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专题讨论会:正常与异常快速眼动睡眠调节:快速眼动睡眠行为障碍:96例患者系列研究的最新进展及世界文献综述

Symposium: Normal and abnormal REM sleep regulation: REM sleep behaviour disorder: an update on a series of 96 patients and a review of the world literature.

作者信息

Schenck CH, Hurwitz TD, Mahowald MW

机构信息

Minnesota Regional Sleep Disorders Center, and Department of Psychiatry.

出版信息

J Sleep Res. 1993 Dec;2(4):224-231. doi: 10.1111/j.1365-2869.1993.tb00093.x.

Abstract

REM sleep behaviour disorder (RBD) is an injurious clinical disorder of attempted dream-enactment ('oneirism') in humans which has a corresponding experimental animal model involving dorsolateral pontine tegmental lesions in cats. To date, our sleep disorders centre has collected data on 96 chronic RBD cases which can be compared with pooled data on 70 chronic RBD cases from other centres contained in 26 reports published in the world literature since 1985, when our initial cases were first reported. The data from our centre and from other centres demonstrate a male predominance in RBD (87.5% vs 63.5%); indicate a similar mean age of RBD onset (52.4 y vs 55.9 y); contain substantial numbers of diverse central nervous system disorders causally associated with RBD (47.9% vs 60.0%); and identify clonazepam treatment as being very effective in controlling both the (violent) dream and sleep behavioural disturbances of RBD. Our centre's data additionally reveal an 80% prevalence of elevated stage 3/4 (slow-wave) sleep% for age in RBD, and reveal a frequent presence of periodic and aperiodic limb movements during NREM sleep. Thus, RBD in humans is a complex syndrome in which there is generalized REM and NREM sleep motor dyscontrol, as was originally observed in the animal RBD model by Jouvet and Delorme in 1965.

摘要

快速眼动睡眠行为障碍(RBD)是一种人类试图进行梦境演绎(“梦呓症”)的有害临床病症,它有一个相应的实验动物模型,涉及猫的脑桥背外侧被盖区损伤。迄今为止,我们的睡眠障碍中心已收集了96例慢性RBD病例的数据,这些数据可与自1985年我们首次报告最初病例以来世界文献中发表的26篇报告中包含的其他中心70例慢性RBD病例的汇总数据进行比较。我们中心和其他中心的数据表明,RBD中男性占主导(87.5%对63.5%);显示RBD发病的平均年龄相似(52.4岁对55.9岁);包含大量与RBD有因果关系的各种中枢神经系统疾病(47.9%对60.0%);并确定氯硝西泮治疗在控制RBD的(暴力)梦境和睡眠行为障碍方面非常有效。我们中心的数据还显示,RBD患者中3/4期(慢波)睡眠占年龄的比例升高的患病率为80%,并显示在非快速眼动睡眠期间经常出现周期性和非周期性肢体运动。因此,人类的RBD是一种复杂的综合征,其中存在全身性快速眼动和非快速眼动睡眠运动控制失调,这与1965年朱维特和德洛姆在动物RBD模型中最初观察到的情况一样。

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