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Evangelista E, Leu-Semenescu S, Pizza F, Plazzi G, Dauvilliers Y, Barateau L, Lambert I. Long sleep time and excessive need for sleep: State of the art and perspectives. Neurophysiol Clin 2024; 54:102949. [PMID: 38387329 DOI: 10.1016/j.neucli.2024.102949] [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: 12/12/2023] [Revised: 01/30/2024] [Accepted: 01/30/2024] [Indexed: 02/24/2024] Open
Abstract
The mechanisms underlying the individual need for sleep are unclear. Sleep duration is indeed influenced by multiple factors, such as genetic background, circadian and homeostatic processes, environmental factors, and sometimes transient disturbances such as infections. In some cases, the need for sleep dramatically and chronically increases, inducing a daily-life disability. This "excessive need for sleep" (ENS) was recently proposed and defined in a European Position Paper as a dimension of the hypersomnolence spectrum, "hypersomnia" being the objectified complaint of ENS. The most severe form of ENS has been described in Idiopathic Hypersomnia, a rare neurological disorder, but this disabling symptom can be also found in other hypersomnolence conditions. Because ENS has been defined recently, it remains a symptom poorly investigated and understood. However, protocols of long-term polysomnography recordings have been reported by expert centers in the last decades and open the way to a better understanding of ENS through a neurophysiological approach. In this narrative review, we will 1) present data related to the physiological and pathological variability of sleep duration and their mechanisms, 2) describe the published long-term polysomnography recording protocols, and 3) describe current neurophysiological tools to study sleep microstructure and discuss perspectives for a better understanding of ENS.
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Affiliation(s)
- Elisa Evangelista
- Sleep Disorder Unit, Carémeau Hospital, Centre Hospitalo-Universitaire de Nîmes, France; Institute for Neurosciences of Montpellier (INM), Univ Montpellier, INSERM, Montpellier, France
| | - Smaranda Leu-Semenescu
- National Reference Center for Orphan Diseases, Narcolepsy, Idiopathic Hypersomnia, and Kleine-Levin Syndrome, Paris, France; Sleep Disorders Clinic, Pitié-Salpêtrière Hospital, APHP-Sorbonne University, Paris, France
| | - Fabio Pizza
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy; IRCCS Istituto delle Scienze Neurologiche, Bologna, Italy
| | - Giuseppe Plazzi
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy; IRCCS Istituto delle Scienze Neurologiche, Bologna, Italy
| | - Yves Dauvilliers
- Institute for Neurosciences of Montpellier (INM), Univ Montpellier, INSERM, Montpellier, France; Sleep-Wake Disorders Unit, Department of Neurology, Gui-de-Chauliac Hospital, CHU Montpellier, France; National Reference Centre for Orphan Diseases, Narcolepsy, Idiopathic Hypersomnia, and Kleine-Levin Syndrome, Montpellier, France
| | - Lucie Barateau
- Institute for Neurosciences of Montpellier (INM), Univ Montpellier, INSERM, Montpellier, France; Sleep-Wake Disorders Unit, Department of Neurology, Gui-de-Chauliac Hospital, CHU Montpellier, France; National Reference Centre for Orphan Diseases, Narcolepsy, Idiopathic Hypersomnia, and Kleine-Levin Syndrome, Montpellier, France
| | - Isabelle Lambert
- APHM, Timone hospital, Sleep Unit, Epileptology and Cerebral Rhythmology, Marseille, France; Aix Marseille Univ, INSERM, INS, Inst Neurosci Syst, Marseille, 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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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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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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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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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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8
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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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9
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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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10
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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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11
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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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12
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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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13
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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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14
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Dodet P, Sanapo F, Leu-Semenescu S, Coupaye M, Bellicha A, Arnulf I, Poitou C, Redolfi S. Sleep Disorders in Adults with Prader–Willi Syndrome: Review of the Literature and Clinical Recommendations Based on the Experience of the French Reference Centre. J Clin Med 2022; 11:jcm11071986. [PMID: 35407596 PMCID: PMC8999159 DOI: 10.3390/jcm11071986] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Revised: 03/22/2022] [Accepted: 03/31/2022] [Indexed: 11/16/2022] Open
Abstract
Prader–Willi syndrome (PWS) is a rare, genetic, multisymptomatic, neurodevelopmental disease commonly associated with sleep alterations, including sleep-disordered breathing and central disorders of hypersomnolence. Excessive daytime sleepiness represents the main manifestation that should be addressed by eliciting the detrimental effects on quality of life and neurocognitive function from the patients’ caregivers. Patients with PWS have impaired ventilatory control and altered pulmonary mechanics caused by hypotonia, respiratory muscle weakness, scoliosis and obesity. Consequently, respiratory abnormalities are frequent and, in most cases, severe, particularly during sleep. Adults with PWS frequently suffer from sleep apnoea syndrome, sleep hypoxemia and sleep hypoventilation. When excessive daytime sleepiness persists after adequate control of sleep-disordered breathing, a sleep study on ventilatory treatment, followed by an objective measurement of excessive daytime sleepiness, is recommended. These tests frequently identify central disorders of hypersomnolence, including narcolepsy, central hypersomnia or a borderline hypersomnolent phenotype. The use of wake-enhancing drugs (modafinil, pitolisant) is discussed in multidisciplinary expert centres for these kinds of cases to ensure the right balance between the benefits on quality of life and the risk of psychological and cardiovascular side effects.
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Affiliation(s)
- Pauline Dodet
- Centre de Référence des Narcolepsies et Hypersomnies Rares, Service des Pathologies du Sommeil (Département R3S), Hôpital la Pitié-Salpêtrière, APHP-Sorbonne, 75013 Paris, France; (F.S.); (S.L.-S.); (I.A.); (S.R.)
- Institut du Cerveau (ICM), INSERM, CNRS, Hôpital la Pitié-Salpêtrière, Sorbonne University, 75013 Paris, France
- Correspondence:
| | - Federica Sanapo
- Centre de Référence des Narcolepsies et Hypersomnies Rares, Service des Pathologies du Sommeil (Département R3S), Hôpital la Pitié-Salpêtrière, APHP-Sorbonne, 75013 Paris, France; (F.S.); (S.L.-S.); (I.A.); (S.R.)
| | - Smaranda Leu-Semenescu
- Centre de Référence des Narcolepsies et Hypersomnies Rares, Service des Pathologies du Sommeil (Département R3S), Hôpital la Pitié-Salpêtrière, APHP-Sorbonne, 75013 Paris, France; (F.S.); (S.L.-S.); (I.A.); (S.R.)
- Institut du Cerveau (ICM), INSERM, CNRS, Hôpital la Pitié-Salpêtrière, Sorbonne University, 75013 Paris, France
| | - Muriel Coupaye
- Rare Diseases Center of Reference ‘Prader-Willi Syndrome and Obesity with Eating Disorders’ (PRADORT), Department of Nutrition, Hôpital la Pitié-Salpêtrière, APHP-Sorbonne, 75013 Paris, France; (M.C.); (C.P.)
| | - Alice Bellicha
- INSERM U1153, Inrae U1125, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center—University of Paris (CRESS), Sorbonne Paris Nord University, 93017 Bobigny, France;
| | - Isabelle Arnulf
- Centre de Référence des Narcolepsies et Hypersomnies Rares, Service des Pathologies du Sommeil (Département R3S), Hôpital la Pitié-Salpêtrière, APHP-Sorbonne, 75013 Paris, France; (F.S.); (S.L.-S.); (I.A.); (S.R.)
- Institut du Cerveau (ICM), INSERM, CNRS, Hôpital la Pitié-Salpêtrière, Sorbonne University, 75013 Paris, France
| | - Christine Poitou
- Rare Diseases Center of Reference ‘Prader-Willi Syndrome and Obesity with Eating Disorders’ (PRADORT), Department of Nutrition, Hôpital la Pitié-Salpêtrière, APHP-Sorbonne, 75013 Paris, France; (M.C.); (C.P.)
- Nutrition and Obesities: Systemic Approaches (NutriOmics), INSERM, Sorbonne University, 75013 Paris, France
| | - Stefania Redolfi
- Centre de Référence des Narcolepsies et Hypersomnies Rares, Service des Pathologies du Sommeil (Département R3S), Hôpital la Pitié-Salpêtrière, APHP-Sorbonne, 75013 Paris, France; (F.S.); (S.L.-S.); (I.A.); (S.R.)
- UMRS1158 Neurophysiologie Respiratoire Expérimentale et Clinique, INSERM, Sorbonne University, 75005 Paris, France
- Dipartimento di Scienze Mediche e Sanità Pubblica, Università di Cagliari, 09134 Cagliari, Italy
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15
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Nigam M, Hippolyte A, Dodet P, Gales A, Maranci JB, Al-Youssef S, Leu-Semenescu S, Arnulf I. Dormir pendant une pandémie : l’impact des restrictions liées au COVID-19 sur la narcolepsie et l’hypersomnie idiopathique. Médecine du Sommeil 2022. [PMCID: PMC8864981 DOI: 10.1016/j.msom.2022.01.163] [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] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Objectif Évaluer l’impact des restrictions liées au COVID-19 sur la narcolepsie de type 1 (NT1), la narcolepsie de type 2 (NT2) et l’hypersomnie idiopathique (HI). Méthodes Enquête en ligne évaluant les caractéristiques clinico-démographiques et professionnelles pendant le premier confinement a été proposée aux patients ayant une NT1, NT2 et HI, suivis dans un hôpital universitaire. Résultats Les 219 personnes ayant répondu à l’enquête ont signalé une augmentation moyenne de 1,2 ± 1,9 h (p < 0,001) du temps de sommeil nocturne et une diminution moyenne de 1,0 ± 3,4 points (p < 0,001) sur l’échelle de somnolence d’Epworth. Les télétravailleurs ont eu une augmentation moyenne de 0,9 ± 1,2 h de leur sommeil nocturne (p < 0,001) et une diminution moyenne du score de somnolence de 1,6 ± 3,1 (p < 0,001). La cataplexie s’est améliorée chez 54,1 % des NT1. La somnolence est corrélée au bien-être psychologique (R = 0,3, p < 0,001). 42,5 % des patients ont apprécié ce premier confinement, grâce à la réaffectation du temps habituellement consacré aux trajets domicile-travail, à un temps de sommeil plus long, aux loisirs et à la famille, et ont apprécié un horaire de sieste plus libre. À l’inverse, 13,2 % des patients ont ressenti un sentiment d’isolement et de détresse psychologique. Conclusion Ces résultats suggèrent que les personnes atteintes d’HI, NT1 et NT2 peuvent bénéficier d’une diminution des contraintes sociales et professionnelles sur les habitudes de sommeil et soulignent l’importance des aménagements des horaires et du lieu de travail dans cette population.
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16
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Maranci JB, Nigam M, Masset L, Msika EF, Vionnet MC, Chaumereil C, Vidailhet M, Leu-Semenescu S, Arnulf I. Eye movement patterns correlate with overt emotional behaviours in rapid eye movement sleep. Sci Rep 2022; 12:1770. [PMID: 35110651 PMCID: PMC8810754 DOI: 10.1038/s41598-022-05905-5] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Accepted: 01/12/2022] [Indexed: 11/09/2022] Open
Abstract
Growing evidence suggests that sleep plays a key role in regulating emotions. Rapid eye movements (REMs) in REM sleep could be associated with dreams emotions, but supporting evidence is indirect. To highlight this association, we studied the REM sleep during video-polysomnography of 20 subjects with REM sleep behaviour disorder (RBD), a model of enacted dreams offering direct access to the emotional content of the sleeper (face expression, speeches, behaviour). Video and the electro-oculography recordings were divided into 3 s time intervals and classified as non-behavioural, or behavioural (neutral, positive or negative emotions), and as containing no eye movements (EMs), slow eye movements (SEMs) or REMs (isolated or bursts). Compared to the absence of EMs, neutral behaviours successively increased in the presence of SEMs (odd ratio, OR = 1.4), then isolated REMs (OR = 2.8) and then REM bursts (OR = 4.6). Positive behaviours increased with SEMs (OR = 2.8) but did not increase further with isolated REMs (OR = 2.8) and REM bursts (OR = 3). Negative behaviours were absent with SEMs, increased with isolated REMs (OR = 2.6) and further with REM bursts (OR = 10.1). These results support an association between REMs and SEMs, and dream emotions.
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Affiliation(s)
- Jean-Baptiste Maranci
- Sleep Disorder Unit, Pitie-Salpetriere University Hospital, APHP, Paris, France.,Center for Advanced Research in Sleep Medicine, Hôpital du Sacré-Coeur de Montréal, Montréal, Canada.,Paris Brain Institute, Paris, France
| | - Milan Nigam
- Sleep Disorder Unit, Pitie-Salpetriere University Hospital, APHP, Paris, France.,Center for Advanced Research in Sleep Medicine, Hôpital du Sacré-Coeur de Montréal, Montréal, Canada
| | - Luc Masset
- Sleep Disorder Unit, Pitie-Salpetriere University Hospital, APHP, Paris, France
| | - Eva-Flore Msika
- Sleep Disorder Unit, Pitie-Salpetriere University Hospital, APHP, Paris, France
| | | | | | - Marie Vidailhet
- Paris Brain Institute, Paris, France.,Sorbonne University, Paris, France
| | - Smaranda Leu-Semenescu
- Sleep Disorder Unit, Pitie-Salpetriere University Hospital, APHP, Paris, France.,Paris Brain Institute, Paris, France
| | - Isabelle Arnulf
- Sleep Disorder Unit, Pitie-Salpetriere University Hospital, APHP, Paris, France. .,Paris Brain Institute, Paris, France. .,Sorbonne University, Paris, France.
