Bugalho Paulo, Ladeira Filipa, Barbosa Raquel, Marto João Pedro, Borbinha Cláudia, da Conceição Laurete, Salavisa Manuel, Saraiva Marlene, Meira Bruna, Fernandes Marco
Department of Neurology, Hospital de Egas Moniz, Centro Hospitalar de Lisboa Ocidental, Lisboa, Portugal; CEDOC, Chronic Diseases Research Center, NOVA Medical School, Portugal.
Department of Neurology, Hospital de Egas Moniz, Centro Hospitalar de Lisboa Ocidental, Lisboa, Portugal.
Sleep Med. 2021 Jan;77:205-208. doi: 10.1016/j.sleep.2020.06.020. Epub 2020 Jun 25.
To assess the predictive value of polysomnographic (PSG) data in the prospective assessment of cognitive, motor, daytime and nighttime sleep dysfunction in Parkinson's Disease (PD) patients.
PD patients were assessed at baseline with video-PSG and with cognitive (MoCA), Sleep (SCOPA-Sleep Nighttime and Daytime scores) and Motor (UPDRSIII) function scales at both baseline and four years later. Linear regression analysis was used to assess the relation between PSG variables at baseline and change in symptoms scores.
We included a total of 25 patients, 12 with rapid eye movement (REM) sleep behavior disorder (RBD) (in 8 PSG was inconclusive, due to lack of REM sleep). MoCA scores decreased significantly at follow-up, while SCOPA-Sleep Daytime and SCOPA-Sleep Nighttime and UPDRSIII did not vary. Lower N3 percentage at baseline was significantly associated with MoCA decrease. Higher Periodic Limb Movements in Sleep index (PLMS) and the presence of RBD were significantly associated with SCOPA daytime score increase. Higher global severity of RBD, tonic RSWA and total number of motor events during REM sleep were associated with SCOPA Nighttime score increase.
The present work suggests that PSG data could be useful for predicting PD cognitive and sleep dysfunction progression. Reduced SWS could predict deterioration of cognitive function, while baseline PLMS could be useful to predict worsening of daytime sleep dysfunction. Severity of RBD could be used for estimating nighttime sleep symptoms progression.
评估多导睡眠图（PSG）数据在帕金森病（PD）患者认知、运动、日间和夜间睡眠功能障碍前瞻性评估中的预测价值。
对PD患者在基线时进行视频PSG评估，并在基线和四年后使用认知（蒙特利尔认知评估量表，MoCA）、睡眠（睡眠障碍量表日间和夜间评分，SCOPA - Sleep）和运动（统一帕金森病评定量表第三部分，UPDRSIII）功能量表进行评估。采用线性回归分析评估基线时PSG变量与症状评分变化之间的关系。
共纳入25例患者，其中12例有快速眼动（REM）睡眠行为障碍（RBD）（8例PSG结果不确定，原因是缺乏REM睡眠）。随访时MoCA评分显著下降，而SCOPA - Sleep日间评分、SCOPA - Sleep夜间评分和UPDRSIII评分无变化。基线时较低的N3百分比与MoCA评分下降显著相关。较高的睡眠期周期性肢体运动指数（PLMS）和RBD的存在与SCOPA日间评分增加显著相关。RBD的整体严重程度较高、紧张性快速眼动睡眠期觉醒（RSWA）以及REM睡眠期间运动事件总数与SCOPA夜间评分增加相关。
本研究表明PSG数据可能有助于预测PD认知和睡眠功能障碍的进展。慢波睡眠减少可预测认知功能恶化，而基线PLMS可能有助于预测日间睡眠功能障碍的恶化。RBD的严重程度可用于估计夜间睡眠症状的进展。
