Hallucinations, dreaming, and frequent dozing in Parkinson disease: impact of right-hemisphere neural networks.
OBJECTIVE
To relate sleep disturbances in Parkinson disease (PD) to hemispheric asymmetry of initial presentation.


BACKGROUND
Sleep disturbances are common in PD arising from the neurodegenerative process underlying the disease, which is usually lateralized at onset. Patients with left-side Parkinson disease onset (LPD: right hemisphere dysfunction) exhibit reduced vigilance relative to those with right-side Parkinson disease onset (RPD: left hemisphere dysfunction), leading us to hypothesize that sleep-related disturbances, particularly excessive daytime sleepiness, would be more severe for LPD than for RPD.


METHODS
Thirty-one nondemented participants with PD (17 RPD and 14 LPD) and 17 age-matched control (CO) participants with chronic health conditions were administered the Parkinson Disease Sleep Scale and polysomnography was performed on a subset of the PD participants.


RESULTS
Both PD subgroups exhibited more nighttime motor symptoms than the CO group, but only LPD endorsed more nocturnal hallucinations and daytime dozing. Controlling for mood additionally revealed more vivid dreaming in LPD than RPD. There were no significant differences between LPD and RPD on measures of sleep architecture.


CONCLUSIONS
Increased dreaming, hallucinations, and daytime somnolescence in LPD may be related to changes in right-hemisphere neural networks implicated in the generation and control of visual images, arousal, and vigilance. Our results underscore the need to consider side of onset in regard to sleep disturbances in PD.
Stavitsky
Karina
K
Department of Psychology, Boston University, Boston, MA, USA.
McNamara
Patrick
P
Durso
Raymon
R
Harris
Erica
E
Auerbach
Sanford
S
Cronin-Golomb
Alice
A
D000368:Aged; D000978:Antiparkinson Agents / Q000627:therapeutic use; D001921:Brain / Q000503:physiopathology*; D003072:Cognition Disorders / Q000175:diagnosis / Q000453:epidemiology; D006970:Disorders of Excessive Somnolence / Q000453:epidemiology*; D004325:Dreams; D005260:Female; D007839:Functional Laterality / Q000502:physiology*; D006212:Hallucinations / Q000453:epidemiology*; D006801:Humans; D007980:Levodopa / Q000627:therapeutic use; D008297:Male; D009415:Nerve Net / Q000503:physiopathology*; D009483:Neuropsychological Tests; D010300:Parkinson Disease / Q000188:drug therapy / Q000453:epidemiology* / Q000503:physiopathology*; D012895:Sleep, REM / Q000502:physiology
D000978:Antiparkinson Agents; D007980:Levodopa
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