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.
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。