#683

I think there could be two separate types of cause
a) Less production by the pineal
b) Some blockage in the CSF that prevents melatonin going into the third ventricle in some way. (or blocks somewhere else in the CSF).

Obviously you could also have a) and b).

#684

18.6% of the PD patients in this study had no sleep disturbances. Presumably, this group had no significant melatonin abnormalities, at least not significant enough to cause any sleep disturbances whatsoever. If almost 20% of PD patients have no melatonin abnormalities, how central can melatonin be to the development of PD, amelioration of PD (by exogenous supplementation, f.ex.) or indeed be a factor in the pathology of PD at all? Perhaps it is one possible downstream effect of PD, but by no means necessarily present in all cases. What physiological features do all PD patients share? It’s not melatonin abnormalities. Substantia nigra gets destroyed, OK. How that happens seems extremely heterogeneous. But what is the grand unifying theory of PD? Are these an extremely diverse set of diseases which happen to share a common presentation despite widely different pathologies leading to that presentation? Maybe it makes no sense to look for a single agent, like, say, melatonin, which governs PD, instead PD is just a set of symptoms stemming from a common area of damage, such as substantia nigra - and how you get there or how you might cure it is going to be all over the map.

1 Like
#685

The thing to measure is melatonin in the CSF. This is a much higher concentration than in serum and is right next to the Substantia Nigra. The concentration is perhaps 20x at night.

This is very hard to measure, but has been measured in people with PD as well as people without.

#686

There’s always a % of people in PD cohorts who actually don’t have PD. It’s maybe just 5% but if they sleep well this might lower this % a bit.

Also, here they looked at five sleep disturbances: RBD, RLS, OSA, insomnia, and EDS. They diagnosed them based on

  • “sleep conditions were comprehensively assessed with clinical questionnaires and polysomnography”
  • “All participants underwent examination by movement disorder specialists through face‒to-face interviews and detailed questionnaires.”
  • “All patients underwent night-time video-polysomnography at the Parkinson’s Disease and Movement Disorder Impatient Clinic.”

They note that “The incidence of insomnia (18.6%) was lower than that reported in a previous study”. This other study (Sleep disorders in Parkinson’s disease, an early and multiple problem 2024) found that “Sleep disorders were systematically diagnosed after medical interview and video-polysomnography in 162 participants with early stage PD and 58 healthy controls from the baseline of the longitudinal ICEBERG cohort. […] Sleep disorders were frequent (71%) and combined in half of the patients. The number of sleep disorders increased with disease duration and dysautonomia. Insomnia was the most common (41%), followed by definite RBD (25%), EDS (25%), and RLS (16%).”

If indeed about 20% of people with PD have no sleep issues at all, then this would question melatonin at being causal @John_Hemming, at least in a subset of people with PD.

However, if you would ask people “Do you think you sleep well?” and “Has your sleep worsened since you got PD?” I guess 100% of people would say they have a sleep issue even though some of them would not be properly diagnosed with a sleep disturbance.

#687

I have for a number of years thought the HPA response to melatonin was serum based. That drives the sleep cycles.

#688

For what it is worth… saw thus today.
Parkinson’s Gut Bacteria Link Suggests an Unexpected, Simple Treatment : ScienceAlert

Link: Parkinson's Gut Bacteria Link Suggests an Unexpected, Simple Treatment : ScienceAlert

We know know that many ulcers were bacteria issues. Unfortunately, many had horrible invasive surgeries that never solved the simple issue.

2 Likes
#689

Yes it’s a paper from last year: Parkinson's disease - #464 by adssx

I tried riboflavin without much success…

1 Like
#690

Lithium Chloride Rescues Dopaminergic Neurons in a Parkinson’s Disease Rat Model Challenged with Rotenone 2025

:warning: Egyptian paper + Rotenone rodent model :warning:

Rotenone significantly resulted in neurobehavioral deficits, gastrointestinal dysfunction, decreased activities of catalase and superoxide dismutase, depleted glutathione, and increased levels of malondialdehyde. It also caused DNA fragmentation and loss of dopaminergic neurons in substantia nigra and decreased striatal tyrosine hydroxylase staining intensity. Concomitant treatment of rats with rotenone and lithium chloride significantly improved behavioral impairment and markedly alleviated gastrointestinal dysfunction. It also increased catalase activity and decreased malondialdehyde levels, indicating antioxidant effects. Moreover, it decreased DNA fragmentation, rescued dopaminergic neurons, and increased tyrosine hydroxylase immunoreactivity in the striatum compared to the rotenone-treated group.

