Abstract：
In the last years, the hypothesis of a close relationship between sleep disorders (SDs) and Parkinson\'s disease (PD) has significantly strengthened. Whether this association is causal has been also highlighted by recent evidence demonstrating a neurobiological link between SDs and PD. Thus, the question is not whether these two chronic conditions are mutually connected, but rather how and when this relationship is expressed. Supporting this, not all SDs manifest with the same temporal sequence in PD patients. Indeed, SDs can precede or occur concomitantly with the onset of the clinical manifestation of PD. This review discusses the existing literature, putting under a magnifying glass the timing of occurrence of SDs in PD-neurodegeneration. Based on this, here, we propose two possible directions for studying the SDs-PD relationship: the first direction, from SDs to PD, considers SDs as potential biomarker/precursor of future PD-neurodegeneration; the second direction, from PD to SDs, considers SDs as concomitant symptoms in manifest PD, mainly related to primary PD-neuropathology and/or parkinsonian drugs. Furthermore, for each direction, we questioned SDs-PD relationship in terms of risk factors, neuronal circuits/mechanisms, and impact on the clinical phenotype and disease progression. Future research is needed to investigate whether targeting sleep may be the winning strategy to treat PD, in the context of a personalized precision medicine.
摘要：
在过去的几年里，睡眠障碍（SDs）与帕金森病（PD）密切相关的假说得到了显著加强。最近的证据证明了SD和PD之间的神经生物学联系，也强调了这种关联是否是因果关系。因此，问题不是这两种慢性病是否相互联系，而是如何以及何时表达这种关系。支持这一点,在PD患者中，并非所有SD都具有相同的时间序列。的确,SD可以先于或伴随PD临床表现的发作而发生。这篇综述讨论了现有的文献，将PD-神经变性中SDs的发生时间置于放大镜下。基于此,在这里，我们提出了研究SDs-PD关系的两个可能方向：第一个方向，从SDs到PD,将SDs视为未来PD-神经变性的潜在生物标志物/前体；第二个方向，从PD到SD，认为SDs是明显PD的伴随症状，主要与原发性PD神经病理学和/或帕金森病药物有关。此外，对于每个方向，我们从风险因素的角度质疑了SDs-PD的关系，神经元回路/机制，以及对临床表型和疾病进展的影响。未来的研究需要调查是否针对睡眠可能是治疗PD的成功策略，在个性化精准医疗的背景下。
