Associations of sleep characteristics with alpha‐synuclein in cerebrospinal fluid in older adults

Wang, Xiaotong; Liu, Feng‐Tao; Bi, Yan‐Lin; Shen, Xue‐Ning; Xu, Wei; Wang, Jian; Tan, Lan; Yu, Jin‐Tai

doi:10.1002/acn3.51204

Cited by 11 publications

(11 citation statements)

References 43 publications

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“…Therefore, it is reasonable to assume that RBD possibly affects glymphatic capacity. EDS is a behavioural biomarker of circadian rhythm disorder and a common non-motor (NM) symptom in PD 39 , 40 . Consistent with previous studies, our results suggest that the disease severity of patients with PD-EDS is closely related to the glymphatic system.…”

Section: Discussionmentioning

confidence: 99%

Neuroimaging evidence of glymphatic system dysfunction in possible REM sleep behavior disorder and Parkinson’s disease

Guo

Wang

et al. 2022

npj Parkinsons Dis.

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Alpha-synucleinopathy is postulated to be central to both idiopathic rapid eye movement sleep behaviour disorder (iRBD) and Parkinson’s disease (PD). Growing evidence suggests an association between the diminished clearance of α-synuclein and glymphatic system dysfunction. However, evidence accumulating primarily based on clinical data to support glymphatic system dysfunction in patients with iRBD and PD is currently insufficient. This study aimed to use diffusion tensor image analysis along the perivascular space (DTI-ALPS) to evaluate glymphatic system activity and its relationship to clinical scores of disease severity in patients with possible iRBD (piRBDs) and those with PD. Further, we validated the correlation between the ALPS index and the prognosis of PD longitudinally. Overall, 168 patients with PD, 119 piRBDs, and 129 healthy controls were enroled. Among them, 50 patients with PD had been longitudinally reexamined. Patients with PD exhibited a lower ALPS index than those with piRBDs (P = 0.036), and both patient groups showed a lower ALPS index than healthy controls (P < 0.001 and P = 0.001). The ALPS index and elevated disease severity were negatively correlated in the piRBD and PD subgroups. Moreover, the ALPS index was correlated with cognitive decline in patients with PD in the longitudinal analyses. In conclusion, DTI-ALPS provided neuroimaging evidence of glymphatic system dysfunction in piRBDs and patients with PD; however, the potential of assessing the pathological progress of α-synucleinopathies as an indicator is worth verifying. Further development of imaging methods for glymphatic system function is also warranted.

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Section: Discussionmentioning

confidence: 99%

Neuroimaging evidence of glymphatic system dysfunction in possible REM sleep behavior disorder and Parkinson’s disease

Guo

Wang

et al. 2022

npj Parkinsons Dis.

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“…Likewise, disruptions to the sleep-wake cycle have been associated with inefficient metabolic clearance and increased oxidative stress in the central nervous system, which leads to excessive accumulation of alpha-synuclein and induction of neuronal loss, thus accelerating the pathogenesis and progression of PD. A cross-sectional study has proven that poor sleep, such as insufficient or excessive sleep duration and unsuitable sleep time, is associated with lower levels of cerebrospinal fluid alpha-synuclein in non-PD individuals (Wang et al, 2020). These U-shaped associations between sleep duration and PD can be explained from the perspectives of sleep quality and efficiency.…”

Section: Discussionmentioning

confidence: 99%

Worse Sleep Quality Aggravates the Motor and Non-Motor Symptoms in Parkinson's Disease

Yu-Peng

Jiang-Ting

et al. 2022

Front. Aging Neurosci.

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BackgroundsSleep disorders are the most common and disabling symptoms in patients with Parkinson's disease (PD). Understanding the associations between sleep characteristics and motor and non-motor symptoms (NMSs) in PD can provide evidence to guide therapeutic interventions and nursing strategies. We aimed to investigate the association between sleep characteristics and motor function and NMSs in PD using multiple approaches.MethodsA total of 328 participants were included, and all participants underwent Pittsburgh Sleep Quality Index (PSQI) evaluation and clinical assessments of PD symptoms. We conducted Spearman's correlation to evaluate the associations between sleep and PD symptoms, nonlinear regression to assess the relationships between sleep habits and PD, and mediated analyses to test the effects of NMSs on global PSQI and PD severity, quality of life, and motor symptoms.ResultsPoor sleep was associated with more severe PD symptoms. In addition, the reflection point for bedtime was around 21:52, associated with motor symptoms, and insufficient and excessive total time spent in bed and nocturnal sleep duration were correlated with higher NMS burdens. The optimal points were 8–9.2 and 6.2–6.9 h, respectively. It was also discovered that NMSs played the mediating roles in global sleep with the quality of life, PD stages, and motor symptoms to a varying range of 6.8–95.4%.ConclusionsSleep disorders have a significant effect on the burden of PD symptoms. The current findings provide new insights into the monitoring and management of sleep and PD and need to be further explored in the future studies.

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“… 26 Other studies suggest that the same glymphatic pathways could affect the accumulation of α-synuclein. 23 24 25 27 Interstitial regions are important in glymphatic function, and reportedly include α-synuclein that can synergistically interact with β-amyloid, 23 26 28 which possibly at least partially explains the appearance of Lewy pathology in most subjects with sporadic Alzheimer’s disease. 25 Sleep disturbances have also been shown to be related to α-synuclein in the cerebrospinal fluid.…”

Section: Discussionmentioning

confidence: 99%

“… 25 Sleep disturbances have also been shown to be related to α-synuclein in the cerebrospinal fluid. 27 …”

Section: Discussionmentioning

confidence: 99%

Severity of Daytime Sleepiness and Parkinsonian-Like Symptoms in Korean Adults Aged 50–64 Years

et al. 2022

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Background and Purpose While excessive daytime sleepiness can predate Parkinson’s disease in late-life, its association with parkinsonian-like (P-L) symptoms in middle age are unknown. Since neurodegeneration can appear decades before a diagnosis of Parkinson’s disease, identifying clinical features associated with this early progression is important. The purpose of this study was to determine the association of daytime sleepiness with P-L symptoms in a population-based sample of middle-aged Korean adults. Methods During 2013 and 2014, daytime sleepiness and P-L symptoms were assessed in 2,063 males and females aged 50–64 years who were participating in the Korean Genome and Epidemiology Study. The severity of daytime sleepiness was quantified by the score on the Epworth Sleepiness Scale (ESS). Self-reported P-L symptoms included nine motor disorders commonly associated with Parkinson’s disease. Participants with parkinsonism and related conditions are excluded. Results The prevalence of excessive daytime sleepiness (ESS score >10) was 7.0%. The frequencies of P-L symptoms ranged from 0.5% (for “trouble buttoning buttons”) to 18.4% (for “handwriting smaller than it once was”). After adjustment for covariates and multiple testing, the relative odds of P-L symptoms comparing the 80th and 20th percentiles of ESS scores was 1.6 ( p =0.001) for “voice is softer than it once was,” 2.1 ( p <0.001) for “balance when walking is poor,” and 1.5 ( p =0.002) for “loss of facial expression.” The prevalence of excessive daytime sleepiness increased from 6.3% to 19.8% when the number of symptoms increased from zero to three ( p =0.004). Conclusions In Korean adults aged 50–64 years, daytime sleepiness is significantly associated with P-L symptoms. Whether coexisting daytime sleepiness and P-L symptoms predate extrapyramidal and other impairments in later life warrants further investigation.

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Associations of sleep characteristics with alpha‐synuclein in cerebrospinal fluid in older adults

Cited by 11 publications

References 43 publications

Neuroimaging evidence of glymphatic system dysfunction in possible REM sleep behavior disorder and Parkinson’s disease

Neuroimaging evidence of glymphatic system dysfunction in possible REM sleep behavior disorder and Parkinson’s disease

Worse Sleep Quality Aggravates the Motor and Non-Motor Symptoms in Parkinson's Disease

Severity of Daytime Sleepiness and Parkinsonian-Like Symptoms in Korean Adults Aged 50–64 Years

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