Background: To investigate the clinical characteristics, iron metabolism and neuroinflam-mation in Parkinson’s disease (PD) patients with excessive daytime sleepiness (EDS). Methods: We studied 379 patients with PD and 30 age-matched controls. All subjects were evaluated by Epworth sleepiness scale (ESS) and a series of rating scales and were divided into PD-EDS and PD-NEDS groups according to ESS score. The concentrations of iron and iron-related proteins and inflammatory cytokines in both cerebrospinal fluid (CSF) and serum were examined. Results: 1. The occurrence rate of EDS in total PD patients was 16.09%. 2. PD-EDS group had significantly severer disease stages, more severe motor and non-motor features of the disease. 3. In CSF, the concentrations of iron and IL-1β in the PD-EDS group were significantly higher and ferritin concentration was prominently lower when compared with the PD-NEDS group and the control group; ESS score was significantly associated with high concentrations of iron and IL-1β and low concentration of ferritin in the PD group. Iron concentration was positively correlated with IL-1β concentration in the PD-EDS group. 4. In serum, no changes were observed in iron and iron-related proteins and inflammatory cytokines among the three groups. Conclusion: EDS was a common symptom in PD patients. PD patients with EDS had more severe motor and some non-motor symptoms. Overloaded iron-relevant inflammation in the brain might be an underlying mechanism of PD-EDS.
CITATION STYLE
Hu, Y., Guo, P., Lian, T. H., Zuo, L. J., Yu, S. Y., Liu, L., … Zhang, W. (2021). Clinical characteristics, iron metabolism and neuroinflammation: New insight into excessive daytime sleepiness in parkinson’s disease. Neuropsychiatric Disease and Treatment, 17, 2041–2051. https://doi.org/10.2147/NDT.S272110
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