Department of Neurology and Center for Sleep Medicine, Mayo Clinic, Rochester, Minnesota, USA.
Ann N Y Acad Sci. 2010 Jan;1184:15-54. doi: 10.1111/j.1749-6632.2009.05115.x.
Rapid eye movement (REM) sleep behavior disorder (RBD) is a parasomnia manifested by vivid, often frightening dreams associated with simple or complex motor behavior during REM sleep. The polysomnographic features of RBD include increased electromyographic tone +/- dream enactment behavior during REM sleep. Management with counseling and pharmacologic measures is usually straightforward and effective. In this review, the terminology, clinical and polysomnographic features, demographic and epidemiologic features, diagnostic criteria, differential diagnosis, and management strategies are discussed. Recent data on the suspected pathophysiologic mechanisms of RBD are also reviewed. The literature and our institutional experience on RBD are next discussed, with an emphasis on the RBD-neurodegenerative disease association and particularly the RBD-synucleinopathy association. Several issues relating to evolving concepts, controversies, and future directions are then reviewed, with an emphasis on idiopathic RBD representing an early feature of a neurodegenerative disease and particularly an evolving synucleinopathy. Planning for future therapies that impact patients with idiopathic RBD is reviewed in detail.
快速眼动（REM）睡眠行为障碍（RBD）是一种睡眠障碍，表现为 REM 睡眠期间生动、常伴有恐惧的梦境，并伴有简单或复杂的运动行为。RBD 的多导睡眠图特征包括 REM 睡眠期间肌电图张力增加（+/- 梦境行为）。通常通过咨询和药物治疗来进行管理，并且效果良好。在这篇综述中，讨论了术语、临床和多导睡眠图特征、人口统计学和流行病学特征、诊断标准、鉴别诊断和管理策略。还回顾了 RBD 疑似病理生理机制的最新数据。接下来讨论了有关 RBD 的文献和我们机构的经验，重点是 RBD-神经退行性疾病的关联，特别是 RBD-突触核蛋白病的关联。然后重点讨论了特发性 RBD 代表神经退行性疾病的早期特征，特别是进展性突触核蛋白病的早期特征，随后回顾了与不断发展的概念、争议和未来方向相关的几个问题。详细讨论了影响特发性 RBD 患者的未来治疗方案。
