Circadian rhythm and autonomic dysfunction in presymptomatic and early Huntington's disease
Por:
Diago, EB, Perez, JP, Lasaosa, SS, Alebesque, AV, Horta, SM, Kulisevsky, J, del Val, JL
Publicada:
1 nov 2017
Resumen:
Introduction: Sleep and circadian rhythm disturbances are common in patients with neurodegenerative diseases such as Huntington's disease (HD). The aim of this study was to evaluate variability in circadian blood pressure (BP) to determine the association between abnormal circadian BP and sleep quality in patients with HD.
Methods: Cross-sectional, multicenter study of 38 HD mutation carriers (23 premanifest and 15 early stage patients) who were compared to 38 age- and sex-matched controls. BP was evaluated by ambulatory blood pressure monitoring (ABPM). Based on the percentage decrease in nocturnal BP, subjects were classified as either dippers (>= 10%) or non-dippers (<10%). Sleep quality and daytime sleepiness were measured, respectively, using the Pittsburgh Sleep Quality Index (PSQI) and the Epworth Daytime Sleepiness Scale (ESS) and the scores on these indices were correlated with the ABPM findings.
Results: Sixty-three percent HD mutation carriers were non-dippers (86.7% of the symptomatic and 47.8% of the premanifest patients) versus 23.7% of controls (p = 0.001). In the HD group, sleep quality was significantly more impaired (PSQI>5) (p = 0.016) with more excessive daytime sleepiness (ESS>9) (p = 0.001) than in the control group. Nocturnal non-dipping was associated with worse sleep quality in patients (p = 0.011) but not in controls.
Conclusion: These results show that patients with HD present early disturbances in the circadian rhythm of BP and that this altered nocturnal BP is associated with poor sleep quality. These findings suggest the potential role of subtle hypothalamic dysfunction in this population. (C) 2017 Elsevier Ltd. All rights reserved.
Filiaciones:
Diago, EB:
Hosp Clin Univ Lozano Blesa, Neurol Dept, San Juan Bosco 15, Zaragoza 50009, Spain
Aragon Inst Hlth Sci, Res Grp Movement Disorders & Headache GIIS070, San Juan Bosco 13, Zaragoza 50009, Spain
Perez, JP:
Inst Salud Carlos III, Madrid, Spain
Hosp Santa Creu & Sant Pau, Neurol Dept, Movement Disorders Unit, Carrer St Quinti 89, Barcelona 08026, Spain
Biomed Res Inst Sant Pau IIB St Pau, Carrer St Quinti 89, Barcelona, Spain
Lasaosa, SS:
Aragon Inst Hlth Sci, Res Grp Movement Disorders & Headache GIIS070, San Juan Bosco 13, Zaragoza 50009, Spain
Ctr Invest Biomed Red Enfermedades Neurodegenerat, Madrid, Spain
Hosp Clin Univ Lozano Blesa, Neurol Dept, San Juan Bosco 15, Zaragoza 50009, Spain
Alebesque, AV:
Aragon Inst Hlth Sci, Res Grp Movement Disorders & Headache GIIS070, San Juan Bosco 13, Zaragoza 50009, Spain
Hosp Clin Univ Lozano Blesa, Neurol Dept, San Juan Bosco 15, Zaragoza 50009, Spain
Horta, SM:
Ctr Invest Biomed Red Enfermedades Neurodegenerat, Madrid, Spain
Biomed Res Inst Sant Pau IIB St Pau, Carrer St Quinti 89, Barcelona, Spain
Hosp Santa Creu & Sant Pau, Neurol Dept, Movement Disorders Unit, Carrer St Quinti 89, Barcelona 08026, Spain
Kulisevsky, J:
Ctr Invest Biomed Red Enfermedades Neurodegenerat, Madrid, Spain
Hosp Santa Creu & Sant Pau, Neurol Dept, Movement Disorders Unit, Carrer St Quinti 89, Barcelona 08026, Spain
Biomed Res Inst Sant Pau IIB St Pau, Carrer St Quinti 89, Barcelona, Spain
del Val, JL:
Hosp Clin Univ Lozano Blesa, Neurol Dept, San Juan Bosco 15, Zaragoza 50009, Spain
Aragon Inst Hlth Sci, Res Grp Movement Disorders & Headache GIIS070, San Juan Bosco 13, Zaragoza 50009, Spain
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