Journal of Neurology

, Volume 259, Issue 2, pp 318–326 | Cite as

Widespread cortical and subcortical brain atrophy in Parkinson’s disease with excessive daytime sleepiness

  • S. Kato
  • H. Watanabe
  • J. Senda
  • M. Hirayama
  • M. Ito
  • N. Atsuta
  • T. Kaga
  • M. Katsuno
  • S. Naganawa
  • G. SobueEmail author
Original Communication


Our aim was to determine regional brain atrophy in Parkinson’s disease (PD) patients with excessive daytime sleepiness (EDS) using voxel-based morphometry (VBM). From 71 consecutive probable PD patients, nine non-demented and non-hallucinating patients with an Epworth Sleepiness Scale (ESS) ≥ 10 and 13 PD patients with an ESS ≤ 3 were selected as having EDS and as not having EDS, respectively. We also enrolled 22 healthy age- and sex-matched controls. Regional brain atrophy was assessed using VBM with 3-T magnetic resonance imaging. There was no difference in the dosage of dopaminergic drugs between PD patients with EDS and PD patients without EDS. PD patients with EDS showed marked atrophy in the gray matter of the frontal lobe, temporal lobe, occipital lobe, limbic lobe including the nucleus basalis of Meynert compared to controls (false discovery rate corrected p < 0.05). In contrast, PD patients without EDS did not show any significant difference in gray matter atrophy compared to controls (false discovery rate corrected p < 0.05). PD patients with EDS showed significant atrophy of the frontal lobe, temporal lobe, occipital lobe, limbic lobe including the nucleus basalis of Meynert compared to PD patients without EDS (uncorrected p < 0.001). PD patients with EDS, even without dementia and hallucination, showed significant gray matter atrophy compared to PD patients without EDS and controls.


Parkinson’s disease Excessive daytime sleepiness Voxel-based morphometry Nucleus basalis of Meynert 



This work was supported by Health and Labor Sciences Research Grants for Research on Measures for Intractable Diseases, and Comprehensive Research on Aging and Health by the Ministry of Health, Labor, and Welfare, Japan.

Conflict of interest


Supplementary material

415_2011_6187_MOESM1_ESM.xls (28 kb)
Supplementary material 1 (XLS 28 kb)
415_2011_6187_MOESM2_ESM.xls (30 kb)
Supplementary material 2 (XLS 30 kb)


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Copyright information

© Springer-Verlag 2011

Authors and Affiliations

  • S. Kato
    • 1
  • H. Watanabe
    • 1
  • J. Senda
    • 1
  • M. Hirayama
    • 1
  • M. Ito
    • 1
  • N. Atsuta
    • 1
  • T. Kaga
    • 1
  • M. Katsuno
    • 1
  • S. Naganawa
    • 2
  • G. Sobue
    • 1
    Email author
  1. 1.Department of NeurologyNagoya University Graduate School of MedicineNagoyaJapan
  2. 2.Department of RadiologyNagoya University Graduate School of MedicineNagoyaJapan

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