Melanopsin Cell Dysfunction is Involved in Sleep Disruption in Parkinson’s Disease

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. 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. 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. 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). 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.

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Prolonged-release melatonin in Parkinson's disease patients with a poor sleep quality: A randomized trial

Parkinsonism & Related Disorders ◽

10.1016/j.parkreldis.2020.03.029 ◽

2020 ◽

Vol 75 ◽

pp. 50-54 ◽

Cited By ~ 1

Author(s):

Jong Hyeon Ahn ◽

Minkyeong Kim ◽

Suyeon Park ◽

Wooyoung Jang ◽

Jinse Park ◽

...

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Sleep Quality ◽

Randomized Trial ◽

Poor Sleep ◽

Prolonged Release ◽

Poor Sleep Quality

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The Impact of Sleep Quality on Cognitive Functioning in Parkinson's Disease

Journal of the International Neuropsychological Society ◽

10.1017/s1355617711001482 ◽

2011 ◽

Vol 18 (1) ◽

pp. 108-117 ◽

Cited By ~ 44

Author(s):

Karina Stavitsky ◽

Sandy Neargarder ◽

Yelena Bogdanova ◽

Patrick McNamara ◽

Alice Cronin-Golomb

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Executive Function ◽

Sleep Quality ◽

Sleep Efficiency ◽

Motor Symptom ◽

Poor Sleep ◽

Psychomotor Function ◽

Wrist Actigraphy ◽

The Impact

AbstractIn healthy individuals and those with insomnia, poor sleep quality is associated with decrements in performance on tests of cognition, especially executive function. Sleep disturbances and cognitive deficits are both prevalent in Parkinson's disease (PD). Sleep problems occur in over 75% of patients, with sleep fragmentation and decreased sleep efficiency being the most common sleep complaints, but their relation to cognition is unknown. We examined the association between sleep quality and cognition in PD. In 35 non-demented individuals with PD and 18 normal control adults (NC), sleep was measured using 24-hr wrist actigraphy over 7 days. Cognitive domains tested included attention and executive function, memory and psychomotor function. In both groups, poor sleep was associated with worse performance on tests of attention/executive function but not memory or psychomotor function. In the PD group, attention/executive function was predicted by sleep efficiency, whereas memory and psychomotor function were not predicted by sleep quality. Psychomotor and memory function were predicted by motor symptom severity. This study is the first to demonstrate that sleep quality in PD is significantly correlated with cognition and that it differentially impacts attention and executive function, thereby furthering our understanding of the link between sleep and cognition. (JINS, 2012, 18, 108–117)

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FREQUENCY AND CORRELATES OF POOR SLEEP QUALITY AMONG PATIENTS OF PARKINSON’S DISEASE

Pakistan Armed Forces Medical Journal ◽

10.51253/pafmj.v70i6.3866 ◽

2020 ◽

Vol 70 (6) ◽

pp. 1640-44

Author(s):

Syed Sakhawat Kazmi ◽

Zahid Hassan ◽

Waseem Alamgir ◽

Asif Hashmat ◽

Muhammad Ali Yousaf ◽

...

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Sleep Quality ◽

Quality Index ◽

Pittsburgh Sleep Quality Index ◽

Military Hospital ◽

Poor Sleep ◽

Motor Disorder ◽

Poor Sleep Quality ◽

Duration Of Illness

Objective: To determine the frequency of poor sleep quality among the patients of Parkinson’s disease (PD) and analyze its relationship with the socio-demographic factors.Study Design: Correlational study. Place and Duration of Study: Pak Emirates Military Hospital Rawalpindi, from Jan 2019 to Jun 2019. Methodology: One hundred and fifty patients of Parkinson’s disease were approached to participate in this study. Pittsburgh sleep quality index (PSQI) was the psychometric tool used to assess the study parameter for the patients. Age, gender, duration of illness, poly pharmacy and tobacco smoking were corelated with presence of poor quality of sleep among the patients of Parkinson’s disease. Results: Out of 150 patients of Parkinson’s disease screened through Pittsburgh sleep quality index, 85 (56.7%)showed the presence of poor sleep quality while 65 (43.3%) had good sleep quality. Mean age of the patients was 66.2 ± 4.648 years. After applying the logistic regression, we found that increasing age and longer duration of illness had significant association with the presence of poor sleep quality among the patients of Parkinson disease. Conclusion: Previously considered a pure motor disorder, Parkinsonism has a lot of other neuro-psychiatricmanifestations as well. Poor sleep quality turned out to be one of these non-motor problems associated with this chronic debilitating illness. Increasing age and longer duration of illness among these patients emerged asindependent risk factors for poor sleep quality in Parkinsonism.

