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Irrera F, Gumiero A, Zampogna A, Boscari F, Avogaro A, Gazzanti Pugliese di Cotrone MA, Patera M, Della Torre L, Picozzi N, Suppa A. Multisensor Integrated Platform Based on MEMS Charge Variation Sensing Technology for Biopotential Acquisition. SENSORS (BASEL, SWITZERLAND) 2024; 24:1554. [PMID: 38475089 DOI: 10.3390/s24051554] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/30/2024] [Revised: 02/25/2024] [Accepted: 02/26/2024] [Indexed: 03/14/2024]
Abstract
We propose a new methodology for long-term biopotential recording based on an MEMS multisensor integrated platform featuring a commercial electrostatic charge-transfer sensor. This family of sensors was originally intended for presence tracking in the automotive industry, so the existing setup was engineered for the acquisition of electrocardiograms, electroencephalograms, electrooculograms, and electromyography, designing a dedicated front-end and writing proper firmware for the specific application. Systematic tests on controls and nocturnal acquisitions from patients in a domestic environment will be discussed in detail. The excellent results indicate that this technology can provide a low-power, unexplored solution to biopotential acquisition. The technological breakthrough is in that it enables adding this type of functionality to existing MEMS boards at near-zero additional power consumption. For these reasons, it opens up additional possibilities for wearable sensors and strengthens the role of MEMS technology in medical wearables for the long-term synchronous acquisition of a wide range of signals.
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Affiliation(s)
- Fernanda Irrera
- Department of Information Engineering, Electronics and Telecommunications, Sapienza University of Rome, 00185 Rome, Italy
| | | | - Alessandro Zampogna
- Department of Human Neurosciences, Sapienza University of Rome, 00185 Rome, Italy
| | | | - Angelo Avogaro
- Department of Medicine, University of Padua, 35122 Padua, Italy
| | | | - Martina Patera
- Department of Human Neurosciences, Sapienza University of Rome, 00185 Rome, Italy
| | | | | | - Antonio Suppa
- Department of Human Neurosciences, Sapienza University of Rome, 00185 Rome, Italy
- IRCCS Neuromed, 86077 Pozzilli, Italy
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2
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York MK, Alcalay R. Enough vs. More: Neuropsychological testing is more useful than genetic testing in the baseline evaluation of Parkinson disease. Parkinsonism Relat Disord 2023:105403. [PMID: 37198082 DOI: 10.1016/j.parkreldis.2023.105403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2023] [Revised: 04/13/2023] [Accepted: 04/16/2023] [Indexed: 05/19/2023]
Abstract
In conclusion, baseline neuropsychological testing provides a vast amount of unique cognitive, psychiatric, behavioral, and psychosocial information that is useful to individuals with PD, care partners, and treatment team providers. As a baseline examination, it provides opportunities for comparison purposes in the future, a prediction of risk assessment and future treatment needs, and at the time of evaluation for clinical treatment to improve quality of life. Such information is not captured by genetic testing, although the ideal path moving forward would be to perform both neuropsychological testing and genetic testing at baseline.
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Affiliation(s)
- Michele K York
- Neurology and Psychiatry and Behavioral Sciences, Section Head, Neuropsychology, Baylor College of Medicine, 7200 Cambridge Street, 9th Floor Neurology, Houston, TX, USA.
| | - Roy Alcalay
- Movement Disorders Division, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel; Neurology, Member, Movement Disorders Division, Columbia University Irving Medical Center, USA.
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3
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Ryoo HG, Byun JI, Choi H, Jung KY. Deep learning signature of brain [ 18F]FDG PET associated with cognitive outcome of rapid eye movement sleep behavior disorder. Sci Rep 2022; 12:19259. [PMID: 36357491 PMCID: PMC9649732 DOI: 10.1038/s41598-022-23347-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Accepted: 10/30/2022] [Indexed: 11/12/2022] Open
Abstract
An objective biomarker to predict the outcome of isolated rapid eye movement sleep behavior disorder (iRBD) is crucial for the management. This study aimed to investigate cognitive signature of brain [18F]FDG PET based on deep learning (DL) for evaluating patients with iRBD. Fifty iRBD patients, 19 with mild cognitive impairment (MCI) (RBD-MCI) and 31 without MCI (RBD-nonMCI), were prospectively enrolled. A DL model for the cognitive signature was trained by using Alzheimer's Disease Neuroimaging Initiative database and transferred to baseline [18F]FDG PET from the iRBD cohort. The results showed that the DL-based cognitive dysfunction score was significantly higher in RBD-MCI than in RBD-nonMCI. The AUC of ROC curve for differentiating RBD-MCI from RBD-nonMCI was 0.70 (95% CI 0.56-0.82). The baseline DL-based cognitive dysfunction score was significantly higher in iRBD patients who showed a decrease in CERAD scores during 2 years than in those who did not. Brain metabolic features related to cognitive dysfunction-related regions of individual iRBD patients mainly included posterior cortical regions. This work demonstrates that the cognitive signature based on DL could be used to objectively evaluate cognitive function in iRBD. We suggest that this approach could be extended to an objective biomarker predicting cognitive decline and neurodegeneration in iRBD.
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Affiliation(s)
- Hyun Gee Ryoo
- grid.412484.f0000 0001 0302 820XDepartment of Nuclear Medicine, Seoul National University Hospital, 101, Daehak-Ro, Jongno-Gu, Seoul, 03080 Republic of Korea ,grid.412480.b0000 0004 0647 3378Department of Nuclear Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Jung-Ick Byun
- grid.289247.20000 0001 2171 7818Department of Neurology, Kyung Hee University Hospital at Gangdong, Kyung Hee University School of Medicine, Seoul, Republic of Korea
| | - Hongyoon Choi
- grid.412484.f0000 0001 0302 820XDepartment of Nuclear Medicine, Seoul National University Hospital, 101, Daehak-Ro, Jongno-Gu, Seoul, 03080 Republic of Korea ,grid.31501.360000 0004 0470 5905Department of Nuclear Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Ki-Young Jung
- grid.412484.f0000 0001 0302 820XDepartment of Neurology, Seoul National University Hospital, 101, Daehak-Ro, Jongno-Gu, Seoul, 03080 Republic of Korea ,grid.31501.360000 0004 0470 5905Neuroscience Research Institute, Seoul National University College of Medicine, Seoul, Korea
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4
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Fasiello E, Scarpelli S, Gorgoni M, Alfonsi V, Galbiati A, De Gennaro L. A systematic review of dreams and nightmares recall in patients with rapid eye movement sleep behaviour disorder. J Sleep Res 2022; 32:e13768. [PMID: 36316953 DOI: 10.1111/jsr.13768] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Revised: 09/08/2022] [Accepted: 10/03/2022] [Indexed: 11/06/2022]
Abstract
Rapid eye movement (REM) sleep behaviour disorder is a REM sleep parasomnia characterised by the loss of the physiological muscle atonia during REM sleep, resulting in dream enactment behaviours that may cause injuries to patients or their bed partners. The nocturnal motor episodes seem to respond to the dream contents, which are often vivid and violent. These behavioural and oneiric features make the REM sleep behaviour disorder a potential model to study dreams. This review aims to unify the literature about dream recall in REM sleep behaviour disorder as a privileged approach to study dreams, systematically reviewing studies that applied retrospective and prospective experimental designs to provide a comprehensive overview of qualitative and quantitative aspects of dream recall in this REM sleep parasomnia. The present work highlights that the study of dreaming in REM sleep behaviour disorder is useful to understand unique aspects of this pathology and to explore neurobiological, electrophysiological, and cognitive mechanisms of REM sleep and dreaming.
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Affiliation(s)
| | - Serena Scarpelli
- Department of Psychology Sapienza ‐ University of Rome Rome Italy
| | - Maurizio Gorgoni
- Department of Psychology Sapienza ‐ University of Rome Rome Italy
- Body and Action Lab IRCCS Fondazione Santa Lucia Rome Italy
| | | | - Andrea Galbiati
- “Vita‐Salute” San Raffaele University Milan Italy
- Department of Clinical Neuroscience, Neurology and Sleep Disorders Center IRCCS San Raffaele Scientific Institute Milan Italy
| | - Luigi De Gennaro
- Department of Psychology Sapienza ‐ University of Rome Rome Italy
- Body and Action Lab IRCCS Fondazione Santa Lucia Rome Italy
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5
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Voloshyna D, Bseiso A, Shaik TA, Sedhai S, Abdelsamad A, Khan MH, Sandhu QI, Saleem F, Ghaffari MAZ. Rapid Eye Movement Behavior Sleep Disorder as a Primary Manifestation of Wilson Disease: A Gateway to Early Intervention. Cureus 2022; 14:e29618. [PMID: 36312644 PMCID: PMC9595345 DOI: 10.7759/cureus.29618] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/26/2022] [Indexed: 11/11/2022] Open
Abstract
Wilson's disease (WD) is one of the most prevalent genetic conditions in the world. The average onset age ranges between 5 and 35 years. The prognosis tends to be worse if the diagnosis is delayed. Neurocognitive and psychological disorders are the most common extrahepatic manifestations of WD. Moreover, rapid eye movement (REM) sleep behavior disorder (RBD) is discovered to have a significant correlation with neurodegenerative disorders, particularly WD. Several synucleinopathies, including WD, have an early prodromal stage that manifests as RBD or sleep behavior disorder. We hereby present a case of a 14-year-old patient with borderline ceruloplasmin levels and REM sleep disorder as an early manifestation of WD. RBD may be considered one of the earliest manifestations of such disorders and a vital phase of the disease's onset, as the patient may be more responsive to treatment at this point.
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6
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Ehgoetz Martens KA, Matar E, Phillips JR, Shine JM, Grunstein RR, Halliday GM, Lewis SJG. Narrow doorways alter brain connectivity and step patterns in isolated REM sleep behaviour disorder. Neuroimage Clin 2022; 33:102958. [PMID: 35151040 PMCID: PMC8844611 DOI: 10.1016/j.nicl.2022.102958] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Revised: 02/03/2022] [Accepted: 02/04/2022] [Indexed: 11/19/2022]
Abstract
iRBD had slower and more variable stepping compared to controls in this VR task. iRBD showed exaggerated responses when passing narrow compared to wide doorways iRBD had altered task-related brain connectivity which was correlated to motor deficits.
