title: Circadian rest-activity rhythm is altered in Parkinson's disease patients with hallucinations.
abstract: The sleep-wake cycle in Parkinson's Disease (PD) is profoundly disrupted, but less is known about circadian rhythm in PD and its relationship to other important clinical features. This study compared rest-activity rhythms in healthy older adults and PD patients with and without hallucinations. Twenty-nine older adults and 50 PD patients (27 with hallucinations, 23 without) were assessed using wrist-worn actigraphy for 5 days. Disease-related and cognitive data were also collected. PD patients demonstrated reduced amplitude of activity (F = 12.719, P < 0.01) and increased intradaily variability (F = 22.005, P < 0.001), compared to healthy older adults, independently of age, and cognitive status. Hallucinators showed lower interdaily stability (F = 7.493, P < 0.01) significantly greater activity during "night-time" (F = 6.080, P < 0.05) and significantly reduced relative amplitude of activity (F = 5.804, P < 0.05) compared to nonhallucinators, independently of clinical factors including motor fluctuations. PD patients with hallucinations display altered rest-activity rhythm characterized by an unpredictable circadian pattern across days, likely arising from damage to brainstem and hypothalamic sleep centers. Treatment of sleep and rest-activity rhythm disturbance is an important target in Parkinson's Disease.
authors.affiliation: King's College London, Institute of Psychiatry, MRC Centre for Neurodegeneration, London, United Kingdom. daisy.whitehead@iop.kcl.ac.uk
authors.forename: Daisy L
authors.initials: DL
authors.lastname: Whitehead
authors.forename: Ann D M
authors.initials: AD
authors.lastname: Davies
authors.forename: Jeremy R
authors.initials: JR
authors.lastname: Playfer
authors.forename: Christopher J
authors.initials: CJ
authors.lastname: Turnbull
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000978:Antiparkinson Agents / Q000627:therapeutic use; D002940:Circadian Rhythm; D018491:Dopamine Agonists / Q000627:therapeutic use; D005260:Female; D006212:Hallucinations / Q000175:diagnosis* / Q000188:drug therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D018670:Monitoring, Ambulatory; D009043:Motor Activity; D010300:Parkinson Disease / Q000175:diagnosis* / Q000188:drug therapy; D012016:Reference Values; D012146:Rest; D020178:Sleep Disorders, Circadian Rhythm / Q000175:diagnosis
chemical_list: D000978:Antiparkinson Agents; D018491:Dopamine Agonists