Behavioral manifestation profi le in idiopathic REM sleep behavior disorder


Authors: J. Nepožitek 1;  C. Ünalp 1,2;  S. Dostálová 1;  I. Příhodová 1;  V. Ibarburu Lorenzo Y Losada 1;  P. Dušek 1;  K. Šonka 1
Authors‘ workplace: Neurologická klinika a Centrum klinických, neurověd, 1. LF UK a VFN v Praze 1;  Faculty of Medicine, Ankara University, Ankara, Turkey 2
Published in: Cesk Slov Neurol N 2019; 82(4): 437-441
Category: Original Paper
doi: 10.14735/amcsnn2019437

Overview

Aim: Abnormal­ly prominent motor activity in rapid eye movement (REM) sleep is a major polysomnographic (PSG) feature of idiopathic REM sleep behavior disorder. The dia­gnosis is based on the complex nature of the movements, but more discreet motor manifestations can be seen in the video record­­ing dur­­ing PSG. The aim of this work was to perform a systematic video analysis of REM sleep movements.

Patients and methods: The motor manifestations identified in the video record­­ing of PSG in 32 patients aged 67.4 ± 7.3 years were clas­sified into four categories accord­­ing to clinical severity (elementary, exces­sive, scenic and violent). In addition, topographic distribution, brief and slow characterization of movement, as­sociation with vocalization, subsequent wakefulness and emotional subtext were determined for each motor event.

Results: An average of 114.6 ± 85.1 motor phenomena was identified. Of these, 67.8% were clas­sified as elementary, 9.1% as exces­sive, 22.3% as scenic, and 0.7% as violent. However, 31.3% of patients experienced violent manifestations. Brief movements were more frequent than slow ones (P = 0.001). Vocalization occur­red in 34.4% of patients. Movement caused wakefulness in 9.4% of patients and was at least once as­sociated with distinct emotion in 21.9%.

Conclusion: This study shows a large number of motor phenomena in REM sleep with extensive variability. Elementary events represent the vast majority. Although violent manifestations are captured in relative minority, they were detected in 31% of patients.

The authors declare they have no potential conflicts of interest concerning drugs, products, or services used in the study.

The Editorial Board declares that the manu­script met the ICMJE “uniform requirements” for biomedical papers.


特发性REM睡眠行为障碍的行为表现特征

目的:快速眼动(REM)睡眠中异常突出的运动活动是特发性REM睡眠行为障碍的主要多导睡眠图(PSG)特征。诊断是基于动作的复杂性,但是在PSG期间的视频记录中可以看到更多谨慎的运动表现。这项工作的目的是对REM睡眠运动进行系统的视频分析。

患者和方法:32例(67.4±7.3岁)患者PSG录像中发现的运动表现按临床严重程度分为4类(初级、过度、不良、暴力)。此外,每个运动事件的地形分布、运动的简短和缓慢特征、与发声的关联、随后的清醒状态和情绪潜台词也被确定。

结果:平均为114.6±85.1。其中,67.8%为初级,9.1%为过度,22.3%为不良,0.7%为暴力。然而,31.3%的患者有暴力表现。短暂运动比缓慢运动更频繁(P = 0.001)。34.4%的患者有发声障碍。9.4%的患者因运动而清醒,21.9%的患者至少有一次明显的情绪变化

结论:这项研究表明REM睡眠中有大量的运动现象,且变化很大。基本事件占绝大多数。尽管在少数人中捕获了暴力表现,但在31%的患者中发现了暴力表现。

关键字:快速眼动睡眠行为障碍–运动活动–快速眼动睡眠

Keywords:

REM sleep behavior disorder – motor activity – REM sleep


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Labels
Paediatric neurology Neurosurgery Neurology

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Czech and Slovak Neurology and Neurosurgery

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