Background Motor impairments in those with isolated REM sleep behaviour disorder (iRBD) significantly increases the likelihood of developing Lewy body disease (e.g. Parkinson’s disease and Dementia with Lewy Bodies). Objective This study sought to explore the prodromal process of neurodegeneration by examining the neural signature underlying motor deficits in iRBD patients. Methods A virtual reality (VR) gait paradigm (which has previously been shown to elicit adaptive changes in gait performance whilst navigating doorways in Parkinson’s Disease - PD) was paired with fMRI to investigate whether iRBD patients demonstrated worsened motor performance and altered connectivity across frontoparietal, motor and basal ganglia networks compared to healthy controls. Forty participants (23 iRBD and 17 healthy controls) completed the virtual reality gait task whilst in the MRI scanner, and an additional cohort of 19 Early PD patients completed the behavioural virtual reality gait task. Results As predicted, iRBD patients demonstrated slower and more variable stepping compared to healthy control participants and demonstrated an exaggerated response when navigating narrow compared to wide doorways, a phenomenon characteristically seen in PD. The iRBD patients also demonstrated less BOLD signal change in the left posterior putamen and right mesencephalic locomotor region, as well as reduced functional connectivity between the frontoparietal network and the motor network, when navigating narrow versus wide doorways compared to healthy control participants. Conclusions Taken together, this study demonstrates that iRBD patients have altered task-related brain connectivity, which may represent the neural underpinnings of early motor impairments that are evident in iRBD.
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Affiliation(s)
- Kaylena A Ehgoetz Martens
- ForeFront Research Team, Brain and Mind Centre, University of Sydney, Australia; Parkinson's Disease Research Clinic, Brain and Mind Centre, University of Sydney, Australia; Department of Kinesiology and Health Sciences, University of Waterloo, Waterloo, Canada.
| | - Elie Matar
- ForeFront Research Team, Brain and Mind Centre, University of Sydney, Australia; Parkinson's Disease Research Clinic, Brain and Mind Centre, University of Sydney, Australia; Department of Kinesiology and Health Sciences, University of Waterloo, Waterloo, Canada
| | - Joseph R Phillips
- ForeFront Research Team, Brain and Mind Centre, University of Sydney, Australia; Parkinson's Disease Research Clinic, Brain and Mind Centre, University of Sydney, Australia; School of Social Sciences and Psychology, Western Sydney University, Sydney, Australia
| | - James M Shine
- ForeFront Research Team, Brain and Mind Centre, University of Sydney, Australia; Parkinson's Disease Research Clinic, Brain and Mind Centre, University of Sydney, Australia
| | - Ron R Grunstein
- ForeFront Research Team, Brain and Mind Centre, University of Sydney, Australia; Department of Kinesiology and Health Sciences, University of Waterloo, Waterloo, Canada
| | - Glenda M Halliday
- ForeFront Research Team, Brain and Mind Centre, University of Sydney, Australia
| | - Simon J G Lewis
- ForeFront Research Team, Brain and Mind Centre, University of Sydney, Australia; Parkinson's Disease Research Clinic, Brain and Mind Centre, University of Sydney, Australia; Department of Kinesiology and Health Sciences, University of Waterloo, Waterloo, Canada; Sleep and Circadian Group (CIRUS), Woolcock Institute of Medical Research, University of Sydney and Royal Prince Alfred Hospital, Australia
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7
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Baumgartner AJ, Kushida CA, Summers MO, Kern DS, Abosch A, Thompson JA. Basal Ganglia Local Field Potentials as a Potential Biomarker for Sleep Disturbance in Parkinson's Disease. Front Neurol 2021; 12:765203. [PMID: 34777232 PMCID: PMC8581299 DOI: 10.3389/fneur.2021.765203] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Accepted: 10/04/2021] [Indexed: 11/18/2022] Open
Abstract
Sleep disturbances, specifically decreases in total sleep time and sleep efficiency as well as increased sleep onset latency and wakefulness after sleep onset, are highly prevalent in patients with Parkinson's disease (PD). Impairment of sleep significantly and adversely impacts several comorbidities in this patient population, including cognition, mood, and quality of life. Sleep disturbances and other non-motor symptoms of PD have come to the fore as the effectiveness of advanced therapies such as deep brain stimulation (DBS) optimally manage the motor symptoms. Although some studies have suggested that DBS provides benefit for sleep disturbances in PD, the mechanisms by which this might occur, as well as the optimal stimulation parameters for treating sleep dysfunction, remain unknown. In patients treated with DBS, electrophysiologic recording from the stimulating electrode, in the form of local field potentials (LFPs), has led to the identification of several findings associated with both motor and non-motor symptoms including sleep. For example, beta frequency (13–30 Hz) oscillations are associated with worsened bradykinesia while awake and decrease during non-rapid eye movement sleep. LFP investigation of sleep has largely focused on the subthalamic nucleus (STN), though corresponding oscillatory activity has been found in the globus pallidus internus (GPi) and thalamus as well. LFPs are increasingly being recognized as a potential biomarker for sleep states in PD, which may allow for closed-loop optimization of DBS parameters to treat sleep disturbances in this population. In this review, we discuss the relationship between LFP oscillations in STN and the sleep architecture of PD patients, current trends in utilizing DBS to treat sleep disturbance, and future directions for research. In particular, we highlight the capability of novel technologies to capture and record LFP data in vivo, while patients continue therapeutic stimulation for motor symptoms. These technological advances may soon allow for real-time adaptive stimulation to treat sleep disturbances.
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Affiliation(s)
- Alexander J Baumgartner
- Department of Neurology, University of Colorado School of Medicine, Aurora, CO, United States
| | - Clete A Kushida
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, United States
| | - Michael O Summers
- Department of Medicine, Division of Pulmonary, Critical Care, Sleep, and Allergy, University of Nebraska Medical Center, Omaha, NE, United States
| | - Drew S Kern
- Department of Neurology, University of Colorado School of Medicine, Aurora, CO, United States.,Department of Neurosurgery, University of Colorado School of Medicine, Aurora, CO, United States
| | - Aviva Abosch
- Department of Neurosurgery, University of Nebraska Medical Center, Omaha, NE, United States
| | - John A Thompson
- Department of Neurology, University of Colorado School of Medicine, Aurora, CO, United States.,Department of Neurosurgery, University of Colorado School of Medicine, Aurora, CO, United States
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8
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Zhou L, Li G, Zhang Y, Zhang M, Chen Z, Zhang L, Wang X, Zhang M, Ye G, Li Y, Chen S, Li B, Wei H, Liu J. Increased free water in the substantia nigra in idiopathic REM sleep behaviour disorder. Brain 2021; 144:1488-1497. [PMID: 33880500 DOI: 10.1093/brain/awab039] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2020] [Revised: 11/14/2020] [Accepted: 12/04/2020] [Indexed: 11/14/2022] Open
Abstract
Imaging markers sensitive to neurodegeneration in the substantia nigra are critically needed for future disease-modifying trials. Previous studies have demonstrated the utility of posterior substantia nigra free water as a marker of progression in Parkinson's disease. In this study, we tested the hypothesis that free water is elevated in the posterior substantia nigra of idiopathic REM sleep behaviour disorder, which is considered a prodromal stage of synucleinopathy. We applied free-water imaging to 32 healthy control subjects, 34 patients with idiopathic REM sleep behaviour disorder and 38 patients with Parkinson's disease. Eighteen healthy control subjects and 22 patients with idiopathic REM sleep behaviour disorder were followed up and completed longitudinal free-water imaging. Free-water values in the substantia nigra were calculated for each individual and compared among groups. We tested the associations between posterior substantia nigra free water and uptake of striatal dopamine transporter in idiopathic REM sleep behaviour disorder. Free-water values in the posterior substantia nigra were significantly higher in the patients with idiopathic REM sleep behaviour disorder patients than in the healthy control subjects, but were significantly lower in patients with idiopathic REM sleep behaviour disorder than in patients with Parkinson's disease. In addition, we observed significantly negative associations between posterior substantia nigra free-water values and dopamine transporter striatal binding ratios in the idiopathic REM sleep behaviour disorder patients. Longitudinal free-water imaging analyses were conducted with a linear mixed-effects model, and showed a significant Group × Time interaction in posterior substantia nigra, identifying increased mean free-water values in posterior substantia nigra of idiopathic REM sleep behaviour disorder over time. These results demonstrate that free water in the posterior substantia nigra is a valid imaging marker of neurodegeneration in idiopathic REM sleep behaviour disorder, which has the potential to be used as an indicator in disease-modifying trials.
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Affiliation(s)
- Liche Zhou
- Department of Neurology and Institute of Neurology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China
| | - Guanglu Li
- Department of Neurology and Institute of Neurology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China
| | - Yuyao Zhang
- School of Information and Science and Technology, Shanghai Tech University, Shanghai, China
| | - Miao Zhang
- Department of Nuclear Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China
| | - Zhichun Chen
- Department of Neurology and Institute of Neurology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China
| | - Lina Zhang
- Department of Biostatistics, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China
| | - Xiaojin Wang
- Department of Biostatistics, Clinical Research Institute, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
| | - Ming Zhang
- Institute for Medical Imaging Technology, School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai, China
| | - Guanyu Ye
- Department of Neurology and Institute of Neurology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China
| | - Yuanyuan Li
- Department of Neurology and Institute of Neurology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China
| | - Shengdi Chen
- Department of Neurology and Institute of Neurology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China
| | - Biao Li
- Department of Nuclear Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China
| | - Hongjiang Wei
- Institute for Medical Imaging Technology, School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai, China
| | - Jun Liu
- Department of Neurology and Institute of Neurology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China
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9
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Kim YE, Kim YJ, Hwang HS, Ma HI. REM sleep behavior disorder in early Parkinson's disease predicts the rapid dopaminergic denervation. Parkinsonism Relat Disord 2020; 80:120-126. [PMID: 32987358 DOI: 10.1016/j.parkreldis.2020.09.032] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Revised: 09/16/2020] [Accepted: 09/20/2020] [Indexed: 12/30/2022]
Abstract
OBJECTIVE To test the hypothesis that REM sleep behavior disorder (RBD) in early Parkinson's disease (PD) predicts rapid progression of dopaminergic denervation. METHODS 123I-FP-CIT single photon emission computed tomography (SPECT) scans were performed sequentially at baseline, 1 year, 2 years, and 4 years in 416 de novo patients with PD. RBD screening questionnaire scores >5 at baseline placed the participant in the likely-RBD group. Temporal changes in the specific binding ratio (SBR; caudate, putamen. sum of both, striatum) were compared between the likely-RBD and the non-likely-RBD groups for more or less affected striatum with a repeated measure ANOVA. RESULTS Likely-RBD was reported in 37.7% of the drug-naïve PD patients at baseline. The likely-RBD and non-likely-RBD groups did not have significant differences in the baseline clinical features including gender, age, disease duration, UPDRS motor score, and striatal SBR. Striatal SBR decreased significantly over four years in both groups (P < .001). In the analysis of a more affected striatum, striatal SBR decreased significantly faster in the likely-RBD group than in the non-likely-RBD group (P < .05 for all), whereas it was not statistically significant for the less affected striatum. The mean striatal SBR value (mean value of both striata), especially the caudate SBR, indicated greater acceleration of denervation in the likely-RBD group than in the non-likely-RBD group over time (P < .05). CONCLUSION Likely-RBD in PD predicts accelerating dopaminergic denervation, thereby implicating it as a marker for a poor prognosis or distinctive subtype in PD.
