Division of Neurology, Department of Brain and Neurosciences, Faculty of Medicine, Tottori University, Japan.
Sleep Med. 2013 Feb;14(2):131-5. doi: 10.1016/j.sleep.2012.10.011. Epub 2012 Dec 3.
Rapid eye movement (REM) sleep behavior disorder (RBD) may be a risk factor for dementia development in patients with Parkinson's disease (PD); however, the role of subclinical RBD remains unknown. Patients with PD and clinical RBD, subclinical RBD, or with normal REM sleep were examined in a cross sectional study and a longitudinal follow-up.
Interviews regarding RBD symptoms and polysomnographies were performed on 82 PD patients divided into RBD subcategories based on the presence/absence of REM sleep without atonia (RWA) and/or RBD symptoms. Descriptive variables were compared and patients were followed-up longitudinally for 21.4±10.8months.
The existence of RBD, but not subclinical RBD, was associated with orthostatic hypotension and levodopa dose equivalents (LDEs) in patients with PD. Kaplan-Myer curves indicated that the occurrence of dementia in the PD group with clinical RBD was significantly faster than in the PD group with normal REM sleep (p=0.013). A Cox hazard regression analysis revealed that development to PD with dementia was only significantly associated with the presence of clinical RBD (hazard ratio: 14.1, p=0.017).
Clinical RBD symptoms, but not subclinical RBD, were associated with the development of dementia in PD.
快速眼动（REM）睡眠行为障碍（RBD）可能是帕金森病（PD）患者痴呆发展的一个危险因素；然而，亚临床 RBD 的作用尚不清楚。在一项横断面研究和纵向随访中，检查了具有临床 RBD、亚临床 RBD 或正常 REM 睡眠的 PD 患者。
对 82 名 PD 患者进行了 REM 睡眠行为障碍症状和多导睡眠图检查，根据是否存在 REM 睡眠无张力（RWA）和/或 RBD 症状将患者分为 RBD 亚组。比较了描述性变量，并对患者进行了 21.4±10.8 个月的纵向随访。
RBD 的存在，而不是亚临床 RBD 的存在，与 PD 患者的直立性低血压和左旋多巴等效剂量（LDEs）有关。Kaplan-Meier 曲线表明，具有临床 RBD 的 PD 组发生痴呆的速度明显快于具有正常 REM 睡眠的 PD 组（p=0.013）。Cox 风险回归分析表明，向具有痴呆的 PD 发展仅与临床 RBD 的存在显著相关（风险比：14.1，p=0.017）。
临床 RBD 症状，而不是亚临床 RBD，与 PD 患者痴呆的发展有关。
