Department of Neurology, University of Minnesota, Minneapolis, MN 55455, USA; Department of Neuroscience, University of Minnesota, Minneapolis, MN 55455, USA.
Department of Neurology, University of Minnesota, Minneapolis, MN 55455, USA.
Clin Neurophysiol. 2020 Aug;131(8):2008-2016. doi: 10.1016/j.clinph.2020.04.017. Epub 2020 May 12.
Increased muscle activity during rapid eye movement (REM) sleep (i.e. REM sleep without atonia) is common in people with Parkinson's disease (PD). This study tested the hypotheses that people with PD and REM sleep without atonia (RSWA) would present with more severe and symmetric rigidity compared to individuals with PD without RSWA and age-matched controls.
Sixty-one individuals participated in this study (41 PD, 20 controls). An overnight sleep study was used to classify participants with PD as having either elevated (PD-RSWA+) or normal muscle activity (PD-RSWA-) during REM sleep. Quantitative measures of rigidity were obtained using a robotic manipulandum that passively pronated and supinated the forearm.
Quantitative measures of forearm rigidity were significantly higher in the PD-RSWA+ group compared to the control group. Rigidity was significantly more asymmetric between limbs in the PD-RSWA- group compared with controls, while there was no significant difference in symmetry between the control and PD-RSWA+ groups.
In people with mild to moderate PD, RSWA is associated with an increased and more symmetric presentation of upper limb rigidity.
Dysfunction of brainstem systems that control muscle tone during REM sleep may contribute to increased rigidity during wakefulness in people with PD.
在快速眼动（REM）睡眠期间（即 REM 睡眠无弛缓）肌肉活动增加在帕金森病（PD）患者中很常见。本研究检验了以下假设：与无 REM 睡眠无弛缓（RSWA）的 PD 患者和年龄匹配的对照组相比，具有 RSWA 的 PD 患者会表现出更严重和更对称的僵硬。
61 名参与者参与了这项研究（41 名 PD，20 名对照组）。通过整夜睡眠研究将 PD 患者分为 REM 睡眠期间肌肉活动升高（PD-RSWA+）或正常（PD-RSWA-）的患者。使用机器人操纵器被动地旋前和旋后前臂来获得前臂僵硬的定量测量。
与对照组相比，PD-RSWA+组的前臂僵硬定量测量值显著更高。与对照组相比，PD-RSWA-组的肢体之间的僵硬明显更不对称，而对照组和 PD-RSWA+组之间的对称性没有显著差异。
在轻度至中度 PD 患者中，RSWA 与上肢僵硬的增加和更对称表现有关。
控制 REM 睡眠期间肌肉张力的脑干系统功能障碍可能导致 PD 患者在清醒时僵硬增加。
