PDF(Pubmed)
Abstract：
OBJECTIVE: This study compared the features of isolated rapid eye movement (REM) sleep behavior disorder (iRBD) and antidepressant-related REM sleep behaviour disorder (RBD) with the aim of highlighting markers that might distinguish the two entities.
METHODS: The observational cohort study included RBD patients with and without antidepressant use (antiD+ and antiD- patients, respectively), without cognitive impairment and parkinsonism. Clinical features of RBD, subtle motor and non-motor symptoms of parkinsonism, sleep architecture, REM atonia index, dopamine transporter-single photon emission computed tomography (DAT-SPECT) and skin biopsies for the intraneuronal alpha-synuclein (α-syn), were evaluated in the baseline work-up.
RESULTS: Thirty-nine patients, 10 antiD+ and 29 antiD-, were included. AntiD+ patients (more frequently female) reported more psychiatric symptoms, less violent dream enactment, and less frequent hyposmia. Dermal α-syn was detected in 93.1% of antiD- versus 30% of antiD+ patients (p = 0.00024). No differences appeared in other motor and non-motor symptoms, Movement Disorder Society-Unified Parkinson\'s Disease Rating Scale part III score, DAT-SPECT, or polysomnographic features.
CONCLUSIONS: Patients with antidepressant-related RBD have clinical and neuropathological features suggesting a lower risk of evolution than those with iRBD.
METHODS: The observational cohort study included RBD patients with and without antidepressant use (antiD+ and antiD- patients, respectively), without cognitive impairment and parkinsonism. Clinical features of RBD, subtle motor and non-motor symptoms of parkinsonism, sleep architecture, REM atonia index, dopamine transporter-single photon emission computed tomography (DAT-SPECT) and skin biopsies for the intraneuronal alpha-synuclein (α-syn), were evaluated in the baseline work-up.
RESULTS: Thirty-nine patients, 10 antiD+ and 29 antiD-, were included. AntiD+ patients (more frequently female) reported more psychiatric symptoms, less violent dream enactment, and less frequent hyposmia. Dermal α-syn was detected in 93.1% of antiD- versus 30% of antiD+ patients (p = 0.00024). No differences appeared in other motor and non-motor symptoms, Movement Disorder Society-Unified Parkinson\'s Disease Rating Scale part III score, DAT-SPECT, or polysomnographic features.
CONCLUSIONS: Patients with antidepressant-related RBD have clinical and neuropathological features suggesting a lower risk of evolution than those with iRBD.
摘要：
目的：这项研究比较了孤立的快速眼动（REM）睡眠行为障碍（iRBD）和抗抑郁药相关的REM睡眠行为障碍（RBD）的特征，目的是突出可能区分这两种实体的标志物。
方法：观察性队列研究包括使用和不使用抗抑郁药的RBD患者（抗D+和抗D-患者，分别)，没有认知障碍和帕金森病。RBD的临床特征,帕金森病的轻微运动和非运动症状，睡眠建筑，REM无张力指数，多巴胺转运蛋白-单光子发射计算机断层扫描（DAT-SPECT）和神经内α-突触核蛋白（α-syn）的皮肤活检，在基线检查中进行了评估。
结果：39名患者，10抗D+和29抗D-，包括在内。抗D+患者（更常见的是女性）报告了更多的精神症状，更少的暴力梦想制定，和不那么频繁的食欲不振。在93.1％的抗D-患者中检测到真皮α-syn，而在30％的抗D患者中检测到（p=0.00024）。其他运动和非运动症状没有差异，运动障碍社会-帕金森病统一评定量表第三部分评分，DAT-SPECT,或多导睡眠图特征。
结论：患有抗抑郁药相关RBD的患者具有临床和神经病理学特征，提示其进化风险低于患有iRBD的患者。
方法：观察性队列研究包括使用和不使用抗抑郁药的RBD患者（抗D+和抗D-患者，分别)，没有认知障碍和帕金森病。RBD的临床特征,帕金森病的轻微运动和非运动症状，睡眠建筑，REM无张力指数，多巴胺转运蛋白-单光子发射计算机断层扫描（DAT-SPECT）和神经内α-突触核蛋白（α-syn）的皮肤活检，在基线检查中进行了评估。
结果：39名患者，10抗D+和29抗D-，包括在内。抗D+患者（更常见的是女性）报告了更多的精神症状，更少的暴力梦想制定，和不那么频繁的食欲不振。在93.1％的抗D-患者中检测到真皮α-syn，而在30％的抗D患者中检测到（p=0.00024）。其他运动和非运动症状没有差异，运动障碍社会-帕金森病统一评定量表第三部分评分，DAT-SPECT,或多导睡眠图特征。
结论：患有抗抑郁药相关RBD的患者具有临床和神经病理学特征，提示其进化风险低于患有iRBD的患者。
