Highlights for Ms: Clinically Relevant Cut-Off Values for the Parkinson's Disease Sleep Scale-2 (PDSS-2): a Validation Study • Nocturnal disturbances are an important part of non-motor symptoms in ...Parkinson's disease (PD). • A PDSS-2 total score ≥18 may provide a cut-off value that could be used in routine clinical practice. • This score can help identify clinically relevant/severe PD-specific sleep problems.
Abstract Parkinson’s disease is increasingly prevalent. It progresses from the pre-motor stage (characterised by non-motor symptoms like REM sleep behaviour disorder), to the disabling motor stage. ...We need objective biomarkers for early/pre-motor disease stages to be able to intervene and slow the underlying neurodegenerative process. Here, we validate a targeted multiplexed mass spectrometry assay for blood samples from recently diagnosed motor Parkinson’s patients ( n = 99), pre-motor individuals with isolated REM sleep behaviour disorder (two cohorts: n = 18 and n = 54 longitudinally), and healthy controls ( n = 36). Our machine-learning model accurately identifies all Parkinson patients and classifies 79% of the pre-motor individuals up to 7 years before motor onset by analysing the expression of eight proteins—Granulin precursor, Mannan-binding-lectin-serine-peptidase-2, Endoplasmatic-reticulum-chaperone-BiP, Prostaglaindin-H2-D-isomaerase, Interceullular-adhesion-molecule-1, Complement C3, Dickkopf-WNT-signalling pathway-inhibitor-3, and Plasma-protease-C1-inhibitor. Many of these biomarkers correlate with symptom severity. This specific blood panel indicates molecular events in early stages and could help identify at-risk participants for clinical trials aimed at slowing/preventing motor Parkinson’s disease.
Zusammenfassung
Das Restless-legs-Syndrom (RLS) ist mit einer Prävalenz von bis zu 10 % eine häufige neurologische Erkrankung und die häufigste Bewegungsstörung im Schlaf. Ein Bewegungsdrang der ...Beine kann mit sensorischen Symptomen und Schlafstörungen zu einer erheblichen Beeinträchtigung der Lebensqualität führen. Das RLS tritt häufig als Komorbidität bei internistischen und neurologischen Erkrankungen auf. RLS wird klinisch anhand fünf essenzieller Kriterien diagnostiziert. Therapeutisch sollte ein Eisenmangel ausgeschlossen bzw. substituiert werden. Zur Pharmakotherapie zugelassen sind L‑DOPA/Benserazid und Dopaminagonisten sowie Oxycodon/Naloxon als Zweitlinientherapie bei schweren Fällen. Augmentation als Verschlimmerung der Symptome unter hochdosierter dopaminerger Medikation ist eine klinisch definierte Komplikation, die spezielle Managementstrategien erfordert. Bei einer Prävalenz von bis zu 25 % spielt RLS bei der Betreuung schwangerer Frauen eine wichtige Rolle.
Insomnia in neurological diseases Mayer, Geert; Happe, Svenja; Evers, Stefan ...
Neurological research and practice,
03/2021, Letnik:
3, Številka:
1
Journal Article
Recenzirano
Odprti dostop
Insomnia is defined as difficulties of initiating and maintaining sleep, early awakening and poor subjective sleep quality despite adequate opportunity and circumstances for sleep with impairment of ...daytime performance. These components of insomnia - namely persistent sleep difficulties despite of adequate sleep opportunity resulting in daytime dysfunction - appear secondary or co-morbid to neurological diseases. Comorbid insomnia originates from neurodegenerative, inflammatory, traumatic or ischemic changes in sleep regulating brainstem and hypothalamic nuclei with consecutive changes of neurotransmitters. Symptoms of neurological disorders (i.e motor deficits), co-morbidities (i.e. pain, depression, anxiety) and some disease-specific pharmaceuticals may cause insomnia and/or other sleep problems.This guideline focuses on insomnias in headaches, neurodegenerative movement disorders, multiple sclerosis, traumatic brain injury, epilepsies, stroke, neuromuscular disease and dementia.The most important new recommendations are: Cognitive behavioral therapy (CBTi) is recommended to treat acute and chronic insomnia in headache patients. Insomnia is one of the most frequent sleep complaints in neurodegenerative movement disorders. Patients may benefit from CBTi, antidepressants (trazodone, doxepin), melatonin and gaba-agonists. Insomnia is a frequent precursor of MS symptoms by up to 10 years. CBTi is recommended in patients with MS, traumatic brain injury and. Melatonin may improve insomnia symptoms in children with epilepsies. Patients with insomnia after stroke can be treated with benzodiazepine receptor agonists and sedating antidepressants. For patients with dementia suffering from insomnia trazodone, light therapy and physical exercise are recommended.