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17
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Gaurav R, Pyatigorskaya N, Biondetti E, Valabrègue R, Yahia-Cherif L, Mangone G, Leu-Semenescu S, Corvol JC, Vidailhet M, Arnulf I, Lehéricy S. Deep Learning-Based Neuromelanin MRI Changes of Isolated REM Sleep Behavior Disorder. Mov Disord 2022; 37:1064-1069. [PMID: 35102604 PMCID: PMC9302679 DOI: 10.1002/mds.28933] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [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: 05/20/2021] [Revised: 01/06/2022] [Accepted: 01/09/2022] [Indexed: 12/24/2022] Open
Abstract
Background Isolated REM sleep behavior disorder (iRBD) is considered a prodromal stage of parkinsonism. Neurodegenerative changes in the substantia nigra pars compacta (SNc) in parkinsonism can be detected using neuromelanin‐sensitive MRI. Objective To investigate SNc neuromelanin changes in iRBD patients using fully automatic segmentation. Methods We included 47 iRBD patients, 134 early Parkinson's disease (PD) patients and 55 healthy volunteers (HVs) scanned at 3 Tesla. SNc regions‐of‐interest were delineated automatically using convolutional neural network. SNc volumes, volumes corrected by total intracranial volume, signal‐to‐noise ratio (SNR) and contrast‐to‐noise ratio were computed. One‐way general linear models (GLM) analysis of covariance (ANCOVA) was conducted while adjusting for age and sex. Results All SNc measurements differed significantly between the three groups (except SNR in iRBD). Changes in iRBD were intermediate between those in PD and HVs. Conclusions Using fully automated SNc segmentation method and neuromelanin‐sensitive imaging, iRBD patients showed neurodegenerative changes in the SNc at a lower level than in PD patients. © 2022 The Authors. Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society
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Affiliation(s)
- Rahul Gaurav
- Center for NeuroImaging Research (CENIR), Paris Brain Institute-ICM, Paris, France.,Sorbonne Université, Paris Brain Institute-ICM, INSERM U1127, CNRS UMR 7225, Pitié-Salpêtrière Hospital, Paris, France.,Movement Investigations and Therapeutics - MOV'IT Team, Paris Brain Institute-ICM, Paris, France
| | - Nadya Pyatigorskaya
- Center for NeuroImaging Research (CENIR), Paris Brain Institute-ICM, Paris, France.,Sorbonne Université, Paris Brain Institute-ICM, INSERM U1127, CNRS UMR 7225, Pitié-Salpêtrière Hospital, Paris, France.,Movement Investigations and Therapeutics - MOV'IT Team, Paris Brain Institute-ICM, Paris, France.,Department of Neuroradiology, Pitié-Salpêtrière Hospital, AP-HP, Paris, France
| | - Emma Biondetti
- Center for NeuroImaging Research (CENIR), Paris Brain Institute-ICM, Paris, France.,Sorbonne Université, Paris Brain Institute-ICM, INSERM U1127, CNRS UMR 7225, Pitié-Salpêtrière Hospital, Paris, France.,Movement Investigations and Therapeutics - MOV'IT Team, Paris Brain Institute-ICM, Paris, France
| | - Romain Valabrègue
- Center for NeuroImaging Research (CENIR), Paris Brain Institute-ICM, Paris, France.,Sorbonne Université, Paris Brain Institute-ICM, INSERM U1127, CNRS UMR 7225, Pitié-Salpêtrière Hospital, Paris, France
| | - Lydia Yahia-Cherif
- Center for NeuroImaging Research (CENIR), Paris Brain Institute-ICM, Paris, France.,Sorbonne Université, Paris Brain Institute-ICM, INSERM U1127, CNRS UMR 7225, Pitié-Salpêtrière Hospital, Paris, France
| | - Graziella Mangone
- Sorbonne Université, Paris Brain Institute-ICM, INSERM U1127, CNRS UMR 7225, Pitié-Salpêtrière Hospital, Paris, France.,INSERM, Clinical Investigation Center for Neurosciences (CIC), Pitié-Salpêtrière Hospital, Paris, France
| | | | - Jean-Christophe Corvol
- Sorbonne Université, Paris Brain Institute-ICM, INSERM U1127, CNRS UMR 7225, Pitié-Salpêtrière Hospital, Paris, France.,Department of Neuroradiology, Pitié-Salpêtrière Hospital, AP-HP, Paris, France.,Department of Neurology, Pitié-Salpêtrière Hospital, AP-HP, Paris, France
| | - Marie Vidailhet
- Sorbonne Université, Paris Brain Institute-ICM, INSERM U1127, CNRS UMR 7225, Pitié-Salpêtrière Hospital, Paris, France.,Movement Investigations and Therapeutics - MOV'IT Team, Paris Brain Institute-ICM, Paris, France.,Department of Neurology, Pitié-Salpêtrière Hospital, AP-HP, Paris, France
| | - Isabelle Arnulf
- Center for NeuroImaging Research (CENIR), Paris Brain Institute-ICM, Paris, France.,Movement Investigations and Therapeutics - MOV'IT Team, Paris Brain Institute-ICM, Paris, France.,Sleep Disorders Unit, Pitié-Salpêtrière Hospital, AP-HP, Paris, France
| | - Stéphane Lehéricy
- Center for NeuroImaging Research (CENIR), Paris Brain Institute-ICM, Paris, France.,Sorbonne Université, Paris Brain Institute-ICM, INSERM U1127, CNRS UMR 7225, Pitié-Salpêtrière Hospital, Paris, France.,Movement Investigations and Therapeutics - MOV'IT Team, Paris Brain Institute-ICM, Paris, France.,INSERM, Clinical Investigation Center for Neurosciences (CIC), Pitié-Salpêtrière Hospital, Paris, France
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18
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Nigam M, Leu-Semenescu S, Arnulf I. Moving the dial on behavioral interventions for idiopathic hypersomnia. J Clin Sleep Med 2022; 18:1473-1474. [PMID: 35088706 PMCID: PMC9059601 DOI: 10.5664/jcsm.9914] [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: 11/13/2022]
Affiliation(s)
- Milan Nigam
- Sleep Disorders Unit, University Hospital Pitié-Salpêtrière, APHP-Sorbonne, Paris, France.,Centre for Advanced Research in Sleep Medicine, Sacré-Coeur Hospital, Montreal, QC, Canada.,Department of Neurosciences, University of Montreal, Montreal, QC, Canada.,Sorbonne University, Paris, France
| | - Smaranda Leu-Semenescu
- Sleep Disorders Unit, University Hospital Pitié-Salpêtrière, APHP-Sorbonne, Paris, France
| | - Isabelle Arnulf
- Sleep Disorders Unit, University Hospital Pitié-Salpêtrière, APHP-Sorbonne, Paris, France.,Sorbonne University, Paris, France.,Institut du Cerveau et de la Moelle (Paris Brain Institute), Paris, France
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19
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Leu-Semenescu S, Maranci JB, Lopez R, Drouot X, Dodet P, Gales A, Groos E, Barateau L, Franco P, Lecendreux M, Dauvilliers Y, Arnulf I. Comorbid parasomnias in narcolepsy and idiopathic hypersomnia: more REM than NREM parasomnias. J Clin Sleep Med 2022; 18:1355-1364. [PMID: 34984974 PMCID: PMC9059608 DOI: 10.5664/jcsm.9862] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
STUDY OBJECTIVES To assess the frequency, determinants and clinical impact of clinical NREM and REM parasomnias in adult patients with narcolepsy type 1 (NT1), narcolepsy type 2 (NT2), and idiopathic hypersomnia (IH) compared to healthy controls. METHODS Familial and past and current personal parasomnias were assessed by questionnaire and medical interviews in 710 patients (220 NT1, 199 NT2, and 221 IH) and 595 healthy controls. RESULTS Except for sleep-related eating disorder (SRED), current NREM parasomnias were rare in all patient groups and controls. SRED was more frequent in NT1 patients (7.9%, vs. 1.8% in NT2 patients, 2.1% in IH patients and 1% in controls) and associated with disrupted nighttime sleep (odds ratio [OR] = 3.9) and nocturnal eating in full awareness (OR = 6.9) but not with sex. Clinical REM sleep behavior disorder (RBD) was more frequent in NT1 patients (41.4%, half being violent) than in NT2 patients (13.2%) and affected men more often than women (OR = 2.4). It was associated with disrupted nighttime sleep, depressive symptoms and antidepressant use. Frequent (>1/week) nightmares were reported by 39% of patients with NT1, 29% with NT2 and 27.8% with IH (vs. 8.3% in controls) and were associated with depressive symptoms in narcolepsy. No parasomnia (except sleep-related hallucinations) worsened daytime sleepiness. CONCLUSIONS In patients with central disorders of hypersomnolence, comorbid NREM parasomnias (except SRED) are rare and do not worsen sleepiness. In contrast, REM parasomnias are prevalent (especially in NT1) and associated with male sex, disrupted nighttime sleep, depressive symptoms and antidepressant use.
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Affiliation(s)
- Smaranda Leu-Semenescu
- Sleep Disorders, Pitié-Salpêtrière University Hospital, AP-HP-Sorbonne, F-75013 Paris, France.,National Reference Center for Orphan Diseases, Narcolepsy, Idiopathic hypersomnia and Kleine-Levin Syndrome
| | - Jean-Baptiste Maranci
- Sleep Disorders, Pitié-Salpêtrière University Hospital, AP-HP-Sorbonne, F-75013 Paris, France.,National Reference Center for Orphan Diseases, Narcolepsy, Idiopathic hypersomnia and Kleine-Levin Syndrome.,Sorbonne University, Paris, France
| | - Regis Lopez
- National Reference Center for Orphan Diseases, Narcolepsy, Idiopathic hypersomnia and Kleine-Levin Syndrome.,Sleep Disorders Center, Department of Neurology, Gui-de-Chauliac Hospital, CHU Montpellier.,Institute for Neurosciences of Montpellier (INM), Montpellier University, INSERM, Montpellier, France
| | - Xavier Drouot
- Clinical Neurophysiology Department, La Miletrie University Hospital, Poitiers, France
| | - Pauline Dodet
- Sleep Disorders, Pitié-Salpêtrière University Hospital, AP-HP-Sorbonne, F-75013 Paris, France.,National Reference Center for Orphan Diseases, Narcolepsy, Idiopathic hypersomnia and Kleine-Levin Syndrome
| | - Ana Gales
- Sleep Disorders, Pitié-Salpêtrière University Hospital, AP-HP-Sorbonne, F-75013 Paris, France.,National Reference Center for Orphan Diseases, Narcolepsy, Idiopathic hypersomnia and Kleine-Levin Syndrome
| | - Elisabeth Groos
- Sleep Disorders, Pitié-Salpêtrière University Hospital, AP-HP-Sorbonne, F-75013 Paris, France.,National Reference Center for Orphan Diseases, Narcolepsy, Idiopathic hypersomnia and Kleine-Levin Syndrome
| | - Lucie Barateau
- National Reference Center for Orphan Diseases, Narcolepsy, Idiopathic hypersomnia and Kleine-Levin Syndrome.,Sleep Disorders Center, Department of Neurology, Gui-de-Chauliac Hospital, CHU Montpellier.,Institute for Neurosciences of Montpellier (INM), Montpellier University, INSERM, Montpellier, France
| | - Patricia Franco
- National Reference Center for Orphan Diseases, Narcolepsy, Idiopathic hypersomnia and Kleine-Levin Syndrome.,Pediatric Sleep Unit, Mother-Children Hospital, Hospices Civils de Lyon, University Lyon1, France, Integrative Physiology of Brain Arousal System, CRNL, INSERM-U1028, CNRS UMR5292, University Lyon 1, Lyon, France
| | - Michel Lecendreux
- National Reference Center for Orphan Diseases, Narcolepsy, Idiopathic hypersomnia and Kleine-Levin Syndrome.,Pediatric Sleep Center, Hospital Robert-Debré, AP-HP, Paris, France
| | - Yves Dauvilliers
- National Reference Center for Orphan Diseases, Narcolepsy, Idiopathic hypersomnia and Kleine-Levin Syndrome.,Sleep Disorders Center, Department of Neurology, Gui-de-Chauliac Hospital, CHU Montpellier.,Institute for Neurosciences of Montpellier (INM), Montpellier University, INSERM, Montpellier, France
| | - Isabelle Arnulf
- Sleep Disorders, Pitié-Salpêtrière University Hospital, AP-HP-Sorbonne, F-75013 Paris, France.,National Reference Center for Orphan Diseases, Narcolepsy, Idiopathic hypersomnia and Kleine-Levin Syndrome.,Sorbonne University, Paris, France
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20
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Nigam M, Hippolyte A, Dodet P, Gales A, Maranci JB, Al-Youssef S, Leu-Semenescu S, Arnulf I. Sleeping through a pandemic: impact of COVID-19-related restrictions on narcolepsy and idiopathic hypersomnia. J Clin Sleep Med 2022; 18:255-263. [PMID: 34314345 PMCID: PMC8807898 DOI: 10.5664/jcsm.9556] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
STUDY OBJECTIVES To assess the impact of coronavirus disease 2019 (COVID-19)-related restrictions on narcolepsy type 1 (NT2), narcolepsy type 2 (NT2), and idiopathic hypersomnia (IH). METHODS Participants with NT1, NT2, and IH followed in a university hospital completed an online 78-question survey assessing demographic, clinical, and occupational features of the population during the first COVID-19-related lockdown. RESULTS A total of 219 of 851 (25.7%) respondents of the survey reported a mean increase of 1.2 ± 1.9 hours (P < .001) in night sleep time and a mean decrease of 1.0 ± 3.4 points (P < .001) on the Epworth Sleepiness Scale during lockdown. Bedtime was delayed by 46.1% of participants and wakeup time was delayed by 59.6%, driven primarily by participants with IH. Teleworkers (but not in-person workers) reported a mean increase of 0.9 ± 1.2 hours in night sleep (P < .001) and a mean decrease in sleepiness score of 1.6 ± 3.1 (P < .001). Cataplexy improved in 54.1% of participants with NT1. Sleepiness correlated with psychological wellness (r = .3, P < .001). As many as 42.5% enjoyed the lockdown, thanks to reallocation of time usually spent commuting toward longer sleep time, hobbies, and family time, and appreciated a freer napping schedule. Conversely, 13.2% disliked the lockdown, feeling isolation and psychological distress. CONCLUSIONS Extended sleep time, circadian delay (in patients with IH), and teleworking resulted in decreased symptoms of central hypersomnias. These findings suggest that people with IH, NT1, and NT2 may benefit from a decrease in social and professional constraints on sleep-wake habits, and support advocacy efforts aimed at facilitating workplace and schedule accommodations for this population. CITATION Nigam M, Hippolyte A, Dodet P, et al. Sleeping through a pandemic: impact of COVID-19-related restrictions on narcolepsy and idiopathic hypersomnia. J Clin Sleep Med. 2022;18(1):255-263.
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Affiliation(s)
- Milan Nigam
- Sleep Disorders Unit, University Hospital Pitié-Salpêtrière, APHP-Sorbonne, Paris, France,Centre for Advanced Research in Sleep Medicine, Sacré-Coeur Hospital, Montreal, Quebec, Canada,Department of Neurosciences, University of Montreal, Montreal, Quebec, Canada,Sorbonne University, Paris, France
| | - Amandine Hippolyte
- Sorbonne University, Paris, France,Faculté des Sciences, Université de Montpellier, Montpellier, France
| | - Pauline Dodet
- Sleep Disorders Unit, University Hospital Pitié-Salpêtrière, APHP-Sorbonne, Paris, France
| | - Ana Gales
- Sleep Disorders Unit, University Hospital Pitié-Salpêtrière, APHP-Sorbonne, Paris, France
| | - Jean-Baptiste Maranci
- Sleep Disorders Unit, University Hospital Pitié-Salpêtrière, APHP-Sorbonne, Paris, France,Sorbonne University, Paris, France
| | - Saba Al-Youssef
- Sleep Disorders Unit, University Hospital Pitié-Salpêtrière, APHP-Sorbonne, Paris, France
| | - Smaranda Leu-Semenescu
- Sleep Disorders Unit, University Hospital Pitié-Salpêtrière, APHP-Sorbonne, Paris, France
| | - Isabelle Arnulf
- Sleep Disorders Unit, University Hospital Pitié-Salpêtrière, APHP-Sorbonne, Paris, France,Sorbonne University, Paris, France,Institut du Cerveau et de la Moelle (Paris Brain Institute), Paris, France,Address correspondence to: Isabelle Arnulf, MD, PhD, Service des Pathologies du Sommeil, Hôpital Pitié-Salpêtrière, 47-83 Bd de l’Hôpital, 75013 Paris; Tel: 33 (0) 1 42 16 77 04; Fax: 33 (0) 1 42 16 77 00;
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21
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Nigam M, Ayadi I, Noiray C, Branquino-Bras AC, Herraez Sanchez E, Leu-Semenescu S, Vidailhet M, Dodet P, Arnulf I. Sweet or Bland Dreams? Taste Loss in Isolated REM-Sleep Behavior Disorder and Parkinson's Disease. Mov Disord 2021; 36:2431-2435. [PMID: 34117799 DOI: 10.1002/mds.28692] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 03/11/2021] [Revised: 05/25/2021] [Accepted: 05/26/2021] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND Hyposmia and isolated REM sleep behavior disorder are well-established features of prodromal Parkinson's disease (PD). OBJECTIVES The objective of the present study was to evaluate whether taste loss (reported in PD and possibly suggesting brain stem involvement) is present at the isolated REM sleep behavior disorder stage. METHODS We assessed taste function using the Taste Strip Test (evaluating 4 concentrations of bitter, sweet, sour, and salty) in 44 participants with isolated REM sleep behavior disorder, 19 with PD, and 29 controls. All participants underwent video-polysomnography, standardized questionnaires, and clinical examination, including olfactory assessment. RESULTS Participants with isolated REM sleep behavior disorder and PD had lower taste scores than controls. There was no difference between isolated REM sleep behavior disorder and PD cohorts, nor was there any correlation between taste and olfaction, age, disease duration, cognition, or autonomic function. CONCLUSION This study demonstrates for the first time the presence of taste impairment in isolated REM sleep behavior disorder that is independent of olfactory dysfunction and comparable to participants with PD. © 2021 International Parkinson and Movement Disorder Society.
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Affiliation(s)
- Milan Nigam
- Sleep Disorders Unit, University Hospital Pitié-Salpêtrière, APHP-Sorbonne, Paris, France.,Centre for Advanced Research in Sleep Medicine, Sacré-Coeur Hospital, Montreal, Quebec, Canada.,Department of Neurosciences, University of Montreal, Montreal, Quebec, Canada
| | - Ines Ayadi
- Sleep Disorders Unit, University Hospital Pitié-Salpêtrière, APHP-Sorbonne, Paris, France
| | - Camille Noiray
- Sleep Disorders Unit, University Hospital Pitié-Salpêtrière, APHP-Sorbonne, Paris, France
| | - Ana Catarina Branquino-Bras
- Sleep Disorders Unit, University Hospital Pitié-Salpêtrière, APHP-Sorbonne, Paris, France.,Department of Neurology - Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - Erika Herraez Sanchez
- Sleep Disorders Unit, University Hospital Pitié-Salpêtrière, APHP-Sorbonne, Paris, France.,Hospital Universitario La Paz, Madrid, Spain
| | - Smaranda Leu-Semenescu
- Sleep Disorders Unit, University Hospital Pitié-Salpêtrière, APHP-Sorbonne, Paris, France
| | - Marie Vidailhet
- Department of Neurology, University Hospital Pitié-Salpêtrière, APHP-Sorbonne, Paris, France.,Institut du Cerveau et de la Moelle (Paris Brain Institute), Paris, France.,Sorbonne University, Paris, France
| | - Pauline Dodet
- Sleep Disorders Unit, University Hospital Pitié-Salpêtrière, APHP-Sorbonne, Paris, France
| | - Isabelle Arnulf
- Sleep Disorders Unit, University Hospital Pitié-Salpêtrière, APHP-Sorbonne, Paris, France.,Institut du Cerveau et de la Moelle (Paris Brain Institute), Paris, France.,Sorbonne University, Paris, France
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22
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Biondetti E, Santin MD, Valabrègue R, Mangone G, Gaurav R, Pyatigorskaya N, Hutchison M, Yahia-Cherif L, Villain N, Habert MO, Arnulf I, Leu-Semenescu S, Dodet P, Vila M, Corvol JC, Vidailhet M, Lehéricy S. The spatiotemporal changes in dopamine, neuromelanin and iron characterizing Parkinson's disease. Brain 2021; 144:3114-3125. [PMID: 33978742 PMCID: PMC8634084 DOI: 10.1093/brain/awab191] [Citation(s) in RCA: 49] [Impact Index Per Article: 16.3] [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: 02/03/2021] [Revised: 04/19/2021] [Accepted: 05/06/2021] [Indexed: 11/13/2022] Open
Abstract
In Parkinson's disease, there is a progressive reduction in striatal dopaminergic function, and loss of neuromelanin-containing dopaminergic neurons and increased iron deposition in the substantia nigra. We tested the hypothesis of a relationship between impairment of the dopaminergic system and changes in the iron metabolism. Based on imaging data of patients with prodromal and early clinical Parkinson's disease, we assessed the spatiotemporal ordering of such changes and relationships in the sensorimotor, associative and limbic territories of the nigrostriatal system. Patients with Parkinson's disease (disease duration < 4 years) or idiopathic REM sleep behaviour disorder (a prodromal form of Parkinson's disease) and healthy controls underwent longitudinal examination (baseline and 2-year follow-up). Neuromelanin and iron sensitive MRI and dopamine transporter single-photon emission tomography were performed to assess nigrostriatal levels of neuromelanin, iron, and dopamine. For all three functional territories of the nigrostriatal system, in the clinically most and least affected hemispheres separately, the following was performed: cross-sectional and longitudinal inter-group difference analysis of striatal dopamine and iron, and nigral neuromelanin and iron; in Parkinson's disease patients, exponential fitting analysis to assess the duration of the prodromal phase and the temporal ordering of changes in dopamine, neuromelanin or iron relative to controls; voxel-wise correlation analysis to investigate concomitant spatial changes in dopamine-iron, dopamine-neuromelanin and neuromelanin-iron in the substantia nigra pars compacta. The temporal ordering of dopaminergic changes followed the known spatial pattern of progression involving first the sensorimotor, then the associative and limbic striatal and nigral regions. Striatal dopaminergic denervation occurred first followed by abnormal iron metabolism and finally neuromelanin changes in the substantia nigra pars compacta, which followed the same spatial and temporal gradient observed in the striatum but shifted in time. In conclusion, dopaminergic striatal dysfunction and cell loss in the substantia nigra pars compacta are interrelated with increased nigral iron content.
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Affiliation(s)
- Emma Biondetti
- Sorbonne Université, Institut du Cerveau - Paris Brain Institute - ICM, INSERM, CNRS, 75013 Paris, France.,ICM, Centre de NeuroImagerie de Recherche - CENIR, 75013 Paris, France.,ICM, Team "Movement Investigations and Therapeutics" (MOV'IT), 75013 Paris, France
| | - Mathieu D Santin
- Sorbonne Université, Institut du Cerveau - Paris Brain Institute - ICM, INSERM, CNRS, 75013 Paris, France.,ICM, Centre de NeuroImagerie de Recherche - CENIR, 75013 Paris, France
| | - Romain Valabrègue
- Sorbonne Université, Institut du Cerveau - Paris Brain Institute - ICM, INSERM, CNRS, 75013 Paris, France.,ICM, Centre de NeuroImagerie de Recherche - CENIR, 75013 Paris, France
| | - Graziella Mangone
- Sorbonne Université, Institut du Cerveau - Paris Brain Institute - ICM, INSERM, CNRS, 75013 Paris, France.,Assistance Publique Hôpitaux de Paris, Hôpital Pitié-Salpêtrière, Department of Neurology, Centre d'Investigation Clinique Neurosciences, 75013 Paris, France.,Assistance Publique Hôpitaux de Paris, Hôpital Pitié-Salpêtrière, Department of Neurology, 75013 Paris, France
| | - Rahul Gaurav
- Sorbonne Université, Institut du Cerveau - Paris Brain Institute - ICM, INSERM, CNRS, 75013 Paris, France.,ICM, Centre de NeuroImagerie de Recherche - CENIR, 75013 Paris, France.,ICM, Team "Movement Investigations and Therapeutics" (MOV'IT), 75013 Paris, France
| | - Nadya Pyatigorskaya
- Sorbonne Université, Institut du Cerveau - Paris Brain Institute - ICM, INSERM, CNRS, 75013 Paris, France.,ICM, Team "Movement Investigations and Therapeutics" (MOV'IT), 75013 Paris, France.,Assistance Publique Hôpitaux de Paris, Hôpital Pitié-Salpêtrière, Department of Neuroradiology, 75013 Paris, France
| | | | - Lydia Yahia-Cherif
- Sorbonne Université, Institut du Cerveau - Paris Brain Institute - ICM, INSERM, CNRS, 75013 Paris, France.,ICM, Centre de NeuroImagerie de Recherche - CENIR, 75013 Paris, France
| | - Nicolas Villain
- Sorbonne Université, Institut du Cerveau - Paris Brain Institute - ICM, INSERM, CNRS, 75013 Paris, France.,Assistance Publique Hôpitaux de Paris, Hôpital Pitié-Salpêtrière, Department of Neurology, 75013 Paris, France
| | - Marie-Odile Habert
- Assistance Publique Hôpitaux de Paris, Hôpital Pitié-Salpêtrière, Department of Nuclear Medicine, 75013 Paris, France.,Sorbonne Université, CNRS, INSERM, Laboratoire d'Imagerie Biomédicale - LIB, 75006 Paris, France
| | - Isabelle Arnulf
- Sorbonne Université, Institut du Cerveau - Paris Brain Institute - ICM, INSERM, CNRS, 75013 Paris, France.,ICM, Team "Movement Investigations and Therapeutics" (MOV'IT), 75013 Paris, France.,Assistance Publique Hôpitaux de Paris, Hôpital Pitié-Salpêtrière, Sleep Disorder Unit, 75013 Paris, France
| | - Smaranda Leu-Semenescu
- Assistance Publique Hôpitaux de Paris, Hôpital Pitié-Salpêtrière, Sleep Disorder Unit, 75013 Paris, France
| | - Pauline Dodet
- Assistance Publique Hôpitaux de Paris, Hôpital Pitié-Salpêtrière, Sleep Disorder Unit, 75013 Paris, France
| | - Miquel Vila
- Neurodegenerative Diseases Research Group, Vall d'Hebron Research Institute (VHIR)-Center for Networked Biomedical Research on Neurodegenerative Diseases (CIBERNED)-Department of Biochemistry and Molecular Biology, Autonomous University of Barcelona (UAB)-Catalan Institution for Research and Advanced Studies (ICREA), 08010 Barcelona, Spain
| | - Jean-Christophe Corvol
- Sorbonne Université, Institut du Cerveau - Paris Brain Institute - ICM, INSERM, CNRS, 75013 Paris, France.,Assistance Publique Hôpitaux de Paris, Hôpital Pitié-Salpêtrière, Department of Neurology, Centre d'Investigation Clinique Neurosciences, 75013 Paris, France.,Assistance Publique Hôpitaux de Paris, Hôpital Pitié-Salpêtrière, Department of Neurology, 75013 Paris, France
| | - Marie Vidailhet
- Sorbonne Université, Institut du Cerveau - Paris Brain Institute - ICM, INSERM, CNRS, 75013 Paris, France.,ICM, Team "Movement Investigations and Therapeutics" (MOV'IT), 75013 Paris, France.,Assistance Publique Hôpitaux de Paris, Hôpital Pitié-Salpêtrière, Department of Neurology, 75013 Paris, France
| | - Stéphane Lehéricy
- Sorbonne Université, Institut du Cerveau - Paris Brain Institute - ICM, INSERM, CNRS, 75013 Paris, France.,ICM, Centre de NeuroImagerie de Recherche - CENIR, 75013 Paris, France.,ICM, Team "Movement Investigations and Therapeutics" (MOV'IT), 75013 Paris, France.,Assistance Publique Hôpitaux de Paris, Hôpital Pitié-Salpêtrière, Department of Neuroradiology, 75013 Paris, France
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23
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Abstract
NONE Narcolepsy type 1 is characterized by excessive daytime sleepiness and cataplexy, as well as hypocretin deficiency. Cataplexy (the loss of voluntary postural muscle tone, often in response to emotional stimuli) is one of the most disabling features and is associated with significant social impairment and risk of injury. Cataplexy is usually alleviated by antidepressants sodium oxybate and pitolisant. In this case report, we describe three patients with severe, drug-resistant cataplexy who experienced a dramatic improvement when treated with tropatepine, an anticholinergic muscarinic antagonist (commonly used to prevent neuroleptic-induced parkinsonism) after the usual treatments had failed. The single side effect was mild mouth dryness. In addition to providing a new therapeutic option for resistant cataplexy, this benefit supports a role of cholinergic muscarinic transmission in rapid eye movement sleep atonia.
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Affiliation(s)
- Milan Nigam
- Centre for Advanced Research in Sleep Medicine, Sacré-Coeur Hospital, Montreal, Québec, Canada.,Department of Neurosciences, University of Montreal, Montreal, Québec, Canada.,National Reference Center for Narcolepsy, Sleep Disorders Unit, University Hospital Pitié-Salpêtrière, Paris, France
| | - Smaranda Leu-Semenescu
- National Reference Center for Narcolepsy, Sleep Disorders Unit, University Hospital Pitié-Salpêtrière, Paris, France
| | - Isabelle Arnulf
- National Reference Center for Narcolepsy, Sleep Disorders Unit, University Hospital Pitié-Salpêtrière, Paris, France.,Sorbonne University, Paris, France
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Mainieri G, Maranci JB, Champetier P, Leu-Semenescu S, Gales A, Dodet P, Arnulf I. Are sleep paralysis and false awakenings different from REM sleep and from lucid REM sleep? A spectral EEG analysis. J Clin Sleep Med 2021; 17:719-727. [PMID: 33283752 DOI: 10.5664/jcsm.9056] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [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: 11/13/2022]
Abstract
STUDY OBJECTIVES To determine the polysomnography characteristics during sleep paralysis, false awakenings, and lucid dreaming (which are states intermediate to rapid eye movement [REM] sleep and wake but exceptionally observed in sleep laboratory). METHODS In 5 participants, we captured 5 episodes of sleep paralysis (2 time marked with the ocular left-right-left-right code normally used to signal lucid dreaming, 1 time marked by an external noise, and 2 retrospectively reported) and 2 episodes of false awakening. The sleep coding (using 3-second mini-epochs) and spectral electroencephalography analysis were compared during these episodes and normal REM sleep as well as wakefulness in the same 4 of 5 participants and vs lucid REM sleep in 4 other patients with narcolepsy. RESULTS During episodes of sleep paralysis, 70.8% of mini-epochs contained theta electroencephalography rhythm (vs 89.7% in REM sleep and 21.2% in wakefulness), 93.8% contained chin muscle atonia (vs 89.7% in REM sleep and 33.3% in wakefulness), and 6.9% contained rapid eye movements (vs 11.9% in REM sleep and 8.1% in wakefulness). The electroencephalography spectrum during sleep paralysis was intermediate between wakefulness and REM sleep in the alpha, theta, and delta frequencies, whereas the beta frequencies were not different between sleep paralysis and normal REM sleep. The power spectrum during false awakening followed the same profile as in sleep paralysis. CONCLUSIONS The predominant theta electroencephalography rhythm during sleep paralysis and false awakenings (with rare and lower alpha rhythm) suggests that the brain during sleep paralysis is not in an awake but in a dreaming state.
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Affiliation(s)
- Greta Mainieri
- Sleep Disorder Unit, Pitié-Salpêtrière University Hospital, AP-HP, Paris, France.,Department of Medical and Surgical Sciences and Advanced Technologies "G.F. Ingrassia", University of Catania, Catania Via S. Sofia 78, Italy
| | - Jean-Baptiste Maranci
- Sleep Disorder Unit, Pitié-Salpêtrière University Hospital, AP-HP, Paris, France.,Sorbonne University, Paris, France.,Paris Brain Institute, Paris, France
| | - Pierre Champetier
- Sleep Disorder Unit, Pitié-Salpêtrière University Hospital, AP-HP, Paris, France.,Paris Brain Institute, Paris, France.,Ecole Normale Supérieure Paris-Saclay, Université Paris-Saclay, France
| | | | - Ana Gales
- Sleep Disorder Unit, Pitié-Salpêtrière University Hospital, AP-HP, Paris, France
| | - Pauline Dodet
- Sleep Disorder Unit, Pitié-Salpêtrière University Hospital, AP-HP, Paris, France
| | - Isabelle Arnulf
- Sleep Disorder Unit, Pitié-Salpêtrière University Hospital, AP-HP, Paris, France.,Sorbonne University, Paris, France.,Paris Brain Institute, Paris, France
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25
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Konkoly KR, Appel K, Chabani E, Mangiaruga A, Gott J, Mallett R, Caughran B, Witkowski S, Whitmore NW, Mazurek CY, Berent JB, Weber FD, Türker B, Leu-Semenescu S, Maranci JB, Pipa G, Arnulf I, Oudiette D, Dresler M, Paller KA. Real-time dialogue between experimenters and dreamers during REM sleep. Curr Biol 2021; 31:1417-1427.e6. [PMID: 33607035 PMCID: PMC8162929 DOI: 10.1016/j.cub.2021.01.026] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [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: 05/09/2020] [Revised: 12/08/2020] [Accepted: 01/08/2021] [Indexed: 12/14/2022]
Abstract
Dreams take us to a different reality, a hallucinatory world that feels as real as any waking experience. These often-bizarre episodes are emblematic of human sleep but have yet to be adequately explained. Retrospective dream reports are subject to distortion and forgetting, presenting a fundamental challenge for neuroscientific studies of dreaming. Here we show that individuals who are asleep and in the midst of a lucid dream (aware of the fact that they are currently dreaming) can perceive questions from an experimenter and provide answers using electrophysiological signals. We implemented our procedures for two-way communication during polysomnographically verified rapid-eye-movement (REM) sleep in 36 individuals. Some had minimal prior experience with lucid dreaming, others were frequent lucid dreamers, and one was a patient with narcolepsy who had frequent lucid dreams. During REM sleep, these individuals exhibited various capabilities, including performing veridical perceptual analysis of novel information, maintaining information in working memory, computing simple answers, and expressing volitional replies. Their responses included distinctive eye movements and selective facial muscle contractions, constituting correctly answered questions on 29 occasions across 6 of the individuals tested. These repeated observations of interactive dreaming, documented by four independent laboratory groups, demonstrate that phenomenological and cognitive characteristics of dreaming can be interrogated in real time. This relatively unexplored communication channel can enable a variety of practical applications and a new strategy for the empirical exploration of dreams. Scientific investigations of dreaming have been hampered by the delay between a dream and when people report on their dream, and by a change in state from sleep to wake. To overcome this problem, Konkoly et al. show that individuals in REM sleep can perceive and answer an experimenter’s questions, allowing for real-time communication about a dream.
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Affiliation(s)
- Karen R Konkoly
- Department of Psychology and Cognitive Neuroscience Program, Northwestern University, Evanston, IL, USA
| | - Kristoffer Appel
- Institute of Cognitive Science, Osnabrück University, Osnabrück, Germany; Institute of Sleep and Dream Technologies, Hamburg, Germany
| | - Emma Chabani
- Institut du Cerveau - Paris Brain Institute - ICM, Sorbonne Université, Inserm, CNRS, Paris, France
| | - Anastasia Mangiaruga
- Donders Institute for Brain, Cognition and Behavior, Radboud University Medical Center, Nijmegen, the Netherlands; Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - Jarrod Gott
- Donders Institute for Brain, Cognition and Behavior, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Remington Mallett
- Department of Psychology, University of Texas at Austin, Austin, TX, USA
| | - Bruce Caughran
- Department of Psychology and Cognitive Neuroscience Program, Northwestern University, Evanston, IL, USA
| | - Sarah Witkowski
- Department of Psychology and Cognitive Neuroscience Program, Northwestern University, Evanston, IL, USA
| | - Nathan W Whitmore
- Department of Psychology and Cognitive Neuroscience Program, Northwestern University, Evanston, IL, USA
| | - Christopher Y Mazurek
- Department of Psychology and Cognitive Neuroscience Program, Northwestern University, Evanston, IL, USA
| | | | - Frederik D Weber
- Donders Institute for Brain, Cognition and Behavior, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Başak Türker
- Institut du Cerveau - Paris Brain Institute - ICM, Sorbonne Université, Inserm, CNRS, Paris, France
| | - Smaranda Leu-Semenescu
- Institut du Cerveau - Paris Brain Institute - ICM, Sorbonne Université, Inserm, CNRS, Paris, France; AP-HP, Pitié-Salpêtrière Hospital, Sleep Disorders Department, Paris, France
| | - Jean-Baptiste Maranci
- Institut du Cerveau - Paris Brain Institute - ICM, Sorbonne Université, Inserm, CNRS, Paris, France; AP-HP, Pitié-Salpêtrière Hospital, Sleep Disorders Department, Paris, France
| | - Gordon Pipa
- Institute of Cognitive Science, Osnabrück University, Osnabrück, Germany
| | - Isabelle Arnulf
- Institut du Cerveau - Paris Brain Institute - ICM, Sorbonne Université, Inserm, CNRS, Paris, France; AP-HP, Pitié-Salpêtrière Hospital, Sleep Disorders Department, Paris, France
| | - Delphine Oudiette
- Institut du Cerveau - Paris Brain Institute - ICM, Sorbonne Université, Inserm, CNRS, Paris, France
| | - Martin Dresler
- Donders Institute for Brain, Cognition and Behavior, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Ken A Paller
- Department of Psychology and Cognitive Neuroscience Program, Northwestern University, Evanston, IL, USA.
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Karroum EG, Leu-Semenescu S, Amdur R, Arnulf I. 0798 “Uncovering My Feet Alleviates My Restless Legs”: Impact of Different Activities and Conditions on Restless Legs Symptoms. Sleep 2020. [DOI: 10.1093/sleep/zsaa056.794] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Introduction
The restless legs syndrome (RLS) is a resting wake state disorder with inactivity/decreased movement as an aggravating factor and activity/increased movement as an alleviating factor. Other activities and conditions may impact RLS symptoms but have not been systematically studied.
