Abstract
BackgroundThis study explored the relationship between symptoms of rapid eye movement sleep behaviour disorder, thermoregulation and sleep in Parkinson’s Disease.MethodsThe study group comprised 12 patients with Parkinson’s Disease and 11 healthy age-matched controls. We investigated markers of thermoregulation (core-body temperature profile), circadian rhythm (locomotor actigraphy) and sleep (polysomnography).ResultsThe mesor (the mean value around which the core temperature rhythm oscillates) of the core-body temperature in patients with Parkinson’s Disease was significantly lower than that of controls. In addition, the nocturnal fall in CBT (the difference between the mesor and the nadir temperature) was also significantly reduced in PD patients relative to controls. Furthermore, in patients the reduction in the amplitude of their core-body temperature profile was strongly correlated with the severity of self-reported rapid eye movement sleep behaviour disorder symptom, reduction in the percentage of REM sleep and prolonged sleep latency. By contrast, these disturbances of thermoregulation and sleep architecture were not found in controls and were not related to other markers of circadian rhythm or times of sleep onset and offset.ConclusionsThese findings suggest that the brainstem pathology associated with disruption of thermoregulation in Parkinson’s disease may also contribute to rapid eye movement sleep behavioural disorder. It is possible that detailed analysis of the core-body temperature profile in at risk populations such as those patients with idiopathic rapid eye movement sleep behaviour disorder might help identify those who are at high risk of transitioning to Parkinson’s Disease.
Highlights
Parkinson’s disease (PD) has been characterised by its constellation of motor symptoms, but non-motor symptoms such as disturbances of sleep, circadian rhythm and thermoregulation have been increasingly recognised[1,2,3,4,5,6]
We examined differences in thermoregulation between patients with Parkinson’s disease and controls as well as its correlations with markers of circadian rhythm, sleep and self-reported symptoms of RBD using an array of established techniques including core-body temperature (CBT) profiling, locomotor actigraphy and polysomnography (PSG)
There were no significant differences in age, gender composition, Mental State Examination Score (MMSE) or BDI-II scores between the PD and control groups
Summary
Parkinson’s disease (PD) has been characterised by its constellation of motor symptoms, but non-motor symptoms such as disturbances of sleep, circadian rhythm and thermoregulation have been increasingly recognised[1,2,3,4,5,6]. Rapid eye movement (REM) sleep behaviour disorder (RBD) is reported in up to 60% of PD patients[7]. This symptom is characterised by loss of muscle atonia during REM sleep, which results in violent nocturnal dream enactments[8]. This study explored the relationship between symptoms of rapid eye movement sleep behaviour disorder, thermoregulation and sleep in Parkinson’s Disease
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