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Melanopsin Cell Dysfunction is Involved in Sleep Disruption in Parkinson's Disease.
- Source :
-
Journal of Parkinson's disease [J Parkinsons Dis] 2020; Vol. 10 (4), pp. 1467-1476. - Publication Year :
- 2020
-
Abstract
- Background: Melanopsin-expressing intrinsically photosensitive retinal ganglion cells (ipRGCs) signal the environmental light to mediate circadian photoentrainment and sleep-wake cycles. There is high prevalence of circadian and sleep disruption in people with Parkinson's disease, however the underlying mechanisms of these symptoms are not clear.<br />Objective: Based on recent evidence of anatomical and functional loss of melanopsin ganglion cells in Parkinson's disease, we evaluate the link between melanopsin function, circadian, and sleep behavior.<br />Methods: The pupil light reflex and melanopsin-mediated post-illumination pupil response were measured using chromatic pupillometry in 30 optimally medicated people with Parkinson's disease and 29 age-matched healthy controls. Circadian health was determined using dim light melatonin onset, sleep questionnaires, and actigraphy. Ophthalmic examination quantified eye health and optical coherence tomography measured retinal thickness.<br />Results: The melanopsin-mediated post-illumination pupil response amplitudes were significantly reduced in Parkinson's disease (p < 0.0001) and correlated with poor sleep quality (r2 = 33; p < 0.001) and nerve fiber layer thinning (r2 = 0.40; p < 0.001). People with Parkinson's disease had significantly poorer sleep quality with higher subjective sleep scores (p < 0.05) and earlier melatonin onset (p = 0.01). Pupil light (outer retinal) response metrics, daily light exposure and outer retinal thickness were similar between the groups (p > 0.05).<br />Conclusion: Our evidence-based data identify a mechanism through which inner retinal ipRGC dysfunction contributes to sleep disruption in Parkinson's disease in the presence of normal outer retinal (rod-cone photoreceptor) function. Our findings provide a rationale for designing new treatment approaches in Parkinson's disease through melanopsin photoreceptor-targeted light therapies for improving sleep-wake cycles.
- Subjects :
- Actigraphy
Aged
Chronobiology Disorders etiology
Chronobiology Disorders metabolism
Female
Humans
Male
Middle Aged
Parkinson Disease complications
Parkinson Disease metabolism
Sleep Wake Disorders etiology
Sleep Wake Disorders metabolism
Tomography, Optical Coherence
Chronobiology Disorders physiopathology
Melatonin metabolism
Parkinson Disease physiopathology
Pupil physiology
Retinal Cone Photoreceptor Cells physiology
Retinal Ganglion Cells physiology
Retinal Rod Photoreceptor Cells physiology
Rod Opsins metabolism
Sleep Wake Disorders physiopathology
Subjects
Details
- Language :
- English
- ISSN :
- 1877-718X
- Volume :
- 10
- Issue :
- 4
- Database :
- MEDLINE
- Journal :
- Journal of Parkinson's disease
- Publication Type :
- Academic Journal
- Accession number :
- 32986681
- Full Text :
- https://doi.org/10.3233/JPD-202178