帕金森病的 REM 睡眠行为障碍与神经病理学。

REM sleep behavior disorder and neuropathology in Parkinson's disease.

机构信息

Department of Neurology, McGill University, Montreal General Hospital, Montreal, Quebec, Canada, Centre d'Études Avancées en Médecine du Sommeil, Hôpital du Sacré-Cœur de Montréal, Montréal, Québec, Canada.

Department of Neurology, Mayo Clinic College of Medicine, Scottsdale, AZ.

出版信息

Mov Disord. 2015 Sep;30(10):1413-7. doi: 10.1002/mds.26347. Epub 2015 Aug 12.

DOI:10.1002/mds.26347

PMID:26265105

Abstract

INTRODUCTION

Rapid eye movement (REM) sleep behavior disorder (RBD) in Parkinson's disease (PD) is associated with differences in clinical phenotype, including dementia, autonomic loss, and gait dysfunction. The pathological basis for this remains unclear.

METHODS

Parkinson's disease subjects in a longitudinal clinicopathologic study were screened for probable RBD with the Mayo Sleep Questionnaire. After death, semiquantitative analyses were conducted for synuclein, amyloid, neurofibrillary tangles, and cerebrovascular lesions.

RESULTS

Forty cases had probable RBD (PD+RBD), and 41 did not (PD-RBD). Despite similar age at death (∼80 y) and disease duration (∼14.5 y), PD+RBD had increased synuclein deposition in all regions examined, with nine of 10 regions significantly different. The Lewy body 10-region total score (scale = 0-40) was 29.5 in PD+RBD versus 24.5 in PD-RBD (Cohen-d effect size = 0.79, P = 0.002). Cerebrovascular lesion burden was slightly higher in PD-RBD.

CONCLUSIONS

Although overlap occurs between groups, PD patients with probable RBD may have greater density and range of synuclein pathology on autopsy.

摘要

简介

帕金森病（PD）中的快速眼动（REM）睡眠行为障碍（RBD）与临床表型的差异有关，包括痴呆、自主神经丧失和步态功能障碍。其病理基础仍不清楚。

方法

对纵向临床病理研究中的帕金森病患者进行了 Mayo 睡眠问卷（Mayo Sleep Questionnaire）以筛查可能的 RBD。死后进行了突触核蛋白、淀粉样蛋白、神经纤维缠结和脑血管病变的半定量分析。

结果

40 例存在可能的 RBD（PD+RBD），41 例不存在（PD-RBD）。尽管死亡年龄（约 80 岁）和疾病持续时间（约 14.5 年）相似，但 PD+RBD 所有检查区域的突触核蛋白沉积均增加，其中 10 个区域中有 9 个显著不同。Lewy 体 10 区域总分（量表=0-40）在 PD+RBD 中为 29.5，在 PD-RBD 中为 24.5（Cohen-d 效应量=0.79，P=0.002）。PD-RBD 中的脑血管病变负担略高。