Abstract

There is increasing awareness on the role played by circadian rhythm abnormalities in neurodegenerative disorders such as Alzheimer’s disease (AD) and Parkinson’s disease (PD). The characterization of the circadian dysfunction parallels the mounting evidence that the hallmarks of neurodegeneration also affect the retina and frequently lead to loss of retinal ganglion cells (RGCs) and to different degrees of optic neuropathy. In the RGC population, there is the subgroup of cells intrinsically photosensitive and expressing the photopigment melanopsin [melanopsin-containing retinal ganglion cells (mRGCs)], which are now well known to drive the entrainment of circadian rhythms to the light–dark cycles. Thus, the correlation between the pathological changes affecting the retina and mRGCs with the circadian imbalance in these neurodegenerative diseases is now clearly emerging, pointing to the possibility that these patients might be amenable to and benefit from light therapy. Currently, this connection is better established for AD and PD, but the same scenario may apply to other neurodegenerative disorders, such as Huntington’s disease. This review highlights similarities and differences in the retinal/circadian rhythm axis in these neurodegenerative diseases posing a working frame for future studies.

Highlights

  • Alzheimer’s disease (AD) and Parkinson’s disease (PD) are the most frequent age-related neurodegenerative disorders with an increasing prevalence with age [1, 2]

  • The role of the eye in influencing and regulating circadian rhythms has been clarified, starting from the discovery of the intrinsically photosensitive melanopsin-containing retinal ganglion cells [7, 8]. These cells constitute a small subset of regular retinal ganglion cells (RGCs) consisting of about 1–2% of the total, and they give origin to the retinohypothalamic tract through which they project to the suprachiasmatic nucleus (SCN) of the hypothalamus synchronizing circadian rhythms to the light–dark cycle [9]

  • Other possible components of the circadian imbalance demonstrated in AD is the presence of SCN neuronal loss and amyloid pathology documented in neuropathological studies of AD postmortem brain [65, 66], which correlates with the degree of rest–activity disruption [67] and can contribute secondarily to the melanopsin-containing retinal ganglion cells (mRGCs) loss demonstrated in AD retinas

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Summary

INTRODUCTION

Alzheimer’s disease (AD) and Parkinson’s disease (PD) are the most frequent age-related neurodegenerative disorders with an increasing prevalence with age [1, 2]. The role of the eye in influencing and regulating circadian rhythms has been clarified, starting from the discovery of the intrinsically photosensitive melanopsin-containing retinal ganglion cells (mRGCs) [7, 8] These cells constitute a small subset of regular retinal ganglion cells (RGCs) consisting of about 1–2% of the total, and they give origin to the retinohypothalamic tract through which they project to the suprachiasmatic nucleus (SCN) of the hypothalamus synchronizing circadian rhythms to the light–dark cycle [9]. We here explore the connection between the eye and circadian functions and dysfunctions in AD and PD with particular reference to the mRGC system and its contribution to circadian functions

EVIDENCE OF INNER RETINA PATHOLOGY IN AD AND PD
CIRCADIAN RHYTHM DYSFUNCTION IN AD AND PD
Circadian rhythm abnormalities
CONCLUDING REMARKS
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