Background:Studies suggest seasonal fluctuations of symptoms in Parkinson’s disease(PD)patients in Western countries.However,the association between seasonal change and variation in nonmotor symptoms(NMS)in Chinese P...Background:Studies suggest seasonal fluctuations of symptoms in Parkinson’s disease(PD)patients in Western countries.However,the association between seasonal change and variation in nonmotor symptoms(NMS)in Chinese PD patients is unclear.Here,we studied whether there is a change rule with annual cycle with severity of NMS for patients with PD in Southeast China.Methods:We studied 1005 PD patients between April 2008 and October 2020.Patients were classified into four seasons according to the 24 Chinese solar terms,based on assessment date.We compared comprehensive NMS scales and polysomnography parameters among groups and conducted further analysis of disease severity.Results:Among the 1005 patients studied,the mean age was 64.2±9.7 years and 569(56.6%)of them were men.Relative to the summer group,patients assessed during winter had higher Scales for Outcomes in Parkinson’s disease-Autonomic Dysfunction(SCOPA-AUT)scores(P=0.045).The sleep efficiency factor scores of Pittsburgh Sleep Quality Index in patients were higher during spring than summer(P=0.009).Among patients who completed polysomnography during the same period(n=135),compared with summer follow-ups,we observed a higher percentage of NREMS1 in winter and spring follow-ups(P=0.042,P=0.011),a higher NREMS1 time in spring follow-ups(P=0.0024),a lower NREMS2 time in winter follow-ups(P=0.007),and a higher percentage of phasic rapid eye movement(REM)-sleep without atonia in autumn and winter follow-ups(P=0.026 and P=0.020,respectively).In a subset of patients with PD and REM sleep behavior disorder(RBD;n=182),those visited during winter had higher scores for RBD questionnaire-Hong Kong and its factor 1(dream-related sub-score)than those visited during summer(P=0.034,P=0.020).We observed similar findings for SCOPA-AUT and sleep efficiency factor scores in early stage patients in subgroup analysis.Conclusions:PD patients assessed for follow-up during summer showed less severe symptoms of autonomic dysfunction and RBD symptoms than those assessed in winter,and less sleep disturbance than those in spring and winter,suggesting that seasonal change and NMS fluctuation are related,especially in patients with early stage PD.展开更多
To the Editor:Alterations of circadian rhythms seem to be the casual contribution to sleep disturbances,depression,and other non-motor symptoms in Parkinson's disease(PD).[1,2]By restoring the circadian rhythm,bri...To the Editor:Alterations of circadian rhythms seem to be the casual contribution to sleep disturbances,depression,and other non-motor symptoms in Parkinson's disease(PD).[1,2]By restoring the circadian rhythm,bright light therapy(BLT)might be a potentially new treatment option for PD.However,no studies have conclusively demonstrated the effects of BLT on the non-motor symptoms in PD.展开更多
To the Editor:Parkinson’s disease(PD)is the second most common neurodegenerative disorder,and sleep disturbance is a major disabling non-motor symptom.[1]Excessive daytime sleepiness(EDS)is defined as inappropriate a...To the Editor:Parkinson’s disease(PD)is the second most common neurodegenerative disorder,and sleep disturbance is a major disabling non-motor symptom.[1]Excessive daytime sleepiness(EDS)is defined as inappropriate and undesirable sleepiness during waking hours,which may occur during activities such as talking or driving.In PD patients,EDS increased the risk of accidents and resulted in a poor quality of life.[2]展开更多
基金supported by grants from the Jiangsu Provincial Medical Key Discipline Project(ZDXKB2016022)Suzhou Clinical Research Center of Neurological Disease(Szzx201503)+2 种基金Suzhou Science and Technology Project(SYS2020130)Chinese Sleep Research Society Hansoh Project(2019HSA03)Discipline Construction Program of the Second Affiliated Hospital of Soochow University(XKTJ-TD202003).
文摘Background:Studies suggest seasonal fluctuations of symptoms in Parkinson’s disease(PD)patients in Western countries.However,the association between seasonal change and variation in nonmotor symptoms(NMS)in Chinese PD patients is unclear.Here,we studied whether there is a change rule with annual cycle with severity of NMS for patients with PD in Southeast China.Methods:We studied 1005 PD patients between April 2008 and October 2020.Patients were classified into four seasons according to the 24 Chinese solar terms,based on assessment date.We compared comprehensive NMS scales and polysomnography parameters among groups and conducted further analysis of disease severity.Results:Among the 1005 patients studied,the mean age was 64.2±9.7 years and 569(56.6%)of them were men.Relative to the summer group,patients assessed during winter had higher Scales for Outcomes in Parkinson’s disease-Autonomic Dysfunction(SCOPA-AUT)scores(P=0.045).The sleep efficiency factor scores of Pittsburgh Sleep Quality Index in patients were higher during spring than summer(P=0.009).Among patients who completed polysomnography during the same period(n=135),compared with summer follow-ups,we observed a higher percentage of NREMS1 in winter and spring follow-ups(P=0.042,P=0.011),a higher NREMS1 time in spring follow-ups(P=0.0024),a lower NREMS2 time in winter follow-ups(P=0.007),and a higher percentage of phasic rapid eye movement(REM)-sleep without atonia in autumn and winter follow-ups(P=0.026 and P=0.020,respectively).In a subset of patients with PD and REM sleep behavior disorder(RBD;n=182),those visited during winter had higher scores for RBD questionnaire-Hong Kong and its factor 1(dream-related sub-score)than those visited during summer(P=0.034,P=0.020).We observed similar findings for SCOPA-AUT and sleep efficiency factor scores in early stage patients in subgroup analysis.Conclusions:PD patients assessed for follow-up during summer showed less severe symptoms of autonomic dysfunction and RBD symptoms than those assessed in winter,and less sleep disturbance than those in spring and winter,suggesting that seasonal change and NMS fluctuation are related,especially in patients with early stage PD.
基金This work was supported by grants from the Jiangsu Provincial Key R&D Program(No.BE2018658)the Jiangsu Provincial Medical Key Discipline Project(No.ZDXKB2016022)+2 种基金Discipline Construction Program of the Second Affiliated Hospital Soochow University(No.XKTJ-XK202001)the National Natural Science Foundation of China(No.81801253)the Natural Science Foundation of Jiangsu Province(BK 20180214).
文摘To the Editor:Alterations of circadian rhythms seem to be the casual contribution to sleep disturbances,depression,and other non-motor symptoms in Parkinson's disease(PD).[1,2]By restoring the circadian rhythm,bright light therapy(BLT)might be a potentially new treatment option for PD.However,no studies have conclusively demonstrated the effects of BLT on the non-motor symptoms in PD.
基金supported by grants from Jiangsu Provincial Key R&D Program(BE2018658)Suzhou Science and Technology Development Plan(Minsheng Science and Technology)(SKJY2021089)+1 种基金Discipline Construction Program of the Second Affiliated Hospital of Soochow University(XKTJ-XK202001)Gusu Health Talents Plan(GSWS2020035,GSWS2019041).
文摘To the Editor:Parkinson’s disease(PD)is the second most common neurodegenerative disorder,and sleep disturbance is a major disabling non-motor symptom.[1]Excessive daytime sleepiness(EDS)is defined as inappropriate and undesirable sleepiness during waking hours,which may occur during activities such as talking or driving.In PD patients,EDS increased the risk of accidents and resulted in a poor quality of life.[2]
