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Epworth sleepiness scale is associated with increased striatal dopamine uptake in Parkinson’s disease: a cross-sectional study

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Abstract

Purpose

A cross-sectional study was designed to investigate the possible association between Epworth sleepiness scale (ESS) scores and striatal dopamine uptake in the early stages of Parkinson’s disease (PD).

Methods

Two groups of PD patients (n = 464) and healthy controls (HC) (n = 162) were enrolled in the current study from the Parkinson’s progression markers initiative cohort (https://www.ppmi-info.org). All the subjects were evaluated for excessive daytime sleepiness (EDS) using the ESS. They also completed specific measures to be assessed for motor and non-motor symptoms, including cognitive, gait, autonomic, and olfactory dysfunction. Dopamine transporter (DaT) scans were used to identify dopamine transporter impairments. Spatial normalization for DaTscan imaging of participants was performed to reach consistent orientation.

Results

A significant correlation was found between ESS score and right putamen (P < 0.001; correlation coefficient = 0.186) and left putamen (P = 0.003; correlation coefficient = 0.139) dopamine uptake in PD patients. The same results were revealed after adjusted Pearson’s correlation for the effects of handedness, age, gender, and education. No significant correlation was found between the ESS score and the amount of caudate nucleus dopamine uptake in PD patients. Moreover, there was a significant association between caudate nucleus dopamine uptake and ESS score in neither PD patients nor HCs.

Conclusions

The results of our study suggest that increased dopaminergic function of putamen nuclei may be associated with ESS scores in the early stages of PD. Further studies are needed at different PD stages and evaluate PD progression as a possible confounder.

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Data Availability

Data used in the preparation of this article were obtained from the Parkinson’s Progression Markers Initiative (PPMI) database (www.ppmi-info.org/access-data-specimens/download-data). For up-to-date information on the study, visit www.ppmi-info.org.

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Acknowledgements

“PPMI—a public-private partnership—is funded by the Michael J. Fox Foundation for Parkinson’s Research and funding partners, including 4D Pharma, Abbvie, Acurex Therapeutics, Allergan, Amathus Therapeutics, ASAP, Avid Radiopharmaceuticals, Bial Biotech, Biogen, BioLegend, Bristol-Myers Squibb, Calico, Celgene, DaCapo Brain Science, Denali, The Edmond J. Safra Foundation, Eli Lilly and Company, GE Healthcare, GlaxoSmithKline, Golub Capital, Handl Therapeutics, Insitro, Janssen Pharmaceuticals, Lundbeck, Merck, Meso Scale Diagnostics, Neurocrine Biosciences, Pfizer, Piramal, Prevail, F. Hoffmann-La Roche Ltd and its affiliated company Genentech Inc., Roche, Sanofi Genzyme, Servier, Takeda, Teva, UCB, Vanqua Bio, Verily, Voyager Therapeutics, and Yumanity Therapeutics. We are also grateful to Dr. Fardin Nabizadeh for helping with the management of the dataset and English editing.

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Authors and Affiliations

  1. School of Medicine, Tehran University of Medical Sciences, Poursina St, Tehran, 14176 13151, Iran

    Erfan Naghavi & Mohammad Mahdi Aliasin

  2. Neuroscience Research Group (NRG), Universal Scientific Education and Research Network (USERN), Tehran, Iran

    Erfan Naghavi

  3. Students’ Scientific Research Center (SSRC), Tehran University of Medical Sciences, Tehran, Iran

    Mohammad Mahdi Aliasin

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  1. Erfan Naghavi
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Correspondence to Erfan Naghavi.

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Naghavi, E., Aliasin, M.M. Epworth sleepiness scale is associated with increased striatal dopamine uptake in Parkinson’s disease: a cross-sectional study. Neurol Sci 45, 149–154 (2024). https://doi.org/10.1007/s10072-023-06974-8

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