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Published on: July 19, 2019
Cerebrospinal fluid hypocretin-1 levels in multiple system atrophy
Jose Enrique Martinez-Rodriguez1, Klaus Seppi, Adriana Cardozo
1Neurology Service, Hospital Clínic de Barcelona and Institut d'Investigació Biomèdica August Pi i Sunyer (IDIBAPS), University of Barcelona Medical School, Barcelona, Spain.
Summary
Cerebrospinal fluid hypocretin-1 levels were normal in multiple system atrophy (MSA) patients, suggesting the hypocretin system is unaffected in this synucleinopathy, unlike other related disorders.
Area of Science:
- Neuroscience
- Sleep Medicine
- Neurology
Background:
- Synucleinopathies like Dementia with Lewy bodies and Parkinson disease are linked to altered hypocretin (orexin) levels and excessive daytime sleepiness (EDS).
- Multiple system atrophy (MSA) is another synucleinopathy where sleep disturbances, including EDS, are common, but its hypocretin system status is less understood.
Purpose of the Study:
- To investigate cerebrospinal fluid (CSF) hypocretin-1 levels in patients with moderately severe MSA.
- To assess for excessive daytime sleepiness (EDS) and sleep onset REM (SOREM) periods using electrophysiological studies in MSA patients.
Main Methods:
- Measured CSF hypocretin-1 levels in 15 patients with moderately severe MSA.
- Conducted polysomnography and Multiple Sleep Latency Test (MSLT) in 5 MSA patients to evaluate sleep patterns and daytime sleepiness.
Main Results:
- All 15 MSA patients exhibited normal CSF hypocretin-1 levels (above 200 pg/mL).
- No SOREM periods were detected in the 5 patients who underwent polysomnography and MSLT.
- While nocturnal sleep efficiency was reduced, mean sleep latencies during the day were within normal limits.
Conclusions:
- The hypocretin system appears to be preserved in moderately severe MSA.
- Unlike other synucleinopathies, MSA may not involve hypocretin deficiency as a cause of sleep disorders or EDS.
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