Department of Neurology and Clinical Research Center of Neurological Disease, The Second Affiliated Hospital of Soochow University, Suzhou, China.
Department of Neurology, Du Shu Lake Hospital Affiliated to Soochow University, Suzhou, China.
CNS Neurosci Ther. 2024 Oct;30(10):e70058. doi: 10.1111/cns.70058.
Levodopa-induced dyskinesia (DYS) adversely affects the quality of life of Parkinson's disease (PD) patients. However, few studies have focused on the relationship between DYS and sleep and electroencephalography (EEG). Our study aimed to establish the objective physiological indicators assessed by polysomnography (PSG) that are associated with DYS in PD patients.
We enrolled 122 patients with PD, divided into two groups: PD with DYS (n = 27) and PD without DYS group (non-DYS, n = 95). The demographics and clinical characteristics and sleep assessment in the two groups were collected. More importantly, overnight six-channel PSG parameters were compared in the two groups. We also compared different bands and brain regions of average power spectral density within each group.
Compared with the non-DYS group, the DYS group tended to have a significantly higher percentage of nonrapid eye movement sleep (NREM). Gender, levodopa equivalent daily dose (LEDD), rapid eye movement (REM) sleep (min), and the NREM percentage were positively correlated with the occurrence of DYS. After adjusting for gender, disease duration, LEDD, taking amantadine or not, and Montreal Cognitive Assessment (MoCA), NREM%, N3%, and REM (min), the percentage of NREM sleep (p = 0.035), female (p = 0.002), and LEDD (p = 0.005), and REM sleep time (min) (p = 0.012) were still associated with DYS. There was no significant difference in whole-night different bands of average power spectral density between two groups. There was no significant difference in normalized average power spectral density of slow wave activity (SWA) (0.5-2 Hz, 0.5-4 Hz, and 2-4 Hz) of early and late NREM sleep in the DYS group. Dynamic normalized average power spectral density of SWA of low-frequency (0.5-2 Hz) reduction in the frontal region (p = 0.013) was associated with DYS in logistic regression after adjusting for confounding factors.
PD patients with DYS have substantial sleep structure variations. Higher NREM percentage and less REM percentage were observed in PD patients with DYS. Dynamic normalized average power spectral density of low-frequency (0.5-2 Hz) SWA reduction in the frontal area could be a new electrophysiological marker of DYS in PD.
左旋多巴诱导的运动障碍（DYS）会降低帕金森病（PD）患者的生活质量。然而，很少有研究关注 DYS 与睡眠和脑电图（EEG）之间的关系。我们的研究旨在确定帕金森病患者 DYS 相关的多导睡眠图（PSG）评估的客观生理指标。
我们纳入了 122 例 PD 患者，分为 DYS 组（n=27）和非 DYS 组（非 DYS，n=95）。收集两组患者的人口统计学和临床特征及睡眠评估资料。更重要的是，比较两组患者的整夜 6 通道 PSG 参数。我们还比较了每组内不同频段和不同脑区的平均功率谱密度。
与非 DYS 组相比，DYS 组的非快速眼动睡眠（NREM）百分比明显较高。性别、左旋多巴等效日剂量（LEDD）、快速眼动（REM）睡眠（min）和 NREM 百分比与 DYS 的发生呈正相关。在校正性别、疾病持续时间、LEDD、是否服用金刚烷胺和蒙特利尔认知评估（MoCA）后，NREM%、N3%和 REM（min）、NREM 睡眠百分比（p=0.035）、女性（p=0.002）和 LEDD（p=0.005）和 REM 睡眠时间（min）（p=0.012）仍与 DYS 相关。两组间整夜不同频段平均功率谱密度无显著差异。DYS 组早期和晚期 NREM 睡眠慢波活动（SWA）（0.5-2Hz、0.5-4Hz 和 2-4Hz）的归一化平均功率谱密度无显著差异。调整混杂因素后，逻辑回归显示，额叶低频（0.5-2Hz）SWA 减少的动态归一化平均功率谱密度（p=0.013）与 DYS 相关。
伴有 DYS 的 PD 患者睡眠结构有明显变化。伴有 DYS 的 PD 患者 NREM 百分比较高，REM 百分比较低。额叶低频（0.5-2Hz）SWA 减少的动态归一化平均功率谱密度可能是 PD 中 DYS 的新电生理标志物。
