REM sleep behavior disorder: Updated review of the core features, the REM sleep behavior disorder-neurodegenerative disease association, evolving concepts, controversies, and future directions.
REM sleep behavior disorder: Updated review of the core features, the REM sleep behavior disorder-neurodegenerative disease association, evolving concepts, controversies, and future directions.
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DOI：
10.1111/j.1749-6632.2009.05115.x
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发表时间：
2010-01
影响因子：
5.2
通讯作者：
Boeve BF
中科院分区：
文献类型：
--
作者：
Boeve BF
快速眼动(REM)睡眠行为障碍(RBD)是一种睡眠障碍，表现为在REM睡眠中伴随着简单或复杂的运动行为的生动的、通常是可怕的梦。患者看起来像是在“表演他们的梦”，其中展示的行为反映了梦的内容，而梦的内容往往涉及一个追逐或攻击的主题。RBD的多导睡眠图特征包括在REM睡眠期间肌电张力增加+/-做梦行为。通过咨询和药物措施进行管理通常是直截了当和有效的。在这篇综述中，讨论了术语、临床和多导睡眠图特征、人口学和流行病学特征、诊断标准、鉴别诊断和处理策略。本文还对RBD疑似病理生理机制的最新资料进行了综述。接下来讨论有关RBD的文献和我们的机构经验，重点是RBD-神经退行性疾病的关联，特别是RBD-突触核病的关联。然后回顾了与进化的概念、争议和未来方向有关的几个问题，重点是特发性RBD，它代表了神经退行性疾病的早期特征，特别是进化中的联合核素病。对影响特发性RBD患者的未来治疗计划进行了详细回顾。
Rapid eye movement (REM) sleep behavior disorder (RBD) is a parasomnia manifested by vivid, often frightening dreams associated with simple or complex motor behavior during REM sleep. Patients appear to “act out their dreams,” in which the exhibited behaviors mirror the content of the dreams, and the dream content often involves a chasing or attacking theme. The polysomnographic features of RBD include increased electromyographic tone +/- dream enactment behavior during REM sleep. Management with counseling and pharmacologic measures is usually straight-forward and effective. In this review, the terminology, clinical and polysomnographic features, demographic and epidemiologic features, diagnostic criteria, differential diagnosis, and management strategies are discussed. Recent data on the suspected pathophysiologic mechanisms of RBD are also reviewed. The literature and our institutional experience on RBD are next discussed, with an emphasis on the RBD-neurodegenerative disease association and particularly the RBD-synucleinopathy association. Several issues relating to evolving concepts, controversies, and future directions are then reviewed, with an emphasis on idiopathic RBD representing an early feature of a neurodegenerative disease and particularly an evolving synucleinopathy. Planning for future therapies that impact patients with idiopathic RBD is reviewed in detail.
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