Methods
Fifty-six patients with primary severe RLS (age: 64.1±11.3; 66% women) responded about the effect of 20 activities/conditions on their RLS symptoms. Responses were assigned a numerical value: Aggravation (-1), No effect/Don’t know (0), Alleviation (+1), with calculating a mean effect score for each activity/condition and using a sign test to determine if that score was significantly above or below zero (no effect). Responses were further analyzed based on age, age at RLS onset, duration of RLS, RLS severity, gender, Familial/Non-familial RLS, and Painful/Non-Painful RLS. Association of continuous variables and categorical variables with each activity/condition was examined using Spearman correlation test and Fisher exact test, respectively. Bonferroni p threshold was set at p=0.00036.
Results
Activities/conditions with significant (p<0.0001) positive mean effect scores were: Feet uncovering (0.70); Leg massaging (0.63); Cold showers (0.54); and Manual activities (0.46). Activities with significant negative mean effect scores were: Vehicle passenger (-0.80); Show attendance (-0.70); Bedsheets weight on legs (-0.57); Watching TV (-0.54); High ambient temperature (-0.45); During meals (-0.39) (all p<0.0001); and Bedsheets rubbing on legs (-0.34; p=0.0002). Activities/conditions with no significant (all p>0.00036) mean effect scores were: Driving (0.00); Gambling (0.02); Professional activities (0.13); Hot showers (0.13); Using computer (0.14); Low ambient temperature (0.21); Sexual activities (0.27); Mental activities (0.29); and Sports activities (0.34). There was no significant association between each activity/condition and age, age at RLS onset, duration of RLS, RLS severity, gender, Familial/Non-familial RLS, or Painful/Non-Painful RLS.
Conclusion
There is a wide range of impact of different activities/conditions on RLS symptoms. These could be further considered in the non-pharmacological treatment or prevention of RLS symptoms.
Support
This study was not funded.
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Affiliation(s)
- E G Karroum
- Department of Neurology, The George Washington University School of Medicine and Health Sciences, Washington, DC
| | - S Leu-Semenescu
- Sleep Disorders Unit, Pitié-Salpêtrière Charles Foix University Hospital, APHP, Paris, FRANCE
- Sorbonne University, Paris, FRANCE
| | - R Amdur
- Department of Surgery, The George Washington University School of Medicine and Health Sciences, Washington, DC
| | - I Arnulf
- Sleep Disorders Unit, Pitié-Salpêtrière Charles Foix University Hospital, APHP, Paris, FRANCE
- Sorbonne University, Paris, FRANCE
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Dauvilliers Y, Arnulf I, Szakacs Z, Leu-Semenescu S, Lecomte I, Scart-Gres C, Lecomte JM, Schwartz JC. Long-term use of pitolisant to treat patients with narcolepsy: Harmony III Study. Sleep 2020; 42:5540186. [PMID: 31529094 PMCID: PMC6802569 DOI: 10.1093/sleep/zsz174] [Citation(s) in RCA: 43] [Impact Index Per Article: 10.8] [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: 02/25/2019] [Revised: 06/08/2019] [Indexed: 11/14/2022] Open
Abstract
Study Objectives To asses the long-term safety and efficacy of pitolisant, an histamine H3-receptor antagonist, on narcolepsy. Methods This open-label, single-arm, pragmatic study, recruited adult patients with narcolepsy and Epworth Sleepiness Scale (ESS) score ≥12. After a titration period, patients were treated for up to 1 year with oral pitolisant once-a-day at up to 40 mg. Concomitant stimulants and anti-cataplectic agents were allowed. The primary endpoint was safety; secondary endpoints included ESS, cataplexy, and other diary parameters. Results Patients (n = 102, 75 with cataplexy) received pitolisant, for the first time in 73 of them. Sixty-eight patients (51 with cataplexy) completed the 12-month treatment. Common treatment-emergent adverse events were headache (11.8% of patients), insomnia (8.8%), weight gain (7.8%), anxiety (6.9%), depressive symptoms (4.9%), and nausea (4.9%). Seven patients had a serious adverse effect, unrelated to pitolisant except for a possibly related miscarriage. One-third of patients stopped pitolisant, mostly (19.6%) for insufficient benefit. ESS score decreased by 4.6 ± 0.6. Two-thirds of patients completing the treatment were responders (ESS ≤ 10 or ESS decrease ≥ 3), and one third had normalized ESS (≤10). Complete and partial cataplexy, hallucinations, sleep paralysis, and sleep attacks were reduced by 76%, 65%, 54%, 63%, and 27%, respectively. Pitolisant as monotherapy (43% of patients) was better tolerated and more efficacious on ESS than on add-on, but efficacy was maintained in this last case. Conclusions Long-term safety and efficacy of pitolisant on daytime sleepiness, cataplexy, hallucinations, and sleep paralysis is confirmed.
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Affiliation(s)
- Yves Dauvilliers
- Reference National Center for Narcolepsy, Sleep Unit, Department of Neurology, Gui-de-Chauliac Hospital, University of Montpellier 1, Montpellier, INSERM U1061, France
| | - Isabelle Arnulf
- Sleep Disorder Unit, Hôpital la Pitié-Salpêtrière, Paris, France
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Chabani E, Vionnet MC, Beauté R, Leu-Semenescu S, Dodet P, Arnulf I. Blackout of my nights: Contentless, timeless and selfless report from the night in patients with central hypersomnias. Conscious Cogn 2020; 81:102931. [PMID: 32339976 DOI: 10.1016/j.concog.2020.102931] [Citation(s) in RCA: 4] [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: 09/23/2019] [Revised: 02/20/2020] [Accepted: 04/06/2020] [Indexed: 11/24/2022]
Abstract
At the extreme spectrum of consciousness during sleep, some patients with rare hypersomnias reported experiencing a specific night 'blackout' when sleeping, i.e., an absence of experiences or recall of them from sleep onset to offset. Thus, we explored through questionnaires the conscious experiences (dreaming experience, mind, self) during the night in 133 patients with idiopathic hypersomnia, 108 patients with narcolepsy, and 128 healthy controls. The night blackout was more frequent in idiopathic hypersomnia than in narcolepsy and control groups. Patients with idiopathic hypersomnia and frequent night amnesia had lower dream recall frequencies, and felt more often sleep as deep and mind as blank during the night. They had a higher proportion of slow wave sleep on their (retrospectively collected) sleep recordings than those without night blackout. This night blackout provides a new model for studying loss of consciousness during sleep, here as a contentless, selfless and timeless feeling upon awakening.
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Affiliation(s)
- Emma Chabani
- Sorbonne University, Paris, France; Paris Brain Institute (IHU@ICM; Inserm UMR_S 975; CNRS UMR 7225), Paris, France
| | | | | | - Smaranda Leu-Semenescu
- Paris Brain Institute (IHU@ICM; Inserm UMR_S 975; CNRS UMR 7225), Paris, France; Sleep Disorders Unit, Pitié-Salpêtrière University Hospital, Assistance Publique - Hôpitaux de Paris, Paris, France; National Reference Center on Narcolepsy and Rare Hypersomnias, France
| | - Pauline Dodet
- Paris Brain Institute (IHU@ICM; Inserm UMR_S 975; CNRS UMR 7225), Paris, France; Sleep Disorders Unit, Pitié-Salpêtrière University Hospital, Assistance Publique - Hôpitaux de Paris, Paris, France; National Reference Center on Narcolepsy and Rare Hypersomnias, France
| | - Isabelle Arnulf
- Sorbonne University, Paris, France; Paris Brain Institute (IHU@ICM; Inserm UMR_S 975; CNRS UMR 7225), Paris, France; Sleep Disorders Unit, Pitié-Salpêtrière University Hospital, Assistance Publique - Hôpitaux de Paris, Paris, France; National Reference Center on Narcolepsy and Rare Hypersomnias, France.
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Barros A, Uguccioni G, Salkin-Goux V, Leu-Semenescu S, Dodet P, Arnulf I. Simple behavioral criteria for the diagnosis of disorders of arousal. J Clin Sleep Med 2019; 16:121-128. [PMID: 31957639 DOI: 10.5664/jcsm.8136] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [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: 11/13/2022]
Abstract
STUDY OBJECTIVES This case-control study aimed to identify and validate behavioral markers supporting the diagnosis of disorders of arousal (DOA) with video polysomnography. METHODS All behaviors associated with 1,335 episodes of N3 interruptions were compared in 52 adult patients with DOA versus 52 participants without DOA (healthy control patients and patients with insomnia, hypersomnia, or sleep apnea syndrome). RESULTS Patients with DOA had more frequent (5.1 ± 2.4 versus 3.4 ± 1.9 interruptions/N3 time) and longer (35.8 ± 33 versus 23.1 ± 21.4 sec) arousals and awakenings from N3 than control patients. In the DOA group, the onset of behaviors was more abrupt, and behaviors including eye opening (69% versus 16%), head raising (41% versus 9%), visually exploring the environment (27% versus 1%), expression of fear/surprise (21% versus zero), speaking (18% versus 0.3%), trunk raising (13% versus 0.3%), and interacting with the environment (13% versus 0.5%), were (unlike quiet, comfort behaviors) more frequent than in control patients. A cutoff of two or more N3 interruptions containing eye opening yielded a sensitivity of 94.2% and a specificity of 76.9% for a DOA diagnosis. This accuracy was confirmed in a second set of data (second night of monitoring). Behaviors including an expression of fear/surprise (67.3%), sitting (32.7%), screaming, and standing up were specific to patients with DOA. CONCLUSIONS A simple, behavioral video marker of behavioral reactions during N3 interruption (ie, opening the eyes at least two times in the same night) was sensitive, specific, and reproducible for discriminating patients with DOA from sleep laboratory control patients. CLINICAL TRIAL REGISTRATION This study is a surrogate study of NCT02648568 and NCT03074578 on ClinicalTrials.gov.
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Affiliation(s)
- Ariana Barros
- AP-HP, Pitié -Salpêtrière Hospital, Sleep Disorders Unit, Paris, France.,Centro Hospitalar de Lisboa Central, Lisboa, Portugal
| | - Ginevra Uguccioni
- AP-HP, Pitié -Salpêtrière Hospital, Sleep Disorders Unit, Paris, France
| | | | - Smaranda Leu-Semenescu
- AP-HP, Pitié -Salpêtrière Hospital, Sleep Disorders Unit, Paris, France.,IHU@ICM, Sorbonne University, Paris, France
| | - Pauline Dodet
- AP-HP, Pitié -Salpêtrière Hospital, Sleep Disorders Unit, Paris, France.,IHU@ICM, Sorbonne University, Paris, France
| | - Isabelle Arnulf
- AP-HP, Pitié -Salpêtrière Hospital, Sleep Disorders Unit, Paris, France.,IHU@ICM, Sorbonne University, Paris, France
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30
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Beigneux Y, Arnulf I, Guillaume-Jugnot P, Leu-Semenescu S, Maillart E, Lubetzki C, Benveniste O, Papeix C. Secondary hypersomnia as an initial manifestation of neuromyelitis optica spectrum disorders. Mult Scler Relat Disord 2019; 38:101869. [PMID: 31785490 DOI: 10.1016/j.msard.2019.101869] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [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: 10/22/2019] [Accepted: 11/23/2019] [Indexed: 11/29/2022]
Abstract
The identification of AQP4-IgG, a specific and pathogenic antibody of NMO/SD has led to a broadening of the clinical spectrum of manifestations of NMO/SD including the presence of encephalic symptoms. Lesions are often distributed on peri‑ependymal area and sometimes affected the diencephalon leading to sleep disorders. We report a case of hypersomnia with polysomnographic documentation during the first attack of NMO/SD. Brain MRI revealed bilateral hypothalamic lesions around the third ventricle, whereas optic nerves and spinal cord were intact. The record of the nocturnal video-polysomnography followed by multiple sleep latency tests (MSLT) revealed an abnormal shortened sleep period with a single sleep onset in REM allowing secondary central hypersomnia diagnosis. The recovery of hypersomnia was complete within few months without psychostimulant treatment and the diencephalic lesion disappeared. Thus, diencephalic form of NMO/SD seems to cause narcolepsy or non-narcoleptic central hypersomnia and have a good recovery.
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Affiliation(s)
- Ysoline Beigneux
- Département de neurologie, Hôpital de la pitié salpêtrière, APHP, Sorbonne Université, Paris 75013, France.
| | - Isabelle Arnulf
- Service des Pathologies du Sommeil, Centre de Référence narcolepsie et hypersomnies rares, Hôpital de la pitié salpêtrière, APHP, Sorbonne Université, Paris 75013, France
| | - Perrine Guillaume-Jugnot
- Service de Médecine Interne et Immunologie Clinique, Hôpital de la pitié salpêtrière, APHP, Sorbonne Université, Paris 75013, France
| | - Smaranda Leu-Semenescu
- Service des Pathologies du Sommeil, Centre de Référence narcolepsie et hypersomnies rares, Hôpital de la pitié salpêtrière, APHP, Sorbonne Université, Paris 75013, France
| | - Elisabeth Maillart
- Département de neurologie, Hôpital de la pitié salpêtrière, APHP, Sorbonne Université, Paris 75013, France
| | - Catherine Lubetzki
- Département de neurologie, Hôpital de la pitié salpêtrière, APHP, Sorbonne Université, Paris 75013, France
| | - Olivier Benveniste
- Service de Médecine Interne et Immunologie Clinique, Hôpital de la pitié salpêtrière, APHP, Sorbonne Université, Paris 75013, France
| | - Caroline Papeix
- Département de neurologie, Hôpital de la pitié salpêtrière, APHP, Sorbonne Université, Paris 75013, France
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Méneret A, Roze E, Maranci JB, Dodet P, Doummar D, Riant F, Tranchant C, Fraix V, Anheim M, Ekmen A, McGovern E, Vidailhet M, Arnulf I, Leu-Semenescu S. Sleep in ADCY5-Related Dyskinesia: Prolonged Awakenings Caused by Abnormal Movements. J Clin Sleep Med 2019; 15:1021-1029. [PMID: 31383240 DOI: 10.5664/jcsm.7886] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [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: 01/25/2019] [Accepted: 03/18/2019] [Indexed: 12/15/2022]
Abstract
STUDY OBJECTIVES ADCY5 mutations cause early-onset hyperkinetic movement disorders comprising diurnal and nocturnal paroxysmal dyskinesia, and patient-reported sleep fragmentation. We aimed to characterize all movements occurring during sleep and in the transition from sleep to awakening, to ascertain if there is a primary sleep disorder, or if the sleep disturbance is rather a consequence of the dyskinesia. METHODS Using video polysomnography, we evaluated the nocturnal motor events and abnormal movements in 7 patients with ADCY5-related dyskinesia and compared their sleep measures with those of 14 age- and sex-matched healthy controls. RESULTS We observed an increased occurrence of abnormal movements during wake periods compared to sleep in patients with ADCY5-related dyskinesia. While asleep, abnormal movements occurred more frequently during stage N2 and REM sleep, in contrast with stage N3 sleep. Abnormal movements were also more frequent during morning awakenings compared to wake periods before falling asleep. The pattern of the nocturnal abnormal movements mirrored those observed during waking hours. Compared to controls, patients with ADCY5-related dyskinesia had lower sleep efficiencies due to prolonged awakenings secondary to the abnormal movements, but no other differences in sleep measures. Notably, sleep onset latency was short and devoid of violent abnormal movements. CONCLUSIONS In this series of patients with ADCY5-related dyskinesia, nocturnal paroxysmal dyskinesia were not associated with drowsiness or delayed sleep onset, but emerged during nighttime awakenings with subsequent delayed sleep, whereas sleep architecture was normal.
