Background: Sleep-related disturbances and sleep disorders are common in Parkinson’s disease (PD) and have a great impact on daily life of PD patients. This study was done to find the sleep characteristics and sleep disturbing factors in PD patients according to disease severity through clinical interview and polysomnographic (PSG) study. Methods: Fifty patients with PD (22 males, age 60.6 ± 6.4, Hoehn and Yahr (HY) stage 2.7 ± 1.0) were recruited and thoroughly interviewed about their sleep. PSG was performed on the patients taking routine antiparkinsonian medications. Patients were grouped into mild and moderate/severe group according to HY stage, and the results were compared between each group. Results: Ninety-four percent of total patients had one or more sleep-related disturbances based on the interview or PSG. On interview, the moderate/severe group complained more insomnia and REM sleep behavior disorder (RBD) than mild group. In PSG findings, the moderate/severe group showed lower sleep efficiency, longer sleep latency, REM sleep latency, waking time after sleep onset, and higher prevalence of RBD. Conclusions: In this study, most patients with PD had sleep disturbances. Clinical interview and PSG findings revealed deterioration of sleep quality along the disease severity. Our results suggest that sleep disturbances in PD patients are prevalent and warrant clinical attention, especially to the patients with advanced disease.

Citations

• A Case Study of Parkinson’s Disease Patient with Anxiety and Insomnia Treated with Korean-medicine Treatment, including Gyejigayonggolmolye-tang
  Eun-chai Cho, Ji-soo Yang, Jae-hwan Lew
  The Journal of Internal Korean Medicine.2023; 44(5): 846.     CrossRef

Background
: The generators of N37 and P37 of posterior tibial nerve somatosensory evoked potential(PTSEP) have not been exactly known. Recently, some reports suggested that P37 and N37 might have different generator. We conducted a study to know the generators of P37 and N37 of PTSEP using gating mechanism. Methods : We evaluated subcortical and cortical somatosensory evoked potentials(SEPs) in response to posterior tibial nerve stimulation in 2 experimental conditions of foot movement and compared them with PTSEPs in full relaxation of foot. The experimental conditions were: (a) active flextion-extention of stimulated foot, (b) isometric contraction of the stimulated foot, (c) passive flextion-extention of the stimulate foot. We analyzed the latencies and amplitudes of following potentials;P30, N37, P37, and N50. Results : The amplitude of P30 potential did not change during at any paradigms. Te amplitudes of P37 and N50 were significantly attenuated in all condition. However, the amplitude of N37 showed no significant change during at any paradigms. Conclusions : These results suggest that the generators of P37 and N37 pf PTSEP be different I cortex.

Dystonia is a movement disorder characterized by sustained, involuntary muscle contractions leading to abnormal postures. Using EMG recordings, three types of involuntary activity can be seen in dystonia. There are abnormalities in many different types of reflexes in dystonia. In view of the strong connection between the basal ganglia and motor areas of the cerebral cortex, there have been several investigations suggesting defects in cortical function including movement-related cortical potentials and contingent negative variation in patients with dystonia. Although dystonia is considered as a movement disorder, there are several phenomena relating to the sensory system that might suggest that dystonia could be primarily a sensory disorder. It is suggested that loss of inhibition from basal ganglia both at the cortical level and brainstem and spinal cord leading to defective control of interneuronal excitability be an important role for the pathogenesis of dystonia.