Clinical and neuroanatomical correlates of daytime sleepiness in Parkinson’s disease (PD) remain inconsistent in the literature. Two studies were conducted here. The first evaluated the interrelation between non-motor and motor symptoms, using a principal component analysis, associated with daytime sleepiness in PD. The second identified the neuroanatomical substrates associated with daytime sleepiness in PD using magnetic resonance imaging (MRI). In the first study, 77 participants with PD completed an extensive clinical, cognitive testing and a polysomnographic recording. In the second study, 29 PD participants also underwent MRI acquisition of T1-weighted images. Vertex-based cortical and subcortical surface analysis, deformation-based morphometry, and voxel-based morphometry were performed to assess the association between daytime sleepiness severity and structural brain changes in participants. In both studies, the severity of daytime sleepiness and the presence of excessive daytime sleepiness (EDS; total score >10) were measured using the Epworth Sleepiness Scale. We found that individuals with EDS had a higher score on a component including higher dosage of dopamine receptor agonists, motor symptoms severity, shorter sleep latency, and greater sleep efficiency. Moreover, increased daytime sleepiness severity was associated with a larger surface area in the right insula, contracted surfaces in the right putamen and right lateral amygdala, and a larger surface in the right posterior amygdala. Hence, daytime sleepiness in PD was associated with dopaminergic receptor agonists dosage, motor impairment, and objective sleep measures. Moreover, neuroanatomical changes in cortical and subcortical regions related to vigilance, motor, and emotional states were associated with more severe daytime sleepiness.

帕金森病（PD）白天嗜睡的临床和神经解剖学相关性在文献中仍然不一致。这里进行了两项研究。第一个研究使用主成分分析评估了与帕金森病患者白天嗜睡相关的非运动症状和运动症状之间的相互关系。第二项研究利用磁共振成像 (MRI) 确定了与 PD 白天嗜睡相关的神经解剖学基础。在第一项研究中，77 名 PD 参与者完成了广泛的临床、认知测试和多导睡眠图记录。在第二项研究中，29 名 PD 参与者还接受了 T1 加权图像的 MRI 采集。进行基于顶点的皮质和皮质下表面分析、基于变形的形态测量和基于体素的形态测量，以评估参与者白天嗜睡严重程度与大脑结构变化之间的关联。在这两项研究中，使用 Epworth 嗜睡量表测量了白天嗜睡的严重程度和是否存在白天过度嗜睡（EDS；总分 >10）。我们发现患有 EDS 的个体在某些方面得分较高，包括较高剂量的多巴胺受体激动剂、运动症状严重程度、较短的睡眠潜伏期和较高的睡眠效率。此外，白天嗜睡严重程度的增加与右侧岛叶较大的表面积、右侧壳核和右侧杏仁核的收缩表面以及右侧杏仁核后部较大的表面有关。因此，帕金森病患者的白天嗜睡与多巴胺能受体激动剂的剂量、运动障碍和客观睡眠测量相关。 此外，与警惕性、运动和情绪状态相关的皮质和皮质下区域的神经解剖学变化与更严重的白天嗜睡有关。