Kimura K, Tachibana N, Aso T, Kimura J, Shibasaki H
Department of Brain Pathophysiology, Kyoto University School of Medicine, Japan.
Sleep. 1997 Oct;20(10):891-4. doi: 10.1093/sleep/20.10.891.
Various neurodegenerative diseases have been reported to be associated with rapid eye movement (REM) sleep behavior disorder (RBD). This is the first report of a patient with corticobasal degeneration (CBD) associated with subclinical RBD. A 72-year-old woman was admitted complaining of fine tremor of the right hand and weakness of the right lower extremity. She was diagnosed as having CBD on the basis of clinical features and neuroimaging studies. Her family noticed snoring and increase in sleep talk, but they did not regard them as pathological. All-night polysomnography (PSG) revealed REM sleep without atonia (RWA) during which 14 episodes of talking and singing were observed. They ranged from the utterance of one word to that of comprehensible words of a song for about 3 minutes accompanied by various nonpurposeful movements of the mouth, hands, and limbs. These episodes were not associated with any sleep-disturbed breathing. Future PSG studies on CBD patients together with postmortem analysis of brain stem structures that are crucial for generating REM sleep-related atonia are warranted for further understanding of the pathophysiological mechanism of RBD.
据报道，多种神经退行性疾病与快速眼动（REM）睡眠行为障碍（RBD）有关。这是首例关于皮质基底节变性（CBD）合并亚临床RBD患者的报告。一名72岁女性因右手细微震颤和右下肢无力入院。根据临床特征和神经影像学检查，她被诊断为CBD。她的家人注意到她打鼾且说梦话增多，但他们并未将其视为病态。整夜多导睡眠图（PSG）显示存在无张力性快速眼动睡眠（RWA），期间观察到14次说话和唱歌发作。发作内容从说出一个单词到唱出一首约3分钟的可理解歌曲，同时伴有口、手和肢体的各种无目的动作。这些发作与任何睡眠呼吸紊乱均无关联。未来有必要对CBD患者进行PSG研究，并对与产生REM睡眠相关无张力性至关重要的脑干结构进行尸检分析，以进一步了解RBD的病理生理机制。
