Crosstalk between movement disorders, sleep disturbances and striatum: A comprehensive review

Movement disorders such as Parkinson’s disease frequently present with comorbid sleep disturbances, which exacerbate motor symptoms and reduce patients’ quality of life. The striatum, a critical basal ganglia structure, is implicated in both motor control and sleep regulation and represents the key anatomical locus affected in these disorders. While nutritional and exercise interventions have shown promise independently, a significant gap remains in understanding the synergistic molecular crosstalk between these lifestyle modifications and how they collectively target the striatal mechanisms disrupted by sleep deprivation. This review synthesizes evidence to elucidate the integrated, neurobiological effects of combined nutritional and exercise interventions on sleep deprivation-associated movement disorders, emphasizing the striatum’s pivotal role. We establish that exercise, through the induction of neurotrophic factors (like BDNF/GDNF) and enhanced dopaminergic signaling (DAT), provides a critical foundation for synaptic repair. This foundation is synergistically amplified by targeted nutritional strategies, such as polyphenols and omega-3s, which augment antioxidant capacity, dampen neuroinflammation (NRF2/NFκB axis), and modulate key receptors (like A2AR) within the striatum. These combined, non-pharmacological approaches more effectively restore striatal homeostasis and redox balance than either intervention alone, resulting in superior improvement in both motor function and sleep quality. Further longitudinal and mechanistic studies (e.g., RCTs with multimodal endpoints) are warranted to refine optimal intervention protocols and personalize therapeutic strategies. Incorporating these findings into clinical guidelines could promote holistic, synergistic management strategies that improve patient outcomes and reduce healthcare costs.