Yousaf Tayyabah, Pagano Gennaro, Wilson Heather, Politis Marios
Neurodegeneration Imaging Group, Department of Basic and Clinical Neuroscience, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom.
Front Neurol. 2018 Sep 11;9:767. doi: 10.3389/fneur.2018.00767. eCollection 2018.
Sleep dysfunction is recognized as a distinct clinical manifestation in movement disorders, often reported early on in the disease course. Excessive daytime sleepiness, rapid eye movement sleep behavior disorder and restless leg syndrome, amidst several others, are common sleep disturbances that often result in significant morbidity. In this article, we review the spectrum of sleep abnormalities across atypical Parkinsonian disorders including multiple system atrophy (MSA), progressive supranuclear palsy (PSP) and corticobasal syndrome (CBS), as well as Parkinson's disease (PD) and Huntington's disease (HD). We also explore the current concepts on the neurobiological underpinnings of sleep disorders, including the role of dopaminergic and non-dopaminergic pathways, by evaluating the molecular, structural and functional neuroimaging evidence based on several novel techniques including magnetic resonance imaging (MRI), functional magnetic resonance imaging (fMRI), diffusion tensor imaging (DTI), single-photon emission computed tomography (SPECT) and positron emission tomography (PET). Based on the current state of research, we suggest that neuroimaging is an invaluable tool for assessing structural and functional correlates of sleep disturbances, harboring the ability to shed light on the sleep problems attached to the limited treatment options available today. As our understanding of the pathophysiology of sleep and wake disruption heightens, novel therapeutic approaches are certain to transpire.
睡眠功能障碍被认为是运动障碍中的一种独特临床表现，常在疾病进程早期就有报道。白天过度嗜睡、快速眼动睡眠行为障碍和不宁腿综合征等多种睡眠障碍较为常见，常导致严重的发病情况。在本文中，我们综述了非典型帕金森氏症（包括多系统萎缩（MSA）、进行性核上性麻痹（PSP）和皮质基底节综合征（CBS））以及帕金森病（PD）和亨廷顿舞蹈病（HD）中睡眠异常的范围。我们还通过评估基于磁共振成像（MRI）、功能磁共振成像（fMRI）、扩散张量成像（DTI）、单光子发射计算机断层扫描（SPECT）和正电子发射断层扫描（PET）等多种新技术的分子、结构和功能神经影像学证据，探讨了睡眠障碍神经生物学基础的当前概念，包括多巴胺能和非多巴胺能通路的作用。基于目前的研究状况，我们认为神经影像学是评估睡眠障碍结构和功能相关性的宝贵工具，能够为当今有限治疗选择所带来的睡眠问题提供线索。随着我们对睡眠和觉醒障碍病理生理学的理解不断加深，新的治疗方法必将出现。
