Severity of REM atonia loss in idiopathic REM sleep behavior disorder predicts Parkinson disease

被引:165
作者
Postuma, R. B. [1 ,2 ]
Gagnon, J. F. [1 ,3 ]
Rompre, S. [1 ]
Montplaisir, J. Y. [1 ,3 ]
机构
[1] Hop Sacre Coeur, Ctr Etud Sommeil & Rythmes Biol, Montreal, PQ H4J 1C5, Canada
[2] McGill Univ, Montreal Gen Hosp, Dept Neurol, Montreal, PQ H3G 1A4, Canada
[3] Univ Montreal, Dept Psychiat, Quebec City, PQ, Canada
关键词
DISTURBANCES; DIAGNOSIS; PATHOLOGY; DEMENTIA;
D O I
10.1212/WNL.0b013e3181ca0166
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Background: Over 50% of persons with idiopathic REM sleep behavior disorder (RBD) will develop Parkinson disease (PD) or dementia. At present, there is no way to predict who will develop disease. Since polysomnography is performed in all patients with idiopathic RBD at diagnosis, there is an opportunity to analyze if baseline sleep variables predict eventual neurodegenerative disease. Methods: In a longitudinally studied cohort of patients with idiopathic RBD, we identified those who had developed neurodegenerative disease. These patients were matched by age, sex, and follow-up duration to patients with RBD who remained disease-free and to controls. Polysomnographic variables at baseline (i.e., before development of neurodegenerative disease) were compared between groups. Results: Twenty-six patients who developed neurodegenerative disease were included (PD 12, multiple system atrophy 1, dementia 13). The interval between polysomnogram and disease onset was 6.7 years, mean age was 69.5, and 81% were male. There were no differences between groups in sleep latency, sleep time, % stages 2-4, % REM sleep, or sleep efficiency. However, patients with idiopathic RBD who developed neurodegenerative disease had increased tonic chin EMG activity during REM sleep at baseline compared to those who remained disease-free (62.7 +/- 6.0% vs 41.0 +/- 6.0%, p = 0.020). This effect was seen only in patients who developed PD (72.9 +/- 6.0% vs 41.0 +/- 6.0%, p = 0.002), and not in those who developed dementia (54.3 +/- 10.3, p = 0.28). There was no difference in phasic submental REM EMG activity between groups. Conclusions: In patients with REM sleep behavior disorder initially free of neurodegenerative disease, the severity of REM atonia loss on baseline polysomnogram predicts the development of Parkinson disease. Neurology (R) 2010; 74: 239-244
引用
收藏
页码:239 / 244
页数:6
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