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Affiliation(s)
- Young Eun Kim
- Department of Neurology, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, South Korea; Hallym Neurological Institute, Hallym University, South Korea
| | - Yun Joong Kim
- Department of Neurology, Yongin Yonsei University Hospital, Yonsei University, South Korea
| | - Hee Sung Hwang
- Department of Nuclear Medicine, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, South Korea.
| | - Hyeo-Il Ma
- Department of Neurology, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, South Korea; Hallym Neurological Institute, Hallym University, South Korea.
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10
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Gibbons CH, Freeman R. Delayed orthostatic hypotension. Auton Neurosci 2020; 229:102724. [PMID: 32942225 DOI: 10.1016/j.autneu.2020.102724] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Revised: 08/24/2020] [Accepted: 09/02/2020] [Indexed: 11/30/2022]
Abstract
Delayed orthostatic hypotension is a fall in blood pressure beyond 3 min of standing or upright tilt table testing. The prevalence, clinical features and pathophysiology are reviewed. To date, there is little data to support a standardized or recommended treatment. However, the 10-year mortality rates of individuals with delayed orthostatic hypotension are approximately 50%. Despite the fact that delayed orthostatic hypotension carries the same symptoms, risks and high mortality rate as classical orthostatic hypotension, but is under-recognized. The frequency with which delayed orthostatic hypotension develops into classical orthostatic hypotension, the high associated mortality rates and risk of development of the neurodegenerative disorders classified as alpha-synucleinopathies underscores the need for further study of this condition.
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Affiliation(s)
- Christopher H Gibbons
- Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.
| | - Roy Freeman
- Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
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11
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Wang N, Garcia J, Freeman R, Gibbons CH. Phosphorylated Alpha-Synuclein Within Cutaneous Autonomic Nerves of Patients With Parkinson's Disease: The Implications of Sample Thickness on Results. J Histochem Cytochem 2020; 68:669-678. [PMID: 32921251 DOI: 10.1369/0022155420960250] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
The detection of cutaneous phosphorylated alpha-synuclein (P-syn) in patients with Parkinson's disease (PD) has ranged from 30% to 100% across different studies. We hypothesize that part of the variability in P-syn detection is due to methodological differences using sections of different tissue thickness. Three skin biopsies were obtained from 29 individuals with PD and 21 controls. Tissues were cut into 10-, 20-, and 50-µm-thick sections and double-stained with protein gene product (PGP) 9.5 and P-syn. We quantified the deposition of P-syn with and without PGP 9.5 in sweat glands, pilomotor muscle, and blood vessels using confocal digital images of autonomic structures. Overall, the P-syn-positive rates with PGP 9.5 colocalization in subjects with PD were 100% using 50 µm sections, 90% using 20 µm sections, and 73% using 10 µm sections with 100% specificity. (No P-syn was detected within control subjects.) Without PGP 9.5, colocalization of the P-syn-positive rates was 100% for all samples, but specificity dropped below 70%. In this study, double-immunostained 50 µm skin biopsy tissue sections are superior to 20 and 10 µm tissue sections at detecting P-syn in subjects with PD. The increased sensitivity is likely secondary to a combination of greater volume of tissue analyzed and improved visualization of nerve fiber architecture.
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Affiliation(s)
- Ningshan Wang
- Center for Autonomic and Peripheral Nerve Disorders, Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA
| | - Jennifer Garcia
- Center for Autonomic and Peripheral Nerve Disorders, Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA
| | - Roy Freeman
- Center for Autonomic and Peripheral Nerve Disorders, Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA
| | - Christopher H Gibbons
- Center for Autonomic and Peripheral Nerve Disorders, Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA
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12
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Wilckens KA, Chahine LM. Sleep and circadian rhythms in the treatment, trajectory, and prevention of neurodegenerative disease. Neurobiol Dis 2020; 145:105075. [PMID: 32890772 DOI: 10.1016/j.nbd.2020.105075] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Affiliation(s)
- Kristine A Wilckens
- University of Pittsburgh, School of Medicine, Department of Psychiatry, Pittsburgh, PA, USA
| | - Lana M Chahine
- University of Pittsburgh, School of Medicine, Department of Neurology, Pittsburgh, PA, USA.
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13
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Dokkedal-Silva V, Kim LJ, Morelhão PK, Galduróz JCF, Tufik S, Andersen ML. Use of clonazepam in REM sleep behavior disorder: association with fall-related injuries and alternative treatments. J Clin Sleep Med 2020; 16:655-656. [PMID: 32022673 DOI: 10.5664/jcsm.8308] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Affiliation(s)
| | - Lenise Jihe Kim
- Departamento de Psicobiologia, Universidade Federal de São Paulo, São Paulo, Brazil
| | | | | | - Sergio Tufik
- Departamento de Psicobiologia, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Monica Levy Andersen
- Departamento de Psicobiologia, Universidade Federal de São Paulo, São Paulo, Brazil
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Salsone M, Arabia G, Manfredini L, Quattrone A, Chiriaco C, Vescio B, Sturniolo M, Morelli M, Nistico' R, Novellino F, Gambardella A, Quattrone A. REM-Sleep Behavior Disorder in Patients With Essential Tremor: What Is Its Clinical Significance? Front Neurol 2019; 10:315. [PMID: 31068885 PMCID: PMC6491751 DOI: 10.3389/fneur.2019.00315] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2018] [Accepted: 03/12/2019] [Indexed: 12/12/2022] Open
Abstract
Objective: REM sleep behavior disorder (RBD) is an important risk factor for the dementia development and for the deterioration of autonomic functions in patients with Parkinson's Disease. RBD has also been reported in patients with Essential Tremor (ET). However, its clinical significance in ET remains still unknown. We aimed to investigate clinical, neuropsychological and cardiac autonomic scintigraphic differences between ET patients with and without RBD. Methods: To assess RBD symptoms, RBD Single-Question has been administered in a cohort of 55 patients with a clinical diagnosis of ET. Patients with clinical RBD underwent polysomnography (PSG) confirmation. All patients completed a battery of neuropsychological assessment of memory, executive function, attention, language, and visuospatial function. Cardiac MIBG scintigraphy was performed in order to measure the cardiac autonomic innervation. Results: Ten ET patients (18%) had a PSG-confirmed RBD (ETRBD+). Compared to ET patients without RBD (ETRBD−), significantly reduced scores on memory domain tests such as Rey auditory verbal learning test immediate recall (p = 0.015) and Rey auditory verbal learning test delayed recall (p = 0.004) and phonemic fluency test (p = 0.028) were present in ETRBD+. By contrast, no other significant clinical difference has emerged from the comparison between two ET groups. Similarly, ETRBD+ patients have cardiac MIBG tracer uptake in the normal value range as occurred in those with ETRBD−. Conclusions: This study improves the knowledge on clinical significance of RBD symptoms in ET patients. Our preliminary findings demonstrate that presence of RBD in ET is associated with neurocognitive impairment, but not with cardiac autonomic dysfunction. Further longitudinal studies are needed to investigate whether ET patients with RBD will develop a frank dementia over the time.
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Affiliation(s)
- Maria Salsone
- Neuroimaging Research Unit, Institute of Molecular Bioimaging and Physiology, National Research Council, Catanzaro, Italy
| | - Gennarina Arabia
- Institute of Neurology, University Magna Graecia, Catanzaro, Italy
| | - Lucia Manfredini
- Institute of Neurology, University Magna Graecia, Catanzaro, Italy
| | - Andrea Quattrone
- Institute of Neurology, University Magna Graecia, Catanzaro, Italy
| | - Carmelina Chiriaco
- Neuroimaging Research Unit, Institute of Molecular Bioimaging and Physiology, National Research Council, Catanzaro, Italy
| | | | - Miriam Sturniolo
- Institute of Neurology, University Magna Graecia, Catanzaro, Italy
| | - Maurizio Morelli
- Institute of Neurology, University Magna Graecia, Catanzaro, Italy
| | - Rita Nistico'
- Neuroimaging Research Unit, Institute of Molecular Bioimaging and Physiology, National Research Council, Catanzaro, Italy
| | - Fabiana Novellino
- Neuroimaging Research Unit, Institute of Molecular Bioimaging and Physiology, National Research Council, Catanzaro, Italy
| | | | - Aldo Quattrone
- Neuroimaging Research Unit, Institute of Molecular Bioimaging and Physiology, National Research Council, Catanzaro, Italy.,Neuroscience Center, University Magna Graecia, Catanzaro, Italy
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15
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A Human Neuroimaging Perspective on Sleep in Normative and Pathological Ageing. CURRENT SLEEP MEDICINE REPORTS 2019. [DOI: 10.1007/s40675-019-0133-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
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16
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Sampathkumar H, DiTommaso C, Holcomb E, Tallavajhula S. Assessment of sleep after traumatic brain injury (TBI). NeuroRehabilitation 2018; 43:267-276. [DOI: 10.3233/nre-182485] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Haresh Sampathkumar
- JH Rehabilitation, Kilpauk, Chennai, India
- TIRR Memorial Hermann, Houston, TX, USA
- University of Texas Health Science Center at Houston
- McGovern Medical School, Houston, TX, USA
| | - Craig DiTommaso
- TIRR Memorial Hermann, Houston, TX, USA
- Baylor St Luke’s Medical Center, Houston, TX, USA
- Baylor College of Medicine, Houston, TX, USA
| | - Erin Holcomb
- TIRR Memorial Hermann, Houston, TX, USA
- Baylor College of Medicine, Houston, TX, USA
| | - Sudha Tallavajhula
- TIRR Memorial Hermann, Houston, TX, USA
- University of Texas Health Science Center at Houston
- McGovern Medical School, Houston, TX, USA
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Figorilli M, Congiu P, Lecca R, Gioi G, Frau R, Puligheddu M. Sleep in Parkinson's Disease with Impulse Control Disorder. Curr Neurol Neurosci Rep 2018; 18:68. [PMID: 30099617 DOI: 10.1007/s11910-018-0875-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
PURPOSE OF REVIEW This paper aims to explore the relationship between impulse-control disorders (ICDs) and sleep problems in patients with Parkinson's disease (PD) among scientific literature. RECENT FINDINGS Previously published results are controversial and sometimes inconclusive. ICDs and sleep disruption represent important non-motor features of Parkinson's disease, responsible for reducing quality of life and increasing burden of disease. The relationship between sleep problems and ICDs is complex and bidirectional. Indeed, sleep disturbances and fragmentation may play a crucial role in increasing susceptibility to impulsive behavior and may represent a risk factor for developing ICDs in PD patients. Moreover, REM sleep behavior disorder (RBD) and restless legs syndrome (RLS) have been indicated as independent risk factors for ICDs in PD patients. On the other hand, also ICDs may lead to sleep restriction and fragmentation, suggesting a bidirectional relationship. The association between sleep problems and ICDs in PD is far from being completely understood. Further studies are needed to confirm the nature of this relationship and its pathophysiology.
