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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Sleep and Circadian Rhythm Regulation in Early Parkinson Disease</title><author><name sortKey="Breen, David P" sort="Breen, David P" uniqKey="Breen D" first="David P." last="Breen">David P. Breen</name></author><author><name sortKey="Vuono, Romina" sort="Vuono, Romina" uniqKey="Vuono R" first="Romina" last="Vuono">Romina Vuono</name></author><author><name sortKey="Nawarathna, Upekshani" sort="Nawarathna, Upekshani" uniqKey="Nawarathna U" first="Upekshani" last="Nawarathna">Upekshani Nawarathna</name></author><author><name sortKey="Fisher, Kate" sort="Fisher, Kate" uniqKey="Fisher K" first="Kate" last="Fisher">Kate Fisher</name></author><author><name sortKey="Shneerson, John M" sort="Shneerson, John M" uniqKey="Shneerson J" first="John M." last="Shneerson">John M. Shneerson</name></author><author><name sortKey="Reddy, Akhilesh B" sort="Reddy, Akhilesh B" uniqKey="Reddy A" first="Akhilesh B." last="Reddy">Akhilesh B. Reddy</name></author><author><name sortKey="Barker, Roger A" sort="Barker, Roger A" uniqKey="Barker R" first="Roger A." last="Barker">Roger A. Barker</name></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">24687146</idno><idno type="pmc">4119609</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4119609</idno><idno type="RBID">PMC:4119609</idno><idno type="doi">10.1001/jamaneurol.2014.65</idno><date when="2014">2014</date><idno type="wicri:Area/Pmc/Corpus">000255</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">000255</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Sleep and Circadian Rhythm Regulation in Early Parkinson Disease</title><author><name sortKey="Breen, David P" sort="Breen, David P" uniqKey="Breen D" first="David P." last="Breen">David P. Breen</name></author><author><name sortKey="Vuono, Romina" sort="Vuono, Romina" uniqKey="Vuono R" first="Romina" last="Vuono">Romina Vuono</name></author><author><name sortKey="Nawarathna, Upekshani" sort="Nawarathna, Upekshani" uniqKey="Nawarathna U" first="Upekshani" last="Nawarathna">Upekshani Nawarathna</name></author><author><name sortKey="Fisher, Kate" sort="Fisher, Kate" uniqKey="Fisher K" first="Kate" last="Fisher">Kate Fisher</name></author><author><name sortKey="Shneerson, John M" sort="Shneerson, John M" uniqKey="Shneerson J" first="John M." last="Shneerson">John M. Shneerson</name></author><author><name sortKey="Reddy, Akhilesh B" sort="Reddy, Akhilesh B" uniqKey="Reddy A" first="Akhilesh B." last="Reddy">Akhilesh B. Reddy</name></author><author><name sortKey="Barker, Roger A" sort="Barker, Roger A" uniqKey="Barker R" first="Roger A." last="Barker">Roger A. Barker</name></author></analytic><series><title level="j">JAMA neurology</title><idno type="ISSN">2168-6149</idno><idno type="eISSN">2168-6157</idno><imprint><date when="2014">2014</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec id="S1"><title>IMPORTANCE</title><p id="P10">Sleep disturbances are recognized as a common nonmotor complaint in Parkinson disease but their etiology is poorly understood.</p></sec><sec id="S2"><title>OBJECTIVE</title><p id="P11">To define the sleep and circadian phenotype of patients with early-stage Parkinson disease.</p></sec><sec id="S3"><title>DESIGN, SETTING, AND PARTICIPANTS</title><p id="P12">Initial assessment of sleep characteristics in a large population-representative incident Parkinson disease cohort (N=239) at the University of Cambridge, England, followed by further comprehensive case-control sleep assessments in a subgroup of these patients (n=30) and matched controls (n=15).</p></sec><sec id="S4"><title>MAIN OUTCOMES AND MEASURES</title><p id="P13">Sleep diagnoses and sleep architecture based on polysomnography studies, actigraphy assessment, and 24-hour analyses of serum cortisol, melatonin, and peripheral clock gene expression (<italic>Bmal1, Per2</italic>, and <italic>Rev-Erb</italic>α).