Daytime Sleepiness and Parkinson’s Disease: The Contribution of the Multiple Sleep Latency Test

Background. Sleep disorders are major nonmotor manifestations of patients with Parkinson’s disease (PD), and excessive daytime sleepiness (EDS) is one of the most common symptoms.Objective. We reviewed a current literature concerning major factors that influence EDS in PD patients, using Multiple Sleep Latency Test (MSLT).Methods. A Medline search found 23 studies.Results. The presence of EDS was observed in 12.7% to 47% in patients without complaints of daytime sleepiness and 47% to 66.7% with complaints of daytime sleepiness. Despite being recognized by several authors, major factors that influence EDS, such as severity of motor symptoms, use of dopaminergic medications, and associated sleep disturbances, presented contradictory data.Conclusions. Available data suggest that the variability of the results may be related to the fact that it was conducted with a small sample size, not counting the neuropathological heterogeneity of the disease. Thus, before carrying out longitudinal studies with significant samples, careful analysis should be done by assigning a specific agent on the responsibility of EDS in PD patients.

Download Full-text

1253 Multiple sleep onset REM episodes in middle age woman with excessive daytime sleepiness – Is this automatically assumed narcolepsy?

SLEEP ◽

10.1093/sleep/zsaa056.1247 ◽

2020 ◽

Vol 43 (Supplement_1) ◽

pp. A477-A477

Author(s):

Kamal Patel ◽

Bianca J Lang

Keyword(s):

Daytime Sleepiness ◽

Sleep Latency ◽

Sleep Onset ◽

Sleep Time ◽

Multiple Sleep Latency Test ◽

Sleep Onset Latency ◽

Onset Latency ◽

Obstructive Sleep ◽

Falling Asleep ◽

Multiple Sleep Latency

Abstract Introduction Presence of sleep onset REM episodes often raises concerns of narcolepsy. However other conditions have shown to have presence of sleep on REM episodes which include but not limited to obstructive sleep apnea, sleep wake schedule disturbance, alcoholism, neurodegenerative disorders, depression and anxiety Report of Case Here we present a case of 30 year old female with history of asthma, patent foraman ovale, migraine headache, and anxiety who presented with daytime sleepiness, falling asleep while at work, occasional scheduled naps, non-restorative sleep, sleep paralysis, and hypnopompic hallucination. Pertinent physical exam included; mallampati score of 4/4, retrognathia, high arched hard palate, crowded posterior oropharynx. She had a score of 16 on Epworth sleepiness scale. Patient previously had multiple sleep latency test at outside facility which revealed 4/5 SOREM, with mean sleep onset latency of 11.5 minutes. She however was diagnosed with narcolepsy and tried on modafinil which she failed to tolerate. She was tried on sertraline as well which was discontinued due to lack of benefit. She had repeat multiple sleep latency test work up which revealed 2/5 SOREM, with mean sleep onset latency was 13.1 minutes. Her overnight polysomnogram prior to repeat MSLT showed SOREM with sleep onset latency of 10 minutes. Actigraphy showed consistent sleep pattern overall with sufficient sleep time but was taking hydroxyzine and herbal medication. Patient did not meet criteria for hypersomnolence disorder and sleep disordered breathing. Conclusion There is possibility her medication may have played pivotal role with her daytime symptoms. We also emphasize SOREMs can be present in other disorders such as anxiety in this case and not solely in narcolepsy

Download Full-text

Role of MicroRNAs in Parkinson’s Disease

International Journal of Molecular Sciences ◽

10.3390/ijms20225649 ◽

2019 ◽

Vol 20 (22) ◽

pp. 5649 ◽

Cited By ~ 20

Author(s):

Suh Yee Goh ◽

Yin Xia Chao ◽

Shaikali Thameem Dheen ◽

Eng-King Tan ◽

Samuel Sam-Wah Tay

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Small Sample Size ◽

Small Sample ◽

Biological Molecules ◽

Incomplete Penetrance ◽

Cellular Functions ◽

Druggable Targets ◽

The Brain

Parkinson’s disease (PD) is a disabling neurodegenerative disease that manifests with resting tremor, bradykinesia, rigidity and postural instability. Since the discovery of microRNAs (miRNAs) in 1993, miRNAs have been shown to be important biological molecules involved in diverse processes to maintain normal cellular functions. Over the past decade, many studies have reported dysregulation of miRNA expressions in PD. Here, we identified 15 miRNAs from 34 reported screening studies that demonstrated dysregulation in the brain and/or neuronal models, cerebrospinal fluid (CSF) and blood. Specific miRNAs-of-interest that have been implicated in PD pathogenesis include miR-30, miR-29, let-7, miR-485 and miR-26. However, there are several challenges and limitations in drawing definitive conclusions due to the small sample size in clinical studies, varied laboratory techniques and methodologies and their incomplete penetrance of the blood–brain barrier. Developing an optimal delivery system and unravelling druggable targets of miRNAs in both experimental and human models and clinical validation of the results may pave way for novel therapeutics in PD.

