You Sooyeoun, Won Kyoung Sook, Kim Keun Tae, Lee Hyang Woon, Cho Yong Won
Department of Neurology, Keimyung University School of Medicine, Daegu 42601, Korea.
Department of Nuclear Medicine, Keimyung University School of Medicine, Daegu 42601, Korea.
J Clin Med. 2021 Nov 19;10(22):5414. doi: 10.3390/jcm10225414.
I-metaiodobenzylguanidine (MIBG) cardiac scintigraphy was performed to assess cardiac autonomic dysfunction and demonstrate its correlation with clinical and polysomnographic characteristics in patients with isolated rapid eye movement (REM) sleep behavior disorder. All subjects including 39 patients with isolated REM sleep behavior disorder and 17 healthy controls underwent MIBG cardiac scintigraphy for cardiac autonomic dysfunction assessment. The isolated REM sleep behavior disorder was confirmed by in-lab overnight polysomnography. A receiver operating curve was constructed to determine the cut-off value of the early and delayed heart-to-mediastinum ratio in patients with isolated REM sleep behavior disorder. Based on each cut-off value, a comparison analysis of REM sleep without atonia was performed by dividing isolated REM sleep behavior disorder patients into two groups. MIBG uptake below the cut-off value was associated with higher REM sleep without atonia. The lower heart-to-mediastinum ratio had significantly higher REM sleep without atonia (%), both with cut-off values of early (11.0 ± 5.6 vs. 29.3 ± 23.2%, = 0.018) and delayed heart-to-mediastinum ratio (9.1 ± 4.3 vs. 30.0 ± 22.9%, = 0.011). These findings indicate that reduced MIBG uptake is associated with higher REM sleep without atonia in isolated REM sleep behavior disorder.
采用碘代间位苄胍（MIBG）心脏闪烁扫描术评估孤立性快速眼动（REM）睡眠行为障碍患者的心脏自主神经功能障碍，并阐明其与临床及多导睡眠图特征的相关性。包括39例孤立性REM睡眠行为障碍患者和17名健康对照者在内的所有受试者均接受了MIBG心脏闪烁扫描术以评估心脏自主神经功能障碍。通过实验室夜间多导睡眠图检查确诊孤立性REM睡眠行为障碍。构建受试者工作特征曲线以确定孤立性REM睡眠行为障碍患者早期和延迟心纵隔比的临界值。基于各临界值，将孤立性REM睡眠行为障碍患者分为两组，对无张力性REM睡眠进行比较分析。MIBG摄取低于临界值与较高的无张力性REM睡眠相关。较低的心纵隔比的无张力性REM睡眠百分比显著更高，早期心纵隔比临界值时（11.0±5.6对29.3±23.2%，P=0.018）及延迟心纵隔比临界值时（9.1±4.3对30.0±22.9%，P=0.011）均如此。这些发现表明，在孤立性REM睡眠行为障碍中，MIBG摄取减少与较高的无张力性REM睡眠相关。
