OBJECTIVE: To examine the role of genes identified through genome-wide association studies (GWASs) of Parkinson disease (PD) in the risk of isolated REM sleep behavior disorder (iRBD). METHODS: We fully sequenced 25 genes previously identified in GWASs of PD in a total of 1,039 patients with iRBD and 1,852 controls. The role of rare heterozygous variants in these genes was examined with burden tests. The contribution of biallelic variants was further tested. To examine the potential effect of rare nonsynonymous BST1 variants on the protein structure, we performed in silico structural analysis. Finally, we examined the association of common variants using logistic regression adjusted for age and sex. RESULTS: We found an association between rare heterozygous nonsynonymous variants in BST1 and iRBD (p = 0.0003 at coverage >50× and 0.0004 at >30×), driven mainly by 3 nonsynonymous variants (p.V85M, p.I101V, and p.V272M) found in 22 (1.2%) controls vs 2 (0.2%) patients. All 3 variants seem to be loss-of-function variants with a potential effect on the protein structure and stability. Rare noncoding heterozygous variants in LAMP3 were also associated with iRBD (p = 0.0006 at >30×). We found no association between rare heterozygous variants in the rest of genes and iRBD. Several carriers of biallelic variants were identified, yet there was no overrepresentation in iRBD. CONCLUSION: Our results suggest that rare coding variants in BST1 and rare noncoding variants in LAMP3 are associated with iRBD. Additional studies are required to replicate these results and to examine whether loss of function of BST1 could be a therapeutic target.
- MeSH
- ADP-ribosylcyklasa genetika MeSH
- CD antigeny genetika MeSH
- celogenomová asociační studie MeSH
- databáze genetické MeSH
- genetická variace MeSH
- GPI-vázané proteiny genetika MeSH
- heterozygot MeSH
- lidé středního věku MeSH
- lidé MeSH
- membránové glykoproteiny asociované s lyzozomy genetika MeSH
- nádorové proteiny genetika MeSH
- počítačová simulace MeSH
- polysomnografie MeSH
- porucha chování v REM spánku epidemiologie genetika MeSH
- sekundární struktura proteinů MeSH
- senioři MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
OBJECTIVE: The aim of the present study was to investigate if prospective memory (PM) is impaired in idiopathic rapid eye movement (REM) sleep behavior disorder (iRBD). RBD is a parasomnia characterized by dream enactment and by REM sleep without muscle atonia. iRBD is considered as the initial stage of neurodegeneration with pathological storage of alpha-synuclein. METHOD: Sixty iRBD patients with polysomnography-confirmed RBD without parkinsonism and dementia and 30 demographically matched normal controls (NC) were enrolled in the present study. Clinical assessment included Movement Disorders Society-Unified Parkinson's Disease Rating Scale (MDS-UPDRS), dopamine transporter single-photon emission computed tomography (DaT-SPECT) for imaging synapses of dopaminergic neurons in the striatum and a neuropsychological battery with embedded time-based and event-based PM measures. RESULTS: iRBD differed significantly from NC in event-based PM, a number of event-based failures to recall intention and total PM performance (all p < .001) but did not differ in time-based PM and recognition. PM did not contribute to impairment of instrumental activities of daily living in iRBD. Despite being preserved in iRBD in comparison to NC, time-based PM correlated significantly with dopaminergic neuronal loss measured by DaT-SPECT. CONCLUSIONS: We show evidence for a differential pattern of PM impairment in iRBD with severe impairment of event-based and concurrent preservation of time-based PM. We theorize that event-based PM impairment in iRBD is caused by severe impairment of retention and recognition mechanisms in episodic memory whereas time-based PM seems to be affected by reduced striatal dopaminergic synapses.
- MeSH
- činnosti denního života psychologie MeSH
- epizodická paměť * MeSH
- jednofotonová emisní výpočetní tomografie metody MeSH
- lidé středního věku MeSH
- lidé MeSH
- neuropsychologické testy MeSH
- polysomnografie metody MeSH
- porucha chování v REM spánku diagnostické zobrazování epidemiologie psychologie MeSH
- poruchy paměti diagnostické zobrazování epidemiologie psychologie MeSH
- senioři MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- MeSH
- demence s Lewyho tělísky diagnóza etiologie patofyziologie MeSH
- diagnostické techniky neurologické * MeSH
- diferenciální diagnóza MeSH
- farmakoterapie * MeSH
- klinický obraz nemoci MeSH
- klonazepam aplikace a dávkování terapeutické užití MeSH
- lidé MeSH
- melatonin aplikace a dávkování terapeutické užití MeSH
- multisystémová atrofie diagnóza etiologie patofyziologie MeSH
- nemoci nervového systému diagnóza etiologie patofyziologie MeSH
- Parkinsonova nemoc diagnóza etiologie patofyziologie MeSH
- polysomnografie metody využití MeSH
- porucha chování v REM spánku * diagnóza epidemiologie etiologie MeSH
- spánek REM MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- práce podpořená grantem MeSH
OBJECTIVE: This controlled study investigated associations between comorbidity and medication in patients with polysomnographically confirmed idiopathic REM sleep behavior disorder (iRBD), using a large multicenter clinic-based cohort. METHODS: Data of a self-administered questionnaire on comorbidity and medication use of 318 patients with iRBD and 318 matched controls were analyzed. Comparisons between cases and controls were made using logistic regression analysis. RESULTS: Patients with iRBD were more likely to report depression (odds ratio [OR] 2.0, 95% confidence interval [CI] 1.3-2.9) and concomitant antidepressant use (OR 2.2, 95% CI 1.4-3.6). Subanalysis of antidepressant agents revealed that the increased use of antidepressants in iRBD was due to selective serotoninergic reuptake inhibitors (OR 3.6, 95% CI 1.8-7.0) and not due to other antidepressant classes. Patients with iRBD reported more lifetime antidepressant use than comorbid depression (antidepressant use: OR 1.9, 95% CI 1.1-3.3; depression: OR 1.6, 95% CI 1.0-2.5). Patients with iRBD reported more ischemic heart disease (OR 1.9, 95% CI 1.1-3.1). This association did not change substantially when adjusting for cardiovascular risk factors (OR 2.3, 95% CI 1.3-3.9). The use of inhaled glucocorticoids was higher in patients with iRBD compared to controls (OR 5.3, 95% CI 1.8-15.8), likely reflecting the higher smoking rate in iRBD (smoking: OR 15.3, 95% CI 2.0-118.8; nonsmoking: OR 2.4, 95% CI 0.4-13.2) and consequent pulmonary disease. CONCLUSIONS: This large study confirms the association between comorbid depression and antidepressant use in iRBD. In addition, there was an unexpected association of iRBD with ischemic heart disease that was not explained by cardiovascular risk factors.