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Affiliation(s)
- Michela Figorilli
- Sleep Disorders Center, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Patrizia Congiu
- Sleep Disorders Center, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Rosa Lecca
- Sleep Disorders Center, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Gioia Gioi
- Sleep Disorders Center, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Roberto Frau
- Department of Biomedical Sciences, Division of Neuroscience and Clinical Pharmacology, University of Cagliari, Cagliari, Italy
| | - Monica Puligheddu
- Sleep Disorders Center, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy.
- Sleep Disorder Centre, Department of Public Health and Clinical and Molecular Medicine, University of Cagliari, ss 554 bivio Sestu 09042 Monserrato, Cagliari, Italy.
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18
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Rahmani F, Ansari M, Pooyan A, Mirbagheri MM, Aarabi MH. Differences in white matter microstructure between Parkinson's disease patients with and without REM sleep behavior disorder. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2017; 2016:1124-1126. [PMID: 28268523 DOI: 10.1109/embc.2016.7590901] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
REM sleep behavior disorder (RBD) is characterized by increased muscle tone and violent limb movements and usually occurs during the early stages of Parkinson disease (PD). PD patients with RBD represent faster motor progression and cognitive dysfunction. We used diffusion imaging to assess which regions are involved in this phenomenon. In the current study, we computed Quantitative Anisotropic (QA), which is based on spin distribution function (SDF) that quantifies the density of diffusing water and is more sensitive to psychological differences between groups and also diffusion MRI connectometry to conduct group analysis between age and gender matched PD patients with and without RBD. The major regions with significantly reduced QA in PD patients with RBD were left and right cingulum and left and left inferior occipital fasciculus.
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Abstract
PURPOSE OF REVIEW Little is known about the presence of parasomnias such as nightmare disorder, sleep paralysis, REM sleep behavior disorder (RBD), and sleep-related eating disorders (SRED) in people with mental illness. A predominant view suggests that psychotropic medications might be contributing to parasomnias. This article summarizes knowledge regarding the relationships between psychiatric disorders and parasomnias, and possible confounds. A systematic search of the literature in the past 10 years identified 19 articles. RECENT FINDINGS There were significantly elevated rates of parasomnias in psychiatric disorders (average prevalence of nightmares was 38.9%, sleep paralysis 22.3%, SRED 9.9%, sleepwalking 8.5%, and RBD 3.8%). Medication usage was only one of many risk factors (other sleep disorders, medical comorbidities, and substance abuse) which were associated with parasomnias. A strong association exists between mental illness and parasomnias which is not fully explained by medications. Prospective longitudinal studies are needed to develop a better understanding of the unique and shared variance from multiple risk factors.
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Affiliation(s)
- Flavie Waters
- School of Psychological Science, The University of Western Australia, 35 Stirling Highway, Crawley, Western Australia, 6009, Australia. .,Clinical Research Centre, Graylands Hospital, North Metropolitan Health Service-Mental Health, Perth, Western Australia, Australia.
| | - Umberto Moretto
- Psychiatric Unit I Department of Clinical and Experimental Medicine, University of Pisa, Via Roma 67, Pisa, Italy.,Center for Studies in Behavioral Neurobiology & PERFORM Center, Department of Exercise Science, Concordia University, 7141 Sherbrooke St. West, SP 165.27, Montreal, H4B 1R6, Canada.,Centre de Recherche de l'Institut Universitaire de Gériatrie de Montréal (CRIUGM), 4545 chemin Queen-Mary, M5815, Montreal, H3W 1W5, Canada
| | - Thien Thanh Dang-Vu
- Center for Studies in Behavioral Neurobiology & PERFORM Center, Department of Exercise Science, Concordia University, 7141 Sherbrooke St. West, SP 165.27, Montreal, H4B 1R6, Canada.,Centre de Recherche de l'Institut Universitaire de Gériatrie de Montréal (CRIUGM), 4545 chemin Queen-Mary, M5815, Montreal, H3W 1W5, Canada
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20
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Lenka A, Herath P, Christopher R, Pal PK. Psychosis in Parkinson's disease: From the soft signs to the hard science. J Neurol Sci 2017; 379:169-176. [PMID: 28716235 DOI: 10.1016/j.jns.2017.06.011] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2017] [Revised: 05/30/2017] [Accepted: 06/11/2017] [Indexed: 01/06/2023]
Abstract
Patients with Parkinson's disease (PD) may develop a wide spectrum of non-motor symptoms during the course of illness. Psychosis is one such commonly observed non-motor symptoms of PD. Although several studies based on neuroimaging, genetics, retinal imaging, and neuropsychological evaluations have explored the pathogenesis of psychosis in PD; exact neural correlates are yet to be understood. Identification of factors related to psychosis in PD is important, as psychosis has been reported to be associated with higher rates of mortality, caregiver distress, and nursing home placements. This review highlights the potential of the previous studies to gain further insights into the soft signs and hard science related to psychosis in PD. Studies based on neuropsychological evaluations have revealed significant dysfunction in attention, executive and visuospatial functions in patients with PD and psychosis. Neuroimaging studies reveal grey matter atrophy in regions of the brain corresponding to both dorsal and ventral visual pathways, hippocampus, and cholinergic structures. Meanwhile, functional imaging studies suggest existence of an aberrant top-to-bottom visual processing system, which dominates the normal bottom-to-top system in patients with PD and visual hallucinations. Although nucleotide polymorphisms of several genes have been studied in PD patients with psychosis, those on -45C>T polymorphisms of cholecystokinin gene (CCK) have shown the greatest promise because of its association with psychosis in PD. All these taken together, cohesively unfold the current status of research in patients with PD and psychosis. This paper also highlights the missing links and discusses the approach to future research in this field.
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Affiliation(s)
- Abhishek Lenka
- Department of Clinical Neurosciences, National Institute of Mental Health & Neurosciences (NIMHANS), Bangalore, India; Department of Neurology, National Institute of Mental Health & Neurosciences (NIMHANS), Bangalore, India
| | - Priyantha Herath
- Department of Neurology, University of South Carolina School of Medicine, Columbia, SC, USA
| | - Rita Christopher
- Department of Neurochemistry, National Institute of Mental Health & Neurosciences (NIMHANS), Bangalore, India
| | - Pramod Kumar Pal
- Department of Neurology, National Institute of Mental Health & Neurosciences (NIMHANS), Bangalore, India.
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21
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Rahayel S, Postuma RB, Montplaisir J, Bedetti C, Brambati S, Carrier J, Monchi O, Bourgouin PA, Gaubert M, Gagnon JF. Abnormal Gray Matter Shape, Thickness, and Volume in the Motor Cortico-Subcortical Loop in Idiopathic Rapid Eye Movement Sleep Behavior Disorder: Association with Clinical and Motor Features. Cereb Cortex 2017; 28:658-671. [DOI: 10.1093/cercor/bhx137] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2017] [Indexed: 11/13/2022] Open
Affiliation(s)
- Shady Rahayel
- Centre for Advanced Research in Sleep Medicine, Hôpital du Sacré-Cœur de Montréal, Montreal, Quebec H4J 1C5, Canada
- Department of Psychology, Université du Québec à Montréal, Montreal, Quebec H2X 3P2, Canada
| | - Ronald B Postuma
- Centre for Advanced Research in Sleep Medicine, Hôpital du Sacré-Cœur de Montréal, Montreal, Quebec H4J 1C5, Canada
- Department of Neurology, Montreal General Hospital, Montreal, Quebec H3G 1A4, Canada
| | - Jacques Montplaisir
- Centre for Advanced Research in Sleep Medicine, Hôpital du Sacré-Cœur de Montréal, Montreal, Quebec H4J 1C5, Canada
- Department of Psychiatry, Université de Montréal, Montreal, Quebec H3C 3J7, Canada
| | - Christophe Bedetti
- Centre for Advanced Research in Sleep Medicine, Hôpital du Sacré-Cœur de Montréal, Montreal, Quebec H4J 1C5, Canada
- Research Centre, Institut universitaire de gériatrie de Montréal, Montreal, Quebec H3W 1W5, Canada
| | - Simona Brambati
- Research Centre, Institut universitaire de gériatrie de Montréal, Montreal, Quebec H3W 1W5, Canada
- Department of Psychology, Université de Montréal, Montreal, Quebec H2V 2S9, Canada
| | - Julie Carrier
- Centre for Advanced Research in Sleep Medicine, Hôpital du Sacré-Cœur de Montréal, Montreal, Quebec H4J 1C5, Canada
- Research Centre, Institut universitaire de gériatrie de Montréal, Montreal, Quebec H3W 1W5, Canada
- Department of Psychology, Université de Montréal, Montreal, Quebec H2V 2S9, Canada
| | - Oury Monchi
- Department of Neurology, Montreal General Hospital, Montreal, Quebec H3G 1A4, Canada
- Research Centre, Institut universitaire de gériatrie de Montréal, Montreal, Quebec H3W 1W5, Canada
- Department of Radiology, Radio-Oncology, and Nuclear Medicine, Université de Montréal, Montreal, Quebec H3T 1A4, Canada
- Departments of Clinical Neurosciences and Radiology, and Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta T2N 4N1, Canada
| | - Pierre-Alexandre Bourgouin
- Centre for Advanced Research in Sleep Medicine, Hôpital du Sacré-Cœur de Montréal, Montreal, Quebec H4J 1C5, Canada
- Department of Psychology, Université du Québec à Montréal, Montreal, Quebec H2X 3P2, Canada
| | - Malo Gaubert
- Centre for Advanced Research in Sleep Medicine, Hôpital du Sacré-Cœur de Montréal, Montreal, Quebec H4J 1C5, Canada
- Department of Psychology, Université du Québec à Montréal, Montreal, Quebec H2X 3P2, Canada
| | - Jean-François Gagnon
- Centre for Advanced Research in Sleep Medicine, Hôpital du Sacré-Cœur de Montréal, Montreal, Quebec H4J 1C5, Canada
- Department of Psychology, Université du Québec à Montréal, Montreal, Quebec H2X 3P2, Canada
- Research Centre, Institut universitaire de gériatrie de Montréal, Montreal, Quebec H3W 1W5, Canada
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22
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Colonic Oxidative and Mitochondrial Function in Parkinson's Disease and Idiopathic REM Sleep Behavior Disorder. PARKINSONS DISEASE 2017; 2017:9816095. [PMID: 28660090 PMCID: PMC5474269 DOI: 10.1155/2017/9816095] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/10/2017] [Revised: 04/01/2017] [Accepted: 05/04/2017] [Indexed: 12/19/2022]
Abstract
OBJECTIVE To determine potential mitochondrial and oxidative alterations in colon biopsies from idiopathic REM sleep behavior disorder (iRBD) and Parkinson's disease (PD) subjects. METHODS Colonic biopsies from 7 iRBD subjects, 9 subjects with clinically diagnosed PD, and 9 healthy controls were homogenized in 5% w/v mannitol. Citrate synthase (CS) and complex I (CI) were analyzed spectrophotometrically. Oxidative damage was assessed either by lipid peroxidation, through malondialdehyde and hydroxyalkenal content by spectrophotometry, or through antioxidant enzyme levels of superoxide dismutase-2 (SOD2), glutathione peroxidase-1 (Gpx1), and catalase (CAT) by western blot. The presence of mitochondrial DNA (mtDNA) deletions was assessed by long PCR and electrophoresis. RESULTS Nonsignificant trends to CI decrease in both iRBD (45.69 ± 18.15; 23% decrease) and PD patients (37.57 ± 12.41; 37% decrease) were found compared to controls (59.51 ± 12.52, p: NS). Lipid peroxidation was maintained among groups (iRBD: 27.46 ± 3.04, PD: 37.2 ± 3.92, and controls: 31.71 ± 3.94; p: NS). Antioxidant enzymes SOD2 (iRBD: 2.30 ± 0.92, PD: 1.48 ± 0.39, and controls: 1.09 ± 0.318) and Gpx1 (iRBD 0.29 ± 0.12, PD: 0.56 ± 0.33, and controls: 0.38 ± 0.16) did not show significant differences between groups. CAT was only detected in 2 controls and 1 iRBD subject. One iRBD patient presented a single mtDNA deletion.
