ArticleFrontiers in neuroscience2026
Depression mediated sleep disturbances and cognitive decline in Parkinson's disease patient.
Article in Frontiers in neuroscience, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Objective: This study investigated the distinct mechanistic pathways linking depression, sleep disturbances, and cognitive decline in Parkinson's disease, with emphasis on differential roles of daytime sleepiness versus rapid eye movement sleep disorder. Participants: The study included 450 Parkinson's disease patients enrolled in the Parkinson's Progression Markers Initiative (PPMI) between 2010 and 2024, leveraging longitudinal clinical and biomarker data. Measurements: Depressive symptoms (Geriatric Depression Scale, GDS), sleep disturbances (Epworth Sleepiness Scale, ESS for daytime sleepiness; REM Sleep Behavior Disorder Questionnaire, RBDSQ), and cognition (Montreal Cognitive Assessment, MoCA) were analyzed using mixed-effects models and structural equation modeling (SEM) with bootstrapped mediation. Results: Structural equation modeling demonstrated excellent model fit (CFI/TLI > 0.94; RMSEA < 0.08). Analyses revealed distinct pathological pathways: (1) Excessive daytime sleepiness impaired cognition fully through depression mediation (indirect effect Conclusion: Divergent neurobehavioral mechanisms underlie sleep-related cognitive decline in PD: daytime sleepiness operates through mood dysregulation, while rapid eye movement sleep disorder involves additional direct neural insult. Interventions targeting these pathways may require distinct strategies.
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