Consistent skin α-synuclein positivity in REM sleep behavior disorder – a two center two-to-four-year follow-up study

2021 ◽  
Author(s):  
K. Doppler ◽  
E. Antelmi ◽  
A. Kuzkina ◽  
V. Donadio ◽  
A. Incensi ◽  
...  
Keyword(s):  
Rem Sleep ◽  
Rem Sleep Behavior Disorder ◽  
Behavior Disorder ◽  
Sleep Behavior ◽  
Follow Up Study

Follow-up study of cardiac 123I-MIBG scintigraphy in idiopathic REM sleep behavior disorder

2011 ◽  
Vol 18 (10) ◽  
pp. 1275-1278 ◽  
Author(s):  
T. Miyamoto ◽  
M. Miyamoto ◽  
M. Iwanami ◽  
K. Hirata
Keyword(s):  
Rem Sleep ◽  
Rem Sleep Behavior Disorder ◽  
Behavior Disorder ◽  
Mibg Scintigraphy ◽  
Sleep Behavior ◽  
Follow Up Study

REM sleep behavior disorder

2017 ◽  
Author(s):  
Ronald B. Postuma
Keyword(s):  
Rem Sleep ◽  
Lewy Bodies ◽  
Rem Sleep Behavior Disorder ◽  
Behavior Disorder ◽  
Clinical History ◽  
Final Diagnosis ◽  
Acting Out ◽  
Sleep Behavior ◽  
Rem Atonia

A diagnosis of REM sleep behavior disorder (RBD), a disorder characterized by “acting out” of dreams during REM sleep, has critical implications for a patient’s future. Aside from being a treatable parasomnia, usually managed with melatonin or clonazepam, RBD is the most powerful risk factor for Parkinson disease and dementia with Lewy bodies yet discovered. Over 70% of patients with idiopathic RBD will develop a neurodegenerative synucleinopathy. Moreover, the disease course is more severe in patients with RBD than those without. Numerous screens have been developed to aid detection, and clinical history can help distinguish RBD from NREM parasomnia. However, final diagnosis relies on polysomnographic documentation of REM atonia loss. Given the profound implications of idiopathic RBD, patients need careful counseling and the offer of neurological follow-up to detect and treat prodromal disease symptoms. Recognition of RBD is also a means to discover and test protective therapies against neurodegenerative disease.

Five-year follow-up of substantia nigra echogenicity in idiopathic REM sleep behavior disorder

2014 ◽  
Vol 29 (14) ◽  
pp. 1774-1780 ◽  
Author(s):  
Alex Iranzo ◽  
Heike Stockner ◽  
Mónica Serradell ◽  
Klaus Seppi ◽  
Francesc Valldeoriola ◽  
...  
Keyword(s):  
Substantia Nigra ◽  
Rem Sleep ◽  
Rem Sleep Behavior Disorder ◽  
Behavior Disorder ◽  
Sleep Behavior ◽  
Substantia Nigra Echogenicity

scholarly journals Conversion to Parkinsonism and Dementia in REM-Sleep Behavior Disorder Using the Chronobiotic Melatonin

2020 ◽  
Author(s):  
Dieter Kunz ◽  
Sophia Stotz ◽  
Frederik Bes
Keyword(s):  
Rem Sleep ◽  
Symptom Severity ◽  
Beta Blockers ◽  
Rem Sleep Behavior Disorder ◽  
Behavior Disorder ◽  
Clock Time ◽  
Melatonin Treatment ◽  
Sleep Behavior ◽  
Disease Modifying

ABSTRACTBackgroundIsolated REM sleep behavior disorder (iRBD), a reliable prodromal stage marker of α-synucleinopathies like Parkinson’s disease or Lewy body dementia, offers an early window for disease-modifying intervention. Current treatments of iRBD, including the two level B therapies with clonazepam and melatonin, are considered symptomatic. However, numbers of reported patients treated with melatonin are low and whether melatonin has disease-modifying potential is unclear.MethodsThis single-center, prospective cohort study included 206 consecutive patients diagnosed with iRBD until January 2020. Thirty-nine patients had applied mixed treatments on the advice of the referring physician, 167 had administered melatonin according to our chronobiotic protocol (low dose, ≥ 6 months, always-at-the-same-clock-time, between 10 and 11 pm - corrected for chronotype), which differs from existing melatonin prescriptions. Clinical examination to determine phenoconversion was performed from October 2018 to August 2020. To evaluate generalizability, we compared factors such as neuropsychological and neuromotor performance, olfactory ability, neurovegetative behavior, and dopamine transporter density in our patients with those reported for other cohorts. Primary outcome was phenoconversion to clinical synucleinopathy, assessed using Kaplan-Meier analysis. Secondary outcomes were changes in cognitive and motor performance, and in RBD-symptom severity, analyzed using mixed models.ResultsRBD characteristics were comparable to those in other published cohorts, including frequency of phenoconversion in our patients with mixed treatments (10/39; follow-up 3.1±2.1 years). In contrast, long-term melatonin-treated patients rarely converted (4/167; follow-up 4.2±3.1 years; hazard-ratio 0.07, 95% CI, 0.02-0.22, p<0.001). Neuromotor and neuropsychological performance did not decline, improved in some domains. Symptom severity gradually improved over the first 4 weeks of treatment (Clinical Global Impression Severity: 5.7 vs. 3.0) and remained stable over years, also in those patients who had stopped melatonin intake after 6 months. The initial response was slower in patients with melatonin suppressing (beta blockers) or REM sleep spoiling co-medication (antidepressants) and failed with inadequate timing of melatonin intake.ConclusionClock-timed melatonin treatment in patients with iRBD appears to be associated with a marked reduction in the development of parkinsonism and dementia as well as with an improvement in neuromotor, cognitive, and specific RBD symptoms. Findings suggest that melatonin treatment may have disease-modifying effects in synucleinopathies. The fact that melatonin is available anywhere at low cost provides the perspective of immediate clinical application in patients at risk for clinical synucleinopathy. On the other hand, clock-time dependency challenges existing prescription guidelines for melatonin. Melatonin should be acknowledged as the darkness signal to circadian clock-work rather than a hypnotic.

scholarly journals 0787 Autonomic Dysfunction and Phenoconversion in Idiopathic/Isolated REM Sleep Behavior Disorder

SLEEP ◽  
2020 ◽  
Vol 43 (Supplement_1) ◽  
pp. A300-A300
Author(s):  
S McCarter ◽  
T Gehrking ◽  
E St. Louis ◽  
M Suarez ◽  
B Boeve ◽  
...  
Keyword(s):  
Autonomic Dysfunction ◽  
Rem Sleep ◽  
Rem Sleep Behavior Disorder ◽  
Behavior Disorder ◽  
Common Finding ◽  
Chi Square ◽  
Sleep Behavior ◽  
Autonomic Testing ◽  
Function Testing

Abstract Introduction REM-sleep behavior disorder (RBD) is a common finding among patients with synucleinopathies. We aimed to determine the degree of autonomic dysfunction in patients presenting with idiopathic RBD (iRBD), and the predictive value of autonomic dysfunction for phenoconversion to a defined neurodegenerative disease. Methods We searched our electronic medical record for patients diagnosed with iRBD who also underwent standardized autonomic function testing within 6 months of iRBD diagnosis, and who had clinical follow-up of at least 3 years following iRBD diagnosis. Patients who received a diagnosis of phenoconversion within 3 months of autonomic testing were excluded. The composite autonomic severity score (CASS) was derived and compared between phenoconverters and non-converters using chi-square and Wilcoxon rank-sum tests. Results We identified 18 patients who fulfilled in- and exclusion criteria. Average age at autonomic testing was 67 ± 6.6 years. Twelve (67%) patients phenoconverted during the follow-up period; 6 developed PD, the other 6 DLB. Fifteen (83%) patients had at least mild autonomic dysfunction. There were no significant differences between overall converters and non-converters in total CASS or CASS subscores. However, iRBD patients who developed DLB had significantly higher total and cardiovagal CASS scores compared with those who developed PD (p &lt;0.05), and a trend for higher adrenergic CASS scores compared to those who developed PD and those who did not phenoconvert (p=0.08 for each). Conclusion Autonomic dysfunction was seen in 83% of iRBD patients, and more severe baseline cardiovagal and adrenergic autonomic dysfunction in iRBD was associated with phenoconversion to DLB but not PD. Prospective studies are needed to confirm the value of autonomic testing for predicting phenoconversion and disease phenotype in iRBD. Support  

scholarly journals Sleep Disturbances and Phenoconversion in Patients with REM Sleep Behavior Disorder

2021 ◽  
Vol 10 (20) ◽  
pp. 4709
Author(s):  
Hyunjin Jo ◽  
Dongyeop Kim ◽  
Jooyeon Song ◽  
Sujung Choi ◽  
Eunyeon Joo
Keyword(s):  
Neurodegenerative Diseases ◽  
Neurodegenerative Disease ◽  
Rem Sleep ◽  
Sleep Disturbances ◽  
Rem Sleep Behavior Disorder ◽  
Behavior Disorder ◽  
Cpap Therapy ◽  
Sleep Behavior ◽  
Obstructive Sleep

