REM sleep behaviour disorder in Parkinson's disease is associated with specific motor features
REM sleep behaviour disorder in Parkinson's disease is associated with specific motor features
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DOI：
10.1136/jnnp.2008.149195
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发表时间：
2008-10-01
影响因子：
11
通讯作者：
Montplaisir, J.
中科院分区：
文献类型：
--
作者：
Postuma, R. B.;Gagnon, J. F.;Montplaisir, J.
背景：快速眼动(REM)睡眠行为障碍(RBD)通常与帕金森病(PD)有关，最近的研究表明，PD患者的RBD与认知障碍、觉醒脑电减慢、自主神经损害和心理健康方面的生活质量下降有关。然而，尚不清楚RBD与帕金森病的相关性是否与该病的运动表现有关。方法：该研究通过多导睡眠图评估了36例帕金森病患者是否存在RBD。患者接受了由运动障碍专家对多导睡眠图结果视而不见的药物治疗前后的广泛评估。结果：PD和RBD患者以震颤为主的可能性较小(14%vs53%；p<；0.02)，且震颤在帕金森病综合评定量表(UPDRS)评分中所占比例较低(8.2%vs19.0%；p<；0.01)。RBD患者跌倒的频率增加(38%比7%；p=0.04)。RBD患者对药物的波幅反应较低(UPDRS改善16.2%对34.8%；p=0.049)。结论：伴有RBD的PD患者存在运动亚型改变，提示伴有RBD的PD患者与无RBD的PD患者可能具有不同的潜在神经退行性改变模式。
Background: Rapid eye movement ( REM) sleep behaviour disorder (RBD) is commonly associated with Parkinson's disease (PD), and recent studies have suggested that RBD in PD is associated with increased cognitive impairment, waking EEG slowing, autonomic impairment and lower quality of life on mental health components. However, it is unclear whether the association of RBD in PD has implications for motor manifestations of the disease.Methods: The study evaluated 36 patients with PD for the presence of RBD by polysomnography. Patients underwent an extensive evaluation on and off medication by a movement disorders specialist blinded to the polysomnography results. Measures of disease severity, quantitative motor indices, motor subtypes, complications of therapy and response to therapy were assessed and compared using regression analysis that adjusted for disease duration and age.Results: Patients with PD and RBD were less likely to be tremor predominant (14% vs 53%; p < 0.02) and had a lower proportion of their Unified Parkinson Disease Rating Scale (UPDRS) score accounted for by tremor (8.2% vs 19.0%; p < 0.01). An increased frequency of falls was noted among patients with RBD (38% vs 7%; p = 0.04). Patients with RBD demonstrated a lower amplitude response to their medication ( UPDRS improvement 16.2% vs 34.8%; p = 0.049). Markers of overall disease severity, quantitative motor testing and motor complications did not differ between groups.Conclusions: The presence of altered motor subtypes in PD with RBD suggests that patients with PD and RBD may have a different underlying pattern of neurodegeneration than PD patients without RBD.