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Unformatted text preview: REVIEW ARTICLE Sleep disorders in neurodegenerative diseases A. Raggi and R. Ferri Department of Neurology I.C., Oasi Institute for Research on Mental Retardation and Brain Aging (IRCCS), Troina, Italy Keywords: neurodegenerative diseases, pathophysiology, REM sleep behaviour disorder, sleep disorders, synucleinopathy, tauopathy Received 25 November 2009 Accepted 9 March 2010 The aim of this review is to provide data on sleep disturbances in three categories of neurodegenerative disorders: synucleinopathies, tauopathies, and other diseases (this heterogeneous group includes also spinocerebellar degeneration and amyotrophic lateral sclerosis). Analysing and knowing sleep disorders in neurodegenerative diseases may offer important insights into the pathomechanism of some of these diseases and calls attention to the still insuciently known sleep neurology . The identification of sleep disorders in some neurodegenerative conditions may make their diagnosis easier and earlier; for example, rapid eye movements sleep behaviour disorder may precede any other clinical manifestation of synucleinopathies by more than 10 years. Introduction Neurodegenerative diseases result from deterioration of neurons which may eventually lead to central nervous system (CNS)-related dysfunction including sleep dis- orders. The pathogenesis of these disturbances may be secondary to direct structural alterations of the sleep- wake generating cells and networks or be the conse- quence of several indirect mechanisms. Here, we classify the neurodegenerative diseases, taking into consideration the type of molecular neu- rodegeneration, as: (i) synucleinopathies, (ii) tauopa- thies and (iii) other diseases. The most frequent sleep disturbances in patients with neurodegenerative diseases are insomnia, hypersomnia, parasomnias, excessive nocturnal motor activity, cir- cadian sleep-wake rhythm disturbances, and respiratory dysrhythmias. These disorders are discussed below taking into consideration both pathophysiological processes and clinical implications. Description of sleep disturbances in neurodegenerative diseases Synucleinopathies Synucleinopathies include Parkinson s disease (PD) (sporadic, familial with a-synucleine mutations, familial with mutation other than a-synucleine), dementia with Lewy bodies (DLB), multiple system atrophy (MSA), neurodegeneration with brain iron accumulation, other diseases that may have synuclein-immunoreactive lesions such as traumatic brain injury . The protein a-synuclein is found both in neuronal and glial cells and its functions are unknown; it seems to interact with other proteins in the formation of microtubules  and to operate as a molecular chaperon in assisting the folding and refolding of synaptic proteins called SNAREs which are crucial for release of neurotrans- mitter, vesicle recycling and synaptic integrity ....
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This note was uploaded on 09/21/2011 for the course MOSAIC 0852 taught by Professor Raymondhalnon during the Spring '09 term at Temple.
- Spring '09
- Tess of the d'Urbervilles