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帕金森病中的快速眼动睡眠行为障碍(综述)

REM sleep behaviour disorder in Parkinson's disease (Review).

作者信息

Diaconu Ștefania, Falup-Pecurariu Oana, Țînț Diana, Falup-Pecurariu Cristian

机构信息

Faculty of Medicine, Transilvania University, 500036 Brașov, Romania.

Department of Electrophysiology and Implantable Devices, Clinicco Hospital, 500059 Brașov, Romania.

出版信息

Exp Ther Med. 2021 Aug;22(2):812. doi: 10.3892/etm.2021.10244. Epub 2021 May 28.

Abstract

Rapid eye movement (REM) sleep behavior disorder (RBD) is a parasomnia defined by simple or complex abnormal movements occurring in REM state, instead of the physiological muscular atonia. RBD may be idiopathic, or secondary as in the case of Parkinson's disease (PD). Several studies have confirmed that idiopathic RBD may precede with several years the onset of the specific motor characteristics of PD. The high prevalence of RBD in PD (19-70%) may be explained by several common pathophysiological pathways, mainly related to the dopaminergic cell loss. RBD is also associated with several comorbidities, including cognitive impairment, hallucinations, dysautonomia, or daytime sleepiness. The gold standard investigation for the diagnosis and assessment of RBD is video polysomnography, but in clinical practice, the use of clinical scales and questionnaires is reasonable for the screening of this complex parasomnia. Management options include ensuring a safe environment for the patient and pharmacological treatment, incuding clonazepam, melatonin or certain antiparkinsonian drugs.

摘要

快速眼动(REM)睡眠行为障碍(RBD)是一种异态睡眠,其定义为在快速眼动状态下出现简单或复杂的异常运动,而非生理性的肌肉弛缓。RBD可能是特发性的,也可能是继发性的,如帕金森病(PD)。多项研究证实,特发性RBD可能比PD特定运动特征的出现提前数年。PD中RBD的高患病率(19%-70%)可能由多种常见的病理生理途径解释,主要与多巴胺能细胞丢失有关。RBD还与多种合并症相关,包括认知障碍、幻觉、自主神经功能障碍或日间嗜睡。诊断和评估RBD的金标准检查是视频多导睡眠图,但在临床实践中,使用临床量表和问卷对这种复杂的异态睡眠进行筛查是合理的。管理选择包括为患者确保安全的环境以及药物治疗,包括氯硝西泮、褪黑素或某些抗帕金森病药物。

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