Neurology Department, Hospital de Egas Moniz (CHLO), Rua da Junqueira, 126, 1349-019, Lisbon, Portugal.
J Neurol. 2011 Jan;258(1):50-5. doi: 10.1007/s00415-010-5679-0. Epub 2010 Aug 9.
We aimed to characterize the clinical features associated with REM sleep behaviour disorder (RBD) in early stage Parkinson's disease (PD). Presence of clinical RBD was determined according to ICSD minimal clinical criteria and a validated RBD questionnaire. We registered time of appearance of RBD symptoms in relation to PD onset and the occurrence of RBD symptoms in the past in non-RBD patients. RBD and non-RBD groups were compared in terms of motor and cognitive dysfunction. The same comparisons were made between patients who reported RBD symptoms at some point in time (including those non-RBD patients that reported occurrence of RBD symptoms in the past) and those who did not (RBDS and non-RBDS, respectively). We assessed 75 patients. Forty-one (55%) patients presented with RBD, 19 beginning before PD onset. Five non-RBD patients reported having had RBD symptoms in the past. There were no significant differences between RBD and non-RBD patients. RBDS group presented a significantly higher proportion of non-tremor motor sub-type compared to non-RBDS patients. Our results suggest that RBD is very frequent in the early stages of PD. In some patients, RBD symptoms could have disappeared before or in the first years after motor disturbance onset. Non-tremor motor sub-type was related to RBD symptoms history, rather than to the presence of RBD clinical criteria at time of evaluation, suggesting that the physiopathological changes that cause the association with motor status could remain, in spite of symptom fluctuation.
我们旨在描述早期帕金森病（PD）中与 REM 睡眠行为障碍（RBD）相关的临床特征。根据国际睡眠障碍分类（ICSD）的最低临床标准和经过验证的 RBD 问卷来确定临床 RBD 的存在。我们记录了 RBD 症状出现在 PD 发病之前的时间以及非 RBD 患者过去出现 RBD 症状的时间。比较 RBD 和非 RBD 组在运动和认知功能障碍方面的差异。还比较了在某个时间点报告 RBD 症状的患者（包括报告过去出现过 RBD 症状的非 RBD 患者）和未报告 RBD 症状的患者（RBDS 和非 RBDS）之间的差异。我们评估了 75 名患者。41 名（55%）患者出现 RBD，19 名患者在 PD 发病之前出现。5 名非 RBD 患者报告过去有过 RBD 症状。RBD 和非 RBD 患者之间没有显著差异。RBDS 组与非 RBDS 患者相比，非震颤运动亚型的比例显著更高。我们的结果表明，RBD 在 PD 的早期阶段非常常见。在某些患者中，RBD 症状可能在运动障碍发病之前或发病后的头几年已经消失。非震颤运动亚型与 RBD 症状的历史有关，而与评估时是否存在 RBD 临床标准无关，这表明导致与运动状态相关的病理生理变化可能仍然存在，尽管症状波动。