This study delves into the critical role of alarmins in chronic spontaneous urticaria (CSU), focusing on their impact on disease severity and the quality of life (QoL) of patients. We investigated ...the alterations in alarmin levels in CSU patients and their correlations with the Urticaria Activity Score (UAS7) and the Dermatology Life Quality Index (DLQI). We analyzed serum levels of interleukin-25 (IL-25), interleukin-33 (IL-33), and thymic stromal lymphopoietin (TSLP) in 50 CSU patients, comparing these to 38 healthy controls. The study examined the relationship between alarmin levels and clinical outcomes, including disease severity and QoL. Elevated levels of IL-33 and TSLP in CSU patients (
< 0.0001) highlight their potential role in CSU pathogenesis. Although IL-25 showed higher levels in CSU patients, this did not reach statistical significance (
= 0.0823). Crucially, IL-33's correlation with both UAS7 and DLQI scores underscores its potential as a biomarker for CSU diagnosis and severity assessment. Of the alarmins analyzed, IL-33 emerges as particularly significant for further exploration as a diagnostic and prognostic biomarker in CSU. Its substantial correlation with disease severity and impact on QoL makes it a compelling candidate for future research, potentially serving as a target for therapeutic interventions. Given these findings, IL-33 deserves additional investigation to confirm its role and effectiveness as a biomarker and therapeutic target in CSU.
Lysosomal and synaptic dysfunctions are hallmarks in neurodegeneration and potentially relevant as biomarkers, but data on early Parkinson's disease (PD) is lacking. We performed targeted mass ...spectrometry with an established protein panel, assessing autophagy and synaptic function in cerebrospinal fluid (CSF) of drug-naïve de novo PD, and sex-/age-matched healthy controls (HC) cross-sectionally (88 PD, 46 HC) and longitudinally (104 PD, 58 HC) over 10 years. Multiple markers of autophagy, synaptic plasticity, and secretory pathways were reduced in PD. We added samples from prodromal subjects (9 cross-sectional, 12 longitudinal) with isolated REM sleep behavior disorder, revealing secretogranin-2 already decreased compared to controls. Machine learning identified neuronal pentraxin receptor and neurosecretory protein VGF as most relevant for discriminating between groups. CSF levels of LAMP2, neuronal pentraxins, and syntaxins in PD correlated with clinical progression, showing predictive potential for motor- and non-motor symptoms as a valid basis for future drug trials.
Restless-legs-Syndrom: ein Update Bartl, Michael; Trenkwalder, Claudia; Muntean, Maria-Lucia ...
Somnologie : Schlafforschung und Schlafmedizin = Somnology : sleep research and sleep medicine,
12/2020, Letnik:
24, Številka:
4
Journal Article
Recenzirano
Zusammenfassung
Das Restless-legs-Syndrom (RLS) ist mit einer Prävalenz von bis zu 10 % eine häufige neurologische Erkrankung und die häufigste Bewegungsstörung im Schlaf. Ein Bewegungsdrang der ...Beine kann mit sensorischen Symptomen und Schlafstörungen zu einer erheblichen Beeinträchtigung der Lebensqualität führen. Das RLS tritt häufig als Komorbidität bei internistischen und neurologischen Erkrankungen auf. RLS wird klinisch anhand fünf essenzieller Kriterien diagnostiziert. Therapeutisch sollte ein Eisenmangel ausgeschlossen bzw. substituiert werden. Zur Pharmakotherapie zugelassen sind L‑DOPA/Benserazid und Dopaminagonisten sowie Oxycodon/Naloxon als Zweitlinientherapie bei schweren Fällen. Augmentation als Verschlimmerung der Symptome unter hochdosierter dopaminerger Medikation ist eine klinisch definierte Komplikation, die spezielle Managementstrategien erfordert. Bei einer Prävalenz von bis zu 25 % spielt RLS bei der Betreuung schwangerer Frauen eine wichtige Rolle.
Augmentation can occur frequently in restless legs syndrome (RLS) patients treated with dopaminergic agents. Video-polysomnographic (PSG) data from augmented RLS patients are scant. The aim of this ...study was to evaluate PSG findings in augmented RLS patients and compare them with those of non-augmented RLS patients.
Valid PSG data were analyzed from 99 augmented and 84 non-augmented RLS inpatients who underwent one night PSG.
Both patient groups showed a high subjective burden of RLS symptoms. The mean scores on the International RLS Study Group Rating Scale (IRLS) were significantly higher in the group with augmentation than in the group without. The periodic leg movement index (PLMI) was increased in both groups, mostly on account of the PLM in wakefulness (PLMW). Both groups presented a reduced sleep efficiency and an increased sleep latency. The levodopa equivalent dose (LED) was significantly higher in the augmented group.
Our study confirms that RLS patients with augmentation have disturbed sleep due to high amount of leg movements and fragmented sleep. Overall, however, polysomnographic characteristics were not different between insufficiently treated RLS and severely augmented RLS patients, implying that augmentation could represent a severe form of RLS and not a different phenomenon.
•RLS patients with augmentation have very disturbed sleep.•Leg movements increased, mainly in wakefulness, despite high dopaminergic doses.•Insufficiently treated RLS and severely augmented RLS had similar PSG results.•Augmentation could represent a severe form of RLS and not a different phenomenon.
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