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Affiliation(s)
- Aurélie Méneret
- Department of Neurology, Pitié-Salpêtrière Hospital, Paris, France.,Faculty of Medicine of Sorbonne University, Institut du Cerveau et de la Moelle épinière, Paris, France
| | - Emmanuel Roze
- Department of Neurology, Pitié-Salpêtrière Hospital, Paris, France.,Faculty of Medicine of Sorbonne University, Institut du Cerveau et de la Moelle épinière, Paris, France
| | - Jean-Baptiste Maranci
- Sleep Disorders (Department "R3S"), Pitié-Salpêtrière Hospital, Sorbonne University, Paris, France
| | - Pauline Dodet
- Sleep Disorders (Department "R3S"), Pitié-Salpêtrière Hospital, Sorbonne University, Paris, France
| | - Diane Doummar
- Department of Pediatric Neurology, Hôpital Armand-Trousseau, Paris, France
| | - Florence Riant
- Groupe hospitalier Lariboisière-Fernand Widal, Laboratoire de Génétique, Paris, France.,Université Paris, Paris, France
| | - Christine Tranchant
- Department of Neurology, Hautepierre Hospital, University Hospitals of Strasbourg, Strasbourg, France.,Institute of Genetics and Molecular and Cellular Biology, University of Strasbourg, Illkirch, France.,Strasbourg Federation of Translational Medicine, University of Strasbourg, Strasbourg, France
| | - Valérie Fraix
- Service de Neurologie, Centre Hospitalier Universitaire Grenoble Alpes, Grenoble Institut des Neurosciences, Université Grenoble Alpes, Grenoble, France
| | - Mathieu Anheim
- Department of Neurology, Hautepierre Hospital, University Hospitals of Strasbourg, Strasbourg, France.,Institute of Genetics and Molecular and Cellular Biology, University of Strasbourg, Illkirch, France.,Strasbourg Federation of Translational Medicine, University of Strasbourg, Strasbourg, France
| | - Asya Ekmen
- Faculty of Medicine of Sorbonne University, Institut du Cerveau et de la Moelle épinière, Paris, France
| | - Eavan McGovern
- Department of Neurology, Pitié-Salpêtrière Hospital, Paris, France
| | - Marie Vidailhet
- Department of Neurology, Pitié-Salpêtrière Hospital, Paris, France.,Faculty of Medicine of Sorbonne University, Institut du Cerveau et de la Moelle épinière, Paris, France
| | - Isabelle Arnulf
- Faculty of Medicine of Sorbonne University, Institut du Cerveau et de la Moelle épinière, Paris, France.,Sleep Disorders (Department "R3S"), Pitié-Salpêtrière Hospital, Sorbonne University, Paris, France
| | - Smaranda Leu-Semenescu
- Sleep Disorders (Department "R3S"), Pitié-Salpêtrière Hospital, Sorbonne University, Paris, France
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Ghergan A, Coupaye M, Leu-Semenescu S, Attali V, Oppert JM, Arnulf I, Poitou C, Redolfi S. Prevalence and Phenotype of Sleep Disorders in 60 Adults With Prader-Willi Syndrome. Sleep 2018; 40:4384753. [PMID: 29294134 DOI: 10.1093/sleep/zsx162] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [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: 11/14/2022] Open
Abstract
Study Objectives Excessive sleepiness is a common symptom in Prader-Willi syndrome (PWS), and it negatively impacts the quality of life. Obstructive sleep apnea and narcolepsy phenotypes have been reported in PWS. We characterized sleep disorders in a large cohort of adults with PWS. Methods All consecutive patients with genetically confirmed PWS unselected for sleep-related symptoms, underwent a clinical interview, polysomnography, and multiple sleep latency tests (MSLT, n = 60), followed by long-term (24 hours) polysomnography (n = 22/60). Results Among 60 adults evaluated (57% female, aged 25 ± 10 years, body mass index: 39 ± 12 kg/m2), 67% reported excessive sleepiness. According to the sleep study results, 43% had a previously unrecognized hypersomnia disorder, 15% had an isolated sleep breathing disorder, 12% had combined hypersomnia disorder and untreated breathing sleep disorder, and only 30% had normal sleep. Isolated hypersomnia disorder included narcolepsy in 35% (type 1, n = 1, and type 2, n = 8), hypersomnia in 12% (total sleep time >11 hours, n = 2, and MSLT <8 minutes, n = 1), and borderline phenotype in 53% (≥2 sleep onset in REM periods and MSLT >8 minutes, n = 10, and 8 minutes < MSLT < 10 minutes, n = 4). Sleep breathing disorders, isolated and combined, included obstructive sleep apnea (n = 14, already treated in seven), sleep hypoxemia (n = 1) and previously undiagnosed hypoventilation (n = 5). Modafinil was taken by 16 patients (well tolerated in 10), resulting in improved sleepiness over a mean 5-year follow-up period. Conclusion Sleepiness affects more than half of adult patients with PWS, with a variety of hypersomnia disorder (narcolepsy, hypersomnia, and borderline phenotypes) and breathing sleep disorders. Earlier diagnosis and management of sleep disorders may improve sleepiness, cognition, and behavior in these patients.
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Affiliation(s)
- Adelina Ghergan
- Assistance Publique-Hôpitaux de Paris (AP-HP), Groupe Hospitalier Pitié-Salpêtrière Charles Foix, Service de Pathologies du Sommeil (Département R3S) et Centre de Référence National pour Narcolepsie, Hypersomnie et Syndrome de Kleine-Levin, Paris, France
| | - Muriel Coupaye
- AP-HP, Groupe Hospitalier Pitié-Salpêtrière Charles Foix, Service de Nutrition, Centre de Référence National pour Syndrome de Prader-Willi et Institut Cardiométabolisme et Nutrition (ICAN), Paris, France
| | - Smaranda Leu-Semenescu
- Assistance Publique-Hôpitaux de Paris (AP-HP), Groupe Hospitalier Pitié-Salpêtrière Charles Foix, Service de Pathologies du Sommeil (Département R3S) et Centre de Référence National pour Narcolepsie, Hypersomnie et Syndrome de Kleine-Levin, Paris, France
| | - Valérie Attali
- Assistance Publique-Hôpitaux de Paris (AP-HP), Groupe Hospitalier Pitié-Salpêtrière Charles Foix, Service de Pathologies du Sommeil (Département R3S) et Centre de Référence National pour Narcolepsie, Hypersomnie et Syndrome de Kleine-Levin, Paris, France.,Sorbonne Universités, UPMC Univ Paris 06, INSERM, UMRS1158 Neurophysiologie respiratoire expérimentale et clinique, Paris, France
| | - Jean-Michel Oppert
- AP-HP, Groupe Hospitalier Pitié-Salpêtrière Charles Foix, Service de Nutrition, Centre de Référence National pour Syndrome de Prader-Willi et Institut Cardiométabolisme et Nutrition (ICAN), Paris, France
| | - Isabelle Arnulf
- Assistance Publique-Hôpitaux de Paris (AP-HP), Groupe Hospitalier Pitié-Salpêtrière Charles Foix, Service de Pathologies du Sommeil (Département R3S) et Centre de Référence National pour Narcolepsie, Hypersomnie et Syndrome de Kleine-Levin, Paris, France
| | - Christine Poitou
- AP-HP, Groupe Hospitalier Pitié-Salpêtrière Charles Foix, Service de Nutrition, Centre de Référence National pour Syndrome de Prader-Willi et Institut Cardiométabolisme et Nutrition (ICAN), Paris, France.,Sorbonne Universités, UPMC Univ Paris 06, INSERM, UMRS1166 Nutriomique team 6, Paris, France
| | - Stefania Redolfi
- Assistance Publique-Hôpitaux de Paris (AP-HP), Groupe Hospitalier Pitié-Salpêtrière Charles Foix, Service de Pathologies du Sommeil (Département R3S) et Centre de Référence National pour Narcolepsie, Hypersomnie et Syndrome de Kleine-Levin, Paris, France.,Sorbonne Universités, UPMC Univ Paris 06, INSERM, UMRS1158 Neurophysiologie respiratoire expérimentale et clinique, Paris, France
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Leu-Semenescu S, Petiau C, Charley Monaca C, Dauvilliers Y. French consensus: Augmentation syndrome in restless legs syndrome. Rev Neurol (Paris) 2018; 174:532-539. [PMID: 30055794 DOI: 10.1016/j.neurol.2018.06.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [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: 12/19/2017] [Revised: 04/16/2018] [Accepted: 06/05/2018] [Indexed: 11/19/2022]
Abstract
Augmentation syndrome is one of the most severe complications of RLS. It is characterised by a worsening of treated symptoms; principally an increase in the severity of symptoms and an earlier onset time. Augmentation syndrome occurs primarily with dopaminergic treatments. It is crucial for the patient to be sufficiently well informed to prevent its occurrence and the prescription of too high doses of dopaminergic agonists avoided. In the presence of augmentation syndrome confirmed using the diagnostic criteria, the specialist treating the restless legs syndrome should quickly modify the patient's treatment. In this article, our expert group proposes a practical strategy for the diagnosis, prevention and treatment of augmentation syndrome.
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Affiliation(s)
- S Leu-Semenescu
- Narcolepsy and Idiopathic Hypersomnia National Reference Centre, 75000 Paris, France; Sleep pathologies Service, Pitié-Salpêtrière/Charles-Foix, AP-HP Hospital Group, 75651 Paris cedex 13, France; The Brain and Spinal Institute Research Centre, UPMC Paris 6, Inserm U1127, CNRS UMR7225, 75000 Paris, France.
| | - C Petiau
- Sainte-Barbe Clinical Sleep Centre, Saint-Vincent Hospital Group, 67000 Strasbourg, France
| | - C Charley Monaca
- Clinical Neurophysiology, Teaching Hospital, Lille University, Inserm UMR 1171, 59037 Lille, France
| | - Y Dauvilliers
- Narcolepsy and Idiopathic Hypersomnia National Reference Centre, 75000 Paris, France; Neurology Department, Sleep disorders Unit, Gui-De-Chauliac Hospital, 34295 Montpellier, France; Inserm U1061, UM1, 34295 Montpellier, France
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Nguyen-Michel VH, Solano O, Leu-Semenescu S, Pierre-Justin A, Gales A, Navarro V, Baulac M, Adam C, Dupont S, Arnulf I. Rapid eye movement sleep behavior disorder or epileptic seizure during sleep? A video analysis of motor events. Seizure 2018; 58:1-5. [DOI: 10.1016/j.seizure.2018.03.021] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2018] [Revised: 03/19/2018] [Accepted: 03/20/2018] [Indexed: 12/31/2022] Open
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Léotard A, Groos E, Chaumereuil C, Peter-Derex L, Rossetti AO, Leu-Semenescu S, Arnulf I. IV steroids during long episodes of Kleine-Levin syndrome. Neurology 2018; 90:e1488-e1492. [PMID: 29572278 DOI: 10.1212/wnl.0000000000005349] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2017] [Accepted: 01/18/2018] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To retrospectively compare the benefits (episode cessation) and risks of IV methylprednisolone (IV-MP) vs abstention during prolonged Kleine-Levin syndrome (KLS) episodes. METHODS A total of 26 patients with KLS received 1 g/d IV-MP for 3 days during 1 to 6 episodes each (totaling 43 IV-MP sessions). The change of episode duration with IV-MP (vs previous episode duration) was compared with the change duration between 2 consecutive episodes in 48 untreated patients matched for age, sex, age at KLS onset, number of episodes, and disease duration (more treated than untreated patients had long episodes). RESULTS Eleven patients (42.3%) had an episode that was at least 1 week shorter than the preceding one when they received IV-MP therapy, whereas shorter episodes were significantly less frequent (10.4%) in the untreated group. This benefit was more marked (65.5% responders, 12 fewer days in an episode vs 0 days in the untreated patients) when IV-MP was infused before the 10th day of the episode. Mild, transient adverse effects (insomnia, muscle pain, nervousness/restlessness, but no manic switching) were reported by 61.3% of patients. No specific responder profile was identified. CONCLUSION In this open-labeled, naturalistic study, early IV-MP (following the protocol for multiple sclerosis relapses) had a good benefit/risk ratio during KLS episodes in patients with long episodes (with half of the patients having an early cessation of episodes). CLASSIFICATION OF EVIDENCE This study provides Class IV evidence that for patients with long episodes of KLS, IV steroids decrease the duration of KLS episodes.
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Affiliation(s)
- Antoine Léotard
- From the Sleep Disorders Unit (A.L., E.G., C.C., S.L.-S., I.A.), National Reference Center for Narcolepsy, Hypersomnia and Kleine-Levin Syndrome, Brain Research Institute (CRICM, UPMC, Paris 6; Inserm UMR_S 975; CNRS UMR 7225), Sorbonne University Paris; Sleep Medicine and Respiratory Disease Center (L.P.-D.), Competence Center for Narcolepsy, Hypersomnia and Kleine-Levin Syndrome, Hospices Civils de Lyon, France; and Center for Investigation and Research in Sleep (A.O.R.), Lausanne University Hospital and Lausanne University, Switzerland
| | - Elisabeth Groos
- From the Sleep Disorders Unit (A.L., E.G., C.C., S.L.-S., I.A.), National Reference Center for Narcolepsy, Hypersomnia and Kleine-Levin Syndrome, Brain Research Institute (CRICM, UPMC, Paris 6; Inserm UMR_S 975; CNRS UMR 7225), Sorbonne University Paris; Sleep Medicine and Respiratory Disease Center (L.P.-D.), Competence Center for Narcolepsy, Hypersomnia and Kleine-Levin Syndrome, Hospices Civils de Lyon, France; and Center for Investigation and Research in Sleep (A.O.R.), Lausanne University Hospital and Lausanne University, Switzerland
| | - Charlotte Chaumereuil
- From the Sleep Disorders Unit (A.L., E.G., C.C., S.L.-S., I.A.), National Reference Center for Narcolepsy, Hypersomnia and Kleine-Levin Syndrome, Brain Research Institute (CRICM, UPMC, Paris 6; Inserm UMR_S 975; CNRS UMR 7225), Sorbonne University Paris; Sleep Medicine and Respiratory Disease Center (L.P.-D.), Competence Center for Narcolepsy, Hypersomnia and Kleine-Levin Syndrome, Hospices Civils de Lyon, France; and Center for Investigation and Research in Sleep (A.O.R.), Lausanne University Hospital and Lausanne University, Switzerland
| | - Laure Peter-Derex
- From the Sleep Disorders Unit (A.L., E.G., C.C., S.L.-S., I.A.), National Reference Center for Narcolepsy, Hypersomnia and Kleine-Levin Syndrome, Brain Research Institute (CRICM, UPMC, Paris 6; Inserm UMR_S 975; CNRS UMR 7225), Sorbonne University Paris; Sleep Medicine and Respiratory Disease Center (L.P.-D.), Competence Center for Narcolepsy, Hypersomnia and Kleine-Levin Syndrome, Hospices Civils de Lyon, France; and Center for Investigation and Research in Sleep (A.O.R.), Lausanne University Hospital and Lausanne University, Switzerland
| | - Andrea O Rossetti
- From the Sleep Disorders Unit (A.L., E.G., C.C., S.L.-S., I.A.), National Reference Center for Narcolepsy, Hypersomnia and Kleine-Levin Syndrome, Brain Research Institute (CRICM, UPMC, Paris 6; Inserm UMR_S 975; CNRS UMR 7225), Sorbonne University Paris; Sleep Medicine and Respiratory Disease Center (L.P.-D.), Competence Center for Narcolepsy, Hypersomnia and Kleine-Levin Syndrome, Hospices Civils de Lyon, France; and Center for Investigation and Research in Sleep (A.O.R.), Lausanne University Hospital and Lausanne University, Switzerland
| | - Smaranda Leu-Semenescu
- From the Sleep Disorders Unit (A.L., E.G., C.C., S.L.-S., I.A.), National Reference Center for Narcolepsy, Hypersomnia and Kleine-Levin Syndrome, Brain Research Institute (CRICM, UPMC, Paris 6; Inserm UMR_S 975; CNRS UMR 7225), Sorbonne University Paris; Sleep Medicine and Respiratory Disease Center (L.P.-D.), Competence Center for Narcolepsy, Hypersomnia and Kleine-Levin Syndrome, Hospices Civils de Lyon, France; and Center for Investigation and Research in Sleep (A.O.R.), Lausanne University Hospital and Lausanne University, Switzerland
| | - Isabelle Arnulf
- From the Sleep Disorders Unit (A.L., E.G., C.C., S.L.-S., I.A.), National Reference Center for Narcolepsy, Hypersomnia and Kleine-Levin Syndrome, Brain Research Institute (CRICM, UPMC, Paris 6; Inserm UMR_S 975; CNRS UMR 7225), Sorbonne University Paris; Sleep Medicine and Respiratory Disease Center (L.P.-D.), Competence Center for Narcolepsy, Hypersomnia and Kleine-Levin Syndrome, Hospices Civils de Lyon, France; and Center for Investigation and Research in Sleep (A.O.R.), Lausanne University Hospital and Lausanne University, Switzerland.
