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Sleep microstructure and neurodegeneration as measured by [123I]β-CIT SPECT in treated patients with Parkinson’s disease

Journal of Neurology volume 251, pages 1465–1471 (2004)Cite this article

Abstract

Objectives

Along with spindles, K-complexes are well known hallmarks of stage 2 (S2) sleep. However, little is known about their quantity in S2 sleep of patients with Parkinson’s disease (PD).

Setting

Sleep laboratory, Department of Neurology, University of Vienna, Austria.

Patients and methods

Whole-night polysomnography (PSG) was performed in twelve treated PD patients and ten healthy controls without history of sleep complaints. The quantity of spontaneous K-complexes, K-alpha-complexes, and sleep spindles in one hour S2 sleep, distributed in four epochs of 15 minutes all through the night, were visually selected and analysed. The quantity and the temporal course of these phasic events were compared with the quantity in age-matched healthy controls. Nine of the twelve PD patients underwent [123I]β-CIT SPECT for calculating dopamine transporter binding in the striatum and serotonin transporter density in the thalamus-hypothalamus region.

Results

There was no difference between the quantity of K-complexes, K-alpha-complexes, and sleep spindles in PD patients and in the healthy control group. K-complexes but not sleep spindles decreased over the night in both groups. The number of sleep spindles did not correlate with the dopamine transporter binding in the striatum or the serotonin binding in the thalamic/hypothalamic region.

Conclusion

K-complexes and sleep spindles are not reduced and do not seem to be related to the degree of dopaminergic degeneration in treated PD patients.

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Abbreviations

EEG:

electroencephalography

EMG:

electromyography

EOG:

electrooculography

NREM:

non-rapid eye movement sleep

PD:

Parkinson’s disease

PET:

positron emission tomography

PLMS:

periodic leg movements during sleep

PSG:

polysomnography

REM:

rapid eye movement sleep

S2:

stage 2 sleep

SPECT:

single photon emission computed tomography

UPDRS:

Unified Parkinson’s Disease Rating Scale

References

  1. Amzica F, Steriade M (1998a) Cellular substrates and laminar profile of sleep K-complex. Neuroscience 82:671–686

    Google Scholar 

  2. Amzica F, Steriade M (1998b) Electrophysiological correlates of sleep delta waves. Electroencephalogr Clin Neurophysiol 107:69–83

    Google Scholar 

  3. Amzica F, Steriade M (2002) The functional significance of K-complexes. Sleep Med Rev 6:139–149

    Google Scholar 

  4. Amzica F, Steriade M (1997) The K-complex: its slow (< 1-Hz) rhythmicity and relation to delta waves. Neurology 49:952–959

    Google Scholar 

  5. Arnulf I, Bejjani BP, Garma L, et al. (2000) Effect of low and high frequency thalamic stimulation on sleep in patients with Parkinson’s disease and essential tremor. J Sleep Res 9:55–62

    Google Scholar 

  6. Bankman IN, Sigillito VG, Wise RA, Smith PL (1992) Feature-based detection of the K-complex wave in the human electroencephalogram using neural networks. IEEE Trans Biomed Eng 39:1305–1310

    Google Scholar 

  7. Brücke T, Kornhuber J, Angelberger P, et al. (1993) SPECT imaging of dopamine and serotonin transporters with [123I]b-CIT. Binding kinetics in the human brain. J Neural Transm (Gen Sect) 94:137–146

    Google Scholar 

  8. Campbell K, Bell I, Bastien C (1992) Evoked potential measures of information processing during natural sleep. In: Broughton RJ, Ogilvie RD (eds) Sleep, arousal, and performance. Birkhäuser, Boston, pp 88–116

  9. Comella CL, Tanner CM, Ristanovic RK (1993) Polysomnographic sleep measures in Parkinson’s disease patients with treatment-induced hallucinations. Ann Neurol 34:710–714

