ArticleMovement disorders : official journal of the Movement Disorder Society2012
Daytime alertness in Parkinson's disease: potentially dose-dependent, divergent effects by drug class.
Article in Movement disorders : official journal of the Movement Disorder Society, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 25 papers.
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Who cites it
25 citing papers in PubMed.
- Clinical symptoms and neuroanatomical substrates of daytime sleepiness in Parkinson's disease.NPJ Parkinson's disease · 2024Article
- Prediction of Quality of Life in Patients With Parkinson's Disease With and Without Excessive Daytime Sleepiness: A Longitudinal Study.Frontiers in aging neuroscience · 2022Article
- Restless Legs Symptoms and Periodic Leg Movements in Sleep Among Patients with Parkinson's Disease.Journal of Parkinson's disease · 2022Article
- Current Update on Clinically Relevant Sleep Issues in Parkinson's Disease: A Narrative Review.Journal of Parkinson's disease · 2021Review
- Approach to Cognitive Impairment in Parkinson's Disease.Neurotherapeutics : the journal of the American Society for Experimental NeuroTherapeutics · 2020Review
- Cortical Phase-Amplitude Coupling in a Progressive Model of Parkinsonism in Nonhuman Primates.Cerebral cortex (New York, N.Y. : 1991) · 2019Article
- Self-reported and experimentally induced self-disgust is heightened in Parkinson's disease: Contribution of behavioural symptoms.PloS one · 2019Article
- Clinical Features and Correlates of Excessive Daytime Sleepiness in Parkinson's Disease.Frontiers in neurology · 2019Article
- Quantitative electroencephalography as a marker of cognitive fluctuations in dementia with Lewy bodies and an aid to differential diagnosis.Clinical neurophysiology : official journal of the International Federation of Clinical Neurophysiology · 2018Article
- Role of the pedunculopontine nucleus in controlling gait and sleep in normal and parkinsonian monkeys.Journal of neural transmission (Vienna, Austria : 1996) · 2018Review
- Changes in Parkinson's disease sleep symptoms and daytime somnolence after bilateral subthalamic deep brain stimulation in Parkinson's disease.NPJ Parkinson's disease · 2018Article
- Idiopathic Hypersomnia.Sleep medicine clinics · 2017Review
- Sleepiness and Depression in Parkinson's Disease Patients Treated with Ropinirole and Levodopa.Journal of movement disorders · 2017Article
- Evaluating and Managing Sleep Disorders in the Parkinson's Disease Clinic.Basal ganglia · 2016Article
- Parkinson's disease and sleep/wake disturbances.Current neurology and neuroscience reports · 2015Review
- Sleep correlates of trait executive function and memory in Parkinson's disease.Journal of Parkinson's disease · 2015Article
- Relationship between oscillatory activity in the cortico-basal ganglia network and parkinsonism in MPTP-treated monkeys.Neurobiology of disease · 2014Article
- Sleep disorders in Parkinsonian macaques: effects of L-dopa treatment and pedunculopontine nucleus lesion.The Journal of neuroscience : the official journal of the Society for Neuroscience · 2014Article
- Fluctuations in cognition and alertness vary independently in dementia with Lewy bodies.Movement disorders : official journal of the Movement Disorder Society · 2014Article
- Treatment of the sleep disorders associated with Parkinson's disease.Neurotherapeutics : the journal of the American Society for Experimental NeuroTherapeutics · 2014Review
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Authors and funding
9 authors.
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Abstract
Many patients with idiopathic Parkinson's disease experience difficulties maintaining daytime alertness. Controversy exists regarding whether this reflects effects of antiparkinsonian medications, the disease itself, or other factors such as nocturnal sleep disturbances. In this study we examined the phenomenon by evaluating medicated and unmedicated Parkinson's patients with objective polysomnographic measurements of nocturnal sleep and daytime alertness. Patients (n = 63) underwent a 48-hour laboratory-based study incorporating 2 consecutive nights of overnight polysomnography and 2 days of Maintenance of Wakefulness Testing. We examined correlates of individual differences in alertness, including demographics, clinical features, nocturnal sleep variables, and class and dosage of anti-Parkinson's medications. Results indicated that, first, relative to unmediated patients, all classes of dopaminergic medications were associated with reduced daytime alertness, and this effect was not mediated by disease duration or disease severity. Second, the results showed that increasing dosages of dopamine agonists were associated with less daytime alertness, whereas higher levels of levodopa were associated with higher levels of alertness. Variables unrelated to the Maintenance of Wakefulness Test defined daytime alertness including age, sex, years with diagnosis, motor impairment score, and most nocturnal sleep variables. Deficits in objectively assessed daytime alertness in Parkinson's disease appear to be a function of both the disease and the medications and their doses used. The apparent divergent dose-dependent effects of drug class in Parkinson's disease are anticipated by basic science studies of the sleep/wake cycle under different pharmacological agents.
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