- MeSH
- aplikace inhalační MeSH
- deprese farmakoterapie epidemiologie MeSH
- glukokortikoidy terapeutické užití MeSH
- ischemická choroba srdeční epidemiologie MeSH
- kohortové studie MeSH
- komorbidita MeSH
- kouření epidemiologie MeSH
- lidé středního věku MeSH
- lidé MeSH
- porucha chování v REM spánku farmakoterapie epidemiologie MeSH
- průzkumy a dotazníky MeSH
- rizikové faktory MeSH
- selektivní inhibitory zpětného vychytávání serotoninu terapeutické užití MeSH
- senioři MeSH
- studie případů a kontrol MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- multicentrická studie MeSH
- práce podpořená grantem MeSH
Narcolepsy-cataplexy (N-C) is a focal neurodegenerative disease with a genetic predisposition and autoimmune etiology; the pathogenesis of narcolepsy without cataplexy (Nw/oC) is less clear. One hundred and forty eight patients underwent clinical face-to face interviews, polysomnography, multiple sleep latency testing and HLA-DQB1*0602 typing. The cohort was divided into four age groups: children and adolescents under 19 years (N = 31), adults aged 20-39 years (N = 51), 40-59 years (N = 28) and over 60 years (N = 38). N-C was found in 93 adults (79.5 %) compared with 16 pediatric patients (51.6 %) (p < 0.01), suggesting that at least some of the children were candidates for developing cataplexy in the future. Statistical evaluation showed an increasing age-related proportion of associated sleep disorders-obstructive sleep apnea, periodic leg movements and restless leg syndrome (p < 0.001). Nw/oC patients showed sleep comorbidities less frequently than N-C group. A close connection with N-C was found particularly in REM behavior disorder (RBD) (p < 0.05). RBD affected a third of the patients in the youngest as well as in the oldest groups. However, association with other sleep disorders had no significant effect on nocturnal sleep (with the exception of obstructive sleep apnea), and the sleep comorbidities under study had no noticeable effect on daytime sleepiness.
- MeSH
- dítě MeSH
- dospělí MeSH
- kohortové studie MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladiství MeSH
- mladý dospělý MeSH
- narkolepsie diagnóza epidemiologie patofyziologie MeSH
- polysomnografie metody MeSH
- porucha chování v REM spánku diagnóza epidemiologie patofyziologie MeSH
- poruchy spánku a bdění diagnóza epidemiologie patofyziologie MeSH
- průřezové studie MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- stadia spánku fyziologie MeSH
- syndrom neklidných nohou diagnóza epidemiologie patofyziologie MeSH
- věkové faktory MeSH
- Check Tag
- dítě MeSH
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladiství MeSH
- mladý dospělý MeSH
- mužské pohlaví MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- srovnávací studie MeSH
BACKGROUND: Obstructive sleep apnoea (OSA) is a condition leading to excessive daytime sleepiness. The aim of the study was a) to study course of daytime sleepiness in patients with OSA and b) to find the most important nocturnal polysomnography parameters influencing daytime sleepiness in OSA. METHODS: The cohort consisted of forty-five patients (6 women, 39 men) diagnosed with OSA. All patients underwent polysomnography, Multiple Sleep Latency Test (MSLT) and rated subjectively their daytime tendency to sleep with the Epworth Sleepiness Scale. RESULTS: Sleep latency was significantly longer at 15:00 and at 17:00 hours compared to previous tests. A significant negative correlation was found between the mean of the MSLT sleep latency and a number of awakenings, the apnoea/hypopnoea index and oxygen desaturation index values. CONCLUSIONS: The study showed the sleep latency prolongation at 15:00 and 17:00 hours respectively and confirmed connection of excessive daytime sleepiness to fragmentation of nocturnal sleep and OSA severity.
- MeSH
- cirkadiánní rytmus fyziologie MeSH
- dospělí MeSH
- kardiovaskulární nemoci epidemiologie MeSH
- kohortové studie MeSH
- komorbidita MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladý dospělý MeSH
- obstrukční spánková apnoe diagnóza epidemiologie patofyziologie MeSH
- polysomnografie MeSH
- porucha chování v REM spánku epidemiologie patofyziologie MeSH
- poruchy nadměrné spavosti epidemiologie patofyziologie MeSH
- senioři MeSH
- spánek fyziologie MeSH
- stadia spánku fyziologie MeSH
- syndrom neklidných nohou epidemiologie patofyziologie MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladý dospělý MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH