Associated factors for REM sleep behavior disorder in Parkinson disease
Associated factors for REM sleep behavior disorder in Parkinson disease
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DOI：
10.1212/wnl.0b013e31822e560e
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发表时间：
2011-09-01
期刊：
影响因子：
9.9
通讯作者：
Trenkwalder, Claudia
中科院分区：
文献类型：
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作者：
Sixel-Doering, Friederike;Trautmann, Ellen;Trenkwalder, Claudia
目的：目的：探讨帕金森病（PD）患者REM睡眠行为障碍（RBD）的发生率、现象学及相关危险因素。我们确定了RBD的频率，并分析了年龄、临床疾病特征、疾病持续时间、认知和身体损害、药物治疗、合并症和睡眠结构的影响。根据我们的队列和修改的定义，RBD没有首选的PD亚型（p = 0.142）。没有性别偏好（p = 0.770）。RBD与年龄较大相关（p = 0.000）。根据年龄和性别调整后，PD和RBD患者的病程较长（p = 0.024），Hoehn & Yahr分期较高（p = 0.002），福尔斯较多（p = 0.018），波动较多（p = 0.005），精神合并症较多（p = 0.026），左旋多巴剂量较高（p = 0.002）。RBD的存在与睡眠效率略有增加（p = 0.007），REM睡眠量较高（p = 0.000），睡眠期间更多的周期性腿部运动（p = 0.019）。结论：RBD是一种常见的和临床相关的夜间障碍的PD的所有阶段。它随着年龄和疾病持续时间的增加而增加，并可能导致PD患者及其床伴的夜间问题。神经病学（R）2011; 77：1048-1054
Objective: To investigate the frequency, phenomenology, and associated risk factors of REM sleep behavior disorder (RBD) in Parkinson disease (PD).Methods: An unselected cohort of sleep-disturbed patients with PD (n = 457) was investigated with video-supported polysomnography. We determined the frequency of RBD and analyzed the influence of age, clinical disease features, disease duration, cognitive and physical impairment, medication, comorbidity, and sleep architecture.Results: The overall frequency of RBD was 46%. According to our cohort and modified definition, there was no preferred PD subtype for RBD (p = 0.142). There was no gender preference (p = 0.770). RBD was associated with older age (p = 0.000). Adjusted for age and gender, patients with PD and RBD had longer disease duration (p = 0.024), higher Hoehn & Yahr stages (p = 0.002), more falls (p = 0.018), more fluctuations (p = 0.005), more psychiatric comorbidity (p = 0.026), and a higher dose of levodopa (p = 0.002). The presence of RBD was related to slightly increased sleep efficiency (p = 0.007), a higher amount of REM sleep (p = 0.000), and more periodic leg movements during sleep (p = 0.019).Conclusion: RBD is a frequent and clinically relevant nocturnal disturbance for all stages of PD. It increases with age and disease duration and may contribute to the nocturnal problems of patients with PD and their bed partners. Neurology (R) 2011; 77: 1048-1054