Martinez-Rodriguez Jose Enrique, Seppi Klaus, Cardozo Adriana, Iranzo Alex, Stampfer-Kountchev Michaela, Wenning Gregor, Tolosa Eduardo, Högl Birgit, Santamaria Joan, Poewe Werner
Neurology Service, Hospital Clínic de Barcelona and Institut d'Investigació Biomèdica August Pi i Sunyer (IDIBAPS), University of Barcelona Medical School, Barcelona, Spain.
Mov Disord. 2007 Sep 15;22(12):1822-4. doi: 10.1002/mds.21668.
Hypocretin (orexin) cerebrospinal fluid (CSF) levels have been previously found normal or decreased in Dementia with Lewy bodies and Parkinson disease, two synucleinopathies commonly associated with excessive daytime sleepiness (EDS). We evaluated CSF hypocretin-1 levels in 15 patients with moderately severe multiple system atrophy (MSA), another synucleinopathy where sleep disorders occur frequently and EDS has been reported, performing additional electrophysiological studies in 5 of them to assess the presence of EDS and sleep onset REM (SOREM) periods. Despite relatively low sleep efficiencies in nocturnal sleep, mean sleep latencies in the Multiple Sleep Latency Test were normal with no SOREM periods. All patients had CSF hypocretin-1 levels in the normal range (>200 pg/mL) suggesting that the hypocretin system is not altered in MSA, at least in patients with a moderately severe disease.
此前研究发现，在路易体痴呆和帕金森病这两种通常与日间过度嗜睡（EDS）相关的突触核蛋白病中，脑脊液（CSF）中下丘脑分泌素（食欲素）水平正常或降低。我们评估了15例中度严重多系统萎缩（MSA）患者的脑脊液下丘脑分泌素-1水平，MSA是另一种突触核蛋白病，睡眠障碍频繁发生且有EDS的报道，我们对其中5例患者进行了额外的电生理研究，以评估是否存在EDS和睡眠起始快速眼动（SOREM）期。尽管夜间睡眠的睡眠效率相对较低，但多次睡眠潜伏期试验中的平均睡眠潜伏期正常，且无SOREM期。所有患者的脑脊液下丘脑分泌素-1水平均在正常范围内（>200 pg/mL），这表明下丘脑分泌素系统在MSA中未发生改变，至少在中度严重疾病患者中如此。
