Chulalongkorn Center of Excellence for Parkinson's Disease & Related Disorders, Chulalongkorn University, Bangkok, Thailand.
Department of Neurology, Innsbruck Medical University, Innsbruck, Austria.
Sleep. 2021 Sep 13;44(9). doi: 10.1093/sleep/zsab067.
To evaluate macro sleep architecture and characterize rapid eye movement (REM) sleep without atonia (RWA) by using the SINBAR excessive electromyographic (EMG) montage including mentalis and upper extremity muscles in early and advanced Parkinson's disease (PD).
We recruited 30 patients with early- and advanced-stage of PD according to Movement Disorder Society (MDS) Clinical Diagnostic Criteria. Participants were classified as early-stage PD if they were treatment-naïve or had no motor complications and had been diagnosed with PD within the previous 6 years. Advanced PD was defined as a disease duration equal to or >6 years with or without motor complications.
There was significantly shorter REM sleep latency in early as compared to the advanced stage of PD. We found that the sleep Innsbruck Barcelona (SINBAR) EMG index and tonic EMG activity of the mentalis muscle in advanced-stage PD were significantly higher than in early-stage PD with a trend in phasic EMG activity of the flexor digitorum superficialis muscles. The SINBAR EMG index, tonic and any EMG activity of the mentalis muscle, and phasic EMG activity of flexor digitorum superficialis muscles significantly correlated with disease duration.
This study analyzed RWA using the SINBAR EMG montage in early- and advanced-stage of PD and showed higher RWA in mentalis and flexor digitorum superficialis muscles and SINBAR EMG index in advanced-PD patients compared to patients in the early stage. Also, polysomnography-confirmed REM sleep behavior disorder was more common in advanced versus early-stage patients. Our findings suggest that RWA worsens or is more intense or more frequent with disease progression.
通过使用包括颏肌和上肢肌肉的 SINBAR 过度肌电图 (EMG) 导联评估宏观睡眠结构，并在帕金森病 (PD) 的早期和晚期特征化 REM 睡眠无动（RWA）。
我们招募了 30 名符合运动障碍协会 (MDS) 临床诊断标准的早期和晚期 PD 患者。如果患者是治疗初治或无运动并发症，并且在过去 6 年内被诊断为 PD，则将其归类为早期 PD。晚期 PD 的定义为疾病持续时间等于或 >6 年，伴有或不伴有运动并发症。
与晚期 PD 相比，早期 PD 的 REM 睡眠潜伏期明显缩短。我们发现，晚期 PD 的睡眠因斯布鲁克巴塞罗那 (SINBAR) EMG 指数和颏肌的紧张性 EMG 活性明显高于早期 PD，而屈指浅肌的相位 EMG 活性呈趋势。SINBAR EMG 指数、颏肌的紧张性和任何 EMG 活性以及屈指浅肌的相位 EMG 活性与疾病持续时间显著相关。
本研究使用 SINBAR EMG 导联分析了早期和晚期 PD 中的 RWA，并显示出晚期 PD 患者颏肌和屈指浅肌的 RWA 以及 SINBAR EMG 指数较高，而早期 PD 患者则较低。此外，经多导睡眠图证实的 REM 睡眠行为障碍在晚期患者中比早期患者更常见。我们的研究结果表明，随着疾病的进展，RWA 恶化或更强烈或更频繁。