</p></sec><sec id="S5"><title>RESULTS</title><p id="P14">Subjective sleep complaints were present in almost half of newly diagnosed patients and correlated significantly with poorer quality of life. Patients with Parkinson disease exhibited increased sleep latency (<italic>P</italic> = .04), reduced sleep efficiency (<italic>P</italic> = .008), and reduced rapid eye movement sleep (<italic>P</italic> = .02). In addition, there was a sustained elevation of serum cortisol levels, reduced circulating melatonin levels, and altered <italic>Bmal1</italic> expression in patients with Parkinson disease compared with controls.</p></sec><sec id="S6"><title>CONCLUSIONS AND RELEVANCE</title><p id="P15">Sleep dysfunction seen in early Parkinson disease may reflect a more fundamental pathology in the molecular clock underlying circadian rhythms.</p></sec></div></front></TEI><pmc article-type="research-article"><pmc-comment>The publisher of this article does not allow downloading of the full text in XML form.</pmc-comment>
<pmc-dir>properties manuscript</pmc-dir>
<front><journal-meta><journal-id journal-id-type="nlm-journal-id">101589536</journal-id><journal-id journal-id-type="pubmed-jr-id">40865</journal-id><journal-id journal-id-type="nlm-ta">JAMA Neurol</journal-id><journal-id journal-id-type="iso-abbrev">JAMA Neurol</journal-id><journal-title-group><journal-title>JAMA neurology</journal-title></journal-title-group><issn pub-type="ppub">2168-6149</issn><issn pub-type="epub">2168-6157</issn></journal-meta><article-meta><article-id pub-id-type="pmid">24687146</article-id><article-id pub-id-type="pmc">4119609</article-id><article-id pub-id-type="doi">10.1001/jamaneurol.2014.65</article-id><article-id pub-id-type="manuscript">EMS59730</article-id><article-categories><subj-group subj-group-type="heading"><subject>Article</subject></subj-group></article-categories><title-group><article-title>Sleep and Circadian Rhythm Regulation in Early Parkinson Disease</article-title></title-group><contrib-group><contrib contrib-type="author" equal-contrib="yes"><name><surname>Breen</surname><given-names>David P.</given-names></name><degrees>MRCP</degrees></contrib><contrib contrib-type="author" equal-contrib="yes"><name><surname>Vuono</surname><given-names>Romina</given-names></name><degrees>PhD</degrees></contrib><contrib contrib-type="author"><name><surname>Nawarathna</surname><given-names>Upekshani</given-names></name><degrees>BSc</degrees></contrib><contrib contrib-type="author"><name><surname>Fisher</surname><given-names>Kate</given-names></name><degrees>BSc</degrees></contrib><contrib contrib-type="author"><name><surname>Shneerson</surname><given-names>John M.</given-names></name><degrees>MD</degrees></contrib><contrib contrib-type="author"><name><surname>Reddy</surname><given-names>Akhilesh B.</given-names></name><degrees>PhD</degrees></contrib><contrib contrib-type="author"><name><surname>Barker</surname><given-names>Roger A.</given-names></name><degrees>PhD</degrees></contrib><aff id="A1">John van Geest Centre for Brain Repair, University of Cambridge, Cambridge, England (Breen, Vuono, Fisher, Barker); Respiratory and Sleep Support Centre, Papworth Hospital, Cambridge, England (Nawarathna, Shneerson); Institute of Metabolic Science, University of Cambridge, Cambridge, England (Reddy)</aff></contrib-group><author-notes><corresp id="CR1"><bold>Corresponding Author:</bold> David P., Breen, MRCP, John van Geest Centre, for Brain Repair, University of, Cambridge, ED Adrian Bldg,, Forvie Site, Robinson Way,, Cambridge CB2 OPY, England, (<email>dpbreen1@gmail.com</email>)</corresp><fn id="FN1"><p id="P1"><bold>Author Contributions:</bold> Dr Breen had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.</p><p id="P2"><italic>Study concept and design:</italic> Breen, Vuono, Shneerson, Reddy, Barker.</p><p id="P3"><italic>Acquisition, analysis, or interpretation of data:</italic> All authors.