Yoritaka Asako, Ohizumi Hideki, Tanaka Shigeki, Hattori Nobutaka
Department of Neurology, Juntendo Urayasu Hospital, Tokyo, Japan.
Eur Neurol. 2009;61(3):164-70. doi: 10.1159/000189269. Epub 2009 Jan 8.
Rapid eye movement sleep behaviour disorder (RBD) may serve as a useful indicator to approach Parkinson's disease (PD); however, PD patients do not always exhibit RBD. We wondered whether the presence of RBD would be reflected in the expansion of PD lesions and represent the same PD entity. We examined the clinical differences between PD with and without RBD and studied the frequency of RBD-like symptoms (RBD-s) and clinical differences in 150 PD patients, including 81 patients (54.0%) who satisfied the International Classification of Sleep Disorders, Revised, minimum clinical criteria for RBD. RBD-s preceding the appearance of parkinsonism were found in 44.4% of patients. Statistically, the presence of RBD-s was associated with ages above 65 years, male gender, constipation, dopa-induced dyskinesia and 'sleep attack', with odds ratios of 3.709, 2.469, 2.184, 5.046 and 6.562, respectively. No differences were found between the 2 groups with regard to symptoms at PD onset, disease duration, Hoehn-Yahr stage, hallucination, dementia, wearing-off, orthostatic hypotension, cerebral blood flow and antiparkinsonism drugs. In the early stage, RBD and autonomic system dysfunction are important factors in the progression of PD.
快速眼动睡眠行为障碍（RBD）可能是帕金森病（PD）的一个有用指标；然而，PD患者并不总是表现出RBD。我们想知道RBD的存在是否会反映在PD病变的扩展中，以及是否代表相同的PD实体。我们检查了有RBD和无RBD的PD患者之间的临床差异，并研究了150例PD患者中RBD样症状（RBD-s）的频率和临床差异，其中包括81例（54.0%）符合《国际睡眠障碍分类（修订版）》RBD最低临床标准的患者。在帕金森病出现之前，44.4%的患者出现了RBD-s。在统计学上，RBD-s的存在与65岁以上的年龄、男性、便秘、多巴诱导的运动障碍和“睡眠发作”相关，优势比分别为3.709、2.469、2.184、5.046和6.562。两组在PD发病时的症状、病程、Hoehn-Yahr分期、幻觉、痴呆、疗效减退、体位性低血压、脑血流量和抗帕金森病药物方面没有差异。在早期阶段，RBD和自主神经系统功能障碍是PD进展的重要因素。
