Abstract
ABSTRACTBackgroundRecent studies have suggested that melatonin—a hormone produced by the pineal gland under circadian control—contributes to PD‐related sleep dysfunction. We hypothesized that degenerative changes to the neural structures controlling pineal function (especially the suprachiasmatic nuclei of the anterior hypothalamus) may be responsible for reduced melatonin output in these patients. We compared hypothalamic volumes in PD patients with matched controls and determined whether volume loss correlated with reduced melatonin output in the PD group.MethodsA total of 12 PD patients and 12 matched controls underwent magnetic resonance imaging to determine hypothalamic volume. In addition, PD patients underwent 24‐hour blood sampling in a controlled environment to determine serum melatonin concentrations using enzyme‐linked immunosorbent assays.ResultsPD patients had significantly reduced hypothalamic gray matter volume when compared with matched controls. Melatonin levels were significantly associated with hypothalamic gray matter volume and disease severity in PD patients.ConclusionMelatonin levels are associated with hypothalamic gray matter volume loss and disease severity in PD patients. This provides anatomical and physiological support for an intrinsic sleep and circadian phenotype in PD. © 2016 The Authors. Movement Disorders published by Wiley Periodicals, Inc. on behalf of International Parkinson and Movement Disorder Society
Highlights
Recent studies have suggested that melatonin—a hormone produced by the pineal gland under circadian control—contributes to Parkinson’s disease (PD)-related sleep dysfunction
Because melatonin is a hormone produced by the pineal gland under circadian control, we hypothesised that degenerative changes to the neural structures controlling pineal function may reduce melatonin output and contribute to certain aspects of sleep dysfunction in PD
Having verified that there were significant differences between patients and controls in terms of hypothalamic volume, we found that melatonin levels were significantly associated with relative hypothalamic gray matter volume in the PD group (r 5 .591, P 5 .028) (Fig. 1D)
Summary
Recent studies have suggested that melatonin—a hormone produced by the pineal gland under circadian control—contributes to PD-related sleep dysfunction. We compared hypothalamic volumes in PD patients with matched controls and determined whether volume loss correlated with reduced melatonin output in the PD group. Methods: A total of 12 PD patients and 12 matched controls underwent magnetic resonance imaging to determine hypothalamic volume. Results: PD patients had significantly reduced hypothalamic gray matter volume when compared with matched controls. Melatonin levels were significantly associated with hypothalamic gray matter volume and disease severity in PD patients. Conclusion: Melatonin levels are associated with hypothalamic gray matter volume loss and disease severity in PD patients. This provides anatomical and physiological support for an intrinsic sleep and circadian phenotype in PD. Results: Sixteen GBA mutation carriers were identified, 5 of which were brains with pure DLB. The most common mutation, E326K, was strongly associated with pure
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