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23
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Ferri R, Rundo F, Silvani A, Zucconi M, Bruni O, Ferini-Strambi L, Plazzi G, Manconi M. REM Sleep EEG Instability in REM Sleep Behavior Disorder and Clonazepam Effects. Sleep 2017; 40:3800356. [DOI: 10.1093/sleep/zsx080] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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24
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Biomarkers of Nonmotor Symptoms in Parkinson's Disease. INTERNATIONAL REVIEW OF NEUROBIOLOGY 2017; 133:259-289. [DOI: 10.1016/bs.irn.2017.05.020] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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25
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Lu S, Shaffery JP, Pang Y, Tien LT, Fan LW. Rapid Eye Movement Sleep Homeostatic Response: A Potential Marker for Early Detection of Parkinson's Disease. ACTA ACUST UNITED AC 2016; 6. [PMID: 27713856 DOI: 10.4172/2161-0460.1000255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Silu Lu
- Department of Pediatrics, Division of Newborn Medicine, University of Mississippi Medical Center, Jackson, MS 39216, USA
| | - James P Shaffery
- Department of Psychiatry and Human Behavior, Animal Behavior Core, University of Mississippi Medical Center, Jackson, MS 39216, USA
| | - Yi Pang
- Department of Pediatrics, Division of Newborn Medicine, University of Mississippi Medical Center, Jackson, MS 39216, USA
| | - Lu-Tai Tien
- School of Medicine, Fu Jen Catholic University, Xinzhuang Dist, New Taipei City 24205, Taiwan
| | - Lir-Wan Fan
- Department of Pediatrics, Division of Newborn Medicine, University of Mississippi Medical Center, Jackson, MS 39216, USA
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26
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Zhang L, Xu Y, Zhuang J, Peng H, Wu H, Zhao Z, He B, Zhao Z. Metabolic abnormality of pontine tegmentum in patients with REM sleep behavior disorder analyzed using magnetic resonance spectroscopy. Clin Neurol Neurosurg 2016; 148:137-41. [PMID: 27448046 DOI: 10.1016/j.clineuro.2016.07.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2015] [Revised: 03/31/2016] [Accepted: 07/02/2016] [Indexed: 10/21/2022]
Abstract
OBJECTIVES We aimed to evaluate the metabolism differences in pontine tegmentum among patients with idiopathic RBD (iRBD), secondary RBD (sRBD) and healthy control groups using magnetic resonance spectroscopy ((1)H-MRS) and whether metabolic changes are correlated with age in patients with RBD. PATIENTS AND METHODS The iRBD, sRBD, and control groups were composed of 18, 26, and 29 patients, respectively. All participants underwent magnetic resonance imaging (MRI) and (1)H-MRS detection at 17:00 for approximately 15min. All NAA/Cr, Cho/Cr and NAA/Cho ratios were automatically generated using FuncTool and the correlation between metabolism and age was analyzed by Pearson's correlation analysis. RESULTS Significant difference in NAA/Cr ratio was found between the sRBD group and the other groups (p<0.05). Significant difference in NAA/Cho ratio was found among all groups (p<0.05). Cho/Cr ratio remarkably increased in the control group (p<0.05) compared with the other groups. NAA/Cr ratio had an adverse correlation with age in the control, iRBD, and sRBD groups (r=-0.822, p=0.000 vs r=-0.663, p=0.003 vs r=-0.583, p=0.002). However, there was no correlation between participants age and Cho/Cr (r=-0.054, p=0.651) or NAA/Cho (r=0.029, p=0.805). CONCLUSION Neurons in the sRBD group were lost or damaged; however, this damage was not obvious in the iRBD group. Nevertheless, NAA and Cho levels were reduced in the local nerve cells of both RBD groups; these changes might indicate the sensitive pathogenic areas among patients with RBD.
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Affiliation(s)
- Lin Zhang
- Department of Neurology, ChangZheng Hospital Affiliated with the Second Military Medical University, Shanghai 200003, China
| | - Yixin Xu
- Department of Neurology, ChangZheng Hospital Affiliated with the Second Military Medical University, Shanghai 200003, China
| | - Jianhua Zhuang
- Department of Neurology, ChangZheng Hospital Affiliated with the Second Military Medical University, Shanghai 200003, China
| | - Hua Peng
- Department of Neurology, ChangZheng Hospital Affiliated with the Second Military Medical University, Shanghai 200003, China
| | - Huijuan Wu
- Department of Neurology, ChangZheng Hospital Affiliated with the Second Military Medical University, Shanghai 200003, China
| | - Zhengqing Zhao
- Department of Neurology, ChangZheng Hospital Affiliated with the Second Military Medical University, Shanghai 200003, China
| | - Bin He
- Department of Neurology, ChangZheng Hospital Affiliated with the Second Military Medical University, Shanghai 200003, China
| | - Zhongxin Zhao
- Department of Neurology, ChangZheng Hospital Affiliated with the Second Military Medical University, Shanghai 200003, China.
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27
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Ciric J, Lazic K, Petrovic J, Kalauzi A, Saponjic J. Age-related disorders of sleep and motor control in the rat models of functionally distinct cholinergic neuropathology. Behav Brain Res 2016; 301:273-86. [DOI: 10.1016/j.bbr.2015.12.046] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2015] [Revised: 11/05/2015] [Accepted: 12/21/2015] [Indexed: 02/06/2023]
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28
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Li SX, Lam SP, Zhang J, Yu MWM, Chan JWY, Liu Y, Lam VKH, Ho CKW, Zhou J, Wing YK. A prospective, naturalistic follow-up study of treatment outcomes with clonazepam in rapid eye movement sleep behavior disorder. Sleep Med 2016; 21:114-20. [PMID: 27448481 DOI: 10.1016/j.sleep.2015.12.020] [Citation(s) in RCA: 64] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2015] [Revised: 12/23/2015] [Accepted: 12/23/2015] [Indexed: 02/05/2023]
Abstract
BACKGROUND Rapid eye movement sleep behavior disorder (RBD) is characterized by prominent dream-enacting behaviors, often resulting in sleep-related injuries. OBJECTIVES This study aimed to prospectively examine the treatment response of people with RBD treated with clonazepam, by quantitatively delineating the characteristic changes in the clinical and polysomnographic features, and to explore the factors associated with this response. METHODS Patients diagnosed with idiopathic RBD (iRBD) were consecutively recruited and invited to complete clinical and polysomnographic (PSG) assessments and self-administered questionnaires (including the modified REM Sleep Behavior Questionnaire, RBDQ-3M) before and after the initiation of treatment with clonazepam. RESULTS Thirty-nine iRBD patients (male: 74.4%, mean age at diagnosis: 68.3 ± 7.8 years) were recruited with a follow-up duration of 28.8 ± 13.3 months. Clonazepam was offered as the first-line treatment (starting dose: 0.43 ± 0.16 mg, range: 0.125-1.00; dose at follow-up: 0.98 ± 0.63 mg, range: 0.125-3). Treatment response, as defined by a complete elimination of sleep-related injuries and potentially injurious behaviors to self and/or to bed partner, at follow-up was reported in 66.7% of the overall study subjects. Frequency of disturbing dreams with violent and frightening content and vigorous behavioral RBD symptoms was significantly reduced, while residual nocturnal symptoms and an increase in REM-related EMG activities were observed at follow-up. Less optimal treatment outcomes were found to be associated with the presence of comorbid obstructive sleep apnea and earlier onset of RBD. CONCLUSIONS Clonazepam differentially changes dream affect and content, as well as reduces vigorous verbal and motor behaviors. Residual RBD symptoms are common, despite treatment. Other more effective alternative or adjunctive interventions are needed for better clinical management of RBD.
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Affiliation(s)
- Shirley Xin Li
- Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China; Department of Psychology, The University of Hong Kong, Pokfulam, Hong Kong SAR, China
| | - Siu Ping Lam
- Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
| | - Jihui Zhang
- Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
| | - Mandy Wai Man Yu
- Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
| | - Joey Wing Yin Chan
- Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
| | - Yaping Liu
- Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
| | - Venny Kwai Ho Lam
- Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
| | - Crover Kwok Wah Ho
- Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
| | - Junying Zhou
- Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China; Sleep Medicine Center, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Yun Kwok Wing
- Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China.
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Impact of Impulse Control Disorders on Sleep-Wake Regulation in Parkinson's Disease. PARKINSONS DISEASE 2015; 2015:970862. [PMID: 26664825 PMCID: PMC4667074 DOI: 10.1155/2015/970862] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/02/2015] [Accepted: 11/03/2015] [Indexed: 01/21/2023]
Abstract
Sleep disturbances are common in patients with Parkinson's disease (PD) and are even more prevalent in patients with behavioural addictions, such as pathological gambling, compulsive sexual behaviour, compulsive buying, binge eating, punding, and the compulsive use of dopamine replacement therapy. An overview of the relationship between these impulse control disorders and sleep disturbances is given and potential underlying mechanisms and treatment strategies are covered.