Download Full-text

Sleep disorders and daytime sleepiness in children with attention-deficit/hyperactivity disorder: A two-night polysomnographic study with a multiple sleep latency test

Sleep Medicine ◽

10.1016/j.sleep.2010.03.017 ◽

2010 ◽

Vol 11 (9) ◽

pp. 922-928 ◽

Cited By ~ 42

Author(s):

Iva Prihodova ◽

Ivo Paclt ◽

David Kemlink ◽

Jelena Skibova ◽

Radek Ptacek ◽

...

Keyword(s):

Attention Deficit Hyperactivity Disorder ◽

Sleep Disorders ◽

Attention Deficit ◽

Daytime Sleepiness ◽

Sleep Latency ◽

Multiple Sleep Latency Test ◽

Hyperactivity Disorder ◽

Multiple Sleep Latency

Download Full-text

Oculomotor changes are associated to daytime sleepiness in the multiple sleep latency test

Journal of Sleep Research ◽

10.1111/j.1365-2869.2005.00444.x ◽

2005 ◽

Vol 14 (2) ◽

pp. 107-112 ◽

Cited By ~ 22

Author(s):

LUIGI DE GENNARO ◽

ALESSANDRA DEVOTO ◽

FABIO LUCIDI ◽

CRISTIANO VIOLANI

Keyword(s):

Daytime Sleepiness ◽

Sleep Latency ◽

Multiple Sleep Latency Test ◽

Multiple Sleep Latency

Download Full-text

Gambling Habits of People With Parkinson’s Disease: An Exploratory Study

Journal of Gambling Issues ◽

10.4309/jgi.v0i37.3995 ◽

2017 ◽

Author(s):

Dominic Nadeau ◽

Isabelle Giroux ◽

Martine Simard ◽

Christian Jacques ◽

Nicolas Dupré

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Impulse Control ◽

Small Sample Size ◽

Structured Interview ◽

Small Sample ◽

Slot Machines ◽

Gambling Problem ◽

Maladie De Parkinson ◽

Gambling Activities

The development of pathological gambling (PG) among people with Parkinson’s disease (PD) is increasingly reported. The intake of dopamine agonists is most often associated with the emergence of this addiction. Although it is known that gambling habits contribute to the onset of gambling problems in the general population, these habits have not yet been studied in individuals with PD. Thus, this study aimed to explore gambling habits in people with PD. Twenty-five individuals with PD and 8 caregivers participated. Thirteen gamblers took part in a semi-structured interview regarding their gambling habits and the presence of a gambling problem and other impulse-control disorders. The results show that gamblers mainly play lotteries and slot machines. Most gamble for pleasure, but some reported wanting to win money to finance a cure for their PD. None of the gamblers involved a caregiver in their gambling activities and no gambler currently presented a gambling problem. However, 2 at-risk gamblers reported having developed a gambling problem in the past. This study sheds light on factors that may contribute to the development of PG among patients with PD, namely, the emergence of new reasons for gambling after a PD diagnosis, erroneous beliefs about gambling, and discretion about gambling habits. Prevention strategies are discussed in view of these results. However, given the small sample size, further studies examining the gambling habits of people with PD are required.RésuméDe plus en plus, on observe le développement du jeu pathologique (JP) chez les personnes atteintes de la maladie de Parkinson (MP). La prise d’agonistes de la dopamine est le plus souvent associée à l’émergence de cette dépendance. Bien qu’il soit connu que les habitudes de jeu contribuent à l’apparition de problèmes de jeu dans la population en général, ces habitudes n’ont pas encore été étudiées chez les personnes atteintes de la maladie de Parkinson (MP). Dans cette optique, cette étude explore les habitudes de jeu chez les personnes atteintes de la MP. Vingt-cinq personnes atteintes de la maladie de Parkinson et huit soignants y ont participé. Treize joueurs ont participé à une entrevue semi-structurée concernant leurs habitudes de jeu et la présence d’un problème de jeu et d’autres troubles liés au contrôle des impulsions. Les résultats montrent que les joueurs jouent principalement aux loteries et aux machines à sous. La plupart jouent par plaisir, mais certains ont déclaré vouloir gagner de l’argent pour financer une thérapie contre la maladie. Aucun des joueurs n’avait avec lui un fournisseur de soins dans ses activités de jeu et aucun joueur ne présentait actuellement de problème de jeu. Cependant, deux joueurs à risque ont déclaré en avoir développé un par le passé. Cette étude met en lumière les facteurs qui peuvent contribuer au développement du jeu pathologique chez les personnes atteintes de Parkinson, à savoir l’émergence de nouvelles raisons pour le jeu après un diagnostic de MP, les croyances erronées sur le jeu et la discrétion sur les habitudes de jeu. Compte tenu de ces résultats, des stratégies de prévention sont analysées. Cependant, étant donné la petite taille de l’échantillon, d’autres études examinant les habitudes de jeu des personnes atteintes de cette maladie sont nécessaires.

