临床神经病学杂志2025，Vol.38Issue(6)：412-418,7.
帕金森病患者日间嗜睡与脑胶质淋巴系统功能障碍及白质病变的关系
Relationship between daytime sleepiness,glymphatic system dysfunction,and white matter lesions in Parkinson's disease patients
摘要
Abstract
Objective To investigate the relationship between excessive daytime sleepiness(EDS)and glymphatic system function and white matter hyperintensities(WMH)in Parkinson's disease(PD)patients,and to analyze the potential mediating role of glymphatic system function.Methods A total of 34 PD patients with EDS,119 PD patients without EDS and 85 healthy controls were included in this study.The DTI analysis along the perivascular space(DTI-ALPS)index(ALPS index for short)was used to assess glymphatic system function,and 3.0 T MRI was utilized to measure WMH volume.Multiple regression analysis was performed to determine independent predictors of ALPS index and WMH volume,and mediation analysis was conducted to explore the potential mediating role of ALPS index between sleep quality and WMH.Results The ALPS index in EDS group was significantly lower than that in non-EDS group[(1.3±0.1)vs.(1.4±0.1),P＜0.001],while WMH volume was significantly higher than that in non-EDS group[(3 000.3±2 578.5)mm3 vs.(2 323.6±1 839.2)mm3,P=0.028].Age and PD sleep scale(PDSS)score were independent predictors of ALPS index(all P＜0.001),while age,PDSS score,MMSE score,and total intracranial volume were independent predictors of WMH volume(all P＜0.05).Mediation analysis revealed that ALPS index completely mediated the effect of PDSS score on WMH volume(B=-7.9513,95％CI:-13.5046--3.8336).Conclusions EDS in PD patients is significantly associated with glymphatic system dysfunction and increased white matter hyperintensity volume,suggesting that the pathological cascade of"sleep disorders → decreased glymphatic function → increased WMH"may be involved in PD disease progression.The ALPS index shows promise as a potential biomarker for assessing sleep disorders and disease progression in PD.关键词
帕金森病/日间过度嗜睡/胶质淋巴系统/白质高信号/中介效应Key words
Parkinson's disease/excessive daytime sleepiness/glymphatic system/white matter hyperintensities/mediation effect分类
医药卫生引用本文复制引用
夏婷婷,刘丽,庄娇娇,邢逸,闫磊,刘卫国,张睿..帕金森病患者日间嗜睡与脑胶质淋巴系统功能障碍及白质病变的关系[J].临床神经病学杂志,2025,38(6):412-418,7.基金项目
国家自然科学基金面上项目(82371268) （82371268）
