Unité des Pathologies du Sommeil, Groupe Hospitalier Pitié-Salpêtrière, Assistance Publique-Hôpitaux de Paris, Paris, France.
Mov Disord. 2009 Dec 15;24(16):2419-23. doi: 10.1002/mds.22854.
Camptocormia (a flexion of the trunk that only appears when standing or walking) affects a minority of patients with Parkinson's disease (PD). As it responds poorly to levodopa and is associated with reduced midbrain and pons volume, it may result from non-dopaminergic, brainstem lesions. As several sleep abnormalities in PD also result from non-dopaminergic brainstem lesions, we monitored sleep in 24 non-demented PD patients with (n = 12) and without (n = 12) camptocormia and in 12 controls. Nearly half (42%) patients with camptocormia had abnormal periodic leg movement indices (>15/h), versus 17% patients without camptocormia and 8% of controls (p = 0.02). In addition, the percentage of enhanced muscle activity during REM sleep (measured on the chin and on the limb muscles) tended to be higher in patients with than without camptocormia (51 +/- 39% vs. 20 +/- 25%, p = 0.06). The other sleep and REM sleep characteristics (sleep and REM sleep onset latencies, sleep time and sleep stage percentages, REMs density, arousal, and apnea-hypopnea indices) were not different between these two PD groups. Lesions causing this axial dystonia may spare the sleep systems but affect the control of movements during sleep.
脊柱前屈（一种仅在站立或行走时出现的躯干弯曲）影响少数帕金森病（PD）患者。由于它对左旋多巴反应不佳，并且与中脑和脑桥体积减少有关，因此可能是由于非多巴胺能、脑干病变引起的。由于 PD 中的几种睡眠异常也源于非多巴胺能的脑干病变，我们监测了 24 名非痴呆 PD 患者（n = 12）和无（n = 12）脊柱前屈患者以及 12 名对照者的睡眠。近一半（42%）脊柱前屈患者的周期性腿部运动指数异常（>15/h），而无脊柱前屈的患者为 17%，对照组为 8%（p = 0.02）。此外，REM 睡眠期间增强的肌肉活动百分比（在下巴和肢体肌肉上测量）在有脊柱前屈的患者中比无脊柱前屈的患者中更高（51 +/- 39%对 20 +/- 25%，p = 0.06）。这两组 PD 患者的其他睡眠和 REM 睡眠特征（睡眠和 REM 睡眠潜伏期、睡眠时间和睡眠阶段百分比、REM 密度、觉醒和呼吸暂停低通气指数）没有差异。导致这种轴性肌张力障碍的病变可能会使睡眠系统免受影响，但会影响睡眠期间的运动控制。
