Department of Neurology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China.
Department of Radiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China.
J Parkinsons Dis. 2024;14(4):833-842. doi: 10.3233/JPD-240001.
Previous studies have demonstrated the importance of the locus coeruleus (LC) in sleep-wake regulation. Both essential tremor (ET) and Parkinson's disease (PD) share common sleep disorders, such as poor quality of sleep (QoS). LC pathology is a feature of both diseases. A question arises regarding the contribution of LC degeneration to the occurrence of poor QoS.
To evaluate the association between LC impairment and sleep disorders in ET and PD patients.
A total of 83 patients with ET, 124 with PD, and 83 healthy individuals were recruited and divided into ET/PD with/without poor QoS (Sle/NorET and Sle/NorPD) subgroups according to individual Pittsburgh Sleep Quality Index (PSQI) score. Neuromelanin-sensitive magnetic resonance imaging (NM-MRI) and free-water imaging derived from diffusion MRI were performed. Subsequently, we evaluated the association between contrast-to-noise ratio of LC (CNRLC) and free-water value of LC (FWLC) with PSQI scores in ET and PD groups.
CNRLC was significantly lower in ET (p = 0.047) and PD (p = 0.018) than in healthy individuals, whereas no significant difference was found in FWLC among the groups. No significant differences were observed in CNR/FWLC between patients with/without sleep disorders after multiple comparison correction. No correlation was identified between CNR/FWLC and PSQI in ET and PD patients.
LC degeneration was observed in both ET and PD patients, implicating its involvement in the pathophysiology of both diseases. Additionally, no significant association was observed between LC integrity and PSQI, suggesting that LC impairment might not directly relate to overall QoS.
先前的研究已经证明蓝斑（LC）在睡眠-觉醒调节中的重要性。特发性震颤（ET）和帕金森病（PD）都有共同的睡眠障碍，如睡眠质量差（QoS）。LC 病理学是这两种疾病的共同特征。因此，LC 退化是否会导致 QoS 下降，这是一个值得探讨的问题。
评估 LC 损伤与 ET 和 PD 患者睡眠障碍之间的关系。
共纳入 83 例 ET 患者、124 例 PD 患者和 83 例健康对照者，根据匹兹堡睡眠质量指数（PSQI）评分将 ET/PD 患者分为睡眠质量好/差（Sle/NorET 和 Sle/NorPD）亚组。通过神经黑色素敏感磁共振成像（NM-MRI）和扩散 MRI 衍生的自由水成像来评估 LC 对比度噪声比（CNRLC）和 LC 自由水值（FWLC）与 ET 和 PD 组 PSQI 评分之间的关系。
与健康对照组相比，ET（p = 0.047）和 PD（p = 0.018）患者的 CNRLC 显著降低，而各组间的 FWLC 无显著差异。经多重比较校正后，睡眠障碍患者与无睡眠障碍患者之间的 CNR/FWLC 无显著差异。在 ET 和 PD 患者中，CNR/FWLC 与 PSQI 之间无相关性。
LC 退变在 ET 和 PD 患者中均有观察到，提示其参与了这两种疾病的病理生理学过程。此外，LC 完整性与 PSQI 之间无显著相关性，提示 LC 损伤可能与整体 QoS 无直接关系。