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Lenka A, Hegde S, Jhunjhunwala KR, Pal PK. Interactions of visual hallucinations, rapid eye movement sleep behavior disorder and cognitive impairment in Parkinson's disease: A review. Parkinsonism Relat Disord 2015; 22:1-8. [PMID: 26639978 DOI: 10.1016/j.parkreldis.2015.11.018] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2015] [Revised: 11/09/2015] [Accepted: 11/17/2015] [Indexed: 01/03/2023]
Abstract
Patients with Parkinson's disease may develop various non-motor symptoms during the course of the illness. Visual hallucinations (VH) and cognitive impairment (CI) are two common non-motor symptoms of Parkinson's disease. Studies have reported association of both VH and CI with presence of rapid eye movement sleep behavior disorder (RBD). Presence of visual hallucinations and cognitive impairment has been described as risk factors for emergence of each other. There is marked overlap in the risk factors for development of RBD, VH and CI in patients with PD. Results of clinical and epidemiological studies as well as studies based on neuroimaging, electrophysiology especially transcranial magnetic stimulation and neuropsycholgical evaluations in PD patients have suggested presence of certain common neurobiological process leading to emergence of RBD, VH and CI. Structural neuroimaging studies using voxel-based morphometry have often reported grey matter atrophy of hippocampus and parahippocampal cortices in PD patients with RBD, VH and CI. Cholinergic dysfunction is common in PD patients with RBD, VH and CI. This review explores the complex interactions of RBD, VH and CI in patients with PD and their potential implications.
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Affiliation(s)
- Abhishek Lenka
- Department of Clinical Neurosciences, National Institute of Mental Health & Neurosciences, Hosur Road, Bangalore 560029, Karnataka, India; Department of Neurology, National Institute of Mental Health & Neurosciences, Hosur Road, Bangalore 560029, Karnataka, India
| | - Shantala Hegde
- Department of Clinical Psychology, National Institute of Mental Health & Neurosciences, Hosur Road, Bangalore 560029, Karnataka, India
| | - Ketan Ramakant Jhunjhunwala
- Department of Clinical Neurosciences, National Institute of Mental Health & Neurosciences, Hosur Road, Bangalore 560029, Karnataka, India; Department of Neurology, National Institute of Mental Health & Neurosciences, Hosur Road, Bangalore 560029, Karnataka, India
| | - Pramod Kumar Pal
- Department of Neurology, National Institute of Mental Health & Neurosciences, Hosur Road, Bangalore 560029, Karnataka, India.
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Jain S, Park SY, Comer D. Patterns of Motor and Non-Motor Features in Medication-Naïve Parkinsonism. Neuroepidemiology 2015; 45:59-69. [PMID: 26227734 DOI: 10.1159/000437228] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2015] [Accepted: 06/28/2015] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Parkinsonism is defined by motor features (tremor, bradykinesia, rigidity, and postural instability). Accompanying non-motor features (e.g. cognitive, autonomic, sleep disturbances) are underrecognized and undertreated. We hypothesized that clinical patterns occurring in early, medication-naïve Parkinsonism are distinguished by features such as tremor, sleep, autonomic, and cognitive dysfunction. METHODS Clinical and neuroimaging data were obtained in the Parkinson's Progression Marker Initiative. Group comparisons of Parkinsonism with dopaminergic deficits (PDD) (n = 388), controls (n = 196), and Parkinsonism with scans without evidence of dopaminergic deficits (n = 64) were done with ANOVA, chi-square, and post-hoc pairwise tests. To examine clinical patterns within the PDD group, k-means clustering was performed with non-motor or motor features, or both. RESULTS Among PDD, 4 non-motor patterns (% of PDD) (impulsive (14.9%), sleep-autonomic (22.9%), cognitive-olfactory (18.0%), and mild (44.1%)), 4 motor patterns (tremor plus bradykinesia (56.2%), tremor without bradykinesia (16.2%), postural instability (6.7%) and no tremor (20.9%)) and 5 combined motor/non-motor patterns (tremor with bradykinesia (42.3%), tremor without bradykinesia (15.5%), no tremor and mild non-motor features (17.0%), postural instability with sleep-autonomic disturbances (6.7%) and oldest onset cognitive-olfactory (18.6%)) were observed. CONCLUSIONS To our knowledge, this is the first description of non-motor clinical patterns in early, medication-naïve Parkinsonism, suggesting that such features are intrinsic to Parkinsonian disorders.
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Affiliation(s)
- Samay Jain
- Department of Neurology, UPMC, University of Pittsburgh School of Medicine, Pittsburgh, Pa., USA
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O'Reilly C, Godin I, Montplaisir J, Nielsen T. REM sleep behaviour disorder is associated with lower fast and higher slow sleep spindle densities. J Sleep Res 2015; 24:593-601. [DOI: 10.1111/jsr.12309] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2014] [Accepted: 05/03/2015] [Indexed: 11/29/2022]
Affiliation(s)
- Christian O'Reilly
- Center for Advanced Research in Sleep Medicine; Hôpital du Sacré-Coeur de Montréal; Montreal QC Canada
- Département de psychiatrie; Université de Montréal; Montreal QC Canada
- Department of Neurology and Neurosurgery; McGill University; Montreal Neurological Institute; Montreal QC Canada
| | - Isabelle Godin
- Center for Advanced Research in Sleep Medicine; Hôpital du Sacré-Coeur de Montréal; Montreal QC Canada
- Département de psychologie; Université de Montréal; Montreal QC Canada
| | - Jacques Montplaisir
- Center for Advanced Research in Sleep Medicine; Hôpital du Sacré-Coeur de Montréal; Montreal QC Canada
- Département de psychiatrie; Université de Montréal; Montreal QC Canada
| | - Tore Nielsen
- Center for Advanced Research in Sleep Medicine; Hôpital du Sacré-Coeur de Montréal; Montreal QC Canada
- Département de psychiatrie; Université de Montréal; Montreal QC Canada
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Abstract
Sleep disorders are a pervasive problem throughout all patient populations but represent an especially important health problem for the elderly. Alterations in sleep architecture that occur as a part of normal aging will contribute to sleep problems as we grow older. Other contributing factors-including comorbid medical conditions, changes in lifestyle and schedule, altered circadian rhythm, among a host of others-can have detrimental effects on the health of the elderly. Coupled with a number of sleep disorders that either emerge or exacerbate with age, the effects of poor sleep often result in an overall worsening of quality of life. Treatment options can be unique in this population and often more difficult due to the effects of normal aging, as well as polypharmacy and possible medication interactions. The following article will focus on the common sleep disorders that can besiege this population, symptoms to aid in diagnosis, and specific treatment options to help improve quality of life in the elderly.
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Affiliation(s)
- Kevin Gleason
- Department of Psychiatry and Health Behavior, Medical College of Georgia, 997 St. Sebastian Way, Augusta, GA, 30912, USA,
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The Clinical Evaluation and Use of Sleep Studies in Neurological Practice. CURRENT SLEEP MEDICINE REPORTS 2015. [DOI: 10.1007/s40675-015-0014-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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Postuma RB, Gagnon JF, Bertrand JA, Génier Marchand D, Montplaisir JY. Parkinson risk in idiopathic REM sleep behavior disorder: preparing for neuroprotective trials. Neurology 2015; 84:1104-13. [PMID: 25681454 PMCID: PMC4371408 DOI: 10.1212/wnl.0000000000001364] [Citation(s) in RCA: 307] [Impact Index Per Article: 34.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2014] [Accepted: 11/19/2014] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To precisely delineate clinical risk factors for conversion from idiopathic REM sleep behavior disorder (RBD) to Parkinson disease, dementia with Lewy bodies, and multiple system atrophy, in order to enable practical planning and stratification of neuroprotective trials against neurodegenerative synucleinopathy. METHODS In a 10-year prospective cohort, we tested prodromal Parkinson disease markers in 89 patients with idiopathic RBD. With Kaplan-Meier analysis, we calculated risk of neurodegenerative synucleinopathy, and using Cox proportional hazards, tested the ability of prodromal markers to identify patients at higher disease risk. By combining predictive markers, we then designed stratification strategies to optimally select patients for definitive neuroprotective trials. RESULTS The risk of defined neurodegenerative synucleinopathy was high: 30% developed disease at 3 years, rising to 66% at 7.5 years. Advanced age (hazard ratio [HR] = 1.07), olfactory loss (HR = 2.8), abnormal color vision (HR = 3.1), subtle motor dysfunction (HR = 3.9), and nonuse of antidepressants (HR = 3.5) identified higher risk of disease conversion. However, mild cognitive impairment (HR = 1.8), depression (HR = 0.63), Parkinson personality, treatment with clonazepam (HR = 1.3) or melatonin (HR = 0.55), autonomic markers, and sex (HR = 1.37) did not clearly predict clinical neurodegeneration. Stratification with prodromal markers increased risk of neurodegenerative disease conversion by 200%, and combining markers allowed sample size reduction in neuroprotective trials by >40%. With a moderately effective agent (HR = 0.5), trials with fewer than 80 subjects per group can demonstrate definitive reductions in neurodegenerative disease. CONCLUSIONS Using stratification with simply assessed markers, it is now not only possible, but practical to include patients with RBD in neuroprotective trials against Parkinson disease, multiple system atrophy, and dementia with Lewy bodies.
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Affiliation(s)
- Ronald B Postuma
- From the Department of Neurology (R.B.P.), McGill University, Montreal General Hospital; Centre d'Études Avancées en Médecine du Sommeil (R.B.P., J.-F.G., J.-A.B., D.G.M., J.Y.M.), Hôpital du Sacré-Cœur de Montréal; Department of Psychology (J.-F.G.), Université du Québec à Montréal; and Department of Psychiatry (J.Y.M.), Université de Montréal, Canada
| | - Jean-Francois Gagnon
- From the Department of Neurology (R.B.P.), McGill University, Montreal General Hospital; Centre d'Études Avancées en Médecine du Sommeil (R.B.P., J.-F.G., J.-A.B., D.G.M., J.Y.M.), Hôpital du Sacré-Cœur de Montréal; Department of Psychology (J.-F.G.), Université du Québec à Montréal; and Department of Psychiatry (J.Y.M.), Université de Montréal, Canada
| | - Josie-Anne Bertrand
- From the Department of Neurology (R.B.P.), McGill University, Montreal General Hospital; Centre d'Études Avancées en Médecine du Sommeil (R.B.P., J.-F.G., J.-A.B., D.G.M., J.Y.M.), Hôpital du Sacré-Cœur de Montréal; Department of Psychology (J.-F.G.), Université du Québec à Montréal; and Department of Psychiatry (J.Y.M.), Université de Montréal, Canada
| | - Daphné Génier Marchand
- From the Department of Neurology (R.B.P.), McGill University, Montreal General Hospital; Centre d'Études Avancées en Médecine du Sommeil (R.B.P., J.-F.G., J.-A.B., D.G.M., J.Y.M.), Hôpital du Sacré-Cœur de Montréal; Department of Psychology (J.-F.G.), Université du Québec à Montréal; and Department of Psychiatry (J.Y.M.), Université de Montréal, Canada
| | - Jacques Y Montplaisir
- From the Department of Neurology (R.B.P.), McGill University, Montreal General Hospital; Centre d'Études Avancées en Médecine du Sommeil (R.B.P., J.-F.G., J.-A.B., D.G.M., J.Y.M.), Hôpital du Sacré-Cœur de Montréal; Department of Psychology (J.-F.G.), Université du Québec à Montréal; and Department of Psychiatry (J.Y.M.), Université de Montréal, Canada.
