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Excessive Day Time Sleepiness is Not Part of Parkinson's Disease Disability in De Novo Patients: Results from the PPMI Study

Simuni, T; Caspell-Garcia, C; Coffey, C; Chahine, L.C; Lasch, S; Oertel, W; Marek, K for the PPMI Sleep Working Group; The Parkinson\'s Progression Markers Initiative
 
2014-06-11
MDS: Stockholm, Sweden
Download Presentation: 803 EDS-Poster-JUNE-2014-MDS.pdf
 
Abstract:
Objective:
To determine the frequency and correlates of excessive day time sleepiness (EDS) in de novo, untreated Parkinson's disease (PD) patients compared with the general population.

Background:
EDS is highly prevalent in PD and is associated with significant disability. The etiology of EDS is multifactorial and attributed to PD pathology as well as medications effect. EDS was also shown to be one of the premotor risk factors for PD. However, there is limited data on the prevalence of EDS in the de novo untreated PD population.

Methods:
Parkinson's Progression Markers Initiative (PPMI) is an international study of de novo, untreated (at enrolment) PD patients and healthy controls (HCs). At baseline, participants were assessed with a wide range of motor and non-motor scales including The Movement Disorder Society Unified Parkinson's disease Rating Scale (MDS-UPDRS). EDS was assessed based on the Epworth Sleepiness scale (ESS) with the cut off >=10.

Results:
423 PD subjects and 196 HCs were recruited into the study. Mean ESS (min, max) score 5.8(0,20) for PD subjects and 5.6(0,19) for HC (p=0.54). 66 (15.6%) PD subjects and 24(12%) HCs had ESS>=10 (p=0.28). There was no difference in demographic characteristics, age of onset, disease duration, PD subtype, cognitive status or utilization of sedatives between PD EDS?+?vs ? group. EDS?+?group had higher MDS-UPDRS Part I and II but not III scores, and had higher depression, anxiety and autonomic dysfunction scores.

Conclusions:
Despite epidemiological data on EDS as a risk factor for PD, our study failed to identify higher prevalence of EDS in the largest cohort of reported subjects with de novo untreated PD compared to HCs. The only clinical correlates of EDS were mood and anxiety. Additional analyses of this cohort will examine neurobiological predictors of EDS, as well as follow the cohort longitudinally.