Mariotti Paolo, Quaranta Davide, Di Giacopo Raffaella, Bentivoglio Anna Rita, Mazza Marianna, Martini Annalisa, Canestri Jorge, Della Marca Giacomo
Unit of Child Neuropsychiatry, Catholic University, Rome, Italy.
International Psychoanalytical Association and Italian Psychoanalytical Association.
Sleep. 2015 Feb 1;38(2):287-94. doi: 10.5665/sleep.4416.
REM sleep behavior disorder (RBD) is a parasomnia characterized by motor activity during sleep with dream mentation. Aggressiveness has been considered a peculiar feature of dreams associated with RBD, despite normal score in aggressiveness scales during wakefulness. We aimed to measure daytime aggressiveness and analyze dream contents in a population of patients with Parkinson disease (PD) with and without RBD.
This is a single-center prospective observational study; it concerns the description of the clinical features of a medical disorder in a case series.
The study was performed in the Department of Neurosciences of the Catholic University in Rome, Italy.
Three groups of subjects were enrolled: patients with PD plus RBD, patients with PD without RBD, and healthy controls.
The diagnosis of RBD was determined clinically and confirmed by means of overnight, laboratory-based video-polysomnography. For the evaluation of diurnal aggressiveness, the Buss-Perry Aggression Questionnaire (BPAQ) was used. The content of dreams was evaluated by means of the methods of Hall and Van De Castle.
Patients with PD without RBD displayed higher levels of anger, and verbal and physical aggressiveness than patients with PD and RBD and controls. Patients with PD and RBD and controls did not differ in hostility.
It can be hypothesized that a noradrenergic impairment at the level of the locus coeruleus could, at the same time, explain the presence of RBD, as well as the reduction of diurnal aggressiveness. This finding also suggests a role for REM sleep in regulating homeostasis of emotional brain function.
快速眼动睡眠行为障碍（RBD）是一种异态睡眠，其特征为睡眠期间伴有梦境的运动活动。尽管清醒时攻击性量表得分正常，但攻击性一直被认为是与RBD相关梦境的一个特殊特征。我们旨在测量帕金森病（PD）伴或不伴RBD患者的日间攻击性，并分析其梦境内容。
这是一项单中心前瞻性观察性研究；它涉及病例系列中一种医学疾病临床特征的描述。
该研究在意大利罗马天主教大学神经科学系进行。
招募了三组受试者：PD伴RBD患者、PD不伴RBD患者和健康对照者。
RBD的诊断通过临床确定，并通过基于实验室的夜间视频多导睡眠图进行确认。为了评估日间攻击性，使用了布斯-佩里攻击性问卷（BPAQ）。梦境内容通过霍尔和范德卡斯尔的方法进行评估。
PD不伴RBD患者比PD伴RBD患者和对照者表现出更高水平的愤怒、言语攻击性和身体攻击性。PD伴RBD患者和对照者在敌意方面没有差异。
可以假设，蓝斑水平的去甲肾上腺素能损害可能同时解释RBD的存在以及日间攻击性的降低。这一发现还表明快速眼动睡眠在调节情绪脑功能的内稳态中发挥作用。
