PDF(Pubmed)
Abstract：
Synucleinopathies are a group of neurodegenerative diseases characterized by abnormal accumulations of insoluble alpha-synuclein in neurons or glial cells. These consist of Parkinson\'s disease (PD), dementia with Lewy bodies (DLB), and multiple system atrophy (MSA). Moreover, idiopathic REM sleep behavior disorder (iRBD) is often the first manifestation of synucleinopathies, demonstrating a pathophysiological continuum. While these disorders vary in prevalence, symptom patterns, and severity, they can all include autonomic nervous system (ANS) dysfunction, which significantly reduces quality of life and worsens prognosis. Consequently, identifying abnormalities of the ANS can provide opportunities for improving quality of life through symptomatic treatments that are tailored to the individual\'s symptoms. An exciting development is using heart rate variability (HRV) as a non-invasive research tool for analyzing how the ANS regulates physiological processes. HRV during sleep, however, may provide a more accurate and reliable measure of ANS activity than during wakefulness, as during awake time, ANS activity is influenced by a variety of factors, including physical activity, stress, and emotions, which may mask or confound the underlying patterns of ANS activity. This review aims to provide an overview of the current knowledge regarding sleep-related HRV in synucleinopathies and to discuss contributing mechanisms. Evidence suggests that iRBD, PD, and MSA are associated with nocturnal ANS dysfunction. Further, comparative studies indicate that the presence of RBD could exacerbate this abnormality. In contrast, no studies have been conducted in patients with DLB. Overall, this review provides new insight into the complex interplay between the ANS and synucleinopathies and underscores the need for further research in this area to develop effective therapies to improve sleep and overall quality of life in patients with synucleinopathies.
摘要：
突触核蛋白病是一组神经退行性疾病，其特征是神经元或神经胶质细胞中不溶性α-突触核蛋白的异常积累。这些包括帕金森病（PD），路易体痴呆（DLB），多系统萎缩（MSA）。此外，特发性REM睡眠行为障碍（iRBD）通常是突触核蛋白病的首发表现，表现出病理生理连续体。虽然这些疾病的患病率各不相同，症状模式，和严重性，它们都可以包括自主神经系统（ANS）功能障碍，这显著降低了生活质量并恶化了预后。因此,识别ANS的异常可以通过针对个体症状的对症治疗为改善生活质量提供机会.一个令人兴奋的发展是使用心率变异性（HRV）作为一种非侵入性研究工具，用于分析ANS如何调节生理过程。睡眠期间的HRV，然而,可以提供比清醒期间更准确和可靠的ANS活动测量，在清醒的时候，ANS活性受多种因素影响,包括体力活动,压力，和情感，这可能会掩盖或混淆ANS活动的基本模式。这篇综述旨在概述有关突触核蛋白病中睡眠相关HRV的最新知识，并讨论其作用机制。证据表明iRBD,PD,MSA与夜间ANS功能障碍有关。Further,比较研究表明，RBD的存在可能会加剧这种异常。相比之下,尚未对DLB患者进行研究.总的来说,这篇综述提供了对ANS与突触核蛋白病之间复杂相互作用的新见解,并强调需要在该领域进行进一步研究,以开发有效的治疗方法来改善突触核蛋白病患者的睡眠和整体生活质量.
