Department of Neurological Sciences, University of Bologna, Bologna, Italy.
Sleep Med. 2011 Dec;12 Suppl 2:S59-63. doi: 10.1016/j.sleep.2011.10.013.
We carried out a systematic video-polysomnographic analysis of the number and type of motor events during REM sleep in narcolepsy-cataplexy patients with REM sleep behavior disorder (NC + RBD) but not clinical RBD (NC-RBD).
Twelve NC + RBD and 10 NC-RBD male patients underwent video-polysomnography (video-PSG). Motor events of different type and complexity (i.e., elementary and complex movements and vocalizations) occurring during REM sleep were visually assessed, and indices of their frequency per hour of REM sleep were calculated. Subsequently, the index values were compared in NC + RBD versus NC-RBD patients.
Typical RBD behaviors observed in five NC + RBD patients were not included in any type of motor events. No objective conventional sleep parameter, including visual analysis of chin electromyographic (EMG) activity, significantly differed between the two groups of NC patients. NC + RBD patients showed higher occurrence of elementary movements (p = 0.034) during REM sleep compared with NC-RBD patients, but the occurrence of complex movements did not differ significantly.
Video-analysis of motor events during REM sleep may improve the diagnosis of RBD in NC. RBD in NC patients is mainly characterized by elementary rather than complex movements, consistent with the view that RBD with NC patients displays a distinct phenotype with respect to other RBD patients.
我们对伴有 REM 睡眠行为障碍(NC + RBD)但无临床 RBD(NC-RBD)的发作性睡病-猝倒症患者 REM 睡眠期间的运动事件数量和类型进行了系统的视频多导睡眠图分析。
12 例 NC + RBD 和 10 例 NC-RBD 男性患者接受了视频多导睡眠图(video-PSG)检查。通过视觉评估 REM 睡眠期间发生的不同类型和复杂程度(即基本运动和复杂运动以及发声)的运动事件,并计算每小时 REM 睡眠中出现的运动事件频率的指数。随后,比较了 NC + RBD 与 NC-RBD 患者的指数值。
5 例 NC + RBD 患者观察到的典型 RBD 行为未包含在任何类型的运动事件中。两组 NC 患者之间,包括颏肌肌电图(EMG)活动的视觉分析在内的客观常规睡眠参数均无显著差异。与 NC-RBD 患者相比,NC + RBD 患者在 REM 睡眠期间更频繁地出现基本运动(p = 0.034),但复杂运动的发生并无显著差异。
REM 睡眠期间运动事件的视频分析可能有助于提高 NC 中 RBD 的诊断。NC 患者的 RBD 主要表现为基本运动而不是复杂运动,这与 NC 患者的 RBD 与其他 RBD 患者相比具有明显不同的表型的观点一致。