Etiologies of insomnia in Parkinson’s disease – Lessons from human studies and animal models.

Mizrahi-Kliger AD, Feldmann LK, KĆ¼hn AA, Bergman H.
Exp Neurol.

Review article


SleepĀ disorders are integral toĀ Parkinson’s diseaseĀ (PD). Insomnia, an inability to maintain stable sleep, affects most patients and is widely rated as one of the most debilitating facets of this disease. PD insomnia is often perceived as a multifactorial entity ā€“ a consequence of several of the disease symptoms, comorbidities and therapeutic strategies. Yet, this view evolved against a backdrop of a relative scarcity of works trying to directly dissect the underlying neural correlates and mechanisms in animal models. The last years have seen the emergence of a wealth of new evidence regarding the neural underpinnings of insomnia in PD. Here, we review early and recent reports from patients and animal models evaluating theĀ etiology of PDĀ insomnia. We start by outlining the phenomenology of PD insomnia and continue to analyze the evidence supporting insomnia as emanating from four distinct subdivisions of etiologies ā€“ the symptoms and comorbidities of the disease, the medical therapy, the degeneration of non-dopaminergic cell groups and subsequent alterations in circadian rhythms, and the degeneration ofĀ dopaminergicĀ neurons in theĀ brainstemĀ and its resulting effect on the basal ganglia. Finally, we review emerging neuromodulation-based therapeutic avenues for PD insomnia.

Published: Apr 2022