title: CSF orexin levels of Parkinson's disease, dementia with Lewy bodies, progressive supranuclear palsy and corticobasal degeneration.
abstract: Excessive daytime sleepiness has been widely accepted as a common problem not only in Parkinson's disease (PD) but also in other related disorders. Lowered excretion of orexin A (hypocretin 1) into the cerebrospinal fluid (CSF) is known to play a pathological role in narcolepsy and secondary hypersomnia due to hypothalamic dysfunction. Although the levels of CSF orexin in PD have been previously examined, the results have been controversial, and no systematic investigation of CSF orexin excretion has been conducted on PD related disorders. In this study, orexin was measured in CSF collected by lumbar puncture in 62 patients with PD, 13 patients with dementia with Lewy bodies (DLB), 16 patients with progressive supranuclear palsy (PSP), and 7 patients with corticobasal degeneration (CBD). Levels of CSF orexin (mean+/-SD pg/ml) were 302+/-38 in PD, 297+/-48 in DLB, 258+/-37 in PSP, 246+/-90 in CBD. The occurrence of low orexin levels (<or=110pg/ml) was rare in both PD and DLB, and orexin levels were significantly lower in the PSP and CBD groups compared to PD (PSP: p<0.001, CBD: p<0.05). Orexin levels were inversely correlated with duration of morbidity in PSP but not in the other conditions studied. These findings suggest that loss of orexin neurons or impaired orexin neurotransmission might exist as a part of the neurodegeneration associated with advanced PSP with long duration of morbidity.
authors.affiliation: Department of Neurology, Institute of Neurological Sciences, Faculty of Medicine, Tottori University, Yonago, Japan. yasui@grape.med.tottori-u.ac.jp
authors.forename: Kenichi
authors.initials: K
authors.lastname: Yasui
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Inoue
authors.forename: Takashi
authors.initials: T
authors.lastname: Kanbayashi
authors.forename: Takashi
authors.initials: T
authors.lastname: Nomura
authors.forename: Masayoshi
authors.initials: M
authors.lastname: Kusumi
authors.forename: Kenji
authors.initials: K
authors.lastname: Nakashima
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000032:analysis / Q000134:cerebrospinal fluid; D002556:Cerebrospinal Fluid Proteins / Q000032:analysis / Q000378:metabolism; D018450:Disease Progression; D015536:Down-Regulation / Q000502:physiology; D005260:Female; D006801:Humans; D007031:Hypothalamus / Q000378:metabolism / Q000503:physiopathology; D047908:Intracellular Signaling Peptides and Proteins / Q000134:cerebrospinal fluid*; D020961:Lewy Body Disease / Q000134:cerebrospinal fluid* / Q000175:diagnosis / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D009479:Neuropeptides / Q000134:cerebrospinal fluid*; D000068797:Orexins; D010300:Parkinson Disease / Q000134:cerebrospinal fluid* / Q000175:diagnosis / Q000503:physiopathology; D011237:Predictive Value of Tests; D045743:Scleroderma, Diffuse / Q000134:cerebrospinal fluid* / Q000175:diagnosis / Q000503:physiopathology; D012893:Sleep Wake Disorders / Q000134:cerebrospinal fluid* / Q000209:etiology / Q000503:physiopathology; D013129:Spinal Puncture
chemical_list: D015415:Biomarkers; D002556:Cerebrospinal Fluid Proteins; C000596229:HCRT protein, human; D047908:Intracellular Signaling Peptides and Proteins; D009479:Neuropeptides; D000068797:Orexins