Objective: We aimed to investigate relationships between sleep disturbances and phenoconversion to neurodegenerative diseases in patients with REM sleep behavior disorder (RBD). Method: Using a comprehensive sleep database in a university-affiliated hospital between December 2014 and March 2021, we reviewed the data of 226 patients with RBD (182 patients with idiopathic RBD (iRBD) and 44 patients with symptomatic RBD (sRBD) with a neurodegenerative disease). Results: Among 226 patients with RBD (male, 61.5%), the mean age at RBD onset and mean disease duration were 59.4 ± 10.5 and 5.9 ± 5.6 years, respectively. Further, 111 (49.1%) patients had periodic limb movements during sleep (PLMS, PLM index ≥ 15/h), while 110 patients (48.7%) had comorbid obstructive sleep apnea (OSA, respiratory disturbance index ≥ 15/h). There was a positive correlation between age at RBD onset and the apnea-hypopnea index and Pittsburgh Sleep Quality Index. Compared to patients with iRBD, patients with sRBD showed a lower N3 sleep (3.3 ± 5.0 vs. 1.6 ± 3.1%, p = 0.004) and higher periodic limb movement index (36.3 ± 31.8 vs. 56.9 ± 47.5/h, p = 0.021) at the baseline. Among the 186 patients with iRBD, 18 (8.0%) developed neurodegenerative diseases (converters, mean follow-up duration: 2.5 ± 1.6 years) and 164 did not (non-converters, mean follow-up 2.4 ± 2.2 years). There was no significant between-group difference in the demographics and baseline clinical features. Continuous positive airway pressure (CPAP) therapy was prescribed in 101 patients with OSA; among them, 71 (70%) patients agreed to use it. CPAP improved dream enactment behaviors. Conclusion: In our study, 8.0% of patients with iRBD showed phenoconversion within a mean follow-up duration of 2.5 years. Polysomnographic parameters could not predict phenoconversion to neurodegenerative disease. However, approximately half of the patients with RBD presented with significant sleep disorders, including OSA or PLMS. CPAP therapy may alleviate RBD symptoms in patients with RBD-OSA.

Follow-up PET studies in case of idiopathic REM sleep behavior disorder

2010 ◽  
Vol 11 (1) ◽  
pp. 100-101 ◽  
Author(s):  
Tomoyuki Miyamoto ◽  
Satoshi Orimo ◽  
Masayuki Miyamoto ◽  
Koichi Hirata ◽  
Tomoko Adachi ◽  
...  
Keyword(s):  
Rem Sleep ◽  
Rem Sleep Behavior Disorder ◽  
Behavior Disorder ◽  
Sleep Behavior

Patients with idiopathic REM sleep behavior disorder follow-up – phenoconversion into parkinsonian syndrome and dementia

2018 ◽  
Vol 81/114 (2) ◽  
pp. 205-207 ◽  
Author(s):  
Pavla Peřinová ◽  
Lenka Plchová ◽  
Jitka Bušková ◽  
David Kemlink ◽  
Veronika Ibaburu Lorenzo Y Losada ◽  
...  
Keyword(s):  
Rem Sleep ◽  
Rem Sleep Behavior Disorder ◽  
Behavior Disorder ◽  
Parkinsonian Syndrome ◽  
Sleep Behavior

scholarly journals Systematic video-analysis of motor events during REM sleep in idiopathic REM sleep behavior disorder, follow-up and DAT-SPECT

2021 ◽  
Author(s):  
Jiri Nepozitek ◽  
Canan Unalp ◽  
Simona Dostalova ◽  
Petr Dusek ◽  
David Kemlink ◽  
...  
Keyword(s):  
Video Analysis ◽  
Rem Sleep ◽  
Rem Sleep Behavior Disorder ◽  
Behavior Disorder ◽  
Sleep Behavior ◽  
Dat Spect

Three-year follow-up on the accumulation of cardiac 123I-MIBG scintigraphy in idiopathic REM sleep behavior disorder

2009 ◽  
Vol 10 (9) ◽  
pp. 1066-1067 ◽  
Author(s):  
Tomoyuki Miyamoto ◽  
Masayuki Miyamoto ◽  
Masaoki Iwanami ◽  
Koichi Hirata
Keyword(s):  
Rem Sleep ◽  
Rem Sleep Behavior Disorder ◽  
Behavior Disorder ◽  
Mibg Scintigraphy ◽  
Sleep Behavior
Sign in / Sign up

Export Citation Format

Share Document