Orexinergic system dysregulation, sleep impairment, and cognitive decline in Alzheimer disease

Claudio Liguori, Andrea Romigi, Marzia Nuccetelli, Silvana Zannino, Giuseppe Sancesario, Alessandro Martorana, Maria Albanese, Nicola Biagio Mercuri, Francesca Izzi, Sergio Bernardini, Alessandra Nitti, Giulia M. Sancesario, Francesco Sica, Maria G. Marciani, Fabio Placidi

Research output: Contribution to journalArticlepeer-review


IMPORTANCE: Nocturnal sleep disruption develops in Alzheimer disease (AD) owing to the derangement of the sleep-wake cycle regulation pathways. Orexin contributes to the regulation of the sleep-wake cycle by increasing arousal levels and maintaining wakefulness. OBJECTIVES: To study cerebrospinal fluid levels of orexin in patients with AD, to evaluate the relationship of orexin cerebrospinal fluid levels with the degree of dementia and the cerebrospinal fluid AD biomarkers (tau proteins and β-amyloid 1-42), and to analyze potentially related sleep architecture changes measured by polysomnography. DESIGN, SETTING, AND PARTICIPANTS: We conducted a case-control study from August 1, 2012, through May 31, 2013.We included 48 drug-naive AD patients referred to the Neurological Clinic of the University Hospital of Rome Tor Vergata. Based on the Mini-Mental State Examination score, 21 patients were included in mild AD group (score, ≥21), whereas 27 were included in the moderate to severe AD group (score,

Original languageEnglish
Pages (from-to)1498-1505
Number of pages8
JournalJAMA Neurology
Issue number12
Publication statusPublished - Dec 1 2014

ASJC Scopus subject areas

  • Arts and Humanities (miscellaneous)
  • Clinical Neurology
  • Medicine(all)


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