Department of Radiology, Sarah Network of Hospitals for Rehabilitation, Fortaleza, CE, Brazil.
Parkinsonism Relat Disord. 2010 May;16(4):275-9. doi: 10.1016/j.parkreldis.2010.01.002. Epub 2010 Feb 24.
Despite common reports in Parkinson's disease (PD), in other parkinsonian syndromes, sleep disturbances have been less frequently described. This study evaluated and compared sleep disturbances in patients with PD, multiple system atrophy (MSA) and progressive supranuclear palsy (PSP) and analyzed associations with brain magnetic resonance imaging (MRI) morphometry. This was a cross-sectional study of 16 PD cases, 13 MSA, 14 PSP and 12 control. Sleep disturbances were evaluated by Epworth Sleepiness Scale, Pittsburgh Sleep Quality Index (PSQI), Restless Legs Scale and Berlin questionnaire. Pons area, midbrain area, medial cerebellar peduncle (MCP) width, and superior cerebellar peduncle width were measured using MRI. Poor quality sleep, risk of obstructive sleep apnea (OSA) and restless legs syndrome (RLS) were detected in all groups. Patients with MSA showed higher risk of OSA and less frequent RLS. In MSA, a correlation between PSQI scores and Hoehn and Yahr stage was observed (p<0.05). In PSP, RLS was frequent (57%) and related with reduced sleep duration and efficiency. In PD, excessive daytime sleepiness was related to atrophy of the MCP (p=0.01). RLS was more frequent in PD and PSP, and in PSP, was associated with reduced sleep efficiency and sleep duration. Brain morphometry abnormalities were found in connection with excessive daytime sleepiness and risk of OSA in PD and PSP suggesting widespread degeneration of brainstem sleep structures on the basis of sleep abnormalities in these patients.
尽管帕金森病（PD）中经常报告有睡眠障碍，但在其他帕金森综合征中，睡眠障碍的描述较少。本研究评估并比较了 PD、多系统萎缩（MSA）和进行性核上性麻痹（PSP）患者的睡眠障碍，并分析了与脑磁共振成像（MRI）形态计量学的关联。这是一项横断面研究，纳入了 16 例 PD 患者、13 例 MSA 患者、14 例 PSP 患者和 12 例对照者。使用 Epworth 嗜睡量表、匹兹堡睡眠质量指数（PSQI）、不宁腿量表和柏林问卷评估睡眠障碍。使用 MRI 测量脑桥面积、中脑面积、内侧小脑脚（MCP）宽度和上小脑脚宽度。所有组均发现睡眠质量差、阻塞性睡眠呼吸暂停（OSA）和不安腿综合征（RLS）风险。MSA 患者的 OSA 风险更高，RLS 发生频率更低。在 MSA 中，PSQI 评分与 Hoehn 和 Yahr 分期之间存在相关性（p<0.05）。在 PSP 中，RLS 很常见（57%），与睡眠时间和效率降低有关。在 PD 中，日间嗜睡与 MCP 萎缩有关（p=0.01）。RLS 在 PD 和 PSP 中更为常见，在 PSP 中，与睡眠效率和睡眠时间降低有关。PD 和 PSP 患者的脑形态计量学异常与日间嗜睡和 OSA 风险有关，提示这些患者的睡眠异常与脑干睡眠结构的广泛变性有关。