    CAS  PubMed  Google Scholar 

  10. Cote KA, de Lugt DR, Langley SD, Campbell KB (1999) Scalp topography of the auditory evoked K-complex in stage 2 and slow wave sleep. J Sleep Res 8:263–272

    Google Scholar 

  11. da Rosa AC, Kemp B, Paiva T, Lopes da Silva FH, Kamphuisen HAC (1991) A model-based detector of vertex waves and K complexes in sleep electroencephalogram. Electroencephalogr Clin Neurophysiol 78:71–78

    Google Scholar 

  12. da Rosa AC, Paiva T (1993) Automatic detection of K-complexes: validation in normals and dysthymic patients. Sleep 16:239–248

    Google Scholar 

  13. Davis H, Davis PA, Loomis AL, Harvey EN, Hobart G (1939) Electrical reactions of the human brain to auditory stimulation during sleep. J Neurophysiol 2:500–514

    Google Scholar 

  14. Emser W, Brenner M, Stober T, Schimrigk K (1988) Changes in nocturnal sleep in Huntington’s and Parkinson’s disease. J Neurol 235:177–179

    Google Scholar 

  15. Happe S, Pirker W, Klösch G, Sauter C, Zeitlhofer J (2003) Periodic leg movements in patients with Parkinson’s disease are associated with reduced striatal dopamine binding. J Neurol 250:83–86

    Google Scholar 

  16. Jobert M, Poiseau E, Jahnig P, Schulz H, Kubicki S (1992) Topographical analysis of sleep spindle activity. Neuropsychobiology 26:210–217

    Google Scholar 

  17. Kendel K, Saprianov G, Graf B (1974) Wach-EEG und Schlaf-EEG beim Parkinson-Syndrom. Akt Neurol 1:125–126

    Google Scholar 

  18. Kubicki S, Herrmann WM (1996) The future of computer-assisted investigation of the polysomnogram: sleep microstructure. J Clin Neurophysiol 13:285–294

    Google Scholar 

  19. Kubicki S, Scheuler W, Jobert M, Pastelak-Price C (1989) The influence of age on the density of sleep spindles and Kcomplexes. Z EEG EMG 20:59–63

    Google Scholar 

  20. Loomis AL, Harvey N, Hobart III GA (1939) Distribution of disturbance patterns in the human electroencephalogram, with special reference to sleep. J Neurophysiol 1:413–430

    Google Scholar 

  21. McCormick L, Nielsen T, Nicolas A, Pito M, Montplaisir J (1997) Topographical distribution of spindles and K-complexes in normal subjects. Sleep 20:939–941

    Google Scholar 

  22. Montplaisir J, Boucher S, Gosselin A, Poirier G, Lavigne G (1996) Persistence of repetitive EEG arousals (K-alpha complexes) in RLS patients treated with L-DOPA. Sleep 19:196–199

    Google Scholar 

  23. Myslobodsky M, Mintz M, Ben-Mayor V, Radwan H (1982) Unilateral dopamine deficit and lateral EEG asymmetry. Sleep abnormalities in hemi-Parkinson’s patients. Electroencephalogr Clin Neurophysiol 54:227–231

    Google Scholar 

  24. Neal H, Keane PE (1980) Electrically and chemically induced spindling and slow waves in the encéphale isolé rat. A possible role for dopamine in the regulation of electrocortical activity. Electroencephal Clin Neurophysiol 48:318–326

    Google Scholar 

  25. Nicolas A, Petit D, Rompré S, Montplaisir J (2001) Sleep spindle characteristics in healthy subjects of different age groups. Clin Neurophysiol 112:521–527

    Google Scholar 

  26. Pirker W, Asenbaum S, Hauk M, et al. (2000) Imaging serotonin and dopamine transporters with 123I-b-CIT SPECT: binding kinetics and effects of normal aging. J Nucl Med 41:36–44

    Google Scholar 

  27. Puca FM, Bricolo A, Turella G (1973) Effect of L-dopa or amantadine therapy on sleep spindles in parkinsonism. Electroencephalogr Clin Neurophysiol 35:327–330

