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L-Dopa treatment alleviates sleep disturbances associated with Parkinson’s disease

Patients suffering from Parkinson’s disease complain of severe sleep disturbances such as inability to fall asleep or, in contrast, periods of drowsiness during the day. While dopaminergic treatment dramatically improves the disease’s motor symptoms (calming tremors, for instance), its effects on sleep continued to be challenged, suggesting that the alteration of other (non-dopaminergic) neurons might be behind these other symptoms. The possible involvement of pedunculopontine nucleus (PPN) neurons, which regulate sleep and wakefulness, had been postulated in particular.

INSERM researchers working under the guidance of Chantal François (INSERM Unit 1127 /Institut du cerveau et de la moelle épinière/Université Pierre et Marie-Curie/AP-HP) have now been able to record and measure over extended periods of time, using a miniature device, the quality of sleep in animals suffering from Parkinson’s disease.

The study shows that a pure dopaminergic lesion gives rise to sleep disturbances, and that treatment using L-Dopa leads to significant improvement.

 The results show a reduction in periods of daytime drowsiness, a decrease in sudden arousal from sleep and a general increase in length of sleep.

As to the pedunculopontine nucleus, it is indeed involved in regulating the wakefulness-sleep cycle. When altered, it impacts the quality of sleep in animals with Parkinson’s disease, after causing severe but transitory disorders.

These results suggest that electrode stimulation of the pedunculopontine nucleus could be beneficial in patients with Parkinson’s disease suffering from severe sleep disturbances, as recent clinical trials show.

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Sleep Disorders in Parkinsonian Macaques: Effects of L-Dopa Treatment and Pedunculopontine Nucleus Lesion Hayat Belaid, 1 Joëlle Adrien, 1 Elodie Laffrat, 1 Dominique Tandé, 1 Carine Karachi,1 David Grabli,1 Isabelle Arnulf,2 Stewart D. Clark,3 Xavier Drouot,4 Etienne C. Hirsch,1 and Chantal François1 1 Institut National de la Santé et de la Recherche Médicale Unité Mixte de Recherche-S975, Université Pierre et Marie Curie Paris 06, Unité Mixte de Recherche-S975, CNRS Unité Mixte de Recherche 7225, and Centre de Recherche-Institut du Cerveau et de la Moelle, Groupe Hospitalier Pitié-Salpêtrière, 75013 Paris, France,
2 Service des pathologies du sommeil, Assistance Publique-Hôpitaux de Paris, Groupe Pitié-Salpêtrière, 75013 Paris, France, 3Department of Pharmacology andToxicology, University at Buffalo, Buffalo, New York 14214, and 4Physiology Department, CHU de Poitiers, 8600 Poitiers, France The Journal of Neuroscience