Featured
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News & Views |
Prodromal Parkinson disease — time is brain
Biomarkers that predict conversion from isolated REM sleep behaviour disorder to Parkinson disease are urgently needed. A new study finds that detection of misfolded α-synuclein in the cerebrospinal fluid is a good marker of conversion risk, but an inability to predict the timeline of progression might limit its utility.
- Sandrina Weber
- & Brit Mollenhauer
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Review Article |
Narcolepsy — clinical spectrum, aetiopathophysiology, diagnosis and treatment
In the past 20 years, understanding of the clinical manifestations, aetiopathophysiology, diagnosis and treatment of narcolepsy has greatly advanced. In this Review, Bassetti et al. present these advances, discuss unmet needs and offer future perspectives for the field of narcolepsy.
- Claudio L. A. Bassetti
- , Antoine Adamantidis
- & Yves Dauvilliers
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News & Views |
Sleep apnoea and poor sleep quality in patients with chronic migraine
Chronic migraine is a debilitating condition that arises from the worsening of episodic migraine. A large population-based questionnaire study showed that individuals with chronic migraine reported more sleep apnoea and worse sleep quality than individuals with episodic migraine. This finding provides important insights into the association between sleep disturbances and chronic migraine.
- Min Kyung Chu
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News & Views |
Multimodal imaging in RBD — present and future
Multimodal imaging in neurodegenerative disorders can provide insights on structural, functional and neurochemical alterations that might not be possible via clinical testing alone. New findings on multimodal imaging in idiopathic REM sleep behaviour disorder (iRBD) have implications for the relationship between iRBD, the clinical phenotype of Parkinson disease and the underlying substrate of Lewy body disease, particularly for understanding the pathophysiology and designing disease-modifying therapies.
- Bradley F. Boeve
- & Kejal Kantarci
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Review Article |
NREM sleep parasomnias as disorders of sleep-state dissociation
Non-rapid eye movement (NREM) sleep parasomnias are thought to derive from incomplete arousal from NREM sleep. Here, the authors present evidence for coexistence of sleep-like and wake-like brain activity in disorders of arousal, including confusional arousals, sleep terrors and sleepwalking.
- Anna Castelnovo
- , Régis Lopez
- & Yves Dauvilliers
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Review Article |
Idiopathic REM sleep behaviour disorder and neurodegeneration — an update
Idiopathic rapid eye movement (REM) sleep behavioural disorder (RBD) is now recognized as an early marker of α-synucleinopathies. Here, Högl and colleagues review potential biomarkers for RBD and summarize the evidence for a prodromal stage, which might enable disease-modifying intervention. In light of these advances, they reconceptualize idiopathic RBD as isolated RBD.
- Birgit Högl
- , Ambra Stefani
- & Aleksandar Videnovic
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In Brief |
Sleep-related breathing disorders after stroke are not linked to lesion location
- Heather Wood
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Review Article |
Restless legs syndrome—current therapies and management of augmentation
Restless legs syndrome that reduces quality of life and disturbs sleep requires pharmacological intervention. In the context of current guidelines and diagnostic criteria, Claudia Trenkwalder and colleagues summarize the treatments that are currently approved and used in clinical practice, including combination therapies. They also draw on their clinical experience to discuss and advise on the management of augmentation induced by dopaminergic drugs.
- Claudia Trenkwalder
- , Juliane Winkelmann
- & Walter Paulus
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Review Article |
Interactions of the histamine and hypocretin systems in CNS disorders
Loss of hypocretin neurons is a hallmark finding in narcolepsy; recent findings have implicated also increased number of histamine neurons in this disorder. This Review provides an overview of coregulation of sleep and wakefulness by hypocretin and histamine. The authors also review the changes in hypocretin and histamine systems in narcolepsy and neurodegenerative diseases (such as Alzheimer disease, Parkinson disease and Huntington disease) and discuss novel therapeutic approaches for manipulation of the histamine system in these diseases.
- Ling Shan
- , Yves Dauvilliers
- & Jerome M. Siegel
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Review Article |
'The clocks that time us'—circadian rhythms in neurodegenerative disorders
Disruption of circadian rhythms in neurodegenerative disorders not only contributes to morbidity and poor quality of life, but could also be involved in driving the disease process itself. Restoration of circadian rhythmicity via behavioural or pharmacological interventions might, therefore, slow down disease progression. In this Review, Videnovic and colleagues provide an overview of the circadian system, and summarize current understanding of the dysfunction of circadian rhythms in Alzheimer disease, Parkinson disease and Huntington disease.
- Aleksandar Videnovic
- , Alpar S. Lazar
- & Sebastiaan Overeem
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Research Highlight |
Increased orexin level correlates with sleep disruption and cognitive decline in Alzheimer disease
- Hemi Malkki
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News & Views |
Disease mechanisms in narcolepsy remain elusive
A pandemic influenza vaccine with a specific type of vaccine antigen has been linked to an increased incidence of narcolepsy in children from 2009–2010. However, the recent retraction of an article that reported a putative autoantigen means that the search for the mechanisms behind the vaccine–narcolepsy connection continues.
- Ilkka Julkunen
- & Markku Partinen
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Review Article |
Cataplexy—clinical aspects, pathophysiology and management strategy
Cataplexy is the pathognomonic symptom of narcolepsy, a condition that is caused by depletion of orexin neurons. Cataplectic attacks are characterized by sudden involuntary muscle weakness or paralysis, often triggered by strong emotions. In this article, Dauvilliers et al. review the latest understanding of potential mechanisms underlying narcolepsy and cataplexy, the utility of experimental models, and the need for early diagnosis and therapy.
- Yves Dauvilliers
- , Jerry M. Siegel
- & John H. Peever
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Opinion |
Sleep and Alzheimer disease pathology—a bidirectional relationship
The past few years have seen the identification of a growing number of risk factors for Alzheimer disease (AD). In this Perspectives article, the authors discuss the evidence for a bidirectional relationship between disrupted sleep patterns and amyloid-β accumulation, and the potential implications for disease progression in AD.
- Yo-El S. Ju
- , Brendan P. Lucey
- & David M. Holtzman
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Research Highlight |
First study of risk factors for REM sleep behaviour disorder uncovers a few surprises
- Katie Kingwell
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Review Article |
Restless legs syndrome: pathophysiology, clinical presentation and management
Restless legs syndrome (RLS) is a somatosensory network disorder, a key feature of which is an overwhelming urge to move the legs. In this article, Trenkwalder and Paulus review the state of knowledge regarding the pathophysiology of RLS, including the proposed roles of the dopamine and iron systems, and discuss current approaches to the diagnosis and treatment of this condition.
- Claudia Trenkwalder
- & Walter Paulus
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