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Haridi M, Weyn Banningh S, Clé M, Leu-Semenescu S, Vidailhet M, Arnulf I. Is there a common motor dysregulation in sleepwalking and REM sleep behaviour disorder? J Sleep Res 2017; 26:614-622. [DOI: 10.1111/jsr.12544] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2016] [Accepted: 03/20/2017] [Indexed: 11/26/2022]
Affiliation(s)
- Mehdi Haridi
- Sleep Disorders Unit; Pitié-Salpêtrière University Hospital; APHP; Paris France
- Centre de Recherche de l'Institut du Cerveau et de la Moelle épinière - UPMC-Paris 6; Inserm UMR_S 975; CNRS UMR 7225; Paris France
| | | | - Marion Clé
- Sleep Disorders Unit; Pitié-Salpêtrière University Hospital; APHP; Paris France
- Centre de Recherche de l'Institut du Cerveau et de la Moelle épinière - UPMC-Paris 6; Inserm UMR_S 975; CNRS UMR 7225; Paris France
| | - Smaranda Leu-Semenescu
- Sleep Disorders Unit; Pitié-Salpêtrière University Hospital; APHP; Paris France
- Centre de Recherche de l'Institut du Cerveau et de la Moelle épinière - UPMC-Paris 6; Inserm UMR_S 975; CNRS UMR 7225; Paris France
| | - Marie Vidailhet
- Centre de Recherche de l'Institut du Cerveau et de la Moelle épinière - UPMC-Paris 6; Inserm UMR_S 975; CNRS UMR 7225; Paris France
- Pierre and Marie Curie University; Paris France
| | - Isabelle Arnulf
- Sleep Disorders Unit; Pitié-Salpêtrière University Hospital; APHP; Paris France
- Centre de Recherche de l'Institut du Cerveau et de la Moelle épinière - UPMC-Paris 6; Inserm UMR_S 975; CNRS UMR 7225; Paris France
- Pierre and Marie Curie University; Paris France
- Clinical Investigation Centre Paris Est CIC-9304; Paris France
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Gallea C, Ewenczyk C, Degos B, Welter ML, Grabli D, Leu-Semenescu S, Valabregue R, Berroir P, Yahia-Cherif L, Bertasi E, Fernandez-Vidal S, Bardinet E, Roze E, Benali H, Poupon C, François C, Arnulf I, Lehéricy S, Vidailhet M. Pedunculopontine network dysfunction in Parkinson's disease with postural control and sleep disorders. Mov Disord 2017; 32:693-704. [DOI: 10.1002/mds.26923] [Citation(s) in RCA: 47] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2016] [Revised: 12/12/2016] [Accepted: 12/19/2016] [Indexed: 11/08/2022] Open
Affiliation(s)
- Cecile Gallea
- Centre de Neuroimagerie de Recherche (CENIR), Institut du Cerveau et de la Moelle, ICM; Paris France
- Inserm, U 1127; Paris France
- CNRS, UMR 7225; Paris France
- Sorbonne Universités, UPMC Univ Paris 06, UMR S 1127; Paris France
- Institut du Cerveau et de la Moelle épinière, ICM; Paris France
| | - Claire Ewenczyk
- Inserm, U 1127; Paris France
- CNRS, UMR 7225; Paris France
- Sorbonne Universités, UPMC Univ Paris 06, UMR S 1127; Paris France
- Institut du Cerveau et de la Moelle épinière, ICM; Paris France
- Assistance Publique Hôpitaux de Paris (APHP), INSERM, ICM, Centre d’Investigation Clinique Pitié Neurosciences, CIC-1422, Département des Maladies du Système Nerveux, Hôpital Pitié-Salpêtrière; Paris France
| | - Bertrand Degos
- AP-HP, Centre Inter-Régional de Coordination de la Maladie de Parkinson, Hôpital de la Pitié Salpêtrière, Département des Maladies du Système Nerveux; Paris France
| | - Marie-Laure Welter
- Inserm, U 1127; Paris France
- CNRS, UMR 7225; Paris France
- Sorbonne Universités, UPMC Univ Paris 06, UMR S 1127; Paris France
- Institut du Cerveau et de la Moelle épinière, ICM; Paris France
- AP-HP, Centre Inter-Régional de Coordination de la Maladie de Parkinson, Hôpital de la Pitié Salpêtrière, Département des Maladies du Système Nerveux; Paris France
| | - David Grabli
- Inserm, U 1127; Paris France
- CNRS, UMR 7225; Paris France
- Sorbonne Universités, UPMC Univ Paris 06, UMR S 1127; Paris France
- Institut du Cerveau et de la Moelle épinière, ICM; Paris France
- AP-HP, Centre Inter-Régional de Coordination de la Maladie de Parkinson, Hôpital de la Pitié Salpêtrière, Département des Maladies du Système Nerveux; Paris France
| | - Smaranda Leu-Semenescu
- Inserm, U 1127; Paris France
- Sorbonne Universités, UPMC Univ Paris 06, UMR S 1127; Paris France
- Institut du Cerveau et de la Moelle épinière, ICM; Paris France
- Sleep Disorders Unit, Pitié-Salpêtrière Hospital, AP-HP; Paris France
| | - Romain Valabregue
- Centre de Neuroimagerie de Recherche (CENIR), Institut du Cerveau et de la Moelle, ICM; Paris France
- Inserm, U 1127; Paris France
- CNRS, UMR 7225; Paris France
- Sorbonne Universités, UPMC Univ Paris 06, UMR S 1127; Paris France
- Institut du Cerveau et de la Moelle épinière, ICM; Paris France
| | - Pierre Berroir
- Centre de Neuroimagerie de Recherche (CENIR), Institut du Cerveau et de la Moelle, ICM; Paris France
- Inserm, U 1127; Paris France
- CNRS, UMR 7225; Paris France
- Sorbonne Universités, UPMC Univ Paris 06, UMR S 1127; Paris France
- Institut du Cerveau et de la Moelle épinière, ICM; Paris France
| | - Lydia Yahia-Cherif
- Centre de Neuroimagerie de Recherche (CENIR), Institut du Cerveau et de la Moelle, ICM; Paris France
- Inserm, U 1127; Paris France
- CNRS, UMR 7225; Paris France
- Sorbonne Universités, UPMC Univ Paris 06, UMR S 1127; Paris France
- Institut du Cerveau et de la Moelle épinière, ICM; Paris France
| | - Eric Bertasi
- Centre de Neuroimagerie de Recherche (CENIR), Institut du Cerveau et de la Moelle, ICM; Paris France
- Inserm, U 1127; Paris France
- CNRS, UMR 7225; Paris France
- Sorbonne Universités, UPMC Univ Paris 06, UMR S 1127; Paris France
- Institut du Cerveau et de la Moelle épinière, ICM; Paris France
| | - Sara Fernandez-Vidal
- Centre de Neuroimagerie de Recherche (CENIR), Institut du Cerveau et de la Moelle, ICM; Paris France
- Inserm, U 1127; Paris France
- CNRS, UMR 7225; Paris France
- Sorbonne Universités, UPMC Univ Paris 06, UMR S 1127; Paris France
- Institut du Cerveau et de la Moelle épinière, ICM; Paris France
| | - Eric Bardinet
- Centre de Neuroimagerie de Recherche (CENIR), Institut du Cerveau et de la Moelle, ICM; Paris France
- Inserm, U 1127; Paris France
- CNRS, UMR 7225; Paris France
- Sorbonne Universités, UPMC Univ Paris 06, UMR S 1127; Paris France
- Institut du Cerveau et de la Moelle épinière, ICM; Paris France
| | - Emmanuel Roze
- Inserm, U 1127; Paris France
- CNRS, UMR 7225; Paris France
- Sorbonne Universités, UPMC Univ Paris 06, UMR S 1127; Paris France
- Institut du Cerveau et de la Moelle épinière, ICM; Paris France
- Assistance Publique Hôpitaux de Paris (APHP), INSERM, ICM, Centre d’Investigation Clinique Pitié Neurosciences, CIC-1422, Département des Maladies du Système Nerveux, Hôpital Pitié-Salpêtrière; Paris France. AP-HP, Centre Inter-Régional de Coordination de la Maladie de Parkinson, Hôpital de la Pitié Salpêtrière, Département des Maladies du Système Nerveux; Paris France
| | - Habib Benali
- CNRS, UMR 7225; Paris France
- Sorbonne Universités, UPMC Univ Paris 06, UMR S 1127; Paris France
| | - Cyril Poupon
- CEA Saclay, Neurospin/LNAO; Gif sur Yvette France
| | - Chantal François
- Inserm, U 1127; Paris France
- CNRS, UMR 7225; Paris France
- Sorbonne Universités, UPMC Univ Paris 06, UMR S 1127; Paris France
- Institut du Cerveau et de la Moelle épinière, ICM; Paris France
| | - Isabelle Arnulf
- Inserm, U 1127; Paris France
- CNRS, UMR 7225; Paris France
- Sorbonne Universités, UPMC Univ Paris 06, UMR S 1127; Paris France
- Institut du Cerveau et de la Moelle épinière, ICM; Paris France
- Sleep Disorders Unit, Pitié-Salpêtrière Hospital, AP-HP; Paris France
| | - Stéphane Lehéricy
- Centre de Neuroimagerie de Recherche (CENIR), Institut du Cerveau et de la Moelle, ICM; Paris France
- Inserm, U 1127; Paris France
- CNRS, UMR 7225; Paris France
- Sorbonne Universités, UPMC Univ Paris 06, UMR S 1127; Paris France
- Institut du Cerveau et de la Moelle épinière, ICM; Paris France
| | - Marie Vidailhet
- Inserm, U 1127; Paris France
- CNRS, UMR 7225; Paris France
- Sorbonne Universités, UPMC Univ Paris 06, UMR S 1127; Paris France
- Institut du Cerveau et de la Moelle épinière, ICM; Paris France
- Assistance Publique Hôpitaux de Paris (APHP), INSERM, ICM, Centre d’Investigation Clinique Pitié Neurosciences, CIC-1422, Département des Maladies du Système Nerveux, Hôpital Pitié-Salpêtrière; Paris France. AP-HP, Centre Inter-Régional de Coordination de la Maladie de Parkinson, Hôpital de la Pitié Salpêtrière, Département des Maladies du Système Nerveux; Paris France
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Leu-Semenescu S, Quera-Salva MA, Dauvilliers Y. French consensus. Idiopathic hypersomnia: Investigations and follow-up. Rev Neurol (Paris) 2017; 173:32-37. [DOI: 10.1016/j.neurol.2016.09.015] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2016] [Accepted: 09/20/2016] [Indexed: 10/20/2022]
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Barateau L, Lopez R, Arnulf I, Lecendreux M, Franco P, Drouot X, Leu-Semenescu S, Jaussent I, Dauvilliers Y. Comorbidity between central disorders of hypersomnolence and immune-based disorders. Neurology 2016; 88:93-100. [PMID: 27864522 DOI: 10.1212/wnl.0000000000003432] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2016] [Accepted: 09/21/2016] [Indexed: 11/15/2022] Open
Abstract
Objective:To assess and compare the frequencies of personal and family history of autoimmune diseases (AID), autoinflammatory disorders (ID), and allergies in a population of patients, adults and children, with narcolepsy type 1 (NT1), narcolepsy type 2 (NT2), and idiopathic hypersomnia (IH), 3 central hypersomnia disorders, and healthy controls.Methods:Personal and family history of AID, ID, and allergies were assessed by questionnaire and medical interview in a large cohort of 450 consecutive adult patients (206 NT1, 106 NT2, 138 IH) and 95 pediatric patients (80 NT1) diagnosed according to the third International Classification of Sleep Disorders criteria in national reference centers for narcolepsy in France and 751 controls (700 adults, 51 children) from the general population.Results:Ten adults with NT1 (4.9%) had a comorbid AID vs 3.4% of adult controls, without between-group differences in adjusted models. AID frequency did not differ between children with NT1 and controls. Conversely, compared with controls, AID frequency was higher in adults with NT2 (p = 0.002), whereas ID (p = 0.0002) and allergy (p = 0.003) frequencies were higher in adults with IH. A positive family history of AID was found in the NT1 group and of ID in the IH group.Conclusions:NT1 is not associated with increased risk of comorbid immune disorders, in favor of a potentially unique pathophysiology. Conversely, compared with controls, the frequency of autoimmune diseases was higher in adults with NT2, whereas allergies and autoinflammatory disorders were more common in adults with IH, suggesting an immune dysregulation mechanism in these conditions.
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Affiliation(s)
- Lucie Barateau
- From the National Reference Centre for Orphan Diseases, Narcolepsy, Idiopathic Hypersomnia and Kleine-Levin Syndrome (L.B., R.L., I.A., M.L., P.F., S.L.-S., Y.D.), Paris; Clinical Neurophysiology Department (X.D), CHU de Poitiers; Inserm, U1061 (L.B., R.L., I.J., Y.D.), Montpellier; Université de Montpellier (L.B., R.L., I.J., Y.D.); Sleep Disorders Center, Department of Neurology (L.B., R.L., Y.D.), Gui-de-Chauliac Hospital, CHU Montpellier; Sleep Disorders Unit (I.A., S.L.-S.), Pitié-Salpêtrière University Hospital, AP-HP, Brain Research Institute (CRICM-UPMC-Paris 6; Inserm UMR-S 975; CNRS UMR 7225), Sorbonne University, UPMC Univ Paris 06; Pediatric Sleep Disorder Centre (M.L.), CHU Robert-Debré, AP-HP, Paris; and Pediatric Sleep Unit (P.F.), Hôpital Femme Mère Enfant, Integrative Physiology of Brain Arousal System, CRNL, INSERM-U1028, CNRS UMR5292, University Lyon 1, France
| | - Régis Lopez
- From the National Reference Centre for Orphan Diseases, Narcolepsy, Idiopathic Hypersomnia and Kleine-Levin Syndrome (L.B., R.L., I.A., M.L., P.F., S.L.-S., Y.D.), Paris; Clinical Neurophysiology Department (X.D), CHU de Poitiers; Inserm, U1061 (L.B., R.L., I.J., Y.D.), Montpellier; Université de Montpellier (L.B., R.L., I.J., Y.D.); Sleep Disorders Center, Department of Neurology (L.B., R.L., Y.D.), Gui-de-Chauliac Hospital, CHU Montpellier; Sleep Disorders Unit (I.A., S.L.-S.), Pitié-Salpêtrière University Hospital, AP-HP, Brain Research Institute (CRICM-UPMC-Paris 6; Inserm UMR-S 975; CNRS UMR 7225), Sorbonne University, UPMC Univ Paris 06; Pediatric Sleep Disorder Centre (M.L.), CHU Robert-Debré, AP-HP, Paris; and Pediatric Sleep Unit (P.F.), Hôpital Femme Mère Enfant, Integrative Physiology of Brain Arousal System, CRNL, INSERM-U1028, CNRS UMR5292, University Lyon 1, France
| | - Isabelle Arnulf
- From the National Reference Centre for Orphan Diseases, Narcolepsy, Idiopathic Hypersomnia and Kleine-Levin Syndrome (L.B., R.L., I.A., M.L., P.F., S.L.-S., Y.D.), Paris; Clinical Neurophysiology Department (X.D), CHU de Poitiers; Inserm, U1061 (L.B., R.L., I.J., Y.D.), Montpellier; Université de Montpellier (L.B., R.L., I.J., Y.D.); Sleep Disorders Center, Department of Neurology (L.B., R.L., Y.D.), Gui-de-Chauliac Hospital, CHU Montpellier; Sleep Disorders Unit (I.A., S.L.-S.), Pitié-Salpêtrière University Hospital, AP-HP, Brain Research Institute (CRICM-UPMC-Paris 6; Inserm UMR-S 975; CNRS UMR 7225), Sorbonne University, UPMC Univ Paris 06; Pediatric Sleep Disorder Centre (M.L.), CHU Robert-Debré, AP-HP, Paris; and Pediatric Sleep Unit (P.F.), Hôpital Femme Mère Enfant, Integrative Physiology of Brain Arousal System, CRNL, INSERM-U1028, CNRS UMR5292, University Lyon 1, France
| | - Michel Lecendreux
- From the National Reference Centre for Orphan Diseases, Narcolepsy, Idiopathic Hypersomnia and Kleine-Levin Syndrome (L.B., R.L., I.A., M.L., P.F., S.L.-S., Y.D.), Paris; Clinical Neurophysiology Department (X.D), CHU de Poitiers; Inserm, U1061 (L.B., R.L., I.J., Y.D.), Montpellier; Université de Montpellier (L.B., R.L., I.J., Y.D.); Sleep Disorders Center, Department of Neurology (L.B., R.L., Y.D.), Gui-de-Chauliac Hospital, CHU Montpellier; Sleep Disorders Unit (I.A., S.L.-S.), Pitié-Salpêtrière University Hospital, AP-HP, Brain Research Institute (CRICM-UPMC-Paris 6; Inserm UMR-S 975; CNRS UMR 7225), Sorbonne University, UPMC Univ Paris 06; Pediatric Sleep Disorder Centre (M.L.), CHU Robert-Debré, AP-HP, Paris; and Pediatric Sleep Unit (P.F.), Hôpital Femme Mère Enfant, Integrative Physiology of Brain Arousal System, CRNL, INSERM-U1028, CNRS UMR5292, University Lyon 1, France
| | - Patricia Franco
- From the National Reference Centre for Orphan Diseases, Narcolepsy, Idiopathic Hypersomnia and Kleine-Levin Syndrome (L.B., R.L., I.A., M.L., P.F., S.L.-S., Y.D.), Paris; Clinical Neurophysiology Department (X.D), CHU de Poitiers; Inserm, U1061 (L.B., R.L., I.J., Y.D.), Montpellier; Université de Montpellier (L.B., R.L., I.J., Y.D.); Sleep Disorders Center, Department of Neurology (L.B., R.L., Y.D.), Gui-de-Chauliac Hospital, CHU Montpellier; Sleep Disorders Unit (I.A., S.L.-S.), Pitié-Salpêtrière University Hospital, AP-HP, Brain Research Institute (CRICM-UPMC-Paris 6; Inserm UMR-S 975; CNRS UMR 7225), Sorbonne University, UPMC Univ Paris 06; Pediatric Sleep Disorder Centre (M.L.), CHU Robert-Debré, AP-HP, Paris; and Pediatric Sleep Unit (P.F.), Hôpital Femme Mère Enfant, Integrative Physiology of Brain Arousal System, CRNL, INSERM-U1028, CNRS UMR5292, University Lyon 1, France
| | - Xavier Drouot
- From the National Reference Centre for Orphan Diseases, Narcolepsy, Idiopathic Hypersomnia and Kleine-Levin Syndrome (L.B., R.L., I.A., M.L., P.F., S.L.-S., Y.D.), Paris; Clinical Neurophysiology Department (X.D), CHU de Poitiers; Inserm, U1061 (L.B., R.L., I.J., Y.D.), Montpellier; Université de Montpellier (L.B., R.L., I.J., Y.D.); Sleep Disorders Center, Department of Neurology (L.B., R.L., Y.D.), Gui-de-Chauliac Hospital, CHU Montpellier; Sleep Disorders Unit (I.A., S.L.-S.), Pitié-Salpêtrière University Hospital, AP-HP, Brain Research Institute (CRICM-UPMC-Paris 6; Inserm UMR-S 975; CNRS UMR 7225), Sorbonne University, UPMC Univ Paris 06; Pediatric Sleep Disorder Centre (M.L.), CHU Robert-Debré, AP-HP, Paris; and Pediatric Sleep Unit (P.F.), Hôpital Femme Mère Enfant, Integrative Physiology of Brain Arousal System, CRNL, INSERM-U1028, CNRS UMR5292, University Lyon 1, France
| | - Smaranda Leu-Semenescu
- From the National Reference Centre for Orphan Diseases, Narcolepsy, Idiopathic Hypersomnia and Kleine-Levin Syndrome (L.B., R.L., I.A., M.L., P.F., S.L.-S., Y.D.), Paris; Clinical Neurophysiology Department (X.D), CHU de Poitiers; Inserm, U1061 (L.B., R.L., I.J., Y.D.), Montpellier; Université de Montpellier (L.B., R.L., I.J., Y.D.); Sleep Disorders Center, Department of Neurology (L.B., R.L., Y.D.), Gui-de-Chauliac Hospital, CHU Montpellier; Sleep Disorders Unit (I.A., S.L.-S.), Pitié-Salpêtrière University Hospital, AP-HP, Brain Research Institute (CRICM-UPMC-Paris 6; Inserm UMR-S 975; CNRS UMR 7225), Sorbonne University, UPMC Univ Paris 06; Pediatric Sleep Disorder Centre (M.L.), CHU Robert-Debré, AP-HP, Paris; and Pediatric Sleep Unit (P.F.), Hôpital Femme Mère Enfant, Integrative Physiology of Brain Arousal System, CRNL, INSERM-U1028, CNRS UMR5292, University Lyon 1, France
| | - Isabelle Jaussent
- From the National Reference Centre for Orphan Diseases, Narcolepsy, Idiopathic Hypersomnia and Kleine-Levin Syndrome (L.B., R.L., I.A., M.L., P.F., S.L.-S., Y.D.), Paris; Clinical Neurophysiology Department (X.D), CHU de Poitiers; Inserm, U1061 (L.B., R.L., I.J., Y.D.), Montpellier; Université de Montpellier (L.B., R.L., I.J., Y.D.); Sleep Disorders Center, Department of Neurology (L.B., R.L., Y.D.), Gui-de-Chauliac Hospital, CHU Montpellier; Sleep Disorders Unit (I.A., S.L.-S.), Pitié-Salpêtrière University Hospital, AP-HP, Brain Research Institute (CRICM-UPMC-Paris 6; Inserm UMR-S 975; CNRS UMR 7225), Sorbonne University, UPMC Univ Paris 06; Pediatric Sleep Disorder Centre (M.L.), CHU Robert-Debré, AP-HP, Paris; and Pediatric Sleep Unit (P.F.), Hôpital Femme Mère Enfant, Integrative Physiology of Brain Arousal System, CRNL, INSERM-U1028, CNRS UMR5292, University Lyon 1, France
| | - Yves Dauvilliers
- From the National Reference Centre for Orphan Diseases, Narcolepsy, Idiopathic Hypersomnia and Kleine-Levin Syndrome (L.B., R.L., I.A., M.L., P.F., S.L.-S., Y.D.), Paris; Clinical Neurophysiology Department (X.D), CHU de Poitiers; Inserm, U1061 (L.B., R.L., I.J., Y.D.), Montpellier; Université de Montpellier (L.B., R.L., I.J., Y.D.); Sleep Disorders Center, Department of Neurology (L.B., R.L., Y.D.), Gui-de-Chauliac Hospital, CHU Montpellier; Sleep Disorders Unit (I.A., S.L.-S.), Pitié-Salpêtrière University Hospital, AP-HP, Brain Research Institute (CRICM-UPMC-Paris 6; Inserm UMR-S 975; CNRS UMR 7225), Sorbonne University, UPMC Univ Paris 06; Pediatric Sleep Disorder Centre (M.L.), CHU Robert-Debré, AP-HP, Paris; and Pediatric Sleep Unit (P.F.), Hôpital Femme Mère Enfant, Integrative Physiology of Brain Arousal System, CRNL, INSERM-U1028, CNRS UMR5292, University Lyon 1, France.
