Sleep disturbances and brain MRI morphometry in Parkinson's disease, multiple system atrophy and progressive supranuclear palsy – a comparative study

Gama, Rômulo L.; Távora, Daniel G.; Bomfim, Rodrigo C.; Silva, Cruiff E.; de Bruin, Veralice M.; de Bruin, Pedro F.C.

doi:10.1016/j.parkreldis.2010.01.002

« Previous Next »Parkinsonism & Related Disorders
Volume 16, Issue 4 , Pages 275-279, May 2010

Sleep disturbances and brain MRI morphometry in Parkinson's disease, multiple system atrophy and progressive supranuclear palsy – a comparative study☆

Rômulo L. Gama
- Department of Radiology, Sarah Network of Hospitals for Rehabilitation, Fortaleza, CE, Brazil
- Research project: A. conception, B. organization, C. execution (R.L. Gama: 1A, 1B, 1C, 3A, D.G. Tavora: 1B, 1C, 3B, R.C. Bomfim: 1B, 1C, 3B, V.M.S. Bruin: 1A, 1B, 1C, 2C, 3A, 3B, P.F.C. Bruin: 1A, 1B, 1C, 3A, 3B).
- Manuscript: A. writing of the first draft, B. review and critique (R.L. Gama: 1A, 1B, 1C, 3A, D.G. Tavora: 1B, 1C, 3B, R.C. Bomfim: 1B, 1C, 3B, V.M.S. Bruin: 1A, 1B, 1C, 2C, 3A, 3B, P.F.C. Bruin: 1A, 1B, 1C, 3A, 3B).
Daniel G. Távora
- Department of Radiology, Sarah Network of Hospitals for Rehabilitation, Fortaleza, CE, Brazil
- Research project: A. conception, B. organization, C. execution (R.L. Gama: 1A, 1B, 1C, 3A, D.G. Tavora: 1B, 1C, 3B, R.C. Bomfim: 1B, 1C, 3B, V.M.S. Bruin: 1A, 1B, 1C, 2C, 3A, 3B, P.F.C. Bruin: 1A, 1B, 1C, 3A, 3B).
- Manuscript: A. writing of the first draft, B. review and critique (R.L. Gama: 1A, 1B, 1C, 3A, D.G. Tavora: 1B, 1C, 3B, R.C. Bomfim: 1B, 1C, 3B, V.M.S. Bruin: 1A, 1B, 1C, 2C, 3A, 3B, P.F.C. Bruin: 1A, 1B, 1C, 3A, 3B).
Rodrigo C. Bomfim
- Department of Radiology, Sarah Network of Hospitals for Rehabilitation, Fortaleza, CE, Brazil
- Research project: A. conception, B. organization, C. execution (R.L. Gama: 1A, 1B, 1C, 3A, D.G. Tavora: 1B, 1C, 3B, R.C. Bomfim: 1B, 1C, 3B, V.M.S. Bruin: 1A, 1B, 1C, 2C, 3A, 3B, P.F.C. Bruin: 1A, 1B, 1C, 3A, 3B).
- Manuscript: A. writing of the first draft, B. review and critique (R.L. Gama: 1A, 1B, 1C, 3A, D.G. Tavora: 1B, 1C, 3B, R.C. Bomfim: 1B, 1C, 3B, V.M.S. Bruin: 1A, 1B, 1C, 2C, 3A, 3B, P.F.C. Bruin: 1A, 1B, 1C, 3A, 3B).
Cruiff E. Silva
- Department of Statistics, Sarah Network of Hospitals for Rehabilitation, Fortaleza, CE, Brazil
- Statistical analysis: A. design, B. execution, C. review and critique (C.E. Silva: 2A, 2B, 2C, V.M.S. Bruin: 1A, 1B, 1C, 2C, 3A, 3B).
Veralice M. de Bruin
- Department of Medicine, Federal University of Ceará, Fortaleza, CE, Brazil
- Corresponding author at: Department of Medicine, Universidade Federal do Ceará, Rua Prof. Costa Mendes 1608 – 4^° Andar CEP: 60430 040, Fortaleza, Ceará, Brazil. Tel.: +55 85 3242 1681; fax: +55 85 3261 5540.
- Research project: A. conception, B. organization, C. execution (R.L. Gama: 1A, 1B, 1C, 3A, D.G. Tavora: 1B, 1C, 3B, R.C. Bomfim: 1B, 1C, 3B, V.M.S. Bruin: 1A, 1B, 1C, 2C, 3A, 3B, P.F.C. Bruin: 1A, 1B, 1C, 3A, 3B).
- Statistical analysis: A. design, B. execution, C. review and critique (C.E. Silva: 2A, 2B, 2C, V.M.S. Bruin: 1A, 1B, 1C, 2C, 3A, 3B).
- Manuscript: A. writing of the first draft, B. review and critique (R.L. Gama: 1A, 1B, 1C, 3A, D.G. Tavora: 1B, 1C, 3B, R.C. Bomfim: 1B, 1C, 3B, V.M.S. Bruin: 1A, 1B, 1C, 2C, 3A, 3B, P.F.C. Bruin: 1A, 1B, 1C, 3A, 3B).
Pedro F.C. de Bruin
- Department of Medicine, Federal University of Ceará, Fortaleza, CE, Brazil
- Research project: A. conception, B. organization, C. execution (R.L. Gama: 1A, 1B, 1C, 3A, D.G. Tavora: 1B, 1C, 3B, R.C. Bomfim: 1B, 1C, 3B, V.M.S. Bruin: 1A, 1B, 1C, 2C, 3A, 3B, P.F.C. Bruin: 1A, 1B, 1C, 3A, 3B).
- Manuscript: A. writing of the first draft, B. review and critique (R.L. Gama: 1A, 1B, 1C, 3A, D.G. Tavora: 1B, 1C, 3B, R.C. Bomfim: 1B, 1C, 3B, V.M.S. Bruin: 1A, 1B, 1C, 2C, 3A, 3B, P.F.C. Bruin: 1A, 1B, 1C, 3A, 3B).

Received 28 September 2009; received in revised form 28 December 2009; accepted 18 January 2010.

Abstract

Despite common reports in Parkinson's disease (PD), in other parkinsonian syndromes, sleep disturbances have been less frequently described. This study evaluated and compared sleep disturbances in patients with PD, multiple system atrophy (MSA) and progressive supranuclear palsy (PSP) and analyzed associations with brain magnetic resonance imaging (MRI) morphometry. This was a cross-sectional study of 16 PD cases, 13 MSA, 14 PSP and 12 control. Sleep disturbances were evaluated by Epworth Sleepiness Scale, Pittsburgh Sleep Quality Index (PSQI), Restless Legs Scale and Berlin questionnaire. Pons area, midbrain area, medial cerebellar peduncle (MCP) width, and superior cerebellar peduncle width were measured using MRI. Poor quality sleep, risk of obstructive sleep apnea (OSA) and restless legs syndrome (RLS) were detected in all groups. Patients with MSA showed higher risk of OSA and less frequent RLS. In MSA, a correlation between PSQI scores and Hoehn and Yahr stage was observed (p<0.05). In PSP, RLS was frequent (57%) and related with reduced sleep duration and efficiency. In PD, excessive daytime sleepiness was related to atrophy of the MCP (p=0.01). RLS was more frequent in PD and PSP, and in PSP, was associated with reduced sleep efficiency and sleep duration. Brain morphometry abnormalities were found in connection with excessive daytime sleepiness and risk of OSA in PD and PSP suggesting widespread degeneration of brainstem sleep structures on the basis of sleep abnormalities in these patients.