Gomutbutra Patama, Kanjanaratanakorn Kittika, Tiyapun Nantaporn
Division of Neurology, Department and Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.
Research Administration Section, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.
Parkinsons Dis. 2018 Feb 4;2018:7657191. doi: 10.1155/2018/7657191. eCollection 2018.
Previous studies have shown that Parkinson's disease (PD) patients who have REM behavior disorder (PD with RBD) might be a PD subtype since they have different symptom clusters and disease trajectories from PD without RBD.
To study the prevalence of PD with pRBD and to compare the clinical characteristics with PD without pRBD. The feasibility of clinical interview of items adopted from the Mayo Sleep Questionnaire was also to be determined.
A total of 140 Parkinson's patients visiting neurological clinics during January to December 2016 were enrolled in this study. "Probable RBD (pRBD)" was defined as present when the patient answered "yes" to a question adapted from the first Mayo Sleep Questionnaire (MSQ). The demographic data, motor symptoms, and nonmotor symptoms were obtained.
The prevalence of pRBD among this study's PD patients was 48.5% (68 out of the total of 140). The median onset of RBD before PD diagnosis was 5 years (range: 0-11 years). By comparison of PD with pRBD and PD without pRBD, this study showed significant difference in the levodopa equivalent dose (742 mg/day versus 566 mg/day; < 0.01), prevalence of symptomatic orthostatic hypotension (35.3% versus 8.3%; < 0.01). The multivariable analysis found that pRBD is independently associated with orthostatic hypotension (OR = 5.02, < 0.01). Conclusion. The findings regarding prevalence and main clinical features of PD with pRBD in this study were similar to those of a previous study of PD with polysomnogram- (PSG-) proven RBD. This study hypothesized that interviewing by adopted MSQ may be a cost-effective tool for screening RBD. Further studies with direct comparison are needed.
既往研究表明，患有快速眼动睡眠行为障碍的帕金森病（PD）患者（PD伴RBD）可能是一种PD亚型，因为他们与无RBD的PD患者具有不同的症状群和疾病轨迹。
研究伴可能快速眼动睡眠行为障碍（pRBD）的PD患病率，并将其临床特征与无pRBD的PD患者进行比较。同时确定采用梅奥睡眠问卷项目进行临床访谈的可行性。
本研究纳入了2016年1月至12月期间到神经科门诊就诊的140例帕金森病患者。“可能的RBD（pRBD）”定义为患者对改编自第一版梅奥睡眠问卷（MSQ）的一个问题回答“是”。收集人口统计学数据、运动症状和非运动症状。
本研究中PD患者的pRBD患病率为48.5%（140例中68例）。RBD在PD诊断前的中位发病时间为5年（范围：0至11年）。通过比较伴pRBD的PD患者和无pRBD的PD患者，本研究显示左旋多巴等效剂量存在显著差异（742mg/天对566mg/天；P<0.01），症状性直立性低血压患病率存在显著差异（35.3%对8.3%；P<0.01）。多变量分析发现pRBD与直立性低血压独立相关（OR=5.02，P<0.01）。结论。本研究中关于伴pRBD的PD患病率和主要临床特征的发现与先前一项关于经多导睡眠图（PSG）证实的RBD的PD研究相似。本研究推测采用MSQ进行访谈可能是一种筛查RBD的经济有效的工具。需要进行进一步直接比较的研究。
