Department of Clinical Neurophysiology, Aarhus University Hospital, Aarhus, Denmark.
Department of Clinical Neurophysiology, Aarhus University Hospital, Aarhus, Denmark.
Sleep Med. 2018 Feb;42:83-89. doi: 10.1016/j.sleep.2017.09.035. Epub 2017 Oct 28.
Idiopathic REM sleep behaviour disorder (iRBD) has been recognised as a significant biomarker for developing a neurodegenerative alpha-synucleinopathy, which is why iRBD is considered to be a prodromal state for alpha-synucleinopathies including Parkinson's disease (PD). Many patients with PD suffer from complaints of pain and present impaired somatosensory function. We hypothesized that pain perception and somatosensory function could be altered already in a preclinical stage of PD including iRBD. Hence, the objective of this study was to investigate pain perception and somatosensory function in patients with iRBD.
Quantitative sensory testing (QST), laser evoked potentials (LEPs), and conditioned pain modulation (CPM) testing were performed in 13 iRBD patients without any clinical signs of PD or narcolepsy (11 males, 2 females, mean age 65.2 years) and 15 gender- and age-matched healthy control subjects (12 males, 3 females, mean age 65.8 years).
Thermal detection thresholds were higher in the iRBD group compared with the control group (cold detection threshold (CDT) p = 0.020, thermal sensory limen (TSL) p = 0.001), indicating an impaired temperature sensation in iRBD patients. The N2/P2 LEPs amplitude was smaller in iRBD patients than controls, but not statistically significant (p = 0.053).
This study found an impaired somatosensory function in iRBD patients, suggesting that somatosensory impairment might be an early feature in the neurodegenerative process of PD.
特发性 REM 睡眠行为障碍（iRBD）已被认为是神经退行性 α-突触核蛋白病发展的重要生物标志物，这就是为什么 iRBD 被认为是包括帕金森病（PD）在内的 α-突触核蛋白病的前驱状态。许多 PD 患者有疼痛主诉，并表现出感觉功能受损。我们假设疼痛感知和躯体感觉功能可能已经在包括 iRBD 的 PD 临床前阶段发生改变。因此，本研究旨在研究 iRBD 患者的疼痛感知和躯体感觉功能。
对 13 名无 PD 或发作性睡病临床症状的 iRBD 患者（男性 11 名，女性 2 名，平均年龄 65.2 岁）和 15 名性别和年龄匹配的健康对照者（男性 12 名，女性 3 名，平均年龄 65.8 岁）进行定量感觉测试（QST）、激光诱发电位（LEP）和条件性疼痛调制（CPM）测试。
iRBD 组的冷觉检测阈值（CDT）高于对照组（p=0.020），热感觉阈值（TSL）高于对照组（p=0.001），表明 iRBD 患者的温度感觉受损。iRBD 患者的 N2/P2 LEPs 振幅小于对照组，但无统计学意义（p=0.053）。
本研究发现 iRBD 患者存在躯体感觉功能障碍，提示躯体感觉障碍可能是 PD 神经退行性过程的早期特征。
