可能的快速眼动睡眠行为障碍增加了轻度认知障碍和帕金森病的风险：一项基于人群的研究。

Probable rapid eye movement sleep behavior disorder increases risk for mild cognitive impairment and Parkinson disease: a population-based study.

机构信息

Department of Neurology, Mayo Clinic College of Medicine, Rochester, MN 55905, USA.

出版信息

Ann Neurol. 2012 Jan;71(1):49-56. doi: 10.1002/ana.22655.

DOI:10.1002/ana.22655

PMID:22275251

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC3270692/

Abstract

OBJECTIVE

Rapid eye movement sleep behavior disorder (RBD) is associated with neurodegenerative disease and particularly with the synucleinopathies. Convenience samples involving subjects with idiopathic RBD have suggested an increased risk of incident mild cognitive impairment (MCI), dementia (usually dementia with Lewy bodies), and Parkinson disease (PD). There are no data on such risks in a population-based sample.

METHODS

Cognitively normal subjects aged 70 to 89 years in a population-based study of aging who screened positive for probable RBD using the Mayo Sleep Questionnaire were followed at 15-month intervals. In a Cox proportional hazards model, we measured the risk of developing MCI, dementia, and PD among the exposed (probable RBD pRBD) and unexposed (pRBD(-)) cohorts.

RESULTS

Forty-four subjects with pRBD(+) status at enrollment (median duration of pRBD features was 7.5 years) and 607 pRBD(-) subjects were followed prospectively for a median of 3.8 years. Fourteen of the pRBD(+) subjects developed MCI, and 1 developed PD (15/44 = 34% developed MCI/PD); none developed dementia. After adjustment for age, sex, education, and medical comorbidity, pRBD(+) subjects were at increased risk of MCI/PD (hazard ratio [HR], 2.2; 95% confidence interval [CI], 1.3-3.9; p = 0.005). Inclusion of subjects who withdrew from the study produced similar results, as did exclusion of subjects with medication-associated RBD. Duration of pRBD symptoms did not predict the development of MCI/PD (HR, 1.05 per 10 years; 95% CI, 0.84-1.3; p = 0.68).

INTERPRETATION

In this population-based cohort study, we observed that pRBD confers a 2.2-fold increased risk of developing MCI/PD over 4 years.

摘要

目的

快速眼动睡眠行为障碍（RBD）与神经退行性疾病有关，尤其是与突触核蛋白病有关。涉及特发性 RBD 患者的方便样本表明，轻度认知障碍（MCI）、痴呆（通常为路易体痴呆）和帕金森病（PD）的发病风险增加。在基于人群的样本中尚无此类风险的数据。

方法

在一项基于人群的老龄化研究中，对年龄在 70 至 89 岁之间、使用 Mayo 睡眠问卷筛查出可能患有 RBD 的认知正常受试者，以 15 个月为间隔进行随访。在 Cox 比例风险模型中，我们测量了暴露组（可能的 RBD pRBD）和未暴露组（pRBD(-)）中发展为 MCI、痴呆和 PD 的风险。

结果

44 名受试者在入组时存在 pRBD(+)状态（pRBD 特征的中位持续时间为 7.5 年），607 名 pRBD(-)受试者进行了前瞻性中位随访 3.8 年。pRBD(+)组有 14 名受试者发展为 MCI，1 名发展为 PD（15/44=34%发展为 MCI/PD）；无一例发展为痴呆。调整年龄、性别、教育程度和合并症后，pRBD(+)受试者发生 MCI/PD 的风险增加（风险比[HR]，2.2；95%置信区间[CI]，1.3-3.9；p=0.005）。包括从研究中退出的受试者或排除因药物相关 RBD 而退出的受试者，结果相似。pRBD 症状的持续时间并不能预测 MCI/PD 的发生（HR，每 10 年增加 1.05；95%CI，0.84-1.3；p=0.68）。