Abnormal sleep and sleepiness in Parkinson's disease
Abnormal sleep and sleepiness in Parkinson's disease
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DOI：
10.1097/wco.0b013e328305044d
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发表时间：
2008-08-01
影响因子：
4.8
通讯作者：
Oudiette, Delphine
中科院分区：
文献类型：
--
作者：
Arnulf, Isabelle;Leu, Smaranda;Oudiette, Delphine
综述的目的睡眠问题在帕金森氏症患者中经常出现，并使人丧失能力。最近的数据提供了快速眼动睡眠行为障碍、失眠和发作性睡病样的日间睡眠障碍的机制和后果的重大进展。最近的一系列研究证实，快速眼动睡眠行为障碍可能先于帕金森症或痴呆症(特别是但不限于路易体痴呆症)几年。在帕金森氏症中，快速眼动睡眠行为障碍会使患者面临更高的痴呆症和幻觉风险。令人惊讶的是，帕金森症在快速眼动睡眠行为障碍期间消失，表明基底节被绕过。在快速眼动睡眠期间，对控制张力的结构的兴趣从桥脑脚核转移到蓝斑下核。帕金森氏病患者下丘脑的神经病理显示大量下丘脑下丘脑生肌素丢失，可能是发作性睡病表型的基础。新的24小时长效罗匹尼罗和罗替戈汀透皮贴剂对睡眠和嗜睡的益处不大。最终，在快速眼动睡眠期间，中皮质边缘通路中的多巴胺释放增加，支持其在多巴胺能诱导的生动梦中的作用。摘要在临床实践中，快速眼动睡眠行为障碍应被视为轻度认知障碍患者神经退行性疾病的前兆，并作为帕金森病患者痴呆和幻觉的危险因素。
Purpose of reviewSleep problems are frequent and disabling in patients with Parkinson's disease. Recent data provide major advances in the mechanisms and consequences of rapid eye movement sleep behavior disorders, insomnia and narcolepsy-like daytime sleepiness.Recent findingsA large series confirms that rapid eye movement sleep behavior disorders may precede parkinsonism or dementia (particularly, but not exclusively, Lewy bodies dementia) for several years. In Parkinson's disease, rapid eye movement sleep behavior disorders expose patients to higher risks of dementia and hallucinations. Surprisingly, parkinsonism disappears during rapid eye movement sleep behavior disorders, suggesting basal ganglia are bypassed. The interest for structures controlling atonia during rapid eye movement sleep switches from the pedunculopontine nuclei to the locus subcoeruleus. The neuropathology of hypothalamus in Parkinson's disease indicates a massive hypocretin loss, probably underlying the narcolepsy phenotype. The benefit of the new, 24-h long acting ropinirole and transdermal rotigotine on sleep and sleepiness is modest. Eventually, the dopamine release in the mesocorticolimbic pathway is increased during rapid eye movement sleep, supporting its role in dopaminergic-induced vivid dreams.SummaryIn clinical practice, rapid eye movement sleep behavior disorders should be looked at as heralding neurodegenerative diseases in patients with mild cognitive impairment and as a risk factor for dementia and hallucinations in patients with Parkinson's disease.