez N, Pouget P, Sitt J, Naccache L, Arnulf I, Oudiette D. Behavioral and brain responses to verbal stimuli reveal transient periods of cognitive integration of the external world during sleep. Nat Neurosci 2023; 26:1981-1993. [PMID: 37828228 PMCID: PMC10620087 DOI: 10.1038/s41593-023-01449-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Accepted: 09/05/2023] [Indexed: 10/14/2023]
Abstract
Sleep has long been considered as a state of behavioral disconnection from the environment, without reactivity to external stimuli. Here we questioned this 'sleep disconnection' dogma by directly investigating behavioral responsiveness in 49 napping participants (27 with narcolepsy and 22 healthy volunteers) engaged in a lexical decision task. Participants were instructed to frown or smile depending on the stimulus type. We found accurate behavioral responses, visible via contractions of the corrugator or zygomatic muscles, in most sleep stages in both groups (except slow-wave sleep in healthy volunteers). Across sleep stages, responses occurred more frequently when stimuli were presented during high cognitive states than during low cognitive states, as indexed by prestimulus electroencephalography. Our findings suggest that transient windows of reactivity to external stimuli exist during bona fide sleep, even in healthy individuals. Such windows of reactivity could pave the way for real-time communication with sleepers to probe sleep-related mental and cognitive processes.
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Affiliation(s)
- Başak Türker
- Sorbonne Université, Institut du Cerveau-Paris Brain Institute-ICM, INSERM, CNRS, Paris, France
| | - Esteban Munoz Musat
- Sorbonne Université, Institut du Cerveau-Paris Brain Institute-ICM, INSERM, CNRS, Paris, France
| | - Emma Chabani
- Sorbonne Université, Institut du Cerveau-Paris Brain Institute-ICM, INSERM, CNRS, Paris, France
| | | | - Jean-Baptiste Maranci
- Sorbonne Université, Institut du Cerveau-Paris Brain Institute-ICM, INSERM, CNRS, Paris, France
- AP-HP, Hôpital Pitié-Salpêtrière, Service des Pathologies du Sommeil, National Reference Centre for Narcolepsy, Paris, France
| | - Nicolas Wattiez
- Sorbonne Université, INSERM, Neurophysiologie Respiratoire Expérimentale et Clinique, Paris, France
| | - Pierre Pouget
- Sorbonne Université, Institut du Cerveau-Paris Brain Institute-ICM, INSERM, CNRS, Paris, France
| | - Jacobo Sitt
- Sorbonne Université, Institut du Cerveau-Paris Brain Institute-ICM, INSERM, CNRS, Paris, France
| | - Lionel Naccache
- Sorbonne Université, Institut du Cerveau-Paris Brain Institute-ICM, INSERM, CNRS, Paris, France
- AP-HP, Hôpital Pitié-Salpêtrière, Service de Neurophysiologie Clinique, Paris, France
| | - Isabelle Arnulf
- Sorbonne Université, Institut du Cerveau-Paris Brain Institute-ICM, INSERM, CNRS, Paris, France
- AP-HP, Hôpital Pitié-Salpêtrière, Service des Pathologies du Sommeil, National Reference Centre for Narcolepsy, Paris, France
| | - Delphine Oudiette
- Sorbonne Université, Institut du Cerveau-Paris Brain Institute-ICM, INSERM, CNRS, Paris, France.
- AP-HP, Hôpital Pitié-Salpêtrière, Service des Pathologies du Sommeil, National Reference Centre for Narcolepsy, Paris, France.
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Sutter J, Cuvelier A, Lukaszewicz R, Maris J, Arnulf I, Similowski T, Patout M. Poor sleep quality and nocturnal home noninvasive ventilation: Prevalence, risk factors and impact. Pulmonology 2023; 29:546-549. [PMID: 37210337 DOI: 10.1016/j.pulmoe.2023.04.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2023] [Revised: 04/07/2023] [Accepted: 04/11/2023] [Indexed: 05/22/2023] Open
Affiliation(s)
- J Sutter
- Service de pneumologie, oncologie thoracique et soins intensifs respiratoires, CHU de Rouen, Université de Rouen, Rouen, France; AP-HP, Groupe Hospitalier Universitaire APHP-Sorbonne Université, site Pitié-Salpêtrière, Service des Pathologies du Sommeil (Département R3S), F-75013 Paris, France
| | - A Cuvelier
- Service de pneumologie, oncologie thoracique et soins intensifs respiratoires, CHU de Rouen, Université de Rouen, Rouen, France; Normandie Université, UNIROUEN, UPRES EA3830 (GRHV), Haute Normandie Recherche et innovation biomédicale, Rouen, France
| | - R Lukaszewicz
- Service de pneumologie, oncologie thoracique et soins intensifs respiratoires, CHU de Rouen, Université de Rouen, Rouen, France
| | - J Maris
- Service de pneumologie, oncologie thoracique et soins intensifs respiratoires, CHU de Rouen, Université de Rouen, Rouen, France
| | - I Arnulf
- AP-HP, Groupe Hospitalier Universitaire APHP-Sorbonne Université, site Pitié-Salpêtrière, Service des Pathologies du Sommeil (Département R3S), F-75013 Paris, France; Institut du cerveau et de la moelle - ICM, Inserm U 1127, CNRS UMR 7225, UPMC, Paris, France
| | - T Similowski
- Sorbonne Université, INSERM, UMRS1158 Neurophysiologie Respiratoire Expérimentale et Clinique, F-75005 Paris, France; AP-HP, Groupe Hospitalier Universitaire APHP-Sorbonne Université, site Pitié-Salpêtrière, Service des Pathologies du Sommeil (Département R3S), F-75013 Paris, France
| | - M Patout
- Service de pneumologie, oncologie thoracique et soins intensifs respiratoires, CHU de Rouen, Université de Rouen, Rouen, France; AP-HP, Groupe Hospitalier Universitaire APHP-Sorbonne Université, site Pitié-Salpêtrière, Service des Pathologies du Sommeil (Département R3S), F-75013 Paris, France; Normandie Université, UNIROUEN, UPRES EA3830 (GRHV), Haute Normandie Recherche et innovation biomédicale, Rouen, France; Sorbonne Université, INSERM, UMRS1158 Neurophysiologie Respiratoire Expérimentale et Clinique, F-75005 Paris, France.
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11
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Arnulf I, Dodet P, Leu-Semenescu S, Maranci JB. Idiopathic hypersomnia and Kleine-Levin syndrome. Rev Neurol (Paris) 2023; 179:741-754. [PMID: 37684104 DOI: 10.1016/j.neurol.2023.08.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/10/2023]
Abstract
Idiopathic hypersomnia (IH) and Kleine-Levin syndrome (KLS) are rare disorders of central hypersomnolence of unknown cause, affecting young people. However, increased sleep time and excessive daytime sleepiness (EDS) occur daily for years in IH, whereas they occur as relapsing/remitting episodes associated with cognitive and behavioural disturbances in KLS. Idiopathic hypersomnia is characterized by EDS, prolonged, unrefreshing sleep at night and during naps, and frequent morning sleep inertia, but rare sleep attacks, no cataplexy and sleep onset in REM periods as in narcolepsy. The diagnosis requires: (i) ruling out common causes of hypersomnolence, including mostly sleep apnea, insufficient sleep syndrome, psychiatric hypersomnia and narcolepsy; and (ii) obtaining objective EDS measures (mean latency at the multiple sleep latency test≤8min) or increased sleep time (sleep time>11h during a 18-24h bed rest). Treatment is similar to narcolepsy (except for preventive naps), including adapted work schedules, and off label use (after agreement from reference/competence centres) of modafinil, sodium oxybate, pitolisant, methylphenidate and solriamfetol. The diagnosis of KLS requires: (i) a reliable history of distinct episodes of one to several weeks; (ii) episodes contain severe hypersomnia (sleep>15h/d) associated with cognitive impairment (mental confusion and slowness, amnesia), derealisation, major apathy or disinhibited behaviour (hypersexuality, megaphagia, rudeness); and (iii) return to baseline sleep, cognition, behaviour and mood after episodes. EEG may contain slow rhythms during episodes, and rules out epilepsy. Functional brain imaging indicates hypoactivity of posterior associative cortex and hippocampus during symptomatic and asymptomatic periods. KLS attenuates with time when starting during teenage, including less frequent and less severe episodes. Adequate sleep habits, avoidance of alcohol and infections, as well as lithium and sometimes valproate (off label, after agreement from reference centres) help reducing the frequency and severity of episodes, and IV methylprednisolone helps reducing long (>30d) episode duration.
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Affiliation(s)
- I Arnulf
- Sorbonne Université, Paris, France; Centre de Référence des narcolepsies et hypersomnies rares, Service des pathologies du sommeil, Hôpital Pitié-Salpêtrière, AP-HP Sorbonne Université, Paris, France; Institut du Cerveau (ICM), Paris Brain Institute, Paris, France.
| | - P Dodet
- Centre de Référence des narcolepsies et hypersomnies rares, Service des pathologies du sommeil, Hôpital Pitié-Salpêtrière, AP-HP Sorbonne Université, Paris, France; Institut du Cerveau (ICM), Paris Brain Institute, Paris, France
| | - S Leu-Semenescu
- Centre de Référence des narcolepsies et hypersomnies rares, Service des pathologies du sommeil, Hôpital Pitié-Salpêtrière, AP-HP Sorbonne Université, Paris, France; Institut du Cerveau (ICM), Paris Brain Institute, Paris, France
| | - J B Maranci
- Sorbonne Université, Paris, France; Centre de Référence des narcolepsies et hypersomnies rares, Service des pathologies du sommeil, Hôpital Pitié-Salpêtrière, AP-HP Sorbonne Université, Paris, France; Institut du Cerveau (ICM), Paris Brain Institute, Paris, France
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12
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Morse AM, Dauvilliers Y, Arnulf I, Thorpy MJ, Foldvary-Schaefer N, Chandler P, Chen A, Hickey L, Black J, Bogan RK. Long-term efficacy and safety of low-sodium oxybate in an open-label extension period of a placebo-controlled, double-blind, randomized withdrawal study in adults with idiopathic hypersomnia. J Clin Sleep Med 2023; 19:1811-1822. [PMID: 37409509 PMCID: PMC10545992 DOI: 10.5664/jcsm.10698] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Revised: 06/23/2023] [Accepted: 06/23/2023] [Indexed: 07/07/2023]
Abstract
STUDY OBJECTIVES To evaluate 6-month efficacy and safety of low-sodium oxybate in people with idiopathic hypersomnia during an open-label extension period (OLE) of a phase 3 clinical trial. METHODS Efficacy measures included the Epworth Sleepiness Scale (ESS), Idiopathic Hypersomnia Severity Scale (IHSS), Patient Global Impression of Change (PGIc), Functional Outcomes of Sleep Questionnaire, short version (FOSQ-10), and Work Productivity and Activity Impairment Questionnaire: Specific Health Problem (WPAI:SHP). Treatment-emergent adverse events were collected throughout the OLE. RESULTS The OLE population included 106 participants. Most were female (71%) and White (83%), and the mean (SD) age was 41.0 (13.8) years. ESS scores decreased (improved) during the OLE (mean [SD], study baseline: 16.3 [2.8]; OLE week 2: 6.7 [4.7]; OLE end: 5.3 [3.7]), and IHSS total scores trended toward a decrease (study baseline: 32.6 [7.3]; OLE week 2: 16.2 [8.9]; OLE end: 14.8 [8.6]. Median (minimum, maximum) paired differences from OLE week 2 to OLE end were ESS, -1.0 (-20, 7; nominal P = .012); IHSS, -1.0 (-31, 19; nominal P = .086). The proportion of participants reporting PGIc ratings of "very much improved" increased from 36.7% at OLE week 2 to 53.8% at the OLE end. The FOSQ-10 and WPAI:SHP scores remained stable during OLE. The incidence of newly reported treatment-emergent adverse events decreased over the duration of the OLE. CONCLUSIONS Efficacy and safety of low-sodium oxybate were maintained or improved during the 6-month OLE, supporting long-term treatment with low-sodium oxybate in adults with idiopathic hypersomnia. CLINICAL TRIAL REGISTRATION Registry: ClinicalTrials.gov; Name: A Multicenter Study of the Efficacy and Safety of JZP-258 in the Treatment of Idiopathic Hypersomnia (IH) With an Open-label Safety Extension; URL: https://clinicaltrials.gov/study/NCT03533114; Identifier: NCT03533114 and Registry: EU Clinical Trials; Name: A Double-blind, Placebo-controlled, Randomized Withdrawal, Multicenter Study of the Efficacy and Safety of JZP-258 in the Treatment of Idiopathic Hypersomnia (IH) with an Open-label Safety Extension; URL: https://www.clinicaltrialsregister.eu/ctr-search/trial/2018-001311-79/results; Identifier: 2018-001311-79. CITATION Morse AM, Dauvilliers Y, Arnulf I, et al. Long-term efficacy and safety of low-sodium oxybate in an open-label extension period of a placebo-controlled, double-blind, randomized withdrawal study in adults with idiopathic hypersomnia. J Clin Sleep Med. 2023;19(10):1811-1822.
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Affiliation(s)
- Anne Marie Morse
- Janet Weis Children’s Hospital, Geisinger, Danville, Pennsylvania
| | - Yves Dauvilliers
- Sleep and Wake Disorders Centre, Department of Neurology, Gui de Chauliac Hospital, Montpellier, France
- University of Montpellier, INSERM Institute Neuroscience Montpellier (INM), Montpellier, France
| | - Isabelle Arnulf
- Sleep Disorder Unit, Pitié-Salpêtrière Hospital and Sorbonne University, Paris, France
| | | | | | | | - Abby Chen
- Jazz Pharmaceuticals, Palo Alto, California
| | - Luke Hickey
- Jazz Pharmaceuticals, Philadelphia, Pennsylvania
| | - Jed Black
- Jazz Pharmaceuticals, Palo Alto, California
- Stanford Center for Sleep Sciences and Medicine, Palo Alto, California
| | - Richard K. Bogan
- University of South Carolina School of Medicine, Columbia, South Carolina
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Abstract
Sleepiness is a frequent and underrecognized symptom in neurological disorders, that impacts functional outcomes and quality of life. Multiple and potentially additive factors might contribute to sleepiness in neurological disorders, including sleep quality alterations, circadian rhythm disorders, drugs, and sleep disorders including sleep apnea or central disorders of hypersomnolence. Physician awareness of the possible symptoms of hypersomnolence, and associated causes is of crucial importance to allow proper identification and treatment of underlying causes. This review first provides a brief overview on clinical aspects of excessive daytime sleepiness, and diagnosis tools, then examines its frequency and mechanisms in various neurological disorders, including neurodegenerative disorders, multiple sclerosis, autoimmune encephalitis, epilepsy, and stroke.
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Affiliation(s)
- A-L Dubessy
- Saint Antoine Hospital, Assistance publique des Hôpitaux de Paris (AP-HP), Paris, France.
| | - I Arnulf
- Sleep Disorder Unit, Pitié-Salpêtrière Hospital and Sorbonne University, Paris, France; National Reference Network for Orphan Diseases: Narcolepsy and Rare Hypersomnias, Paris, France
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14
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Arnulf I, Dauvilliers Y. Editorial. Rev Neurol (Paris) 2023; 179:641-642. [PMID: 37743083 DOI: 10.1016/j.neurol.2023.09.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/26/2023]
Affiliation(s)
- I Arnulf
- Service des pathologies du sommeil, hôpital Pitié-Salpêtrière, AP-HP-Sorbonne, institut du cerveau (ICM), Paris Brain Institute, Sorbonne université, Paris, France; Centre de référence des narcolepsies et hypersomnies rares, Montpellier, France.
| | - Y Dauvilliers
- Centre de référence des narcolepsies et hypersomnies rares, Montpellier, France; Département de neurologie, hôpital Gui de Chauliac, Inserm, institut de neuroscience de Montpellier, unité de veille-sommeil, université de Montpellier, Montpellier, France.
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15
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Arnulf I, Maranci JB. Stimulating hypocretin receptors improves sleepiness and vigilance in idiopathic hypersomnia: lessons from a proof of concept study. Sleep 2023; 46:zsad085. [PMID: 37200618 PMCID: PMC10485564 DOI: 10.1093/sleep/zsad085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Indexed: 05/20/2023] Open
Affiliation(s)
- Isabelle Arnulf
- National Reference Center for Narcolepsy and Rare Hypersomnias, Sleep Clinic, Pitie-Salpetriere Hospital, APHP-Sorbonne University, Paris, France
| | - Jean-Baptiste Maranci
- National Reference Center for Narcolepsy and Rare Hypersomnias, Sleep Clinic, Pitie-Salpetriere Hospital, APHP-Sorbonne University, Paris, France
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16
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Yu E, Krohn L, Ruskey JA, Asayesh F, Spiegelman D, Shah Z, Chia R, Arnulf I, Hu MTM, Montplaisir JY, Gagnon J, Desautels A, Dauvilliers Y, Gigli GL, Valente M, Janes F, Bernardini A, Högl B, Stefani A, Ibrahim A, Heidbreder A, Sonka K, Dusek P, Kemlink D, Oertel W, Janzen A, Plazzi G, Antelmi E, Figorilli M, Puligheddu M, Mollenhauer B, Trenkwalder C, Sixel‐Döring F, Cochen De Cock V, Ferini‐Strambi L, Dijkstra F, Viaene M, Abril B, Boeve BF, Rouleau GA, Postuma RB, Scholz SW, Gan‐Or Z. HLA in isolated REM sleep behavior disorder and Lewy body dementia. Ann Clin Transl Neurol 2023; 10:1682-1687. [PMID: 37401389 PMCID: PMC10502660 DOI: 10.1002/acn3.51841] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Accepted: 06/20/2023] [Indexed: 07/05/2023] Open
Abstract
Synucleinopathies-related disorders such as Lewy body dementia (LBD) and isolated/idiopathic REM sleep behavior disorder (iRBD) have been associated with neuroinflammation. In this study, we examined whether the human leukocyte antigen (HLA) locus plays a role in iRBD and LBD. In iRBD, HLA-DRB1*11:01 was the only allele passing FDR correction (OR = 1.57, 95% CI = 1.27-1.93, p = 2.70e-05). We also discovered associations between iRBD and HLA-DRB1 70D (OR = 1.26, 95%CI = 1.12-1.41, p = 8.76e-05), 70Q (OR = 0.81, 95%CI = 0.72-0.91, p = 3.65e-04) and 71R (OR = 1.21, 95%CI = 1.08-1.35, p = 1.35e-03). Position 71 (pomnibus = 0.00102) and 70 (pomnibus = 0.00125) were associated with iRBD. Our results suggest that the HLA locus may have different roles across synucleinopathies.
