Sleep Problems Are Related to a Worse Quality of Life and a Greater Non-Motor Symptoms Burden in Parkinson's Disease.

INTRODUCTION: The aim of the present study was to examine the frequency of self-reported sleep problems and their associated factors in a large cohort of PD patients. METHODS: PD patients and controls, recruited from 35 centers of Spain from the COPPADIS cohort were included in this cross-sectional study. Sleep problems were assessed by the Spanish version of the Parkinson's disease Sleep Scale version 1 (PDSS-1). An overall score below 82 or a score below 5 on at least 1 item was defined as sleep problems. RESULTS: The frequency of sleep problems was nearly double in PD patients compared to controls: 65.8% (448/681) vs 33.5% (65/206) (p < 0.0001). Mean total PDSS score was lower in PD patients than controls: 114.9 ± 28.8 vs 132.8 ± 16.3 (p < 0.0001). Quality of life (QoL) was worse in PD patients with sleep problems compared to those without: PDQ-39SI, 19.3 ± 14 vs 13 ± 11.6 (p < 0.0001); EUROHIS-QoL8, 3.7 ± 0.5 vs 3.9 ± 0.5 (p < 0.0001). Non-motor symptoms burden (NMSS; OR = 1.029; 95%CI 1.015-1.043; p < 0.0001) and impulse control behaviors (QUIP-RS; OR = 1.054; 95%CI 1.009-1.101; p = 0.018) were associated with sleep problems after adjustment for age, gender, disease duration, daily equivalent levodopa dose, H&Y, UPDRS-III, UPDRS-IV, PD-CRS, BDI-II, NPI, VAS-Pain, VAFS, FOGQ, and total number of non-antiparkinsonian treatments. CONCLUSION: Sleep problems were frequent in PD patients and were related to both a worse QoL and a greater non-motor symptoms burden in PD. These findings call for increased awareness of sleep problems in PD patients.

[L-dopa sensitive Parkinsonism in neurocysticercosis]. / Parkinsonismo sensible a levodopa en neurocisticercosis.

INTRODUCTION: Neurocysticercosis (NC) is a chronic parasitary disease that may have different neurological manifestations, such as seizures, dementia or obstructive hydrocephalus. On rare occasions, pictures secondary to hydrocephalia may occur with Parkinsonian syndrome. CASE REPORT: We present the case of a 29-year old woman with serologically confirmed NC and obstructive hydrocephalia secondary to a cyst in the IV ventricle. The patient required repeated ventricle-peritoneal shunt replacement because of valvular malfunction and obstructive hydrocephalia. She developed Parkinsonian's syndrome, which subsided after combined treatment with cysticidal drugs and L-dopa. DISCUSSION: Parkinsonian syndrome is an atypical presentation in NC. In this case, the above-mentioned profile is found within the context of multiple valvular malfunctions who nature is reversible after appropriate treatment. It seems to be related with increases in intraventricular cerebrospinal fluid pressure. We can conclude that Parkinsonian syndromes may be one more expression of NC. This acquires greater importance according to its context, in addition to the limited presence of similar cases in our environment in the literature.