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Disturbed sleep in P arkinson's disease: anatomical and pathological correlates
Author(s) -
Kalaitzakis M. E.,
Gentleman S. M.,
Pearce R. K. B.
Publication year - 2013
Publication title -
neuropathology and applied neurobiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.538
H-Index - 95
eISSN - 1365-2990
pISSN - 0305-1846
DOI - 10.1111/nan.12024
Subject(s) - pathological , sleep (system call) , disease , medicine , neuroscience , pathology , psychology , computer science , operating system
Aims Abnormal sleep is a common feature of P arkinson's disease ( PD ) and prodromal disorders of sleep are frequent (e.g. restless legs syndrome and rapid eye movement sleep behaviour disorder). However, the exact pathological basis of disturbed sleep remains as yet undefined. Methods To investigate this further, 32 PD cases were stratified into three groups: (1) PD with disturbed sleep, PD ( S ); (2) PD with dementia ( PDD ) and disturbed sleep, PDD ( S ); and (3) PD without disturbed sleep, PD (nS). The extent of α‐synuclein (α S yn) and A lzheimer disease ( AD )‐type pathology [amyloid β peptide ( A β) and tau] was assessed in 15 regions of the PD brain. Results The results demonstrate a significant association between disturbed sleep in PD and α S yn pathology in specific brainstem [locus coeruleus ( P = 0.006) and raphe nuclei ( P = 0.02)], hypothalamic [paramammillary nuclei ( P = 0.04) and posterior nucleus ( P = 0.02)], subcortical/limbic [amygdala ( P = 0.03), thalamus ( P = 0.01)] and cortical [entorhinal cortex ( P = 0.01)] regions. A statistically significant increase of tau pathology was observed in the amygdala ( P = 0.03), CA 2 sector of the hippocampus ( P = 0.01) and entorhinal cortex ( P = 0.04) in PD cases with disturbed sleep. Conclusions Pathological changes in these structures, residing in the brain circuitry relating to sleep physiology, strongly predict the presence of sleep disturbances in PD .