    Google Scholar 

  28. Puca FM, Di Perri R (1970) Analisi comparativa degli effetti della L-DOPA sul sonno di atetosici e parkinsoniani sottoposti e non a talamolisi. Riv Neurol 40:365–373

    Google Scholar 

  29. Rechtschaffen A, Kales A (1968) A manual of standardized terminology technique and scoring system for sleep stages of human subject. Brain Information Service, University of California

  30. Roth C, Jeanmonod D, Magnin M, Morel A, Achermann P (2000) Effects of medial thalamotomy and pallidothalamic tractotomy on sleep and waking EEG in pain and Parkinsonian patients. Clin Neurophysiol 111:1266–1275

    Google Scholar 

  31. Roth M, Shaw J, Green J (1956) The form, voltage distribution and physiological significance of the K-complex. EEG Clin Neurophysiol 8:385–402

    Google Scholar 

  32. Steriade M, Domich L, Oakson G, Deschenes M (1987) The deafferented reticular thalamic nucleus generates spindle rhythmicity. J Neurophysiol 57:260–273

    Google Scholar 

  33. Steriade M, Contreras D, Curro Dossi R, Nunez A (1993) The slow (< 1 Hz) oscillation in reticular thalamic and thalamocortical neurons: scenario of sleep rhythm generation in interacting thalamic and neocortical networks. J Neuroscience 13:3284–3299

    Google Scholar 

  34. Steriade M, MacCormick DA, Sejnowski TJ (1993) Thalamocortical oscillations in the sleeping and aroused brain. Science 262:679–685

    Google Scholar 

  35. Volk S, Blass K, Stecker K, Jost K, Pflug B (1995) Spindel- und K-Komplexdichte während des Stadium 2-Schlafes bei hochbetagten, kognitiv unbeeinträchtigten Probanden. Z EEG-EMG 26:235–238

    Google Scholar 

  36. Walter WG (1953) The living brain. Duckworth, London

  37. Wauquier A, Aloe L, Declerck A (1995) K-complexes: are they signs of arousal or sleep protective? J Sleep Res 4:138–143

    Google Scholar 

  38. Zeitlhofer J, Gruber G, Anderer P, Asenbaum S, Schimicek P, Saletu B (1997) Topographic distribution of sleep spindles in young healthy subjects. J Sleep Res 6:149–155

    Google Scholar 

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Author information

Affiliations

  1. Department of Neurology, University of Vienna, Austria

    Svenja Happe MD, Walter Pirker MD, Gerhard Klösch & Josef Zeitlhofer MD, PhD

  2. Department of Clinical Neurophysiology, University of Göttingen, Robert-Koch-Str. 40, 37099, Göttingen, Germany

    Svenja Happe MD

  3. Department of Psychiatry, University of Vienna, Austria

    Peter Anderer PhD, Georg Gruber & Bernd Saletu MD

Authors
  1. Svenja Happe MD
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  2. Peter Anderer PhD
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  3. Walter Pirker MD
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  4. Gerhard Klösch
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  5. Georg Gruber
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  6. Bernd Saletu MD
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  7. Josef Zeitlhofer MD, PhD
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Corresponding author

Correspondence to Svenja Happe MD.

Additional information

This research was supported in part by the European Commission, DG XII (Project Biomed-2 BMH4-CT97–2040 “SIESTA”) and by the Austrian National Bank (Project 7870). Svenja Happe, MD, was recipient for a fellowship stipend of the European Neurological Society (ENS).

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Happe, S., Anderer, P., Pirker, W. et al. Sleep microstructure and neurodegeneration as measured by [123I]β-CIT SPECT in treated patients with Parkinson’s disease. J Neurol 251, 1465–1471 (2004). https://doi.org/10.1007/s00415-004-0564-3

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  • DOI: https://doi.org/10.1007/s00415-004-0564-3

Key words

  • K-complex
  • sleep spindle
  • Parkinson’s disease
  • SPECT
  • dopamine