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Arnaldi D, Latimier A, Leu-Semenescu S, De Carli F, Vidailhet M, Arnulf I. Does Postural Rigidity Decrease during REM Sleep without Atonia in Parkinson Disease? J Clin Sleep Med 2016; 12:839-47. [PMID: 26857056 DOI: 10.5664/jcsm.5882] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [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: 08/07/2015] [Accepted: 01/13/2016] [Indexed: 11/13/2022]
Abstract
STUDY OBJECTIVES Rigidity is a muscle hypertonia typical of Parkinson disease (PD), whereas rapid eye movement (REM) sleep behavior disorder (RBD) is characterized by abnormally increased muscle tone during REM sleep (REM sleep without atonia) and enacting dream behaviors. Because movements are not bradykinetic during RBD in patients with PD, we investigated whether the background, wake postural rigidity is attenuated during REM sleep without atonia, in absence of movement. METHODS The amplitude of levator menti (postural muscle) electromyographic activity during relaxed evening wakefulness (considered as reference) and sleep (N2, N3, atonic REM sleep, and quiet REM sleep without atonia) was measured in 20 patients with PD (with and without RBD), 10 patients with idiopathic RBD patients and 10 healthy subjects. RESULTS The chin tone amplitude progressively decreased from wake to N2, N3, and atonic REM sleep in the four groups, but the highest amplitude was observed in PD patients with RBD during atonic REM sleep. Furthermore, chin muscle tone amplitude did not attenuate from wake to REM sleep without atonia in patients with both PD and RBD but dramatically attenuated (by 40% on average) in patients with idiopathic RBD. CONCLUSIONS The high amplitude of chin muscle tone in PD with RBD (but not in idiopathic RBD) during REM sleep with and without atonia suggests that both PD-related hypertonia and RBD-related enhanced muscle tone coexist during REM sleep, together affecting chin muscle tone. Consequently, some rapid RBD movements likely start against a rigid postural tone.
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Affiliation(s)
- Dario Arnaldi
- APHP- Pitié-Salpêtrière Hospital, Sleep Disorders Unit, Paris, France.,Clinical Neurology, Department of Neuroscience (DINOGMI), University of Genoa, Italy
| | - Alice Latimier
- Brain Research Institute- UPMC Paris 6 Univ, Inserm U 1127; CNRS UMR 7225, IHU neuroscience, Paris, France
| | - Smaranda Leu-Semenescu
- APHP- Pitié-Salpêtrière Hospital, Sleep Disorders Unit, Paris, France.,Brain Research Institute- UPMC Paris 6 Univ, Inserm U 1127; CNRS UMR 7225, IHU neuroscience, Paris, France
| | - Fabrizio De Carli
- Institute of Bioimaging and Molecular Physiology, National Research Council, Genoa, Italy
| | - Marie Vidailhet
- Brain Research Institute- UPMC Paris 6 Univ, Inserm U 1127; CNRS UMR 7225, IHU neuroscience, Paris, France.,APHP- Pitié-Salpêtrière Hospital, Neurology Department, Paris, France
| | - Isabelle Arnulf
- APHP- Pitié-Salpêtrière Hospital, Sleep Disorders Unit, Paris, France.,Brain Research Institute- UPMC Paris 6 Univ, Inserm U 1127; CNRS UMR 7225, IHU neuroscience, Paris, France
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Arnulf I, Leu-Semenescu S. [Sleepiness complaint: when is it necessary to monitor sleep?]. Rev Prat 2016; 66:666-668. [PMID: 27538326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
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Barateau L, Jaussent I, Lopez R, Boutrel B, Leu-Semenescu S, Arnulf I, Dauvilliers Y. Smoking, Alcohol, Drug Use, Abuse and Dependence in Narcolepsy and Idiopathic Hypersomnia: A Case-Control Study. Sleep 2016; 39:573-80. [PMID: 26564129 DOI: 10.5665/sleep.5530] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [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: 07/09/2015] [Accepted: 10/01/2015] [Indexed: 11/03/2022] Open
Abstract
STUDY OBJECTIVES Basic experiments support the impact of hypocretin on hyperarousal and motivated state required for increasing drug craving. Our aim was to assess the frequencies of smoking, alcohol and drug use, abuse and dependence in narcolepsy type 1 (NT1, hypocretin-deficient), narcolepsy type 2 (NT2), idiopathic hypersomnia (IH) (non-hypocretin-deficient conditions), in comparison to controls. We hypothesized that NT1 patients would be less vulnerable to drug abuse and addiction compared to other hypersomniac patients and controls from general population. METHODS We performed a cross-sectional study in French reference centres for rare hypersomnia diseases and included 450 adult patients (median age 35 years; 41.3% men) with NT1 (n = 243), NT2 (n = 116), IH (n = 91), and 710 adult controls. All participants were evaluated for alcohol consumption, smoking habits, and substance (alcohol and illicit drug) abuse and dependence diagnosis during the past year using the Mini International Neuropsychiatric Interview. RESULTS An increased proportion of both tobacco and heavy tobacco smokers was found in NT1 compared to controls and other hypersomniacs, despite adjustments for potential confounders. We reported an increased regular and frequent alcohol drinking habit in NT1 versus controls but not compared to other hypersomniacs in adjusted models. In contrast, heavy drinkers were significantly reduced in NT1 versus controls but not compared to other hypersomniacs. The proportion of patients with excessive drug use (codeine, cocaine, and cannabis), substance dependence, or abuse was low in all subgroups, without significant differences between either hypersomnia disorder categories or compared with controls. CONCLUSIONS We first described a low frequency of illicit drug use, dependence, or abuse in patients with central hypersomnia, whether Hcrt-deficient or not, and whether drug-free or medicated, in the same range as in controls. Conversely, heavy drinkers were rare in NT1 compared to controls but not to other hypersomniacs, without any change in alcohol dependence or abuse frequency. Although disruption of hypocretin signaling in rodents reduces drug-seeking behaviors, our results do not support that hypocretin deficiency constitutes a protective factor against the development of drug addiction in humans.
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Affiliation(s)
- Lucie Barateau
- Sleep Disorders Center, Department of Neurology, Gui-de-Chauliac Hospital, CHU Montpellier, France
| | - Isabelle Jaussent
- Inserm, U1061, Montpellier, France; Université Montpellier 1, Montpellier, France
| | - Régis Lopez
- Sleep Disorders Center, Department of Neurology, Gui-de-Chauliac Hospital, CHU Montpellier, France.,Inserm, U1061, Montpellier, France; Université Montpellier 1, Montpellier, France.,National Reference Centre for Orphan Diseases, Narcolepsy, Idiopathic Hypersomnia and Kleine-Levin Syndrome, Paris, France
| | - Benjamin Boutrel
- Center for Psychiatric Neuroscience, Department of Psychiatry, Lausanne University Hospital, Switzerland
| | - Smaranda Leu-Semenescu
- National Reference Centre for Orphan Diseases, Narcolepsy, Idiopathic Hypersomnia and Kleine-Levin Syndrome, Paris, France.,Sleep Disorders Unit, Pitié-Salpêtrière University Hospital, AP-HP, Brain Research Institute (CRICM-UPMC-Paris6; Inserm UMR_S 975; CNRS UMR 7225), Sorbonne Universities, UPMC Univ Paris 06, Paris, France
| | - Isabelle Arnulf
- National Reference Centre for Orphan Diseases, Narcolepsy, Idiopathic Hypersomnia and Kleine-Levin Syndrome, Paris, France.,Sleep Disorders Unit, Pitié-Salpêtrière University Hospital, AP-HP, Brain Research Institute (CRICM-UPMC-Paris6; Inserm UMR_S 975; CNRS UMR 7225), Sorbonne Universities, UPMC Univ Paris 06, Paris, France
| | - Yves Dauvilliers
- Sleep Disorders Center, Department of Neurology, Gui-de-Chauliac Hospital, CHU Montpellier, France.,Inserm, U1061, Montpellier, France; Université Montpellier 1, Montpellier, France.,National Reference Centre for Orphan Diseases, Narcolepsy, Idiopathic Hypersomnia and Kleine-Levin Syndrome, Paris, France
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Ehrminger M, Latimier A, Pyatigorskaya N, Garcia-Lorenzo D, Leu-Semenescu S, Vidailhet M, Lehericy S, Arnulf I. The coeruleus/subcoeruleus complex in idiopathic rapid eye movement sleep behaviour disorder. Brain 2016; 139:1180-8. [PMID: 26920675 DOI: 10.1093/brain/aww006] [Citation(s) in RCA: 120] [Impact Index Per Article: 15.0] [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: 09/14/2015] [Accepted: 12/11/2015] [Indexed: 11/14/2022] Open
Abstract
Idiopathic rapid eye movement sleep behaviour disorder is characterized by nocturnal violence, increased muscle tone during rapid eye movement sleep and the lack of any other neurological disease. However, idiopathic rapid eye movement sleep behaviour disorder can precede parkinsonism and dementia by several years. Using 3 T magnetic resonance imaging and neuromelanin-sensitive sequences, we previously found that the signal intensity was reduced in the locus coeruleus/subcoeruleus area of patients with Parkinson's disease and rapid eye movement sleep behaviour disorder. Here, we studied the integrity of the locus coeruleus/subcoeruleus complex with neuromelanin-sensitive imaging in 21 patients with idiopathic rapid eye movement sleep behaviour disorder and compared the results with those from 21 age- and gender-matched healthy volunteers. All subjects underwent a clinical examination, motor, cognitive, autonomous, psychological, olfactory and colour vision tests, and rapid eye movement sleep characterization using video-polysomnography and 3 T magnetic resonance imaging. The patients more frequently had preclinical markers of alpha-synucleinopathies, including constipation, olfactory deficits, orthostatic hypotension, and subtle motor impairment. Using neuromelanin-sensitive imaging, reduced signal intensity was identified in the locus coeruleus/subcoeruleus complex of the patients with idiopathic rapid eye movement sleep behaviour. The mean sensitivity of the visual analyses of the signal performed by neuroradiologists who were blind to the clinical diagnoses was 82.5%, and the specificity was 81% for the identification of idiopathic rapid eye movement sleep behaviour. The results confirm that this complex is affected in idiopathic rapid eye movement sleep behaviour (to the same degree as it is affected in Parkinson's disease). Neuromelanin-sensitive imaging provides an early marker of non-dopaminergic alpha-synucleinopathy that can be detected on an individual basis.
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Affiliation(s)
- Mickael Ehrminger
- Sleep Disorders Unit, Pitié-Salpêtrière Hospital, AP-HP, Paris, France Ecole Normale Supérieure, Paris, France Sorbonne University, UPMC Paris-6, Paris, France
| | - Alice Latimier
- Sleep Disorders Unit, Pitié-Salpêtrière Hospital, AP-HP, Paris, France Sorbonne University, UPMC Paris-6, Paris, France Brain and Spine Institute - ICM, Centre for Neuroimaging Research - CENIR, UPMC UMR 1127; Inserm U 1127; CNRS UMR 7225, Team Control of Normal and Abnormal Movement, Paris, France
| | - Nadya Pyatigorskaya
- Sorbonne University, UPMC Paris-6, Paris, France Brain and Spine Institute - ICM, Centre for Neuroimaging Research - CENIR, UPMC UMR 1127; Inserm U 1127; CNRS UMR 7225, Team Control of Normal and Abnormal Movement, Paris, France
| | - Daniel Garcia-Lorenzo
- Sorbonne University, UPMC Paris-6, Paris, France Brain and Spine Institute - ICM, Centre for Neuroimaging Research - CENIR, UPMC UMR 1127; Inserm U 1127; CNRS UMR 7225, Team Control of Normal and Abnormal Movement, Paris, France
| | - Smaranda Leu-Semenescu
- Sleep Disorders Unit, Pitié-Salpêtrière Hospital, AP-HP, Paris, France Sorbonne University, UPMC Paris-6, Paris, France
| | - Marie Vidailhet
- Sorbonne University, UPMC Paris-6, Paris, France Brain and Spine Institute - ICM, Centre for Neuroimaging Research - CENIR, UPMC UMR 1127; Inserm U 1127; CNRS UMR 7225, Team Control of Normal and Abnormal Movement, Paris, France
| | - Stéphane Lehericy
- Sorbonne University, UPMC Paris-6, Paris, France Brain and Spine Institute - ICM, Centre for Neuroimaging Research - CENIR, UPMC UMR 1127; Inserm U 1127; CNRS UMR 7225, Team Control of Normal and Abnormal Movement, Paris, France
| | - Isabelle Arnulf
- Sleep Disorders Unit, Pitié-Salpêtrière Hospital, AP-HP, Paris, France Sorbonne University, UPMC Paris-6, Paris, France Brain and Spine Institute - ICM, Centre for Neuroimaging Research - CENIR, UPMC UMR 1127; Inserm U 1127; CNRS UMR 7225, Team Control of Normal and Abnormal Movement, Paris, France INSERM AP-HP, CIC-1421, University Hospital, Paris, 75013, France
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Ehrminger M, Leu-Semenescu S, Cormier F, Corvol JC, Vidailhet M, Debellemaniere E, Brice A, Arnulf I. Sleep aspects on video-polysomnography in LRRK2 mutation carriers. Mov Disord 2015; 30:1839-43. [PMID: 26468079 DOI: 10.1002/mds.26412] [Citation(s) in RCA: 18] [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: 01/04/2015] [Revised: 07/21/2015] [Accepted: 07/31/2015] [Indexed: 11/08/2022] Open
Abstract
BACKGROUND Rapid eye movement sleep behavior disorder and sleepiness precede or accompany idiopathic Parkinson's disease (PD), but their presence in subjects with leucine-rich repeat kinase 2 mutations is unknown. METHODS Ten patients with leucine-rich repeat kinase 2-associated PD, four healthy leucine-rich repeat kinase 2 mutation carriers, 20 patients with idiopathic PD, and 12 healthy controls underwent clinical assessments and a nighttime video-polysomnography. RESULTS No sleep changes, no rapid eye movement sleep behavior disorder, or rapid eye movement sleep without atonia was found in the 14 subjects with leucine-rich repeat kinase 2mutations compared with controls, whereas 41% of patients with idiopathic PD had rapid eye movement sleep behavior disorder. Eventually, 20% of patients with leucine-rich repeat kinase 2-associated PD had abnormal periodic leg movements, a frequency similar to the idiopathic PD group frequency. CONCLUSIONS The sleep phenotype in leucine-rich repeat kinase 2 mutations parallels that of idiopathic PD, except for absent rapid eye movement sleep behavior disorder here in the presymptomatic and symptomatic stages.
