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Low levels of ventricular CSF orexin/hypocretin in advanced PD

From Service de Physiologie-Explorations Fonctionnelles (Drs. Drouot, Lefaucheur, Goldenberg, and d’Ortho), Unité Inserm U421-Université Paris XII, Faculté de Médecine de Créteil (Dr. Drouot), Service de Biochimie (Dr. Mouterau), Service de Neurochirurgie (Dr. Nguyen), and Service de Neurologie (Drs. Créange and Remy), Hôpital Henri Mondor, Assistance Publique–Hôpitaux de Paris, Créteil, France.

Address correspondence and reprint requests to Dr. Xavier Drouot, Service de Physiologie–Explorations Fonctionnelles, Hôpital Henri Mondor, 51 avenue du Maréchal de Lattre de Tassigny, 94 010 Créteil, France; e-mail: xavier.drouot{at}hmn.ap-hop-paris.fr

The origins of excessive daytime sleepiness in Parkinson disease (PD) are unclear. The authors hypothesize that orexin neurons, a recently identified wake promoting system, could contribute to its pathophysiology. They measured orexin-A/hypocretin-1 concentration in ventricular CSF in 19 parkinsonian patients and compared it with neurologic controls. Orexin levels were lower in patients and decreased with the severity of the disease. The authors suggest that orexin neurons contribute to daytime sleepiness in late stage PD.

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