Changing demographics in REM sleep behavior disorder: Possible effect of autoimmunity and antidepressants
Changing demographics in REM sleep behavior disorder: Possible effect of autoimmunity and antidepressants
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DOI：
10.1016/j.sleep.2010.07.022
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发表时间：
2011-03-01
期刊：
影响因子：
4.8
通讯作者：
Duntley, Stephen
中科院分区：
文献类型：
--
作者：
Ju, Yo-El;Larson-Prior, Linda;Duntley, Stephen
背景资料：快速眼动（REM）睡眠行为障碍（RBD）主要见于老年男性，并与神经退行性疾病相关。但在最近的报告和临床实践中，越来越多的病例不符合这种描述：因此，我们试图描述目前的RBD人群，并可能确定新的亚组与RBD.Methods：记录115例连续多导睡眠图证实的RBD在学术睡眠center.Results：男性与女性的比例为2：1，和1.25：1早发性（年龄< 50岁）的情况下。诊断时的平均年龄为53.7 ± 16.4岁。大多数（60%）病例是特发性的，神经退行性疾病主要发生在老年男性中。自身免疫性疾病在女性中出乎意料地常见（20%），特别是在30-49岁年龄组（40%）。抗抑郁药的使用是频繁的（46.1%），特别是在早发病例（57.8%）。结论：RBD是诊断更平等的男性和女性之间，在年轻的个人比以前报道的。虽然神经退行性疾病在老年男性中经常与RBD同时发生，但大多数女性和早发性病例具有“特发性”RBD。RBD女性自身免疫性疾病的高患病率表明免疫功能障碍与RBD之间存在有趣的联系。抗抑郁药的高使用率支持抗抑郁药在RBD中的潜在因果作用。(C)2011 Elsevier B. V.保留所有权利。
Background: Rapid eye movement (REM) sleep behavior disorder (RBD) has been described predominantly in elderly men and in association with neurodegenerative disease. But an increasing proportion of cases in recent reports and in clinical practice do not fit this description: thus we sought to describe a current RBD population and possibly identify new subgroups with RBD.Methods: Records of 115 consecutive patients with polysomnogram-confirmed RBD at an academic sleep center were retrospectively reviewed.Results: Male to female ratio was 2:1, and 1.25:1 for early-onset (age < 50) cases. Mean age at diagnosis was 53.7 +/- 16.4 years. Most (60%) cases were idiopathic, and neurodegenerative disease was coincident primarily in older men. Autoimmune disease was unexpectedly common in women (20%) particularly in the 30-49 age groups (40%). Antidepressant use was frequent (46.1%), especially in early-onset cases (57.8%).Conclusions: RBD is diagnosed more equally between men and women and in younger individuals than previously reported. While neurodegenerative disease is frequently co-incident with RBD in older men, most women and early-onset cases have "idiopathic" RBD. High prevalence of autoimmune disease among women with RBD suggests an intriguing link between immune dysfunction and RBD. A high rate of antidepressant use provides support for a potentially causal role for antidepressants in RBD. (C) 2011 Elsevier B.V. All rights reserved.