Ferini-Strambi L, Marelli S, Galbiati A, Rinaldi F, Giora E
Sleep Disorders Center, Division of Neuroscience, Università Vita-Salute San Raffaele, Milan, Italy. Email:
Arch Ital Biol. 2014 Jun-Sep;152(2-3):129-46. doi: 10.12871/000298292014238.
Rapid eye movement (REM) sleep behavior disorder (RBD) can occur in the absence of any other obvious associated neurologic disorder or in association with a neurodegenerative disease, in which case it is considered as symptomatic RBD. RBD is frequently associated with Parkinson's disease (PD), Lewy body dementia or multiple system atrophy (MSA), and in several cases may even antedate the occurrence of motor symptoms by decades. When no neurologic disorder is obvious, RBD can be considered as idiopathic (iRBD). Several studies have looked at neurophysiologic and neuropsychological functions in iRBD and have found evidence of CNS dysfunction during both wakefulness and sleep in a variable proportion of these patients, challenging the concept of iRBD. Identifying subjects with a high risk of developing a neurodegenerative process may be crucial in order to develop early intervention strategies. Some prospective results in iRBD showed that potential markers of neurodegeneration are the following: 1) marked EEG slowing on spectral analysis; 2) decreased striatal 123I-FPCIT; 3) impaired color vision.
快速眼动（REM）睡眠行为障碍（RBD）可在无任何其他明显相关神经系统疾病的情况下发生，或与神经退行性疾病相关，在后一种情况下，它被视为症状性RBD。RBD常与帕金森病（PD）、路易体痴呆或多系统萎缩（MSA）相关，在某些情况下甚至可能比运动症状的出现早几十年。当无明显神经系统疾病时，RBD可被视为特发性（iRBD）。多项研究观察了iRBD患者的神经生理和神经心理功能，发现这些患者中有不同比例的人在清醒和睡眠期间均存在中枢神经系统功能障碍的证据，这对iRBD的概念提出了挑战。识别具有发生神经退行性病变高风险的个体对于制定早期干预策略可能至关重要。iRBD的一些前瞻性研究结果表明，神经退行性变的潜在标志物如下：1）频谱分析显示脑电图明显减慢；2）纹状体123I-FPCIT降低；3）色觉受损。
