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Excessive daytime sleepiness may be associated with caudate denervation in Parkinson disease.
- Source :
-
Journal of the neurological sciences [J Neurol Sci] 2018 Apr 15; Vol. 387, pp. 220-227. Date of Electronic Publication: 2018 Feb 21. - Publication Year :
- 2018
-
Abstract
- Excessive daytime sleepiness (EDS) is one of the earliest and most common non-motor symptoms of PD, substantially impacting on patient's quality of life. Using the Parkinson's Progression Markers Initiative database, we performed a case-control study to investigate whether dopaminergic deficit is associated with the development of EDS using dopaminergic specific single photon emission computed tomography (SPECT) molecular imaging of dopamine transporters (DAT). We enrolled 84 early de novo PD patients with EDS and 84 without EDS, who were matched for age, gender, age of diagnosis, years of education and disease duration. We assessed and compared semi-quantified [ <superscript>123</superscript> I]FP-CIT SPECT, and motor and non-motor features among these two groups, alongside exploring the clinical and imaging correlates of EDS and the predictive significance of these markers in the development of EDS. PD patients with EDS had worse non-motor (MDS-UPDRS Part-I, P < 0.001) and motor (MDS-UPRDS Part-II, P = 0.005) experiences of daily living, as well as worse autonomic (SCOPA-AUT, P < 0.0001) and cognitive (MoCA P = 0.05) function, depression (GDS, P = 0.002), and reduced caudate DAT ([ <superscript>123</superscript> I]FP-CIT, P = 0.024) compared to PD patients without EDS. Lower caudate [ <superscript>123</superscript> I]FP-CIT values correlated with higher EDS scores (r = -0.192, P = 0.013). Among patients without EDS, 47 PD patients (56%) developed EDS over a median follow-up of 36 months. Cox multivariate analysis, including all clinical and imaging data available, revealed that abnormal caudate [ <superscript>123</superscript> I]FP-CIT uptake (P = 0.030) and disease duration (P = 0.018) were predictors for the development of EDS. Although our findings indicate that dopaminergic deficits in the caudate may be associated to EDS in patients with PD, the pathophysiological causality is debateable, given that dopamine caudate denervation may covary with dopaminergic involvement at other targets and with non-dopaminergic involvement.<br /> (Copyright © 2018 Elsevier B.V. All rights reserved.)
- Subjects :
- Aged
Caudate Nucleus drug effects
Disorders of Excessive Somnolence diagnostic imaging
Dopamine Agonists therapeutic use
Dopamine Plasma Membrane Transport Proteins drug effects
Dopamine Plasma Membrane Transport Proteins metabolism
Female
Humans
Magnetic Resonance Imaging
Male
Middle Aged
Parkinson Disease diagnostic imaging
Parkinson Disease drug therapy
Protein Binding drug effects
Severity of Illness Index
Statistics, Nonparametric
Tomography, Emission-Computed, Single-Photon
Tropanes pharmacokinetics
Caudate Nucleus diagnostic imaging
Disorders of Excessive Somnolence etiology
Parkinson Disease complications
Subjects
Details
- Language :
- English
- ISSN :
- 1878-5883
- Volume :
- 387
- Database :
- MEDLINE
- Journal :
- Journal of the neurological sciences
- Publication Type :
- Academic Journal
- Accession number :
- 29571867
- Full Text :
- https://doi.org/10.1016/j.jns.2018.02.032