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Cipriani G, Lucetti C, Danti S, Nuti A. Sleep disturbances and dementia. Psychogeriatrics 2015; 15:65-74. [PMID: 25515641 DOI: 10.1111/psyg.12069] [Citation(s) in RCA: 82] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2014] [Revised: 08/15/2014] [Accepted: 08/18/2014] [Indexed: 12/20/2022]
Abstract
Sleep is a complex behavioural state, the ultimate functions of which remain poorly understood. It becomes more fragmented as we age, with more night-time awakenings and greater tendency for daytime sleep. The magnitude of disordered sleep among individuals affected by dementia has been clearly demonstrated, and disturbed sleep is a major clinical problem in dementia. Comorbid insomnia and other sleep disturbances are common in patients with neurodegenerative disorders, such Alzheimer's disease and other dementing disorders. How and when sleep problems manifest themselves can depend on the type of dementia involved as well as the stage of the dementia. However, differences in sleep pattern presentation show more variation during the initial stages of dementias than they do during the later stages. Effective, pragmatic interventions are largely anecdotal and untested.
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Chen H, Zhao EJ, Zhang W, Lu Y, Liu R, Huang X, Ciesielski-Jones AJ, Justice MA, Cousins DS, Peddada S. Meta-analyses on prevalence of selected Parkinson's nonmotor symptoms before and after diagnosis. Transl Neurodegener 2015; 4:1. [PMID: 25671103 PMCID: PMC4322463 DOI: 10.1186/2047-9158-4-1] [Citation(s) in RCA: 112] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2014] [Accepted: 01/05/2015] [Indexed: 12/11/2022] Open
Abstract
Background Nonmotor symptoms are common among patients with Parkinson’s disease (PD) and some may precede disease diagnosis. Methods We conducted a meta-analysis on the prevalence of selected nonmotor symptoms before and after PD diagnosis, using random-effect models. We searched PubMed (1965 through October/November 2012) for the following symptoms: hyposmia, constipation, rapid eye movement sleep behavior disorder, excessive daytime sleepiness, depression, and anxiety. Eligible studies were publications in English with original data on one or more of these symptoms. Results The search generated 2,373 non-duplicated publications and 332 met the inclusion criteria, mostly (n = 320) on symptoms after PD diagnosis. For all symptoms, the prevalence was substantially higher in PD cases than in controls, each affecting over a third of the patients. Hyposmia was the most prevalent (75.5% in cases vs. 19.1% in controls), followed by constipation (50% vs. 17.7%), anxiety (39.9% vs. 19.1%), rapid eye movement sleep behavior disorder (37.0% vs. 7.0%), depression (36.6% vs. 14.9%), and excessive daytime sleepiness (33.9% vs. 10.5%). We observed substantial heterogeneities across studies and meta-regression analyses suggested that several factors might have contributed to this. However, the prevalence estimates were fairly robust in several sensitivity analyses. Only 20 studies had data on any symptoms prior to PD diagnosis, but still the analyses revealed higher prevalence in future PD cases than in controls. Conclusion These symptoms are common among PD patients both before and after diagnosis. Further studies are needed to understand the natural history of nonmotor symptoms in PD and their etiological and clinical implications. Electronic supplementary material The online version of this article (doi:10.1186/2047-9158-4-1) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Honglei Chen
- Epidemiology Branch, National Institute of Environmental Health Sciences, 111 T.W. Alexander Dr, P.O. Box 12233, Mail drop A3-05, Research Triangle Park, NC 27709 USA
| | - Edward J Zhao
- Epidemiology Branch, National Institute of Environmental Health Sciences, 111 T.W. Alexander Dr, P.O. Box 12233, Mail drop A3-05, Research Triangle Park, NC 27709 USA
| | - Wen Zhang
- Epidemiology Branch, National Institute of Environmental Health Sciences, 111 T.W. Alexander Dr, P.O. Box 12233, Mail drop A3-05, Research Triangle Park, NC 27709 USA
| | - Yi Lu
- Social & Scientific Systems, Inc, Durham, North Carolina USA
| | - Rui Liu
- Epidemiology Branch, National Institute of Environmental Health Sciences, 111 T.W. Alexander Dr, P.O. Box 12233, Mail drop A3-05, Research Triangle Park, NC 27709 USA
| | - Xuemei Huang
- Departments of Neurology, Radiology, Neurosurgery, Pharmacology, & Kinesiology, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey, Pennsylvania USA
| | | | | | | | - Shyamal Peddada
- Biostatistics Branch, National Institute of Environmental Health Sciences, Research Triangle Park, NC USA
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Guerreiro S, Florence C, Rousseau E, Hamadat S, Hirsch EC, Michel PP. The Sleep-Modulating Peptide Orexin-B Protects Midbrain Dopamine Neurons from Degeneration, Alone or in Cooperation with Nicotine. Mol Pharmacol 2014; 87:525-32. [DOI: 10.1124/mol.114.095703] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023] Open
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Polysomnographic Features of Sleep Disturbances and REM Sleep Behavior Disorder in the Unilateral 6-OHDA Lesioned Hemiparkinsonian Rat. PARKINSONS DISEASE 2014; 2014:852965. [PMID: 25610706 PMCID: PMC4291192 DOI: 10.1155/2014/852965] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/27/2014] [Revised: 12/10/2014] [Accepted: 12/10/2014] [Indexed: 01/11/2023]
Abstract
Sleep pattern disruption, specifically REM sleep behavior disorder (RBD), is a major nonmotor cause of disability in PD. Understanding the pathophysiology of these sleep pattern disturbances is critical to find effective treatments. 24-hour polysomnography (PSG), the gold standard for sleep studies, has never been used to test sleep dysfunction in the standard 6-OHDA lesioned hemiparkinsonian (HP) rat PD model. In this study, we recorded 24-hour PSG from normal and HP rats. Recordings were scored into wake, rapid eye movement (REM), and non-REM (NREM). We then examined EEG to identify REM periods and EMG to check muscle activity during REM. Normal rats showed higher wakefulness (70-80%) during the dark phase and lower wakefulness (20%) during the light phase. HP rats showed 30-50% sleep in both phases, less modulation and synchronization to the light schedule (P < 0.0001), and more long run lengths of wakefulness (P < 0.05). HP rats also had more REM epochs with muscle activity than control rats (P < 0.05). Our findings that the sleep architecture in the HP rat resembles that of PD patients demonstrate the value of this model in studying the pathophysiological basis of PD sleep disturbances and preclinical therapeutics for PD related sleep disorders including RBD.
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dos Santos AB, Kohlmeier KA, Barreto GE. Are Sleep Disturbances Preclinical Markers of Parkinson’s Disease? Neurochem Res 2014; 40:421-7. [DOI: 10.1007/s11064-014-1488-7] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2014] [Revised: 11/21/2014] [Accepted: 11/24/2014] [Indexed: 10/24/2022]
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Abstract
AbstractBackground: A large hexanucleotide repeat expansion in C9orf72 has been identified as the most common genetic cause in familial amyotrophic lateral sclerosis and frontotemporal dementia. Rapid Eye Movement Sleep Behavior Disorder (RBD) is a sleep disorder that has been strongly linked to synuclein-mediated neurodegeneration. The aim of this study was to evaluate the role of the C9orf72 expansions in the pathogenesis of RBD. Methods: We amplified the C9orf72 repeat expansion in 344 patients with RBD by a repeat-primed polymerase chain reaction assay. Results: We identified two RBD patients carrying the C9orf72 repeat expansion. Most interestingly, these patients have the same C9orf72 associated-risk haplotype identified in 9p21-linked amyotrophic lateral sclerosis and frontotemporal dementia families. Conclusions: Our study enlarges the phenotypic spectrum associated with the C9orf72 hexanucleotide repeat expansions and suggests that, although rare, this expansion may play a role in the pathogenesis of RBD.
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Kim YE, Jeon BS, Paek SH, Yun JY, Yang HJ, Kim HJ, Ehm G, Kim HJ, Lee JY, Kim JY. Rapid eye movement sleep behavior disorder after bilateral subthalamic stimulation in Parkinson's disease. J Clin Neurosci 2014; 22:315-9. [PMID: 25439757 DOI: 10.1016/j.jocn.2014.07.016] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2014] [Accepted: 07/06/2014] [Indexed: 11/30/2022]
Abstract
The effect of subthalamic nucleus (STN) deep brain stimulation (DBS) on rapid eye movement sleep behavior disorder (RBD) in Parkinson's disease (PD) is not well known. We evaluated the change in the incidence of probable RBD after bilateral STN DBS in PD patients. Ninety patients with PD treated with bilateral STN DBS underwent retrospective assessment of RBD by interview before and after DBS. Forty-seven (52.2%) of the 90 patients had RBD preoperatively. RBD was resolved only in one patient and persisted in 46 patients at 1 year after DBS. RBD developed de novo in 16 patients (de novo RBD group) within 1 year after DBS, resulting in 62 (68.9%) of the 90 patients having RBD 1 year after DBS. Patients with RBD at any time within 1 year after DBS (RBD group, n = 63) were older than the patients without RBD (non-RBD group, n = 27). The sum of the Unified Parkinson Disease Rating Scale (UPDRS) axial score for the "on" state was lower in the RBD group than in the non-RBD group after DBS (p = 0.029). Comparing the de novo RBD group and non-RBD group, the UPDRS Part III and total score and the levodopa equivalent daily doses for the "on" states decreased more in the de novo RBD group than in the non-RBD group (p < 0.05). The incidence of clinical RBD increased after bilateral STN DBS because de novo RBD developed and pre-existing RBD persisted after DBS.
