Excessive Muscle Activity Increases Over Time in Idiopathic REM Sleep Behavior Disorder
Excessive Muscle Activity Increases Over Time in Idiopathic REM Sleep Behavior Disorder
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DOI：
10.1093/sleep/32.9.1149
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发表时间：
2009-09-01
期刊：
影响因子：
5.6
通讯作者：
Santamaria, Joan
中科院分区：
文献类型：
--
作者：
Iranzo, Alex;Luca Ratti, Pietro;Santamaria, Joan
研究目的：快速眼动（REM）睡眠行为障碍（RBD）的特征是由于脑干结构调节REM睡眠弛缓功能障碍引起的过度肌电图（EMG）活动。患有特发性RBD的患者多年来经常发展为神经退行性疾病，例如帕金森病，这表明脑干中潜在的病理过程的进展。目前尚不清楚特发性RBD患者REM睡眠中的过度EMG活动是否会随时间变化。设定：参与者：11例特发性RBD患者在基线和平均随访5年后进行研究。干预措施：NA。测量和结果：11例特发性RBD患者在诊断RBD（PSG 1）时和平均随访5年（PSG 2）后进行多导睡眠图（PSG）。在PSG 1和PSG 2中的紧张性EMG活动在REM睡眠期间在颏肌中被盲量化和比较。在PSG 1和PSG 2中的相性EMG活动被盲法量化，并在REM睡眠期间的颏肌、肱二头肌和胫前肌中进行比较。患者为9名男性和2名女性，平均年龄为73.2 ± 5.4岁，PSG 2时的平均RBD持续时间为10.7 ± 5.3年。在所评估的5块肌肉中的每一块肌肉和肌肉组合中，PSG 2中的时相EMG活动显著大于PSG 1中的时相EMG活动（在所研究的所有肌肉中P < 0.022）。颏部紧张性肌电图活动从30%增加到54%（P = 0.013）。在PSG 1（强直性; P = 0.69，阶段性P = 0.89）和PSG 2（强直性; P = 0.16，阶段性; P = 0.42），患者的年龄和EMG活动量之间没有发现相关性。结论：特发性RBD受试者在REM睡眠期间过度的强直性和阶段性EMG活动随时间增加。这一发现表明，在患有特发性RBD的受试者中，存在一种潜在的渐进性病理过程，其损害调节REM睡眠的脑干结构。
Study Objectives: Rapid eye movement (REM) sleep behavior disorder (RBD) is characterized by excessive electromyographic (EMG) activity due to dysfunction of the brainstem structures modulating REM sleep atonia. Patients with idiopathic RBD often develop a neurodegenerative disease, such as Parkinson disease, over the years, suggesting progression of an underlying pathologic process in the brainstem. It is unknown if the excessive EMG activity in REM sleep changes over time in patients with idiopathic RBD. Setting: University hospital sleep disorders center.Participants: Eleven patients with idiopathic RBD who were studied at baseline and after a mean follow-up of 5 years.Interventions: NA.Measurements and Results: Eleven patients with idiopathic RBD underwent polysomnography (PSG) at the moment of the diagnosis of RBD (PSG 1) and after a mean follow-up of 5 years (PSG2). Tonic EMG activity in PSG1 and PSG2 was blindly quantified and compared in the mentalis muscle during REM sleep. Phasic EMG activity in PSG1 and PSG2 was blindly quantified and compared in the mentalis muscle, both biceps brachii, and both anterior tibialis during REM sleep. Patients were 9 men and 2 women with a mean age of 73.2 +/- 5.4 years and a mean RBD duration of 10.7 +/- 5.3 years at PSG2. In each of the 5 muscles and combination of muscles evaluated, phasic EMG activity was significantly greater in PSG2 than in PSG1 (P < 0.022 in all muscles studied). Mentalis tonic EMG activity increased from 30% to 54% (P = 0.013). No correlation was found between age of the patients and quantity of EMG activity at PSG1 (tonic; P = 0.69, phasic P = 0.89) and at PSG2 (tonic; P = 0.16, phasic; P = 0.42).Conclusion: Excessive tonic and phasic EMG activity during REM sleep increases over time in subjects with idiopathic RBD. This finding suggests that, in subjects with idiopathic RBD, there is an underlying progressive pathologic process damaging the brainstem structures that modulate REM sleep.