帕金森病伴冻结步态时 REM 睡眠无张力增加。
Increased REM sleep without atonia in Parkinson disease with freezing of gait.
机构信息
From the Departments of Neurology (A.V., C.D.M.) and Physical Therapy and Human Movement Sciences (C.M., L.A., C.D.M.), Northwestern University, Chicago, IL; Doctor of Physical Therapy Program (L.A.), San Diego State University, CA; Departments of Applied Physiology and Kinesiology (P.J.P., D.E.V.), Neurology (D.E.V.), and Biomedical Engineering (D.E.V.), University of Florida, Gainesville; and Department of Neurology (C.D.M.), University of Minnesota, Minneapolis.
出版信息
Neurology. 2013 Sep 17;81(12):1030-5. doi: 10.1212/WNL.0b013e3182a4a408. Epub 2013 Aug 14.
OBJECTIVE
The objective of this cross-sectional study was to test the hypothesis that patients with Parkinson disease (PD) and freezing of gait (PD+FOG) would demonstrate sleep disturbances comparable to those seen in patients with REM sleep behavior disorder (RBD) and these changes would be significantly different from those in PD patients without FOG (PD-FOG) and age-matched controls.
METHODS
We conducted overnight polysomnography studies in 4 groups of subjects: RBD, PD-FOG, PD+FOG, and controls. Tonic and phasic muscle activity during REM sleep were quantified using EMG recordings from the chin, compared among study groups, and correlated with disease metrics.
RESULTS
There were no significant differences in measures of disease severity, duration, or dopaminergic medications between the PD+FOG and PD-FOG groups. Tonic muscle activity was increased significantly (p < 0.007) in the RBD and PD+FOG groups compared to the PD-FOG and control groups. There was no significant difference in tonic EMG between the PD+FOG and RBD group (p = 0.364), or in tonic or phasic EMG between the PD-FOG and control group (p = 0.107). Phasic muscle activity was significantly increased in the RBD group compared to all other groups (p = 0.029) and between the PD+FOG and control group (p = 0.001), but not between the PD+FOG and PD-FOG groups (p = 0.059).
CONCLUSIONS
These findings provide evidence that increased muscle activity during REM sleep is a comorbid feature of patients with PD who exhibit FOG as a motor manifestation of their disease.
目的
本横断面研究旨在检验以下假设，即帕金森病（PD）伴冻结步态（PD+FOG）患者的睡眠障碍与快速眼动睡眠行为障碍（RBD）患者相似，且这些变化与不伴 FOG 的 PD 患者（PD-FOG）和年龄匹配的对照组明显不同。
方法
我们对 4 组受试者进行了整夜多导睡眠图研究：RBD、PD-FOG、PD+FOG 和对照组。通过颏肌肌电图记录定量比较 REM 睡眠期间的紧张性和阵发性肌肉活动，并与疾病指标相关。
结果
PD+FOG 组和 PD-FOG 组之间的疾病严重程度、持续时间或多巴胺能药物治疗无显著差异。与 PD-FOG 和对照组相比，RBD 和 PD+FOG 组的紧张性肌肉活动明显增加（p<0.007）。PD+FOG 组与 RBD 组之间的紧张性肌电图无显著差异（p=0.364），或 PD-FOG 组与对照组之间的紧张性或阵发性肌电图无显著差异（p=0.107）。与所有其他组相比，RBD 组的阵发性肌肉活动明显增加（p=0.029），与 PD+FOG 组和对照组相比（p=0.001），但与 PD+FOG 组和 PD-FOG 组之间无显著差异（p=0.059）。
结论
这些发现为 PD 患者在 REM 睡眠期间肌肉活动增加是其疾病运动表现为 FOG 的共病特征提供了证据。
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