Shimohata Takayoshi, Inoue Yuichi, Hirata Koichi
Department of Neurology, Brain Research Institute, Niigata University.
Rinsho Shinkeigaku. 2017 Feb 25;57(2):63-70. doi: 10.5692/clinicalneurol.cn-000961. Epub 2017 Jan 28.
Rapid eye movement (REM) sleep behavior disorder (RBD) is a parasomnia characterized by dream enactment behavior during REM sleep. It has been demonstrated that patients with idiopathic RBD are at a significantly increased risk of developing one of the α-synucleinopathies later in life, and this is called "phenoconversion". Although some physicians argue against disclosing information that could cause patients psychological stress, the patients also have a "right to know" about their own disease. Therefore, determining when and how to disclose this information, in addition to appropriate follow-up, is important. Clonazepam is the first choice of treatment for RBD associated with α-synucleinopathies. Since RBD is one of the premotor symptoms of α-synucleinopathies, and enables its early diagnosis, a combination of RBD and other examinations may contribute to the realization of a disease-modifying therapy. It is hoped that the early establishment of biomarkers could help predict the phenoconversion from RBD to α-synucleinopathies.
快速眼动(REM)睡眠行为障碍(RBD)是一种异态睡眠,其特征是在快速眼动睡眠期间出现梦境行为。已经证明,特发性RBD患者在晚年发生α-突触核蛋白病的风险显著增加,这被称为“表型转化”。尽管一些医生反对透露可能给患者带来心理压力的信息,但患者也有“知情权”了解自己的疾病。因此,除了进行适当的随访外,确定何时以及如何透露这些信息很重要。氯硝西泮是与α-突触核蛋白病相关的RBD的首选治疗药物。由于RBD是α-突触核蛋白病的运动前症状之一,并能实现早期诊断,RBD与其他检查相结合可能有助于实现疾病修饰治疗。希望生物标志物的早期建立有助于预测从RBD到α-突触核蛋白病的表型转化。