Objective: The present study aimed to explore the neural mechanism of Excessive daytime sleepiness (EDS) in Parkinson disease (PD).

Background: EDS is common in PD, but the neural basis of EDS in PD is unclear.

Methods: In the present study, 38 patients with PD and 19 control subjects were enrolled. We classified PD patients into PD patients with EDS (PD-EDS) (n=17) with a ESS score of 10 or greater, and PD patients without EDS (PD-nonEDS) (n=21) with a ESS score 3 or less. All subjects underwent clinical assessments and resting state functional magnetic resonance imaging (MRI). We combined the amplitude of low-frequency fluctuations (ALFF) with functional connectivity (FC) approaches to analyze the neural activity changes in PD-related EDS.

Results: As a result, we found that, compared with the control subjects, patients with PD with EDS had decreased ALFF in the pons and increased ALFF in the Frontal_Mid_Orb_L. Moreover, patients with PD with EDS showed decreased ALFF of the left posterior cingulate cortex (PCC) relative to PD without EDS, which was negatively correlated with the Epworth Sleepiness Scale scores. After that, the FC analysis with the left PCC region of interest showed reduced FC of the right PCC and right precuneus in PD with EDS compared with PD without EDS.

Conclusions: To conclude, we hypothesized the wake-promoting pathways and the default mode network dysfunctions underlying the EDS in PD patients independent of cognitive dysfunction.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/altered-amplitude-of-low-frequency-fluctuations-and-functional-connectivity-in-excessive-daytime-sleepiness-in-parkinson-disease/