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Ventricular orexin-A (hypocretin-1) levels correlate with rapid-eye-movement sleep without atonia in Parkinson's disease

Authors Bridoux A, Moutereau S, Covali-Noroc A, Margarit L, Palfi S, Nguyen JP, Lefaucheur JP, Césaro P, d'Ortho M, Drouot X

Received 6 December 2012

Accepted for publication 28 February 2013

Published 12 June 2013 Volume 2013:5 Pages 87—91


Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 2

Agathe Bridoux,1,2 Stephane Moutereau,3 Ala Covali-Noroc,1 Laurent Margarit,1 Stephane Palfi,4 Jean-Paul Nguyen,5 Jean-Pascal Lefaucheur,1,2 Pierre Césaro,6 Marie-Pia d'Ortho,7 Xavier Drouot1,2

1Service de Physiologie, Groupe Henri Mondor, 2Faculté de Médecine, Université Paris Est Créteil, 3Service de Biochimie, Groupe Henri Mondor, 4UF Neurochirurgie Fonctionnelle, Groupe Henri Mondor, Créteil, France; 5Service de Neurochirurgie, Hôpital Nord Laënnec, Nantes, France; 6Service de Neurologie, Groupe Henri Mondor, Créteil, France; 7Service de Physiologie, Groupe Bichat – Claude Bernard, Paris, France

Objective: Patients with Parkinson's disease frequently complain of sleep disturbances and loss of muscle atonia during rapid-eye-movement (REM) sleep is not rare. The orexin-A (hypocretin-1) hypothalamic system plays a central role in controlling REM sleep. Loss of orexin neurons results in narcolepsy-cataplexy, a condition characterized by diurnal sleepiness and REM sleep without atonia. Alterations in the orexin-A system have been also documented in Parkinson's disease, but whether these alterations have clinical consequences remains unknown.
Methods: Here, we measured orexin-A levels in ventricular cerebrospinal fluid from eight patients with Parkinson's disease (four males and four females) who underwent ventriculography during deep brain-stimulation surgery and performed full-night polysomnography before surgery.
Results: Our results showed a positive correlation between orexin-A levels and REM sleep without muscle atonia.
Conclusion: Our results suggest that high levels of orexin-A in Parkinson's disease may be associated with loss of REM muscle atonia.

Keywords: Parkinson, orexin-A, ventricular CSF, REM atonia

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