Epworth sleepiness scale is associated with increased striatal dopamine uptake in Parkinson's disease: a cross-sectional study.

Abstract

A cross-sectional study was designed to investigate the possible association between Epworth sleepiness scale (ESS) scores and striatal dopamine uptake in the early stages of Parkinson's disease (PD). Two groups of PD patients (n = 464) and healthy controls (HC) (n = 162) were enrolled in the current study from the Parkinson's progression markers initiative cohort ( https://www.ppmi-info.org ). All the subjects were evaluated for excessive daytime sleepiness (EDS) using the ESS. They also completed specific measures to be assessed for motor and non-motor symptoms, including cognitive, gait, autonomic, and olfactory dysfunction. Dopamine transporter (DaT) scans were used to identify dopamine transporter impairments. Spatial normalization for DaTscan imaging of participants was performed to reach consistent orientation. A significant correlation was found between ESS score and right putamen (P < 0.001; correlation coefficient = 0.186) and left putamen (P = 0.003; correlation coefficient = 0.139) dopamine uptake in PD patients. The same results were revealed after adjusted Pearson's correlation for the effects of handedness, age, gender, and education. No significant correlation was found between the ESS score and the amount of caudate nucleus dopamine uptake in PD patients. Moreover, there was a significant association between caudate nucleus dopamine uptake and ESS score in neither PD patients nor HCs. The results of our study suggest that increased dopaminergic function of putamen nuclei may be associated with ESS scores in the early stages of PD. Further studies are needed at different PD stages and evaluate PD progression as a possible confounder.