a First Faculty of Medicine, Department of Neurology and Center of Clinical Neuroscience , Charles University and General University Hospital , Prague , Czech Republic.
b First Faculty of Medicine, Institute of Nuclear Medicine , Charles University and General University Hospital , Prague , Czech Republic.
Clin Neuropsychol. 2018 Jul;32(5):1019-1037. doi: 10.1080/13854046.2017.1394493. Epub 2017 Oct 26.
The aim of the present study was to investigate if prospective memory (PM) is impaired in idiopathic rapid eye movement (REM) sleep behavior disorder (iRBD). RBD is a parasomnia characterized by dream enactment and by REM sleep without muscle atonia. iRBD is considered as the initial stage of neurodegeneration with pathological storage of alpha-synuclein.
Sixty iRBD patients with polysomnography-confirmed RBD without parkinsonism and dementia and 30 demographically matched normal controls (NC) were enrolled in the present study. Clinical assessment included Movement Disorders Society-Unified Parkinson's Disease Rating Scale (MDS-UPDRS), dopamine transporter single-photon emission computed tomography (DaT-SPECT) for imaging synapses of dopaminergic neurons in the striatum and a neuropsychological battery with embedded time-based and event-based PM measures.
iRBD differed significantly from NC in event-based PM, a number of event-based failures to recall intention and total PM performance (all p < .001) but did not differ in time-based PM and recognition. PM did not contribute to impairment of instrumental activities of daily living in iRBD. Despite being preserved in iRBD in comparison to NC, time-based PM correlated significantly with dopaminergic neuronal loss measured by DaT-SPECT.
We show evidence for a differential pattern of PM impairment in iRBD with severe impairment of event-based and concurrent preservation of time-based PM. We theorize that event-based PM impairment in iRBD is caused by severe impairment of retention and recognition mechanisms in episodic memory whereas time-based PM seems to be affected by reduced striatal dopaminergic synapses.
本研究旨在探讨特发性快速眼动（REM）睡眠行为障碍（iRBD）患者是否存在前瞻性记忆（PM）损伤。RBD 是一种以梦境行为和 REM 睡眠无肌弛缓为特征的睡眠障碍。iRBD 被认为是神经退行性疾病的早期阶段，病理性地储存α-突触核蛋白。
本研究纳入了 60 例经多导睡眠图（PSG）证实的 RBD 患者（无帕金森病和痴呆）和 30 名年龄匹配的正常对照组（NC）。临床评估包括运动障碍学会统一帕金森病评定量表（MDS-UPDRS）、多巴胺转运体单光子发射计算机断层扫描（DaT-SPECT），用于评估纹状体多巴胺能神经元突触，以及包含基于时间和基于事件的 PM 测量的神经心理学测试。
iRBD 患者在基于事件的 PM 中与 NC 显著不同，包括事件记忆失败次数、意向回忆失败次数和总 PM 表现（均 p<0.001），但在基于时间的 PM 和识别方面无差异。PM 与 iRBD 患者的工具性日常生活活动损害无关。尽管与 NC 相比，iRBD 患者的 PM 仍然存在，但基于时间的 PM 与 DaT-SPECT 测量的多巴胺能神经元丢失显著相关。
我们的研究结果表明，iRBD 患者的 PM 损伤模式存在差异，表现为严重的基于事件的 PM 损伤，同时基于时间的 PM 保存。我们推测，iRBD 患者的基于事件的 PM 损伤是由于情景记忆的保留和识别机制严重受损所致，而基于时间的 PM 似乎受到纹状体多巴胺能突触减少的影响。
