Ratti Pietro-Luca, Sierra-Peña Maria, Manni Raffaele, Simonetta-Moreau Marion, Bastin Julien, Mace Harrison, Rascol Olivier, David Olivier
Department of Clinical Pharmacology, Toulouse University Hospital and Paul Sabatier University, Toulouse, France; UMR 825 Brain imaging and neurological dysfunctions, INSERM, Toulouse, France; Sleep and Epilepsy center, Neurocenter of Southern Switzerland, Civic Hospital (EOC) of Lugano, Lugano, Switzerland.
Department of Neurology, Toulouse University Hospital and Paul Sabatier University, Toulouse, France.
PLoS One. 2015 Mar 10;10(3):e0120973. doi: 10.1371/journal.pone.0120973. eCollection 2015.
To characterize parasomnia behaviors on arousal from NREM sleep in Parkinson's Disease (PD) and Multiple System Atrophy (MSA).
From 30 patients with PD, Dementia with Lewy Bodies/Dementia associated with PD, or MSA undergoing nocturnal video-polysomnography for presumed dream enactment behavior, we were able to select 2 PD and 2 MSA patients featuring NREM Parasomnia Behviors (NPBs). We identified episodes during which the subjects seemed to enact dreams or presumed dream-like mentation (NPB arousals) versus episodes with physiological movements (no-NPB arousals). A time-frequency analysis (Morlet Wavelet Transform) of the scalp EEG signals around each NPB and no- NPB arousal onset was performed, and the amplitudes of the spectral frequencies were compared between NPB and no-NPB arousals.
19 NPBs were identified, 12 of which consisting of 'elementary' NPBs while 7 resembling confusional arousals. With quantitative EEG analysis, we found an amplitude reduction in the 5-6 Hz band 40 seconds before NPBs arousal as compared to no-NPB arousals at F4 and C4 derivations (p<0.01).
Many PD and MSA patients feature various NREM sleep-related behaviors, with clinical and electrophysiological differences and similarities with arousal parasomnias in the general population.
This study help bring to attention an overlooked phenomenon in neurodegenerative diseases.
描述帕金森病（PD）和多系统萎缩（MSA）患者非快速眼动睡眠（NREM）觉醒时的异态睡眠行为。
从30例因疑似梦呓行为而接受夜间视频多导睡眠监测的PD、路易体痴呆/与PD相关的痴呆或MSA患者中，我们能够选出2例有NREM异态睡眠行为（NPB）的PD患者和2例MSA患者。我们确定了受试者似乎在演绎梦境或类似梦境的思维过程的发作（NPB觉醒）与生理性运动的发作（非NPB觉醒）。对每个NPB和非NPB觉醒开始前后头皮脑电图信号进行时频分析（莫雷小波变换），并比较NPB和非NPB觉醒之间频谱频率的振幅。
共识别出19次NPB，其中12次为“基本”NPB，7次类似混乱觉醒。通过定量脑电图分析，我们发现与非NPB觉醒相比，在F4和C4导联处，NPB觉醒前40秒5-6Hz频段的振幅降低（p<0.01）。
许多PD和MSA患者具有各种与NREM睡眠相关的行为，在临床和电生理方面与普通人群的觉醒性异态睡眠存在差异和相似之处。
本研究有助于引起人们对神经退行性疾病中一个被忽视现象的关注。