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Affiliation(s)
- Eric Yu
- Department of Human GeneticsMcGill UniversityMontréalQuébecCanada
- The Neuro (Montréal Neurological Institute‐Hospital)McGill UniversityMontréalQuébecCanada
| | - Lynne Krohn
- Department of Human GeneticsMcGill UniversityMontréalQuébecCanada
- The Neuro (Montréal Neurological Institute‐Hospital)McGill UniversityMontréalQuébecCanada
| | - Jennifer A. Ruskey
- The Neuro (Montréal Neurological Institute‐Hospital)McGill UniversityMontréalQuébecCanada
- Department of Neurology and NeurosurgeryMcGill UniversityMontréalQuébecCanada
| | - Farnaz Asayesh
- The Neuro (Montréal Neurological Institute‐Hospital)McGill UniversityMontréalQuébecCanada
- Department of Neurology and NeurosurgeryMcGill UniversityMontréalQuébecCanada
| | - Dan Spiegelman
- The Neuro (Montréal Neurological Institute‐Hospital)McGill UniversityMontréalQuébecCanada
- Department of Neurology and NeurosurgeryMcGill UniversityMontréalQuébecCanada
| | - Zalak Shah
- Neurodegenerative Diseases Research UnitNational Institute of Neurological Disorders and StrokeBethesdaMarylandUSA
| | - Ruth Chia
- Neuromuscular Diseases Research SectionNational Institute on AgingBethesdaMarylandUSA
| | - Isabelle Arnulf
- Sleep Disorders Unit, Pitié Salpêtrière HospitalParis Brain Institute and Sorbonne UniversityParisFrance
| | - Michele T. M. Hu
- Oxford Parkinson's Disease Centre (OPDC)University of OxfordOxfordUK
- Division of Neurology, Nuffield Department of Clinical NeurosciencesUniversity of OxfordOxfordUK
| | - Jacques Y. Montplaisir
- Center for Advanced Research in Sleep MedicineCentre Intégré Universitaire de Santé et de Services Sociaux du Nord‐de‐l'Île‐de‐Montréal – Hôpital du Sacré‐Coeur de MontréalMontréalQuébecCanada
- Department of PsychiatryUniversité de MontréalMontréalQuébecCanada
| | - Jean‐François Gagnon
- Center for Advanced Research in Sleep MedicineCentre Intégré Universitaire de Santé et de Services Sociaux du Nord‐de‐l'Île‐de‐Montréal – Hôpital du Sacré‐Coeur de MontréalMontréalQuébecCanada
- Department of PsychologyUniversité du Québec à MontréalMontréalQuébecCanada
| | - Alex Desautels
- Center for Advanced Research in Sleep MedicineCentre Intégré Universitaire de Santé et de Services Sociaux du Nord‐de‐l'Île‐de‐Montréal – Hôpital du Sacré‐Coeur de MontréalMontréalQuébecCanada
- Department of NeurosciencesUniversité de MontréalMontréalQuébecCanada
| | - Yves Dauvilliers
- National Reference Center for Narcolepsy, Sleep Unit, Department of Neurology, Gui‐de‐Chauliac Hospital, CHU MontpellierUniversity of Montpellier, Inserm U1061MontpellierFrance
| | - Gian Luigi Gigli
- Clinical Neurology Unit, Department of NeurosciencesUniversity Hospital of UdineUdineItaly
- Department of Medicine (DAME)University of UdineUdineItaly
| | - Mariarosaria Valente
- Clinical Neurology Unit, Department of NeurosciencesUniversity Hospital of UdineUdineItaly
- Department of Medicine (DAME)University of UdineUdineItaly
| | - Francesco Janes
- Clinical Neurology Unit, Department of NeurosciencesUniversity Hospital of UdineUdineItaly
| | - Andrea Bernardini
- Clinical Neurology Unit, Department of NeurosciencesUniversity Hospital of UdineUdineItaly
| | - Birgit Högl
- Sleep Disorders Clinic, Department of NeurologyMedical University of InnsbruckInnsbruckAustria
| | - Ambra Stefani
- Sleep Disorders Clinic, Department of NeurologyMedical University of InnsbruckInnsbruckAustria
| | - Abubaker Ibrahim
- Sleep Disorders Clinic, Department of NeurologyMedical University of InnsbruckInnsbruckAustria
| | - Anna Heidbreder
- Department for Sleep Medicine and Neuromuscular diseaseUniversity Hospital MuensterMuensterGermany
| | - Karel Sonka
- Department of Neurology and Centre of Clinical NeuroscienceCharles University, First Faculty of Medicine and General University HospitalPragueCzech Republic
| | - Petr Dusek
- Department of Neurology and Centre of Clinical NeuroscienceCharles University, First Faculty of Medicine and General University HospitalPragueCzech Republic
| | - David Kemlink
- Department of Neurology and Centre of Clinical NeuroscienceCharles University, First Faculty of Medicine and General University HospitalPragueCzech Republic
| | | | - Annette Janzen
- Department of NeurologyPhilipps UniversityMarburgGermany
| | - Giuseppe Plazzi
- Department of Biomedical, Metabolic and Neural SciencesUniversity of Modena and Reggio‐EmiliaModenaItaly
- IRCCS, Institute of Neurological Sciences of BolognaBolognaItaly
| | - Elena Antelmi
- Neurology Unit, Movement Disorders Division, Department of Neurosciences, Biomedicine and Movement SciencesUniversity of VeronaVeronaItaly
| | - Michela Figorilli
- Department of Medical Sciences and Public Health, Sleep Disorder Research CenterUniversity of CagliariCagliariItaly
| | - Monica Puligheddu
- Department of Medical Sciences and Public Health, Sleep Disorder Research CenterUniversity of CagliariCagliariItaly
| | - Brit Mollenhauer
- Paracelsus‐Elena‐KlinikKasselGermany
- Department of NeurosurgeryUniversity Medical Centre GöttingenGöttingenGermany
| | - Claudia Trenkwalder
- Paracelsus‐Elena‐KlinikKasselGermany
- Department of NeurosurgeryUniversity Medical Centre GöttingenGöttingenGermany
| | - Friederike Sixel‐Döring
- Department of NeurologyPhilipps UniversityMarburgGermany
- Paracelsus‐Elena‐KlinikKasselGermany
| | - Valérie Cochen De Cock
- Sleep and Neurology UnitBeau Soleil ClinicMontpellierFrance
- EuroMov Digital Health in MotionUniversity of Montpellier IMT Mines AlesMontpellierFrance
| | - Luigi Ferini‐Strambi
- Department of Neurological SciencesUniversità Vita‐Salute San RaffaeleMilanItaly
| | - Femke Dijkstra
- Laboratory for Sleep DisordersSt. Dimpna Regional HospitalGeelBelgium
- Department of NeurologySt. Dimpna Regional HospitalGeelBelgium
- Department of NeurologyUniversity Hospital AntwerpEdegemAntwerpBelgium
| | - Mineke Viaene
- Laboratory for Sleep DisordersSt. Dimpna Regional HospitalGeelBelgium
- Department of NeurologySt. Dimpna Regional HospitalGeelBelgium
| | - Beatriz Abril
- Sleep disorder UnitCarémeau Hospital, University Hospital of NîmesNîmesFrance
| | | | - Guy A. Rouleau
- Department of Human GeneticsMcGill UniversityMontréalQuébecCanada
- The Neuro (Montréal Neurological Institute‐Hospital)McGill UniversityMontréalQuébecCanada
- Department of Neurology and NeurosurgeryMcGill UniversityMontréalQuébecCanada
| | - Ronald B. Postuma
- The Neuro (Montréal Neurological Institute‐Hospital)McGill UniversityMontréalQuébecCanada
- Department of Neurology and NeurosurgeryMcGill UniversityMontréalQuébecCanada
- Center for Advanced Research in Sleep MedicineCentre Intégré Universitaire de Santé et de Services Sociaux du Nord‐de‐l'Île‐de‐Montréal – Hôpital du Sacré‐Coeur de MontréalMontréalQuébecCanada
| | | | - Sonja W. Scholz
- Neurodegenerative Diseases Research UnitNational Institute of Neurological Disorders and StrokeBethesdaMarylandUSA
- Department of NeurologyJohns Hopkins University Medical CenterBaltimoreMarylandUSA
| | - Ziv Gan‐Or
- Department of Human GeneticsMcGill UniversityMontréalQuébecCanada
- The Neuro (Montréal Neurological Institute‐Hospital)McGill UniversityMontréalQuébecCanada
- Department of Neurology and NeurosurgeryMcGill UniversityMontréalQuébecCanada
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17
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Rahayel S, Tremblay C, Vo A, Misic B, Lehéricy S, Arnulf I, Vidailhet M, Corvol JC, Gagnon JF, Postuma RB, Montplaisir J, Lewis S, Matar E, Ehgoetz Martens K, Borghammer P, Knudsen K, Hansen AK, Monchi O, Gan-Or Z, Dagher A. Mitochondrial function-associated genes underlie cortical atrophy in prodromal synucleinopathies. Brain 2023; 146:3301-3318. [PMID: 36826230 PMCID: PMC10393413 DOI: 10.1093/brain/awad044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Revised: 01/12/2023] [Accepted: 02/03/2023] [Indexed: 02/25/2023] Open
Abstract
Isolated rapid eye movement sleep behaviour disorder (iRBD) is a sleep disorder characterized by the loss of rapid eye movement sleep muscle atonia and the appearance of abnormal movements and vocalizations during rapid eye movement sleep. It is a strong marker of incipient synucleinopathy such as dementia with Lewy bodies and Parkinson's disease. Patients with iRBD already show brain changes that are reminiscent of manifest synucleinopathies including brain atrophy. However, the mechanisms underlying the development of this atrophy remain poorly understood. In this study, we performed cutting-edge imaging transcriptomics and comprehensive spatial mapping analyses in a multicentric cohort of 171 polysomnography-confirmed iRBD patients [67.7 ± 6.6 (49-87) years; 83% men] and 238 healthy controls [66.6 ± 7.9 (41-88) years; 77% men] with T1-weighted MRI to investigate the gene expression and connectivity patterns associated with changes in cortical thickness and surface area in iRBD. Partial least squares regression was performed to identify the gene expression patterns underlying cortical changes in iRBD. Gene set enrichment analysis and virtual histology were then done to assess the biological processes, cellular components, human disease gene terms, and cell types enriched in these gene expression patterns. We then used structural and functional neighbourhood analyses to assess whether the atrophy patterns in iRBD were constrained by the brain's structural and functional connectome. Moreover, we used comprehensive spatial mapping analyses to assess the specific neurotransmitter systems, functional networks, cytoarchitectonic classes, and cognitive brain systems associated with cortical changes in iRBD. All comparisons were tested against null models that preserved spatial autocorrelation between brain regions and compared to Alzheimer's disease to assess the specificity of findings to synucleinopathies. We found that genes involved in mitochondrial function and macroautophagy were the strongest contributors to the cortical thinning occurring in iRBD. Moreover, we demonstrated that cortical thinning was constrained by the brain's structural and functional connectome and that it mapped onto specific networks involved in motor and planning functions. In contrast with cortical thickness, changes in cortical surface area were related to distinct genes, namely genes involved in the inflammatory response, and to different spatial mapping patterns. The gene expression and connectivity patterns associated with iRBD were all distinct from those observed in Alzheimer's disease. In summary, this study demonstrates that the development of brain atrophy in synucleinopathies is constrained by specific genes and networks.
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Affiliation(s)
- Shady Rahayel
- The Neuro (Montreal Neurological Institute-Hospital), McGill University, Montreal H3A 2B4, Canada
- Centre for Advanced Research in Sleep Medicine, Hôpital du Sacré-Cœur de Montréal, Montreal H4J 1C5, Canada
| | - Christina Tremblay
- The Neuro (Montreal Neurological Institute-Hospital), McGill University, Montreal H3A 2B4, Canada
| | - Andrew Vo
- The Neuro (Montreal Neurological Institute-Hospital), McGill University, Montreal H3A 2B4, Canada
| | - Bratislav Misic
- The Neuro (Montreal Neurological Institute-Hospital), McGill University, Montreal H3A 2B4, Canada
| | - Stéphane Lehéricy
- Institut du Cerveau–Paris Brain Institute–ICM, INSERM, CNRS, Sorbonne Université, Paris 75013, France
| | - Isabelle Arnulf
- Institut du Cerveau–Paris Brain Institute–ICM, INSERM, CNRS, Sorbonne Université, Paris 75013, France
| | - Marie Vidailhet
- Institut du Cerveau–Paris Brain Institute–ICM, INSERM, CNRS, Sorbonne Université, Paris 75013, France
| | - Jean-Christophe Corvol
- Institut du Cerveau–Paris Brain Institute–ICM, INSERM, CNRS, Sorbonne Université, Paris 75013, France
| | - Jean-François Gagnon
- Centre for Advanced Research in Sleep Medicine, Hôpital du Sacré-Cœur de Montréal, Montreal H4J 1C5, Canada
- Department of Psychology, University of Quebec in Montreal, Montreal H2X 3P2, Canada
- Research Centre, Institut universitaire de gériatrie de Montréal, Montreal H3W 1W5, Canada
| | - Ronald B Postuma
- Centre for Advanced Research in Sleep Medicine, Hôpital du Sacré-Cœur de Montréal, Montreal H4J 1C5, Canada
- Department of Neurology, Montreal General Hospital, Montreal H3G 1A4, Canada
| | - Jacques Montplaisir
- Centre for Advanced Research in Sleep Medicine, Hôpital du Sacré-Cœur de Montréal, Montreal H4J 1C5, Canada
- Department of Psychiatry, University of Montreal, Montreal H3T 1J4, Canada
| | - Simon Lewis
- ForeFront Parkinson’s Disease Research Clinic, Brain and Mind Centre, University of Sydney, Camperdown NSW 2050, Australia
| | - Elie Matar
- ForeFront Parkinson’s Disease Research Clinic, Brain and Mind Centre, University of Sydney, Camperdown NSW 2050, Australia
| | - Kaylena Ehgoetz Martens
- ForeFront Parkinson’s Disease Research Clinic, Brain and Mind Centre, University of Sydney, Camperdown NSW 2050, Australia
- Department of Kinesiology, University of Waterloo, Waterloo N2L 3G1, Canada
| | - Per Borghammer
- Department of Nuclear Medicine and PET, Aarhus University Hospital, Aarhus DK-8200, Denmark
| | - Karoline Knudsen
- Department of Nuclear Medicine and PET, Aarhus University Hospital, Aarhus DK-8200, Denmark
| | - Allan K Hansen
- Department of Nuclear Medicine and PET, Aarhus University Hospital, Aarhus DK-8200, Denmark
| | - Oury Monchi
- Research Centre, Institut universitaire de gériatrie de Montréal, Montreal H3W 1W5, Canada
- Department of Radiology, Radio-Oncology, and Nuclear Medicine, University of Montreal, Montreal H3T 1A4, Canada
- Department of Neurology and Neurosurgery, McGill University, Montreal H3A 1A1, Canada
| | - Ziv Gan-Or
- The Neuro (Montreal Neurological Institute-Hospital), McGill University, Montreal H3A 2B4, Canada
- Department of Neurology and Neurosurgery, McGill University, Montreal H3A 1A1, Canada
- Department of Human Genetics, McGill University, Montreal H3A 0C7, Canada
| | - Alain Dagher
- The Neuro (Montreal Neurological Institute-Hospital), McGill University, Montreal H3A 2B4, Canada
- Department of Neurology and Neurosurgery, McGill University, Montreal H3A 1A1, Canada
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18
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Cochen De Cock V, Dodet P, Leu‐Semenescu S, Aerts C, Abril B, Castelnovo G, Landragin N, Drapier S, Olivet H, Corbillé A, Leclair‐Visonneau L, Anheim M, Vidailhet M, Arnulf I, Doulazmi M, Roze E. Night-Time Apomorphine Infusion: Who Are the Best Candidates? Mov Disord Clin Pract 2023; 10:1192-1197. [PMID: 37635769 PMCID: PMC10450238 DOI: 10.1002/mdc3.13799] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Revised: 04/28/2023] [Accepted: 05/08/2023] [Indexed: 08/29/2023] Open
Abstract
Background We recently demonstrated in a randomized controlled trial (APOMORPHEE, NCT02940912) that night-time only subcutaneous apomorphine infusion improves sleep disturbances and insomnia in patients with advanced Parkinson's disease and moderate to severe insomnia. Objectives To identify the best candidates for receiving night-time only subcutaneous apomorphine infusion in routine care. Methods In this post-hoc analysis of APOMORPHEE, we compared the characteristics of patients according to whether they chose to continue night-time only subcutaneous apomorphine infusion at the end of the study period or not. Results Half of the patients (22/42) chose to continue the treatment. Off duration (day or night), painful Off dystonia, and insomnia severity at baseline were associated with night-time only apomorphine continuation. Multivariate analysis retained only Off duration as an independent predictor of continuation. Conclusions The best candidates for night-time only apomorphine are patients with severe and prolonged Off periods (day or night) and severe insomnia.
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Affiliation(s)
- Valérie Cochen De Cock
- Sleep and Neurology DepartmentBeau Soleil ClinicMontpellierFrance
- EuroMov Digital Health in MotionUniv Montpellier, IMT Mines AlèsMontpellierFrance
| | - Pauline Dodet
- Sleep Disorders UnitPitié‐Salpêtrière University HospitalParisFrance
| | | | - Cécile Aerts
- Sleep and Neurology DepartmentBeau Soleil ClinicMontpellierFrance
- EuroMov Digital Health in MotionUniv Montpellier, IMT Mines AlèsMontpellierFrance
| | - Beatriz Abril
- Sleep DepartmentUniversity Hospital of NîmesNîmesFrance
| | | | | | - Sophie Drapier
- Department of NeurologyPontchaillou INSERM CIC1414RennesFrance
| | - Hélène Olivet
- Sleep DepartmentPolyclinique Rennes Saint‐LaurentRennesFrance
| | | | - Laurène Leclair‐Visonneau
- Clinical Neurophysiology DepartmentUniversity Hospital of Nantes, INSERM U1235, Nantes UniversityNantesFrance
| | - Mathieu Anheim
- Department of NeurologyUniversity Hospital of StrasbourgStrasbourgFrance
- Genetic Institute and Molecular and Cellular Biology (IGBMC), INSERM‐U964/CNRS‐UMR7104/ Strasbourg UniversityIllkirchFrance
| | - Marie Vidailhet
- AP‐HP, Salpetriere Hospital, DMU Neuroscience 6ParisFrance
- Sorbonne University, Paris Brain Institute, Inserm, CNRSParisFrance
| | - Isabelle Arnulf
- Sleep Disorders UnitPitié‐Salpêtrière University HospitalParisFrance
- Sorbonne University, Paris Brain Institute, Inserm, CNRSParisFrance
| | - Mohamed Doulazmi
- Adaptation Biologique et Vieillissement (UMR8256), Institut de Biologie Paris Seine, Sorbonne University, CNRSParisFrance
| | - Emmanuel Roze
- AP‐HP, Salpetriere Hospital, DMU Neuroscience 6ParisFrance
- Sorbonne University, Paris Brain Institute, Inserm, CNRSParisFrance
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19
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Ollila HM, Sharon E, Lin L, Sinnott-Armstrong N, Ambati A, Yogeshwar SM, Hillary RP, Jolanki O, Faraco J, Einen M, Luo G, Zhang J, Han F, Yan H, Dong XS, Li J, Zhang J, Hong SC, Kim TW, Dauvilliers Y, Barateau L, Lammers GJ, Fronczek R, Mayer G, Santamaria J, Arnulf I, Knudsen-Heier S, Bredahl MKL, Thorsby PM, Plazzi G, Pizza F, Moresco M, Crowe C, Van den Eeden SK, Lecendreux M, Bourgin P, Kanbayashi T, Martínez-Orozco FJ, Peraita-Adrados R, Benetó A, Montplaisir J, Desautels A, Huang YS, Jennum P, Nevsimalova S, Kemlink D, Iranzo A, Overeem S, Wierzbicka A, Geisler P, Sonka K, Honda M, Högl B, Stefani A, Coelho FM, Mantovani V, Feketeova E, Wadelius M, Eriksson N, Smedje H, Hallberg P, Hesla PE, Rye D, Pelin Z, Ferini-Strambi L, Bassetti CL, Mathis J, Khatami R, Aran A, Nampoothiri S, Olsson T, Kockum I, Partinen M, Perola M, Kornum BR, Rueger S, Winkelmann J, Miyagawa T, Toyoda H, Khor SS, Shimada M, Tokunaga K, Rivas M, Pritchard JK, Risch N, Kutalik Z, O'Hara R, Hallmayer J, Ye CJ, Mignot EJ. Narcolepsy risk loci outline role of T cell autoimmunity and infectious triggers in narcolepsy. Nat Commun 2023; 14:2709. [PMID: 37188663 DOI: 10.1038/s41467-023-36120-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Accepted: 01/17/2023] [Indexed: 05/17/2023] Open
Abstract
Narcolepsy type 1 (NT1) is caused by a loss of hypocretin/orexin transmission. Risk factors include pandemic 2009 H1N1 influenza A infection and immunization with Pandemrix®. Here, we dissect disease mechanisms and interactions with environmental triggers in a multi-ethnic sample of 6,073 cases and 84,856 controls. We fine-mapped GWAS signals within HLA (DQ0602, DQB1*03:01 and DPB1*04:02) and discovered seven novel associations (CD207, NAB1, IKZF4-ERBB3, CTSC, DENND1B, SIRPG, PRF1). Significant signals at TRA and DQB1*06:02 loci were found in 245 vaccination-related cases, who also shared polygenic risk. T cell receptor associations in NT1 modulated TRAJ*24, TRAJ*28 and TRBV*4-2 chain-usage. Partitioned heritability and immune cell enrichment analyses found genetic signals to be driven by dendritic and helper T cells. Lastly comorbidity analysis using data from FinnGen, suggests shared effects between NT1 and other autoimmune diseases. NT1 genetic variants shape autoimmunity and response to environmental triggers, including influenza A infection and immunization with Pandemrix®.
