The path linking excessive daytime sleepiness and activity of daily living in Parkinson’s disease: the longitudinal mediation effect of autonomic dysfunction

Huang, Ying; Du, Sidan; Chen, Durong; Qin, Yao; Cui, Jing; Han, Ho Jae; Ge, Xiaoyan; Bai, Wenlin; Zhang, Xinnan; Yu, Hongmei

doi:10.1007/s10072-022-06081-0

Cited by 5 publications

(2 citation statements)

References 37 publications

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“…[9] We found autonomic symptoms were positively associated with ESS scores, which was supported by a recent study showing that more severe EDS in PD patients was in parallel with more worsened autonomic symptoms. [41] A previous study showed that female sex, high HY stage, high UPDRS total and subtotal scores, and cognitive decline were significantly associated with depressive symptoms. [42] In this study, we found autonomic symptoms were also associated with depressive symptoms, which was consistent with the results reported by a multi-center cohort study in China.…”

Section: Discussionmentioning

confidence: 99%

Both brain network topology and striatal dopamine depletion mediate the effects of autonomic dysfunction on disease burden of Parkinson’s disease

Chen,

Li,

Zhou

et al. 2023

Preprint

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Background: Autonomic dysfunction is one of the most common non-motor symptoms in Parkinson's disease (PD). Whether autonomic dysfunction contributes to disease progression and brain network abnormalities in PD remain largely unknown. The objective of this study is to evaluate how autonomic dysfunction affects clinical features and brain networks of PD patients. Methods: PD patients from Parkinson's Progression Markers Initiative (PPMI) database were included if they received magnetic resonance imaging. According to the scores of Scale for Outcomes in Parkinson's Disease-Autonomic (SCOPA-AUT), PD patients were classified into lower quartile group (SCOPA-AUT score rank: 0%~25%), interquartile group (SCOPA-AUT score rank: 26%~75%), and upper quartile group (SCOPA-AUT score rank: 76%~100%) based on their SCOPA-AUT score quartiles to examine how autonomic dysfunction shapes clinical manifestations and brain networks. Results: PD patients in the upper quartile group showed more severe motor and non-motor symptoms, as well as more deficits in dopamine transporter binding compared to lower quartile group. Additionally, they also showed statistically different topological properties in structural and functional network compared to lower quartile group. Both structural and functional network metrics mediated the effects of autonomic dysfunction on clinical symptoms of PD patients. Reduced dopamine transporter binding also contributed to the effects of autonomic dysfunction on disease burden of PD patients. Conclusions: PD patients with more severe autonomic dysfunction exhibit worse disease and impairment of brain network topology. Both network topology and striatal dopamine depletion mediate the effects of autonomic dysfunction on clinical symptoms of PD patients.

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Section: Discussionmentioning

confidence: 99%

Both brain network topology and striatal dopamine depletion mediate the effects of autonomic dysfunction on disease burden of Parkinson’s disease

Chen,

Li,

Zhou

et al. 2023

Preprint

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“…The issue of EDS and its relationship with cognitive impairment may be relevant during the clinical interview: for this reason, the presence of caregivers is crucial when assessing EDS in these patients. Furthermore, deteriorated autonomic function assessed with the Scale for Outcomes in Parkinson's disease -Autonomic Symptoms (SCOPA-AUT) was related to EDS in PD patients and could worsen the ADLs in these patients (Huang et al, 2022). Orthostatic hypotension may be particularly invalidating, and its presence should be assessed by clinicians when patients report fatigability and difficulty in activities worsening with orthostatism.…”

Section: Risk Factorsmentioning

confidence: 99%

Daytime sleepiness in Parkinson's disease: a multifaceted symptom

Di Laudo,

Baldelli,

Mainieri

et al. 2023

Front. Sleep

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Excessive daytime sleepiness is a symptom experienced by more than one-third of patients with Parkinson's disease and is associated with disease duration and severity, dopaminergic therapy, and several non-motor symptoms. In recent years, growing evidence has been suggesting “primary” sleepiness as a symptom in Parkinson's disease due to common pathophysiological features: for this reason, it is crucial to recognize sleepiness in these patients and to investigate and exclude other conditions possibly leading to sleepiness (e.g., heavy dopaminergic therapy or breathing disorders during sleep). For both inpatients and outpatients, the key to a correct diagnosis is a structured clinical interview, together with questionnaires, for a better characterization of symptoms and the use of objective measures as the most precise method to assess excessive daytime sleepiness. Finally, there are some therapeutical approaches that may be attempted for these patients, and although there is still no consensus on a standardized therapy, clinical trials with new drugs are currently persevered on.

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Temporal Sequence of Cognitive Function and ADLs and Mediation Effect of Apathy in Parkinson’s Disease: Cross-Lagged Analyses

Cui,

Lu,

et al. 2024

Clinical Gerontologist

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The path linking excessive daytime sleepiness and activity of daily living in Parkinson’s disease: the longitudinal mediation effect of autonomic dysfunction

Cited by 5 publications

References 37 publications

Both brain network topology and striatal dopamine depletion mediate the effects of autonomic dysfunction on disease burden of Parkinson’s disease

Both brain network topology and striatal dopamine depletion mediate the effects of autonomic dysfunction on disease burden of Parkinson’s disease

Daytime sleepiness in Parkinson's disease: a multifaceted symptom

Temporal Sequence of Cognitive Function and ADLs and Mediation Effect of Apathy in Parkinson’s Disease: Cross-Lagged Analyses

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