</p><p id="P4"><italic>Drafting of the manuscript:</italic> Breen, Barker.</p><p id="P5"><italic>Critical revision of the manuscript for important intellectual content:</italic> Vuono, Nawarathna, Fisher, Schneerson, Reddy.</p><p id="P6"><italic>Statistical analysis:</italic> Breen, Barker.</p><p id="P7"><italic>Administrative, technical, or material support:</italic> Breen, Vuono, Nawarathna, Shneerson, Barker.</p><p id="P8"><italic>Study supervision:</italic> Shneerson, Reddy, Barker.</p></fn><fn id="FN3"><p id="P9"><bold>Additional Contributions:</bold> We thank staff at the Wellcome Trust Clinical Research Facility in Addenbrooke’s Hospital, Cambridge, for performing the circadian blood sampling as well as staff at the Respiratory and Sleep Support Centre in Papworth Hospital, Cambridge, for their support and assistance throughout the study. We are grateful to Alpar Lazar, PhD, John van Geest Centre for Brain Repair, University of Cambridge, for helpful suggestions during preparation of the manuscript and Jonathan Evans, PhD, John van Geest Centre for Brain Repair, University of Cambridge, for helping recruit patients to the PICNICS study and carrying out clinical assessments. We acknowledge Neil Goddard, PhD, Roche Applied Science, for technical advice during the experiments.</p></fn></author-notes><pub-date pub-type="nihms-submitted"><day>22</day><month>7</month><year>2014</year></pub-date><pub-date pub-type="ppub"><month>5</month><year>2014</year></pub-date><pub-date pub-type="pmc-release"><day>01</day><month>11</month><year>2014</year></pub-date><volume>71</volume><issue>5</issue><fpage>589</fpage><lpage>595</lpage><pmc-comment>elocation-id from pubmed: 10.1001/jamaneurol.2014.65</pmc-comment>
<permissions><copyright-statement>Copyright 2014 American Medical Association. All rights reserved.</copyright-statement><copyright-year>2014</copyright-year></permissions><abstract><sec id="S1"><title>IMPORTANCE</title><p id="P10">Sleep disturbances are recognized as a common nonmotor complaint in Parkinson disease but their etiology is poorly understood.</p></sec><sec id="S2"><title>OBJECTIVE</title><p id="P11">To define the sleep and circadian phenotype of patients with early-stage Parkinson disease.</p></sec><sec id="S3"><title>DESIGN, SETTING, AND PARTICIPANTS</title><p id="P12">Initial assessment of sleep characteristics in a large population-representative incident Parkinson disease cohort (N=239) at the University of Cambridge, England, followed by further comprehensive case-control sleep assessments in a subgroup of these patients (n=30) and matched controls (n=15).</p></sec><sec id="S4"><title>MAIN OUTCOMES AND MEASURES</title><p id="P13">Sleep diagnoses and sleep architecture based on polysomnography studies, actigraphy assessment, and 24-hour analyses of serum cortisol, melatonin, and peripheral clock gene expression (<italic>Bmal1, Per2</italic>, and <italic>Rev-Erb</italic>α).</p></sec><sec id="S5"><title>RESULTS</title><p id="P14">Subjective sleep complaints were present in almost half of newly diagnosed patients and correlated significantly with poorer quality of life. Patients with Parkinson disease exhibited increased sleep latency (<italic>P</italic> = .04), reduced sleep efficiency (<italic>P</italic> = .008), and reduced rapid eye movement sleep (<italic>P</italic> = .02). In addition, there was a sustained elevation of serum cortisol levels, reduced circulating melatonin levels, and altered <italic>Bmal1</italic> expression in patients with Parkinson disease compared with controls.</p></sec><sec id="S6"><title>CONCLUSIONS AND RELEVANCE</title><p id="P15">Sleep dysfunction seen in early Parkinson disease may reflect a more fundamental pathology in the molecular clock underlying circadian rhythms.</p></sec></abstract></article-meta></front></pmc></record>Pour manipuler ce document sous Unix (Dilib)
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