Sleep disorders cause Parkinson's disease or the reverse is true: Good GABA good night,CNS Neuroscience & Therapeutics

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Sleep disorders cause Parkinson's disease or the reverse is true: Good GABA good night
CNS Neuroscience & Therapeutics ( IF 4.8 ) Pub Date : 2024-03-16 , DOI: 10.1111/cns.14521
Hayder M Al-Kuraishy ₁ , Ali I Al-Gareeb ₁ , Ali K Albuhadily ₁ , Yaser Hosny Ali Elewa _{2,

3} , Ammar Al-Farga ₄ , Faisal Aqlan ₅ , Mahmoud Hosny Zahran ₆ , Gaber El-Saber Batiha ₇

Affiliation

BackgroundParkinson's disease (PD) is a progressive neurodegenerative brain disease due to degeneration of dopaminergic neurons (DNs) presented with motor and non‐motor symptoms. PD symptoms are developed in response to the disturbance of diverse neurotransmitters including γ‐aminobutyric acid (GABA). GABA has a neuroprotective effect against PD neuropathology by protecting DNs in the substantia nigra pars compacta (SNpc). It has been shown that the degeneration of GABAergic neurons is linked with the degeneration of DNs and the progression of motor and non‐motor PD symptoms. GABA neurotransmission is a necessary pathway for normal sleep patterns, thus deregulation of GABAergic neurotransmission in PD could be the potential cause of sleep disorders in PD.AimSleep disorders affect GABA neurotransmission leading to memory and cognitive dysfunction in PD. For example, insomnia and short sleep duration are associated with a reduction of brain GABA levels. Moreover, PD‐related disorders including rigidity and nocturia influence sleep patterns leading to fragmented sleep which may also affect PD neuropathology. However, the mechanistic role of GABA in PD neuropathology regarding motor and non‐motor symptoms is not fully elucidated. Therefore, this narrative review aims to clarify the mechanistic role of GABA in PD neuropathology mainly in sleep disorders, and how good GABA improves PD. In addition, this review of published articles tries to elucidate how sleep disorders such as insomnia and REM sleep behavior disorder (RBD) affect PD neuropathology and severity. The present review has many limitations including the paucity of prospective studies and most findings are taken from observational and preclinical studies. GABA involvement in the pathogenesis of PD has been recently discussed by recent studies. Therefore, future prospective studies regarding the use of GABA agonists in the management of PD are suggested to observe their distinct effects on motor and non‐motor symptoms.ConclusionThere is a bidirectional relationship between the pathogenesis of PD and sleep disorders which might be due to GABA deregulation.

中文翻译：

睡眠障碍会导致帕金森病，反之亦然：晚安 GABA

背景帕金森病（PD）是一种进行性神经退行性脑部疾病，由于多巴胺能神经元（DN）变性而出现运动和非运动症状。 PD 症状是由于多种神经递质（包括 γ-氨基丁酸 (GABA)）受到干扰而出现的。 GABA 通过保护黑质致密部 (SNpc) 中的 DN，对 PD 神经病理学具有神经保护作用。研究表明，GABA 能神经元的变性与 DN 的变性以及运动和非运动 PD 症状的进展有关。 GABA神经传递是正常睡眠模式的必要途径，因此PD中GABA能神经传递的失调可能是PD睡眠障碍的潜在原因。目的睡眠障碍影响GABA神经传递，导致PD记忆和认知功能障碍。例如，失眠和睡眠时间短与大脑 GABA 水平降低有关。此外，包括强直和夜尿在内的帕金森病相关疾病会影响睡眠模式，导致睡眠碎片化，这也可能影响帕金森病的神经病理学。然而，GABA 在 PD 神经病理学中关于运动和非运动症状的机制作用尚未完全阐明。因此，这篇叙述性综述旨在阐明 GABA 在 PD 神经病理学（主要是睡眠障碍）中的机制作用，以及良好的 GABA 如何改善 PD。此外，这篇对已发表文章的综述试图阐明失眠和快速眼动睡眠行为障碍 (RBD) 等睡眠障碍如何影响 PD 神经病理学和严重程度。目前的综述有许多局限性，包括缺乏前瞻性研究，并且大多数发现来自观察性和临床前研究。最近的研究讨论了 GABA 参与 PD 发病机制。因此，未来关于使用 GABA 激动剂治疗 PD 的前瞻性研究建议观察其对运动和非运动症状的独特影响。结论 PD 的发病机制与睡眠障碍之间存在双向关系，这可能是由 GABA 引起的放松管制。

更新日期：2024-03-16

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