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Affiliation(s)
- Mickael Ehrminger
- Ecole Normale Supérieure, Paris, France.,AP-HP, Hôpital Pitié-Salpêtrière, Sleep Disorders unit and Neurology Department, F-75013, Paris, France
| | - Smaranda Leu-Semenescu
- AP-HP, Hôpital Pitié-Salpêtrière, Sleep Disorders unit and Neurology Department, F-75013, Paris, France.,Sorbonne Universitiés, UPMC Univ Paris 06, UMR_S1127, ICM, F-75013, Paris, France.,INSERM, UMR_S1127 and CIC-1422, ICM, F-75013, Paris, France.,CNRS, UMR_7225, ICM, F-75005, Paris, France
| | - Florence Cormier
- AP-HP, Hôpital Pitié-Salpêtrière, Sleep Disorders unit and Neurology Department, F-75013, Paris, France.,Sorbonne Universitiés, UPMC Univ Paris 06, UMR_S1127, ICM, F-75013, Paris, France.,INSERM, UMR_S1127 and CIC-1422, ICM, F-75013, Paris, France.,CNRS, UMR_7225, ICM, F-75005, Paris, France
| | - Jean-Christophe Corvol
- AP-HP, Hôpital Pitié-Salpêtrière, Sleep Disorders unit and Neurology Department, F-75013, Paris, France.,Sorbonne Universitiés, UPMC Univ Paris 06, UMR_S1127, ICM, F-75013, Paris, France.,INSERM, UMR_S1127 and CIC-1422, ICM, F-75013, Paris, France.,CNRS, UMR_7225, ICM, F-75005, Paris, France
| | - Marie Vidailhet
- AP-HP, Hôpital Pitié-Salpêtrière, Sleep Disorders unit and Neurology Department, F-75013, Paris, France.,Sorbonne Universitiés, UPMC Univ Paris 06, UMR_S1127, ICM, F-75013, Paris, France.,INSERM, UMR_S1127 and CIC-1422, ICM, F-75013, Paris, France.,CNRS, UMR_7225, ICM, F-75005, Paris, France
| | - Eden Debellemaniere
- Sorbonne Universitiés, UPMC Univ Paris 06, UMR_S1127, ICM, F-75013, Paris, France.,INSERM, UMR_S1127 and CIC-1422, ICM, F-75013, Paris, France.,CNRS, UMR_7225, ICM, F-75005, Paris, France
| | - Alexis Brice
- AP-HP, Hôpital Pitié-Salpêtrière, Sleep Disorders unit and Neurology Department, F-75013, Paris, France.,Sorbonne Universitiés, UPMC Univ Paris 06, UMR_S1127, ICM, F-75013, Paris, France.,INSERM, UMR_S1127 and CIC-1422, ICM, F-75013, Paris, France.,CNRS, UMR_7225, ICM, F-75005, Paris, France
| | - Isabelle Arnulf
- AP-HP, Hôpital Pitié-Salpêtrière, Sleep Disorders unit and Neurology Department, F-75013, Paris, France.,Sorbonne Universitiés, UPMC Univ Paris 06, UMR_S1127, ICM, F-75013, Paris, France.,INSERM, UMR_S1127 and CIC-1422, ICM, F-75013, Paris, France.,CNRS, UMR_7225, ICM, F-75005, Paris, France
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Leu-Semenescu S, Le Corvec T, Groos E, Lavault S, Golmard JL, Arnulf I. Lithium therapy in Kleine-Levin syndrome: An open-label, controlled study in 130 patients. Neurology 2015; 85:1655-62. [PMID: 26453648 DOI: 10.1212/wnl.0000000000002104] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2015] [Accepted: 06/22/2015] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To compare the benefits and risks of lithium therapy vs abstention/other treatments in Kleine-Levin syndrome (KLS). METHODS In a KLS cohort followed in a single center, 130 patients regularly took lithium carbonate (median dose 1,000 mg/day; n = 71; 40 children), valproate (n = 5), contraceptive pill (n = 5), or no treatment (n = 49). The disease characteristics (frequency, mean, and longest durations of episodes, time incapacitated per year) were compared before and after follow-up in the lithium vs abstention groups. RESULTS The time between KLS onset and therapeutic onset was 69 ± 92 months. The patients were then followed up for a mean of 21.5 ± 17.8 months. Before treatment, the 71 patients treated with lithium tended to have a higher frequency of episodes per year (3.8 ± 2.9 vs 2.9 ± 2.6) and had a longer time spent incapacitated (57 ± 51 vs 37 ± 35 days) than the untreated patients. The mean (-8 ± 20 vs 2 ± 13 days) and longest (-18 ± 35 vs -5 ± 13) episode duration, the time spent incapacitated (-37 ± 65 days vs -10 ± 38), as well as the frequency of episodes per year (-2.6 ± 2.9 vs 1.3 ± 2.78) decreased significantly more in the treated than in the untreated patients. Side effects (reported by 50% of the patients) were mild and classical with lithium (tremor, increased drinking, diarrhea, and subclinical hypothyroidism). CONCLUSIONS In this large, prospective, open-label, controlled study, the benefit/risk ratio of lithium therapy is superior to that of abstention, supporting the concept that lithium has anti-inflammatory/neuroprotective effects. CLASSIFICATION OF EVIDENCE This study provides Class IV evidence that for patients with KLS, lithium decreases the frequency and duration of KLS episodes.
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Affiliation(s)
- Smaranda Leu-Semenescu
- From the Sleep Disorders Unit and National Reference Center for Narcolepsy, Hypersomnia and Kleine-Levin Syndrome (S.L.-S., T.L.C., E.G., S.L., I.A.), and Department of Biostatistics (J.-L.G.), Pitié-Salpêtrière University Hospital; AP-HP (S.L.-S., I.A.), Brain Research Institute (CRICM-UPMC-Paris 6; Inserm UMR_S 975; CNRS UMR 7225), Sorbonne Universities, UPMC Univ Paris 06; and AP-HP and ER4 (J.-L.G.), Pierre and Marie Curie University, Paris, France
| | - Thibault Le Corvec
- From the Sleep Disorders Unit and National Reference Center for Narcolepsy, Hypersomnia and Kleine-Levin Syndrome (S.L.-S., T.L.C., E.G., S.L., I.A.), and Department of Biostatistics (J.-L.G.), Pitié-Salpêtrière University Hospital; AP-HP (S.L.-S., I.A.), Brain Research Institute (CRICM-UPMC-Paris 6; Inserm UMR_S 975; CNRS UMR 7225), Sorbonne Universities, UPMC Univ Paris 06; and AP-HP and ER4 (J.-L.G.), Pierre and Marie Curie University, Paris, France
| | - Elisabeth Groos
- From the Sleep Disorders Unit and National Reference Center for Narcolepsy, Hypersomnia and Kleine-Levin Syndrome (S.L.-S., T.L.C., E.G., S.L., I.A.), and Department of Biostatistics (J.-L.G.), Pitié-Salpêtrière University Hospital; AP-HP (S.L.-S., I.A.), Brain Research Institute (CRICM-UPMC-Paris 6; Inserm UMR_S 975; CNRS UMR 7225), Sorbonne Universities, UPMC Univ Paris 06; and AP-HP and ER4 (J.-L.G.), Pierre and Marie Curie University, Paris, France
| | - Sophie Lavault
- From the Sleep Disorders Unit and National Reference Center for Narcolepsy, Hypersomnia and Kleine-Levin Syndrome (S.L.-S., T.L.C., E.G., S.L., I.A.), and Department of Biostatistics (J.-L.G.), Pitié-Salpêtrière University Hospital; AP-HP (S.L.-S., I.A.), Brain Research Institute (CRICM-UPMC-Paris 6; Inserm UMR_S 975; CNRS UMR 7225), Sorbonne Universities, UPMC Univ Paris 06; and AP-HP and ER4 (J.-L.G.), Pierre and Marie Curie University, Paris, France
| | - Jean-Louis Golmard
- From the Sleep Disorders Unit and National Reference Center for Narcolepsy, Hypersomnia and Kleine-Levin Syndrome (S.L.-S., T.L.C., E.G., S.L., I.A.), and Department of Biostatistics (J.-L.G.), Pitié-Salpêtrière University Hospital; AP-HP (S.L.-S., I.A.), Brain Research Institute (CRICM-UPMC-Paris 6; Inserm UMR_S 975; CNRS UMR 7225), Sorbonne Universities, UPMC Univ Paris 06; and AP-HP and ER4 (J.-L.G.), Pierre and Marie Curie University, Paris, France
| | - Isabelle Arnulf
- From the Sleep Disorders Unit and National Reference Center for Narcolepsy, Hypersomnia and Kleine-Levin Syndrome (S.L.-S., T.L.C., E.G., S.L., I.A.), and Department of Biostatistics (J.-L.G.), Pitié-Salpêtrière University Hospital; AP-HP (S.L.-S., I.A.), Brain Research Institute (CRICM-UPMC-Paris 6; Inserm UMR_S 975; CNRS UMR 7225), Sorbonne Universities, UPMC Univ Paris 06; and AP-HP and ER4 (J.-L.G.), Pierre and Marie Curie University, Paris, France.
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Arnulf I, Neutel D, Herlin B, Golmard JL, Leu-Semenescu S, Cochen de Cock V, Vidailhet M. Sleepiness in Idiopathic REM Sleep Behavior Disorder and Parkinson Disease. Sleep 2015; 38:1529-35. [PMID: 26085299 DOI: 10.5665/sleep.5040] [Citation(s) in RCA: 66] [Impact Index Per Article: 7.3] [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: 10/20/2014] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVE To determine whether patients with idiopathic and symptomatic RBD were sleepier than controls, and if sleepiness in idiopathic RBD predicted earlier conversion to Parkinson disease. METHODS The Epworth Sleepiness Scale (ESS) and its determinants were compared at the time of a video-polysomnography for an RBD diagnosis in patients with idiopathic RBD, in patients with Parkinson disease, and in controls. Whether sleepiness at time of RBD diagnosis predicted an earlier conversion to neurodegenerative diseases was retrospectively analyzed in the followed-up patients. RESULTS The 75 patients with idiopathic RBD were sleepier (ESS: 7.8 ± 4.6) at the time of RBD diagnosis than 74 age- and sex-matched controls (ESS: 5.0 ± 3.6, P < 0.0001). They reached the levels of 114 patients with Parkinson disease (ESS: 8.7 ± 4.8), whether they had (n = 78) or did not have (n = 36) concomitant RBD. The severity of sleepiness in idiopathic RBD correlated with younger age, but not with sleep measures. Among the 69 patients with idiopathic RBD who were followed up for a median 3 years (1-15 years), 16 (23.2%) developed parkinsonism (n = 6), dementia (n = 6), dementia plus parkinsonism (n = 2), and multiple system atrophy (n = 2). An ESS greater than 8 at time of RBD diagnosis predicted a shorter time to phenoconversion to parkinsonism and dementia, from RBD onset, and from RBD diagnosis (when adjusted for age and time between RBD onset and diagnosis). CONCLUSIONS Sleepiness is associated with idiopathic REM sleep behavior disorder and predicts more rapid conversion to parkinsonism and dementia, suggesting it is an early marker of neuronal loss in brainstem arousal systems.
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Affiliation(s)
- Isabelle Arnulf
- Sorbonne Universities, UPMC Univ Paris 06, Paris, France.,Brain Research Institute (CRICM - UPMC-Paris6), Paris, France.,Sleep Disorders Unit, Pitié-Salpêtrière University Hospital, Paris, France
| | - Dulce Neutel
- Sleep Disorders Unit, Pitié-Salpêtrière University Hospital, Paris, France
| | - Bastien Herlin
- Sleep Disorders Unit, Pitié-Salpêtrière University Hospital, Paris, France
| | - Jean-Louis Golmard
- Department of Biostatistics, Salpêtrière Hospital, ER4, Sorbonne Universites, UPMC Univ Paris 06, Paris, France
| | - Smaranda Leu-Semenescu
- Brain Research Institute (CRICM - UPMC-Paris6), Paris, France.,Sleep Disorders Unit, Pitié-Salpêtrière University Hospital, Paris, France
| | | | - Marie Vidailhet
- Sorbonne Universities, UPMC Univ Paris 06, Paris, France.,Brain Research Institute (CRICM - UPMC-Paris6), Paris, France
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49
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Affiliation(s)
- Dulce Neutel
- APHP, Sleep Disorder Unit, Pitié-Salpêtrière University Hospital, Paris, France
| | - Smaranda Leu-Semenescu
- APHP, Sleep Disorder Unit, Pitié-Salpêtrière University Hospital, Paris, France; Centre de Recherche de l'Institut du Cerveau et de la Moelle épinière - Université Pierre et Marie Curie-Paris 6, Inserm UMR_S 975, CNRS UMR 7225, France
| | - Emmanuel Roze
- Centre de Recherche de l'Institut du Cerveau et de la Moelle épinière - Université Pierre et Marie Curie-Paris 6, Inserm UMR_S 975, CNRS UMR 7225, France
| | - Isabelle Arnulf
- APHP, Sleep Disorder Unit, Pitié-Salpêtrière University Hospital, Paris, France; Centre de Recherche de l'Institut du Cerveau et de la Moelle épinière - Université Pierre et Marie Curie-Paris 6, Inserm UMR_S 975, CNRS UMR 7225, France.
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50
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Herlin B, Leu-Semenescu S, Chaumereuil C, Arnulf I. Evidence that non-dreamers do dream: a REM sleep behaviour disorder model. J Sleep Res 2015; 24:602-9. [PMID: 26307463 DOI: 10.1111/jsr.12323] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.6] [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: 03/15/2015] [Accepted: 06/05/2015] [Indexed: 11/28/2022]
Abstract
To determine whether non-dreamers do not produce dreams or do not recall them, subjects were identified with no dream recall with dreamlike behaviours during rapid eye movement sleep behaviour disorder, which is typically characterised by dream-enacting behaviours congruent with sleep mentation. All consecutive patients with idiopathic rapid eye movement sleep behaviour disorder or rapid eye movement sleep behaviour disorder associated with Parkinson's disease who underwent a video-polysomnography were interviewed regarding the presence or absence of dream recall, retrospectively or upon spontaneous arousals. The patients with no dream recall for at least 10 years, and never-ever recallers were compared with dream recallers with rapid eye movement sleep behaviour disorder regarding their clinical, cognitive and sleep features. Of the 289 patients with rapid eye movement sleep behaviour disorder, eight (2.8%) patients had no dream recall, including four (1.4%) patients who had never ever recalled dreams, and four patients who had no dream recall for 10-56 years. All non-recallers exhibited, daily or almost nightly, several complex, scenic and dreamlike behaviours and speeches, which were also observed during rapid eye movement sleep on video-polysomnography (arguing, fighting and speaking). They did not recall a dream following sudden awakenings from rapid eye movement sleep. These eight non-recallers with rapid eye movement sleep behaviour disorder did not differ in terms of cognition, clinical, treatment or sleep measures from the 17 dreamers with rapid eye movement sleep behaviour disorder matched for age, sex and disease. The scenic dreamlike behaviours reported and observed during rapid eye movement sleep in the rare non-recallers with rapid eye movement sleep behaviour disorder (even in the never-ever recallers) provide strong evidence that non-recallers produce dreams, but do not recall them. Rapid eye movement sleep behaviour disorder provides a new model to evaluate cognitive processing during dreaming and subsequent recall.
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Affiliation(s)
- Bastien Herlin
- Sleep Disorders Unit, Pitié-Salpêtrière University Hospital, APHP, Paris, France.,Centre de Recherche de l'Institut du Cerveau et de la Moelle épinière - UPMC-Paris 6, Inserm UMR_S 975, CNRS UMR 7225, Paris, France
| | - Smaranda Leu-Semenescu
- Sleep Disorders Unit, Pitié-Salpêtrière University Hospital, APHP, Paris, France.,Centre de Recherche de l'Institut du Cerveau et de la Moelle épinière - UPMC-Paris 6, Inserm UMR_S 975, CNRS UMR 7225, Paris, France
| | | | - Isabelle Arnulf
- Sleep Disorders Unit, Pitié-Salpêtrière University Hospital, APHP, Paris, France.,Centre de Recherche de l'Institut du Cerveau et de la Moelle épinière - UPMC-Paris 6, Inserm UMR_S 975, CNRS UMR 7225, Paris, France.,Inserm U1127, Paris, France.,Pierre and Marie Curie University, Paris, France
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