Aggressive dream content without daytime aggressiveness in REM sleep behavior disorder
Aggressive dream content without daytime aggressiveness in REM sleep behavior disorder
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DOI：
10.1212/01.wnl.0000179346.39655.e0
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发表时间：
2005-10-11
期刊：
影响因子：
9.9
通讯作者：
Ferini-Strambi, L
中科院分区：
文献类型：
--
作者：
Fantini, ML;Corona, A;Ferini-Strambi, L
背景：快速眼动睡眠行为障碍(RBD)的特征是伴随着梦境的剧烈睡眠运动。RBD患者经常报告充满行动和暴力的梦。目的：系统评价RBD患者和对照组的梦境特征和日间攻击性。方法：对49例多导睡眠图确诊的RBD患者和71例年龄、性别相匹配的对照组，要求回忆最近的梦境并完成攻击性问卷(AQ)。41例RBD患者(81.6%；男36例，女5例；平均年龄67.5±7.5岁)和35例对照组(49.3%；男30例，女5例；平均年龄69.1±5.9岁)能够记住他们的梦，两组共收集98个(RBD)和69个(对照组)梦。逐字逐句的梦境描述被评分，并根据Hall和Van de Castle方法进行分析。结果：RBD患者梦境中至少有一次攻击性发作(DWA)的比例高于对照组(66%比15%；P&t；0.00001)，攻击/友好互动比(86%比44%；P&t；0.0001)和动物角色出现的频率(19%比4%；P&t；0.0001)更高。与对照组相比，无一例RBD患者做梦有性取向(0%vs9%；p<；0.0001)。两组在AQ总分上没有不同，除了RBD患者的身体攻击性分量表得分低于对照组(16.5+/-6.4vs20.4+/-8.3p<；0.034)。没有观察到梦境攻击性与年龄、持续时间或RBD症状频率之间的相关性。结论：REM睡眠行为障碍患者的梦境具有更高比例的攻击性内容，尽管白天攻击性水平正常。具有攻击性的梦和已知的快速眼动睡眠时相肌肉活动过度可能与一种常见的神经元生成器的过度活动有关。
Background: REM sleep behavior disorder (RBD) is characterized by vigorous sleep motor activity associated with dream mentation. Patients with RBD frequently report action-filled and violent dreams. Objective: To systematically assess dream characteristics and daytime aggressiveness in patients with RBD and controls. Methods: Forty-nine patients with polysomnographic-confirmed RBD diagnosis and 71 age-and sex-matched controls were asked to recall the most recent dreams and to complete the Aggression Questionnaire (AQ). Forty-one patients with RBD (81.6%; 36 men, 5 women; mean age: 67.5 +/- 7.5 years) and 35 controls (49.3%; 30 men, 5 women; mean age: 69.1 +/- 5.9 years) were able to remember their dreams and a total of 98 ( RBD) and 69 ( controls) dreams were collected in the two groups. Verbatim dream descriptions were scored and analyzed according to the Hall and Van De Castle method. Results: Patients with RBD showed a higher percentage of dream with at least one aggressive episode (DWA) than controls (66% vs 15%; p < 0.00001), a higher aggression/friendliness interaction ratio (86% vs 44%; p < 0.0001), and a greater frequency of animal characters (19% vs 4%; p < 0.0001). In contrast to controls, no patient with RBD had dreams with elements of sexuality (0% vs 9%; p < 0.0001). The two groups did not differ in total AQ scores, except for a lower score on the physical aggressiveness subscale in patients with RBD compared to control subjects (16.5 +/- 6.4 vs 20.4 +/- 8.3; p < 0.034). No correlation was observed between dream aggressiveness and age, duration, or frequency of RBD symptoms. Conclusions: Dreams in patients with REM sleep behavior disorder were characterized by an elevated proportion of aggressive contents, despite normal levels of daytime aggressiveness. Dreams with aggressiveness and the known excessive phasic muscle activity during REM sleep may be related to the hyperactivity of a common neuronal generator.