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Affiliation(s)
- Hanna M Ollila
- Stanford University, Center for Sleep Sciences and Medicine, Department of Psychiatry and Behavioral Sciences, Palo Alto, CA, 94304, USA
- Institute for Molecular Medicine Finland, HiLIFE, University of Helsinki, Helsinki, Finland
- Anesthesia, Critical Care, and Pain Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
- Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, USA
| | - Eilon Sharon
- Department of Genetics, Stanford University, Stanford, CA, 94305, USA
- Department of Biology, Stanford University, Stanford, CA, 94305, USA
| | - Ling Lin
- Stanford University, Center for Sleep Sciences and Medicine, Department of Psychiatry and Behavioral Sciences, Palo Alto, CA, 94304, USA
| | - Nasa Sinnott-Armstrong
- Department of Genetics, Stanford University, Stanford, CA, 94305, USA
- Department of Biology, Stanford University, Stanford, CA, 94305, USA
| | - Aditya Ambati
- Stanford University, Center for Sleep Sciences and Medicine, Department of Psychiatry and Behavioral Sciences, Palo Alto, CA, 94304, USA
| | - Selina M Yogeshwar
- Stanford University, Center for Sleep Sciences and Medicine, Department of Psychiatry and Behavioral Sciences, Palo Alto, CA, 94304, USA
- Department of Neurology, Charité-Universitätsmedizin, 10117, Berlin, Germany
- Charité-Universitätsmedizin Berlin, Einstein Center for Neurosciences Berlin, 10117, Berlin, Germany
| | - Ryan P Hillary
- Stanford University, Center for Sleep Sciences and Medicine, Department of Psychiatry and Behavioral Sciences, Palo Alto, CA, 94304, USA
| | - Otto Jolanki
- Department of Genetics, Stanford University, Stanford, CA, 94305, USA
| | - Juliette Faraco
- Stanford University, Center for Sleep Sciences and Medicine, Department of Psychiatry and Behavioral Sciences, Palo Alto, CA, 94304, USA
| | - Mali Einen
- Stanford University, Center for Sleep Sciences and Medicine, Department of Psychiatry and Behavioral Sciences, Palo Alto, CA, 94304, USA
| | - Guo Luo
- Stanford University, Center for Sleep Sciences and Medicine, Department of Psychiatry and Behavioral Sciences, Palo Alto, CA, 94304, USA
| | - Jing Zhang
- Stanford University, Center for Sleep Sciences and Medicine, Department of Psychiatry and Behavioral Sciences, Palo Alto, CA, 94304, USA
| | - Fang Han
- Division of Sleep Medicine, The Peking University People's Hospital, Beijing, China
| | - Han Yan
- Division of Sleep Medicine, The Peking University People's Hospital, Beijing, China
| | - Xiao Song Dong
- Division of Sleep Medicine, The Peking University People's Hospital, Beijing, China
| | - Jing Li
- Division of Sleep Medicine, The Peking University People's Hospital, Beijing, China
| | - Jun Zhang
- Department of Neurology, The Peking University People's Hospital, Beijing, China
| | - Seung-Chul Hong
- Department of Psychiatry, St. Vincent's Hospital, The Catholic University of Korea, Suwon, Korea
| | - Tae Won Kim
- Department of Psychiatry, St. Vincent's Hospital, The Catholic University of Korea, Suwon, Korea
| | - Yves Dauvilliers
- Sleep-Wake Disorders Center, National Reference Network for Narcolepsy, Department of Neurology, Gui-de-Chauliac Hospital, CHU Montpellier; Institute for Neurosciences of Montpellier (INM), INSERM, Université Montpellier 1, Montpellier, France
| | - Lucie Barateau
- Sleep-Wake Disorders Center, National Reference Network for Narcolepsy, Department of Neurology, Gui-de-Chauliac Hospital, CHU Montpellier; Institute for Neurosciences of Montpellier (INM), INSERM, Université Montpellier 1, Montpellier, France
| | - Gert Jan Lammers
- Department of Neurology, Leiden University Medical Center, Leiden, The Netherlands
- Stichting Epilepsie Instellingen Nederland (SEIN), Sleep-Wake Centre, Heemstede, The Netherlands
| | - Rolf Fronczek
- Department of Neurology, Leiden University Medical Center, Leiden, The Netherlands
- Stichting Epilepsie Instellingen Nederland (SEIN), Sleep-Wake Centre, Heemstede, The Netherlands
| | - Geert Mayer
- Hephata Klinik, Schimmelpfengstr. 6, 34613, Schwalmstadt, Germany
- Philipps Universität Marburg, Baldinger Str., 35043, Marburg, Germany
| | - Joan Santamaria
- Neurology Service, Institut de Neurociències Hospital Clínic, University of Barcelona, Barcelona, Spain
| | - Isabelle Arnulf
- Sleep Disorder Unit, Pitié-Salpêtrière Hospital, Assistance Publique-Hopitaux de Paris, 75013, Paris, France
| | - Stine Knudsen-Heier
- Norwegian Centre of Expertise for Neurodevelopment Disorders and Hypersomnias (NevSom), Department of Rare Disorders, Oslo University Hospital and University of Oslo, Oslo, Norway
| | - May Kristin Lyamouri Bredahl
- Norwegian Centre of Expertise for Neurodevelopment Disorders and Hypersomnias (NevSom), Department of Rare Disorders, Oslo University Hospital and University of Oslo, Oslo, Norway
- Hormone Laboratory, Department of Medical Biochemistry, Oslo University Hospital, Oslo, Norway
| | - Per Medbøe Thorsby
- Hormone Laboratory, Department of Medical Biochemistry, Oslo University Hospital, Oslo, Norway
| | - Giuseppe Plazzi
- Department of Biomedical and Neuromotor Sciences (DIBINEM), University of Bologna, Via Ugo Foscolo 7, 40123, Bologna, Italy
- IRCCS Institute of Neurological Sciences, Bologna, Italy
| | - Fabio Pizza
- Department of Biomedical and Neuromotor Sciences (DIBINEM), University of Bologna, Via Ugo Foscolo 7, 40123, Bologna, Italy
- IRCCS Institute of Neurological Sciences, Bologna, Italy
| | - Monica Moresco
- Department of Biomedical and Neuromotor Sciences (DIBINEM), University of Bologna, Via Ugo Foscolo 7, 40123, Bologna, Italy
- IRCCS Institute of Neurological Sciences, Bologna, Italy
| | | | | | - Michel Lecendreux
- Pediatric Sleep Center and National Reference Center for Narcolepsy and Idiopathic Hypersomnia Hospital Robert Debre, Paris, France
| | - Patrice Bourgin
- Department of Sleep Medicine, Strasbourg University Hospital, Strasbourg University, Strasbourg, France
| | - Takashi Kanbayashi
- Department of Neuropsychiatry, Akita University Graduate School of Medicine, Akita, Japan
- International Institute for Integrative Sleep Medicine (WPI-IIIS), University of Tsukuba, Tsukuba, Japan
| | - Francisco J Martínez-Orozco
- Sleep Unit. Clinical Neurophysiology Service. San Carlos University Hospital. University Complutense of Madrid, Madrid, Spain
| | - Rosa Peraita-Adrados
- Sleep and Epilepsy Unit, Clinical Neurophysiology Service, Gregorio Marañón University General Hospital and Research Institute, University Complutense of Madrid (UCM), Madrid, Spain
| | | | - Jacques Montplaisir
- Center for Advanced Research in Sleep Medicine, Hôpital du Sacré-Coeur and Department of Neurosciences, University of Montréal, Montréal, QC, Canada
| | - Alex Desautels
- Center for Advanced Research in Sleep Medicine, Hôpital du Sacré-Coeur and Department of Neurosciences, University of Montréal, Montréal, QC, Canada
| | - Yu-Shu Huang
- Department of Child Psychiatry and Sleep Center, Chang Gung Memorial Hospital and University, Taoyuan, Taiwan
| | - Poul Jennum
- Danish Center for Sleep Medicine, Department of Clinical Neurophysiology, University of Copenhagen, Glostrup Hospital, Glostrup, Denmark
| | - Sona Nevsimalova
- Department of Neurology and Centre of Clinical Neurosciences, First Faculty of Medicine, Charles University and General University Hosptal, Prague, Czech Republic
| | - David Kemlink
- Department of Neurology and Centre of Clinical Neurosciences, First Faculty of Medicine, Charles University and General University Hosptal, Prague, Czech Republic
| | - Alex Iranzo
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
- Department of Neurology, Barcelona, Spain
- Multidisciplinary Sleep Disorders Unit, Barcelona, Spain
| | - Sebastiaan Overeem
- Sleep Medicine Center Kempenhaeghe, P.O. Box 61, 5590 AB, Heeze, The Netherlands
- Eindhoven University of Technology, Eindhoven, The Netherlands
| | - Aleksandra Wierzbicka
- Department of Clinical Neurophysiology, Institute of Psychiatry and Neurology, Warsaw, Poland
| | - Peter Geisler
- Department of Psychiatry and Psychotherapy, University of Regensburg, Regensburg, Germany
| | - Karel Sonka
- Department of Neurology and Centre of Clinical Neurosciences, First Faculty of Medicine, Charles University and General University Hosptal, Prague, Czech Republic
| | - Makoto Honda
- Department of Psychiatry and Behavioral Sciences, Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan
- Seiwa Hospital, Neuropsychiatric Research Institute, Tokyo, Japan
| | - Birgit Högl
- Department of Neurology, Medical University Innsbruck (MUI), Innsbruck, Austria
| | - Ambra Stefani
- Department of Neurology, Medical University Innsbruck (MUI), Innsbruck, Austria
| | | | - Vilma Mantovani
- Center for Applied Biomedical Research (CRBA), St. Orsola-Malpighi University Hospital, Bologna, Italy
| | - Eva Feketeova
- Neurology Department, Medical Faculty of P. J. Safarik University, University Hospital of L. Pasteur Kosice, Kosice, Slovak Republic
| | - Mia Wadelius
- Department of Medical Sciences and Science for Life Laboratory, Uppsala University, Uppsala, Sweden
| | - Niclas Eriksson
- Department of Medical Sciences and Science for Life Laboratory, Uppsala University, Uppsala, Sweden
- Uppsala Clinical Research Center, Uppsala, Sweden
| | - Hans Smedje
- Division of Child and Adolescent Psychiatry, Karolinska Institutet, Stockholm, Sweden
| | - Pär Hallberg
- Department of Medical Sciences and Science for Life Laboratory, Uppsala University, Uppsala, Sweden
| | | | - David Rye
- Department of Neurology, Emory University School of Medicine, Atlanta, GA, USA
| | - Zerrin Pelin
- Faculty of Health Sciences, Hasan Kalyoncu University, Gaziantep, Turkey
| | - Luigi Ferini-Strambi
- Sleep Disorders Center, Division of Neuroscience, Ospedale San Raffaele, Università Vita-Salute, Milan, Italy
| | - Claudio L Bassetti
- Neurology Department, EOC, Ospedale Regionale di Lugano, Lugano, Ticino, Switzerland
- Department of Neurology, Inselspital, Bern University Hospital, and University of Bern, Bern, Switzerland
| | - Johannes Mathis
- Department of Neurology, Inselspital, Bern University Hospital, and University of Bern, Bern, Switzerland
| | - Ramin Khatami
- Department of Neurology, Inselspital, Bern University Hospital, and University of Bern, Bern, Switzerland
- Center for Sleep Medicine and Sleep Research, Clinic Barmelweid AG, Barmelweid, Switzerland
| | - Adi Aran
- Shaare Zedek Medical Center, Jerusalem, Israel
| | - Sheela Nampoothiri
- Department of Pediatric Genetics, Amrita Institute of Medical Sciences & Research Centre, Kerala, India
| | - Tomas Olsson
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Ingrid Kockum
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Markku Partinen
- Helsinki Sleep Clinic, Vitalmed Research Centre, Helsinki, Finland
- Department of Clinical Neurosciences, University of Helsinki, Helsinki, Finland
| | - Markus Perola
- University of Helsinki, Institute for Molecular Medicine, Finland (FIMM) and Diabetes and Obesity Research Program. University of Tartu, Estonian Genome Center, Tartu, Estonia
| | - Birgitte R Kornum
- Department of Neuroscience, University of Copenhagen, Copenhagen, Denmark
| | - Sina Rueger
- Swiss Institute of Bioinformatics, Lausanne, Switzerland
| | - Juliane Winkelmann
- Institute of Neurogenomics, Helmholtz Zentrum München, German Research Centre for Environmental Health, Neuherberg, Germany
- Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
- Neurologische Klinik und Poliklinik, Klinikum rechts der Isar der Technischen Universität München, Munich, Germany
| | - Taku Miyagawa
- Department of Psychiatry and Behavioral Sciences, Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan
- Department of Human Genetics, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Hiromi Toyoda
- Department of Psychiatry and Behavioral Sciences, Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan
| | - Seik-Soon Khor
- Department of Human Genetics, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Mihoko Shimada
- Department of Human Genetics, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Katsushi Tokunaga
- Department of Human Genetics, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Manuel Rivas
- Department of Biomedical Data Science-Administration, Stanford University, Palo Alto, CA, USA
| | | | - Neil Risch
- Dept. Epidemiology and Biostatistics, UCSF, 513 Parnassus Avenue, San Francisco, CA, 94117, USA
| | - Zoltan Kutalik
- Swiss Institute of Bioinformatics, Lausanne, Switzerland
- University Center for Primary Care and Public Health, University of Lausanne, Lausanne, Switzerland, Lausanne, 1010, Switzerland
| | - Ruth O'Hara
- Department of Psychiatry and Behavioral Sciences, Stanford University, Palo Alto, CA, USA
- Mental Illness Research Education Clinical Centers (MIRECC), VA Palo Alto, Palo Alto, CA, USA
| | - Joachim Hallmayer
- Department of Psychiatry and Behavioral Sciences, Stanford University, Palo Alto, CA, USA
- Mental Illness Research Education Clinical Centers (MIRECC), VA Palo Alto, Palo Alto, CA, USA
| | - Chun Jimmie Ye
- Department of Epidemiology & Biostatistics, Institute for Human Genetics, University of California San Francisco, San Francisco, CA, USA
| | - Emmanuel J Mignot
- Stanford University, Center for Sleep Sciences and Medicine, Department of Psychiatry and Behavioral Sciences, Palo Alto, CA, 94304, USA.
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20
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Yu E, Krohn L, Ruskey JA, Asayesh F, Spiegelman D, Shah Z, Chia R, Arnulf I, Hu MT, Montplaisir JY, Gagnon JF, Desautels A, Dauvilliers Y, Gigli GL, Valente M, Janes F, Bernardini A, Högl B, Stefani A, Ibrahim A, Heidbreder A, Sonka K, Dusek P, Kemlink D, Oertel W, Janzen A, Plazzi G, Antelmi E, Figorilli M, Puligheddu M, Mollenhauer B, Trenkwalder C, Sixel-Döring F, De Cock VC, Ferini-Strambi L, Dijkstra F, Viaene M, Abril B, Boeve BF, Rouleau GA, Postuma RB, Scholz SW, Gan-Or Z. HLA in isolated REM sleep behavior disorder and Lewy body dementia. medRxiv 2023:2023.01.31.23284682. [PMID: 36778313 PMCID: PMC9915822 DOI: 10.1101/2023.01.31.23284682] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Background and Objectives Isolated/idiopathic REM sleep behavior disorder (iRBD) and Lewy body dementia (LBD) are synucleinopathies that have partial genetic overlap with Parkinson's disease (PD). Previous studies have shown that neuroinflammation plays a substantial role in these disorders. In PD, specific residues of the human leukocyte antigen ( HLA ) were suggested to be associated with a protective effect. This study examined whether the HLA locus plays a similar role in iRBD, LBD and PD. Methods We performed HLA imputation on iRBD genotyping data (1,072 patients and 9,505 controls) and LBD whole-genome sequencing (2,604 patients and 4,032 controls) using the multi-ethnic HLA reference panel v2 from the Michigan Imputation Server. Using logistic regression, we tested the association of HLA alleles, amino acids and haplotypes with disease susceptibility. We included age, sex and the top 10 principal components as covariates. We also performed an omnibus test to examine which HLA residue positions explain the most variance. Results In iRBD, HLA-DRB1 *11:01 was the only allele passing FDR correction (OR=1.57, 95% CI=1.27-1.93, p =2.70e-05). We also discovered associations between iRBD and HLA-DRB1 70D (OR=1.26, 95%CI=1.12-1.41, p =8.76e-05), 70Q (OR=0.81, 95% CI=0.72-0.91, p =3.65e-04) and 71R (OR=1.21, 95% CI=1.08-1.35, p =1.35e-03). In HLA-DRB1 , position 71 ( p omnibus =0.00102) and 70 ( p omnibus =0.00125) were associated with iRBD. We found no association in LBD. Discussion This study identified an association between HLA-DRB1 11:01 and iRBD, distinct from the previously reported association in PD. Therefore, the HLA locus may play different roles across synucleinopathies. Additional studies are required better to understand HLA's role in iRBD and LBD.
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Affiliation(s)
- Eric Yu
- Department of Human Genetics, McGill University, Montréal, QC, Canada
- The Neuro (Montreal Neurological Institute-Hospital), McGill University, Montréal, QC, Canada
| | - Lynne Krohn
- Department of Human Genetics, McGill University, Montréal, QC, Canada
- The Neuro (Montreal Neurological Institute-Hospital), McGill University, Montréal, QC, Canada
| | - Jennifer A. Ruskey
- The Neuro (Montreal Neurological Institute-Hospital), McGill University, Montréal, QC, Canada
- Department of Neurology and Neurosurgery, McGill University, Montréal, QC, Canada
| | - Farnaz Asayesh
- The Neuro (Montreal Neurological Institute-Hospital), McGill University, Montréal, QC, Canada
- Department of Neurology and Neurosurgery, McGill University, Montréal, QC, Canada
| | - Dan Spiegelman
- The Neuro (Montreal Neurological Institute-Hospital), McGill University, Montréal, QC, Canada
- Department of Neurology and Neurosurgery, McGill University, Montréal, QC, Canada
| | - Zalak Shah
- Neurodegenerative Diseases Research Unit, National Institute of Neurological Disorders and Stroke, Bethesda, MD, USA
| | - Ruth Chia
- Neuromuscular Diseases Research Section, National Institute on Aging, Bethesda, MD, USA
| | - Isabelle Arnulf
- Sleep Disorders Unit, Pitié Salpêtrière Hospital, Paris Brain Institute and Sorbonne University, Paris, France
| | - Michele T.M. Hu
- Oxford Parkinson’s Disease Centre (OPDC), University of Oxford, Oxford, United Kingdom
- Division of Neurology, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, United Kingdom
| | - Jacques Y. Montplaisir
- Center for Advanced Research in Sleep Medicine, Centre Intégré Universitaire de Santé et de Services Sociaux du Nord-de-l’île-de-Montréal – Hopital du Sacré-Coeur de Montréal, Montréal, QC, Canada
- Department of Psychiatry, Université de Montréal, Montréal, QC, Canada
| | - Jean-François Gagnon
- Center for Advanced Research in Sleep Medicine, Centre Intégré Universitaire de Santé et de Services Sociaux du Nord-de-l’île-de-Montréal – Hopital du Sacré-Coeur de Montréal, Montréal, QC, Canada
- Department of Psychology, Université du Québec à Montreal, Montréal, QC, Canada
| | - Alex Desautels
- Center for Advanced Research in Sleep Medicine, Centre Intégré Universitaire de Santé et de Services Sociaux du Nord-de-l’île-de-Montréal – Hopital du Sacré-Coeur de Montréal, Montréal, QC, Canada
- Department of Neurosciences, Universite de Montréal, Montréal, QC, Canada
| | - Yves Dauvilliers
- National Reference Center for Narcolepsy, Sleep Unit, Department of Neurology, Gui-de-Chauliac Hospital, CHU Montpellier, University of Montpellier, Inserm U1061, Montpellier, France
| | - Gian Luigi Gigli
- Clinical Neurology Unit, Department of Neurosciences, University Hospital of Udine, Udine, Italy
- Department of Medicine (DAME), University of Udine, Udine, Italy
| | - Mariarosaria Valente
- Clinical Neurology Unit, Department of Neurosciences, University Hospital of Udine, Udine, Italy
- Department of Medicine (DAME), University of Udine, Udine, Italy
| | - Francesco Janes
- Clinical Neurology Unit, Department of Neurosciences, University Hospital of Udine, Udine, Italy
| | - Andrea Bernardini
- Clinical Neurology Unit, Department of Neurosciences, University Hospital of Udine, Udine, Italy
| | - Birgit Högl
- Sleep Disorders Clinic, Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria
| | - Ambra Stefani
- Sleep Disorders Clinic, Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria
| | - Abubaker Ibrahim
- Sleep Disorders Clinic, Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria
| | - Anna Heidbreder
- Sleep Disorders Clinic, Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria
- Department for Sleep Medicine and Neuromuscular disease, University Hospital Muenster, Muenster, Germany
| | - Karel Sonka
- Department of Neurology and Centre of Clinical Neuroscience, Charles University, First Faculty of Medicine and General University Hospital, Prague, Czech Republic
| | - Petr Dusek
- Department of Neurology and Centre of Clinical Neuroscience, Charles University, First Faculty of Medicine and General University Hospital, Prague, Czech Republic
| | - David Kemlink
- Department of Neurology and Centre of Clinical Neuroscience, Charles University, First Faculty of Medicine and General University Hospital, Prague, Czech Republic
| | - Wolfgang Oertel
- Department of Neurology, Philipps University, Marburg, Germany
| | - Annette Janzen
- Department of Neurology, Philipps University, Marburg, Germany
| | - Giuseppe Plazzi
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio-Emilia, Modena, Italy
- IRCCS, Institute of Neurological Sciences of Bologna, Bologna, Italy
| | - Elena Antelmi
- Neurology Unit, Movement Disorders Division, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Michela Figorilli
- Department of Medical Sciences and Public Health, Sleep Disorder Research Center, University of Cagliari, Cagliari, Italy
| | - Monica Puligheddu
- Department of Medical Sciences and Public Health, Sleep Disorder Research Center, University of Cagliari, Cagliari, Italy
| | - Brit Mollenhauer
- Paracelsus-Elena-Klinik, Kassel, Germany
- Department of Neurosurgery, University Medical Centre Gættingen, Gottingen, Germany
| | - Claudia Trenkwalder
- Paracelsus-Elena-Klinik, Kassel, Germany
- Department of Neurosurgery, University Medical Centre Gættingen, Gottingen, Germany
| | - Friederike Sixel-Döring
- Department of Neurology, Philipps University, Marburg, Germany
- Paracelsus-Elena-Klinik, Kassel, Germany
| | - Valérie Cochen De Cock
- Sleep and Neurology Unit, Beau Soleil Clinic, Montpellier, France
- EuroMov Digital Health in Motion, University of Montpellier IMT Mines Ales, Montpellier, France
| | - Luigi Ferini-Strambi
- Department of Neurological Sciences, Università Vita-Salute San Raffaele, Milan, Italy
| | - Femke Dijkstra
- Laboratory for Sleep Disorders, St. Dimpna Regional Hospital, Geel, Belgium
- Department of Neurology, St. Dimpna Regional Hospital, Geel, Belgium
- Department of Neurology, University Hospital Antwerp, Edegem, Antwerp, Belgium
| | - Mineke Viaene
- Laboratory for Sleep Disorders, St. Dimpna Regional Hospital, Geel, Belgium
- Department of Neurology, St. Dimpna Regional Hospital, Geel, Belgium
| | - Beatriz Abril
- Sleep disorder Unit, Carémeau Hospital, University Hospital of Nîmes, France
| | | | - Guy A. Rouleau
- Department of Human Genetics, McGill University, Montréal, QC, Canada
- The Neuro (Montreal Neurological Institute-Hospital), McGill University, Montréal, QC, Canada
- Department of Neurology and Neurosurgery, McGill University, Montréal, QC, Canada
| | - Ronald B. Postuma
- The Neuro (Montreal Neurological Institute-Hospital), McGill University, Montréal, QC, Canada
- Department of Neurology and Neurosurgery, McGill University, Montréal, QC, Canada
- Center for Advanced Research in Sleep Medicine, Centre Intégré Universitaire de Santé et de Services Sociaux du Nord-de-l’île-de-Montréal – Hopital du Sacré-Coeur de Montréal, Montréal, QC, Canada
| | - Sonja W. Scholz
- Neurodegenerative Diseases Research Unit, National Institute of Neurological Disorders and Stroke, Bethesda, MD, USA
- Department of Neurology, Johns Hopkins University Medical Center, Baltimore, MD, USA
| | | | - Ziv Gan-Or
- Department of Human Genetics, McGill University, Montréal, QC, Canada
- The Neuro (Montreal Neurological Institute-Hospital), McGill University, Montréal, QC, Canada
- Department of Neurology and Neurosurgery, McGill University, Montréal, QC, Canada
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21
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Joanny S, Redolfi S, Louapre C, Morelot C, Arnulf I, Maillart E. Syndrome d’apnées du sommeil chez des patients atteints de sclérose en plaques sévère. Rev Neurol (Paris) 2023. [DOI: 10.1016/j.neurol.2023.01.661] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/29/2023]
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22
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Brunet de Courssou JB, Testard P, Sallansonnet-Froment M, Brechemier ML, Ricard D, Psimaras D, Ferrand M, Maillet T, Depierre P, Ohlmann C, Capron J, Arnulf I, Gales A. Narcolepsy secondary to anti-Ma2 encephalitis: two case reports. J Clin Sleep Med 2023; 19:837-841. [PMID: 36708258 PMCID: PMC10071386 DOI: 10.5664/jcsm.10448] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Revised: 12/09/2022] [Accepted: 12/09/2022] [Indexed: 01/29/2023]
Abstract
Recent studies suggest that sleep disorders are present in two-thirds of patients with autoimmune encephalitis. In anti-Ma2 encephalitis, hypersomnia appears to be frequent. However, only few cases of type 1 narcolepsy have been reported to date with anti-Ma2 encephalitis. We report 2 new cases of patients with narcolepsy secondary to anti-Ma2 encephalitis. Patient 1, a 68-year-old man, had narcolepsy type 1, including sleep attacks, cataplexy, abnormal Multiple Sleep Latency Tests and hypocretin-1 deficiency (< 50 ng/L) in the cerebrospinal fluid (CSF), associated with a cerebellar syndrome. Anti-Ma2 antibodies were present in the serum and CSF and antivoltage-gated potassium channel antibodies in the serum. He benefited from a treatment with pitolisant. Patient 2, a 42-year-old man, had narcolepsy type 2, including hypersomnolence, no cataplexy, intermediate CSF levels of hypocretin-1 (138 ng/L), abnormal Multiple Sleep Latency Tests, and a limbic encephalitis presentation. Anti-Ma2 antibodies were present in the serum and CSF, and anti-Ma1 antibodies were in the CSF. For both, repeated polysomnographies were necessary to establish the precise diagnosis of central hypersomnia, emphasizing the importance of carrying out sleep investigations in a tertiary neurology center with sleep medicine expertise in patients with anti-Ma2 encephalitis. CITATION Brunet de Courssou J-B, Testard P, Sallansonnet-Froment M, et al. Narcolepsy secondary to anti-Ma2 encephalitis: two case reports. J Clin Sleep Med. 2023;19(4):837-841.