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Antiparkinsonian drugs as potent contributors to nocturnal sleep in patients with Parkinson’s disease

PLoS ONE ◽

10.1371/journal.pone.0255274 ◽

2021 ◽

Vol 16 (7) ◽

pp. e0255274

Author(s):

Soutarou Taguchi ◽

Hirofumi Koide ◽

Hiroko Oiwa ◽

Miku Hayashi ◽

Kazuhiro Ogawa ◽

...

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Sleep Quality ◽

Sleep Disturbances ◽

Poor Sleep ◽

Total Dosage ◽

Dose Ratio ◽

Nocturnal Sleep ◽

Antiparkinsonian Drugs ◽

Daily Total

Objective To clarify whether antiparkinsonian drugs contribute to nocturnal sleep disturbances in patients with Parkinson’s disease (PD). Background Although the major antiparkinsonian drugs L-dopa and dopamine agonists (DAs) have been found to affect sleep, little is known about the effects of specific drugs on sleep in PD patients. Methods The study participants consisted of 112 PD patients (median age 72.5 years [inter-quartile range: IQR 65–79]; mean disease duration 8.44 years [standard deviation: 7.33]; median Hoehn and Yahr stage 3 [IQR 2–3.75]) taking one of three types of non-ergot extended-release DAs (rotigotine 32; pramipexole 44; ropinirole 36) with or without L-dopa (median daily total dosage of antiparkinsonian drugs 525.5 mg [IQR 376.25–658] levodopa equivalent dose [LED]). Participants were assessed using the PD Sleep Scale-2 (PDSS-2). Results For the whole PD patient cohort, the PDSS-2 sleep disturbance domain score and the scores for item 1 assessing sleep quality and item 8 assessing nocturia were positively correlated with daily total dosage of antiparkinsonian drugs and dosage of L-dopa, but not with the dosage of DAs. Sub-analysis according to DA treatment revealed that DA dosage was not correlated with item 1 or 8 score in any of the subgroups. The LED ratio of rotigotine to the total dosage of antiparkinsonian drugs was inversely correlated with the item 1 score. Conclusions These data suggest that antiparkinsonian drugs, in particular L-dopa, adversely affect nocturnal sleep in PD patients, especially in terms of sleep quality and nocturia. Thus, adjusting both the total dosage of antiparkinsonian drugs and the dose-ratio of L-dopa might be key actions for alleviating poor sleep quality in patients with PD. Among DAs, we found a clear positive correlation between the dose-ratio of rotigotine and sleep quality. Thus, partial L-dopa replacement with rotigotine could improve sleep quality in patients with PD.

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Prevalence and Risk Factors for Minor Hallucinations in Patients with Parkinson’s Disease

Behavioural Neurology ◽

10.1155/2021/3469706 ◽

2021 ◽

Vol 2021 ◽

pp. 1-10

Author(s):

Min Zhong ◽

Ruxin Gu ◽

Sha Zhu ◽

Yu Bai ◽

Zhuang Wu ◽

...

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Sleep Quality ◽

Rating Scale ◽

Life Quality ◽

Behavior Disorder ◽

Poor Sleep ◽

Dopamine Receptor Agonist ◽

Binary Logistic Regression Model ◽

Sleep Behavior

Purpose. As the most frequent and earliest type of psychotic phenomenon in Parkinson’s disease (PD), minor hallucination (MH) can occur before the onset of motor symptoms. This sensation may be an early predictor of severe psychotic and cognitive states and is often overlooked in clinics. This study was aimed at providing a comprehensive and in-depth understanding of MHs. Patients and Methods. Demographic information was obtained from 262 patients with PD, and a series of clinical assessment questionnaires were provided. According to the result of the Movement Disorders Society Unified Parkinson’s Disease Rating Scale Part I, the patients were classified into the MH and nonhallucination (NH) groups. Results. MHs were the most common psychotic symptom with 38.9% prevalence. The most frequent MH was visual illusion, especially object misidentification. Three minor phenomena were somewhat consistent in terms of external factors, temporal factors, and content. Disease duration, daily levodopa equivalent dose, and percentage of levodopa and dopamine-receptor agonist use were remarkably greater in the MH group than in the NH group. After covariate control, the MH group had worse life quality and more severe nonmotor symptoms, including poor sleep quality and rapid eye movement sleep behavior disorder (RBD), than the NH group. The binary logistic regression model showed that RBD, sleep quality, and health-related life quality were associated with MHs. Conclusion. A high prevalence of MHs was observed in patients with PD. Further studies are needed to confirm and expand the identified clinical factors related to MH, which have potential prognostic and therapeutic implication.

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