RESUMEN
Excessive daytime sleepiness has been widely accepted as a common problem not only in Parkinson's disease (PD) but also in other related disorders. Lowered excretion of orexin A (hypocretin 1) into the cerebrospinal fluid (CSF) is known to play a pathological role in narcolepsy and secondary hypersomnia due to hypothalamic dysfunction. Although the levels of CSF orexin in PD have been previously examined, the results have been controversial, and no systematic investigation of CSF orexin excretion has been conducted on PD related disorders. In this study, orexin was measured in CSF collected by lumbar puncture in 62 patients with PD, 13 patients with dementia with Lewy bodies (DLB), 16 patients with progressive supranuclear palsy (PSP), and 7 patients with corticobasal degeneration (CBD). Levels of CSF orexin (mean+/-SD pg/ml) were 302+/-38 in PD, 297+/-48 in DLB, 258+/-37 in PSP, 246+/-90 in CBD. The occurrence of low orexin levels (Asunto(s)
Péptidos y Proteínas de Señalización Intracelular/líquido cefalorraquídeo
, Enfermedad por Cuerpos de Lewy/líquido cefalorraquídeo
, Neuropéptidos/líquido cefalorraquídeo
, Enfermedad de Parkinson/líquido cefalorraquídeo
, Esclerodermia Difusa/líquido cefalorraquídeo
, Trastornos del Sueño-Vigilia/líquido cefalorraquídeo
, Anciano
, Anciano de 80 o más Años
, Biomarcadores/análisis
, Biomarcadores/líquido cefalorraquídeo
, Proteínas del Líquido Cefalorraquídeo/análisis
, Proteínas del Líquido Cefalorraquídeo/metabolismo
, Progresión de la Enfermedad
, Regulación hacia Abajo/fisiología
, Femenino
, Humanos
, Hipotálamo/metabolismo
, Hipotálamo/fisiopatología
, Enfermedad por Cuerpos de Lewy/diagnóstico
, Enfermedad por Cuerpos de Lewy/fisiopatología
, Masculino
, Persona de Mediana Edad
, Orexinas
, Enfermedad de Parkinson/diagnóstico
, Enfermedad de Parkinson/fisiopatología
, Valor Predictivo de las Pruebas
, Esclerodermia Difusa/diagnóstico
, Esclerodermia Difusa/fisiopatología
, Trastornos del Sueño-Vigilia/etiología
, Trastornos del Sueño-Vigilia/fisiopatología
, Punción Espinal
RESUMEN
Hypocretin-1 is involved in the regulation of the sleep-wake cycle. The authors prospectively assessed CSF hypocretin-1 levels in 44 consecutive patients with acute traumatic brain injury (TBI). Compared with controls, hypocretin-1 levels were abnormally lower in 95% of patients with moderate to severe TBI and in 97% of patients with posttraumatic brain CT changes. Hypocretin-1 deficiency after TBI may reflect hypothalamic damage and be linked with the frequent development of posttraumatic sleep-wake disorders.