Abstract
IntroductionExcessive daytime sleepiness (EDS) is one of the common and burdensome non-motor symptoms of Parkinson’s disease (PD). However, the underlying neuropathology mechanism in PD patients with EDS (PD-EDS) remains unclear. The present study aims to delineate potential locations of structural alteration of subcortical regions in early stage and drug-naïve PD-EDS.MethodsThe study had 252 patients with PD and 92 matched healthy controls (HC). EDS was estimated with the Epworth Sleepiness Scale, with a cutoff of 10. Ultimately, 59 patients were considered as PD-EDS. The remaining 193 were PD patients without EDS (PD-nEDS). FMRIB’s Integrated Registration and Segmentation Tool (FIRST) was employed to assess the volumetric and surface alterations of subcortical nuclei in PD and PD-EDS.ResultsVolumetric analyses found no difference in the subcortical nucleus volume between PD and HC, or PD-EDS and PD-nEDS groups. The shape analyses revealed the local atrophic changes in bilateral caudate and right putamen in patients with PD. In addition, the hypertrophic changes were located in the right putamen and left pallidum in PD-EDS than in PD-nEDS.ConclusionOur findings revealed the regional hypertrophy of the striatum in PD-EDS. Our results indicate that local hypertrophic striatum would be a valuable early biomarker for detecting the alteration in PD-EDS. The shape analysis contributes valuable information when investigating PD-EDS.
Highlights
Excessive daytime sleepiness (EDS) is one of the common and burdensome non-motor symptoms of Parkinson’s disease (PD)
One reason for inconsistent findings might be the small sample size and antiparkinsonian medication in previous studies. Another important factor might be attributed to the limitation of the voxel-based morphometry (VBM) analysis, which is based on a standard template
magnetic resonance imaging (MRI) data analyses were performed using the tools from FSL (Jenkinson et al, 2012)
Summary
Excessive daytime sleepiness (EDS) is one of the common and burdensome non-motor symptoms of Parkinson’s disease (PD). Parkinson’s disease (PD) is the second most common neurodegenerative disorder associated with both motor and numerous non-motor symptoms (De Lau and Breteler, 2006). Studies have shown associations with EDS symptoms in PD including non-tremor dominant phenotype, autonomic dysfunction, depression, anxiety, and disorders of rapid eye movement sleep behavior (Simuni et al, 2015; Amara et al, 2017; Wen et al, 2017), the neural mechanism of EDS in PD remains poorly understood. One reason for inconsistent findings might be the small sample size and antiparkinsonian medication in previous studies Another important factor might be attributed to the limitation of the voxel-based morphometry (VBM) analysis, which is based on a standard template. A previous volumetric analysis of PD pathology showed conflicting results on subcortical structures (Uitti et al, 2005; Gama et al, 2010; Péran et al, 2010)
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