Abnormal vestibular evoked myogenic potentials are correlated with REM sleep without atonia in patients with isolated REM sleep behavior disorder

2019 ◽  
Vol 64 ◽  
pp. S114
Author(s):  
M. Puligheddu ◽  
M. Figorilli ◽  
A. Serra ◽  
I. Laccu ◽  
P. Congiu ◽  
...  
Keyword(s):  
Rem Sleep ◽  
Rem Sleep Behavior Disorder ◽  
Behavior Disorder ◽  
Vestibular Evoked Myogenic Potentials ◽  
Sleep Behavior ◽  
Rem Sleep Without Atonia

scholarly journals REM Sleep without atonia correlates with abnormal vestibular-evoked myogenic potentials in isolated REM sleep behavior disorder

SLEEP ◽  
2019 ◽  
Vol 42 (9) ◽  
Author(s):  
Monica Puligheddu ◽  
Michela Figorilli ◽  
Alessandra Serra ◽  
Ilaria Laccu ◽  
Patrizia Congiu ◽  
...  
Keyword(s):  
Rem Sleep ◽  
Neurodegenerative Disorder ◽  
Statistical Significance ◽  
Rem Sleep Behavior Disorder ◽  
Behavior Disorder ◽  
Vestibular Evoked Myogenic Potentials ◽  
Sleep Behavior ◽  
Automated Method ◽  
Rem Sleep Without Atonia ◽  
Dat Scan

Abstract Study Objectives The neurophysiological hallmark of REM sleep behavior disorder (RBD) is loss of atonia during REM sleep. Indeed, signs and symptoms of neurodegeneration can occur after years, even decades, from its beginning. This study aimed to measure neurophysiological alterations of the brainstem that potentially correlate with the severity of atonia loss, and determining whether a prodromal neurodegenerative disorder underlines this condition when it occurs as an isolated condition (iRBD). Methods Subjects with iRBD and matched healthy controls were recruited. The study included the recording of one-night polysomnography, vestibular-evoked myogenic potentials (VEMPs), and a [123I]-FP-CIT dopamine transporter (DAT) scan. The quantification of REM sleep without atonia (RSWA) was made according to two previously published manual methods and one automated method. Results The rate of alteration of VEMPs and VEMP score were significantly higher in iRBD patients than controls. Moreover, VEMP score was negatively correlated with the automated REM atonia index; a marginal statistical significance was also reached for the positive correlation with the visual tonic electromyographic parameter, while the other correlations, including that with DAT-scan score were not statistically significant. Conclusions Brainstem neurophysiology in iRBD can be assessed by VEMPs and their alterations may possibly indicate an early expression of the neurodegenerative process underlying this disorder at the brainstem level, which awaits future longitudinal confirmation. The correlation between RSWA and VEMP alteration might also represent a prodromal aspect anticipating the possible evolution from iRBD to neurodegeneration, whereas DAT-scan abnormalities might represent a later step in this evolution.

scholarly journals P077 Reliability of the Clinical Characterization of Isolated REM Sleep Behavior Disorder

2021 ◽  
Vol 2 (Supplement_1) ◽  
pp. A46-A46
Author(s):  
D Levendowski ◽  
J Lee-Iannotti ◽  
D Shprecher ◽  
C Guevarra ◽  
P Timm ◽  
...  
Keyword(s):  
Risk Assessment ◽  
Rem Sleep ◽  
False Positive ◽  
False Negative ◽  
Rem Sleep Behavior Disorder ◽  
Behavior Disorder ◽  
Sleep Behavior ◽  
Negative Case ◽  
Rem Sleep Without Atonia

