Stavitsky Karina, McNamara Patrick, Durso Raymon, Harris Erica, Auerbach Sanford, Cronin-Golomb Alice
Department of Psychology, Boston University, Boston, MA, USA.
Cogn Behav Neurol. 2008 Sep;21(3):143-9. doi: 10.1097/WNN.0b013e318185e698.
To relate sleep disturbances in Parkinson disease (PD) to hemispheric asymmetry of initial presentation.
Sleep disturbances are common in PD arising from the neurodegenerative process underlying the disease, which is usually lateralized at onset. Patients with left-side Parkinson disease onset (LPD: right hemisphere dysfunction) exhibit reduced vigilance relative to those with right-side Parkinson disease onset (RPD: left hemisphere dysfunction), leading us to hypothesize that sleep-related disturbances, particularly excessive daytime sleepiness, would be more severe for LPD than for RPD.
Thirty-one nondemented participants with PD (17 RPD and 14 LPD) and 17 age-matched control (CO) participants with chronic health conditions were administered the Parkinson Disease Sleep Scale and polysomnography was performed on a subset of the PD participants.
Both PD subgroups exhibited more nighttime motor symptoms than the CO group, but only LPD endorsed more nocturnal hallucinations and daytime dozing. Controlling for mood additionally revealed more vivid dreaming in LPD than RPD. There were no significant differences between LPD and RPD on measures of sleep architecture.
Increased dreaming, hallucinations, and daytime somnolescence in LPD may be related to changes in right-hemisphere neural networks implicated in the generation and control of visual images, arousal, and vigilance. Our results underscore the need to consider side of onset in regard to sleep disturbances in PD.
探讨帕金森病（PD）睡眠障碍与初始表现的半球不对称性之间的关系。
睡眠障碍在PD中很常见，源于该疾病潜在的神经退行性过程，而这一过程在发病时通常是单侧化的。左侧帕金森病起病（LPD：右半球功能障碍）的患者相对于右侧帕金森病起病（RPD：左半球功能障碍）的患者表现出警觉性降低，这使我们推测与睡眠相关的障碍，尤其是日间过度嗜睡，在LPD中比在RPD中更为严重。
对31名无痴呆的PD患者（17名RPD和14名LPD）以及17名年龄匹配的患有慢性健康问题的对照（CO）参与者进行帕金森病睡眠量表评估，并对部分PD参与者进行多导睡眠图检查。
两个PD亚组夜间运动症状均比CO组更多，但只有LPD认可更多的夜间幻觉和日间打瞌睡。在控制情绪后还发现，LPD比RPD有更生动的梦境。LPD和RPD在睡眠结构指标上无显著差异。
LPD中梦境增加、幻觉和日间嗜睡可能与右半球神经网络的变化有关，这些神经网络参与视觉图像的产生和控制、觉醒及警觉。我们的结果强调在考虑PD睡眠障碍时需要关注起病侧。
