Cerebrospinal fluid hypocretin-1 levels in multiple system atrophy

Authors

  • Jose Enrique Martinez-Rodriguez MD,

    1. Neurology Service, Hospital Clínic de Barcelona and Institut d'Investigació Biomèdica August Pi i Sunyer (IDIBAPS), University of Barcelona Medical School, Barcelona, Spain
    Current affiliation:
    1. Neurology Service, Hospital del Mar, IMAS, Barcelona, Spain
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  • Klaus Seppi MD,

    1. Clinical Department of Neurology, Innsbruck Medical University, Innsbruck, Austria
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  • Adriana Cardozo MD,

    1. Neurology Service, Hospital Clínic de Barcelona and Institut d'Investigació Biomèdica August Pi i Sunyer (IDIBAPS), University of Barcelona Medical School, Barcelona, Spain
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  • Alex Iranzo MD,

    1. Neurology Service, Hospital Clínic de Barcelona and Institut d'Investigació Biomèdica August Pi i Sunyer (IDIBAPS), University of Barcelona Medical School, Barcelona, Spain
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  • Michaela Stampfer-Kountchev MD,

    1. Clinical Department of Neurology, Innsbruck Medical University, Innsbruck, Austria
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  • Gregor Wenning MD,

    1. Clinical Department of Neurology, Innsbruck Medical University, Innsbruck, Austria
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  • Eduardo Tolosa MD,

    1. Neurology Service, Hospital Clínic de Barcelona and Institut d'Investigació Biomèdica August Pi i Sunyer (IDIBAPS), University of Barcelona Medical School, Barcelona, Spain
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  • Birgit Högl MD,

    1. Clinical Department of Neurology, Innsbruck Medical University, Innsbruck, Austria
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  • Joan Santamaria MD,

    Corresponding author
    1. Neurology Service, Hospital Clínic de Barcelona and Institut d'Investigació Biomèdica August Pi i Sunyer (IDIBAPS), University of Barcelona Medical School, Barcelona, Spain
    • Neurology Service, Hospital Clínic de Barcelona, c/Villarroel 170, 08036 Barcelona, Spain
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  • Werner Poewe MD

    1. Clinical Department of Neurology, Innsbruck Medical University, Innsbruck, Austria
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Abstract

Hypocretin (orexin) cerebrospinal fluid (CSF) levels have been previously found normal or decreased in Dementia with Lewy bodies and Parkinson disease, two synucleinopathies commonly associated with excessive daytime sleepiness (EDS). We evaluated CSF hypocretin-1 levels in 15 patients with moderately severe multiple system atrophy (MSA), another synucleinopathy where sleep disorders occur frequently and EDS has been reported, performing additional electrophysiological studies in 5 of them to assess the presence of EDS and sleep onset REM (SOREM) periods. Despite relatively low sleep efficiencies in nocturnal sleep, mean sleep latencies in the Multiple Sleep Latency Test were normal with no SOREM periods. All patients had CSF hypocretin-1 levels in the normal range (>200 pg/mL) suggesting that the hypocretin system is not altered in MSA, at least in patients with a moderately severe disease. © 2007 Movement Disorder Society

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