Yoshizawa Mondo, Tamura Yoshiyuki, Yasuda-Ohata Asami, Yoshihara Shinsuke, Takasaki Hideki, Hashioka Sadayuki
Department of Psychiatry, School of Medicine, Asahikawa Medical University, Midorigaoka Higashi 2-1-1-1, Asahikawa, Hokkaido 078-8510 Japan.
Sleep Biol Rhythms. 2023 Jul 5;21(4):455-460. doi: 10.1007/s41105-023-00472-2. eCollection 2023 Oct.
The pathogenesis of rapid eye movement (REM) sleep behavior disorder (RBD) is unclear. According to the cortical hypothesis, severe RBD episode (RBDE) occurs when spinal motoneurons are less inhibited and cortical and limbic systems are more active. We made this study to prove the hypothesis for the development of RBDE using video-polysomnography (VPSG). VPSG records of 35 patients with RBD were analyzed. According to severity, RBDEs were classified into three motor events (MEs): ME 1; small movements or jerks, ME 2; proximal movements including violent behavior, and ME 3; axial movements including bed falls. For each ME, we measured the number of MEs preceded or not preceded by both REM sleep without atonia (RWA) and REMs during the 10-s-period immediately before ME onset. In severe RBDE (ME 3), the number of MEs preceded by both RWA and REMs was significantly higher than that of MEs not preceded by both (0.8 vs. 0.2, = 0.033). This was not the case for mild RBDE (ME 1) and moderate RBDE (ME 2). Our results suggest that both RWA and REMs are associated with the development of severe RBDE.
快速眼动（REM）睡眠行为障碍（RBD）的发病机制尚不清楚。根据皮质假说，当脊髓运动神经元受抑制较少且皮质和边缘系统更活跃时，就会发生严重的RBD发作（RBDE）。我们进行这项研究以使用视频多导睡眠图（VPSG）来验证RBDE发生发展的这一假说。分析了35例RBD患者的VPSG记录。根据严重程度，RBDE被分为三种运动事件（ME）：ME 1；小运动或抽搐，ME 2；包括暴力行为在内的近端运动，以及ME 3；包括坠床在内的轴向运动。对于每个ME，我们测量了在ME发作前10秒内伴有或不伴有无张力快速眼动睡眠（RWA）和快速眼动（REMs）的ME数量。在严重RBDE（ME 3）中，伴有RWA和REMs的ME数量显著高于不伴有两者的ME数量（0.8对0.2，P = 0.033）。轻度RBDE（ME 1）和中度RBDE（ME 2）则并非如此。我们的结果表明，RWA和REMs均与严重RBDE的发生发展有关。