Abstract Purpose Compare agreements between polysomnography-based (PSG) diagnosis of isolated REM-sleep-behavior-disorder (iRBD) and Non-REM-Hypertonia (NRH), a novel biomarker independently associated with synucleinopathy-related neurodegenerative diseases. Methods Sixteen patients with histories of dream-enactment-behavior (DEB)(women=38%; age:64.6±13.0) underwent PSG with simultaneously-recorded Sleep Profiler (SP). Two boarded sleep neurologists independently characterized iRBD. Physician1 combined abnormal qualitative REM-sleep-without-atonia (RSWA) by submental electromyography, with video-confirmation of probably DEB. Physician2 relied solely on qualitative RSWA. SP was auto-staged, technically reviewed, and reprocessed for automated abnormal NRH detection. Kappa scores measured physician and NRH agreements. Results In the 14 records with REM sleep, iRBD was characterized in: Physician1=64%, Physician2=79%, NRH=71% of the records. Across the three methods, unanimous iRBD agreement occurred in 57% of the records (positive=7, negative=1). The between-physician agreement in iRBD classifications was fair (kappa=0.32). The agreement between NRH and Physician1 was moderate (kappa=0.52) versus slight with Physician2 (kappa=0.05). NRH comparisons to consensus physician agreement yielded one false-positive and one false-negative iRBD finding. Physician2 classified: a) iRBD in two cases that were negative by Physician1 and NRH, and b) one negative case that Physician1 and NRH characterized as iRBD. Physician1 identified one negative case that was classified iRBD by Physician2 and NRH. Additionally, NRH was abnormal in one of the two records with no REM sleep. Discussion NRH may assist in iRBD risk assessment, given it agreed with at least one physician in 86% of the cases and the between-physician iRBD agreement was only fair. NRH also characterized iRBD-risk in patients with insufficient REM sleep for RSWA assessment.

scholarly journals REM sleep behavior disorder in children with type 1 Narcolepsy treated with Sodium Oxybate

Neurology ◽  
2020 ◽  
pp. 10.1212/WNL.0000000000011157
Author(s):  
Elena Antelmi ◽  
Marco Filardi ◽  
Fabio Pizza ◽  
Stefano Vandi ◽  
Monica Moresco ◽  
...  
Keyword(s):  
Rem Sleep ◽  
Sleep Stage ◽  
Rem Sleep Behavior Disorder ◽  
Behavior Disorder ◽  
Sodium Oxybate ◽  
Direct Role ◽  
Sleep Behavior ◽  
Rem Sleep Without Atonia ◽  
Nighttime Sleep

Objective:The aim was to study the effect of stable treatment with Sodium Oxybate (SO) on nocturnal REM sleep behavior disorder (RBD) and REM sleep without atonia (RSWA) that severely affected children with type 1 narcolepsy (NT1.Methods:Nineteen NT1 children and adolescents (nine females; mean age 12.5±2.7, mean disease duration: 3.4±1.6 years) underwent neurological investigations and video-polysomnography (v-PSG) at baseline and after three months of stable treatment with SO.v-PSG was independently analysed by two sleep experts, in order to rate RBD episodes. RSWA was automatically computed by means of the validated REM sleep atonia index (RAI).Results:Compared to baseline, RAI significantly improved (p< 0.05) and complex movements during REM sleep were remarkably reduced after stable treatment with SO. Compared to baseline, children also reported improvement in clinical complaints and showed a different nighttime sleep stage architecture.Conclusions:RBD and RSWA improved after treatment with SO, pointing to a direct role of the drug in modulating motor control during REM sleep.

scholarly journals REM Sleep Behavior Disorder and REM Sleep Without Atonia in Probable Alzheimer Disease

SLEEP ◽  
2006 ◽  
Vol 29 (10) ◽  
pp. 1321-1325 ◽  
Author(s):  
Jean-François Gagnon ◽  
Dominique Petit ◽  
Maria Livia Fantini ◽  
Sylvie Rompré ◽  
Serge Gauthier ◽  
...  
Keyword(s):  
Alzheimer Disease ◽  
Rem Sleep ◽  
Rem Sleep Behavior Disorder ◽  
Behavior Disorder ◽  
Sleep Behavior ◽  
Rem Sleep Without Atonia
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