Subtle gait changes in patients with REM sleep behavior disorder.
Subtle gait changes in patients with REM sleep behavior disorder.
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REM睡眠行为障碍患者的微妙步态变化。
DOI：
10.1002/mds.25653
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发表时间：
2013-11
影响因子：
8.6
通讯作者：
Petersen, Ronald C.
中科院分区：
文献类型：
--
作者：
McDade, Eric M.;Boot, Brendon P.;Christianson, Teresa J. H.;Pankratz, V. Shane;Boeve, Bradley F.;Ferman, Tanis J.;Bieniek, Kevin;Hollman, John H.;Roberts, Rosebud O.;Mielke, Michelle M.;Knopman, David S.;Petersen, Ronald C.
许多患有快速眼动睡眠行为障碍的人都有潜在的联核症，其中最常见的是路易体病。识别其他异常的临床特征可能有助于识别那些演变为更严重综合征的更高风险的人。由于步态障碍在突触核病中很常见，REM睡眠行为障碍患者的早期步态异常有助于识别那些明显发展为帕金森氏症和/或认知障碍的高危人群。我们使用Mayo睡眠问卷确定了42名可能的REM睡眠行为障碍受试者和492名对照组，并使用自动步态分析系统评估了步速、节奏和步态动力学。病例组和对照组在年龄(79.9±4.7和80.1±4.7，p=0.74)、UPDRS评分(3.3±5.5和1.9±4.1，p=0.21)和简易智力状态检查(27.2±1.9和27.7±1.6，p=0.10)方面相似。诊断可能的快速眼动睡眠行为障碍与速度减慢(−7.9厘米/秒，95%CI−13.8至−2.0，p<；0.01)、节奏(−4.4步/分钟，95%CI−7.6至−1.3，p<；双腿支持变异性(30%，95%可信区间6-60，p=0.01)、更大的步态时间变异(29%，95%可信区间2-63，p=0.03)和摆动时间变异(46%，95%可信区间15-84，p<；0.01)。可能的快速眼动睡眠行为障碍与临床帕金森病前的微妙步态改变有关。诊断可能的快速眼动睡眠行为障碍，辅以步态分析，可能有助于作为α-突触核蛋白障碍的筛查工具。
Many people with REM sleep behavior disorder have an underlying synucleinopathy, the most common of which is Lewy body disease. Identifying additional abnormal clinical features may help in identifying those at greater risk of evolving to a more severe syndrome. As gait disorders are common in the synucleinopathies, early abnormalities in gait in those with REM sleep behavior disorder could help in identifying those at increased risk of developing overt parkinsonism and/or cognitive impairment. We identified 42 probable REM sleep behavior disorder subjects and 492 controls using the Mayo Sleep Questionnaire and assessed gait velocity, cadence and stride dynamics with an automated gait analysis system. Cases and controls were similar in age (79.9 ± 4.7 & 80.1 ± 4.7, p= 0.74), UPDRS score (3.3 ± 5.5 & 1.9 ± 4.1, p=0.21) and Mini-Mental State Examination scores (27.2 ± 1.9 & 27.7 ± 1.6, p=0.10). A diagnosis of probable REM sleep behavior disorder was associated with decreased velocity (−7.9 cm/sec, 95%CI −13.8 to −2.0, p<0.01), cadence (−4.4 steps/min, 95%CI −7.6 to −1.3, p<0.01), and significantly increased double limb support variability (30%, 95%CI 6 – 60, p=0.01), greater stride time variability (29%, 95%CI 2 – 63, p=0.03) and swing time variability (46%, 95%CI 15 – 84, p<0.01). Probable REM sleep behavior disorder is associated with subtle gait changes prior to overt clinical parkinsonism. Diagnosis of probable REM sleep behavior disorder supplemented by gait analysis may help as a screening tool for disorders of α-synuclein.
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影响因子：
4.8
作者：
Boeve, Bradley F.;Molano, Jennifer R.;Ferman, Tanis J.;Smith, Glenn E.;Lin, Siong-Chi;Bieniek, Kevin;Haidar, Wael;Tippmann-Peikert, Maja;Knopman, David S.;Graff-Radford, Neill R.;Lucas, John A.;Petersen, Ronald C.;Silber, Michael H.
通讯作者：
Silber, Michael H.
影响因子：
1.8
作者：
Hausdorff, Jeffrey M.;Doniger, Glen M.;Simon, Ely S.
通讯作者：
Simon, Ely S.
影响因子：
14.5
作者：
Ferraye, M. U.;Debu, B.;Pollak, P.
通讯作者：
Pollak, P.
影响因子：
11
作者：
Postuma, R. B.;Gagnon, J. F.;Montplaisir, J.
通讯作者：
Montplaisir, J.
影响因子：
3.3
作者：
Habaguchi, T;Takakusaki, K;Sakamoto, T
通讯作者：
Sakamoto, T