Correlation of Antidepressant Use and Symptom Time Period in Dream Enactment Behaviors
Correlation of Antidepressant Use and Symptom Time Period in Dream Enactment Behaviors
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抗抑郁药物使用与梦境表现行为症状时间段的相关性
DOI：
10.1002/mdc3.13378
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发表时间：
2021
影响因子：
4
通讯作者：
Ozeki Yuji
中科院分区：
文献类型：
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作者：
Sumi Yukiyoshi;Kadotani Hiroshi;Ozeki Yuji
首先，应考虑服用抗抑郁药引起的梦境重现行为（DEBs）的发生率。据报道，抗抑郁药会导致deb。2考虑到帕金森病（PD）患者常伴有抑郁，本研究PD伴攻击性梦组可能包括抗抑郁药所致deb患者，提示抑郁合并症可能是一个混杂因素。尽管根据这篇文章，“所有的患者都处于早期阶段，在基线时没有药物治疗”，但这项研究和帕金森病进展标记倡议数据库都没有描述抑郁症的发病率或抗抑郁药的使用情况。这将有助于明确用于解决这一问题的抗抑郁药。其次，氯硝西泮的使用可能导致认知能力下降。Otaiku报道，PD伴攻击性梦组患者的认知功能明显受损。由于快速眼动（REM）睡眠行为障碍（RBD）患者经常发生损伤，因此开始使用药物缓解DEBs以防止损伤是必要和适当的。然而，氯硝西泮，通常用于DEB治疗，引起镇静副作用和损害认知功能。作者可以通过描述基线和随访时DEB治疗的使用来解决药物对认知障碍的影响。第三，未考虑PD患者DEBs症状的波动。特发性RBD或PD合并RBD患者的DEBs可能随着时间的推移而减少。我们之前的研究发现，在特发性RBD患者中，DEBs的频率在RBD发病后2-8年达到高峰，随后下降。4此外，据报道，四分之一的PD患者RBD症状在随访3年后有所改善。DEBs似乎在一段时间内加剧，然后强度减弱，而不是随着时间的推移而恶化。因此，在评估PD患者的梦境体验时，有三种可能的情况：从未做过攻击性梦的人；正在做攻击性梦的人；那些以前经历过攻击性梦但现在没有经历的人。在RBD筛查问卷（RBDSQ）中，攻击性梦经历的时间没有定义（例如，最近6个月）。因此，对RBDSQ第2项回答“我的梦经常有攻击性或动作内容”的患者可能包括以前从未做过攻击性梦的人，以及曾经做过攻击性梦但现在不再做的人。攻击性梦消失的那一组是否应该被包括在“没有攻击性梦”的那一组中，还是单独指出，还有待确定。然而，必须明确调查的时间框架，并获得以往症状发生的信息。在PD无攻击性梦组中，从未经历过攻击性梦或攻击性梦消失的比例应予描述。
First, the incidence of dream enactment behaviors (DEBs) due to antidepressant intake should be considered. Antidepressants have been reported to cause DEBs. 2 Considering that patients with Parkinson’s disease (PD) are commonly comorbid with depression, the PD with aggressive dreams group in this study may include patients with DEBs caused by antidepressants, suggesting that depression comorbidity may be a confounding factor. Although according to the article,“all patients were at an early stage and unmedicated at baseline,” neither the study nor the Parkinson’s Progression Marker Initiative database describes the rate of depression or the use of antidepressants. It would be helpful to specify the antidepressants used to resolve this concern. Second, clonazepam use may lead to cognitive decline. Otaiku reported that in patients in the PD with aggressive dreams group, cognitive function was significantly impaired. Since patients with rapid eye movement (REM) sleep behavior disorder (RBD) are often injured, it is necessary and appropriate to start medications to relieve DEBs to prevent injury. However, clonazepam, commonly used in DEB treatment, cause sedative side effects and impair cognitive function. 3 The author could address the impact of medications on cognitive impairment by describing the use of DEB treatment at baseline and follow-up. Third, the fluctuation in the symptoms of DEBs in PD patients was not considered. DEBs in patients with idiopathic RBD or PD with RBD may diminish over time. Our previous study found that in patients with idiopathic RBD, the frequency of DEBs peaked 2–8 years after RBD onset and decreased afterwards. 4 Moreover, it was reported that RBD symptoms improved after 3 years of followup in a quarter of PD patients with RBD. 5 The DEBs seem to exacerbate for a while and then lessen in intensity, rather than worsen over time. Therefore, when assessing the dream experience of patients with PD, there are three possible situations: those who never had aggressive dreams; those currently experiencing aggressive dreams; those who previously experienced aggressive dreams but are not currently experiencing them. In the RBD screening questionnaire (RBDSQ), the period of aggressive dream experience is not defined (eg, the last 6 months). Therefore, patients who answered “No” to item 2 of the RBDSQ, stating that “My dreams frequently have an aggressive or action-packed content,” may include those who never experienced aggressive dreams before, and those who once experienced aggressive dreams but now no longer do. It remains to be determined whether the group whose aggressive dreams have disappeared should be included in the “without aggressive dreams” group or indicated separately. However, it is essential to clarify the time frame in the survey and obtain information on previous symptom occurrences. The proportion of those who have never experienced aggressive dreams before or whose aggressive dreams have disappeared in the PD without aggressive dreams group should be described.
快速动眼睡眠行为障碍症状频率随病程的变化
影响因子：
--
作者：
Sumi Yukiyoshi;Matsuo Masahiro;Nakabayashi Takao;Masuda Fumi;Takahashi Masahiro;Kanemura Takashi;Kuriyama Kenichi;Yamada Naoto;Takami Masanori;Kadotani Hiroshi
通讯作者：
Kadotani Hiroshi
影响因子：
4
作者：
Otaiku, Abidemi I.
通讯作者：
Otaiku, Abidemi I.