Download Full-text

Frequency of the LRRK2 G2019S mutation in late-onset sporadic patients with Parkinson’s disease

Arquivos de Neuro-Psiquiatria ◽

10.1590/0004-282x20140019 ◽

2014 ◽

Vol 72 (5) ◽

pp. 356-359 ◽

Cited By ~ 6

Author(s):

Hsin Fen Chien ◽

Tamires Rocha Figueiredo ◽

Marianna Almeida Hollaender ◽

Fabiano Tofoli ◽

Leonel Takao Takada ◽

...

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Late Onset ◽

Small Sample Size ◽

Clinical Manifestations ◽

Small Sample ◽

Genetical Analysis ◽

G2019s Mutation ◽

Lrrk2 Gene ◽

And Gender

Mutations in the LRRK2 gene, predominantly G2019S, have been reported in individuals with autosomal dominant inheritance and sporadic Parkinson’s disease (PD). The G2019S mutation has an age-dependent penetrance and evidence shows common ancestry. The clinical manifestations are indistinguishable from idiopathic PD. Its prevalence varies according to the population studied ranging from less than 0.1% in Asians to 41% in North African Arabs. This study aimed to identify G2019S mutation in Brazilian idiopathic PD patients.Method:We sampled 100 PD patients and 100 age- and gender-matched controls. Genetical analysis was accomplished by polymerase chain reaction (PCR).Results:No G2019S mutations were found in both patients with sporadic PD and controls.Conclusions:Our results may be explained by the relatively small sample size.

Download Full-text

The Effect of Rotigotine on Cognitive Function and Sleep Problems in Parkinson's Disease: an Open-Label Pilot Study

10.21203/rs.3.rs-138691/v1 ◽

2021 ◽

Author(s):

Keisuke Suzuki ◽

Kei Funakoshi ◽

Hiroaki Fujita ◽

Koichi Hirata

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Cognitive Function ◽

Daytime Sleepiness ◽

Sleep Disturbances ◽

Rating Scale ◽

Sleep Problems ◽

Motor Symptoms ◽

Open Label ◽

Updrs Part

Abstract Background: We hypothesized that rotigotine may have a positive effect on cognitive function in patients with Parkinson’s disease (PD) by improving daytime motor function and nighttime sleep status due to its 24-hour sustained properties.Methods: We evaluated the effect of rotigotine on motor symptoms, cognitive function, daytime sleepiness, sleep disturbances, and motor symptoms in 10 PD patients with sleep disturbances, defined as a PD Sleep Scale (PDSS)-2 score of ≥ 15, in a single-center, 3-month open-label study. Participants received 24 mg/24 h (patch content: 4.5-9 mg) rotigotine for a 3-month period. At baseline and 3 months, patients were evaluated on the Movement Disorder Society Revision of the Unified PD Rating Scale (MDS-UPDRS) parts III and IV and cognitive assessments, such as the Mini-Mental State Examination (MMSE), frontal assessment battery (FAB) and Montreal Cognitive Assessment (MoCA). The Epworth Sleepiness Scale (ESS) and PDSS-2 were administered at baseline and at 1 month, 2 months and 3 months.Results: At 3 months, MDS-UPDRS part III (-10.7, p<0.001) and MDS-UPDRS part IV (-1.0, p=0.023) scores significantly decreased, MoCA scores (1.7, p=0.0095) significantly increased, and off time significantly decreased (-43.0 min; p=0.029) from baseline. PDSS-2 scores significantly decreased from baseline at 2 months (-14.5, p<0.05) and 3 months (-20.0, p<0.001). ESS, MMSE or FAB scores did not significantly change after rotigotine treatment.Conclusion: Our preliminary findings suggest that low-dose rotigotine could improve motor symptoms, sleep disturbance, and cognitive function without worsening daytime sleepiness in patients with PD.

Download Full-text