Objective: To explore clinical biomarkers associated with excessive daytime sleepiness (EDS) using a real-world cohort database of Parkinson’s disease (PD).

Background: Although evidence for current treatments for PD has been established through RCTs and other studies, there are some cases in clinical practice that do not fit into this category. In addition, no reliable biomarkers have been found to reflect disease status. Therefore, to establish the treatments and biomarkers, we have established a prospective real-world database with a target of more than 1,000 cases. EDS in PD affects a quality of life that must be taken into consideration, as it is present in 25 to 70% of patients and appears in combination with autonomic dysfunction and psychiatric symptoms in advanced stages. Although the side effects of drugs are often highlighted, previous reports have shown an association between EDS and NREM sleep at night, as well as a correlation with axial symptoms. Therefore, we examine the impact of EDS on the disease pathomechanisms by analyzing real-world data from the early to advanced stages of the disease, as well as clinical findings.

Method: This prospective study enrolled 1,015 PD by January 2023. Of those cases, 746 cases of cross-sectional data with no missing JESS (Japanese version of the Epworth Sleepiness Scale) score (age; 66.7 ± 10.5; female/male; 378/364, disease duration; 8.99 ± 5.98) were analyzed. The patients have evaluated the various clinical parameters, biomarkers, and symptom severity scales such as UPDRS-I, II, III, IV, MoCA-J, JESS, PDSS-2, and HAM-D6. We especially analyzed the clinical symptoms between with (JESS > 9 points) and without EDS.

Results: In the EDS group, although there are no significant differences in age or duration of disease,  UPDRS-I, II, III, IV, HAM-D6, and PDSS-2 were higher than those without EDS group (without vs with EDS: UPDRS-I; 9.40 ± 5.17 vs 14.3 ± 5.86, UPDRS-II; 11.6 ± 8.50 vs 18.0 ± 9.49, UPDRS-III; 22.3 ± 13.7 vs 26.5 ± 14.8, UPDRS-IV; 3.73 ± 4.10 vs 5.01 ± 4.55, HAM-D6; 2.01 ± 2.35 vs 2.54 ± 2.64, and PDSS-2; 13.7 ± 8.79 vs 18.8 ± 9.78).

Conclusion: The EDS group tends to have more severe not only motor and non-motor symptoms but also ADL and motor complications compared to the without EDS group. We will continue to analyze the effects of EDS in combination with biomarkers, not only in relation to drugs but also to pathomechanisms.

« Back to 2023 International Congress

MDS Abstracts - https://www.mdsabstracts.org/abstract/analysis-of-excessive-daytime-sleepiness-and-clinical-findings-in-parkinsons-disease/