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Affiliation(s)
| | - Pauline Testard
- Sleep Disorders Unit, Hôpital Pitié-Salpêtrière, Paris, France
| | | | | | - Damien Ricard
- Neurology Department, Hôpital d’Instruction des Armées Percy, Clamart, France
| | - Dimitri Psimaras
- Neurology Department, Onco-Neurology Service, Hôpital Pitié-Salpêtrière, Paris, France
| | - Mickaël Ferrand
- Neurology Department, Hôpital Central - CHRU de Nancy, Nancy, France
| | - Thibault Maillet
- Internal Medicine Department, Centre Hospitalier de Mâcon, Mâcon, France
| | | | - Charlotte Ohlmann
- Radiology Department, Hôpital d’Instruction des Armées Percy, Clamart, France
| | - Jean Capron
- Neurology Department, Hôpital Saint-Antoine, Paris, France
| | - Isabelle Arnulf
- Sleep Disorders Unit, Hôpital Pitié-Salpêtrière, Paris, France
- Sorbonne University, Paris, France
| | - Ana Gales
- Sleep Disorders Unit, Hôpital Pitié-Salpêtrière, Paris, France
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23
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Stefani A, Trenkwalder C, Arnulf I, Bliwise DL, Boeve BF, Inoue Y, Iranzo A, Lewis SJ, Provini F, Schenck C, Wenning GK, Wing YK, Hogl B, Videnovic A. Isolated rapid eye movement sleep behaviour disorder: clinical and research implications. J Neurol Neurosurg Psychiatry 2023:jnnp-2022-330913. [PMID: 36977554 DOI: 10.1136/jnnp-2022-330913] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Accepted: 02/05/2023] [Indexed: 03/30/2023]
Affiliation(s)
- Ambra Stefani
- Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria
- Department of Neurology, Harvard Medical School, Boston, Massachusetts, USA
| | - Claudia Trenkwalder
- Paracelsus Elena Klinik, Kassel, Germany
- Neurologische Klinik, Georg August Universität, Göttingen, Germany
| | - Isabelle Arnulf
- Assistance Publique Hôpitaux de Paris, Service des pathologies du Sommeil, Hôpital Pitié-Salpêtrière, Paris, France
- UMR S 1127, CNRS UMR 7225, ICM, Sorbonne Universités, UPMC Univ Paris 06, Paris, France
| | - Donald L Bliwise
- Neurology, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Bradley F Boeve
- Department of Neurology, Mayo Clinic, Rochester, Minnesota, USA
| | | | | | - Simon Jg Lewis
- Healthy Brain Ageing Clinic, University of Sydney, Sydney, New South Wales, Australia
| | - Federica Provini
- Department of Biomedical and Neuromotor Sciences and IRCCS Institute of Neurosciences, Bologna, University of Bologna, Bologna, Italy
| | - Carlos Schenck
- Dept. of Psychiatry and Sleep Disorders Center, Minnesota Regional Sleep Disorders Center and University of Minnesota, Minneapolis, Minnesota, USA
| | | | - Yun Kwok Wing
- Psychiatry, The Chinese University of Hong Kong Faculty of Medicine, Hong Kong, Hong Kong
| | - Birgit Hogl
- Department of Neurology, Innsbruck Medical University, Innsbruck, Austria
| | - Aleksandar Videnovic
- Department of Neurology, Massachusetts General Hospital, Boston, Massachusetts, USA
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24
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Rossi J, Gales A, Attali V, Leu-Smenescu S, Dodet P, Groos E, Arnulf I. Do the EEG and behavioral criteria of NREM arousal disorders apply to sexsomnia? Sleep 2023:7068072. [PMID: 36866491 DOI: 10.1093/sleep/zsad056] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Indexed: 03/04/2023] Open
Abstract
STUDY OBJECTIVES To establish whether the recent EEG and behavioral criteria of arousal disorders apply to sexsomnia. METHODS EEG and behavioral markers upon N3 sleep interruptions in videopolysomnography were retrospectively compared in 24 participants with sexsomnia, 41 participants with arousals disorders, and 40 healthy controls. The specificity and sensitivity of previously suggested EEG and behavioral cutoffs for supporting arousal disorders diagnosis were measured in the sexsomnia vs. control groups. RESULTS Participants with sexsomnia and arousals disorders showed a higher N3 fragmentation index, slow/mixed N3 arousal index, and number of eye openings during N3 interruptions than healthy controls. Ten (41.7%) participants with sexsomnia (vs. one sleepwalker and no control) displayed an apparently sexual behavior (masturbation, sexual vocalization, pelvic thrusting, and hand within the pajama) during N3 arousal. An N3 sleep fragmentation index ≥ 6.8/h of N3 sleep and two or more N3 arousals associated with eye opening was 95% specific but poorly (46% and 42%) sensitive for diagnosing sexsomnia. An index of slow/mixed N3 arousals ≥ 2.5/h of N3 sleep was 73% specific and 67% sensitive. An N3 arousal with trunk raising, sitting, speaking, showing an expression of fear/surprise, shouting, or exhibiting sexual behavior was 100% specific for a diagnosis of sexsomnia. CONCLUSION In patients with sexsomnia, videopolysomnography based markers of arousal disorders are intermediate between healthy individuals and patients with other arousal disorders, supporting the concept of sexsomnia as a specialized, but less neurophysiologically severe, NREM parasomnia. Previously validated criteria for arousal disorders partially fit in patients with sexsomnia.
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Affiliation(s)
- Jessica Rossi
- Sleep Clinic, Pitie-Salpetriere Hospital, APHP-Sorbonne, Paris, France.,Clinical and Experimental Medicine PhD Program, University of Modena and Reggio Emilia, 41125 Modena, Italy
| | - Ana Gales
- Sleep Clinic, Pitie-Salpetriere Hospital, APHP-Sorbonne, Paris, France
| | - Valérie Attali
- Sleep Clinic, Pitie-Salpetriere Hospital, APHP-Sorbonne, Paris, France.,INSERM, UMRS1158 Neurophysiologie Respiratoire Expérimentale et Clinique, Paris, France
| | - Smaranda Leu-Smenescu
- Sleep Clinic, Pitie-Salpetriere Hospital, APHP-Sorbonne, Paris, France.,Paris Brain Institute (ICM), INSERM, CNRS, Paris, France
| | - Pauline Dodet
- Sleep Clinic, Pitie-Salpetriere Hospital, APHP-Sorbonne, Paris, France.,Sorbonne University, Paris, France
| | - Elisabeth Groos
- Sleep Clinic, Pitie-Salpetriere Hospital, APHP-Sorbonne, Paris, France
| | - Isabelle Arnulf
- Sleep Clinic, Pitie-Salpetriere Hospital, APHP-Sorbonne, Paris, France.,Paris Brain Institute (ICM), INSERM, CNRS, Paris, France.,Sorbonne University, Paris, France
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25
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Nobileau A, Gaurav R, Chougar L, Faucher A, Valabrègue R, Mangone G, Leu-Semenescu S, Lejeune FX, Corvol JC, Arnulf I, Vidailhet M, Grabli D, Degos B, Lehéricy S. Neuromelanin-Sensitive Magnetic Resonance Imaging Changes in the Locus Coeruleus/Subcoeruleus Complex in Patients with Typical and Atypical Parkinsonism. Mov Disord 2023; 38:479-484. [PMID: 36592065 DOI: 10.1002/mds.29309] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Revised: 11/16/2022] [Accepted: 11/21/2022] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND The locus coeruleus/subcoeruleus complex (LC/LsC) is a structure comprising melanized noradrenergic neurons. OBJECTIVE To study the LC/LsC damage across Parkinson's disease (PD) and atypical parkinsonism in a large group of subjects. METHODS We studied 98 healthy control subjects, 47 patients with isolated rapid eye movement sleep behavior disorder (RBD), 75 patients with PD plus RBD, 142 patients with PD without RBD, 19 patients with progressive supranuclear palsy (PSP), and 19 patients with multiple system atrophy (MSA). Twelve patients with MSA had proven RBD. LC/LsC signal intensity was derived from neuromelanin magnetic resonance imaging using automated software. RESULTS The signal intensity was reduced in all parkinsonian syndromes compared with healthy control subjects, except in PD without RBD. The signal intensity decreased as age increased. Moreover, the signal intensity was lower in MSA than in isolated RBD and PD without RBD groups. In PD, the signal intensity correlated negatively with the percentage of REM sleep without atonia. There were no differences in signal intensity between PD plus RBD, PSP, and MSA. CONCLUSIONS Neuromelanin signal intensity was reduced in all parkinsonian disorders, except in PD without RBD. The presence of RBD in parkinsonian disorders appears to be associated with lower neuromelanin signal intensity. Furthermore, lower LC/LsC signal changes in PSP could be partly caused by the effect of age. © 2023 The Authors. Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.
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Affiliation(s)
- Alexis Nobileau
- Paris Brain Institute (ICM), Sorbonne Université, INSERM U1127, CNRS 7225, Pitié-Salpêtrière Hospital, Paris, France
- ICM, Center for NeuroImaging Research, Paris, France
- Department de Neuroradiology, Assistance Publique Hôpitaux de Paris, Hôpital Pitié-Salpêtrière, Paris, France
| | - Rahul Gaurav
- Paris Brain Institute (ICM), Sorbonne Université, INSERM U1127, CNRS 7225, Pitié-Salpêtrière Hospital, Paris, France
- ICM, Center for NeuroImaging Research, Paris, France
- ICM, Team "Movement Investigations and Therapeutics" (MOV'IT), Paris, France
| | - Lydia Chougar
- Paris Brain Institute (ICM), Sorbonne Université, INSERM U1127, CNRS 7225, Pitié-Salpêtrière Hospital, Paris, France
- ICM, Center for NeuroImaging Research, Paris, France
- Department de Neuroradiology, Assistance Publique Hôpitaux de Paris, Hôpital Pitié-Salpêtrière, Paris, France
- ICM, Team "Movement Investigations and Therapeutics" (MOV'IT), Paris, France
| | - Alice Faucher
- Dynamics and Pathophysiology of Neuronal Networks Team, Center for Interdisciplinary Research in Biology, Collège de France, CNRS UMR7241/INSERM U1050, Université PSL, Paris, France
- Service de Neurologie, Hôpital Avicenne, Hôpitaux Universitaires de Paris-Seine Saint Denis, Sorbonne Paris Nord, Bobigny, France
| | - Romain Valabrègue
- Paris Brain Institute (ICM), Sorbonne Université, INSERM U1127, CNRS 7225, Pitié-Salpêtrière Hospital, Paris, France
- ICM, Center for NeuroImaging Research, Paris, France
| | - Graziella Mangone
- Paris Brain Institute (ICM), Sorbonne Université, INSERM U1127, CNRS 7225, Pitié-Salpêtrière Hospital, Paris, France
- Department de Neurology, Centre d'Investigation Clinique Neurosciences, Assistance Publique Hôpitaux de Paris, Hôpital Pitié-Salpêtrière, Paris, France
| | - Smaranda Leu-Semenescu
- Sleep Disorder Unit, Assistance Publique Hôpitaux de Paris, Hôpital Pitié-Salpêtrière, Paris, France
| | - François-Xavier Lejeune
- Paris Brain Institute (ICM), Sorbonne Université, INSERM U1127, CNRS 7225, Pitié-Salpêtrière Hospital, Paris, France
| | - Jean-Christophe Corvol
- Paris Brain Institute (ICM), Sorbonne Université, INSERM U1127, CNRS 7225, Pitié-Salpêtrière Hospital, Paris, France
- Department de Neurology, Centre d'Investigation Clinique Neurosciences, Assistance Publique Hôpitaux de Paris, Hôpital Pitié-Salpêtrière, Paris, France
| | - Isabelle Arnulf
- Paris Brain Institute (ICM), Sorbonne Université, INSERM U1127, CNRS 7225, Pitié-Salpêtrière Hospital, Paris, France
- ICM, Team "Movement Investigations and Therapeutics" (MOV'IT), Paris, France
- Sleep Disorder Unit, Assistance Publique Hôpitaux de Paris, Hôpital Pitié-Salpêtrière, Paris, France
| | - Marie Vidailhet
- Paris Brain Institute (ICM), Sorbonne Université, INSERM U1127, CNRS 7225, Pitié-Salpêtrière Hospital, Paris, France
- ICM, Team "Movement Investigations and Therapeutics" (MOV'IT), Paris, France
- Department de Neurology, Assistance Publique Hôpitaux de Paris, Hôpital Pitié-Salpêtrière, Paris, France
| | - David Grabli
- Paris Brain Institute (ICM), Sorbonne Université, INSERM U1127, CNRS 7225, Pitié-Salpêtrière Hospital, Paris, France
- Department de Neurology, Assistance Publique Hôpitaux de Paris, Hôpital Pitié-Salpêtrière, Paris, France
| | - Bertrand Degos
- Dynamics and Pathophysiology of Neuronal Networks Team, Center for Interdisciplinary Research in Biology, Collège de France, CNRS UMR7241/INSERM U1050, Université PSL, Paris, France
- Service de Neurologie, Hôpital Avicenne, Hôpitaux Universitaires de Paris-Seine Saint Denis, Sorbonne Paris Nord, Bobigny, France
| | - Stéphane Lehéricy
- Paris Brain Institute (ICM), Sorbonne Université, INSERM U1127, CNRS 7225, Pitié-Salpêtrière Hospital, Paris, France
- ICM, Center for NeuroImaging Research, Paris, France
- Department de Neuroradiology, Assistance Publique Hôpitaux de Paris, Hôpital Pitié-Salpêtrière, Paris, France
- ICM, Team "Movement Investigations and Therapeutics" (MOV'IT), Paris, France
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Grassion L, Gonzalez-Bermejo J, Arnulf I, Patout M. Diagnosing sleep disordered breathing in patients with chronic pulmonary disease: which test for which patient? Breathe (Sheff) 2023; 19:220199. [PMID: 37378060 PMCID: PMC10292791 DOI: 10.1183/20734735.0199-2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2022] [Accepted: 02/12/2023] [Indexed: 06/29/2023] Open
Abstract
Overnight polysomnography should be the first-line diagnostic test in patients with severe respiratory disease. However, if access to polysomnography is limited, overnight polygraphy can be used as an alternative first-line diagnostic. https://bit.ly/3KlmFED.
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Affiliation(s)
- Léo Grassion
- Sorbonne Université, INSERM, UMRS1158 Neurophysiologie Respiratoire Expérimentale et Clinique, Paris, France
- Service des Maladies Respiratoires, CHU de Haut-Lévêque, Pessac, France
| | - Jésus Gonzalez-Bermejo
- Sorbonne Université, INSERM, UMRS1158 Neurophysiologie Respiratoire Expérimentale et Clinique, Paris, France
- AP-HP, Groupe Hospitalier Universitaire APHP-Sorbonne Université, site Pitié-Salpêtrière, Service de Réhabilitation respiratoire (Département R3S), Paris, France
| | - Isabelle Arnulf
- AP-HP, Groupe Hospitalier Universitaire APHP-Sorbonne Université, site Pitié-Salpêtrière, Service des Pathologies du Sommeil (Département R3S), Paris, France
- Institut du Cerveau et de la Moelle, Sorbonne University, Pitié Salpêtrière Hospital, Paris, France
| | - Maxime Patout
- Sorbonne Université, INSERM, UMRS1158 Neurophysiologie Respiratoire Expérimentale et Clinique, Paris, France
- AP-HP, Groupe Hospitalier Universitaire APHP-Sorbonne Université, site Pitié-Salpêtrière, Service des Pathologies du Sommeil (Département R3S), Paris, France
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27
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Coarelli G, Tchikviladzé M, Dodet P, Arnulf I, Charles P, Tankeré F, Similowski T, Seilhean D, Brice A, Duyckaerts C, Durr A. Motor neuron involvement threatens survival in spinocerebellar ataxia type 1. Neuropathol Appl Neurobiol 2023; 49:e12897. [PMID: 36855904 DOI: 10.1111/nan.12897] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Revised: 02/22/2023] [Accepted: 02/22/2023] [Indexed: 03/02/2023]
Affiliation(s)
- Giulia Coarelli
- Sorbonne Université, Paris Brain Institute (ICM Institut du Cerveau), INSERM, CNRS, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France.,Department of Genetics, Pitié-Salpêtrière Charles-Foix University Hospital, Assistance Publique - Hôpitaux de Paris (AP-HP), 75013, Paris, France
| | - Maya Tchikviladzé
- Department of Genetics, Pitié-Salpêtrière Charles-Foix University Hospital, Assistance Publique - Hôpitaux de Paris (AP-HP), 75013, Paris, France
| | - Pauline Dodet
- Sleep Disorders Unit, Pitié-Salpêtrière University Hospital, AP-HP, Paris, France.,ICM, Sorbonne Université, Inserm U 1127, CNRS UMR 7225, Paris, France
| | - Isabelle Arnulf
- Sleep Disorders Unit, Pitié-Salpêtrière University Hospital, AP-HP, Paris, France.,ICM, Sorbonne Université, Inserm U 1127, CNRS UMR 7225, Paris, France
| | - Perrine Charles
- Department of Genetics, Pitié-Salpêtrière Charles-Foix University Hospital, Assistance Publique - Hôpitaux de Paris (AP-HP), 75013, Paris, France
| | - Frederic Tankeré
- Department of Otolaryngology-Head and Neck Surgery, Pitié-Salpêtrière Charles-Foix University Hospital, Assistance Publique - Hôpitaux de Paris (AP-HP), Sorbonne Université, 75013, Paris, France
| | - Thomas Similowski
- Sorbonne Université, INSERM, UMRS1158 Neurophysiologie Respiratoire Expérimentale et Clinique; AP-HP, Groupe Hospitalier Universitaire APHP-Sorbonne Université, site Pitié-Salpêtrière, Département R3S (Respiration, Réanimation, Réhabilitation respiratoire, Sommeil), F-75013, Paris, France
| | - Danielle Seilhean
- Sorbonne Université, Paris Brain Institute (ICM Institut du Cerveau), INSERM, CNRS, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France.,Laboratoire de Neuropathologie R. Escourolle, Pitié-Salpêtrière Charles-Foix University Hospital, Assistance Publique - Hôpitaux de Paris (AP-HP), Sorbonne Université, 75013, Paris, France
| | - Alexis Brice
- Sorbonne Université, Paris Brain Institute (ICM Institut du Cerveau), INSERM, CNRS, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France
| | - Charles Duyckaerts
- Sorbonne Université, Paris Brain Institute (ICM Institut du Cerveau), INSERM, CNRS, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France.,Laboratoire de Neuropathologie R. Escourolle, Pitié-Salpêtrière Charles-Foix University Hospital, Assistance Publique - Hôpitaux de Paris (AP-HP), Sorbonne Université, 75013, Paris, France
| | - Alexandra Durr
- Sorbonne Université, Paris Brain Institute (ICM Institut du Cerveau), INSERM, CNRS, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France.,Department of Genetics, Pitié-Salpêtrière Charles-Foix University Hospital, Assistance Publique - Hôpitaux de Paris (AP-HP), 75013, Paris, France
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28
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Somerville EN, Krohn L, Yu E, Rudakou U, Senkevich K, Ruskey JA, Asayesh F, Ahmad J, Spiegelman D, Dauvilliers Y, Arnulf I, Hu MT, Montplaisir JY, Gagnon JF, Desautels A, Ibrahim A, Stefani A, Hogl B, Gigli GL, Valente M, Janes F, Bernardini A, Dusek P, Sonka K, Kemlink D, Plazzi G, Antelmi E, Biscarini F, Mollenhauer B, Trenkwalder C, Sixel-Doring F, Figorilli M, Puligheddu M, De Cock VC, Ferini-Strambi L, Heibreder A, Monaca CC, Abril B, Dijkstra F, Viaene M, Boeve BF, Postuma RB, Rouleau GA, Gan-Or Z. NPC1 variants are not associated with Parkinson’s disease, REM-sleep behaviour disorder or Dementia with Lewy bodies in European cohorts. Neurobiol Aging 2023; 127:94-98. [PMID: 37032242 DOI: 10.1016/j.neurobiolaging.2023.03.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Revised: 01/31/2023] [Accepted: 03/03/2023] [Indexed: 03/09/2023]
Abstract
NPC1 encodes a lysosomal protein involved in cholesterol transport. Biallelic mutations in this gene may lead to Niemann-Pick disease type C (NPC), a lysosomal storage disorder. The role of NPC1 in alpha synucleinopathies is still unclear, as different genetic, clinical, and pathological studies have reported contradictory results. This study aimed to evaluate the association of NPC1 variants with the synucleinopathies Parkinson's disease (PD), dementia with Lewy bodies (DLB), and rapid eye movement-sleep behavior disorder (RBD). We analyzed common and rare variants from 3 cohorts of European descent: 1084 RBD cases and 2945 controls, 2852 PD cases and 1686 controls, and 2610 DLB cases and 1920 controls. Logistic regression models were used to assess common variants while optimal sequence Kernel association tests were used to assess rare variants, both adjusted for sex, age, and principal components. No variants were associated with any of the synucleinopathies, supporting that common and rare NPC1 variants do not play an important role in alpha synucleinopathies.