1 Like
#691

Rats. But what about human genes and GWAS?

https://www.sciencedirect.com/topics/medicine-and-dentistry/lithium-chloride

"### 6.2.3.1 Lithium

Lithium chloride, one of the most well-known mood stabilizers with antisuicidal effects, is currently being utilized as an agent for acute mania and as maintenance treatment in bipolar disorder (BD).81,82 Unfortunately, there are few pharmacogenomic studies that address the issue of response to lithium treatment (reviewed in Ref. [83]), while previous GWASs, also dealing with lithium treatment response, have added a few genetic factors affecting lithium response including only limited criteria for the phenotypic characterization of treatment response (Ref. [2] and references therein).

According to published candidate-gene studies, several genomic variants in different genes, such as 5-HTT, TPH, DRD1, FYN, INPP1, CREB1, BDNF, GSK3β, ARNTL, TIM, DPB, NR3C1, BCR, XBP1, and CACNG2 genes, have been shown to be associated with lithium treatment response. Moreover, SLC6A4 and ACCN1 gene variants have also been associated with lithium treatment outcomes in patients with BD.

In recent studies, it has been shown that the rs1800532 variant in the TPH1 gene was associated with poor lithium response in patients with the rs1800532A/A genotype. Furthermore, the rs4532 variant in the DRD1 gene is associated with poor response to lithium.84 The rs3730353 variant in the FYN gene showed prophylactic response to lithium in patients diagnosed with BD, while the c.C973A variant in the INPP1 gene affected lithium treatment efficacy. Notably, an association was also observed in the lithium response and the rs206472 variant85 As for CREB1 gene, two variants (rs6740584/rs2551710) have been correlated with response to lithium treatment, but further investigations are needed to confirm these findings.84 Furthermore, in a large-scale study, including 3874 psychiatric patients from Sweden and the United Kingdom, it was shown that variants in the PLET1 gene are significantly associated with response to lithium treatment.85

Notably, some of the genes, already mentioned to be associated with lithium response, have overlapping effects in response to antidepressants in major depressive disorder and lithium treatment response in BD, such as SLC6A4 genomic variants.85

Unfortunately, despite the large amount of genetic data on lithium response published so far, we still miss conclusive and robust evidence suggesting that certain genomic variants could be reliably used to predict the probability of responding to lithium,84 and currently, there is no single pharmacogenomic biomarker that has been approved by the FDA or the EMA yet."

Looks to me like in this particular case there is a long way from rats to how humans might react to lithium chloride. YMMV.

1 Like
#692

Lithium at higher concentrations inhibits some of the citrate transporters. That’s why I am to keep the levels around the 10-50 micromolar level (sadly too low for the labs I use to measure properly).

1 Like
#693

This is probably a useful review if anyone can get a copy.

1 Like
#694

Automated Imaging Differentiation for Parkinsonism

https://jamanetwork.com/journals/jamaneurology/fullarticle/2831631

My question is how early in the disease can they do this differentiation imaging?

#695

That’s very good! I wonder when it will be commercially available.

#696

:warning:Preprint>:warning:

A novel function of glyoxalase domain containing protein 4 (GLOD4) is associated with neuron dysfunction and neurodegeneration

Good drug target exploration for PD.

1 Like
#697

Hopefully in a few months we’ll be able to ask AI “find me existing drugs, supplements, foods or therapies that downregulate or upregulate this”.

1 Like
#698

I thought this would’ve already happened by now. So much hype over AI, still waiting for real gamechangers in usefulness. YMMV.

1 Like
#699

Have you tried Deep Research with ChatGPT 4.5? It’s VERY useful. It’s like having a smart and super efficient PhD student available 24/7. The best intellectual sparring partner possible. This has a lot of value. It won’t solve everything for you. But it’s like a super power.

2 Likes
#700

Haven’t tried it. I guess I’ve been old school just putting in loads of time reading the literature. But I should look into it, get on with the times.

2 Likes
#701

Yes, have a look. It’s also very good to challenge a paper (just send the URL or the PDF), or to confront two papers or sum them up.

1 Like
#702

I’ve been thinking about sleep disturbances and melatonin in the context of our exchanges, and looked for more studies. Since I know you especially appreciate French papers, here’s this one:

Sleep disorders in Parkinson’s disease, an early and multiple problem

https://www.nature.com/articles/s41531-024-00642-0

“The aims of this study were to determine the prevalence of sleep disturbances (insomnia, EDS, definite RBD, RLS, and SDB) in a large, systematic series of participants at an early stage of PD enrolled in a cohort for predicting PD trajectories, and in healthy controls (both studied with video-polysomnography), with a special emphasis on combination of sleep disturbances, as well as their clinical and polysomnographic associations.”