特发性快速眼动睡眠行为障碍患者和帕金森病患者的睡眠稳定性及睡眠转换
Sleep stability and transitions in patients with idiopathic REM sleep behavior disorder and patients with Parkinson's disease.
作者信息
Christensen Julie Anja Engelhard, Jennum Poul, Koch Henriette, Frandsen Rune, Zoetmulder Marielle, Arvastson Lars, Christensen Søren Rahn, Sorensen Helge Bjarrup Dissing
机构信息
Department of Electrical Engineering, Technical University of Denmark, Kongens Lyngby, Denmark; Danish Center for Sleep Medicine, Department of Clinical Neurophysiology, University of Copenhagen, Glostrup Hospital, Glostrup, Denmark; H. Lundbeck A/S, Copenhagen, Denmark.
Danish Center for Sleep Medicine, Department of Clinical Neurophysiology, University of Copenhagen, Glostrup Hospital, Glostrup, Denmark.
出版信息
Clin Neurophysiol. 2016 Jan;127(1):537-543. doi: 10.1016/j.clinph.2015.03.006. Epub 2015 Mar 20.
OBJECTIVE
Patients with idiopathic rapid eye movement (REM) sleep behavior disorder (iRBD) are at high risk of developing Parkinson's disease (PD). As wake/sleep-regulation is thought to involve neurons located in the brainstem and hypothalamic areas, we hypothesize that the neurodegeneration in iRBD/PD is likely to affect wake/sleep and REM/non-REM (NREM) sleep transitions.
METHODS
We determined the frequency of wake/sleep and REM/NREM sleep transitions and the stability of wake (W), REM and NREM sleep as measured by polysomnography (PSG) in 27 patients with PD, 23 patients with iRBD, 25 patients with periodic leg movement disorder (PLMD) and 23 controls. Measures were computed based on manual scorings and data-driven labeled sleep staging.
RESULTS
Patients with PD showed significantly lower REM stability than controls and patients with PLMD. Patients with iRBD had significantly lower REM stability compared with controls. Patients with PD and RBD showed significantly lower NREM stability and significantly more REM/NREM transitions than controls.
CONCLUSIONS
We conclude that W, NREM and REM stability and transitions are progressively affected in iRBD and PD, probably reflecting the successive involvement of brain stem areas from early on in the disease.
SIGNIFICANCE
Sleep stability and transitions determined by a data-driven approach could support the evaluation of iRBD and PD patients.
目的
特发性快速眼动（REM）睡眠行为障碍（iRBD）患者患帕金森病（PD）的风险很高。由于觉醒/睡眠调节被认为涉及位于脑干和下丘脑区域的神经元，我们推测iRBD/PD中的神经退行性变可能会影响觉醒/睡眠以及快速眼动/非快速眼动（NREM）睡眠转换。
方法
我们通过多导睡眠图（PSG）测定了27例PD患者、23例iRBD患者、25例周期性腿部运动障碍（PLMD）患者和23名对照者的觉醒/睡眠和快速眼动/非快速眼动睡眠转换频率以及觉醒（W）、快速眼动和非快速眼动睡眠的稳定性。测量基于人工评分和数据驱动的标记睡眠分期进行计算。
结果
PD患者的快速眼动稳定性显著低于对照者和PLMD患者。iRBD患者的快速眼动稳定性与对照者相比显著降低。PD和RBD患者的非快速眼动稳定性显著降低，快速眼动/非快速眼动转换显著多于对照者。
结论
我们得出结论，iRBD和PD患者的觉醒、非快速眼动和快速眼动稳定性及转换逐渐受到影响，这可能反映了疾病早期脑干区域的相继受累。
意义
通过数据驱动方法确定的睡眠稳定性和转换可以支持对iRBD和PD患者的评估。
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