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29
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Arnulf I, Thomas R, Roy A, Dauvilliers Y. Update on the treatment of idiopathic hypersomnia: Progress, challenges, and expert opinion. Sleep Med Rev 2023; 69:101766. [PMID: 36921459 DOI: 10.1016/j.smrv.2023.101766] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Revised: 12/13/2022] [Accepted: 02/20/2023] [Indexed: 02/27/2023]
Abstract
Idiopathic hypersomnia is a central hypersomnolence disorder of unknown origin characterized by excessive daytime sleepiness despite normal or long sleep time, and frequent severe sleep inertia. Management strategies have been largely derived from expert consensus, due to a lack of disease-specific assessments and reliance on case series and rare randomized controlled studies. Guidelines recommend treatment with off-label medications. Modafinil, which was approved for idiopathic hypersomnia until 2011 in Europe, is the most commonly used treatment and improved sleepiness in two recent randomized placebo-controlled trials. In 2021, low-sodium oxybate (LXB) was approved in the United States for idiopathic hypersomnia. In a placebo-controlled, double-blind, randomized withdrawal study, LXB reduced daytime sleepiness and sleep inertia, and improved daily functioning. Here, treatment options are reviewed considering the authors' professional experience, current guidelines, and the latest research developments. The choice of pharmacotherapy should be guided by symptom profile, age, comorbidities (eg, depressive symptoms, cardiovascular problems), and concomitant medications (eg, oral contraceptives). Nonpharmacologic approaches have a role in management. An instrument (idiopathic hypersomnia severity scale) has been validated in idiopathic hypersomnia specifically, opening a path to better assessment of symptoms, impact, and response to treatment. Continued research on idiopathic hypersomnia is needed to support treatment algorithms.
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Affiliation(s)
- Isabelle Arnulf
- Sleep Disorder Unit, Pitié-Salpêtrière Hospital and Sorbonne University, Paris, France; National Reference Network for Orphan Diseases: Narcolepsy and Rare Hypersomnias, Paris, France.
| | - Robert Thomas
- Department of Medicine, Division of Pulmonary, Critical Care & Sleep Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Asim Roy
- Ohio Sleep Medicine Institute, Dublin, OH, USA
| | - Yves Dauvilliers
- National Reference Network for Orphan Diseases: Narcolepsy and Rare Hypersomnias, Paris, France; Sleep and Wake Disorders Centre, Department of Neurology, Gui de Chauliac Hospital, Montpellier, France; University of Montpellier, INSERM Institute Neuroscience Montpellier (INM), Montpellier, France
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Dodet P, Noiray C, Leu-Semenescu S, Lefevre E, Nigam M, Faucher P, Maranci JB, Jublanc C, Poitou C, Arnulf I. Hypersomnia and Narcolepsy in 42 Adult Patients with Craniopharyngioma. Sleep 2023; 46:7043838. [PMID: 36799460 DOI: 10.1093/sleep/zsad032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Revised: 01/09/2023] [Indexed: 02/18/2023] Open
Abstract
STUDY OBJECTIVES To evaluate sleep, sleepiness and excessive need for sleep in patients with craniopharyngioma (a suprasellar tumor which can affect sleep-wake systems). METHODS A retrospective study of all adult craniopharyngioma patients referred to the sleep clinic, who received a sleep interview, nocturnal polysomnography, multiple sleep latency tests (MSLT) and 18-hour bed rest polysomnography. Their sleep measurements were compared with those of age- and sex-matched healthy controls. RESULTS Of 54 patients screened with craniopharyngioma, 42 were analyzed, 80% of whom complained of excessive daytime sleepiness. Sleep testing revealed that 6 (14.3%) of them had secondary narcolepsy (including one with cataplexy), and 11 (26.2%) had central hypersomnia associated with a medical disorder. Compared with controls, patients were more frequently obese, had a shorter mean sleep latency on MSLT and slept longer on the first night. There was a non-significant trend for patients with (vs. without) narcolepsy and hypersomnia to be younger, to have a higher body mass index, to be more likely to have received radiation therapy and to have more severe damage to the hypothalamus after surgery. Treatment with stimulants (modafinil, pitolisant and methylphenidate) was beneficial in 9/10 patients. CONCLUSION Nearly half of the patients with craniopharyngioma and sleep disorders have a central disorder of hypersomnolence (narcolepsy and hypersomnia), which should be investigated and lead to considerations beyond sleep apnea syndrome in these obese patients.
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Affiliation(s)
- Pauline Dodet
- Assistance Publique-Hôpitaux de Paris-Sorbonne (AP-HP-Sorbonne), Hôpital la Pitié-Salpêtrière, Service des Pathologies du Sommeil et Centre de Référence National des Narcolepsies et Hypersomnies rares, Paris, France.,Sorbonne University and Paris Brain Institute (ICM), Paris, France
| | - Camille Noiray
- Assistance Publique-Hôpitaux de Paris-Sorbonne (AP-HP-Sorbonne), Hôpital la Pitié-Salpêtrière, Service des Pathologies du Sommeil et Centre de Référence National des Narcolepsies et Hypersomnies rares, Paris, France
| | - Smaranda Leu-Semenescu
- Assistance Publique-Hôpitaux de Paris-Sorbonne (AP-HP-Sorbonne), Hôpital la Pitié-Salpêtrière, Service des Pathologies du Sommeil et Centre de Référence National des Narcolepsies et Hypersomnies rares, Paris, France.,Sorbonne University and Paris Brain Institute (ICM), Paris, France
| | - Etienne Lefevre
- Sorbonne University and Paris Brain Institute (ICM), Paris, France.,AP-HP-Sorbonne, Hôpital la Pitié-Salpêtrière, Neurosurgery Department
| | - Milan Nigam
- Assistance Publique-Hôpitaux de Paris-Sorbonne (AP-HP-Sorbonne), Hôpital la Pitié-Salpêtrière, Service des Pathologies du Sommeil et Centre de Référence National des Narcolepsies et Hypersomnies rares, Paris, France.,Center for Advanced Research in Sleep Medicine, Hôpital du Sacré-Coeur de Montréal, Montréal, Canada
| | - Pauline Faucher
- AP-HP-Sorbonne, Hôpital la Pitié-Salpêtrière, Department of Nutrition and National Reference Center for Rare Diseases: "Prader-Willi Syndrome and other rare forms of obesity with eating disorders' (PRADORT)
| | - Jean-Baptiste Maranci
- Assistance Publique-Hôpitaux de Paris-Sorbonne (AP-HP-Sorbonne), Hôpital la Pitié-Salpêtrière, Service des Pathologies du Sommeil et Centre de Référence National des Narcolepsies et Hypersomnies rares, Paris, France.,Sorbonne University and Paris Brain Institute (ICM), Paris, France
| | - Christel Jublanc
- Pituitary Unit, Hôpital Pitié-Salpêtrière, Assistance Publique Hôpitaux de Paris, Paris, France
| | - Christine Poitou
- AP-HP-Sorbonne, Hôpital la Pitié-Salpêtrière, Department of Nutrition and National Reference Center for Rare Diseases: "Prader-Willi Syndrome and other rare forms of obesity with eating disorders' (PRADORT).,Sorbonne Université/INSERM, Nutrition and Obesity; Systemic Approaches (NutriOmics) Research Unit, Paris, France
| | - Isabelle Arnulf
- Assistance Publique-Hôpitaux de Paris-Sorbonne (AP-HP-Sorbonne), Hôpital la Pitié-Salpêtrière, Service des Pathologies du Sommeil et Centre de Référence National des Narcolepsies et Hypersomnies rares, Paris, France.,Sorbonne University and Paris Brain Institute (ICM), Paris, France
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31
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Masset L, Nigam M, Ladarre A, Vidailhet M, Leu-Semenescu S, Fossati P, Arnulf I, Maranci JB. The dynamics of emotional behaviors in rapid eye movement sleep. Sleep 2023; 46:6852875. [PMID: 36445852 DOI: 10.1093/sleep/zsac285] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Revised: 09/14/2022] [Indexed: 12/03/2022] Open
Abstract
Dream's emotions could exert a major role in desensitizing negative emotions. Studying emotional dynamics (how emotions fluctuate across time) during rapid eye movement (REM) sleep could provide some insight into this function. However, studies so far have been limited to dream reports. To bypass this limit, REM sleep behavior disorder (RBD), in which participants enact their dreams, enables direct access to overt emotional dream behaviors (such as facial expressions and speeches). In total, 17 participants with RBD, and 39.7 h of REM sleep video were analyzed. The frequency of emotional behaviors did not differ between REM sleep episodes of early and late night. Within individual REM sleep episodes, emotional behaviors exhibited a biphasic temporal course, including an increased frequency for the first 10 min, followed by a progressive decrease. The negative emotional behaviors occurred earlier (mean time: 11.3 ± 10 min) than positive (14.4 ± 10.7 min) and neutral behaviors (16.4 ± 11.8 min). Emotional behaviors of opposing (negative and positive) valences were observed in 31% (N = 14) of episodes containing at least one emotional behavior, and were separated by a median time of 4.2 [1.1-10.9] min. The biphasic temporal course of behaviors in REM sleep could include the generation reactivation of emotional content during the ascending phase, followed by processing and extinction during the descending phase. The earlier occurrence time of negative emotional behavior suggests that negative emotions may need to be processed first. The rapid succession of emotions of opposite valence could prevent prolonged periods of negative emotions and eventually nightmares.
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Affiliation(s)
- Luc Masset
- Sleep Disorder Unit, Pitié-Salpêtrière University Hospital, Assistance Publique Hôpitaux de Paris, Paris, France
| | - Milan Nigam
- Sleep Disorder Unit, Pitié-Salpêtrière University Hospital, Assistance Publique Hôpitaux de Paris, Paris, France.,Center for Advanced Research in Sleep Medicine, Hôpital du Sacré-Coeur, Montréal, Canada
| | - Anne Ladarre
- Sleep Disorder Unit, Pitié-Salpêtrière University Hospital, Assistance Publique Hôpitaux de Paris, Paris, France.,Paris Brain Institute (ICM), Paris, France.,AP-HP, Sorbonne University, Paris, France
| | - Marie Vidailhet
- Paris Brain Institute (ICM), Paris, France.,AP-HP, Sorbonne University, Paris, France
| | - Smaranda Leu-Semenescu
- Sleep Disorder Unit, Pitié-Salpêtrière University Hospital, Assistance Publique Hôpitaux de Paris, Paris, France.,Paris Brain Institute (ICM), Paris, France
| | - Philippe Fossati
- Paris Brain Institute (ICM), Paris, France.,AP-HP, Sorbonne University, Paris, France.,Department of Psychiatry, Pitié-Salpêtriere University Hospital, Assistance Publique Hôpitaux de Paris, Paris, France
| | - Isabelle Arnulf
- Sleep Disorder Unit, Pitié-Salpêtrière University Hospital, Assistance Publique Hôpitaux de Paris, Paris, France.,Paris Brain Institute (ICM), Paris, France.,AP-HP, Sorbonne University, Paris, France
| | - Jean-Baptiste Maranci
- Sleep Disorder Unit, Pitié-Salpêtrière University Hospital, Assistance Publique Hôpitaux de Paris, Paris, France.,Paris Brain Institute (ICM), Paris, France.,AP-HP, Sorbonne University, Paris, France
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Onanga M, Joanny S, Rivals I, Perger E, Arnulf I, Redolfi S, Sevoz-Couche C. Screening of obstructive sleep apnea syndrome by the deep breathing technique. J Clin Sleep Med 2023; 19:293-302. [PMID: 36148620 PMCID: PMC9892745 DOI: 10.5664/jcsm.10314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Revised: 09/20/2022] [Accepted: 09/20/2022] [Indexed: 02/04/2023]
Abstract
STUDY OBJECTIVES Obstructive sleep apnea syndrome (OSAS) is associated with alterations in heart rate variability (HRV) in relation to chronic autonomic dysfunction. We tested the ability of the deep breathing technique-a simple way to evaluate HRV-to identify patients with OSAS. METHODS Consecutive patients referred for suspected OSAS (without obesity, diabetes, and heart diseases) were included. They underwent a measure of HRV at rest and of heart rate oscillations during expiration vs inspiration (DeltaHRDB) when breathing deeply at the resonant frequency of 6 cycles per minute (deep breathing technique) while sitting awake, followed by a nighttime polysomnography. We measured DeltaHRDB and performed temporal and spectral HRV analysis. RESULTS Of 31 included participants (77% male), 14 had mild to moderate OSAS (apnea-hypopnea index median [IQR]: 18 [12]) and 17 had no OSAS. The conventional HRV analysis did not reveal any difference between the groups with vs without OSAS. However, the DeltaHRDB was lower in those with than without OSAS. Lower DeltaHRDB correlated with higher apnea-hypopnea index, arousal index, and desaturation degree. A DeltaHRDB below 11 beats per minute (bpm) predicted OSAS with a sensitivity of 100% and specificity of 86%. CONCLUSIONS The deep breathing technique accurately identifies a reduction in cardiac changes in patients with mild to moderate OSAS. It could be used as a simple screening tool to select patients for polysomnography. CITATION Onanga M, Joanny S, Rivals I, et al. Screening of obstructive sleep apnea syndrome by the deep breathing technique. J Clin Sleep Med. 2023;19(2):293-302.
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Affiliation(s)
- Mwetty Onanga
- Assistance Publique- Hôpitaux de Paris (APHP), Groupe Hospitalier Universitaire APHP–Sorbonne Université, site Pitié-Salpêtrière, Service des Pathologies du Sommeil (Département R3S), Paris, France
| | - Sarah Joanny
- Assistance Publique- Hôpitaux de Paris (APHP), Groupe Hospitalier Universitaire APHP–Sorbonne Université, site Pitié-Salpêtrière, Service des Pathologies du Sommeil (Département R3S), Paris, France
| | - Isabelle Rivals
- Sorbonne Université, Institut National de la Santé et de la Recherche Médicale (INSERM), UMRS1158, Neurophysiologie Respiratoire Expérimentale et Clinique, Paris, France
- Equipe de Statistique Appliquée, École supérieure de physique et de chimie industrielles de la ville de Paris (ESPCI), Paris, Paris Sciences et Lettres (PSL) Research University, Paris, France
| | - Elisa Perger
- Assistance Publique- Hôpitaux de Paris (APHP), Groupe Hospitalier Universitaire APHP–Sorbonne Université, site Pitié-Salpêtrière, Service des Pathologies du Sommeil (Département R3S), Paris, France
| | - Isabelle Arnulf
- Assistance Publique- Hôpitaux de Paris (APHP), Groupe Hospitalier Universitaire APHP–Sorbonne Université, site Pitié-Salpêtrière, Service des Pathologies du Sommeil (Département R3S), Paris, France
- Sorbonne Université, Pitié Salpêtrière Hospital, Institut du Cerveau et de la Moelle, Paris, France
| | - Stefania Redolfi
- Assistance Publique- Hôpitaux de Paris (APHP), Groupe Hospitalier Universitaire APHP–Sorbonne Université, site Pitié-Salpêtrière, Service des Pathologies du Sommeil (Département R3S), Paris, France
- Sorbonne Université, Institut National de la Santé et de la Recherche Médicale (INSERM), UMRS1158, Neurophysiologie Respiratoire Expérimentale et Clinique, Paris, France
| | - Caroline Sevoz-Couche
- Sorbonne Université, Institut National de la Santé et de la Recherche Médicale (INSERM), UMRS1158, Neurophysiologie Respiratoire Expérimentale et Clinique, Paris, France
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Attali V, Weber M, Rivals I, Similowski T, Arnulf I, Gatignol P. Moderate-to-severe obstructive sleep apnea syndrome is associated with altered tongue motion during wakefulness. Eur Arch Otorhinolaryngol 2023; 280:2551-2560. [PMID: 36707431 DOI: 10.1007/s00405-023-07854-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2022] [Accepted: 01/18/2023] [Indexed: 01/29/2023]
Abstract
PURPOSE Impairment of genioglossus control is a frequent "non-anatomical" cause of obstructive sleep apnea syndrome (OSAS) in non- or mildly obese patients. Although wake-related compensatory mechanisms prevent the occurrence of obstructive events, the genioglossus control is often impaired during wakefulness. We hypothesized that the lingual motion would be altered during wakefulness in this population in patients with moderate-to-severe OSAS. METHODS We included non- or mildly obese participants with suspected OSAS. They underwent a Bucco-Linguo-Facial Motor Skills assessment using the MBLF ("Motricité Bucco-Linguo-Faciale"), which includes an evaluation of 13 movements of the tongue. This was followed by a night-attended polysomnography. We compared patients with moderate-to-severe OSAS (apnea-hypopnea index (AHI) ≥ 15/h; n = 15) to patients without or with mild OSAS (AHI < 15/h; n = 24). RESULTS MBLF total and "tongue" sub-scores were lower in patients with moderate-to-severe OSAS: total z-score - 0.78 [- 1.31; 0.103] versus 0.20 [- 0.26; 0.31], p = 0.0011; "tongue" z-sub-score (- 0.63 [- 1.83; 0.41] versus 0.35 [0.26; 0.48], p = 0.014). There was a significant age-adjusted correlation between the "tongue" sub-score and AHI. The logistic regression model for the prediction of moderate-to-severe OSAS gave area under the curve ratio of 88.2% for MBLF score plus age. CONCLUSIONS Myofunctional activity of the tongue is impaired during wakefulness in non- or mildly obese patients with moderate-to-severe OSAS. This study supports the lingual myofunctional assessment using the MBLF in screening of moderate-to-severe OSAS. This simple tool could help clinicians to select patients with suspected moderate-to-severe OSAS for polysomnography.
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Affiliation(s)
- Valérie Attali
- UMRS1158 Neurophysiologie Respiratoire Expérimentale et Clinique, Sorbonne Université, INSERM, 75005, Paris, France. .,Département R3S, Service des Pathologies du Sommeil, AP-HP, Sorbonne Université, Hôpital Pitié-Salpêtrière, 75013, Paris, France.
| | - Mathilde Weber
- Département d'Orthophonie, Faculté de Médecine UFR 967, Sorbonne Université, 75013, Paris, France
| | - Isabelle Rivals
- UMRS1158 Neurophysiologie Respiratoire Expérimentale et Clinique, Sorbonne Université, INSERM, 75005, Paris, France.,Equipe de Statistique Appliquée, ESPCI Paris, PSL Research University, Paris, France
| | - Thomas Similowski
- UMRS1158 Neurophysiologie Respiratoire Expérimentale et Clinique, Sorbonne Université, INSERM, 75005, Paris, France.,Département R3S, Hôpital Pitié-Salpêtrière, AP-HP, Sorbonne Université, 75013, Paris, France
| | - Isabelle Arnulf
- Département R3S, Service des Pathologies du Sommeil, AP-HP, Sorbonne Université, Hôpital Pitié-Salpêtrière, 75013, Paris, France.,Institut du Cerveau, Paris Brain Institute-ICM, INSERM, CNRS, Sorbonne Université, 75013, Paris, France
| | - Peggy Gatignol
- UMRS1158 Neurophysiologie Respiratoire Expérimentale et Clinique, Sorbonne Université, INSERM, 75005, Paris, France.,Département d'Orthophonie, Faculté de Médecine UFR 967, Sorbonne Université, 75013, Paris, France.,Service d'Oto-Rhino-Laryngologie, Hôpital Pitié-Salpêtrière, AP-HP, Sorbonne Université, 75013, Paris, France
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Perretti C, Gales A, Leu-Semenescu S, Dodet P, Arnulf I. Short slow wave sleep latency in patients with disorders of arousal. Sleep Med X 2023; 5:100063. [PMID: 36794266 PMCID: PMC9923220 DOI: 10.1016/j.sleepx.2023.100063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Accepted: 01/20/2023] [Indexed: 01/24/2023] Open
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Arnulf I. Ideas that come at night: on sleep research in 2022. Lancet Neurol 2023; 22:23-24. [PMID: 36517161 DOI: 10.1016/s1474-4422(22)00481-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Accepted: 11/15/2022] [Indexed: 12/15/2022]
Affiliation(s)
- Isabelle Arnulf
- Sleep Disorders Unit, Sorbonne University, Paris Brain Institute, Pitie-Salpetriere Hospital, Paris 75013, France.
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36
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Krohn L, Heilbron K, Blauwendraat C, Reynolds RH, Yu E, Senkevich K, Rudakou U, Estiar MA, Gustavsson EK, Brolin K, Ruskey JA, Freeman K, Asayesh F, Chia R, Arnulf I, Hu MTM, Montplaisir JY, Gagnon JF, Desautels A, Dauvilliers Y, Gigli GL, Valente M, Janes F, Bernardini A, Högl B, Stefani A, Ibrahim A, Šonka K, Kemlink D, Oertel W, Janzen A, Plazzi G, Biscarini F, Antelmi E, Figorilli M, Puligheddu M, Mollenhauer B, Trenkwalder C, Sixel-Döring F, Cochen De Cock V, Monaca CC, Heidbreder A, Ferini-Strambi L, Dijkstra F, Viaene M, Abril B, Boeve BF, Scholz SW, Ryten M, Bandres-Ciga S, Noyce A, Cannon P, Pihlstrøm L, Nalls MA, Singleton AB, Rouleau GA, Postuma RB, Gan-Or Z. Genome-wide association study of REM sleep behavior disorder identifies polygenic risk and brain expression effects. Nat Commun 2022; 13:7496. [PMID: 36470867 PMCID: PMC9722930 DOI: 10.1038/s41467-022-34732-5] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Accepted: 11/03/2022] [Indexed: 12/11/2022] Open
Abstract
Rapid-eye movement (REM) sleep behavior disorder (RBD), enactment of dreams during REM sleep, is an early clinical symptom of alpha-synucleinopathies and defines a more severe subtype. The genetic background of RBD and its underlying mechanisms are not well understood. Here, we perform a genome-wide association study of RBD, identifying five RBD risk loci near SNCA, GBA, TMEM175, INPP5F, and SCARB2. Expression analyses highlight SNCA-AS1 and potentially SCARB2 differential expression in different brain regions in RBD, with SNCA-AS1 further supported by colocalization analyses. Polygenic risk score, pathway analysis, and genetic correlations provide further insights into RBD genetics, highlighting RBD as a unique alpha-synucleinopathy subpopulation that will allow future early intervention.
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Affiliation(s)
- Lynne Krohn
- Department of Human Genetics, McGill University, Montréal, QC, Canada
- The Neuro (Montreal Neurological Institute-Hospital), McGill University, Montréal, QC, Canada
| | | | - Cornelis Blauwendraat
- Laboratory of Neurogenetics, National Institute on Aging, National Institutes of Health, Bethesda, MD, USA
| | - Regina H Reynolds
- Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, University College London, London, UK
- Great Ormond Street Institute of Child Health, Genetics and Genomic Medicine, University College London, London, UK
| | - Eric Yu
- Department of Human Genetics, McGill University, Montréal, QC, Canada
- The Neuro (Montreal Neurological Institute-Hospital), McGill University, Montréal, QC, Canada
| | - Konstantin Senkevich
- Department of Human Genetics, McGill University, Montréal, QC, Canada
- The Neuro (Montreal Neurological Institute-Hospital), McGill University, Montréal, QC, Canada
| | - Uladzislau Rudakou
- Department of Human Genetics, McGill University, Montréal, QC, Canada
- The Neuro (Montreal Neurological Institute-Hospital), McGill University, Montréal, QC, Canada
| | - Mehrdad A Estiar
- Department of Human Genetics, McGill University, Montréal, QC, Canada
- The Neuro (Montreal Neurological Institute-Hospital), McGill University, Montréal, QC, Canada
| | - Emil K Gustavsson
- Great Ormond Street Institute of Child Health, Genetics and Genomic Medicine, University College London, London, UK
- NIHR Great Ormond Street Hospital Biomedical Research Centre, University College London, London, UK
| | - Kajsa Brolin
- Lund University, Translational Neurogenetics Unit, Department of Experimental Medical Science, Lund, Sweden
| | - Jennifer A Ruskey
- The Neuro (Montreal Neurological Institute-Hospital), McGill University, Montréal, QC, Canada
| | - Kathryn Freeman
- The Neuro (Montreal Neurological Institute-Hospital), McGill University, Montréal, QC, Canada
| | - Farnaz Asayesh
- The Neuro (Montreal Neurological Institute-Hospital), McGill University, Montréal, QC, Canada
| | - Ruth Chia
- Laboratory of Neurogenetics, National Institute on Aging, National Institutes of Health, Bethesda, MD, USA
| | - Isabelle Arnulf
- Sleep Disorders Unit, Pitié Salpêtrière Hospital, APHP-Sorbonne, Paris Brain Insitute and Sorbonne University, Paris, France
| | - Michele T M Hu
- Oxford Parkinson's Disease Centre (OPDC), University of Oxford, Oxford, UK
- Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
| | - Jacques Y Montplaisir
- Centre d'Études Avancées en Médecine du Sommeil, Hôpital du Sacré-Cœur de Montréal, Montréal, QC, Canada
- Department of Psychiatry, Université de Montréal, Montréal, QC, Canada
| | - Jean-François Gagnon
- Centre d'Études Avancées en Médecine du Sommeil, Hôpital du Sacré-Cœur de Montréal, Montréal, QC, Canada
- Department of Psychology, Université du Québec à Montréal, Montreal, QC, Canada
| | - Alex Desautels
- Centre d'Études Avancées en Médecine du Sommeil, Hôpital du Sacré-Cœur de Montréal, Montréal, QC, Canada
- Department of Neurosciences, Université de Montréal, Montréal, QC, Canada
| | - Yves Dauvilliers
- National Reference Center for Narcolepsy, Sleep Unit, Department of Neurology, Gui-de-Chauliac Hospital, CHU Montpellier, University of Montpellier, Institute Neuroscience Montpellier Inserm, Montpellier, France
| | - Gian Luigi Gigli
- Clinical Neurology Unit, Department of Neurosciences, University Hospital of Udine, Udine, Italy
| | - Mariarosaria Valente
- Clinical Neurology Unit, Department of Neurosciences, University Hospital of Udine, Udine, Italy
- Department of Medicine (DAME), University of Udine, Udine, Italy
| | - Francesco Janes
- Clinical Neurology Unit, Department of Neurosciences, University Hospital of Udine, Udine, Italy
| | - Andrea Bernardini
- Clinical Neurology Unit, Department of Neurosciences, University Hospital of Udine, Udine, Italy
| | - Birgit Högl
- Sleep Disorders Clinic, Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria
| | - Ambra Stefani
- Sleep Disorders Clinic, Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria
| | - Abubaker Ibrahim
- Sleep Disorders Clinic, Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria
| | - Karel Šonka
- Department of Neurology and Centre of Clinical Neuroscience, Charles University, First Faculty of Medicine and General University Hospital, Prague, Czech Republic
| | - David Kemlink
- Department of Neurology and Centre of Clinical Neuroscience, Charles University, First Faculty of Medicine and General University Hospital, Prague, Czech Republic
| | - Wolfgang Oertel
- Department of Neurology, Philipps-University, Marburg, Germany
| | - Annette Janzen
- Department of Neurology, Philipps-University, Marburg, Germany
| | - Giuseppe Plazzi
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio-Emilia, Modena, Italy
- IRCCS, Institute of Neurological Sciences of Bologna, Bologna, Italy
| | - Francesco Biscarini
- Department of Biomedical and Neuromotor Sciences (DIBINEM), Alma Mater Studiorum, University of Bologna, Bologna, Italy
| | - Elena Antelmi
- IRCCS, Institute of Neurological Sciences of Bologna, Bologna, Italy
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Michela Figorilli
- Department of Medical Sciences and Public Health, Sleep Disorder Research Center, University of Cagliari, Cagliari, Italy
| | - Monica Puligheddu
- Department of Medical Sciences and Public Health, Sleep Disorder Research Center, University of Cagliari, Cagliari, Italy
| | - Brit Mollenhauer
- Paracelsus-Elena-Klinik, Kassel, Germany
- Department of Neurology, University Medical Centre Goettingen, Goettingen, Germany
| | - Claudia Trenkwalder
- Paracelsus-Elena-Klinik, Kassel, Germany
- Department of Neurology, University Medical Centre Goettingen, Goettingen, Germany
| | - Friederike Sixel-Döring
- Department of Neurology, Philipps-University, Marburg, Germany
- Paracelsus-Elena-Klinik, Kassel, Germany
| | - Valérie Cochen De Cock
- Sleep and Neurology Unit, Beau Soleil Clinic, Montpellier, France
- EuroMov Digital Health in Motion, University of Montpellier IMT Mines Ales, Montpellier, France
| | - Christelle Charley Monaca
- University Lille North of France, Department of Clinical Neurophysiology and Sleep Center, CHU Lille, Lille, France
| | - Anna Heidbreder
- Institute of Sleep Medicine and Neuromuscular Disorders, University of Münster, Münster, Germany
| | - Luigi Ferini-Strambi
- Department of Neurological Sciences, Università Vita-Salute San Raffaele, Milan, Italy
| | - Femke Dijkstra
- Laboratory for Sleep Disorders, St. Dimpna Regional Hospital, Geel, Belgium
- Department of Neurology, St. Dimpna Regional Hospital, Geel, Belgium
- Department of Neurology, Antwerp University Hospital, Edegem, Belgium
| | - Mineke Viaene
- Laboratory for Sleep Disorders, St. Dimpna Regional Hospital, Geel, Belgium
- Department of Neurology, St. Dimpna Regional Hospital, Geel, Belgium
| | - Beatriz Abril
- Sleep disorder Unit, Carémeau Hospital, University Hospital of Nîmes, Nîmes, France
| | | | | | - Sonja W Scholz
- Neurodegenerative Diseases Research Unit, National Institute of Neurological Disorders and Stroke, Bethesda, MD, USA
- Department of Neurology, Johns Hopkins University Medical Center, Baltimore, MD, USA
| | - Mina Ryten
- Great Ormond Street Institute of Child Health, Genetics and Genomic Medicine, University College London, London, UK
- NIHR Great Ormond Street Hospital Biomedical Research Centre, University College London, London, UK
| | - Sara Bandres-Ciga
- Laboratory of Neurogenetics, National Institute on Aging, National Institutes of Health, Bethesda, MD, USA
| | - Alastair Noyce
- Preventive Neurology Unit, Wolfson Institute of Preventive Medicine, Queen Mary University of London, London, UK
- Department of Clinical and Movement Neurosciences, University College London, Institute of Neurology, London, UK
| | | | - Lasse Pihlstrøm
- Department of Neurology, Oslo University Hospital, Oslo, Norway
| | - Mike A Nalls
- Data Tecnica International, Glen Echo, MD, USA
- Center for Alzheimer's and Related Dementias, National Institutes of Health, Bethesda, MD, USA
| | - Andrew B Singleton
- Laboratory of Neurogenetics, National Institute on Aging, National Institutes of Health, Bethesda, MD, USA
- Center for Alzheimer's and Related Dementias, National Institutes of Health, Bethesda, MD, USA
| | - Guy A Rouleau
- Department of Human Genetics, McGill University, Montréal, QC, Canada
- The Neuro (Montreal Neurological Institute-Hospital), McGill University, Montréal, QC, Canada
- Department of Neurology and Neurosurgery, McGill University, Montreal, QC, Canada
| | - Ronald B Postuma
- The Neuro (Montreal Neurological Institute-Hospital), McGill University, Montréal, QC, Canada
- Department of Neurology and Neurosurgery, McGill University, Montreal, QC, Canada
| | - Ziv Gan-Or
- Department of Human Genetics, McGill University, Montréal, QC, Canada.
- The Neuro (Montreal Neurological Institute-Hospital), McGill University, Montréal, QC, Canada.
- Department of Neurology and Neurosurgery, McGill University, Montreal, QC, Canada.
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Rahayel S, Tremblay C, Vo A, Lehéricy S, Arnulf I, Vidailhet M, Corvol JC, Study Group I, Gagnon JF, Postuma R, Montplaisir J, Lewis S, Matar E, Ehgoetz Martens K, Borghammer P, Knudsen K, Monchi O, Misic B, Dagher A. Brain atrophy in REM sleep behavior disorder is shaped by gene expression and structural connectivity. Sleep Med 2022. [DOI: 10.1016/j.sleep.2022.05.603] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Dauvilliers Y, Bogan RK, Arnulf I, Scammell TE, St Louis EK, Thorpy MJ. Clinical considerations for the diagnosis of idiopathic hypersomnia. Sleep Med Rev 2022; 66:101709. [PMID: 36401976 DOI: 10.1016/j.smrv.2022.101709] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Revised: 09/19/2022] [Accepted: 10/14/2022] [Indexed: 11/06/2022]
Abstract
Idiopathic hypersomnia is a sleep disorder of neurologic origin characterized by excessive daytime sleepiness, with sleep inertia, long, unrefreshing naps, and prolonged nighttime sleep being key symptoms in many patients. Idiopathic hypersomnia is described in the International Classification of Sleep Disorders, 3rd Edition as a central disorder of hypersomnolence with distinct clinical features and diagnostic criteria; however, confirming the diagnosis of idiopathic hypersomnia is often challenging. Diagnosis of idiopathic hypersomnia is based on objective sleep testing and the presence of associated clinical features but may be difficult for clinicians to recognize and correctly diagnose because of its low prevalence, clinical heterogeneity, and symptoms, which are similar to those of other sleep disorders. The testing required for diagnosis of idiopathic hypersomnia also presents logistical barriers, and reliability of objective sleep measures is suboptimal. The pathophysiology of idiopathic hypersomnia remains unknown. In this review, clinical considerations related to the pathogenesis, diagnosis, and management of idiopathic hypersomnia will be discussed, including perspectives from the European Union and United States.
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Affiliation(s)
- Yves Dauvilliers
- Sleep and Wake Disorders Centre, Department of Neurology, Gui de Chauliac Hospital, Montpellier, France; University of Montpellier, INSERM Institute Neuroscience Montpellier (INM), Montpellier, France.
| | - Richard K Bogan
- University of South Carolina School of Medicine, Columbia, SC, USA
| | - Isabelle Arnulf
- Sleep Disorder Unit, Pitié-Salpêtrière Hospital and Sorbonne University, Paris, France
| | | | - Erik K St Louis
- Mayo Center for Sleep Medicine, Mayo Clinic, Rochester, MN, USA
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Gaurav R, Nobileau A, Chougar L, Faucher A, Valabrègue R, Mangone G, Leu-Semenescu S, Lejeune FX, Corvol JC, Arnulf I, Vidailhet M, Grabli D, Degos B, Lehéricy S. Role of REM Sleep Behavior Disorder in Atypical Parkinsonism: A Locus Coeruleus-based Neuromelanin MRI Study. Sleep Med 2022. [DOI: 10.1016/j.sleep.2022.05.616] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Gaurav R, Valabrègue R, Yahia-Chérif L, Mangone G, Narayanan S, Arnulf I, Vidailhet M, Corvol JC, Lehéricy S. NigraNet: An automatic framework to assess nigral neuromelanin content in early Parkinson's disease using convolutional neural network. Neuroimage Clin 2022; 36:103250. [PMID: 36451356 PMCID: PMC9668659 DOI: 10.1016/j.nicl.2022.103250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Revised: 10/15/2022] [Accepted: 10/28/2022] [Indexed: 11/06/2022]
Abstract
BACKGROUND Parkinson's disease (PD) demonstrates neurodegenerative changes in the substantia nigra pars compacta (SNc) using neuromelanin-sensitive (NM)-MRI. As SNc manual segmentation is prone to substantial inter-individual variability across raters, development of a robust automatic segmentation framework is necessary to facilitate nigral neuromelanin quantification. Artificial intelligence (AI) is gaining traction in the neuroimaging community for automated brain region segmentation tasks using MRI. OBJECTIVE Developing and validating AI-based NigraNet, a fully automatic SNc segmentation framework allowing nigral neuromelanin quantification in patients with PD using NM-MRI. METHODS We prospectively included 199 participants comprising 144 early-stage idiopathic PD patients (disease duration = 1.5 ± 1.0 years) and 55 healthy volunteers (HV) scanned using a 3 Tesla MRI including whole brain T1-weighted anatomical imaging and NM-MRI. The regions of interest (ROI) were delineated in all participants automatically using NigraNet, a modified U-net, and compared to manual segmentations performed by two experienced raters. The SNc volumes (Vol), volumes corrected by total intracranial volume (Cvol), normalized signal intensity (NSI) and contrast-to-noise ratio (CNR) were computed. One-way GLM-ANCOVA was performed while adjusting for age and sex as covariates. Diagnostic performance measurement was assessed using the receiver operating characteristic (ROC) analysis. Inter and intra-observer variability were estimated using Dice similarity coefficient (DSC). The agreements between methods were tested using intraclass correlation coefficient (ICC) based on a mean-rating, two-way, mixed-effects model estimates for absolute agreement. Cronbach's alpha and Bland-Altman plots were estimated to assess inter-method consistency. RESULTS Using both methods, Vol, Cvol, NSI and CNR measurements differed between PD and HV with an effect of sex for Cvol and CNR. ICC values between the methods demonstrated optimal agreement for Cvol and CNR (ICC > 0.9) and high reproducibility (DSC: 0.80) was also obtained. The SNc measurements also showed good to excellent consistency values (Cronbach's alpha > 0.87). Bland-Altman plots of agreement demonstrated no association of SNc ROI measurement differences between the methods and ROI average measurements while confirming that 95 % of the data points were ranging between the limits of mean difference (d ± 1.96xSD). Percentage changes between PD and HV were -27.4 % and -17.7 % for Vol, -30.0 % and -22.2 % for Cvol, -15.8 % and -14.4 % for NSI, -17.1 % and -16.0 % for CNR for automatic and manual measurements respectively. Using automatic method, in the entire dataset, we obtained the areas under the ROC curve (AUC) of 0.83 for Vol, 0.85 for Cvol, 0.79 for NSI and 0.77 for CNR whereas in the training dataset of 0.96 for Vol, 0.95 for Cvol, 0.85 for NSI and 0.85 for CNR. Disease duration correlated negatively with NSI of the patients for both the automatic and manual measurements. CONCLUSIONS We presented an AI-based NigraNet framework that utilizes a small MRI training dataset to fully automatize the SNc segmentation procedure with an increased precision and more reproducible results. Considering the consistency, accuracy and speed of our approach, this study could be a crucial step towards the implementation of a time-saving non-rater dependent fully automatic method for studying neuromelanin changes in clinical settings and large-scale neuroimaging studies.
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Affiliation(s)
- Rahul Gaurav
- Paris Brain Institute – ICM, Sorbonne University, UPMC Univ Paris 06, INSERM U1127, CNRS UMR 7225, Pitié-Salpêtrière Hospital, Paris, France,Movement Investigations and Therapeutics Team (MOV’IT), ICM, Paris, France,Center for NeuroImaging Research – CENIR, ICM, Paris, France,Corresponding author at: Centre de NeuroImagerie de Recherche – CENIR, Institut du Cerveau – ICM, Hôpital Pitié-Salpêtrière, 47 Boulevard de l’Hôpital, 75013 Paris, France.
| | - Romain Valabrègue
- Paris Brain Institute – ICM, Sorbonne University, UPMC Univ Paris 06, INSERM U1127, CNRS UMR 7225, Pitié-Salpêtrière Hospital, Paris, France,Center for NeuroImaging Research – CENIR, ICM, Paris, France
| | - Lydia Yahia-Chérif
- Paris Brain Institute – ICM, Sorbonne University, UPMC Univ Paris 06, INSERM U1127, CNRS UMR 7225, Pitié-Salpêtrière Hospital, Paris, France,Center for NeuroImaging Research – CENIR, ICM, Paris, France
| | - Graziella Mangone
- Paris Brain Institute – ICM, Sorbonne University, UPMC Univ Paris 06, INSERM U1127, CNRS UMR 7225, Pitié-Salpêtrière Hospital, Paris, France,INSERM, Clinical Investigation Center for Neurosciences (CIC), Pitié-Salpêtrière Hospital, Paris, France
| | - Sridar Narayanan
- McConnell Brain Imaging Centre, Montreal Neurological Institute, McGill University, 3801 University Street, Montreal, Quebec, H3A 2B4, Canada
| | - Isabelle Arnulf
- Paris Brain Institute – ICM, Sorbonne University, UPMC Univ Paris 06, INSERM U1127, CNRS UMR 7225, Pitié-Salpêtrière Hospital, Paris, France,Movement Investigations and Therapeutics Team (MOV’IT), ICM, Paris, France,Sleep Disorders Unit, Pitié-Salpêtrière Hospital, AP-HP, Paris, France
| | - Marie Vidailhet
- Paris Brain Institute – ICM, Sorbonne University, UPMC Univ Paris 06, INSERM U1127, CNRS UMR 7225, Pitié-Salpêtrière Hospital, Paris, France,Movement Investigations and Therapeutics Team (MOV’IT), ICM, Paris, France,Department of Neurology, Pitié-Salpêtrière Hospital, AP-HP, Paris, France
| | - Jean-Christophe Corvol
- Paris Brain Institute – ICM, Sorbonne University, UPMC Univ Paris 06, INSERM U1127, CNRS UMR 7225, Pitié-Salpêtrière Hospital, Paris, France,INSERM, Clinical Investigation Center for Neurosciences (CIC), Pitié-Salpêtrière Hospital, Paris, France,Department of Neurology, Pitié-Salpêtrière Hospital, AP-HP, Paris, France
| | - Stéphane Lehéricy
- Paris Brain Institute – ICM, Sorbonne University, UPMC Univ Paris 06, INSERM U1127, CNRS UMR 7225, Pitié-Salpêtrière Hospital, Paris, France,Movement Investigations and Therapeutics Team (MOV’IT), ICM, Paris, France,Center for NeuroImaging Research – CENIR, ICM, Paris, France,Department of Neuroradiology, Pitié-Salpêtrière Hospital, AP-HP, Paris, France
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Dubessy AL, Stankoff B, Arnulf I. Author Response: Association of Central Hypersomnia and Fatigue in Patients With Multiple Sclerosis: A Polysomnographic Study. Neurology 2022; 99:727. [PMID: 36253130 DOI: 10.1212/wnl.0000000000201357] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/16/2023] Open
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Lacaux C, Andrillon T, Arnulf I, Oudiette D. Memory loss at sleep onset. Cereb Cortex Commun 2022; 3:tgac042. [PMID: 36415306 PMCID: PMC9677600 DOI: 10.1093/texcom/tgac042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Revised: 10/21/2022] [Accepted: 10/26/2022] [Indexed: 11/22/2022] Open
Abstract
Every night, we pass through a transitory zone at the borderland between wakefulness and sleep, named the first stage of nonrapid eye movement sleep (N1). N1 sleep is associated with increased hippocampal activity and dream-like experiences that incorporate recent wake materials, suggesting that it may be associated with memory processing. Here, we investigated the specific contribution of N1 sleep in the processing of memory traces. Participants were asked to learn the precise locations of 48 objects on a grid and were then tested on their memory for these items before and after a 30-min rest during which participants either stayed fully awake or transitioned toward N1 or deeper (N2) sleep. We showed that memory recall was lower (10% forgetting) after a resting period, including only N1 sleep compared to N2 sleep. Furthermore, the ratio of alpha/theta power (an electroencephalography marker of the transition toward sleep) correlated negatively with the forgetting rate when taking into account all sleepers (N1 and N2 groups combined), suggesting a physiological index for memory loss that transcends sleep stages. Our findings suggest that interrupting sleep onset at N1 may alter sleep-dependent memory consolidation and promote forgetting.
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Affiliation(s)
- Célia Lacaux
- Sorbonne Université, Institut du Cerveau - Paris Brain Institute - ICM, Mov'it team, Inserm, CNRS, 47-83 boulevard de l'Hôpital , Paris 75013 , France
| | - Thomas Andrillon
- Sorbonne Université, Institut du Cerveau - Paris Brain Institute - ICM, Mov'it team, Inserm, CNRS, 47-83 boulevard de l'Hôpital , Paris 75013 , France
| | - Isabelle Arnulf
- Sorbonne Université, Institut du Cerveau - Paris Brain Institute - ICM, Mov'it team, Inserm, CNRS, 47-83 boulevard de l'Hôpital , Paris 75013 , France
- AP-HP, Hôpital Pitié-Salpêtrière, Service des Pathologies du Sommeil, National Reference Centre for Narcolepsy , 47-83 boulevard de l'Hôpital, Paris 75013 , France
| | - Delphine Oudiette
- Sorbonne Université, Institut du Cerveau - Paris Brain Institute - ICM, Mov'it team, Inserm, CNRS, 47-83 boulevard de l'Hôpital , Paris 75013 , France
- AP-HP, Hôpital Pitié-Salpêtrière, Service des Pathologies du Sommeil, National Reference Centre for Narcolepsy , 47-83 boulevard de l'Hôpital, Paris 75013 , France
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43
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Mangone G, Houot M, Gaurav R, Boluda S, Pyatigorskaya N, Chalancon A, Seilhean D, Prigent A, Lehéricy S, Arnulf I, Corvol JC, Vidailhet M, Duyckaerts C, Degos B. Relationship between Substantia Nigra Neuromelanin Imaging and Dual Alpha-Synuclein Labeling of Labial Minor in Salivary Glands in Isolated Rapid Eye Movement Sleep Behavior Disorder and Parkinson's Disease. Genes (Basel) 2022; 13:1715. [PMID: 36292600 PMCID: PMC9601642 DOI: 10.3390/genes13101715] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Revised: 09/16/2022] [Accepted: 09/21/2022] [Indexed: 08/27/2023] Open
Abstract
We investigated the presence of misfolded alpha-Synuclein (α-Syn) in minor salivary gland biopsies in relation to substantia nigra pars compacta (SNc) damage measured using magnetic resonance imaging in patients with isolated rapid eye movement sleep behavior disorder (iRBD) and Parkinson's disease (PD) as compared to healthy controls. Sixty-one participants (27 PD, 16 iRBD, and 18 controls) underwent a minor salivary gland biopsy and were scanned using a 3 Tesla MRI. Deposits of α-Syn were found in 15 (55.6%) PD, 7 (43.8%) iRBD, and 7 (38.9%) controls using the anti-aggregated α-Syn clone 5G4 antibody and in 4 (14.8%) PD, 3 (18.8%) iRBD and no control using the purified mouse anti-α-Syn clone 42 antibody. The SNc damages obtained using neuromelanin-sensitive imaging did not differ between the participants with versus without α-Syn deposits (irrespective of the antibodies and the disease group). Our study indicated that the α-Syn detection in minor salivary gland biopsies lacks sensitivity and specificity and does not correlate with the SNc damage, suggesting that it cannot be used as a predictive or effective biomarker for PD.
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Affiliation(s)
- Graziella Mangone
- Centre National de la Recherche Scientifique CNRS, Institut National de la Santé Et de la Recherche Médicale INSERM, Institut du Cerveau ICM, Sorbonne Université, 47-83 Bd de l’Hôpital, 75013 Paris, France
- Clinical Investigation Center for Neurosciences, Department of Neurology, Assistance Publique Hôpitaux de Paris, Pitié-Salpêtrière Hospital, 47-83 Bd de l’Hôpital, 75013 Paris, France
| | - Marion Houot
- Centre National de la Recherche Scientifique CNRS, Institut National de la Santé Et de la Recherche Médicale INSERM, Institut du Cerveau ICM, Sorbonne Université, 47-83 Bd de l’Hôpital, 75013 Paris, France
- Centre of Excellence of Neurodegenerative Disease (CoEN), AP-HP, Pitié-Salpêtrière Hospital, 47-83 Bd de l’Hôpital, 75013 Paris, France
- Department of Neurology, Institute of Memory and Alzheimer’s Disease (IM2A), AP-HP, Pitié-Salpêtrière Hospital, 47-83 Bd de l’Hôpital, 75013 Paris, France
| | - Rahul Gaurav
- Centre National de la Recherche Scientifique CNRS, Institut National de la Santé Et de la Recherche Médicale INSERM, Institut du Cerveau ICM, Sorbonne Université, 47-83 Bd de l’Hôpital, 75013 Paris, France
- Centre de NeuroImagerie de Recherche CENIR, Institut du Cerveau ICM, 47-83 Bd de l’Hôpital, 75013 Paris, France
- Institut du Cerveau-ICM, Team “Movement Investigations and Therapeutics” (MOV’IT), 47-83 Bd de l’Hôpital, 75013 Paris, France
| | - Susana Boluda
- Centre National de la Recherche Scientifique CNRS, Institut National de la Santé Et de la Recherche Médicale INSERM, Institut du Cerveau ICM, Sorbonne Université, 47-83 Bd de l’Hôpital, 75013 Paris, France
- Department of Neuropathology, Assistance Publique Hôpitaux de Paris, Pitié-Salpêtrière Hospital, 47-83 Bd de l’Hôpital, 75013 Paris, France
| | - Nadya Pyatigorskaya
- Centre National de la Recherche Scientifique CNRS, Institut National de la Santé Et de la Recherche Médicale INSERM, Institut du Cerveau ICM, Sorbonne Université, 47-83 Bd de l’Hôpital, 75013 Paris, France
- Centre de NeuroImagerie de Recherche CENIR, Institut du Cerveau ICM, 47-83 Bd de l’Hôpital, 75013 Paris, France
- Institut du Cerveau-ICM, Team “Movement Investigations and Therapeutics” (MOV’IT), 47-83 Bd de l’Hôpital, 75013 Paris, France
| | - Alizé Chalancon
- Centre National de la Recherche Scientifique CNRS, Institut National de la Santé Et de la Recherche Médicale INSERM, Institut du Cerveau ICM, Sorbonne Université, 47-83 Bd de l’Hôpital, 75013 Paris, France
- Clinical Investigation Center for Neurosciences, Department of Neurology, Assistance Publique Hôpitaux de Paris, Pitié-Salpêtrière Hospital, 47-83 Bd de l’Hôpital, 75013 Paris, France
| | - Danielle Seilhean
- Centre National de la Recherche Scientifique CNRS, Institut National de la Santé Et de la Recherche Médicale INSERM, Institut du Cerveau ICM, Sorbonne Université, 47-83 Bd de l’Hôpital, 75013 Paris, France
- Department of Neuropathology, Assistance Publique Hôpitaux de Paris, Pitié-Salpêtrière Hospital, 47-83 Bd de l’Hôpital, 75013 Paris, France
| | - Annick Prigent
- HYSTOMICS Platform, Centre National de la Recherche Scientifique-CNRS, Institut National de la Santé Et de la Recherche Médicale-INSERM, Institut du Cerveau-ICM, Sorbonne Université, 47-83 Bd de l’Hôpital, 75013 Paris, France
| | - Stéphane Lehéricy
- Centre National de la Recherche Scientifique CNRS, Institut National de la Santé Et de la Recherche Médicale INSERM, Institut du Cerveau ICM, Sorbonne Université, 47-83 Bd de l’Hôpital, 75013 Paris, France
- Centre de NeuroImagerie de Recherche CENIR, Institut du Cerveau ICM, 47-83 Bd de l’Hôpital, 75013 Paris, France
- Institut du Cerveau-ICM, Team “Movement Investigations and Therapeutics” (MOV’IT), 47-83 Bd de l’Hôpital, 75013 Paris, France
| | - Isabelle Arnulf
- Centre National de la Recherche Scientifique CNRS, Institut National de la Santé Et de la Recherche Médicale INSERM, Institut du Cerveau ICM, Sorbonne Université, 47-83 Bd de l’Hôpital, 75013 Paris, France
- Sleep Disorders Unit, Assistance Publique Hôpitaux de Paris, Pitié-Salpêtrière Hospital, 47-83 Bd de l’Hôpital, 75013 Paris, France
| | - Jean-Christophe Corvol
- Centre National de la Recherche Scientifique CNRS, Institut National de la Santé Et de la Recherche Médicale INSERM, Institut du Cerveau ICM, Sorbonne Université, 47-83 Bd de l’Hôpital, 75013 Paris, France
- Clinical Investigation Center for Neurosciences, Department of Neurology, Assistance Publique Hôpitaux de Paris, Pitié-Salpêtrière Hospital, 47-83 Bd de l’Hôpital, 75013 Paris, France
| | - Marie Vidailhet
- Centre National de la Recherche Scientifique CNRS, Institut National de la Santé Et de la Recherche Médicale INSERM, Institut du Cerveau ICM, Sorbonne Université, 47-83 Bd de l’Hôpital, 75013 Paris, France
- Clinical Investigation Center for Neurosciences, Department of Neurology, Assistance Publique Hôpitaux de Paris, Pitié-Salpêtrière Hospital, 47-83 Bd de l’Hôpital, 75013 Paris, France
- Institut du Cerveau-ICM, Team “Movement Investigations and Therapeutics” (MOV’IT), 47-83 Bd de l’Hôpital, 75013 Paris, France
| | - Charles Duyckaerts
- Centre National de la Recherche Scientifique CNRS, Institut National de la Santé Et de la Recherche Médicale INSERM, Institut du Cerveau ICM, Sorbonne Université, 47-83 Bd de l’Hôpital, 75013 Paris, France
- Department of Neuropathology, Assistance Publique Hôpitaux de Paris, Pitié-Salpêtrière Hospital, 47-83 Bd de l’Hôpital, 75013 Paris, France
| | - Bertrand Degos
- Neurology Unit, Avicenne University Hospital, Hôpitaux Universitaires de Paris-Seine Saint Denis, Sorbonne Paris Nord, AP-HP, NS-PARK/FCRIN Network, 125 Route de Stalingrad, 93009 Bobigny, France
- Dynamics and Pathophysiology of Neuronal Networks Team, Center for Interdisciplinary Research in Biology, Collège de France, PSL University, 11 Place Marcelin Berthelot, 75005 Paris, France
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Hédou J, Cederberg KL, Ambati A, Lin L, Farber N, Dauvilliers Y, Quadri M, Bourgin P, Plazzi G, Andlauer O, Hong SC, Huang YS, Leu-Semenescu S, Arnulf I, Taheri S, Mignot E. Proteomic biomarkers of Kleine-Levin syndrome. Sleep 2022; 45:zsac097. [PMID: 35859339 PMCID: PMC9453623 DOI: 10.1093/sleep/zsac097] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2021] [Revised: 03/21/2022] [Indexed: 07/23/2023] Open
Abstract
STUDY OBJECTIVES Kleine-Levin syndrome (KLS) is characterized by relapsing-remitting episodes of hypersomnia, cognitive impairment, and behavioral disturbances. We quantified cerebrospinal fluid (CSF) and serum proteins in KLS cases and controls. METHODS SomaScan was used to profile 1133 CSF proteins in 30 KLS cases and 134 controls, while 1109 serum proteins were profiled in serum from 26 cases and 65 controls. CSF and serum proteins were both measured in seven cases. Univariate and multivariate analyses were used to find differentially expressed proteins (DEPs). Pathway and tissue enrichment analyses (TEAs) were performed on DEPs. RESULTS Univariate analyses found 28 and 141 proteins differentially expressed in CSF and serum, respectively (false discovery rate <0.1%). Upregulated CSF proteins included IL-34, IL-27, TGF-b, IGF-1, and osteonectin, while DKK4 and vWF were downregulated. Pathway analyses revealed microglial alterations and disrupted blood-brain barrier permeability. Serum profiles show upregulation of Src-family kinases (SFKs), proteins implicated in cellular growth, motility, and activation. TEA analysis of up- and downregulated proteins revealed changes in brain proteins (p < 6 × 10-5), notably from the pons, medulla, and midbrain. A multivariate machine-learning classifier performed robustly, achieving a receiver operating curve area under the curve of 0.90 (95% confidence interval [CI] = 0.78-1.0, p = 0.0006) in CSF and 1.0 (95% CI = 1.0-1.0, p = 0.0002) in serum in validation cohorts, with some commonality across tissues, as the model trained on serum sample also discriminated CSF samples of controls versus KLS cases. CONCLUSIONS Our study identifies proteomic KLS biomarkers with diagnostic potential and provides insight into biological mechanisms that will guide future research in KLS.
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Affiliation(s)
- Julien Hédou
- Department of Psychiatry and Behavioral Sciences, Center for Sleep Sciences and Medicine, Stanford University, Palo Alto, CA, USA
| | - Katie L Cederberg
- Department of Psychiatry and Behavioral Sciences, Center for Sleep Sciences and Medicine, Stanford University, Palo Alto, CA, USA
| | - Aditya Ambati
- Department of Psychiatry and Behavioral Sciences, Center for Sleep Sciences and Medicine, Stanford University, Palo Alto, CA, USA
| | - Ling Lin
- Department of Psychiatry and Behavioral Sciences, Center for Sleep Sciences and Medicine, Stanford University, Palo Alto, CA, USA
| | - Neal Farber
- Kleine-Levin Syndrome Foundation, Boston, MA, USA
| | - Yves Dauvilliers
- National Reference Centre for Orphan Diseases, Narcolepsy-Rare Hypersomnias, Sleep Unit, Department of Neurology, CHU Montpellier, Univ Montpellier, Montpellier, France
- Department of Neurology, Institute for Neurosciences of Montpellier INM, Univ Montpellier, INSERM, Montpellier, France
| | | | - Patrice Bourgin
- Sleep Disorders Center, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | - Giuseppe Plazzi
- Department of Biomedical and Neuromotor Sciences, University of Bologna and IRCCS Institute of Neurological Sciences, Bologna, Italy
| | | | - Seung-Chul Hong
- Department of Psychiatry, St. Vincent’s Hospital, Catholic University of Korea, Seoul, South Korea
| | - Yu-Shu Huang
- Department of Child Psychiatry and Sleep Center, Chang Gung Memorial Hospital and University, Taoyuan, Taiwan
| | - Smaranda Leu-Semenescu
- Sleep Disorders, Pitié-Salpêtrière Hospital, Assistance Publique-Hôpitaux de Paris-Sorbonne, National Reference Center for Narcolepsy, Idiopathic Hypersomnia and Kleine-Levin Syndrome, Paris, France
| | - Isabelle Arnulf
- Sleep Disorders, Pitié-Salpêtrière Hospital, Assistance Publique-Hôpitaux de Paris-Sorbonne, National Reference Center for Narcolepsy, Idiopathic Hypersomnia and Kleine-Levin Syndrome, Paris, France
- Sorbonne University, Institut Hospitalo-Universitaire, Institut du Cerveau et de la Moelle, Paris, France
| | - Shahrad Taheri
- Department of Medicine and Clinical Research Core, Weill Cornell Medicine—Qatar, Qatar Foundation—Education City, Doha, Qatar
| | - Emmanuel Mignot
- Corresponding author. Emmanuel Mignot, Center for Narcolepsy and Related Disorders, Stanford University, 3165 Porter Drive, Palo Alto, CA 94305, USA.
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45
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Abstract
Idiopathic hypersomnia (IH) includes a clinical phenotype resembling narcolepsy (with repeated, short restorative naps), and a phenotype with an excess of sleep, sleep drunkenness, drowsiness, and infrequent long, nonrestorative naps. Sleep tests reflect this heterogeneity. MSLTs are greater than 8 min in 2/3 of the cases and poorly repeatable. Sleep excess is better captured by extended monitoring identifying 11 to 16h of sleep/24 h. Patients with IH are young and more often female. Possible mechanisms of IH include deficiencies in arousal systems, inappropriate stimulation of sleep-inducing systems, and long biological night. Treatments now include robust studies of modafinil, clarithromycin, and sodium oxybate.
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Affiliation(s)
- Isabelle Arnulf
- Service des pathologies du sommeil, Hopital Pitie-Salpetriere, 83 boulevard de l'Hopital, Paris 75013, France; Sorbonne University, Paris, France.
| | - Smaranda Leu-Semenescu
- Service des pathologies du sommeil, Hopital Pitie-Salpetriere, 83 boulevard de l'Hopital, Paris 75013, France
| | - Pauline Dodet
- Service des pathologies du sommeil, Hopital Pitie-Salpetriere, 83 boulevard de l'Hopital, Paris 75013, France
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46
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Rahayel S, Tremblay C, Vo A, Zheng YQ, Lehéricy S, Arnulf I, Vidailhet M, Corvol JC, Gagnon JF, Postuma RB, Montplaisir J, Lewis S, Matar E, Ehgoetz Martens K, Borghammer P, Knudsen K, Hansen A, Monchi O, Misic B, Dagher A. Brain atrophy in prodromal synucleinopathy is shaped by structural connectivity and gene expression. Brain 2022; 145:3162-3178. [PMID: 35594873 DOI: 10.1093/brain/awac187] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Revised: 05/06/2022] [Accepted: 05/12/2022] [Indexed: 11/14/2022] Open
Abstract
Isolated REM sleep behaviour disorder (iRBD) is a synucleinopathy characterized by abnormal behaviours and vocalizations during REM sleep. Most iRBD patients develop dementia with Lewy bodies, Parkinson's disease, or multiple system atrophy over time. Patients with iRBD exhibit brain atrophy patterns that are reminiscent of those observed in overt synucleinopathies. However, the mechanisms linking brain atrophy to the underlying alpha-synuclein pathophysiology are poorly understood. Our objective was to investigate how the prion-like and regional vulnerability hypotheses of alpha-synuclein might explain brain atrophy in iRBD. Using a multicentric cohort of 182 polysomnography-confirmed iRBD patients who underwent T1-weighted MRI, we performed vertex-based cortical surface and deformation-based morphometry analyses to quantify brain atrophy in patients (67.8 years, 84% men) and 261 healthy controls (66.2 years, 75%) and investigated the morphological correlates of motor and cognitive functioning in iRBD. Next, we applied the agent-based Susceptible-Infected-Removed model (i.e., a computational model that simulates in silico the spread of pathologic alpha-synuclein based on structural connectivity and gene expression) and tested if it recreated atrophy in iRBD by statistically comparing simulated regional brain atrophy to the atrophy observed in patients. The impact of SNCA and GBA gene expression and brain connectivity was then evaluated by comparing the model fit to the one obtained in null models where either gene expression or connectivity was randomized. The results showed that iRBD patients present with cortical thinning and tissue deformation, which correlated with motor and cognitive functioning. Next, we found that the computational model recreated cortical thinning (r = 0.51, p = 0.0007) and tissue deformation (r = 0.52, p = 0.0005) in patients, and that the connectome's architecture along with SNCA and GBA gene expression contributed to shaping atrophy in iRBD. We further demonstrated that the full agent-based model performed better than network measures or gene expression alone in recreating the atrophy pattern in iRBD. In summary, atrophy in iRBD is extensive, correlates with motor and cognitive function, and can be recreated using the dynamics of agent-based modelling, structural connectivity, and gene expression. These findings support the concepts that both prion-like spread and regional susceptibility account for the atrophy observed in prodromal synucleinopathies. Therefore, the agent-based Susceptible-Infected-Removed model may be a useful tool for testing hypotheses underlying neurodegenerative diseases and new therapies aimed at slowing or stopping the spread of alpha-synuclein pathology.