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Affiliation(s)
- Young Eun Kim
- Department of Neurology, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Republic of Korea; Parkinson's Disease Study Group, Seoul National University Hospital, Seoul, Republic of Korea
| | - Beom S Jeon
- Parkinson's Disease Study Group, Seoul National University Hospital, Seoul, Republic of Korea; Department of Neurology and Movement Disorder Center, Seoul National University Hospital, Seoul, Republic of Korea.
| | - Sun-Ha Paek
- Parkinson's Disease Study Group, Seoul National University Hospital, Seoul, Republic of Korea; Department of Neurosurgery and Movement Disorder Center, Seoul National University Hospital, Seoul, Republic of Korea
| | - Ji Young Yun
- Parkinson's Disease Study Group, Seoul National University Hospital, Seoul, Republic of Korea; Department of Neurology, Ewha Womans University Mokdong Hospital, Republic of Korea
| | - Hui-Jun Yang
- Parkinson's Disease Study Group, Seoul National University Hospital, Seoul, Republic of Korea; Department of Neurology, Ulsan University Hospital, Ulsan, Republic of Korea
| | - Han-Joon Kim
- Parkinson's Disease Study Group, Seoul National University Hospital, Seoul, Republic of Korea; Department of Neurology and Movement Disorder Center, Seoul National University Hospital, Seoul, Republic of Korea
| | - Gwanhee Ehm
- Parkinson's Disease Study Group, Seoul National University Hospital, Seoul, Republic of Korea; Department of Neurology and Movement Disorder Center, Seoul National University Hospital, Seoul, Republic of Korea
| | - Hee Jin Kim
- Parkinson's Disease Study Group, Seoul National University Hospital, Seoul, Republic of Korea; Department of Neurology, Konkuk University Hospital, Seoul, Republic of Korea
| | - Jee-Young Lee
- Parkinson's Disease Study Group, Seoul National University Hospital, Seoul, Republic of Korea; Department of Neurology, Seoul National University, Metropolitan Boramae Hospital, Seoul, Republic of Korea
| | - Ji-Young Kim
- Parkinson's Disease Study Group, Seoul National University Hospital, Seoul, Republic of Korea; Departments of Neurology, Inje University Seoul Paik Hospital, Seoul, Republic of Korea
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Baier PC, Brzózka MM, Shahmoradi A, Reinecke L, Kroos C, Wichert SP, Oster H, Wehr MC, Taneja R, Hirrlinger J, Rossner MJ. Mice lacking the circadian modulators SHARP1 and SHARP2 display altered sleep and mixed state endophenotypes of psychiatric disorders. PLoS One 2014; 9:e110310. [PMID: 25340473 PMCID: PMC4207740 DOI: 10.1371/journal.pone.0110310] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2014] [Accepted: 09/11/2014] [Indexed: 12/14/2022] Open
Abstract
Increasing evidence suggests that clock genes may be implicated in a spectrum of psychiatric diseases, including sleep and mood related disorders as well as schizophrenia. The bHLH transcription factors SHARP1/DEC2/BHLHE41 and SHARP2/DEC1/BHLHE40 are modulators of the circadian system and SHARP1/DEC2/BHLHE40 has been shown to regulate homeostatic sleep drive in humans. In this study, we characterized Sharp1 and Sharp2 double mutant mice (S1/2-/-) using online EEG recordings in living animals, behavioral assays and global gene expression profiling. EEG recordings revealed attenuated sleep/wake amplitudes and alterations of theta oscillations. Increased sleep in the dark phase is paralleled by reduced voluntary activity and cortical gene expression signatures reveal associations with psychiatric diseases. S1/2-/- mice display alterations in novelty induced activity, anxiety and curiosity. Moreover, mutant mice exhibit impaired working memory and deficits in prepulse inhibition resembling symptoms of psychiatric diseases. Network modeling indicates a connection between neural plasticity and clock genes, particularly for SHARP1 and PER1. Our findings support the hypothesis that abnormal sleep and certain (endo)phenotypes of psychiatric diseases may be caused by common mechanisms involving components of the molecular clock including SHARP1 and SHARP2.
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Affiliation(s)
- Paul C. Baier
- Department of Neurology, University of Kiel, Kiel, Germany
- Department of Clinical Neurophysiology, University of Göttingen, Göttingen, Germany
| | | | - Ali Shahmoradi
- Research Group Gene Expression, Max Planck Institute of Experimental Medicine, Göttingen, Germany
| | - Lisa Reinecke
- Research Group Gene Expression, Max Planck Institute of Experimental Medicine, Göttingen, Germany
| | - Christina Kroos
- Research Group Gene Expression, Max Planck Institute of Experimental Medicine, Göttingen, Germany
| | - Sven P. Wichert
- Department of Psychiatry, Ludwig-Maximilian-University, Munich, Germany
| | - Henrik Oster
- Circadian Rhythms Group, Max Planck Institute of Biophysical Chemistry, Göttingen, Germany
- Medical Department I, University of Lübeck, Lübeck, Germany
| | - Michael C. Wehr
- Department of Psychiatry, Ludwig-Maximilian-University, Munich, Germany
| | - Reshma Taneja
- Department of Physiology, National University of Singapore, Singapore, Singapore
| | - Johannes Hirrlinger
- Research Group Gene Expression, Max Planck Institute of Experimental Medicine, Göttingen, Germany
- Carl-Ludwig Institute of Physiology, University of Leipzig, Leipzig, Germany
| | - Moritz J. Rossner
- Department of Psychiatry, Ludwig-Maximilian-University, Munich, Germany
- Research Group Gene Expression, Max Planck Institute of Experimental Medicine, Göttingen, Germany
- * E-mail:
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Petrovic J, Lazic K, Kalauzi A, Saponjic J. REM sleep diversity following the pedunculopontine tegmental nucleus lesion in rat. Behav Brain Res 2014; 271:258-68. [DOI: 10.1016/j.bbr.2014.06.026] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2014] [Revised: 06/09/2014] [Accepted: 06/10/2014] [Indexed: 11/28/2022]
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Limongi JCP. REM sleep behavior disorder, neurodegeneration and Wilson's disease. ARQUIVOS DE NEURO-PSIQUIATRIA 2014; 72:649-650. [PMID: 25252226 DOI: 10.1590/0004-282x20140172] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/02/2014] [Accepted: 08/22/2014] [Indexed: 06/03/2023]
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Lee JH, Han YH, Cho JW, Lee JS, Lee SJ, Kim DJ, Kim TH, Kang BM, Kim TH, Mun CW. Evaluation of brain iron content in idiopathic REM sleep behavior disorder using quantitative magnetic resonance imaging. Parkinsonism Relat Disord 2014; 20:776-8. [DOI: 10.1016/j.parkreldis.2014.03.023] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2014] [Revised: 02/11/2014] [Accepted: 03/22/2014] [Indexed: 11/25/2022]
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Reduced thalamic volume in Parkinson disease with REM sleep behavior disorder: volumetric study. Parkinsonism Relat Disord 2014; 20:1004-8. [PMID: 24998995 DOI: 10.1016/j.parkreldis.2014.06.012] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2014] [Revised: 05/16/2014] [Accepted: 06/17/2014] [Indexed: 11/23/2022]
Abstract
INTRODUCTION REM sleep behavior disorder (RBD) is a common non motor feature of Parkinson's Disease (PD) affecting about half the patients with this disease. Distinct structural brain tissue abnormalities have been reported in several regions modulating REM sleep of the patients with idiopathic RBD. At the present time, there are no conventional MRI studies investigating patients with PD associated with RBD. METHODS Herein, we used voxel-based morphometry (VBM) to detect the neuroanatomical profile of PD patients with and without RBD. Optimized VBM was applied to the MRI brain images in 11 PD patients with RBD (PD-RBD), 11 PD patients without RBD (PD) and 18 age-and sex-matched controls. To corroborate VBM findings we used automated volumetric method (FreeSurfer) to quantify subcortical brain regions volumes. Patients and controls also underwent DAT-SPECT and cardiac MIBG scintigraphies. RESULTS The VBM analysis showed markedly reduced gray matter volume in the right thalamus of PD-RBD patients in comparison with PD patients and controls. Automatic thalamic segmentation in PD-RBD patients showed a bilaterally reduced thalamic volume as compared with PD patients or controls. All PD patients (with and without RBD) showed a reduced tracer uptake on DAT-SPECT and cardiac MIBG scintigraphies as compared to controls. CONCLUSIONS Our findings suggest that the presence of RBD symptoms in PD patients is associated with a reduced thalamic volume suggesting a pathophysiologic role of the thalamus in the complex circuit causing RBD.
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Tang WK, Hermann DM, Chen YK, Liang HJ, Liu XX, Chu WCW, Ahuja AT, Abrigo J, Mok V, Ungvari GS, Wong KS. Brainstem infarcts predict REM sleep behavior disorder in acute ischemic stroke. BMC Neurol 2014; 14:88. [PMID: 24758223 PMCID: PMC4004510 DOI: 10.1186/1471-2377-14-88] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2014] [Accepted: 04/16/2014] [Indexed: 11/13/2022] Open
Abstract
Background Rapid eye movement (REM) sleep behavior disorder (RBD) is a sleep disturbance in which patients enact their dreams while in REM sleep. The behavior is typically violent in association with violent dream content, so serious harm can be done to the patient or the bed partner. The prevalence of RBD is well-known in Parkinson’s disease, Lewy body dementia, and multiple systems atrophy. However, its prevalence and causes in stroke remained unclear. The aim of this study was to determine factors influencing the appearance of RBD in a prospective cohort of patients with acute ischemic stroke. Methods A total of 2,024 patients with first-ever or recurrent acute ischemic stroke were admitted to the Acute Stroke Unit at the Prince of Wales Hospital between January 2010 and November 2011; 775 of them received an MRI scan. Within 2 days of admission, a research nurse collected demographic and clinical data and assessed the severity of each stroke using the National Institute of Health Stroke Scale (NIHSS). One hundred and nineteen of the 775 patients meeting study entry criteria formed the study sample. All eligible participants were invited to attend a research clinic 3 months after the onset of the index stroke. In the attendance, a research assistant administered the MMSE and the 13-item RBD questionnaire (RBDQ). Results Among 119 stroke patients, 10.9% were exhibited RBD, defined as an REM sleep behavior disorder questionnaire score of 19 or above. The proportion of patients with acute brainstem infarct was significantly higher in RBD patients than those without RBD. Compared with patients without RBD, RBD patients were more likely to have brainstem infarcts and had smaller infarct volumes. In a multivariate analysis, in which stroke location and infarct volume were inserted, brainstem infarcts were an independent predictor of RBD (odds ratio = 3.686; P = 0.032). Conclusions The results support the notion of a predominant role of brainstem injury in the development of RBD and suggest that patients with brainstem infarcts RBD should be evaluated by a clinical neurologist.
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Affiliation(s)
- Wai Kwong Tang
- Department of Psychiatry, Chinese University of Hong Kong, Hong Kong, SAR, China.
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