Femke Dijkstra1,2,3, Ilse de Volder4,5,6,7, Mineke Viaene8, Patrick Cras4,5,9, David Crosiers4,5,9. 1. Department of Neurology, Antwerp University Hospital, Drie Eikenstraat 655, 2650, Edegem, Belgium. Femke.Dijkstra@uza.be. 2. Faculty of Medicine and Health Sciences, Translational Neurosciences, University of Antwerp, Universiteitsplein 1, 2610, Wilrijk, Belgium. Femke.Dijkstra@uza.be. 3. Laboratory for Sleep Disorders and Department of Neurology, St.-Dimpna Regional Hospital, J.-B. Stessensstraat 2, 2440, Geel, Belgium. Femke.Dijkstra@uza.be. 4. Department of Neurology, Antwerp University Hospital, Drie Eikenstraat 655, 2650, Edegem, Belgium. 5. Faculty of Medicine and Health Sciences, Translational Neurosciences, University of Antwerp, Universiteitsplein 1, 2610, Wilrijk, Belgium. 6. Department of Psychiatry, Antwerp University Hospital, Drie Eikenstraat 655, 2650, Edegem, Belgium. 7. Multidisciplinary Sleep Disorders Center, Antwerp University Hospital, Drie Eikenstraat 655, 2650, Edegem, Belgium. 8. Laboratory for Sleep Disorders and Department of Neurology, St.-Dimpna Regional Hospital, J.-B. Stessensstraat 2, 2440, Geel, Belgium. 9. Born-Bunge Institute, University of Antwerp, Universiteitsplein 1, 2610, Wilrijk, Belgium.
Abstract
PURPOSE OF REVIEW: Sleep disturbances are an important nonmotor feature of Parkinson's disease (PD) that can cause polysomnographic (PSG) alterations. These alterations are already present in early PD and may be associated with a specific disease course. This systematic review describes the role of PSG variables as predictors of sleep dysfunction, motor and cognitive dysfunction progression in PD. RECENT FINDINGS: Nineteen longitudinal cohort studies were included. Their main findings were that (1) REM sleep behavioral events, REM sleep without atonia (RSWA), and electroencephalography (EEG) changes (mainly microsleep instability) are predictors of the development of REM sleep behavior disorder (RBD); (2) RBD, RSWA, and lower slow-wave sleep energy predict motor progression; (3) RBD, EEG slowing, and sleep spindles changes are predictors of cognitive deterioration; and (4) OSA is associated with severe motor and cognitive symptoms at baseline, with inconsistent findings on the effect of continuous positive airway pressure (CPAP) therapy for these symptoms. The results of our systematic review support a role of the video-PSG in disease progression prediction in PD and its usefulness as a biomarker. However, future studies are needed to investigate whether treatment of these PSG abnormalities and sleep disturbances may have a neuroprotective effect on disease progression.
PURPOSE OF REVIEW: Sleep disturbances are an important nonmotor feature of Parkinson's disease (PD) that can cause polysomnographic (PSG) alterations. These alterations are already present in early PD and may be associated with a specific disease course. This systematic review describes the role of PSG variables as predictors of sleep dysfunction, motor and cognitive dysfunction progression in PD. RECENT FINDINGS: Nineteen longitudinal cohort studies were included. Their main findings were that (1) REM sleep behavioral events, REM sleep without atonia (RSWA), and electroencephalography (EEG) changes (mainly microsleep instability) are predictors of the development of REM sleep behavior disorder (RBD); (2) RBD, RSWA, and lower slow-wave sleep energy predict motor progression; (3) RBD, EEG slowing, and sleep spindles changes are predictors of cognitive deterioration; and (4) OSA is associated with severe motor and cognitive symptoms at baseline, with inconsistent findings on the effect of continuous positive airway pressure (CPAP) therapy for these symptoms. The results of our systematic review support a role of the video-PSG in disease progression prediction in PD and its usefulness as a biomarker. However, future studies are needed to investigate whether treatment of these PSG abnormalities and sleep disturbances may have a neuroprotective effect on disease progression.
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