Objective: We explored the relationship between the build-up and the downscaling process in patients with Parkinson’s disease by analyzing theta frequency spectral bands.

Background: During slow wave sleep (SWS), slow wave activity (SWA) plays a significant role in downscaling synaptic strength, crucial for the brain’s ability to adapt and change. SWA, typically occurring in the early part of the night, serves as a primary electrophysiological marker for the homeostatic process. Conversely, theta activity during wakefulness indicates synaptic potentiation, with SWA decreasing during sleep and theta increasing during wakefulness.

A connection between levodopa-induced dyskinesia (LID) in Parkinson’s disease (PD) and impairment in sleep-mediated synaptic downscaling has been noted [1,2]. However, it remains unclear whether this dysfunction is due to impaired SWA-mediated downscaling or a lower build-up process. Therefore, this study focuses on theta activity to investigate the build-up process during wakefulness.

Method: Three different PD groups—de novo (n = 8), advanced (n = 6), and dyskinetic (n = 6)—were recruited and compared to healthy volunteers (n = 7). All participants underwent physical and neurological examinations and were provided with inertial sensors to monitor their sleep-wake cycle for a week. Two short EEG recordings were conducted, the first in the morning and the second 9 hours later. During the EEG recording, participants also performed a go/no-go task.

Results: Our preliminary findings suggest alterations in theta activity in the morning among dyskinetic patients, indicating an altered build-up during the day compared to the other groups. These results support the notion of an inherent disruption in the sleep-mediated mechanism of synaptic downscaling.

Conclusion: This study sheds light on the relationship between sleep and the onset of LID in PD. Confirmation of these results could lead to innovative therapies aimed at enhancing SWA in PD, potentially offering new treatment avenues for LID.

References: [1] Amato N, Manconi M, Möller JC, Sarasso S, Stanzione P, Staedler C, Kaelin-Lang A, Galati S. Levodopa induced dyskinesia in Parkinson disease: Sleep matters. Ann Neurol. 2018 Dec;84(6):905-917. doi: 10.1002/ana.25360. Epub 2018 Nov 29. PMID: 30328147.
[2] Amato, N., Caverzasio, S., Manconi, M. et al. Slow wave activity across sleep-night could predict levodopa-induced dyskinesia. Sci Rep 13, 15468 (2023). https://doi.org/10.1038/s41598-023-42604-1

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MDS Abstracts - https://www.mdsabstracts.org/abstract/altered-eeg-theta-activity-characterizes-parkinsons-disease-with-levodopa-induced-dyskinesia/