CSF orexin levels of Parkinson's disease, dementia with Lewy bodies, progressive supranuclear palsy and corticobasal degeneration

J Neurol Sci. 2006 Dec 1;250(1-2):120-3. doi: 10.1016/j.jns.2006.08.004. Epub 2006 Sep 26.


Excessive daytime sleepiness has been widely accepted as a common problem not only in Parkinson's disease (PD) but also in other related disorders. Lowered excretion of orexin A (hypocretin 1) into the cerebrospinal fluid (CSF) is known to play a pathological role in narcolepsy and secondary hypersomnia due to hypothalamic dysfunction. Although the levels of CSF orexin in PD have been previously examined, the results have been controversial, and no systematic investigation of CSF orexin excretion has been conducted on PD related disorders. In this study, orexin was measured in CSF collected by lumbar puncture in 62 patients with PD, 13 patients with dementia with Lewy bodies (DLB), 16 patients with progressive supranuclear palsy (PSP), and 7 patients with corticobasal degeneration (CBD). Levels of CSF orexin (mean+/-SD pg/ml) were 302+/-38 in PD, 297+/-48 in DLB, 258+/-37 in PSP, 246+/-90 in CBD. The occurrence of low orexin levels (<or=110pg/ml) was rare in both PD and DLB, and orexin levels were significantly lower in the PSP and CBD groups compared to PD (PSP: p<0.001, CBD: p<0.05). Orexin levels were inversely correlated with duration of morbidity in PSP but not in the other conditions studied. These findings suggest that loss of orexin neurons or impaired orexin neurotransmission might exist as a part of the neurodegeneration associated with advanced PSP with long duration of morbidity.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aged, 80 and over
  • Biomarkers / analysis
  • Biomarkers / cerebrospinal fluid
  • Cerebrospinal Fluid Proteins / analysis
  • Cerebrospinal Fluid Proteins / metabolism
  • Disease Progression
  • Down-Regulation / physiology
  • Female
  • Humans
  • Hypothalamus / metabolism
  • Hypothalamus / physiopathology
  • Intracellular Signaling Peptides and Proteins / cerebrospinal fluid*
  • Lewy Body Disease / cerebrospinal fluid*
  • Lewy Body Disease / diagnosis
  • Lewy Body Disease / physiopathology
  • Male
  • Middle Aged
  • Neuropeptides / cerebrospinal fluid*
  • Orexins
  • Parkinson Disease / cerebrospinal fluid*
  • Parkinson Disease / diagnosis
  • Parkinson Disease / physiopathology
  • Predictive Value of Tests
  • Scleroderma, Diffuse / cerebrospinal fluid*
  • Scleroderma, Diffuse / diagnosis
  • Scleroderma, Diffuse / physiopathology
  • Sleep Wake Disorders / cerebrospinal fluid*
  • Sleep Wake Disorders / etiology
  • Sleep Wake Disorders / physiopathology
  • Spinal Puncture


  • Biomarkers
  • Cerebrospinal Fluid Proteins
  • HCRT protein, human
  • Intracellular Signaling Peptides and Proteins
  • Neuropeptides
  • Orexins