Ma Cui-Hong, Ren Ning, Xu Jing, Chen Lei
Department of Neurology, Huanhu Hospital Affiliated to Tianjin Medical University, 6 Jizhao Road, Jinnan District, Tianjin, 300350, China.
Department of Neurology, Chengde Central Hospital, Chengde, 067000, China.
Cell Commun Signal. 2025 Mar 18;23(1):144. doi: 10.1186/s12964-025-02153-8.
Sleep disorders occur frequently among patients with Parkinson's disease (PD). Neurotransmitters and neurosteroids are known to be involved in various neurophysiological processes, including sleep development. We aimed to assess the associations of peripheral neurotransmitter and neurosteroid levels with various sleep disorders in early-stage PD.
Fifty-nine patients with early-stage PD and 30 healthy controls were enrolled. Demographic and clinical data were collected, and sleep conditions were comprehensively assessed with clinical questionnaires and polysomnography. Blood samples were obtained from all participants at 1:00 AM and 9:00 AM. The concentrations of plasma neurotransmitters and neurohormones were detected via high-performance liquid chromatography tandem mass spectrometry.
Sleep disorders were common nonmotor symptoms (81.4%) and coexisted in approximately half of the patients. Dysautonomia was significantly associated with the presence of multiple sleep disorders. RBD was associated with dysautonomia and was negatively correlated with the plasma melatonin concentration at 1:00 AM (r = - 0.40, p = 0.002) in early-stage PD patients. The RLS group had higher PSQI scores, and RLS was negatively associated with the 5-hydroxytryptamine levels (r = - 0.40, p = 0.002) at 1:00 AM and glutamine levels (r = - 0.39, p = 0.002) at 9:00 AM. SDB was associated with cognitive impairment, a greater body mass index, and lower plasma acetylcholine concentrations at 1:00 AM.
Combined sleep disturbances are common in early-stage PD. Dysautonomia is closely related to various sleep disorders, including RBD, EDS, and insomnia. Changes in peripheral neurotransmitter and neurohormone levels may be involved in the development of sleep disorders.
睡眠障碍在帕金森病（PD）患者中频繁出现。已知神经递质和神经甾体参与包括睡眠发育在内的各种神经生理过程。我们旨在评估外周神经递质和神经甾体水平与早期PD各种睡眠障碍之间的关联。
纳入59例早期PD患者和30名健康对照者。收集人口统计学和临床数据，并通过临床问卷和多导睡眠图对睡眠状况进行全面评估。于凌晨1点和上午9点采集所有参与者的血样。通过高效液相色谱串联质谱法检测血浆神经递质和神经激素的浓度。
睡眠障碍是常见的非运动症状（81.4%），约半数患者并存。自主神经功能障碍与多种睡眠障碍的存在显著相关。快速眼动睡眠行为障碍（RBD）与自主神经功能障碍相关，且与早期PD患者凌晨1点时的血浆褪黑素浓度呈负相关（r = -0.40，p = 0.002）。不安腿综合征（RLS）组的匹兹堡睡眠质量指数（PSQI）得分更高，且RLS与凌晨1点时的5-羟色胺水平（r = -0.40，p = 0.002）和上午9点时的谷氨酰胺水平（r = -0.39，p = 0.002）呈负相关。睡眠呼吸障碍（SDB）与认知障碍、更高的体重指数以及凌晨1点时更低的血浆乙酰胆碱浓度相关。
合并性睡眠障碍在早期PD中很常见。自主神经功能障碍与包括RBD、日间过度嗜睡（EDS）和失眠在内的各种睡眠障碍密切相关。外周神经递质和神经激素水平的变化可能参与了睡眠障碍的发生发展。
