Objective: To explore the electroencephalographic (EEG) characteristics and brain functional connectivity patterns in Parkinson’s disease (PD) patients with daytime sleepiness.

Background: Daytime sleepiness is a highly prevalent and debilitating non-motor symptom in PD, affecting up to 50% of patients and significantly impairing quality of life, yet its underlying neural mechanisms remain poorly understood due to the heterogeneity of PD pathology and the lack of objective neurophysiological biomarkers.

Method: A total of 69 PD patients were enrolled and divided into two groups based on the Epworth Sleepiness Scale (ESS) score: the daytime sleepiness group (27 patients, ESS score ≥ 7) and the non-daytime sleepiness group (42 patients). All patients underwent overnight polysomnography (PSG) and resting-state functional magnetic resonance imaging (fMRI). The Chronux toolbox with the multi-taper estimation method was used for preprocessing and power spectral density (PSD) analysis of sleep EEG data to compare differences in EEG activity between the two groups across different sleep stages, brain regions, and frequency bands. Voxel-wise functional connectivity (FC) analysis was performed with bilateral occipital lobes as seed regions to compare changes in functional connectivity between the two groups.

Results: There were no significant differences in general demographic data such as age, years of education, and disease duration between the two groups (P > 0.05). Sleep EEG PSD analysis revealed that the PSD of the beta (13–30 Hz) and alpha (8–13 Hz) bands in the occipital lobe was significantly higher in the daytime sleepiness group than in the non-daytime sleepiness group (P < 0.05). Functional magnetic resonance imaging analysis showed that compared with the non-daytime sleepiness group, the functional connectivity between the right precentral gyrus and bilateral occipital lobes was significantly reduced in the daytime sleepiness group (P < 0.05, corrected by AlphaSim).

Conclusion: PD patients with daytime sleepiness exhibit abnormal occipital lobe EEG activity and weakened functional connectivity between the right precentral gyrus and occipital lobes. These findings suggest that excessive excitability of the occipital cortex and disrupted functional connectivity between the motor cortex and visual cortex may be involved in the pathogenesis of daytime sleepiness in PD.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/electroencephalographic-and-functional-magnetic-resonance-imaging-analysis-of-daytime-sleepiness-in-parkinsons-disease/