Occurrence and clinical correlates of REM sleep behaviour disorder in patients with Parkinson's disease over time
Occurrence and clinical correlates of REM sleep behaviour disorder in patients with Parkinson's disease over time
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DOI：
10.1136/jnnp.2007.116830
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发表时间：
2008-04-01
影响因子：
11
通讯作者：
Larsen, J. P.
中科院分区：
文献类型：
--
作者：
Gjerstad, M. D.;Boeve, B.;Larsen, J. P.
目的：在超过 8 年的社区队列中检查帕金森病 (PD) 患者的 REM 睡眠行为障碍 (RBD) 的发生情况以及临床和人口统计学相关性。方法：1993 年的一项基于人群的患病率研究纳入了 231 名帕金森病患者。然后对患者进行前瞻性随访，并在 4 和 8 年后重新检查。所有研究访视均采用半结构化访谈来获取临床和人口统计数据信息。使用帕金森病、抑郁症和认知障碍的标准化评定量表。可能的 RBD (pRBD) 的诊断是基于睡眠问卷。使用聚类数据的比例优势有序 Logistic 回归模型来研究 pRBD 与各种人口统计和临床变量之间的关系。结果：1993 年对 231 名患者进行了 RBD 评估，4 年后和 8 年后，分别有 142 名和 89 名患者可进行重新评估。研究期间，pRBD 的频率从 14.6% 到 27% 不等。可能的 RBD 与男性、较高的多巴胺能治疗和较轻的帕金森病有关。结论：我们发现 pRBD 的频率随时间变化，并且与男性、较少的帕金森病和较高的左旋多巴当量剂量有关。我们的研究结果表明，多巴胺能治疗可能有助于 RBD 的表达，并且 RBD 在 PD 的早期阶段有症状。
Objective: To examine the occurrence and clinical and demographic correlates of REM sleep behaviour disorder (RBD) in patients with Parkinson's disease (PD) in a community-based cohort over 8 years.Methods: 231 patients with PD were included in a population-based prevalence study in 1993. Patients were then followed prospectively and reexamined after 4 and 8 years. Semi-structured interviews for information on clinical and demographic data were applied at all study visits. Standardised rating scales of parkinsonism, depression and cognitive impairment were used. The diagnosis of probable RBD (pRBD) was based on a sleep questionnaire. Proportional-odds ordinal logistic regression models for clustered data were used to study the relationship between pRBD and various demographic and clinical variables.Results: 231 patients were evaluated for RBD in 1993 and, after 4 and 8 years, 142 and 89 patients, respectively, were available for re-evaluation. The frequency of pRBD varied from 14.6% to 27% during the study period. Probable RBD was related to male gender, higher dopaminergic treatment and less severe parkinsonism.Conclusion: We found that the frequency of pRBD varied over time and that it is associated with male gender, less parkinsonism and higher levodopa equivalent dose. Our findings indicate that dopaminergic therapy may contribute to the expression of RBD and that RBD is symptomatic in earlier stages of PD.