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Affiliation(s)
- Shady Rahayel
- The Neuro (Montreal Neurological Institute-Hospital), McGill University, Montreal H3A 2B4, Canada.,Centre for Advanced Research in Sleep Medicine, Hôpital du Sacré-Cœur de Montréal, Montreal H4J 1C5, Montreal, Canada
| | - Christina Tremblay
- The Neuro (Montreal Neurological Institute-Hospital), McGill University, Montreal H3A 2B4, Canada
| | - Andrew Vo
- The Neuro (Montreal Neurological Institute-Hospital), McGill University, Montreal H3A 2B4, Canada
| | - Ying-Qiu Zheng
- Wellcome Centre for Integrative Neuroimaging, Centre for Functional Magnetic Resonance Imaging of the Brain, University of Oxford, John Radcliffe Hospital, Oxford OX3 9DU, United Kingdom
| | - Stéphane Lehéricy
- Sorbonne Université, Institut du Cerveau - Paris Brain Institute - ICM, INSERM, CNRS, Assistance Publique Hôpitaux de Paris, Pitié-Salpêtrière Hospital, Paris 75013, France
| | - Isabelle Arnulf
- Sorbonne Université, Institut du Cerveau - Paris Brain Institute - ICM, INSERM, CNRS, Assistance Publique Hôpitaux de Paris, Pitié-Salpêtrière Hospital, Paris 75013, France
| | - Marie Vidailhet
- Sorbonne Université, Institut du Cerveau - Paris Brain Institute - ICM, INSERM, CNRS, Assistance Publique Hôpitaux de Paris, Pitié-Salpêtrière Hospital, Paris 75013, France
| | - Jean-Christophe Corvol
- Sorbonne Université, Institut du Cerveau - Paris Brain Institute - ICM, INSERM, CNRS, Assistance Publique Hôpitaux de Paris, Pitié-Salpêtrière Hospital, Paris 75013, France
| | | | - Jean-François Gagnon
- Centre for Advanced Research in Sleep Medicine, Hôpital du Sacré-Cœur de Montréal, Montreal H4J 1C5, Montreal, Canada.,Department of Psychology, Université du Québec à Montréal, Montreal H2X 3P2, Canada.,Research Centre, Institut universitaire de gériatrie de Montréal, Montreal H3W 1W5, Canada
| | - Ronald B Postuma
- Centre for Advanced Research in Sleep Medicine, Hôpital du Sacré-Cœur de Montréal, Montreal H4J 1C5, Montreal, Canada.,Department of Neurology, Montreal General Hospital, Montreal H3G 1A4, Canada
| | - Jacques Montplaisir
- Centre for Advanced Research in Sleep Medicine, Hôpital du Sacré-Cœur de Montréal, Montreal H4J 1C5, Montreal, Canada.,Department of Psychiatry, Université de Montréal, Montreal H3 T 1J4, Canada
| | - Simon Lewis
- ForeFront Parkinson's Disease Research Clinic, Brain and Mind Centre, University of Sydney, Camperdown NSW 2050, Australia
| | - Elie Matar
- ForeFront Parkinson's Disease Research Clinic, Brain and Mind Centre, University of Sydney, Camperdown NSW 2050, Australia
| | - Kaylena Ehgoetz Martens
- ForeFront Parkinson's Disease Research Clinic, Brain and Mind Centre, University of Sydney, Camperdown NSW 2050, Australia.,Department of Kinesiology and Health Sciences, University of Waterloo, Waterloo N2L 3G1, Canada
| | - Per Borghammer
- Department of Nuclear Medicine and PET, Aarhus University Hospital, Aarhus DK-8200, Denmark
| | - Karoline Knudsen
- Department of Nuclear Medicine and PET, Aarhus University Hospital, Aarhus DK-8200, Denmark
| | - Allan Hansen
- Department of Nuclear Medicine and PET, Aarhus University Hospital, Aarhus DK-8200, Denmark
| | - Oury Monchi
- Research Centre, Institut universitaire de gériatrie de Montréal, Montreal H3W 1W5, Canada.,Departments of Clinical Neurosciences, Radiology, and Hotchkiss Brain Institute, University of Calgary, Calgary T2N 4N1, Canada
| | - Bratislav Misic
- The Neuro (Montreal Neurological Institute-Hospital), McGill University, Montreal H3A 2B4, Canada
| | - Alain Dagher
- The Neuro (Montreal Neurological Institute-Hospital), McGill University, Montreal H3A 2B4, Canada
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47
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De Cock VC, Dodet P, Leu-Semenescu S, Aerts C, Castelnovo G, Abril B, Drapier S, Olivet H, Corbillé AG, Leclair-Visonneau L, Sallansonnet-Froment M, Lebouteux M, Anheim M, Ruppert E, Vitello N, Eusebio A, Lambert I, Marques A, Fantini ML, Devos D, Monaca C, Benard-Serre N, Lacombe S, Vidailhet M, Arnulf I, Doulazmi M, Roze E. Safety and efficacy of subcutaneous night-time only apomorphine infusion to treat insomnia in patients with Parkinson's disease (APOMORPHEE): a multicentre, randomised, controlled, double-blind crossover study. Lancet Neurol 2022; 21:428-437. [DOI: 10.1016/s1474-4422(22)00085-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Revised: 02/15/2022] [Accepted: 02/21/2022] [Indexed: 12/13/2022]
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48
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Sosero YL, Yu E, Estiar MA, Krohn L, Mufti K, Rudakou U, Ruskey JA, Asayesh F, Laurent SB, Spiegelman D, Trempe JF, Quinnell TG, Oscroft N, Arnulf I, Montplaisir JY, Gagnon JF, Desautels A, Dauvilliers Y, Gigli GL, Valente M, Janes F, Bernardini A, Sonka K, Kemlink D, Oertel W, Janzen A, Plazzi G, Antelmi E, Biscarini F, Figorilli M, Puligheddu M, Mollenhauer B, Trenkwalder C, Sixel-Döring F, Cochen De Cock V, Monaca CC, Heidbreder A, Ferini-Strambi L, Dijkstra F, Viaene M, Abril B, Boeve BF, Postuma RB, Rouleau GA, Ibrahim A, Stefani A, Högl B, Hu MTM, Gan-Or Z. Rare PSAP Variants and Possible Interaction with GBA in REM Sleep Behavior Disorder. J Parkinsons Dis 2022; 12:333-340. [PMID: 34690151 DOI: 10.3233/jpd-212867] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND PSAP encodes saposin C, the co-activator of glucocerebrosidase, encoded by GBA. GBA mutations are associated with idiopathic/isolated REM sleep behavior disorder (iRBD), a prodromal stage of synucleinopathy. OBJECTIVE To examine the role of PSAP mutations in iRBD. METHODS We fully sequenced PSAP and performed Optimized Sequence Kernel Association Test in 1,113 iRBD patients and 2,324 controls. We identified loss-of-function (LoF) mutations, which are very rare in PSAP, in three iRBD patients and none in controls (uncorrected p = 0.018). RESULTS Two variants were stop mutations, p.Gln260Ter and p.Glu166Ter, and one was an in-frame deletion, p.332_333del. All three mutations have a deleterious effect on saposin C, based on in silico analysis. In addition, the two carriers of p.Glu166Ter and p.332_333del mutations also carried a GBA variant, p.Arg349Ter and p.Glu326Lys, respectively. The co-occurrence of these extremely rare PSAP LoF mutations in two (0.2%) GBA variant carriers in the iRBD cohort, is unlikely to occur by chance (estimated co-occurrence in the general population based on gnomAD data is 0.00035%). Although none of the three iRBD patients with PSAP LoF mutations have phenoconverted to an overt synucleinopathy at their last follow-up, all manifested initial signs suggestive of motor dysfunction, two were diagnosed with mild cognitive impairment and all showed prodromal clinical markers other than RBD. Their probability of prodromal PD, according to the Movement Disorder Society research criteria, was 98% or more. CONCLUSION These results suggest a possible role of PSAP variants in iRBD and potential genetic interaction with GBA, which requires additional studies.
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Affiliation(s)
- Yuri L Sosero
- Department of Human Genetics, McGill University, Montréal, QC, Canada.,Montreal Neurological Institute, McGill University, Montréal, QC, Canada
| | - Eric Yu
- Department of Human Genetics, McGill University, Montréal, QC, Canada.,Montreal Neurological Institute, McGill University, Montréal, QC, Canada
| | - Mehrdad A Estiar
- Department of Human Genetics, McGill University, Montréal, QC, Canada.,Montreal Neurological Institute, McGill University, Montréal, QC, Canada
| | - Lynne Krohn
- Department of Human Genetics, McGill University, Montréal, QC, Canada.,Montreal Neurological Institute, McGill University, Montréal, QC, Canada
| | - Kheireddin Mufti
- Department of Human Genetics, McGill University, Montréal, QC, Canada.,Montreal Neurological Institute, McGill University, Montréal, QC, Canada
| | - Uladzislau Rudakou
- Department of Human Genetics, McGill University, Montréal, QC, Canada.,Montreal Neurological Institute, McGill University, Montréal, QC, Canada
| | - Jennifer A Ruskey
- Montreal Neurological Institute, McGill University, Montréal, QC, Canada.,Department of Neurology and Neurosurgery, McGill University, Montréal, QC, Canada
| | - Farnaz Asayesh
- Montreal Neurological Institute, McGill University, Montréal, QC, Canada.,Department of Neurology and Neurosurgery, McGill University, Montréal, QC, Canada
| | - Sandra B Laurent
- Montreal Neurological Institute, McGill University, Montréal, QC, Canada.,Department of Neurology and Neurosurgery, McGill University, Montréal, QC, Canada
| | - Dan Spiegelman
- Montreal Neurological Institute, McGill University, Montréal, QC, Canada.,Department of Neurology and Neurosurgery, McGill University, Montréal, QC, Canada
| | - Jean-François Trempe
- Department of Pharmacology & Therapeutics and Centre de Recherche en Biologie Structurale, McGill University, Montréal, Québec, Canada
| | | | | | - Isabelle Arnulf
- Sleep Disorders Unit, Sorbonne University, Institut du Cerveau - Paris Brain Institute - ICM, Inserm, CNRS, AP-HP, Hôpital de la Pitié Salpêtrière, Paris, France
| | - Jacques Y Montplaisir
- Centre d'Études Avancées en Médecine du Sommeil, Hôpital du Sacré-Coeur de Montréal, Montréal, QC, Canada.,Department of Psychiatry, Université de Montréal, Montréal, QC, Canada
| | - Jean-François Gagnon
- Centre d'Études Avancées en Médecine du Sommeil, Hôpital du Sacré-Coeur de Montréal, Montréal, QC, Canada.,Department of Psychology, Université du Québec à Montréal, Montréal, QC, Canada
| | - Alex Desautels
- Centre d'Études Avancées en Médecine du Sommeil, Hôpital du Sacré-Coeur de Montréal, Montréal, QC, Canada.,Department of Neurosciences, Université de Montréal, Montréal, QC, Canada
| | - Yves Dauvilliers
- National Reference Centre for Orphan Diseases, Narcolepsy- Rare hypersomnias, Sleep Unit, Department of Neurology, CHU Montpellier, Institute for Neurosciences of Montpellier INM, Univ Montpellier, INSERM, Montpellier, France
| | - Gian Luigi Gigli
- Department of Neurosciences, Clinical Neurology Unit, University Hospital of Udine, Udine, Italy.,Department of Medicine (DAME), University of Udine, Udine, Italy
| | - Mariarosaria Valente
- Department of Neurosciences, Clinical Neurology Unit, University Hospital of Udine, Udine, Italy.,Department of Medicine (DAME), University of Udine, Udine, Italy
| | - Francesco Janes
- Department of Neurosciences, Clinical Neurology Unit, University Hospital of Udine, Udine, Italy
| | - Andrea Bernardini
- Department of Neurosciences, Clinical Neurology Unit, University Hospital of Udine, Udine, Italy
| | - Karel Sonka
- Department of Neurology and Centre of Clinical Neuroscience, Charles University, First Faculty of Medicine and General University Hospital, Prague, Czech Republic
| | - David Kemlink
- Department of Neurology and Centre of Clinical Neuroscience, Charles University, First Faculty of Medicine and General University Hospital, Prague, Czech Republic
| | - Wolfgang Oertel
- Department of Neurology, Philipps University, Marburg, Germany
| | - Annette Janzen
- Department of Neurology, Philipps University, Marburg, Germany
| | - Giuseppe Plazzi
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy.,IRCCS, Institute of Neurological Sciences of Bologna, Bologna, Italy
| | - Elena Antelmi
- IRCCS, Institute of Neurological Sciences of Bologna, Bologna, Italy.,Department of Neurosciences, Neurology Unit, Movement Disorders Division, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Francesco Biscarini
- Department of Biomedical and Neuromotor Sciences (DIBINEM), Alma Mater Studiorum, University of Bologna, Bologna, Italy
| | - Michela Figorilli
- Department of Medical Sciences and Public Health, Sleep Disorder Research Center, University of Cagliari, Cagliari, Italy
| | - Monica Puligheddu
- Department of Medical Sciences and Public Health, Sleep Disorder Research Center, University of Cagliari, Cagliari, Italy
| | - Brit Mollenhauer
- Paracelsus-Elena-Klinik, Kassel, Germany.,Department of Neurology, University Medical Centre Göttingen, Göttingen, Germany
| | - Claudia Trenkwalder
- Paracelsus-Elena-Klinik, Kassel, Germany.,Department of Neurology, University Medical Centre Göttingen, Göttingen, Germany
| | - Friederike Sixel-Döring
- Department of Neurology, Philipps University, Marburg, Germany.,Paracelsus-Elena-Klinik, Kassel, Germany
| | - Valérie Cochen De Cock
- Sleep and Neurology Unit, Beau Soleil Clinic, Montpellier, France.,EuroMov, University of Montpellier, Montpellier, France
| | - Christelle Charley Monaca
- Department of Clinical Neurophysiology and Sleep Center, University Lille North of France, CHU Lille, Lille, France
| | - Anna Heidbreder
- Department of Sleep Medicine and Neuromuscular Disorders, University of Münster, Münster, Germany
| | - Luigi Ferini-Strambi
- Department of Neurological Sciences, Università Vita-Salute San Raffaele, Milan, Italy
| | - Femke Dijkstra
- Laboratory for Sleep Disorders, St. Dimpna Regional Hospital, Geel, Belgium.,Department of Neurology, St. Dimpna Regional Hospital, Geel, Belgium.,Department of Neurology, University Hospital Antwerp, Edegem, Antwerp, Belgium
| | - Mineke Viaene
- Laboratory for Sleep Disorders, St. Dimpna Regional Hospital, Geel, Belgium.,Department of Neurology, St. Dimpna Regional Hospital, Geel, Belgium
| | - Beatriz Abril
- Sleep disorder Unit, Carémeau Hospital, University Hospital of Nîmes, France
| | | | - Ronald B Postuma
- Montreal Neurological Institute, McGill University, Montréal, QC, Canada.,Department of Neurology and Neurosurgery, McGill University, Montréal, QC, Canada.,Centre d'Études Avancées en Médecine du Sommeil, Hôpital du Sacré-Coeur de Montréal, Montréal, QC, Canada
| | - Guy A Rouleau
- Department of Human Genetics, McGill University, Montréal, QC, Canada.,Montreal Neurological Institute, McGill University, Montréal, QC, Canada.,Department of Neurology and Neurosurgery, McGill University, Montréal, QC, Canada
| | - Abubaker Ibrahim
- Department of Neurology, Sleep Disorders Clinic, Medical University of Innsbruck, Innsbruck, Austria
| | - Ambra Stefani
- Department of Neurology, Sleep Disorders Clinic, Medical University of Innsbruck, Innsbruck, Austria
| | - Birgit Högl
- Department of Neurology, Sleep Disorders Clinic, Medical University of Innsbruck, Innsbruck, Austria
| | - Michele T M Hu
- Department of Sleep Medicine and Neuromuscular Disorders, University of Münster, Münster, Germany.,Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, United Kingdom
| | - Ziv Gan-Or
- Department of Human Genetics, McGill University, Montréal, QC, Canada.,Montreal Neurological Institute, McGill University, Montréal, QC, Canada.,Department of Neurology and Neurosurgery, McGill University, Montréal, QC, Canada
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49
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Högl B, Arnulf I, Bergmann M, Cesari M, Gan-Or Z, Heidbreder A, Iranzo A, Krohn L, Luppi PH, Mollenhauer B, Provini F, Santamaria J, Trenkwalder C, Videnovic A, Stefani A. Rapid eye movement sleep behaviour disorder: Past, present, and future. J Sleep Res 2022; 31:e13612. [PMID: 35470494 PMCID: PMC9541438 DOI: 10.1111/jsr.13612] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Revised: 03/31/2022] [Accepted: 03/31/2022] [Indexed: 11/26/2022]
Abstract
This manuscript presents an overview of REM sleep behaviour disorder (RBD) with a special focus on European contributions. After an introduction examining the history of the disorder, we address the pathophysiological and clinical aspects, as well as the diagnostic issues. Further, implications of RBD diagnosis and biomarkers are discussed. Contributions of European researchers to this field are highlighted.
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Affiliation(s)
- Birgit Högl
- Department of Neurology, Innsbruck Medical University, Innsbruck, Austria
| | - Isabelle Arnulf
- Service des Pathologies du Sommeil, Hôpital Pitié-Salpêtrière, Paris, France.,Faculty of Medicine, Sorbonne University, Paris, France
| | - Melanie Bergmann
- Department of Neurology, Innsbruck Medical University, Innsbruck, Austria
| | - Matteo Cesari
- Department of Neurology, Innsbruck Medical University, Innsbruck, Austria
| | - Ziv Gan-Or
- Montreal Neurological Institute and Hospital, McGill University, Montréal, Québec, Canada.,Department of Neurology & Neurosurgery, McGill University, Montréal, Québec, Canada.,Department of Human Genetics, McGill University, Montréal, Québec, Canada
| | - Anna Heidbreder
- Department of Neurology, Innsbruck Medical University, Innsbruck, Austria
| | - Alex Iranzo
- Neurology Service, Hospital Clínic de Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED:CB06/05/0018-ISCIII) Barcelona, University of Barcelona, Barcelona, Spain
| | - Lynne Krohn
- Montreal Neurological Institute and Hospital, McGill University, Montréal, Québec, Canada.,Department of Neurology & Neurosurgery, McGill University, Montréal, Québec, Canada.,Department of Human Genetics, McGill University, Montréal, Québec, Canada
| | - Pierre-Hervé Luppi
- Centre of Neuroscience of Lyon, UMR 5292 CNRS/U1028 INSERM, Lyon, France.,Centre Hospitalier Le Vinatier, Bron, France
| | - Brit Mollenhauer
- Paracelsus-Elena-Klinik, Kassel, Germany.,Department of Neurology, University Medical Center Göttingen, Göttingen, Germany
| | - Federica Provini
- IRCCS Institute of Neurological Sciences, UOC NeuroMet, Bellaria Hospital, Bologna, Italy.,Department of Biomedical and NeuroMotor Sciences, University of Bologna, Bologna, Italy
| | - Joan Santamaria
- Neurology Service, Hospital Clínic de Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED:CB06/05/0018-ISCIII) Barcelona, University of Barcelona, Barcelona, Spain
| | - Claudia Trenkwalder
- Department of Neurology, University Medical Center Göttingen, Göttingen, Germany.,Department of Neurosurgery, University Medical Center, Göttingen, Germany
| | - Aleksandar Videnovic
- Department of Neurology, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Ambra Stefani
- Department of Neurology, Innsbruck Medical University, Innsbruck, Austria
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50
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Vollhardt R, Arnulf I, Garcin B. Sleep Recording for the Diagnosis and Treatment of Paraplegia. JAMA Neurol 2022; 79:627. [PMID: 35404382 DOI: 10.1001/jamaneurol.2022.0619] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
- Raphaël Vollhardt
- Sleep Disorders Unit, Pitié-Salpêtrière Hospital, APHP, Sorbonne University, Paris, France
| | - Isabelle Arnulf
- Sleep Disorders Unit, Pitié-Salpêtrière Hospital, APHP, Sorbonne University, Paris, France
| | - Béatrice Garcin
- Neurology Department, Avicenne Hospital, APHP, Sorbonne Paris Nord University, Bobigny, France
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