Sleep and Circadian Rhythm Regulation in Early Parkinson Disease
Identifieur interne : 000162 ( Ncbi/Curation ); précédent : 000161; suivant : 000163Sleep and Circadian Rhythm Regulation in Early Parkinson Disease
Auteurs : David P. Breen ; Romina Vuono ; Upekshani Nawarathna ; Kate Fisher ; John M. Shneerson ; Akhilesh B. Reddy ; Roger A. BarkerSource :
- JAMA neurology [ 2168-6149 ] ; 2014.
Abstract
Sleep disturbances are recognized as a common nonmotor complaint in Parkinson disease but their etiology is poorly understood.
To define the sleep and circadian phenotype of patients with early-stage Parkinson disease.
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).
Sleep diagnoses and sleep architecture based on polysomnography studies, actigraphy assessment, and 24-hour analyses of serum cortisol, melatonin, and peripheral clock gene expression (
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 (
Sleep dysfunction seen in early Parkinson disease may reflect a more fundamental pathology in the molecular clock underlying circadian rhythms.
Url:
DOI: 10.1001/jamaneurol.2014.65
PubMed: 24687146
PubMed Central: 4119609
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PMC:4119609Le document en format XML
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<author><name sortKey="Breen, David P" sort="Breen, David P" uniqKey="Breen D" first="David P." last="Breen">David P. Breen</name>
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<author><name sortKey="Vuono, Romina" sort="Vuono, Romina" uniqKey="Vuono R" first="Romina" last="Vuono">Romina Vuono</name>
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<author><name sortKey="Nawarathna, Upekshani" sort="Nawarathna, Upekshani" uniqKey="Nawarathna U" first="Upekshani" last="Nawarathna">Upekshani Nawarathna</name>
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<author><name sortKey="Fisher, Kate" sort="Fisher, Kate" uniqKey="Fisher K" first="Kate" last="Fisher">Kate Fisher</name>
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<author><name sortKey="Shneerson, John M" sort="Shneerson, John M" uniqKey="Shneerson J" first="John M." last="Shneerson">John M. Shneerson</name>
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<author><name sortKey="Reddy, Akhilesh B" sort="Reddy, Akhilesh B" uniqKey="Reddy A" first="Akhilesh B." last="Reddy">Akhilesh B. Reddy</name>
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<author><name sortKey="Barker, Roger A" sort="Barker, Roger A" uniqKey="Barker R" first="Roger A." last="Barker">Roger A. Barker</name>
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<author><name sortKey="Vuono, Romina" sort="Vuono, Romina" uniqKey="Vuono R" first="Romina" last="Vuono">Romina Vuono</name>
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<author><name sortKey="Nawarathna, Upekshani" sort="Nawarathna, Upekshani" uniqKey="Nawarathna U" first="Upekshani" last="Nawarathna">Upekshani Nawarathna</name>
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<author><name sortKey="Fisher, Kate" sort="Fisher, Kate" uniqKey="Fisher K" first="Kate" last="Fisher">Kate Fisher</name>
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<author><name sortKey="Shneerson, John M" sort="Shneerson, John M" uniqKey="Shneerson J" first="John M." last="Shneerson">John M. Shneerson</name>
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<author><name sortKey="Reddy, Akhilesh B" sort="Reddy, Akhilesh B" uniqKey="Reddy A" first="Akhilesh B." last="Reddy">Akhilesh B. Reddy</name>
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<author><name sortKey="Barker, Roger A" sort="Barker, Roger A" uniqKey="Barker R" first="Roger A." last="Barker">Roger A. Barker</name>
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<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>
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