
The ubiquitin proteasome pathway – PD genes Adapted from Eriksen et al Arch Neurol 2005, 6: 353-357
Sleep disturbances etiology • Degeneration of forebrain preoptic area • Thalamic dysfunction • Dopaminergic drugs
Sleep disturbances in PD • Insomnia • Motor • Urinary • Neuropsychiatric Vivid dreams Hallucinations REM behavior disorder - RLS
Sleepiness in PD – 15 % • Depression • Drugs • Disturbed sleep • Progressive disease course
Hedonistic dysregulation syndrome • Need for increasing dopaminergic drugs • Drug seeking behavior • Impaired social functioning • Hypomanic cyclothymic affective syndrome • Withdrawal state of depression, anxiety
Hedonistic homeostatic regulation • Related to DA stimulation • Young onset • Male • Drug seeking • Adventure seeking • Pathological gambling
Limitations • Retrospective • Interview • Possible relationship between PD dementia - family history of dementia